Acetaminophen, long ago called paracetamol. As the name suggests, it can relieve fever and analgesia.
The drug has an antipyretic effect by inhibiting prostaglandin synthase in the hypothalamic thermoregulatory center, reducing the synthesis and release of prostaglandin PGE1, causing peripheral blood vessel dilation and sweating, and its antipyretic effect is similar to that of aspirin.
The analgesic effect is not strong and is only effective for mild to moderate pain.
The sulfhydryl donor N-acetylcysteine is a specific drug for acetaminophen poisoning.
Zheng Ren saw this in the doctor's order and knew that the ICU had already prescribed the right medicine, so he didn't say anything nonsense.
The serious power of 912 is quite powerful. Apart from the strange situation of the inexplicable discoloration of urine caused by propofol, Zheng Ren felt that he did not need to comment too much.
For a patient with liver failure caused by acetaminophen poisoning, collective efforts are needed to treat him.
This is a clear diagnosis, and an experienced doctor can tell what the disease is at just a glance.
But treatment is difficult, even more difficult.
"Why did you take so many Yinqiao tablets?" Su Yun looked at the medical records and frowned, "Do you really think that Yinqiao tablets are traditional Chinese medicine?"
Zheng Ren and Professor Yang both sighed, but no one said anything.
The instructions for Yinqiao Tablets say - dispelling wind and relieving surface, clearing away heat and detoxifying. It is used for fever, headache, cough, dry mouth and sore throat caused by wind-heat and cold.
Standard Chinese medicine vocabulary gives people the feeling that this is Chinese medicine.
When they have a cold, many people are willing to take a set of Yinqiao tablets orally, and the effect is indeed good.
But if you read the instructions for Yinqiao Tablets carefully, its ingredients are not that simple.
Mountain honeysuckle, forsythia, nepeta, light tempeh, light bamboo leaves, burdock, reed root, platycodon, etc., licorice, chlorpheniramine maleate, acetaminophen, vitamin C, peppermint oil.
Chlorpheniramine maleate, also known as chlorpheniramine, is an antihistamine.
This drug ingredient plays an anti-allergic effect by antagonizing H1 receptors. Mainly used for rhinitis, skin and mucous membrane allergies, and relief of cold symptoms such as tearing, sneezing, and runny nose.
Next, it also contains acetaminophen, a drug that can relieve symptoms when taken in small amounts, but can cause liver failure when taken in large amounts.
Each Yinqiao tablet contains more than 100mg of acetaminophen.
So it worked well, and I still came back to acetaminophen after all the twists and turns.
In addition, other cold medicines also contain acetaminophen. The child named Chen Li not only took double the oral dosage, but also used several medicines in combination.
The amount of acetaminophen taken... is almost lethal.
While every drug has an effect and benefits the human body, it also has hidden dangers.
Ingesting a large amount of it, let alone medicines, even eating bananas is not enough. Not to mention being popular, even if you drink too much water, it won't work.
The word "appropriate amount" is correct.
Zheng Ren looked at the medical records and his brows were almost tied together, like the straps of a sterile surgical gown.
It would be difficult to save this child named Chen Li, Zheng Ren made a judgment in his mind.
During the process of looking at the medical records, directors and professors from relevant departments in the hospital came one after another.
At the hospital, Vice President Yuan presided over the hospital-wide consultation, and Director Ye and Deputy Director Lin of the Medical Department were all present.
Seeing how seriously the hospital took it, everyone felt a little heavier.
It's different from diseases like cancer. If you are a cancer patient, you are sick. You are destined to live or die. You just have to do your best.
What he was facing in front of him was a young college student who had studied hard for more than ten years. He had not yet entered the society and was about to pass away in good health.
For this alone, Zheng Ren felt that the patient's family could not bear it.
A person with white hair gives a gift to a person with black hair. This is the greatest tragedy in the world. There is nothing more miserable than this in the world of mortals.
The person who reports the medical history in the ICU is the chief resident. He tries to report the medical history that he already knows as concisely as possible. The doctors who come later have a basic idea of this.
The diagnoses of acetaminophen poisoning, acute liver failure, peritoneal effusion, coagulation dysfunction, etc. were clear and clear.
The ICU has begun to replenish platelets and use artificial liver blood purification technology to treat patients.
Artificial liver blood purification technology refers to plasma exchange and blood adsorption technology.
The inflammatory substances or toxins dissolved in the blood are adsorbed onto solid substances with a rich surface area to remove inflammatory substances and toxins from the blood.
For this student named Chen Li, all it takes is to filter out the remaining acetaminophen in the liver and blood.
Artificial liver technology is specifically designed to detoxify the blood.
It uses "blood transfusion" to remove toxins from the patient's plasma, that is, replacing the patient's toxin-containing plasma with healthy plasma. Each time, about 50% of the plasma in the body is replaced.
But this is a measure to remedy the situation before the remaining acetaminophen in the plasma continues to damage the liver.
However, artificial liver blood purification technology cannot treat the damaged liver.
In 1986, Professor Li Lanjuan and her team from the First Affiliated Hospital of Zhejiang University carried out research and clinical application of this technology.
Up to now, the technology has become relatively mature, and the intensivists at 912 are proficient in it, so there is no problem in applying it.
After reporting on the medical history, speeches by many directors and professors followed.
In fact, there is not much that can be said or said.
Sickness, that’s what it is.
The situation is this.
The patient got sick quickly. Although he was sent to the hospital in time and responded appropriately, his condition was not optimistic.
This can be seen clearly on the faces of the chief resident, second-line professors, and directors of the ICU.
They have a good judgment of the patient's condition and hope that the patient will get better quickly after symptomatic treatment.
It's just that during the period from taking over to treatment, they have their own judgment.
Rich clinical experience says silently that all treatment methods are available now, but the chance of making the patient recover is not high.
Not to mention the expensive treatment costs, this patient spends at least 50,000 yuan per day. Just talk about the severity of the condition...
Thinking of this, Zheng Ren had a headache.
"I suggest that you prepare with both hands and do organ transplant matching. If conservative treatment fails, you can perform liver transplantation." Professor Yang spoke, and what he said was very simple.
"Where is Doctor Zheng?" Vice President Yuan looked at Zheng Ren and asked seriously.
"I agree with Professor Yang. I haven't seen the patient yet, but based on the drug dosage calculations in the medical record, the patient has taken too much acetaminophen. I think it is not possible to improve and correct liver failure through various first aid methods. big."
"I suggest preparing for a liver transplant... if a liver source can be found."
Zheng Ren said firmly.
Liver transplantation, from Zheng Ren's point of view, only liver transplantation can save this child.