What is the reaction of taking different medicines together?Taking different medicines together may cause a variety of reactions, which are mainly divided into the following categories:
1. ** Pharmacological interaction **: Before a medicinal preparation enters a usable state, a physical or chemical reaction occurs between the drugs, causing the physical and chemical properties of the drug to change, thus affecting the efficacy of the drug. For example, when drugs are compatible in the body, it may cause reactions such as settling, color change, deliquescence, and neutralizing, which may affect the efficacy of the drug and even affect the safety of the patient's medication. This is also called compatibility taboo.
2. ** Pharmacokinetical interaction **: It refers to any link in the absorption, distribution, metabolism, and exhalation process of one drug that changes the concentration of the drug in the plasma or its target, and finally changes its efficacy or adverse reactions.
3. ** Pharmacological interaction **: When two or more drugs act on the same or different receptor, they will produce a synergy, additivity, or antagonist effect. There may be no obvious effect on the concentration of the drug in the plasma or the target. Among them, synergy refers to the enhancement of the efficacy of the two drugs when they are combined. For example, diuretics and other antihyperbaric drugs can enhance the efficacy of various antihyperbaric drugs when combined, and trimethoprim and sulfamide can enhance the antiseptic effect of sulfamide drugs when combined. Antagonism refers to the effect of the combination of the two drugs is less than that of the effect of the two drugs alone. For example, metoclopramine has antiemetic effect, while atropine is a spasmodictic drug. These two drugs are antagonistic to each other, and taking them at the same time will weaken the efficacy.
Clinically, the effects of drug interactions on patients could be divided into three situations: beneficial to the patient, irrelevant, and adverse effects. According to the severity, it could be divided into:
1. ** Minor drug interaction **: The effect is not of clinical significance, and there is no need to change the treatment plan. For example, paraments could reduce the diuretical effect of fursemide, but it would not significantly affect the clinical efficacy, and there was no need to change the dosage.
2. ** Medium drug interaction **: Although the combination of drugs will cause definite adverse consequences, it will still be used under close observation in clinical practice. For example, when isoniazid was used together with rifampicin, rifampicin would promote the conversion of isoniazid to the hepatic toxic antagonist, isoniazid. Rifampicin itself also had liver damage effects. The combination of the two drugs would enhance the hepatic toxicity, but the combination of the two drugs had a cooperative antiseptic effect on the bacteria. Therefore, this combination was still one of the preferred medication plans for patients with normal liver function. However, liver function should be checked regularly during treatment.
3. ** Serious drug interaction **: The combination of drugs will cause serious toxic reactions. You need to choose a new drug or change the dosage and administration plan. For example, the combination of anti-allergic drugs terfenadin and astemizole with imidizole-type antimycoals and cyclolide antibiotics can cause severe cardiac toxicity, and one of the combined drugs needs to be stopped. Skeletal muscle relaxants combined with the antimycoside antibiotics gentamin may enhance and prolong the skeletal muscle relaxation effect, and even cause respiratory paralysis. Therefore, gentamin and other antibiotics are prohibited before and after anesthesia.
In addition, certain foods and drugs may also produce similar interactions. For example, grapefruit and grapefruit contain naringin and furanocoumarins, which will inhibit the activity of the metabolism of the P450 system. If taken at the same time as contraceptives, it will reduce the body's ability to digest contraceptives and increase the components of contraceptives in the blood. Grapefruit may also affect some antihyperbaric drugs, lipid-lowering drugs, sleeping pills, etc., increasing the risk of side effects. Rifampicin, some sleeping pills, anticonvulsants, tricyclics, and other painkillers may increase the activity of liver metabolism, resulting in a decrease in the effectiveness of contraceptives.
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