Common adverse reactions of Livazeb include rhabdomyolysis and liver dysfunction, which require effective management through symptom identification and grading. The following system explains the types of adverse reactions and corresponding treatment measures.

1. Rhabdomyolysis

(1) Typical symptoms: muscle pain/weakness, brownish urine, and significant increase in CK.

(2) Emergency treatment: Stop medication immediately and intravenously hydrate 200-300ml/h.

(3) Monitoring indicators: CK, creatinine, and urine output are measured every 6 hours.

(4) Blood purification indication: CK>10000U/L with acute kidney injury.

2. Abnormal liver function

(1) Warning symptoms: jaundice, decreased appetite, and upper right abdominal pain.

(2) Discontinuation criteria: ALT/AST>8 times ULN.

(3) Liver protection treatment: intravenous infusion of glutathione 1.2g/day.

(4) Restart condition: Reduce by 50% after liver function is restored to<3 times ULN.

3. Gastrointestinal reactions

(1) Common symptoms: nausea, vomiting, diarrhea.

(2) Preventive measures: Take medication 1 hour after meals and omeprazole 20mg/day.

(3) Symptomatic treatment: montmorillonite powder to stop diarrhea, ondansetron to stop vomiting.

(4) Dehydration risk: Maintain daily urine output>1500ml.

4. Skin adverse reactions

(1) Grading of rash: maculopapular (grade 1) to Stevens Johnson syndrome (grade 4).

(2) Treatment principle: If there is a grade 2 rash, permanent discontinuation of medication is required.

(3) Antiallergic treatment: intravenous dexamethasone 5-10mg/day.

(4) Skin care: Use non irritating moisturizers.

5. Abnormal blood system

(1) Monitoring focus: The risk of bleeding significantly increases when the platelet count is less than 50 × 10 ⁹/L.

(2) Intervention threshold: Platelets<30 × 10 ⁹/L require platelet transfusion.

(3) Combination therapy: Avoid using anticoagulant/antiplatelet drugs in combination.

(4) Recovery cycle: Platelets usually rebound 2-4 weeks after discontinuation of medication.

6. Cardiovascular effects

(1) QT interval monitoring: baseline and ECG on the third day after medication.

(2) Danger signal: QTc>500ms or increase from baseline>60ms.

(3) Electrolyte management: Maintain blood potassium levels above 4.0mmol/L.

(4) Combination medication contraindications: Combination use of Class Ia/III antiarrhythmic drugs is prohibited.