At 8 o’clock on the evening of December 31st, the fifth guest, Li Zhiling, deputy director of the Pharmacy Department of Shanghai Children’s Hospital, was welcomed in the series of live broadcasts of "COVID-19’s big talk about epidemic prevention" to discuss with you the issues related to rational drug use in COVID-19. Li Zhiling also answered some hot topics that netizens care about. The following are the key questions and answers:
Q: When there are no related symptoms, is it necessary to take more medicine in advance to prevent Covid-19?
Li Zhiling:There are no drugs that can definitely reduce the risk of COVID-19 infection. Neither Chinese patent medicine nor other cold medicines can prevent infection by taking medicine in advance. If there is no infection in itself, if the therapeutic drugs are used indiscriminately to prevent infection, it may cause problems such as overdose and liver damage, which requires vigilance.
Therefore, it is not recommended to prevent COVID-19 by taking medicine. Such problems can be enhanced by wearing masks, washing hands frequently, ventilating frequently, paying attention to diet, adjusting work and rest, reducing fatigue and so on, and the environment can be well sterilized.
Q: The online "COVID-19 medication sequence chart" is widely circulated. Is this chart reliable? Is it necessary to take medicine after infection?
Li Zhiling:"COVID-19’s medication order chart" is not reliable. The patients infected with COVID-19 have different symptoms, so there is no absolutely complete medication order.
The first one in the order of taking medicine is Chinese patent medicine. If you have symptoms of sore throat and believe in Chinese medicine, you can take it. If there is no sore throat, you don’t need to take it. The second is wind-cold and cold granules, which can be taken when symptoms such as stuffy nose, runny nose and sore throat appear after suffering from flu. If the above situation does not occur, you do not need to take it. The third and fourth place is compound paracetamol and amantadine tablets. If it is used with ibuprofen, it may aggravate the damage of liver and kidney function. In the same way, even Huaqingwen is the same. If it is in the case of nasal congestion and sore throat, it can be taken, but if there are no symptoms, it is also unnecessary to take it.
Q: Fever symptoms after infection are common. What antipyretics do you take the most now?
Li Zhiling:When you have a fever, adults and children use different drugs. Adults can choose a wider range of drugs. Adults can take ibuprofen, acetaminophen and aspirin, but children can only use two antipyretics: ibuprofen and acetaminophen.
Children need to take drugs according to their age. If the baby under three months has a fever, it is recommended to go to the hospital for treatment, because the condition changes too quickly. Babies aged 3 to 6 months can only use acetaminophen; Babies over 6 months old can use ibuprofen; Under the age of 12, ibuprofen and acetaminophen can be taken.
Q: What are the precautions when taking ibuprofen and acetaminophen?
Li Zhiling:The dose of acetaminophen is 10-15 mg/kg according to body weight, and it should be used for the second time at least four hours apart, and it can only be taken five times at most within 24 hours, and it can only be used for three days at most. If it is used for more than three days to the fourth day, it will accumulate damage to the liver. Also divided into the following two situations:
A situation of high fever, high infection, etc., should go to the hospital in time. Another is that you still have a little fever, and your health is actually very good. You can change a drug on the third day, acetaminophen on the first three days, and ibuprofen on the fourth day, which can appropriately reduce the accumulated liver damage. It should be noted that ibuprofen can only be taken once every six hours, not for more than three days in a row, and only four times in a 24-hour period.
It is suggested that people with poor renal function can choose acetaminophen first; People with poor liver function can choose ibuprofen first.
Q: If the fever can’t come down after repeated attacks, can I increase the dosage or take other drugs by myself? If so, how much is the dose increased?
Li Zhiling:First of all, we should observe the mental state. If the body temperature has shown a downward trend, it will take some time for the body temperature to drop after taking the medicine. If the body temperature does not drop but rises after taking the antipyretic, it is necessary to check whether the dosage of the antipyretic is enough. The dosage in the general instructions is relatively conservative, and it can be larger than the dosage in the instructions as appropriate.
How much does the dose increase? Ibuprofen is 5-10 mg/kg, and acetaminophen is 10-15 mg/kg. Please consult the medical staff for the specific increase. At the same time, it is necessary to check whether you drink enough water. Only by drinking water can you discharge the heat from your body. If the fever can’t come down for more than three days, we should consider the seriousness of the disease itself. Among the diseases that can be treated at home routinely, the body temperature can be lowered in three days with antipyretics.
Parents are especially reminded to check whether the medicine is vomited by the child after feeding, and the medicine itself has not been absorbed. In this case, you can choose supplementary feeding. The time is limited to 15 minutes. If the child vomits again within 15 days after taking the medicine, the original dose needs to be supplemented again.
Finally, check whether the drug is effective. Although some drugs are still within the validity period, once the drugs are opened and exposed to air, these drugs will not be valid for more than half a year.
Q: Are there any matters needing attention when using Chinese medicine and Chinese patent medicine at home?
Li Zhiling:There is no need to store too many Chinese patent medicines of the same type. The guide to preparing medicines at home is not as many as possible. Just choose one of them. At the same time, there is no need to blindly increase the dose. Some components in drugs may have opposite effects, even if they have the same effect, the superposition of two or three drugs may lead to drug-induced liver injury.
Q: The symptoms related to virus infection have been relieved. Do you want to continue taking medicine to consolidate the curative effect?
Li Zhiling:Fever medicine is taken on demand, the body temperature is greater than 38.5 degrees Celsius, and the mental state is not good, so it is necessary to take it. Even if it is still positive, you don’t need to take it without a fever; It is unnecessary to take antipyretics if you have completely turned negative and have no fever.
It is not excluded that in some cases, taking drugs can properly reach a course of treatment. For example: allergic rhinitis induced by COVID-19, which leads to sinusitis, thus causing headaches. In this case, the general course of treatment for sinusitis is 10-14 days and nearly two weeks. Even if the symptoms get better, once the drug is stopped, the disease caused by virus or bacteria will be repeated. The same is true for pneumonia, which usually lasts for 10-14 days.
Q: Can children use adult antipyretics? Can adults use children’s antipyretics?
Li Zhiling:Generally speaking, most adults can use children’s medicine, but most children can’t use adults’ medicine. For example: antipyretics, children can use two kinds of ibuprofen and acetaminophen, adults can use ibuprofen, acetaminophen, aspirin, nimesulide, etc. Among these drugs, nimesulide is prohibited under the age of 12. If adults take nimesulide for children, it will lead to adverse reactions such as liver and kidney function damage and central nervous system.
For adults, it is easy to metabolize drugs out of the body, but children can’t metabolize the drugs taken by these adults. Therefore, children should try not to use adult antipyretics. If you want to use adult drugs, you need to read the instructions carefully. Look at the column of children’s medication. It says that it is forbidden under a few years old. If it says forbidden, you must never take it under the prescribed age. If it is not written, it is not clear whether the drug can be taken by children. You can consult the medical staff further.