Chapter 1376: A man who can recite the drug instructions

"There is no hypoglycemia in the drug instructions, which does not mean that captopil does not have such a problem." Zhou Congwen said.

The doctor in the circulatory internal medicine seemed to be curling his lips, but he restrained his expression and doubts and tried hard to lower his head.

Zhou Congwen is not in the limelight. He has already wiped the butt for the Circulatory Department. Even if he says something without saying anything, the Circulatory Doctor knows that he has to endure it no matter what.

Looking at the expression of the circulatory physician, Zhou Congwen smiled.

"I know the instruction manual." Zhou Congwendao.

The circulatory physician's expression showed disbelief.

"First, patients with allergic to this product and leukopenia are contraindicated."

"Secondly, renal insufficiency, elderly patients and pregnant women should use it with caution."

"third……"

"tenth……"

"Thirteenth, if proteinuria gradually increases when using this product, suspend this product or reduce the dosage."

Zhou Congwen immediately began to recite the instructions.

As he told him about the side effects, the atmosphere in the classroom became extremely subtle.

All the previous doubts disappeared.

It’s not that Professor Zhou Congwen and Zhou don’t understand, nor do they know that they can recite one by one, and even say that he can recite it backwards like a stream of people here believe it.

Internal medicine is usually the main focus of taking medicine, but who can recite the instructions for medicine?

If someone can recite the drug instructions, then what he said is probably true.

"The drug instructions were only the result of research under historical conditions at that time. They could not be limited to it. They were drawn as prisons." Zhou Congwen looked at the circulatory physician and smiled, "The reason why I wanted to sit down and talk about this was mainly for the side effects of captopril."

"The manual is the result of research at that time. Now captopril has some other super instructional uses. For example, the treatment of cirrhosis ascites."

"Ah? Ascites with cirrhosis?" Tengfei was stunned.

"The renin-angiotensin-aldosterone system in most patients with cirrhosis is often more active. The increased angiotensin and vitality can cause renal artery contraction, which may be one of the mechanisms of liver and renal syndrome. Captopril has the effect of selectively dilating blood vessels. After using this drug, the systemic arterial pressure drops, and the liver blood flow also decreases."

“!!!”

“!!!”

Everyone was stunned.

"Along with that, captopilol can treat Raynaud's disease."

"Well……"

"In addition to inhibiting the production of angiotensin II, the participation of bradykinin is also related to the fact that the decrease of angiotensin II and the increase of bradykinin leads to vasodilation and a slight decrease in vascular resistance, which improves the microcirculation at the fingers and toes."

Zhou Congwen stood in front of the blackboard and talked, while Shen Lang gradually became a little confused.

Is this the true gossip spirit that Zhou Congwen talked about?

However, the various uses of captopril seem to be meaningless. There is no such thing as those gossips from the emergency department, Shen Lang thought to himself.

"So, from research and development to clinical practice, the principles of use are changing. It's like sildenafil citrate..."

Zhou Congwen said this and immediately stopped.

I can't say much about this kind of thing. I have already left the nickname of "a different place" in 912. Always mentioning sildenafil citrate will make people think that I am really having problems.

"Now, let's talk about it." Zhou Congwen knocked on the blackboard, not giving everyone here the opportunity to think about whether he had a "distant place" problem. He continued, "Insulin autoimmune syndrome is one of the causes of organic hypoglycemia."

"About half of this type of patients have triggers. If you ask about your medical history carefully, you often find that patients have used drugs containing thiol."

"Captopil is exactly one of the drugs containing thiol groups."

"Professor Zhou, what are the drugs of thiol?" Teng Fei no longer doubted, but asked for advice humbly.

"Anti-thyroid drugs such as methimazole, antihypertensive drug captopril, hepatitis protecting drugs glutathione and thiopronin, antibiotics such as imipenem, penicillamine and beta-lactamase antibiotics, and endocrinology drugs used in the treatment of diabetes neuropathy, etc."

"In ICIU, the patient's blood sugar is unstable. After excluding other possibilities, you should pay attention to whether the patient has used imipenem, penicillamine and beta-lactamase antibiotics."

"In daily life, if you frequently experience hypoglycemia coma, you should consider whether you have used glutathione."

"There was a patient who had always had an unstable blood sugar in severe cases and fluctuated violently." Zhou Congwen began his own gossip. When he said this, he looked at Shen Lang deeply.

Shen Lang listened with his ears.

"The blood sugar fluctuates violently, and no matter how you check, you can't answer it. Finally, I consulted and searched all over the entire imperial capital. After my boss went there, I took the medicine and finally confirmed that it was caused by Jingdiantai."

Taineng, also known as imipenem cistatin sodium for injection, is the most advanced antibiotic commonly used in clinical practice.

And it actually had this side effect, and Zhou Congwen's explanation made the doctors in the circulatory department dumbfounded.

Director Han listened carefully, his little eyes kept turning, as if he was thinking about something.

Zhou Congwen spoke for twenty minutes before stopping.

"A drug containing thiol can reduce the disulfide bonds of insulin to cleave it, causing the structure of endogenous insulin to change, leading to the exposure of certain autoantigens, recognized by specific major histocompatible complex molecules and triggering specific T cell cloning and proliferation, leading to the production of insulin autoantibody."

"Similar reactions are not very common, and captopilol is not unusable. If captopilol is stopped because of a rare hypoglycemia, it will be a waste of food."

"I mean, as a department that often uses this type of drug, it is necessary to understand the side effects of the drug. Once a patient has similar problems in the future, it will not be said that it has nothing to do with him and will make a joke."

It’s a joke, these four words really make sense, Director Han smiled slightly.

Professor Zhou Congwen and Zhou are the generous ones.

"Okay, that's all." Zhou Congwen clapped his hands, "Director Han, what to do next depends on your opinion. I think it's more appropriate to put the patient in the hospital."

"Okay, Professor Zhou, you said so clearly. I dare not let the patient go." Director Han smiled, "This is the hospital and the hospital will bear the cost. You can't do something wrong and don't admit it."

Fuji sighed.

Zhou Congwen said she was confused. She really didn't expect that a common medicine would have so many things.

Defeat yourself with what you are best at... This thought suddenly appeared in Tengfei's mind.

But what do you have to say? Can someone recite the drug instructions and what refute it yourself?
Chapter completed!