Speaking of bismuth, Presumably everyone will not be unfamiliar, as a type of gastric mucosal protector, it is widely used in gastroenterology. The most common are Lizhu del, pectin bismuth, bismuth hypocarbonate and so on.
So what are its pharmacological properties and clinical applications? Let's take a look.
1. Commonly used bismuth agent types
Bismuth agent refers to a class of drugs that contain the element "bismuth" in the active ingredient of the drug. At present, the drugs used clinically are: bismuth potassium citrate tablets (Lix), compound bismuth aluminum acid tablets (stomach x treatment), compound stone calamus alkaline bismuth nitrate tablets (stomach x le), colloidal pectin bismuth capsules (vitamin x) and so on.
2. Pharmacological effect of bismuth
Bismuth is a kind of gastric mucosa protective drug, which plays the principle of gastric mucosal protection is: bismuth agent into the stomach acidic environment, metal ion "bismuth" and protein complex, trait changes, in the gastric mucosa surface to form a protective covering film, to prevent gastric acid, food, pepsin on the ulcer site stimulation.
3. Indications for bismuth agents
(1) It is used for chronic gastritis and to relieve stomach pain, heartburn heat (heartburn) and acid reflux caused by excessive stomach acid.
(2) Combined with other drugs for the radical treatment of Helicobacter pylori.
4. Precautions for the use of bismuth
(1) Oral odor (ammonia water smell), black stool, etc. can appear during the medication, and it can disappear on its own after stopping the drug, so there is no need to worry too much.
(2) It is not advisable to use this class of drugs for a long time
1) Bismuth is a heavy metal, which can be absorbed in the gastrointestinal tract in a small amount, and the general medication time is not more than 8 weeks, otherwise it will be poisoned by bismuth accumulation.
2) Long-term use can cause kidney toxicity, nervous system toxicity, bone, muscle toxicity, etc.
A. Neurotoxicity: When the blood concentration of bismuth is greater than 100ng/ml, it may lead to bismuth encephalopathy. Manifested by confusion, muscle rigidity, dyskinesia, dysarthria, etc.
b. Bone and muscle toxicity: it is related to the excessive concentration of bismuth in the bone, and the more common is osteoarthropathy associated with bismuth encephalopathy, which is often presumptive to unilateral or bilateral shoulder pain.
It should also be noted that when the blood bismuth concentration < 50 μmol/l, the possibility of causing serious adverse reactions is extremely small, while the clinical application of the bismuth-containing helicobacter pylori eradication regimen is 1 to 2 weeks, and the blood bismuth concentration is much lower than this concentration. This drug is relatively safe at regular doses and during the cycle of taking.
(3) Severe renal insufficiency is prohibited, pregnant women, lactating women are prohibited, and children should be used with caution.
(4) It is not advisable to take more than two kinds of bismuth agents at the same time.
5. How to take bismuth
(1) For gastric mucosal protection: take it with 30-50ml of warm water half an hour before meals.
(2) For killing Helicobacter pylori: it needs to be combined with two antibacterial drugs.
(3) During the treatment period, alcoholic beverages or carbonated beverages should not be consumed, and coffee, tea, etc. should be consumed less.
(4) Milk and antacids can interfere with the effect of this drug, can not be taken at the same time, if it is necessary to use together, should be at least half an hour apart.
(5) The specific dosage should refer to the drug instructions or follow the doctor's instructions, however, the continuous use of this drug should not exceed 2 months, and the bismuth-containing drugs should be discontinued for 2 months, and the next course of treatment can be continued.
Resources:
1. Bismuth citrate potassium tablets, compound bismuth aluminum acid tablets, compound stone calamus alkaline bismuth nitrate tablets, colloidal pectin bismuth capsule instructions
2. National formulary