In daily life, it is very common to take medicine when you are sick. In fact, drugs are like a "double-edged sword" to human health, and the safety and rationality of drugs is "good medicine", on the contrary, abuse of drugs, repeated administration, self-medication, and follow the trend will make drugs become "poison". There is never a natural "panacea" in the world, and the right use and reasonable use are the key.
As we all know, there are certain adverse reactions while the drug plays a therapeutic role, and in general, serious adverse drug reactions are relatively rare, but minor adverse reactions are more common. So has the common drugs such as vitamin C silver tablets, compound licorice tablets, ribavirin, metamizole, and pidotimod that have recently been fermented on the Internet have really been banned? Could it be that these commonly used drugs can no longer be used?
Vitamin C silver warp
Vitamin C silver warp tablets is a compound preparation of Chinese and Western medicines, of which the main ingredients of the medicine are honeysuckle, forsythia, licorice, etc., and the western medicine ingredients are vitamin C, chlorpheniramine (chlorpheniramine), acetaminophen (paracetamol), which has the effect of cooling and detoxifying. Vitamin C can enhance the body's resistance; chlorpheniramine is an anti-allergic drug, and its main adverse reaction is central inhibition; paracetamol can be dehemotic, but has a certain degree of liver toxicity, and the daily limit dose should not exceed 4g. According to the statistical results of the "Adverse Drug Reaction Information Circular", a total of 1885 cases of adverse reactions have been reported in the past 7 years, mainly involving 48 serious cases of the central and peripheral nervous system, digestive system, skin, etc., and there are no deaths, in fact, the incidence of adverse reactions, especially the incidence of serious adverse reactions, is not very high. In 2013, the Hong Kong Department of Health had urged everyone not to buy an oral product labeled as Vitamin C Silver Tablets, which was actually a "Oolong" incident in which the parties artificially caused the incident by putting other cold medicines containing prohibited ingredients (phenacetin, aminopyrine) into a bottle of Vitamin C Silver Tablets. Therefore, we can still use vitamin C silver tablets with confidence, but we should pay attention to the central inhibitory effect it may cause, and do not overdoses or long-term use, the possibility of serious adverse reactions is still very low.
Compound licorice tablets
Compound licorice tablets are also a kind of traditional Chinese medicine compound preparation, the main ingredients are licorice extract powder, opioid powder, camphor, star anise oil, etc., for antitussive expectorant. In 2014, it was reported that a Chinese person was sentenced to be barred from entering the country for five years because of the chinese carrying compound licorice tablets to the United States. The reason for this is because compound licorice tablets are considered illegal drugs in the United States, contain illegal ingredients, and are not approved by the FDA. In fact, the opioid powder contained in compound licorice tablets has an antitussive effect, but there is a certain degree of addiction and respiratory depression, and morphine, which is commonly used in clinical practice, belongs to opioids and needs to be strictly controlled. As early as 2005, compound licorice tablets in China were limited to prescription drugs, need to be used under the guidance of doctors, it is not recommended to buy themselves, nor should they be used as a common drug at home, and because this drug has a certain degree of addiction, it is not suitable for long-term, large-dose use. In addition, compound licorice tablets may also cause adverse reactions such as hypokalemia, and clinical manifestations are paralysis, arrhythmia, nausea, constipation, etc.
Annais
Metamizole is a compound combining aminopyrine with sodium sulfite, which is mainly used for fever reduction at high fever, and can also be used for headaches, migraines, muscle pain, dysmenorrhea and other treatments. The antipyretic and analgesic effect of metamizole was powerful and rapid, and it was marketed in Germany in 1922 and immediately became a popular antipyretic miracle drug. However, with the widespread use of drugs, its adverse reactions are gradually discovered, including involving the blood and hematopoietic system, urinary system, skin, digestive system, etc., which can cause serious consequences such as kidney toxicity, rash, granulocytopenia and so on. The drug has a 1.1% chance of inducing agranulocytosis, and the onset is urgent, and the serious one is life-threatening. As early as 2002, China's adverse drug reaction monitoring center collected a number of adverse reactions caused by metamizole, including 11 cases of anaphylactic shock, 7 deaths; 16 cases of hematologic reactions, 1 death; 31 cases and 4 deaths of skin and muscle reactions; 17 cases and 5 deaths of urinary system reactions. Abroad, Sweden revoked its marketing authorization in 1974, the United States began to ban the drug in 1977, and then more than 30 countries banned the drug. In 2013, India also banned the use of this drug. On September 4, 1982, the former Ministry of Health issued the "Notice on Announcing the Elimination of 127 Drugs", and in this list of eliminated drugs, "compound metamizole tablets" were listed. However, metamizole tablets, metamizole injections, metamizole nasal drops, etc. were retained.
In fact, foreign studies have shown that metamizole is used for mild and moderate pain, and the overall risk of death is still low compared with other antipyretic analgesics. Therefore, in 1995 Sweden re-approved the use of metamizole 50 mg tablets and 500 mg/ml injections for the short-term treatment of acute moderate and severe pain and acute moderate and severe colic after tissue injury.
In short, metamizole is still allowed to be used clinically in China, its antipyretic analgesia effect is good, the price is low, but the drug may lead to severe agranulocytosis, aplastic anemia and other consequences, use must be cautious, and should not be used as a first-line drug for antipyretic analgesia, only when other antipyretic analgesic drugs are ineffective, fever and pain can be considered. In addition, the drug can also be used for a short period of time to eliminate acute pain from tissue injuries and surgical wounds, but care must be taken to monitor the blood picture.
Ribavirin
Ribavirin, commonly known as "viral azole", is a nucleoside broad-spectrum antiviral drug that the U.S. Food and Drug Administration (FDA) only allows for the treatment of hepatitis C, human respiratory fusion virus (RSV), and hemorrhagic fever in combination with long-acting interferons. The Chinese Pharmacopoeia Clinical Medication Instructions (2010 Edition) states that ribavirin should not be used in patients who have not been laboratory-diagnosed with respiratory syncytial virus infection. However, at present, the abuse of this drug in China is very common, cold and flu, fever does not recede, diarrhea, herpetic pharyngitis, hand, foot and mouth disease and other diseases are more common, and even this drug has been "given" anti-tumor effect. In fact, the common cold is mainly caused by viruses, and rhinovirus, coronavirus-based, mostly self-limited diseases, there is no specific antiviral drug specifically for the common cold, the early use of ribavirin aerosol spray nasopharynx may have certain benefits, but generally symptomatic treatment can be.
Hand-foot-and-mouth disease is mainly an enterovirus infection, severe and fatal cases are mainly caused by enterovirus type 71 (EV-71), is also a self-limiting disease, also based on symptomatic treatment, for severe cases of EV-71 infection can indeed consider the use of ribavirin. However, for influenza, neuraminidase inhibitors (such as oseltamivir, zanamivir, etc.) and M2 ion channel blockers are generally recommended, of which amantadine and rimantadine have not been recommended for the prevention and treatment of A flow alone. In summary, ribavirin is used under strict indications, and not any viral disease can be used. In addition, ribavirin also has more serious adverse reactions, mainly manifested as hemolytic anemia, teratogenicity, etc., so pregnant and lactating women are banned. Clinically, when weighing the pros and cons of using ribavirin, do a good job of blood routine and liver function tests.
Pidomod
Pidotimod is an immune enhancer that can be used for recurrent infections of the upper and lower respiratory tracts, recurrent infections of OTOL, urinary tract infections, gynecological infections, prevention of acute infections, etc., and is a commonly used drug in pediatrics. However, a recent article questioning it has put the drug on the forefront. In fact, Pidotimod is not yet listed in the United States and the European Union, and most of its research is still in the pre-clinical animal experimental stage. The data showed that there was no statistical difference between the prevention of acute respiratory infections in healthy children aged 3 years compared with placebo. As we all know, preschool children's immune system is still in the process of continuous development and maturation, so it should not be labeled as "low immunity" and use Pidotimod arbitrarily. On March 9 this year, the State Food and Drug Administration website published the "Announcement on Revising the Instructions for the Preparation of Pitomod", which stipulates that the indications for the drug are: for the adjuvant treatment of chronic or recurrent respiratory tract infections and urinary tract infections. People who are allergic to this product, children under 3 years of age, women within 3 months of pregnancy, hereditary fructose intolerance, glucose-galactose malabsorption patients are contraindicated from this drug. In addition, according to the monitoring data and literature, possible adverse reactions of Pidotimod are listed, such as nausea, vomiting, skin allergies, headache, dizziness, etc. It can be seen that Pidotimod is not a "miracle drug", and it is only recommended for adjuvant treatment of chronic or recurrent infections in China, and must not be abused.
In short, the above 5 drugs can still be used normally in China, but reasonable and safe medication is abnormally critical. As a professional pharmacist, the author is very concerned about the clinical efficacy and adverse reactions of drugs, in fact, adverse reactions are the innate attributes of drugs, there is no "miracle drug" with only therapeutic effects and no adverse reactions, but some drugs have smaller adverse reactions and some are more serious. Of course, there is no doubt that we care about the efficacy of the drug, but the use still needs to weigh the pros and cons, only when the benefits of the clinical efficacy are greater than the disadvantages caused by the adverse reactions, or the adverse reactions of the drug are known and controllable, it can be used in the clinic with confidence.
Drugs are indications, arbitrary abuse of many hidden dangers, follow the trend of medication is even more important, only according to the individual's disease situation, basic level, comprehensive drug efficacy and adverse reactions of the consideration, in order to truly achieve "individualized" rational and safe use of drugs, escort for health!
