In fact, the discomfort caused by medication is very common in clinic, that is, "drug-induced diseases", which belong to the category of adverse drug reactions. Among them, drug-induced arrhythmia is drug-induced arrhythmia. In recent years, with the increasing incidence of adverse drug reactions, the incidence of drug-induced arrhythmia has also increased, which has become an indispensable part of the cause of arrhythmia.
Adverse reactions caused by drinking alcohol after taking cephalosporins belong to "drug-induced arrhythmia". This is because the interaction between them produces a disulfiram-like reaction in the body, which can inhibit acetaldehyde dehydrogenase and make acetaldehyde accumulate in the body, and then a series of uncomfortable symptoms appear. The occurrence of adverse reactions is mostly due to the disorder of myocardial metabolism, leading to tachycardia and atrial fibrillation. Blood pressure dropped and heart rate increased during physical examination. Therefore, patients who use cephalosporins must avoid drinking alcohol during the medication and within 5 days after stopping the drug, so as not to cause physical discomfort.
There are many types of drug-induced arrhythmia, such as persistent or non-persistent ventricular tachycardia, torsional ventricular tachycardia, ventricular flutter or fibrillation, ventricular premature beats, supraventricular arrhythmia and conduction block.
According to the research, antiarrhythmic drugs, corticosteroids, anti-infective drugs, antiepileptic drugs and antihistamines are the most likely to induce arrhythmia, and the incidence of these five drugs accounts for 48.72% of the total incidence. Antiarrhythmic drugs often cause arrhythmia due to the increase of blood concentration due to too fast dosage, and the incidence rate is 5%- 10%. The incidence of life-threatening arrhythmia such as ventricular tachycardia or ventricular fibrillation is 1.5%-8%. One kind of antiarrhythmic drugs can cause or aggravate arrhythmia in the course of use, while the second and third kinds of antiarrhythmic drugs cause less arrhythmia, among which amiodarone has a higher incidence and fatal arrhythmia can reach 2.8%, especially ventricular premature beats. Sotalol hydrochloride tablets, as a new class III antiarrhythmic drug, have the characteristics of both class II and class III drugs, have the function of blocking β-receptor, and can prolong myocardial action potential, effective refractory period and QT interval, with higher safety and effectiveness than amiodarone, and belong to a broad-spectrum antiarrhythmic drug.
The occurrence of drug-induced arrhythmia may have susceptible factors besides the drug itself. Mainly: age; Gender; Potential arrhythmia; Electrolyte balance disorder, such as hypokalemia and hypomagnesemia; Basic diseases, such as heart disease and brain injury; Drug interaction and metabolism; Liver and kidney dysfunction and so on. In addition, there are more complicated relationships among heredity, pharmacogenomics and drug-induced arrhythmia.
The arrhythmia caused by drugs is mainly the prolongation of QT interval, that is, the prolongation of ventricular repolarization, and then it manifests as cusp-cusp torsional ventricular tachycardia, which leads to arrhythmia. A few patients may have unconscious symptoms when drug-induced arrhythmia occurs, while most patients will have dizziness, syncope, collapse, arrhythmia, palpitation and so on.
In a word, we should pay enough attention to drug-induced diseases. In order to prevent the occurrence of drug-induced arrhythmia, patients should take drugs under the guidance of doctors, and pay attention to dosage, treatment time and incompatibility with other drugs, so as to nip in the bud. At the same time, we should fully understand the action characteristics and possible adverse reactions of various drugs, especially antiarrhythmic drugs, and stop taking drugs in time when adverse reactions occur and prescribe the right medicine. Before taking the medicine, we should also pay attention to correct the risk factors that are prone to arrhythmia, such as myocardial ischemia, hypoxia, hypotension, cardiac insufficiency, electrolyte disorder (especially low potassium, low magnesium and low calcium) and acidosis. Attention should also be paid to ECG monitoring when intravenous injection of antiarrhythmic drugs, especially those complicated with bradycardia, conduction block and prolonged QT interval.