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Naloxone in the use of cephalosporins caused by drinking during the wake disulfide reactions_23872

By Pedro Hamilton,2014-11-02 09:49
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Naloxone in the use of cephalosporins caused by drinking during the wake disulfide reactions_23872

    Naloxone in the use of cephalosporins caused by drinking during the wake disulfide reactions

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     [Keywords:] naloxone, cephalosporins, disulfide wake up response

     Naloxone (Naloxone, also known as allyl Oxymorphone for the opioid receptor antagonist, for the first time since 1960, has been successfully synthesized, not because of their pharmacological effects on normal, safety, large, significant effect, and therefore clinical more and more widely on the application. This statistic was admitted to our hospital

    emergency department during the use of cephalosporins disulfide wake up drinking response caused the 60 patients, and in which the application of naloxone.

     1 Clinical data

     1.1 General Information July 2006 -2008 in July were treated

    in the emergency department of our hospital 60 patients were treated with cephalosporin antibiotics drinking alcohol during the reaction led to disulfide awake patients, 48 male and 12

    females, age maximum 65 and the youngest 20 years old.

    including the use of 26 patients cefoperazone, ceftriaxone in 20 cases, 10 cases of cefotaxime, cefuroxime 4 cases.

     1.2 All patients showed clinical manifestations of fever for the face, head and neck vessels severe beating, chest tightness, tachycardia, irritability, etc.; In addition, there are 15 cases of nausea and vomiting in 10 cases, 5 cases of chest pain, respiratory depression in 1.

     Treatment of saline 250ml + 1.3 0.8 ~ 2.0mg intravenous naloxone, 10% glucose 400ml +10% potassium chloride 1.5g + Vit

    C 3.0g +50% glucose 100ml Continued points, and tachycardia were given propranolol (10mg orally, nausea, vomiting stomach complex to give amine (10mg intramuscular injection, and so measures to symptomatic treatment.

     2 Results

     All patients had intravenous naloxone in the clinical symptoms resolved after about 0.5h and about 2h vast majority of patients return to normal, only in recent 4h individual patients returned to normal.

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     3 Discussion

     Ethanol, alcohol dehydrogenase in the body (ADH effect, first broken down into acetaldehyde, and aldehyde dehydrogenase (ALDH decomposition under the action of acetic acid, and further decomposition of carbon dioxide and water. People show when drunk The effects were mainly caused by

    acetaldehyde poisoning.

     Wake disulfide (Disulfiram, also known as dual-curing

    tetraethyl Autumn Lamb, disulfiram, amine acid disulfide, ethanol sensitizing agents, the structure of the dual-sulfur

    molybdenum with trace elements in the integration, the loss of biological role, and molybdenum is essential for liver aldehyde dehydrogenase component. molybdenum content of the product to make ethanol, reduced to suppress the body's metabolism of acetaldehyde accumulation leaving alcohol,

    produce a series of symptoms. the sulfur methyl tetrazole groups cephalosporins, have similar disulfide wake up function. Therefore, cephalosporins and ethanol are combined to produce disulfide wake up reaction (also known as disulfiram-like reaction, disulfiram reaction, there

    accumulation of toxic acetaldehyde performance.

     Cefoperazone, ceftriaxone and other cephalosporins inhibit aldehyde dehydrogenase and dopamine B-hydroxylase activity,

    leading to intermediates of oxidative metabolism of ethanol -

    a lot of accumulation of acetaldehyde in the body, blocked dopamine metabolism in vivo, concentration stimulate mast cells to release vasoactive substances, causing the small arteries, veins and telangiectasia, increased vascular permeability, plasma extravasation, and caused reflex

    sympathetic excitement, to promote nerve endings release a lot of adrenaline, noradrenaline , dopamine, 5 - HT and other

    monoamine neurotransmitters, which appears a series of vasomotor and neuropsychiatric symptoms. has been confirmed

    that acetaldehyde reduced dopamine synthesis in the body of endogenous opioid alkaloids, direct or indirect effects opioid receptors in the brain, producing symptoms of acute poisoning.

     Pure opioid antagonist naloxone to have blocked the

    exogenous and endogenous opioid receptor agonist effect of morphine-like substances, arrest and reversal of opioid induced central inhibition. In addition, naloxone also has the wake of non-specific effect. disulfide wake up in response to the application of naloxone, a very significant effect, therefore, naloxone treatment in our hospital as a wake up response disulfide drug of choice. In practice, naloxone and Traditional Chinese Medicine preparations Xingnaojing (10 ~

    20ml, intravenous combination of clinical efficacy will be more apparent, the patient will be in a relatively short period of time back to normal. But those who have high blood pressure caution, requiring regular monitoring of blood

    pressure.

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