Other names are Benadryl, Konamin, Benadryl, Bid amlne, bendevlae, Alle d yi, De mistina, Dibendyl, Lens, Diphenhydamine.
Standard Source: People's Republic of China (PRC) Pharmacopoeia (2000 Edition), Part II, page 626.
Molecular formula and molecular weight c 17h2 1no HCl, 29 1.82.
gender
White crystalline powder, odorless and bitter, melting point 167 ~ 17 1℃. Soluble in water, soluble in ethanol and chloroform, slightly soluble in acetone, very slightly soluble in ether and benzene.
pharmacological action
As a derivative of ethanolamine, the antihistamine effect is not as good as promethazine, and the duration of action is shorter, and the sedative effect of the two drugs is the same. It also has local anesthesia, antiemetic and anticholinergic effects.
(1) Histamine action: It can compete with histamine released from tissues for H 1 receptor on effector cells, thus stopping allergic attacks;
(2) Sedative and hypnotic effects: The mechanism of inhibiting central nervous system activity is not clear;
(3) antitussive effect: It can directly act on the cough center of medulla oblongata and inhibit cough reflex.
In vivo process
Diphenhydramine was absorbed by gastrointestinal tract after oral administration, and its blood concentration reached its peak in 3 hours, lasting for 4 ~ 6 hours. After liver metabolism, it is excreted through urine, feces and sweat, and some lactating women can also be excreted through breast milk.
clinical application
1. Skin mucous membrane allergy, such as urticaria, angioneurotic edema, allergic rhinitis, other skin pruritus, anal pruritus, vulvar pruritus, drug eruption or jaundice, is also effective for insect bites and contact dermatitis;
2. Acute allergic reaction can reduce allergic reaction caused by blood transfusion or plasma;
3. The prevention and treatment of motion sickness and seasickness has a strong antiemetic effect, and can also be used to prevent and treat radiation sickness, postoperative vomiting and drug-induced nausea and vomiting;
4. Used for Parkinson's disease and extrapyramidal symptoms;
5. Sedation, used for hypnosis and preoperative administration;
6. Dental local anesthesia, when patients are highly allergic to commonly used local anesthetics, 1% diphenhydramine solution can be used as dental local anesthesia;
7. As a non-addictive antitussive drug, relieving cough and asthma is suitable for treating cough caused by cold or allergy, but its antitussive effect has not been confirmed.
8. Xue and Lu reported that it is safe and effective to take diphenhydramine 50mg before going to bed every day for 10 ~ 14 days.
Matters needing attention
1. After taking diphenhydramine, patients with bronchial asthma may make the sputum sticky, difficult to cough up, and aggravate dyspnea, which should be paid attention to.
2. Use with caution in patients with hypotension, hypertension, other cardiovascular diseases, hyperthyroidism and glaucoma.
3. Early pregnant women, lactating women, newborns and premature babies are prohibited.
4. Long-term use of this product may cause hemolysis or hematopoietic dysfunction, especially long-term injection.
Although antihistamines are antiallergic drugs, they may also cause allergies. Diphenhydramine has caused allergic skin rash, so if the patient has a rash during medication, he should stop taking the drug or switch to other antihistamines.
6. Diphenhydramine should be avoided if combined with hypnotic, sedative and antipsychotic drugs, or drinking alcohol at the same time can aggravate central inhibition.
7. Antihistamine drugs usually have rapid reaction (rapid allergic reaction) or drug resistance reaction. For example, when patients with habitual allergy use diphenhydramine, the initial curative effect is often very significant, but with the extension of medication time, the effect gradually decreases. When this kind of drug resistance reaction occurs, it is advisable to switch to other kinds of antihistamines as soon as possible to avoid the development of drug resistance affecting the curative effect.
8. Excessive use can cause drowsiness, palpitation, muscle tremor, blurred vision, insanity and even convulsions. Measures such as gastric lavage, oxygen supply and convulsion control should be taken.
9. Old people are prone to long-term stagnation or dizziness after taking medicine.
10. In case of renal failure, the administration interval should be prolonged. The antiemetic effect of this product can make some diseases difficult to diagnose, such as appendicitis and some drug poisoning.
1 1. This product can affect the conduction of neuromuscular joints, and is prohibited for patients with myasthenia gravis.
counteraction
1. The most common diseases are drowsiness, inattention, fatigue, dizziness, dizziness, ataxia, nausea, vomiting, loss of appetite, dry mouth, etc.
2. Rare things are: shortness of breath, chest tightness, cough, dystonia, etc. It has been reported that clenching teeth and throat spasm, anaphylactic shock and arrhythmia may occur after taking this medicine. Excessive use can lead to acute poisoning and mental disorders.
Drug overdose and its treatment
The toxicity of this product mainly inhibits the central nervous system first, then excites the central nervous system, and finally produces debilitating inhibition. The severity depends on the dose. Once you find that you have taken this product by mistake or overdose, you should immediately send it to the hospital for emergency treatment.
It is characterized by anorexia, nausea, vomiting, constipation or diarrhea, thirst, frequent urination or dysuria, hematuria, hearing impairment, blurred vision, dyskinesia, shallow breathing, tachycardia, fever and pain under the sternum; In severe cases, convulsions, coma, cardiac depression and respiratory paralysis may occur.
When rescuing, they should be sent to the hospital immediately for vomiting, gastric lavage, catharsis, intravenous infusion, oxygen inhalation and symptomatic treatment. For patients in the excited phase, sedatives are generally not used except convulsions to avoid central inhibition. During convulsion, 10% chloral hydrate solution 10 ~ 15 ml can be given for retention enema or intravenous injection of thiopental sodium. Central stimulants should not be used when inhibition occurs. For those with deep inhibition, especially when breathing is affected, respiratory stimulants should be given as appropriate, but they should be closely observed to prevent convulsions.
drug interaction
(1) This product can temporarily affect the absorption of barbiturates and sulfacetamide sodium.
(2) The combination with sodium p-aminosalicylate can reduce the plasma concentration of the latter.
(3) It can enhance the effect of central nervous system inhibitors.
Demisone
English name: Dexamethasone
Synonyms: Flumethasone, Demisone, atopalm, Delongni, Dexamethasone, Dexamethasone, Flumethylprednisolone, etc.
Chemical name: (1 1β, 16α)-9- fluoro-1,17,21-trihydroxy-/kloc-0.
Manufacturing patent: U.S. patent 3,007,923 (1961,Laboratory. France. Chimio, the others. )，GerPat 1， 1 13，690 ( 196 1)。 Co.), British patent 869,511(to Upjohn).
Dexamethasone was synthesized by Arth and Oliveto in 1958, Merck &; The company produces dexamethasone sodium phosphate. Up to now, the number of dexamethasone derivatives on the market has exceeded 12.
The chemical structure of dexamethasone is that fluorine atom is introduced into the 9α position of prednisolone B ring and methyl group is introduced into the 16α position of D ring; 9α fluoride and 16α methyl significantly enhanced its anti-inflammatory activity, while 16α methyl significantly reduced the side effects of dexamethasone in water and sodium retention. The clinical bioequivalent dose ratio of dexamethasone to prednisolone is 0.75:5, and the biological half-life is 36-54 hours, which belongs to long-acting glucocorticoid.
Dexamethasone, like other glucocorticoids, has pharmacological effects such as anti-inflammatory, anti-endotoxin, immunosuppression, anti-shock and stress response, so it is widely used in various departments to treat many diseases, such as autoimmune diseases, allergies, inflammation, asthma, dermatology and ophthalmology. Dexamethasone sodium phosphate injection is an indispensable first-aid medicine to save dying patients. In recent ten years, clinicians have used dexamethasone sodium phosphate to treat and prevent drug allergy caused by various Chinese and western medicines and to treat fever caused by viral cold, so that the clinical dosage of dexamethasone has increased year by year. So far, China has become the largest dexamethasone market in the world.
Glucocorticoids, such as dexamethasone, have no obvious adverse reactions in the application of physiological dose replacement therapy, and most of the adverse reactions occur in the application of pharmacological dose, which is closely related to the course of treatment, dose, drug type, usage and route of administration. The common adverse reactions are as follows: 1. Long-term use can cause the following side effects: face and posture, weight gain, edema of lower limbs, purple stripes, bleeding tendency, poor wound healing, acne, menstrual disorder, ischemic necrosis of humerus or femoral head, osteoporosis and fractures (including vertebral compression fractures and pathological fractures of long bones), muscle weakness, muscular atrophy and hypokalemia. Pancreatitis, peptic ulcer or perforation, growth inhibition in children, glaucoma, cataract, benign intracranial hypertension syndrome, abnormal glucose tolerance and aggravation of diabetes. 2. Patients may have mental symptoms: euphoria, excitement, delirium, anxiety, disorientation or inhibition. Mental symptoms include people who are prone to chronic wasting diseases and people who have mental disorders in the past. 3. Infection is the main adverse reaction of adrenocortical hormone. Mainly fungi, tuberculosis, staphylococcus, Proteus, Pseudomonas aeruginosa and various herpes viruses. 4. Glucocorticoid withdrawal syndrome. Sometimes patients have dizziness, fainting tendency, abdominal pain or backache, low fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue and weakness after stopping taking the drug. If careful examination can rule out adrenal hypofunction and recurrence of primary disease, it can be considered as glucocorticoid dependence syndrome.
Glucocorticoid dexamethasone, commonly known as "skin opium", is a banned ingredient in cosmetics. When consumers use cosmetics containing dexamethasone, their skin will feel obviously better at first, but long-term use will not only lead to dependence, but also lead to dermatitis and even various diseases.
Chinese name: Dexamethasone
Short for Pinyin: DSMS
English name: Dexamethasone
Industry: ACTH and ACTH drugs
Drug description:
Alias Shamisen; Flumethylprednisolone; Fluoromethyl dehydrohydrocortisone; Flumethasone; Dexamethasone; Meflonol
dexamethasone
The pharmacological effects of anti-inflammatory, anti-allergic and anti-toxic are stronger than those of prednisone, and the side effects of water and sodium retention are few, so it can be injected by muscle or vein.
Indications are the same as prednisone. Mainly used as emergency medicine for critical diseases, treating various inflammations and allergic reactions.
Dosage and usage: 1. Oral administration: 1, 0.75 ~ 6 mg daily, divided into 2 ~ 4 times. The maintenance dose of 1 day is 0.5 ~ 0.75 mg. 2. intramuscular injection (detrimisone acetate injection), 1 time 8 ~ 16 mg, 1 time interval 2-3 weeks. 3. Intravenous drip (dithizone sodium phosphate injection), 2 ~ 20 mg each time, or as directed by the doctor. 4. Anti-inflammatory and anti-allergic, 65438+ 0.5 ~ 3 mg per day, once in the morning or twice in the afternoon.
Precautions 1. If taken in large quantities, it is easy to cause diabetes and Cushing's syndrome. 2. Long-term use is more likely to cause mental symptoms and psychosis, and it is best not to use it for those with memory and mental history. 3. Patients with ulcer, thrombophlebitis, active pulmonary tuberculosis and intestinal anastomosis should use it with caution. 4. For other precautions, please refer to the "Precautions for Application" of this kind of drugs.
Specification 1. Demisone acetate tablets: 0.75 mg per tablet. 2. Demesol sodium phosphate injection: 65438 0 mg (65438 0 ml) and 2 mg (65438 0 ml) each 1 branch; 5 mg (1 ml).