Penicillin is widely used antibacterial drugs, which itself toxicity is very small, but it is more common drug allergies , adverse reactions and even death. ADM is an antibacterial effect at low concentrations of antibacterial, sterilization at high concentrations. Streptococcus pneumoniae double ball so Gram-positive cocci better, grape sensitive bacteria also play a role, for meningococcus, Neisseria gonorrhoeae and other Gram-negative bacteria, as well as diphtheria bacteria, Clostridium tetani and other Gram-positive bacilli and spirochetes also play a role.
Clinically, penicillin for the treatment of pneumonia, tonsillitis , otitis media, Feng nest tissue inflammation, bacterial endocarditis, osteomyelitis , meningococcal meningitis, pneumococcal meningitis, syphilis, relapsing fever , gonorrhea, anthrax, tetanus and other diseases have a good effect. Regardless of the route of administration of penicillin can be absorbed.
More commonly used intramuscular injection, can be fully absorbed. Aqueous crystalline penicillin soluble salts absorbed quickly, to reach peak blood concentration within 15 to 30 minutes, and procaine penicillin, penicillin oil absorption is slower. Penicillin in the body is mainly excreted by the kidneys. Injection agent who, in one hour plasma concentrations of penicillin decreased by half. Skin, mucous membranes, etc. is also very easy to absorb, but also more likely to cause allergies than injections, so this route of administration to pay attention to the prevention of allergic reactions. Using skin tests so greatly reduced the incidence of allergies, but often inaccurate because of the amount of skin test caused too large, or the patient's own special sensitive, and sometimes can make skin allergy test because sometimes occur, it is mainly clinical allergic reactions.
Severe allergies often appear in skin test or injection 10 minutes. Patients first felt tightness gas hold, trembling and even convulsions, dizziness, headache, dyspnea, cyanosis, pale, cold hands and feet, blood pressure abrupt decline, pulse fast thin and weak, such as the rescue is not timely, often due to respiratory and circulatory failure death of patients with severe allergic reactions, you should immediately subcutaneous or intravenous 0 l% adrenaline 0.5-1 ml. Using acupuncture therapy, acupuncture people, the customs and other points.
According to the condition, ten minutes later, you can re-injected 0.1% epinephrine 0.3-0.5 ml. Conditions, should be intravenous infusion, enter 5% dextrose or grape saline, liquid can hydrocortisone 100-200 mg, a sharp decline in blood pressure who added boost infusion drugs such as Alamin or go norepinephrine. Conditions may be oxygen inhalation. Such as injection drug use desensitization phenergan (promethazine) 25 mg, and the use of other methods of symptomatic treatment.
When the site without the infusion conditions, could I intravenously 60-80 ml of 25% glucose, intravenous vasopressors, but the speed should be slow to push drugs, without intravenous conditions also intramuscular Alamin. Although the incidence of penicillin allergy oncoming abrupt, but if handled properly, recovery and prognosis are more favorable, and this aid measures (such as intramuscular adrenaline major), in rural primary health care units also can be used. Such as forced severe allergic shock patients, swerved to the hospital, was not processed, often a variety of dangerous situations that occur on the way.
In this regard, should cause the ambulance crew's attention.
For general allergic reactions, such as hives, can use desensitizing drugs, such as diphenhydramine, each oral 25 mg three times a day, or application chlorpheniramine, oral administration of 4 mg each, three times a day .
Prevent allergies, mainly before treatment, you must understand the patients without previous history of penicillin allergy, if so, must not be used, such as non-allergic officials, then the injection should be made in accordance with the provisions of the skin test dose (per usual penicillin skin test 100 ml of a drug containing 1000 units, with 0.1 mg for intradermal test, which injected 10 to 100 units of penicillin) intradermal, 20 minutes later, such as local redness and pseudopodia, big l cm diameter tumor positive reaction, that should not be injected. If negative, can be injected.
When the injection is completed, the patient should not leave immediately, no response was observed 10 minutes after the walk. After continuous withdrawal, when then need injections, such as interrupt reached five days should be tested.
