Public popular science and science communication! Click on the blue wordone click to follow
Expert of this article: Liu Zhijun, Beijing Security Bureau affiliated to Capital Medical University Zhen Hospital Pharmacy Department
According to reports, Liu Moumou, a 27-year-old former TV host in Hefei, died after hanging from the water in the First Affiliated Hospital of Anhui Medical University.autopsy Reports show that moxifloxacin caused sudden cardiac death.
Why does moxifloxacin infusion cause such serious adverse reactions as sudden death? What exactly is moxifloxacin? Can I still eat it later?
What is moxifloxacin?
Moxifloxacin is one of the most commonly used antibacterial drugs in the respiratory department and belongs to the quinolones, so it is also called “respiratory quinolone”. “. Mainly used for the treatment of community-acquired pneumonia caused by common Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae, etc., especially for SARS such as Mycoplasma pneumoniae, Chlamydia pneumoniae infection caused by pathogenic bacteria.
Photo courtesy of the author
Clinically, Moxifloxacin is contraindicated in:
①Those who are allergic to moxifloxacin;
②Pregnant women and lactating women;
③Children under 18 years old;
④Severe liver function Insufficiency or transaminase elevation greater than 5 times the upper limit of normal;
⑤Patients with a history of using quinolones to treat related tendon diseases;
< p>⑥ Patients with congenital or acquired QT interval prolongation.
If these contraindications are ruled out prior to moxifloxacin use, Mycoplasma pneumoniae use of moxifloxacin is appropriate and reasonable.
swipe up
< strong>
For patients who are taking moxifloxacin for the first time, there is currently no way for doctors and patients to determine whether they are allergic to it.
The instructions and clinical practice do not mandate a skin test before use, because the incidence of allergic reactions such as rashes is extremely low.
Articles 2 and 3 are because quinolones such as moxifloxacin may affect cartilage development in infants and young children.
Article 4 is because moxifloxacin may cause liver function damage, and liver function needs to be monitored during use (such as whether the transaminase is elevated) .
Article 5 is because moxifloxacin can cause Achilles tendinitis and Achilles tendon rupture, so it is contraindicated for those with a history of such diseases.
Article 6QT interval prolongation is the most dreaded adverse reaction, although it occurs The rate is low (≈1‰), but the mortality rate is high.
The QT interval is the distance (in seconds or milliseconds) from the Q wave to the T wave on an electrocardiogram. The normal range is 0.32 seconds to 0.44 seconds.
Generally speaking, a QT interval >0.45 sec in men and a QT interval > 0.46 sec in women can be regarded as QT interval prolongation.
Photo courtesy of the author
If the prolongation of the QT interval is obvious, especially when some drugs are used in combination that can cause the QT intervalProlonged drugs (eg, fluoroquinolones, amiodarone, quinidine) or concomitant hypokalemia can lead to malignant arrhythmias, of which torsades de pointes is the most feared form that can be life-threatening.
Why does moxifloxacin cause sudden cardiac death?
Moxifloxacin has been shown to prolong the ECG QT interval in some patients.
moxifloxacin 0.4 g intravenously (infusion time per day) 1 hour), the mean QT interval was prolonged by 10 ms (±22) from pre-dose to day 1 of dosing.
It is recommended that moxifloxacin be avoided for: ① patients with prolonged QT interval; ② ventricular arrhythmias, Including torsades de pointes ventricular arrhythmia; ③ untreated/corrected hypokalemia or hypomagnesemia; ④ concomitant use of drugs that cause QT interval prolongation (mainly antiarrhythmic drugs, antipsychotics, antidepressants) ).
The above conditions will aggravate the QT interval prolongation caused by moxifloxacin and induce torsades de pointes ventricular arrhythmia , causing sudden cardiac death.
Gallery copyright width<600"> /p>
Before the use of moxifloxacin, the patient needs to know: whether there is a history of arrhythmia, In the absence of hypokalemia, whether other drugs being taken may exacerbate QT prolongation.
Arrhythmia caused by QT interval prolongation is a small probability event and can only be Close observation of moxifloxacin and timely intervention.
What happens if moxifloxacin is used improperly?
Moxifloxacin is an antibacterial drug used to treat infections caused by susceptible bacteria.
Abuse of antibioticsEasy to induce drug resistance of pathogens, leading to treatment Ineffective;At the same time, the irrational use of antibacterial drugs also increase the occurrence of drug toxicity and side effects.
Therefore, China currently strictly controls the use of antibacterial drugs. In general, professional doctors in medical institutions choose the application according to the infection situation.
How to take medicine safely?
①Carefully choose quinolones.
Gallery copyright images, do not authorize reprint
②The patient’s reaction should be closely observed within 30 minutes before oral or intravenous infusion of moxifloxacin.
In general, any infusion should be in the “infusion room” and the patient should be closely observed as the infusion begins. If abnormal reactions occur, such as rash, throat tightening, wheezing, chest tightness and other symptoms, symptomatic treatment or rescue should be performed as soon as possible.
③Remember the contraindications of moxifloxacin.
In short, moxifloxacin is a widely used respiratory quinolone, mainly used for respiratory infectious diseases. It is also used for the treatment of abdominal and pelvic infections caused by certain anaerobic bacteria.
Overall, moxifloxacin is safe , but for certain groups, such as infants, pregnant women, lactating women, long QT syndrome, patients with severe hepatic insufficiency is prohibited. Hypokalemia and concomitant use of drugs that prolong QT relief can increase the risk of torsades de pointes.
Therefore, clinical contraindications to moxifloxacin should be excluded, and the risk of QT interval prolongation should be assessed in patients. , use with caution.
Article cover and pictures with watermarks
Please support usShare Comments and Likes are watching ☟☟☟
Public Popular Science Science Communication
China Association for Science and Technology Official WeChat National Science Popularization Platform
Long press to identify the QR code on the left and follow us