If you are sick, can intravenous infusion help you get better quickly? The answer may not be what you think

Author: Zhao Zhigang, Chief Pharmacist, Beijing Tiantan Hospital, Capital Medical University

Reviewer: Liu Zhi, Chief Physician, Xuanwu Hospital, Capital Medical University

As the saying goes, people who eat grains will inevitably get sick, so "taking medicine" has become something we often come into contact with in our lives.

However, many friends have many misunderstandings about "medication". Today I will correct some common misunderstandings for you. Come and take a look!

1. Misconception 1: Intravenous infusion can make you better quickly, so you just go for an infusion when you are sick.

When choosing medicine, we should follow this general principle: if you can take medicine, don't get an injection; if you can get an injection, don't get an infusion. Why?

Figure 1 Original copyright image, no permission to reprint

Because blood vessels are a closed system, although the fluid used for infusion looks clean and free of impurities, it actually contains many particles. Most of these particles are invisible to the naked eye but can be detected under a microscope. Once they enter the blood vessels, they will accompany the blood throughout the body for life. When they run into very thin blood vessels, they may block the small blood vessels.

In addition to microparticles, intravenous fluids also contain endotoxins, which are released from bacteria after they die.

In the process of making infusion drugs, although bacteria can be killed by high temperature, the inactivated bacteria cannot be completely expelled, and the production of endotoxins cannot be avoided. Endotoxins in the human body may cause infusion reactions, such as chills, fever, agitation, etc.

The more fluid is infused, the more endotoxins enter the human body, and the greater the probability of an infusion reaction.

In addition, if you want to add medicine to the infusion liquid, thousands of particles and glass fragments will be generated in an instant when the ampoule is opened. At the moment of opening, some of them will fall into the ampoule. When the nurse draws them out from the ampoule and puts them into the infusion liquid, they may enter the blood vessels with the infusion.

These particles are very sharp. They will scratch our blood vessels as they travel, and may cause cuts all over them.

Therefore, if taking medicine or injections can solve the problem, do not get an infusion to avoid unnecessary risks.

2. Misconception 2: Except for cephalexin, you can drink alcohol while taking other medicines.

As we all know, cephalexin combined with alcohol can work just fine.

This is because after drinking, alcohol will turn into acetaldehyde under the action of alcohol dehydrogenase in the liver, and then turn into acetic acid under the action of acetaldehyde dehydrogenase, and finally be metabolized into carbon dioxide and water and excreted from the body.

If you take drugs with the same structure or mechanism of action as disulfiram before or after drinking, acetaldehyde will not be converted into acetic acid, causing acetaldehyde to accumulate in the body, leading to symptoms such as difficulty breathing, palpitations, headache, nausea, etc. In severe cases, it can cause shock, respiratory depression, and acute heart failure.

In addition to cephalosporins, there are many drugs that have structures similar to disulfiram. For example, nitrofuran drugs, furazolidone; nitroimidazole drugs, metronidazole, tinidazole; sulfonylurea oral hypoglycemic drugs, glimepiride. Drinking alcohol while taking these drugs will also cause similar reactions.

In addition, there are many other drugs that can be affected by drinking. For example, drinking while taking acetaminophen can increase the risk of liver damage and liver failure; for example, drinking while taking benzodiazepine sedatives and hypnotics can cause respiratory depression.

For the general population, it is difficult to tell which drugs may affect alcohol. So it is safest not to drink alcohol when taking any medicine.

Figure 2 Original copyright image, no permission to reprint

3. Misconception 3: The more adverse reactions listed in the instructions, the less safe the drug is.

Qualified drugs that produce unexpected reactions or reactions unrelated to treatment when used in normal dosage and usage are called adverse drug reactions.

During the clinical trial of a drug, any adverse reactions that occur, even if they occur in a few cases among thousands or tens of thousands of people, must be written down in the instructions. The more adverse reactions are written down, the more cases the drug has been studied, the longer the study lasted, and the more fully the doctors understand it.

Figure 3 Original copyright image, no permission to reprint

Therefore, the adverse reactions written in the instructions do not mean that they will all occur in you. Some of them have a very low incidence rate.

If you take a certain medicine and a certain symptom occurs, and the drug instructions say that it is one of the adverse reactions of the drug, then we don't need to panic, tell the doctor the specific situation in detail, and the doctor will make corresponding treatment.

If there is nothing written in the instructions, it means that there may be less basic research on this drug, or the trial population is relatively small, and there may not be any patients who have experienced adverse reactions yet. Or, some patients have experienced adverse reactions, but the data have not been collected and evaluated in detail, so they are not written in the instructions.

Therefore, the more adverse reactions written on the drug instructions, the more it tends to mean that the drug has been fully researched, the risks are controllable, and it may be relatively safer.

The safety of medicines that indicate in the instructions that they have no adverse reactions or whose adverse reactions are not yet clear is actually unknown and must be handled with caution.