thi cai don thuoc do thay se hoi ve tuong tac thuoc cong dung tung thuoc co nhung thuoc

nao trng nhom tac dung phu tai sao chon thuoc nay ma ko chon thuoc khac roi bo thuoc nao duoc ko roi don thuoc tri gi benh do la nhu the nao co thuoc nao khac tri benh do hay ko N 1 : VIM TRT DA DAY, NHIM HP Xem lai antibio Amoxicillin C ch : Khang sinh beta-lactam nhom A, c ch sinh tng hp peptidoglycan thanh TB vi khun Chi inh : Cac nhim khun ng h hp trn/di, tit niu, ng mt, da, c, bnh lu, trong phac iu tri H.P Phu hp Liu lng Cach dung :i vi phac b 3 chun la 1g x 2 ln/ngay /10-14 ngay; b 2 la 1g x 3 ln/ngay/14 ngay. Trong n nay s dung phac cu van vi levofloxacin, liu 500mg x 2 hi thp. Thuc khng bi anh hng bi thc n Thn trong Chng chi inh : CC : tin s di ng vi peni va cepha (phan ng trn da, nga, trn h hp) Thn trong : kim tra chc nng gan, thn. Phu n mang thai : loai B. Cho con bu : qua c sa, dung thn trong ADR : Di ng : May ay, ban o, h/c steven johnson : xut hin chm ngng thuc Tiu hoa : bun nn/nn , tiu chay, loan tap khun, dung antibio, yogurt Nguy c nhim clostridium. difficile Him : tng SGOT gan, ri loan ct mau, thn kinh (kich ng, vt va) Levofloxacin (getlox) C ch : Khang sinh quinolon th h III, c ch DNA gyrase sao chep DNA Chi inh : Phac cu van iu tri H.P Liu lng - cach dung : 500 mg bid phu hp. Dang vin nen chi bi anh hng nhe bi thc n , khng cn quan tm. Thn trong chng chi inh ADR : CC : Di ng vi cac quinolone ADR : Da nhay cam vi anh sang (ban o, phng rp, phu, tit dich tai vung tip xuc) Tn thng n gn : thng nht la gn Achile, co th tay, bp chn, vai, Phan ng di ng : truy tim mach, ha HA, shock, phan ng trn da nng, co ph quan kho th Han ch tip xuc vi anh nng. Ngng thuc nu co au c, phan ng da nng, di ng. Khac : Tn thng gan, ri loan thn kinh, nguy c vim rut kt mang gia (Tiu chy c th chy nc v i khi c mu, st, m hoc cht nhy trong phn.), ri loan ng huyt, Phu n mang thai : loai C Vao c sa, ngng cho bu Esomeprazole (Nexium) C ch : Thuc c ch bm proton (c ch khng hi phuc) Chi inh : Trao ngc da day, thc quan, loet da day ta trang, H/c Zollinger Ellison Liu lng cach dung : Phac H.p : mi ngay 1 ln 40mg phu hp. Ung trc ba n sang 30 phut 1 gi, dang bao ch vin bao tan trong rut ung nguyn vin khng c nhai Thn trong CC : CC : Qua mn vi thuc Thn trong :

Loai tr kha nng bi u ac tinh, thuc che du triu chng, chm chn oan Ngi co nhiu loet Tim IV phong chay mau loet Mang thai : loai B. Co th qua c sa me ADR : Nhc u, bun ngu, chong mt Tiu hoa : bun nn, nn, au bung, tao bon, chng bung , vim dd(him) C xng : au khp, au c Tng nguy c nhim khun : vim phi, lao, Tng nguy c bin chng tim mach : suy tim, t t, Co th lam giam Vit B12 nu s dung chung PPI lu dai vi s tach B12 khoi thc n cn mi trng acid (B sung : Magnes-B6 (B6 5mg + Magnesi lactate 470mg) C ch : Magnesium la mt cation co nhiu trong ni bao. Magnesium lam giam tinh kich thich cua neurone va s dn truyn neurone-c. Magnesium tham gia vao nhiu phan ng men. Vitamin B6 la mt coenzyme, tham gia vao nhiu qua trinh chuyn hoa Chi inh : Thiu Mg nng, kem hp thu Mg : nn ma , tiu chay, bong thiu Calci i kem , cn lo u i kem vi tng thng khi (tang d co git) khi cha co iu tri c hiu, ngn chn tac dung phu ln thn kinh cua thuc (isoniazid) Liu lng cach dung : Thiu Mg : 3 v x2/ngay, tang co git : 2 v x 2/ngay liu cho hi thp. Ung vi nhiu nc CC : Suy thn nng Clcr <30ml/phut Thn trong : thiu calci i km th phi b sung magnesi trc khi b sung calci. Mang thai : loai A ADR : Tiu chay, au bung Antibio (Dang ng kh cha vi sinh sng Lactobacillus acidophilus) C ch : Khi vao c th Lactobacillus phat trin nhanh, i lp vi cac vi khun gy bnh. Khi phuc h vi khun ng rut do dung ks Chi inh : Tiu chy do rotavirus, tiu chy do nhim khun, tiu chy do s dng khng sinh. Ngn nga cc ri lon tiu ha khc nh: to bn, trng bng, a phn sng tr em. Liu lng : Tre em 1 goi/ngay. Ngi ln 1 goi x 2 ln/ngay. Hoa vao it nc un si ngui, khng hoa tan thuc vi nc nong Tng tac : Amox va levoflox c ch hp thu B6 do pha h tap khun rut (nhe) Mg lam giam s hp thu levo Thi gian dung : Trc ba sang 30min 1 h : amox, getlox, nexium,. Sau 2 ting : antibio. MgB6. Trong ba ti : amox, getlox . 2 ting sau : antibio, Mg-B6 N 2 : VIM DA DAY Coi lai Enzystal Rabeprazole : Tng t n 1. Liu trong n cao con 1 ln/ngay thi. Lu y : Rabeprazole it chuyn hoa qua 2C19 it tng tac vi clopidogrel hn cac thuc khac AHFS : Loet ta trang ung sau ba n sang Almagate (hydrated aluminium-magnesium hydroxycarbonate, hn dich ung) C ch : Trung hoa acid dich vi c ch hoat tinh pepsin Chi inh : Giam triu chng vim loet da day : giam au, chua, kho tiu Liu lng - cach dung : Dung luc oi tac dung ngn ngui (15-30 min). Dung 1-2 gi sau khi n keo dai tac dung (3-4 gi). ung sau n va trc khi ngu . Liu cho hi thp. CC : Suy thn, bnh thn nng . Clcr <30ml/phut Thn trong : Ngi cao tui, co bnh thn, mt nc nghen ng rut

ADR : Mt phosphate do co Al, tng Mg huyt, tiu chay tao bon (Mg nhun, Al tao bon trung hoa cho nhau). Phan ng rebound (Nabica manh hn). Lam nng thm bnh thn. Mosapride C ch : 5HT4-agonist chon loc. Thuc y nhu ng da day rut Chi inh : Trao ngc da day thc quan. Hi chng rut kich thich (trng bung, nong, nn) i kem vi vim da day man tinh Liu lng cach dung : 5mg x 3 ln/ngay trc n 30 phut phu hp CC : Qua mn vi thanh phn thuc, chay mau tiu hoa, tt rut c hoc, QT keo dai. Thn trong : tre em, ngi gia, co thai (B) , cho con bu ADR : Tiu hoa : tiu chay, au bung, tao bon, bun nn/nn Thn kinh : bun ngu, au u Tng men gan, TG, bach cu ai toan Enzystal (Pancreatin; Cao Fellis bovis (cao mt bo); Hemicellulase,v nen bao tan rut) Hn hp men tiu hoa, mui mt. Dung cho cac triu chng kho tiu . CC : Qua mn, tt mt hoan toan, vang da. Khng dung trong vim gan vang da, au bung cp nghi la rut tha Liu lng cach dung : 1-2 vin/ln x 3 ln/ngy. Ung nguyn vin Khng nhai khi ung. Ung trong hay sau ba n khac vi n ADR : au nhc ming & quanh hu mn tr nh. Qa mn; ht hi, chy nc mt, pht ban, hoc co tht, pht ban hoc co tht ph qun. Liu cao c th gy bun nn, co cng c bng hoc tiu chy. Tng tac thuc : khng co Thi gian dung : Trc n sang 30min : Rabe, mosapride. Trong : enzystal. Sau 2 gi : almagate Trc n tra 30min : mosap. Trong enzystal. Sau 2 gi : almagate Trc ba ti 30min : mosap. Trong enzystal. Sau 2 gi : almagate Trc khi ngu : rabe N 3 : Vim da day, ta trang H.P + Xem lai phac tri HP BNF Captomed 500 (Clarithromycin nen bao phim) C ch : Khang sinh macrolid ban tng hp. Gn vao tiu n vi 50S c ch tng hp protein Chi inh : (Xem lai ph). Nm trong phac b 3 tri H.P Liu lng Cach dung : Phac b 3 : clari 500 mg x 2 ln/ ngay 10-14 ngay. Khng bi anh hng bi thc n CC : Di ng , dung chung vi terfenadin c bit co bnh tim mach (c ch enzym) Thn trong : Suy gan, thn, co thai (C), cho con bu ADR : Tiu hoa : ri loan, tiu chay, vim ai trang mang gia Da : may ay, nga. Phan ng di ng qua mn, h/c steven johnson Him : mt (au bung) , bun nn/nn. Chc nng gan bt thng (tng bilirubin serum, vang da, st phat ban), tng eosinophin, ic co th hi phuc (liu cao) - Ngng thuc Amoxicillin 500 (Holdamox ) : xem n 1 Pantoprazole 40mg (vi hat) Xem n 1. Phac 3 thuc cua panto la 40 mg bid (vi rabe la 20mg bid, ome la 20mg bid, esome la 40 mg qd (AHFS) hoc 20mg bid BNF, lanso 30mg bid) ung trc n 30min 1 gi, trong n ghi sai ADR : thm tng men gan nhe Sulpiride 50mg (Dogmatil) C ch : Thuc chng loan thn khng in hinh c ch D2 dopaminergic va serotonergic. Tng trng lc di c vong thc quan, tng y thc n ra khoi da day sau ba n Chi inh : Liu cao chng loan thn cp, liu thp chng trm ut (lng cc)

Kich thich nhu ng da day thc quan, chng nn Liu lng cach dung : 50 100 mg/ngay phu hp. CC : Nghi ng u tuy thng thn (tai bin cao HA nng) Dung levodopin, ru,. Thn trong : Ngi cao tui, suy thn, Parkinson, ng kinh (giam ngng gy ng kinh) Han ch dung trong thai ky (b cui thai ky ) cha phn loai ADR: Tng tit prolactin tng tit sa, giam libido, vu to nam. Ha HA t th, tim chm, triu chng ngoai thap, ri loan vn ng, bun ngu Domperidone C ch : i khang D2 dopaminergic, khng co tac ng TKTW, kich thich nhu ng, tng vn ng dd thc quan Chi inh : iu tri cam giac bun nn/nn , cam giac chng nng thng vi, kho tiu sau ba n Liu lng cach dung : Liu 10 20mg 3-4 ln/ngay, liu trong n hi thp, trc ba n 15 30 phut CC : Nn sau khi m, chay mau tiu hoa, tt rut c hoc, tre di 1 tui, dung dai ngay. Thn trong : Ngi parkinson (dung khng qua 12 tun khi pp khac kg co tac dung), ngi suy thn. ng IV (ha K, loan nhip) ADR : Him : chay sa, ri loan kinh nguyt , vu to (tng prolactin). Ri loan ngoai thap, bun ngu rt it ngng thuc Varogel (Al(OH)3, Mg(OH)3, simethicol, hn dich ung) Xem n 2 Simeticone la mt cht chng bot, iu tri cac triu chng y hi, chng bung, cn au bung tre em, hi chng rut kich thich nhng cha co bng chng ro rang. Khng co c nhng xp C cho phu n co thai Liu : 2-4 ln / ngay : phu hp. Dung 1-2 gi sau khi n (trong n ghi sai) Tng tac thuc : Nguy him , thay th : clari + dompe tng khoang QT, xon inh Quan trong, theo doi : Clari c ch enzym lam tng nng dompe Varogel, panto tng pH giam hp thu sulpiride Sulpiride va dompe co cung c ch tng c tinh ri loan ngoai thap, thn kinh, Khng quan trong : clari va amox co s i khang v dc lc Dung thuc : nghi bo dompe Trc ba sang 30min : 2 ks, panto, dompe, dogma. Sau n 2 gi varogel Trc ba ti 30min : 2ks , dompe, dogma Trc khi ngu : panto, varogel N 4 : HI CHNG RUT KICH THICH, BNH GAN Coi legalon la thuc hay TPCN, antibio Hi chng rut kich thich : dc lc hoc / 675 Trimebutine (mabin 100 mg) C ch : Thuc i khang TT muscarinic va chu vn yu trn muy-opioid chon loc trn c trn, c vong. Chng co tht da day, rut, phuc hi hoat ng sinh ly. Kch hot s vn ng sinh l ca d dy, rut trong trng hp lit rut Chi inh : au do co tht, trng hp lit rut Liu lng cach dung : ngi ln 100mg tid, ti a 200mg tid . Ung trc ba n CC : Qua mn vi thuc Thn trong : Phu n co thai 3 thang u. Ngi cao tui, ngi suy thn ADR : Him phan ng trn da nh nga, ni m ay ngng thuc Antibio (n 1), Dogmatil (n 3) Silymarin (Legalon 70mg cy cuc gai silybum marianum)

C ch : bo v t bo gan v chc nng ca cc cu trc xung quanh v bn trong t bo gan, gip gan hot ng hiu qu hn v tng hiu qu thi c ca gan. Chi inh : iu tr cc ri lon chc nng tiu ha trong cc bnh v gan. Liu lng cach dung : Mi ln 2 vin , 2-3 ln/ngay liu hi thp. ADR : Him khi au da day, tiu chay, di ng. Tng tac thuc : ?? Thi gian dung : Trc n sang 30 min : mabin, dogmatil, antibio. Trong ba n : legalon Bui chiu : mabin, antibio Trc ba ti 30 phut : mabin, dogmatil, antibio. Trong ba n : legalon N 5 : VIM KHP DANG THP Furosemid C ch : c ch Na+ - K+- 2Cl- oan day nhanh ln cua quai Henle. Tng thai Ca2+, Mg2+ Chi inh : Cac triu chng phu phi cp, phu do tim, gan, thn, tng HA co tn thng thn. Tng Ca huyt. Liu lng cach dung : y la iu tri phu. Bt u liu 40mg/ngay. Nu nhe co th 20mg/ngay hay 40mg/ngay cach nht. y la thuc co trn cao nn co th tng liu/s ln dung tng tac dung. Trng hp cp cu co th IM-IV chm (phu phi cp) CC : Mn cam vi sulfonamid. Tin hn m gan, hn m gan. V niu, suy thn. Thn trong : Ngi phi ai tuyn tin lit vi ai kho , thuc y bi tiu tin cp Mang thai : C (qua nhau thai co thai ri loan nc in giai thai nhi. Chi dung 3 thang cui khi kg co thuc thay th, liu thp thi gian ngn) Co th c ch tit sa khi cho con bu. ADR : Ha HA th ng (giam th tich mau liu cao) Giam Na, K, Ca, Mg huyt, nhim kim do giam Cl. Tng a.uric, glucose huyt, lipid huyt Ri loan tiu hoa Him : Giam b/c, mt b/c hat. Phan ng trn da (ni mn) Methyl prednisolon 16mg (xem lai bai corticoid) Vim khp dng thp: Liu bt u l 4 n 6 mg methylprednisolon mi ngy. Trong t cp tnh, dng liu cao hn: 16 n 32 mg/ngy, sau gim dn nhanh. Mt khc c th iu tr ngi c triu chng ch yu ca bnh mt hoc vi khp bng cch tim trong khp methylprednisolon acetat 10 n 80 mg, ty theo kch thc ca khp. Magnesi al hydroxyd (n 3) Panto (n 3) Glucosamin sulfat 250 mg C ch : La nguyn liu tng hp proteoglycan kich thich tng hp muco-polysaccharide, thanh phn c ban tao nn u sun khp. c ch cac enzym nh collagenase, phospholipase A2, giam cac gc t do superoxide. Tng sinh san cht nhy dich khp bi trn. Ngn qua trinh thoai hoa khp tin trin. Kich thich sinh san m lin kt cua xng, giam qua trinh mt Ca Chi inh : Thoai hoa xng khp, vim khp cp ,man. Loang xng, gay xng teo khp. Liu lng cach dung : Nhe ,tb : 500mg qd 4-12 tun , nhc lai 2-3 ln/nm. Nng : 500mg tid 2 tun u duy tri 500mg bid 6 tun tip theo. Duy tri : 500mg bid 3-4 thang liu phu hp CC : qua mn Thn trong : Thai ky, d inh co thai. Tre <12 tui. Theo doi ng huyt vi b/n ai thao ng ADR : Liu cao gy y bung, tiu chay, bun nn Dopropy 1200 (Piracetam, vin bao phim) C ch : Thuc anh hng n thn kinh va mach mau nao, anh hng n kha nng nhn thc ma khng phai thuc an thn hay kich thich. Thuc tng hoat ng cua knh AMPA tac ng ln cac knh ion. (Thuc hng tri) Chi inh : iu tr triu chng chng mt. ngi cao tui: Suy gim tr nh, chng mt, km tp trung, hoc thiu tnh to, thay i kh sc, ri lon hnh vi, km ch n bn thn, sa st tr tu do nhi mu no nhiu .

t qu thiu mu cc b cp iu tr nghin ru. iu tr bnh thiu mu hng cu lim tr em iu tr h tr chng kh c. Dng b tr trong iu tr git rung c c ngun gc v no. Liu lng cach dung : iu tr di ngy cc hi chng tm thn thc th ngi cao tui: 1,2 2,4 g mt ngy, ty theo tng trng hp. Liu c th cao ti 4,8 g/ngy trong nhng tun u. phu hp n CC : Chay mau nao, bnh Huntington, suy gan, suy thn, co thai va cho con bu ADR : Tng cn, cng thng, kich thich, bun ngu, trm cam, suy nhc, nhc u, lo u, lu ln, chong mt, mt ngu au bung,tiu chay bun nn, nn, , phat ban Tng tac thuc : furo va methylp : ha K huyt yu c, mt moi Furo va magnesi : ri loan nc, in giai co th dn n loan nhip, ng kinh Methyl va magnesi : ri loan nc, in giai (ha K huyt) loan nhip, yu c, ng kinh Furo va panto : Ha mg huyt (ca 2 u co tinh cht nay) loan nhip, yu c, run, ng kinh Thi gian dung thuc : Trc ba sang 30 phut : panto, furo, gluco, pira. Trong ba sang : methyl (lu y ung 7-8 gi sang). Sau khi n ti : gluco, pira Trc khi i ngu : antacid N 6 : THOAI HOA KHP GI/ SUY TINH MACH CHN Meloxicam : NSAID nhom oxiam, c ch chon loc COX 2 Chi inh : Vim xng khp, vim khp dang thp, vim khp tre nho, nga nguy c tim mach Liu lng cach dung : 7.5mg qd , co th tng ln 15mg qd liu trong n cao, it bi anh hng bi thc n CC : Tin s mn cam, dich ng vi melox hay vi cac NSAID. au sau phu thut bt cu ng mach vanh Thn trong : Nguy c trn tim mach (COX 2 selective) Nguy c vim loet dd-ta trang (it) Tn thng thn , hoai t nhu thn . Nguy c cao : suy gan, suy thn, suy tim, mt dich, ngi gia, dung ACEi, ARB Co thai : loai C ADR : Phan ng di ng trn da, sc phan v au bung, tiu chay,y hi, kho tiu, nn Bun ngu, au u Nhim khun ng h hp trn au c, xng Omeprazole (vin nang bao tan trong rut) Xem n 1, y liu 20mg bid cao Glucosamin sulfat (zennif) xem n 5 Liu bi thp Hapacol codein (para 500, codein phosphat 8mg, vin nen sui bot) Paracetamol Thuc giam au ha st Chi inh : Giam au trong cac chng au nhe, va Ha thn nhit ngi st (chi tri triu chng, co th che lp bnh) Liu lng cach dung : (xem lai slide c cht) 500mg-1g mi 4-6 gi, khng qua 4g/ngay ngi thng va 2g/ngay vi ngi nghin ru. CC : Qua mn, thiu men G6PD, co bnh tim, phi, thn, gan, bnh nhiu ln thiu mau Thn trong : Him co phan ng qua mn trn da, trn h hp. Giam bach cu, tiu cu. Cac ch phm para co aspartam (ngi phenyl-ceton niu), co sulfit (phan ng dich ng)

Ngi thiu mau t trc, che du triu chng met-hem Tranh, han ch ung ru Mang thai : loai B ADR : Ban da, nn, bun nn, loan tao mau, thiu mau, c tinh trn thn khi dung dai ngay Him : phan ng qua mn Xem lai c tinh trn gan do qua liu Codein Thuc giam au opioid. Chi inh : Giam au gy ngu, tri ho. Liu lng cach dung : liu dao ng 15-60 mg, ti a 240mg/ngay. CC : Mn cam, tre di 1 tui, bnh gan, suy h hp Thn trong : Bnh ng h hp (hen, khi ph thung). Bnh gan, thn, tin s nghin. Khng dung giam ho trong mung mu phi cn khac m Mang thai : C (Me dung, con co hi chng thiu thuc luc sinh ra). Qua sa , thn trong suy h hp cho tre. ADR : Thn kinh : au u, chong mt, khat, cam giac la Tiu hoa: bun nn, nn, tao bon Tit niu : bi tiu , tiu it Tim mach : mach nhanh, chm, hi hp, yu mt, ha HA th ng It gp : Phn ng d ng: Nga, my ay. Thn kinh: Suy h hp, an du, sng khoi, bn chn. Tiu ha: au d dy, co tht ng mt. Nghin thuc : thi gian dai, co hi chng thiu thuc Diacerein 50mg (Sinbre) C ch : Vao gan chuyn hoa thanh rhein , c ch interleukin 1, duy tri c tac ng sau khi ngng thuc Chi inh : iu tr ng ung di hn c hiu i vi cc bnh thoi ha khp (vim xng khp v cc bnh c lin quan). Liu lng cach dung : 50 mg bid, tuy nhin do lam tng nhanh y thc n khoi rut, 2 tun u nn bt u bng 50mg qd vao ba ti phu hp CC : tin s qu mn cm vi cc dn xut ca anthraquinone Ri loan ng rut, ai trang d bi kich thich Thn trong : Suy thn, tre di 15 tui Khng dung cho phu n co thai cho con bu ADR : Nc tiu sm mau (o mau) Kich thich nhu ng rut (nhun trang ) Daflon (diosmin 450mg + hesperidin 50mg. Diosmin ban tng hp t hesperidin co citrus) C ch : keo dai tac dung co mach cua norepinephrine trn thanh tinh mach giam gian tinh mach, tr Chi inh : Tr tinh mach trong ri lon tun hon tnh mch (chn sng au, bt rt) v iu tr cc triu chng ca cn tr cp. Liu lng, cach dung : suy tinh mach : ung 2 vin /ngay trong ba n phu hp CC : Qu mn vi thnh phn thuc hoc cc sulfamid. - Tin s ph Quincke. - Suy tim mt b cha iu tr. - Suy thn nng, suy gan nng. - Gim kali mu. - Ph n c thai & cho con b. Thn trong : Suy gan, ri lon in gii, thng phong, suy tim, suy thn, hp ng mch thn, ngi cao tui, ngi li xe & vn hnh my. Mang thai : thn trong, cha co thng tin.

ADR : ri lon d dy thng thng v ri lon thn kinh thc vt (cm gic bt an), khng cn ngng iu tr. Tng tac thuc ome tng nng melox qua c ch 2C9/10, (nhe) Thi gian dung Trc ba sang 30 phut : tt ca. Trong ba ti : tt ca tr ome Trc khi i ngu : ome N 7 : VIM MUI DI NG Xem lai t th nho, thymomodulin (ban tng h) Xem lai th t nho - xit Desler (Desloratadin, vin nen) Thuc khang histamine H1 th h 2 Chi inh : Vim mui di ng . May ay. Liu lng cach dung : 5mg qd phu hp CC : qua mn cam Thn trong : San phm cha aspartam (phenyl-cetone niu) Mang thai : C Ngng 48 gi trc khi lam xet nghim da. ADR : Ngi ln > 12 t, tri vim mui di ng : kh ming, vim hong, bun nn, au u, mt moi (him) , Thymomodulin(immugrong) C ch : Ban cht la cac protein , chit xut tinh ch t tuyn c cua b . Thuc lam tng s lng bach cu, c bit la lympho T, kich thich tuy xng thanh lp khang th, thuc y thanh lp phc hp min dich Chi inh : H tr d phng ti pht nhim khun h hp Vim mui di ng, h tr d phng ti pht d ng thc n H tr ci thin cc triu chng lm sng bnh nhn HIV/AIDS, h tr tng cng h min dch suy gim ngi cao tui Liu lng cach dung : i vi vim mui di ng liu dung 120mg/ngay trong thi gian 4 thang (hng dn cua cuc quan ly Dc), liu dung trong n hi cao. Dung ngay sau khi n CC : qua mn ADR : Ri lon tiu ha, au bng, i ngoi (it) Marimer (dd nc mui sinh ly, nho mui) Nho mui , mt, co th ra cac vt xc Cach nho mui : Sau khi ra sch tay, nh nhng dng khn vi sch lau sch mi v nh tng git thuc theo liu lng yu cu vo tng l mi. T th tt nht l nm nga trn ging vi u nga ra ngoi cnh ging hoc c th nm sp, u ngoi cnh ging v hng xung nn. Cn gi t th ny khong t 2-3 pht sau khi nh thuc vo mi. iu ny gip thuc nh khng b chy ra ngoi hoc chy ngc vo cung hng m thuc s c lu li trong khoang mi. Sau , qu gi v ta nh u xung nn ging thm khong 2 pht. Khng nn a git thuc vo mi t th ngi hoc ng v nhng t th ny khin cho b mt bn trong khoang mi s khng c cc git thuc ph sng. Hn na, nh thuc t th ng cn c th khin cc git thuc khng c gi khoang mi m s thot ly vo b my tiu ha. Manison (Methylprednisolone 4mg) Hoc ky trong slide AHFS : cho mt s trng hp di ng (vim da tip xuc, c thng xun) 24 mg = 6v 1st day. Sau o duy tri 4mg qd cho u 21 vin.

Trng hp vim mui di ng chi dung corticoid hit (fluticason, budesonid) trong n khng phu hp. Dung 2 ln sang chiu cung kg phu hp Cac ch liu cua corticoid trong lm sang : (Hiu lc khang vim cua methylpred : pred =5:4) * Liu cao, dng nhiu ln/ngy thng dng khi c cc biu hin vim mc nng nh: vim mch h thng, vim khp mc nng, t bt pht luput ban h thng... * Liu cao dng mt ln vo bui sng: cch ny hay p dng cho bnh nhn nng, phi dng thuc ko di, da vo nhp sinh l ngy m ca nng cortico-steroid trong huyt tng. Cch ny gip t hiu qu iu tr v trnh c ch trc i th-tuyn yn- tuyn thng thn. * Dng liu nh t ngn < 10 mg/ngy, prednisolon mc sinh l thng dng trong iu tr kim sot triu chng vim khp bnh nhn vim khp dng thp. * Liu trung bnh-cch ngy: liu dng c th dng mt ln vo bui sng, cch dng ny thng p dng khi gim liu corticoid hoc chun b ngng thuc, khi bnh mn tnh cn c kim sot cc triu chng v tr em. Tng liu thuc a vo c th gim nhng vn c kh nng t c hiu qu iu tr, t tc dng ph. * Liu cao t ngn (pulse-therapy). Thng dng methylprednisolon 500-1000mg truyn tnh mch mi ngy, t iu tr 3 ngy lin tip, hay 3 ngy ngt qung cch ngy dng mt ln. Phng php ny p dng cho cc trng hp c hi chng thn h do luput ban h thng, vim mch h thng do vim khp dng thp, cc th lm sng nng khc. Phng php ny c tc dng ln chc nng ca cc t bo lympho T, B v cc t bo khc, tc dng iu tr c th duy tr nhiu tun hoc nhiu thng. Ky thut thuc hit Dng ht tnh liu theo nht xt (nh corticoid ht). Khng a u ng xt vo su trong mi m ch t u ng xt ngay u mi xt thuc (dng git, hay phun sng) vo ng nim mc mi. Dng dung dch nh git, tnh liu theo git (nh cc dung dch nh mi). Dng hai ngn tay kp nh, cho thuc chy ra theo git, ch khng dng c tay hay nhiu ngn bp mnh lm thuc chy thnh dng, khng m c, s dn n qu liu. Cn gip tr dng, v tr di 12 tui kh thc hin ng k thut ni trn d rt n gin. Dng khng ng k thut s khng m bo c liu dng hoc qu liu, kh t hiu qu, d b ng c. Revclav 625 (amox 500 + clavuclanate 125) Amox xem n 1 Amox : Liu thng dng l 250 mg - 500 mg, cch 8 gi mt ln. liu trong n kg hp ly (vi ks nay tac dung phu thuc thi gian) Phi hp vi acid clavulanic m rng ph khang khun ra cac vk tit beta-lactamase CC : Tin s dung amox-clavu gy vang da mt, ri loan chc nng gan Use of extended-release tablets containing 1 g of amoxicillin in those with Clcr <30 mL/minute or in hemodialysis patients Lu y dang mui K cua clavu co th tng K huyt. Tng tac thuc Khng co Thi gian dung : Trong ba sang : des, immur, methyl (2 vin), amox (7-8 gi) Trong ba ti, immur, revclav Merimer : nho mui ngay 2 3 ln. DN 8 : AU U CNG C Coi lai au u cng c Xem liu Gabapentin Liu Tolperison Panadol xem n 6 Gabapentin 300mg (Neurontin) C ch : Tng cng tac ng cua h Gabanergic (gn vao tiu n vi 2 cua knh Ca, c ch phong thich cht dn truyn thn kinh)

Chi inh : Cn ng kinh au thn kinh Ri loan vn mach (cn bc hoa phu n man kinh,) Liu lng cach dung : cn au thn kinh : 300mg once daily on day 1, then 300mg twice daily on day 2, then 300mg 3 times daily on day 3 or initially 300mg 3 times daily on day 1, then increased according to response in steps of 300mg (in 3 divided doses) every 23 days up to max. 3.6 g daily Liu trong n thp CC : Qua mn vi thuc Thn trong: Kich ng, hiu chin tre em 3-12 tui tri ng kinh Ngng thuc bt cht gy tng tn s cn ng kinh Tng tinh trang t t trong ng kinh Mang thai : C. Phn b vao sa , chi dung khi tht s cn ADR : Ngi ln tri au dy thn kinh : ngu ga, bun ngu, phu iu tri ng kinh : nhim virus, bun nn/nn, kich ng, mt iu hoa vn ng, rung git nhan cu, bun ngu, mt moi Swellmind (thc phm chc nng) Ginkgo Biloa Extract: 80mg (Tng tac tng chay mau vi NSAID) Vitamin B1: 1,5mg Vitamin B3: 20mg Vinpocetine: 5mg Cholin Bitartrate: 50mg Quercetin: 50mg H tr Suy tun hon no - suy gim tr nh. Tai bin v sau tai bin mch mu no Ri lon thn kinh th gic v tun hon thn kinh. Ginkgo biloba c dng iu tr giai on sm ca bnh Alzheimer, sa st tri thc, khp khnh ngoi bin do mch, tai do mch gy nn Vinpocetin : ban tng hp t vincamine (alkaloid cua cy da can chu u vinca minor). Co tac dung gian mach, tng cng tri nh, khang vim C ch : c ch chon loc knh Na, c ch PDE 1. Quercetin : flavonoid co nhiu trong ru vang , bi, to, tr en chng xy ha, chng vim, h tr iu tri ung th Choline : L mt dng cht thit yu trong sinh tng hp acetylcholine mt cht dn truyn thn kinh , la thnh phn chnh yu trong mng t bo. Magne B6 : n 1 Tolperisone (Mydocalm) C ch : c ch knh Na trung tm c ch s dn truyn thn kinh gy gian c (c vn va c trn mach mau) c ch knh Ca c ch phong thich cac cht trung gian hoa hoc Liu : 150-400 mg chia lam 3 ln Chi inh : Tng trng lc c, co tht c. Co tht kem theo cac bnh vn ng (thoai hoa t sng, thoai hoa khp) iu tri bnh nghen mach (x va ng mach, nghen mach mau trong tiu ng, Raynaur, ) CC : Mn cam, nhc c nng. 3 thang u thai ky, cho con bu ADR : Nhc c, nhc u, h huyt p, bun nn, nn, au bng Him khi di ng (nga, hng ban, m ay, ph thn kinh mch, sc phn v, kh th) Tng tac thuc : gaba giam nng para (tng chuyn hoa, nhe) Ginkgo co cha ginkgotoxin la cht c thn kinh gy kich thich cn ng kinh i khang tac dung cua gabapentin Thi gian dung : Tt ca ung 2 ln trong ba sang va ba ti, mi ln 1 vin.

N 9 : VIM MUI HONG, RI LOAN TIU HOA (TRE EM) Cefpodoxim (ofiss) La cefa th h th III Chi inh : xem lai ph . Cac bnh nhe trung binh ng h hp di, trn. Vim tai gia. Nhim khun tit niu nhe va va. Mt liu duy nht iu tri lu cu. Nhim khun da. Liu lng cach dung : Vim hong, vim amidan nhe 2 thang -12 tui : 5mg/kg mi 12 gi 5-10 ngay (ti a 100mg) Liu hp ly. Ung trong ba n Chng chi inh : Di ng vi cepha, ri loan chuyn hoa porphyrin Thn trong : Tin s di ng vi cepha, peni Mang thai : B. i vao sa ngng cho bu. Giam hp thu khi dung chung antacid ADR : Tiu ha: Bun nn, nn, a chy, au bng. Chung: au u. Phn ng d ng: Pht ban, ni my ay, nga. Him : di ng nng (phat ban, st, p/ phan v, vim thn m ke) Ri loan ct mau, anh hng n gan (vim gan, vang da mt), thn kinh (kich ng) Betamethasone Xem v corticoid 1 thang -18t : liu t 10100micrograms/kg daily in 12 divided doses, adjusted according to response. Tarabutine (trimebutine 100) xem n 4 Tr em trn 5 tui: Ung mi ln na vin (50mg), ngy 3 ln. Tr em di 5 tui v tr s sinh: Theo ch dn ca thy thuc. Cetirizine 10mg (zilertal) Thuc khang histamine H1 th h th 2 Chi inh : Vim mui di ng dai dng, vim mui di ng theo mua May ay , di ng da Liu lng cach dung : Seasonal Self-medication in children 2 to <6 years of age: 2.5 mg once daily (as oral solution); may increase dosage to a maximum of 5 mg daily, given either as a 5-mg dose once daily or, alternatively, as a 2.5-mg dose every 12 hours Perennial 2-5 years of age : the same with the info above. liu trong n cao. Thuc khng bi anh hng bi thc n CC : Tin s di ng cetirizine, hydroxyzine Thn trong : Suy thn, thm phn chay thn nhn tao, suy gan (iu chinh liu) Tranh vn hanh may moc (ngu ga). Tranh dung ru va thuc c ch TKTW Mang thai B. ADR : Ngu ga (hay gp) mt mi, kh ming, vim hng, chng mt, nhc u, bun nn. Chn n hoc tng thm n, b tiu, bng, tng tit nc bt. Him : ri loan gan, thn , mau, shock Domperidone (Flamilium) : xem n 3 Child 1 month12 years 200400micrograms/kg (max. 20mg) 34 times daily before food Cn tng s ln dung thuc. Paracetamol 500 xem n 6 Chu y Khng c dng paracetamol t iu tr gim au qu 10 ngy ngi ln hoc qu 5 ngy tr em, tr khi do thy thuc hng dn, v au nhiu v ko di nh vy c th l du hiu ca mt tnh trng bnh l cn thy thuc chn on v iu tr c gim st. Khng dng paracetamol cho ngi ln v tr em t iu tr st cao (trn 39,5OC), st ko di trn 3 ngy, hoc st ti pht, tr khi do thy thuc hng dn, v st nh vy c th l du hiu ca mt bnh

nng cn c thy thuc chn on nhanh chng. gim thiu nguy c qu liu, khng nn cho tr em qu 5 liu paracetamol gim au hoc h st trong vng 24 gi, tr khi do thy thuc hng dn. Tr em 2 - 3 tui, 160 mg. 4 6 gi /ln BNFC Child 16 years 120250mg every 46 hours (max. 4 doses in 24 hours) Liu hp ly Ibuprofen 200 NSAID khng chon loc , nhom d/c aryl propionic acid Chi inh : Chng au v vim t nh n va (au bung kinh, vim khp dang thp,) Phi hp giam au vi opioid Vim mang ngoai tim Ha st PDA tre sinh non Liu lng cach dung : BNFC: Child 14 years 100mg 3 times daily; max.30mg/kg daily in 34 divided doses Liu trong n hi thp CC : Lot d dy t trng tin trin. Qu mn vi aspirin hay vi cc thuc chng vim khng steroid khc Ngi bnh b hen hay b co tht ph qun, ri lon chy mu, bnh tim mch, tin s lot d dy t trng, suy gan hoc suy thn (lu lng lc cu thn di 30 ml/pht). Ngi bnh ang c iu tr bng thuc chng ng coumarin. Ngi bnh b suy tim sung huyt, b gim khi lng tun hon do thuc li niu hoc b suy thn (tng nguy c ri lon chc nng thn). Ngi bnh b bnh to keo (c nguy c b vim mng no v khun. Cn ch l tt c cc ngi bnh b vim mng no v khun u c tin s mc mt bnh t min). 3 thng cui ca thai k. Thn trong : Ngi cao tui. Tng transaminase, ri loan thi giac. Tng thi gian chay mau Co thai : c ch co bop t cung lam chm e., tranh 3 thang cui : B ADR : Phn ng d ng (c bit co tht ph qun ngi bnh b hen), vim mi, ni my ay. H/c steven johnson, phu,ban o (him) Tiu ha: au bng, chy mu d dy - rut, lm lot d dy tin trin. Mu: Thi gian mu chy ko di. Ri loan thn kinh, giac quan Anh hng chc nng gan, thn Tng tac thuc : Ibu va beta tng nguy c vim loet dd-ta trang (quan trong) Cefo canh tranh thai tr vi ibu (anion) lam tng nng (nhe) Dexa cam ng cyp 3A4 lam giam nng dompe (nhe) Para va ibu cung chi inh ha st kg cn thit Dexa cam ng cyp 3A4 c gan Thi gian dung Trc ba sang 30min : trimebu, dompe. Trong ba sang : cef , beta, ceti Chiu (3-4 gi) : beta Trc ba ti 30min : trime, dompe, cef, ceti Para va ibu ung luc st > 37,8oC (dung para theo hng dn trn) N 10 : TNG HA, RI LOAN LIPID, THIU MAU C TIM (CAO TUI) Nifedipin 30 (Adalat LA, vin nang mm) C ch : Thuc chen knh Ca nhom DHP gian mach (m vanh, tiu m ) Chi inh : D phng au tht ngc, c bit khi c yu t co mch nh trong au tht ngc kiu Prinzmetal. Tng huyt p.

Hi chng Raynaud. Liu lng cach dung : Tng HA : Dang phong thich chm, keo dai 10-40mg bid hoc 30-90mg qd, hoc 20-100mg qd tuy ch phm a dung D phong au tht ngc : tng t Manufacturer recommends that Adalat CC be administered on an empty stomach Dosage of extended-release nifedipine tablets should be decreased gradually with close clinical supervision when discontinuance of the drug is required Dang vin nang tac dung nhanh dung cho h/c Raynaud CC : Sc do tim. Hp ng mch ch nng. Nhi mu c tim trong vng 1 thng. Cn au cp trong au tht ngc. Ri lon chuyn ha porphyrin. Thn trong : Ngng thuc khi co cn au do thiu mau tim cuc b (bnh nhn ang co) Lam nng cn suy tim Giam liu trong tn thng gan, ai thao ng Tng tac nc bi chum c ch chuyn da e : C, ngng cho bu ADR : Tim nhanh, trng ngc, ha HA nng nng thm cn au tht ngc Phu mt ca, au u, mt moi, trng ngc Ri loan tiu hoa Da : phat ban, may ay, nga Allopurinol 300 C ch : c ch xanthin oxidase giam thanh lp acid uric Chi inh : Gout, tng a.uric huyt trong hoa tri liu, soi thn Tng a.uric trong ngi thiu G6PD, ang iu tri vi thiazid , ethambutol, Liu cach dung Initially, 100 mg daily, Usual dosage is 200-300 mg daily in patients with mild gout and 400-600 mg daily in those with moderately severe tophaceous gout. preferably after meals appropriate dose Ung vi nhiu nc tranh nguy c soi xanthin CC : Qua mn Thn trong : Tn thng gan (tng men gan) Gy bun ngu, thn trong iu khin may moc Phan ng di ng nng : phat ban Allopurinol khng dung trong gout cp Mang thai : C; thn trong cho con bu ADR : nga, sn, phat ban Atorvastatin 10mg C ch : c ch HMG-CoA reductase ngn thanh lp cholesterol Chi inh : Ha cholesterol toan phn, ha LDL ngi tng lipid huyt Ngn nga cac bin chng tim mach Liu lng cach dung : Patients should be placed on a standard lipid-lowering diet before initiation of atorvastatin therapy and should remain on this diet during treatment with the drug Initially, atorvastatin 10 or 20 mg once daily; patients who require a large reduction in LDLcholesterol concentration (>45%) may receive 40 mg once daily At any time of day without regard to meals CC : Bnh gan, tng transaminase huyt tng Co thai va cho con bu Qua mn Thn trong - ADR Co thai (giam tng hp cholesterol thai nhi) : X c gan, tng transaminase huyt. Tng creatin kinase tiu c vn, suy thn. Biu hin yu c, au c Trimetazidine MR 35mg C ch : c ch 3-KAT (3-ketoacyl thiolase) giam s beta oxy hoa cht beo giam nhu cu oxy (ly nng lng t glyco giai it dung oxy hn). n inh mang t bao

Chi inh : Hin nay, iu tr cn au tht ngc, tuy nhin ch nh liu php b sung iu tr triu chng cho bnh nhn khng p ng y hoc khng dung np vi liu php u tay iu tr au tht ngc. Liu dung : Thng 1v bid phu hp. Ung vao ba n Khng c bu liu khi qun CC : Phu n co thai, cho con bu au tht ngc cp, nhi mau c tim Qua mn. Parkinson, suy thn nng Thn trong ADR : Nhc u, phat ban, ri loan tiu hoa, tng men gan Cac triu chng cua parkinson (run, ri loan vn ng run khi nghi ngi, cng khp, di chuyn chm chap, t th khng vng) Aspirin 81mg La NSAID khng chon loc Chi inh : Giam au nhe, ha st, khang vim (vim khp, t sng...) khng con chi inh Chng kt tp tiu cu : d phong nhi mau c tim, t quy Hi chng Kawasaki (st cao v dai dng, mt , li , da tr ni hng ban. Nu khng c iu tr ng mch vnh b sng lm tng kh nng t vong) Liu lng cach dung : c ch kt tp tiu cu: Ung 100 - 150 mg/ngy. liu trong n hi thp (cao tui). Ung trong ba n vi nhiu nc CC : Tin s di ng vi cac NSAID khac, hen suyn bnh a chy mu, gim tiu cu, lot d dy hoc t trng ang hot ng, suy tim va v nng, suy gan, suy thn, c bit ngi c tc lc cu thn di 30 ml/pht v x gan. Thn trong : Dung chung thuc chng ng Khng kt hp NSAID, corticoid khac iu tr cho ngi b suy tim nh, bnh thn hoc bnh gan, c bit khi dng ng thi vi thuc li tiu, cn quan tm xem xt cn thn nguy c gi nc v nguy c gim chc nng thn tre em gy hi chng Reye Ngi cao tui (suy thn) Mang thai : c ch tao PG tn thng ong ng ng mach, c ch co bop t cung, chay mau khi sinh CC 3 thang cui ADR : Tiu hoa : nguy c vim loet, ri loan tiu hoa Di ng : da, sc phan v, co tht ph quan... Huyt hoc: chay mau, thiu mau tan mau Thn kinh : mt moi, mt ngu, cau gt,... Suy giam chc nng thn, c gan Omeprazol : xem n 1 Liu 20mg bid cao giam con 1 ln thi Tng tac thuc nife c ch CYP3A4 lam tng nng atorvas Nife c ch P-g tng tac dung atorvas Nife va aspi : aspi giam tac dung thuc ha HA (c ch tac ng gian mach cua cac PG,PC) Ome va astor : tng nng astor, tng tac dung phu ln c vn (c ch CYP 3A4, c ch Pg) Ome giam acid giam hp thu aspi (minor) Ome lam tng hp thu, can thip s chuyn hoa cua nife tng tac dung nife (minor) Thi gian dung : Trc ba sang 30 phut : nife, trime, ome. Sau ba sang 2 gi : allo Trong ba tra : aspi Trong ba ti trime Trc khi ngu : ome, ator N 11 : RUNG NHI, T T2, TNG HA

Coi digoxin co ung trc n 30 phut khng. Digoxin 0,25 C ch : La glycosid tr tim , c ch Na-K-ATPase tng Na ni bao c ch Na-Ca antiporter Tng Ca ni bao Tng co bop tim Chi inh : Suy tim Rung nhi , cung ng nhi (gy nhanh nhip tht, PSVT) Liu cach dung : Liu 100 microgam (0,1 mg) cu thuc tim hoc nang cha dung dch digoxin tng ng sinh hc vi liu 125 microgram (0,125 mg) ca vin nn hoc cn ngt digoxin. xac inh ung dang bao ch Usually administer orally as a single daily dose. Divided daily dosing generally recommended in infants and young children (<10 years of age). Rapid digitalisation, for atrial brillation or utter, by mouth, 0.751.5mg over 24 hours in divided doses Maintenance, for atrial brillation or utter, by mouth, according to renal function and initial loading dose; usual range 125250micrograms daily Liu thay i trn th trang bnh nhn tun thu thi gian biu Chu y hng dn liu duy tri Liu duy tr: l liu cn b sung cho lng Digoxin thi ra c th mi ngy nhm duy tr nng iu tr t c. Thng dng liu thp 0.125 mg/ngy c khong trng (ngh 1-2 ngy/tun, ngh cch ngy hoc dng 2 ln/ tun) hay khng c khong trng cn cn nhc trn nhiu yu t (tui, th trng, bnh tim nn, chc nng gan thn, dng thuc tng tc..). Liu duy tr 0.125 mg/ngy (nn m ca s 1 ngy/tun) thng c s dng trong hu ht cc bnh nhn, sau 5-7 ngy (thi im thuc thng t trng thi n nh trong mu) nn o li ECG, in gii v xem xt nh lng nng Digoxin/mu (nu c) iu chnh thuc duy tr nng /mu 0.5-0.9 ng/ml. BN c YTNC d ng c: ln tui > 70, suy thn, gy, dng thuc c tng tc (tng nng hoc tng nhy cm vi Digoxin), p ng-liu nhy vi Digoxin ( gim tn s nhanh > 30% so vi nhp ban u ch vi 1-2 liu Digoxin ban u) v liu duy tr 0.125 mg/ngy v phi m ca s 2 ngy trong tun hoc dng cch ngy hoc dng liu 0.0625 mg/ngy. Nu BN cng kt hp nhiu YTNC d ng c c th dng 0.0625 mg/cch ngy. BN c cc YTNC d ng c, thng phi theo di st hn, sau 3-4 ngy iu tr nn o li ECG, in gii v xem xt nh lng nng Digoxin/mu (nu c) iu chnh thuc duy tr nng /mu 0.5-0.9 ng/ml. Xac inh liu da vao th trong ly tng o lng nng Digoxin (thng phi ly mu mu t nht sau 8 gi ca liu Digoxin trc trnh pha phn phi thuc) nn lm trong cc trng hp:

Lm sng nghi ng c ng c BN c nhng iu kin lm thay i nng thuc Trong giai on sm (3-4 ngy BN c YTNC d ng c, 5-7 ngy a s BN ) ca liu trnh iu tr ban u ( duy tr nng /mu: 0.5-0.9 ng/ml)

CC : Blc tim hon ton tng cn, blc nh - tht hai; hi chng Wolff - Parkinson - White; bnh c tim ph i tc nghn Thn trong : Ngi co nhip tim chm nhiu, nhi mau c tim cp Ngi suy thn, thiu nng giap iu chinh liu Ha K, Tng Ca tng nhay cam cua thuc

Mang thai : C ADR : Tiu hoa : Chan n, bun nn, nn, ri loan tiu hoa Loan nhip tim Thn kinh : nhc u, mt moi, ngu lim Ri loan thi giac Tng K huyt vi ng c cp giai c vi antidot la digibind (Fab) Isosorbid mononitrat 30 (Imdur, nen tac dung keo dai) C ch : Thuc gian mach . phong thich NO hoat hoa guanylat cyclase tao GMP dephosphoryl hoa myosin LC gian mach Chi inh : Phong, iu tri au tht ngc Suy tim sung huyt Liu cach dung : Phong nga au tht ngc : Ung: 10 - 20 mg/ln, 3 - 4 ln mi ngy, c th dng dng gii phng chm 20 - 40 - 60 mg gim s ln ung. liu phu hp. Ung vi nhiu nc khi thc dy vao bui sang, khng c nhai (AHFS) CC : Huyt p thp, try tim mch. Thiu mu nng. Tng p lc ni s, glaucom. Nhi mu c tim tht phi. Hp van ng mch ch, bnh c tim tc nghn. Thn trong : Tng liu t t, dung liu cao khng giam t ngt ha HA t th Mang thai : C ADR : Gin mch ngoi vi da bng , trong mt d gy tng tit dch v lm tng nhn p, trong no c th gy tng p lc ni s v lm au u. Ha HA t th (ngi gia) Khng dung cp tinh, thn trong ngi lai xe Cac thuc ha HA nng , ung xong nn ngi nghi, hay nm. Khng ng i. Tanatril 5mg (Imidapril HCl) ACEi (Xem lai ACEi dc ly) Chi inh : ha HA (BNF) Initially 5mg daily before food King mui. Clopidogrel 75 (Plavix) Chuyn hoa qua 2C19, Thuc c ch kt tp tiu cu Chi inh : c ch kt tp tiu cu, phong nguy c t quy va bnh mach vanh, huyt khi ng mach do x va Liu cach dung : 75 mg once daily, without regard to meals CC : Qu mn vi thnh phn thuc. Suy gan nng. ang c chy mu bnh l. Thn trong : Reduced Efficacy Associated with Impaired CYP2C19 Function (nn dung Rabe) Ngng thuc t ngt nguy c tim mach Nguy c xut huyt do chn thng, phu thut hoc cc bnh l km theo. Bnh gan (vi no la tin dc) Mang thai B : nguy c chay mau luc sinh kg dung 3 thang cui thai ky ADR : xut huyt tiu ho, bm, t mu, chy mu mi, tiu mu, xut huyt ni s, au bng, kh tiu, vim d dy, to bn, ni mn, nga. Gliclazide MR 30mg (Diamicron) C ch : SU ha ng huyt th h 2, kich thich t bao beta t.tuy san xut insulin Chi inh : T typ 2 , u tin ngi cao tui (it ha g huyt qua mc) Liu lng cach dung : C th bt u dng vi liu: 40 - 80 mg, ri tng dn nu cn. Trong a s trng hp: Ung 160 mg/ngy, ung 1 ln vo lc n sng. liu phu hp

Trng hp iu tr cha t c th tng dn liu ln, ti a l 320 mg/ngy chia 2 ln. Ung trong ba n sng. CC : T typ 1. Hn m hay tin hn m do i tho ng. Suy gan nng, suy thn nng. C tin s d ng vi sulfonamid v cc sulfonylur khc. Nhim khun nng hoc chn thng nng, phu thut ln. Thn trong : TT thuc khang nm (c ch 2C9 tng nng SU) Khi ung phai tip tuc n king iu chinh liu : suy gan, thn, phi hp thuc tac ng ng huyt Mang thai : CC ADR : Thn kinh: au u. Tiu ha: Ri lon tiu ha, bun nn. Da: Pht ban. Ri lon ct mau (co hi phuc) Metformin 1000 (glucophage) C ch : Nhom biguanid, lam tng nhay cam insulin gan va m ngoai bin Chi inh : T typ 2 kg kim soat bng ch n king n tri hay phi hp SU Liu lng cach dung : Vin nn 500 mg: Bt u ung 500 mg/ln, ngy 2 ln (ung vo cc ba n sng v ti). Tng liu thm mt vin mi ngy, mi tun tng 1 ln, ti mc ti a l 2.500 mg/ngy. Nhng liu ti 2.000 mg/ngy c th ung lm 2 ln trong ngy. Nu cn dng liu 2.500 mg/ngy, chia lm 3 ln trong ngy (ung vo ba n), dung np thuc tt hn. Vin nn 850 mg: Bt u ung 850 mg/ngy, ung 1 ln (ung vo ba n sng). Tng liu thm 1 vin 1 ngy, cch 1 tun tng 1 ln, cho ti mc ti a l 2.550 mg/ngy. Liu duy tr thng dng l 850 mg/ln, ngy 2 ln (ung vo cc ba n sng v ti). Mt s ngi bnh c th dng 850 mg/ln, ngy 3 ln (vo cc ba n). Ngi cao tui : Liu bt u v liu duy tr cn d dt, v c th c suy gim chc nng thn. Ni chung, nhng ngi bnh cao tui khng nn iu tr ti liu ti a metformin. CC : Sole therapy in patients with type 1 diabetes and in patients with diabetes complicated by acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma Renal impairment or abnormal Scr. Renal impairment may result from conditions such as cardiovascular collapse (shock), AMI, or septicemia. Congestive heart failure requiring drug therapy (e.g., digoxin, furosemide) Known hypersensitivity to metformin hydrochloride or any ingredient in the formulations. Hoi th (cac bnh giam oxy m), nghin ru, thiu dinh dng. Suy giam chc nng gan Thn trong : Theo doi ng huyt va nguy c nhim a .lactic Duy tri ch n king Theo doi chc nng thn : tng nguy c tich luy , nhim a.lactic (ngng 2-3 ngay trc chup X-ray co Iod chc nng thn binh thng mi dung lai, lu y cac thuc thn) Ngng dung trong phu thut Mang thai : B ADR : Tiu ha: Chn n, bun nn, nn, ri loan tiu hoa. Da: Ban, my ay, cm th vi nh sng. Chuyn ha: Gim nng vitamin B12. t gp, Huyt hc: thiu mau, suy ty, gim tiu cu, mt bch cu ht. Chuyn ha: Nhim acid lactic. Tng tac thuc : digox tng nng metformin do canh tranh ao thai thn (cation) Imi tng tac dung ha ng huyt cua gli, met bng cach tng s nhay cam vi insulin ACEi lam giam phn sut loc cu thn giam thai tr digoxin qua thn tng nng

ACEi tng tac dung gian mach cua nitrat Thi gian dung : Thc dy bui sang : iso Trc ba sang 30 : imida ; trong ba sang : digox, clopi, gli, met Trong ba ti : met N 12 : CAO HA, TIU NG, RL LIPID MAU Nifedipin 20 xem n 10 Gliclazid 80 xem n 11 Trong a s trng hp: Ung 160 mg/ngy, ung 1 ln vo lc n sng. Liu nh trong n khng hp ly lm (co th la ngoai l) Metformin 500 xem n 11 Vin nn 500 mg: Bt u ung 500 mg/ln, ngy 2 ln liu nh trong n thp Atorvastatin 10 xem n 10 liu phu hp Bisoprolol 5mg (Bisocar) 1-selective adrenergic blocking agent Chi inh : tng HA, suy tim Liu lng, cach dung : Individualize dosage according to patient response and tolerance If long-term therapy is discontinued, reduce dosage gradually over a period of about 1-2 weeks BNF : Hypertension and angina, usually 10mg once daily (5mg may be adequate in some patients); max. 20mg daily absorption does not appear to be affected by food CC : Nhip xoang chm, block nhi tht > 1, shock do tim, cn suy tim cp (sung huyt phi, phu mach,) Qua mn vi cac thanh phn cua thuc Thn trong : Tranh dung cho suy tim cp Giam liu t t Thn trong dung cho ngi co tht ph quan (block beta 2) Giam triu chng ha ng huyt, cng giap Dung thn trong ha HA trong phu thut. Mang thai : C ADR : Fatigue, headache, diarrhea, peripheral edema, and upper respiratory tract infection Che lp triu chng canh bao sm ha ng huyt. Tng tac thuc : Nife c ch CYP3A4, c ch tac dung block Pg Nife va biso : reductions in heart rate, cardiac conduction, and cardiac contractility, potentially serious cardiovascular adverse effects such as congestive heart failure, severe hypotension, and/or exacerbation of angina may occur Biso che du triu chng ha ng huyt tt met va gli Nife tng hp thu metfor qua tiu hoa tng nguy c nhim a.lactic chuyn hoa Thi gian dung : Trc n sang 30 phut : Nife, biso. Trong ba sang: gli, met Trc n ti 30 : Nife, biso. Trong : gli Trc khi ngu : ator N 13 : SUY THN MAN, CAO HA , THOAI HOA A KHP, VIM DA DAY Furosemid xem n 5 Liu ok Pantoprazole xem n 1 : liu ngay 2 ln cao Domperidone xem n 3 : Liu thp, ung trc khi n Enalapril 5mg (Shinapril) : vin nen Xem ACEi Chi inh : Tng HA, suy tim, bnh thn do ai thao ng (AHFS) Sau nhi mu c tim (huyt ng hc n nh). Suy thn tun tin man (dc th)

S dng thuc trong 3 thng gia v 3 thng cui ca thai k c th gy bnh dn n cht thai v tn thng cho tr s sinh, gm: H huyt p, gim sn s s sinh, suy thn hi phc hoc khng hi phc v t vong. Phi ngng dng enalapril cng sm cng tt sau khi pht hin c thai. Thi k cho con b CC : Hp ng mch thn hai bn thn hoc hp ng mch thn ngi ch c mt thn. Hp van ng mch ch, v bnh c tim tc nghn nng. H huyt p c trc. Liu cach dung : Tng huyt p v cn: Liu khi u thng dng cho ngi ln l 2,5 - 5 mg/ngy. iu chnh liu theo p ng v huyt p ca ngi bnh. Liu duy tr thng thng t 10 - 20 mg, ung mt ln hng ngy; gii hn liu thng thng cho ngi ln: 40 mg/ngy. Liu tam n (thuc HA liu tuy thuc c ia bnh nhn) Thn trong : Ngi gim chc nng thn. i vi ngi nghi b hp ng mch thn, cn phi nh lng creatinin mu trc khi bt u iu tr. ADR : Ho, phu mach , tng K huyt, Aluminum phosphat gel Lu y ADR tao bon c bit ngi gia dung nhiu nc Nn i lai dang khng cha phosphat ly bt phosphat ngi suy thn Tng tac thuc: ena + furo : giam phn sut loc cu thn giam hiu qua thai mui cua furo, gy ha HA, tng nguy c suy giam chc nng thn, suy thn cp. (Significant) Furo + PPI tng kha nng ha Mg huyt Nhe : Alu lam giam hp thu ena do tng pH, do keo dai thi gian lam rng da day Thi gian dung : Trc ba sang 30 phut : furo + panto + dompe + ena . Sau ba sang 2 gi alu 3-4 gi chiu furo Trc ba ti 30min : dompe, ena Trc khi i ngu : panto, alu N 14 : AU CT SNG LNG (CAO TUI Suy gan thn) Hoc tn khoa hoc cac dl Xem lai ri loan ngoai thap Mephenesin 250mg oc thng tin v clorphenesin Chlorphenesin is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. Chlorphenesin is used, along with rest and physical therapy, to treat injuries and other painful muscular conditions. Use caution when driving, operating machinery, or performing other hazardous activities. Chlorphenesin may cause dizziness or drowsiness. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking chlorphenesin. It is not known whether chlorphenesin will harm an unborn baby. Do not take chlorphenesin without first talking to your doctor if you are pregnant. It is also not known whether chlorphenesin passes into breast milk. Do not take chlorphenesin without first talking to your doctor if you are breast-feeding a baby. Chlorphenesin is not approved for use in children. Take each dose with a full glass of water. ADR : Allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives). Dose mephenesin : 500mg-1000mg tid liu trong n thp

Meloxicam 7.5 xem n 6 , liu ok Trimetazidine 20mg xem n Thng ung 20mg tid, ung vao ba n, liu trong n thp Cinnarizin 25 Khang histamin H1 nhom cyclizin th h 1 Chi inh : Phng say tu xe. Ri lon tin nh nh chng mt, tai, bun nn, nn trong bnh Mnire (Bnh l biu hin ca s ri lon tai trong, gy nh hng n sc nghe v s thng bng cc mc khc nhau. c trng bi cc thi k chng mt, tai v kh nng nghe gim dn, thng l mt tai.). CC : Mn cam, porphyria (Porphyria l mt nhm gm cc ri lon khc nhau c gy ra bi s bt thng trong cc phn ng ha hc dn n vic sn xut haeme - mt cht quan trng trong c th. Lng ln nht ca haeme tn ti trong mu v ty xng, ni mang oxy. Haeme cng c tm thy trong gan v cc m khc.
Ri lon chuyn ha porphyrin cutaneous th tc ng trn da. Ngi b ri lon chuyn ha porphyrin da c nhng vt rp, nga v sng ty trn phn da tip xc vi nh nng mt tri. Ri lon chuyn ha porphyrin acute nh hng n h thn kinh. Triu chng ca ri lon ny l nhng cn au ngc, bng, chi v lng, t c, tai, lit hay chut rt, nn, to bn, thay i tnh cch hay ri lon tm thn. Nhng triu chng ny xut hin khng lin tc.)

Thn trong : Cng nh vi nhng thuc khng histamin khc, cinarizin c th gy au vng thng v. Ung thuc sau ba n c th lm gim kch ng d dy. Cinarizin c th gy ng g, c bit lc khi u iu tr. Phi trnh nhng cng vic cn s tnh to (v d: li xe). Phi trnh dng cinarizin di ngy ngi cao tui, v c th gy tng hoc xut hin nhng triu chng ngoi thp, i khi kt hp vi cm gic trm cm trong iu tr ko di. Liu lng cach dung : Liu lng: Phng say tu xe : Ngi ln: 25 mg, 2 gi trc khi i tu xe; sau 15 mg, c 8 gi mt ln trong cuc hnh trnh nu cn. Tr em 5 - 12 tui: 1/2 liu ngi ln. Ri lon tin nh: 30 mg, 3 ln mi ngy. Tr em 5 - 12 tui: 1/2 liu ngi ln. liu hi thp Dung sau ba n Domperidon 10 : xem n 6. Liu hi thp B.A.R (Cao c Actiso, Cao c bin sc (rau ng), Bt bm bm.) Bim bim (khin ngu t) Tc Dng Ty X: cht Pharbitin Tc Dng Ln Thn: Khin ngu t lm tng lc Inulin ca Thn. Tc Dng Dit Giun Cng dung : Cha b i tiu tin, ph thng, hen, giun. Bin suc Tng chuyn ho nc, iu ho tiu tin bt thng, dit k sinh trng v tr nga. Actiso Phuc hi t bao gan, tng chc nng chng c cua gan Phong nga x va ng mach, thng tiu Tng tit mt, ha cholesterol Chi inh : Dng cho nhng ngi thiu nng gan, vim gan gy mt mi, kh tiu, vng da, mn nht, l nga, b i tiu tin, to bn. Gii c, chng d ng. c bit suy gim chc nng gan do dng nhiu bia ru. X va ng mch, m trong mu cao. Liu cach dung : Ngi ln: Ngy ung 3 ln, mi ln 1 - 2 vin. Tr em: ngy ung 3 ln, mi ln 1 vin. Liu ok Tng tac thuc : khng co Thi gian ung : Trc ba sang 30 min : dompe .Trong ba sang (sau khi n) : mephe, melox, trime, cinna, BAR

Trc ba ti 30 min : dompe. Trong ba ti : mephe, trime, cinna, BAR N 15 : K PHI GIAI OAN IIIB COPD G II Glaucom Cac giai oan K phi : Giai on I. Ung th giai on ny xm chim cc m phi nm bn di nhng khng ly lan n cc hch bch huyt. Phu thut, i khi ha tr Giai on II. iu ny, giai on ung th lan n hch bch huyt ln cn hoc xm chim thnh ngc hoc cu trc ln cn khc. Phu thut, ha tr, x Giai on IIIA. giai on ny, ung th lan rng t phi n cc hch bch huyt trung tm ca ngc. Kt hp ha tr v x, i khi phu thut da trn kt qu iu tr Giai on IIIB. Ung th lan truyn ti a phng n cc khu vc nh tim, mch mu, kh qun v thc qun - tt c trong lng ngc - hoc n cc hch bch huyt trong lnh vc xng n hoc n cc m bao quanh phi trong lng ngc (mng phi). Ha tr liu, i khi bc xHa tr liu, i khi bc x Giai on IV. Ung th lan ra cc phn khc ca c th, chng hn nh, gan, xng hay no. Ha tr liu, thuc theo mc tiu iu tr, th nghim lm sng, h tr chm sc COPD la bnh ng h hp nho c trng bi tc nghen thng khi do vim ph quan man hay khi ph thung (bnh do tng proteinase hay giam proteinase lam tiu huy elastin trong phi la cu truc cua cac si an hi va cht nn ngoai bao pha huy khng hi phuc thanh cac khoang cha khi) biu hin la tinh trang ho khac am keo dai , kho th khi gng sc va tc nghen thng khi (giam FEV 1) Cac chi s c ban - Force vital capacity (FVC): Tng th tch th ra ti a trong 1 hi th. - Forced Expiratory Volume in One Second (FEV1): Th tch kh th ra gng sc trong 1 giy u tin. - FEV1/FVC. FEV1/FVC bnh thng l 0.7 0.8. Khi ch s ny < 0.7 th gi c hin tng tc nghn ng dn kh, tuy nhin ngi ln tui, ch s ny bnh thng c th mc 0.65 0.7. Bn cnh , ngi ta cn s dng mt s cc ch s khc: - FEV6: Th tch kh th ra gng sc trong 6 giy u tin. Ch s ny gn bng FVC ngi bnh thng. FEV6 c s dng thay th FVC trong nhng trng hp tc nghn ng dn kh nng, khi bnh nhn cn n 15 giy th ra hon ton, v v vy thng ngng li trc hu qu l FVC o c s thp hn FVC thc t. - Slow VC: Bnh nhn ht vo ti a nhng th ra t t, khng gng sc. Mt s guideline khuyn co s dng ch s FEV1/Slow VC nhng bnh nhn COPD mc nng. Cac giai oan COPD :

COPD giai on 0: triu chng mn tnh ca bnh COPD nh l: ho, khc m ko di, chc nng h hp hon ton bnh thng. COPD giai on 1: ngi bnh ho, khc m ko di vo bui sng nhng khng kh th, chc nng h hp FEV1 > 80% nhng FEV1/FVC < 70%. COPD giai on 2: ngi bnh c th c ho, khc m hay khng, thm d chc nng h hp cho thy tc nghn ng th mc nh: tr s FEV 1 trong khong 50 80% so vi gi tr d on ngi bnh thng. COPD giai on 3: ngi bnh c th c ho, khc m hay khng, thm d chc nng h hp cho thy tc nghn ng th mc trung bnh: tr s FEV 1 trong khong 30 50% so vi gi tr d on ngi bnh thng. COPD giai on 4: ngoi triu chng ho, khc m ko di, ngi bnh cn kh th ban u ch xut hin khi gng sc, sau ny xut hin c lc ngh ngi, thm d

chc nng h hp cho thy tc nghn ng th mc nng: tr s FEV 1 < 30 % so vi gi tr d on ngi bnh thng. Medrol 16 : xem slide, liu kg hp ly Nexium 40 liu ok, xem n 1 Kaleodrid 600 (KCl) vin phong thich keo dai Chi inh : gim kali mu, v ion clorid cng cn iu chnh gim clo mu thng xy ra cng vi gim kali mu.
x gan c chc nng thn bnh thng, mt s trng thi a chy, k c do s dng thuc nhun trng di ngy, nn ko di, hi chng Bartter (tng aldosterol th phat), bnh thn gy mt kali, nhng ngi bnh (k c tr em) iu tr corticosteroid ko di. Liu cach dung : Liu lng ph thuc vo ion - huyt thanh v cn bng kim toan. Thiu kali c tnh theo cng thc: mmol kali = kg th trng x 0,2 x 2 x (4,5 - kali huyt thanh hin ti tnh theo mmol); Trng hp chc chn h kali mu (di 3,6 mmol/l), bt u vi liu hng ngy tng ng vi 4 g KCl, tng ng vi 52 mmol kali. Liu hng ngy c chia lm 2 n 3 ln, nn ung thuc vo cui ba n. Ngi cao tui, bnh thn xem xet giam liu CC : tng kali mu, v tng thm kali c th gy ngng tim. dng vin ung chng ch nh khi thc qun b chn p, d dy chm tiu, tc rut, hp mn v, v cn tr kali clorid qua d dy - rut c th gy kch ng d dy rut nng hn, do nng kali cao ti ch. Thn trong : suy thn hoc suy thng thn, bnh tim, mt nc cp, say nng, ph hy m rng nh bng nng, hoc ngi dng thuc li tiu t thi kali. ngi lot d dy t trng, phi chng ch nh dng dng vin. Phi thn trng khi ghi n thuc c kali ung dng rn, c bit khi dng liu cao cho ngi mang thai hoc ngi bnh ng thi dng thuc khng acetylcholin, v c kh nng lm gim nhu ng d dy - rut. thiu magnesi do dng thuc li tiu s ngn cn hp thu kali rut, v vy cn phi iu chnh gim magnesi huyt iu tr gim kali mu. Kali clorid c th lm trm trng thm bnh lit chu k c tnh cht gia nh hoc cc bnh lon trng lc c bm sinh, Mang thai : C. It qua sa, dung c ADR : tng kali mu, nhp tim khng u, pht hin d dng bng in tm . Mt cm gic hoc nh kim chm bn tay, bn chn hoc mi, chi di yu hoc c cm gic nng. Kich ng tiu hoa Th nng hoc kh th. Tatanol codein xem n 6 , liu ok Berodual MDI (fenoterol 0,05;ipratropium 0,02. Bm xit inh liu, xem cach dung slide c Q) Fenoterol C ch : Thuc ch vn beta2 chn lc; tac dung nhanh Chi inh : iu tr cn hen ph qun cp. D phng cn hen do vn ng. Triu chng co tht ph qun c km vim ph qun, kh ph thng, gin ph qun hoc nhng bnh phi tc nghn khc. CC : Qu mn .Ph i c tim c tc nghn; lon nhp tim nhanh. Thn trong : tng nhn p gc ng, ngi mc bnh tim mch (v d: tng huyt p, bnh ng mch vnh, suy c tim, lon nhp tim), ngi ung digitalis hoc thuc li tiu do tc dng trc tip lm tng nhp tim hoc do gy h kali huyt). Mang thai C ADR : Run c, tnh trng kch ng, nhc u. nhp tim nhanh, nh trng ngc. tai. Gim kali huyt, nhc c, au c, co cng c kch ng ti ch, co tht ph qun nghch l (khi dng ht).

Di ng Ipratropium Thuc gin ph qun khng acetylcholin. Chi inh : iu tri hen, ch nn dng thuc ny cho nhng ngi bnh no dng cc thuc kch thch beta2 vi liu thng thng m b tc dng ph nng. Dng trong tc nghn ng dn kh c hi phc, nht l trong vim ph qun mn tnh. Chy nc mi nhiu khng do nhim khun ngi trn 12 tui (dung dch nh mi). Thm do chc nng h hp CC : qu mn vi lecithin u nnh (l t dc), atropin va dn cht Thn trong : Khng bt u dng ipratropium bromid giai on cp ca co tht ph qun ang i hi phi c gii quyt co tht nhanh. Glcm gc hp, ph i tuyn tin lit, cht hp c bng quang. Khi ngi bnh cm thy liu dng thng thng tr nn km tc dng cn phi tng liu thuc gin ph qun hng ngy, th l du hiu bnh nng hn. Lc ny ngi bnh nn n thy thuc khm, khng nn t tng liu ln mi. Mang thai B ADR : Kh ming, mi, hng b kch ng. Ri lon iu tit mt. B tiu tin. Di ng Liu cach dung : iu tr cch qung v iu tr di hn: 50 - 100 microgam fenoterol hydrobromid v 20 - 40 microgam ipratropium bromid (1 - 2 liu xt) mi ln, ti a 8 liu xt/ngy (trung bnh mi ln 1 - 2 liu xt, ngy 3 ln). liu ok Tng tac thuc : medrol va feno ha K huyt a dung KCl Thi gian dung : Trc n sang 30 phut : ome. Trong ba sang (sau khi n) medrol, KCl, Tata (khoang 7-8 gi) Trong ba tra : medrol Trong ba ti : KCl, tata Thuc xit trc khi vn ng manh hay trc khi ngu. N 16 : VIM H HP TRN, ST N3 (n3 la ngay 3) (11 TUI) Cefa ung luc oi Cefaclor 250 La cepha th h 2 coi lai dc ly/ph CC : di ng cefa, peni (tn s mn cam thp hn) Liu cach dung: Child 512 years 250mg 3 times daily; dose doubled for severe infections liu hi thp Ung luc oi Thn trong : i trng gi mc. Thn trng i vi ngi bnh c tin s ng tiu ha, c bit vim i trng. chc nng thn suy gim Test Combs co th + do thuc (pht hin khng th khng t bo hng cu, dung trong ngn hang mau) Tim glucose niu gy + gia ADR : Tiu hoa, vim ai trang mang gia Di ng (trn da steven lyell, phan ng phan v) Serratiopeptidase Cc Qun l dc b Y t va c vn bn cho bit mt s nc (Nht Bn, Hn Quc) ngng cp php lu hnh v thu hi cc thuc c cha hot cht Serratiopeptidase do khng chng minh c hiu qu iu tr ca thuc.

Dextromethorphan 15 Thuc giam ho nhom opioid tac ng ln trung tm ho hanh nao. Khng co tac dung giam au va rt it co tac dung an thn Chi inh : chng ho do hng v ph qun b kch thch khi cm lnh thng thng hoc khi ht phi cht kch thch. Ho khng c m, mn tnh. khng phu hp khi k trong toa nay Liu cach dung : Tr em 6 - 12 tui: Ung 5 - 10 mg, 4 gi/ln, hoc 15 mg, 6 - 8 gi/ln, ti a 60 mg/24 gi. liu ok CC : di 2 tui Qua mn, ang dung IMAOs Thn trong : ho c qu nhiu m v ho mn tnh c nguy c hoc ang b suy gim h hp. tr em b d ng.(co lin quan n giai phong histamin) mang thai C han ch dung chung vi alcohol ADR : Ton thn: Mt mi, chng mt. Tun hon: Nhp tim nhanh. Tiu ha: Bun nn Da: bng Paracetamol Child 512 years 250500mg every 46 hours as necessary (max. 4 doses in 24 hours) liu ok NaCl xem n 7 Vitamin C Chi inh : Phng v iu tr bnh do thiu vitamin C. Phi hp vi desferrioxamin lm tng thm o thi st trong iu tr bnh thalassemia. Methemoglobin huyt v cn khi khng c sn xanh methylen. Cc ch nh khc nh phng cm, chng lin vt thng, phng ung th cha c chng minh. CC : Chng ch nh dng vitamin C liu cao cho ngi b thiu ht G6PD (nguy c thiu mu huyt tn) ngi c tin s si thn, tng oxalat niu v lon chuyn ha oxalat (tng nguy c si thn), b bnh thalassemia (tng nguy c hp thu st). Thn trong : Dng vitamin C liu cao ko di c th dn n hin tng nhn thuc, do khi gim liu s dn n thiu ht vitamin C. Ung liu ln vitamin C trong khi mang thai dn n bnh scorbut tr s sinh. Tng oxalat niu c th xy ra sau khi dng liu cao vitamin C. Vitamin C c th gy acid - ha nc tiu, i khi dn n kt ta urat hoc cystin, hoc si oxalat, hoc thuc trong ng tit niu. Tim tnh mch nhanh vitamin C (s dng khng hp l v khng an ton) c th dn n xu nht thi hoc chng mt, v c th gy ngng tim. Ngi bnh thiu ht glucose - 6 - phosphat dehydrogenase dng liu cao vitamin C tim tnh mch hoc ung c th b chng tan mu. Huyt khi tnh mch su cng xy ra sau khi dng liu cao vitamin C. ADR : Thn: Tng oxalat niu. Mau, ri loan tiu hoa, thn kinh, tim mach Liu cach dung : ung cao ( tri scurbut cung chi khuyn cao 250-500 qd) Khi dng Vitamine C, bn nn dng vo bui sng v nu bn dng bui ti c th gy kh ng. Phi dng sau khi n, v nu bn ung vo lc bng i c th gy xt d dy. Tng tac : Ascorbic canh tranh ao thai cefaclor (knh anionic) tng tac dung (minor) Thi gian dung : Ung trong ba sang (sau khi n) tt ca Trong bui tra (sau khi n) para va c

Trong ba ti : tt ca tr c 1. Cac phac tri HP 2. Ks beta-lactam , quinolon, macrolid 3. Di ng thuc 4. Cac PPI 5. Cac probiotic (Slide hoa dc c Ha) 6. Cac antacid 7. Cac thuc chng hi lu , rut kich thich 8. Cac mui mt 9. Thuc chng loan thn 10. Hi chng rut kich thich (DLH/ 675) 11. Cac thuc li tiu 12. Corticoid, NSAID 13. Cac ky hiu sustained-release (SR), sustained-action (SA), long action (LA), extended-release (ER, XR, XL), timed-release (TR), controlled-release (CR), modified release (MR), or continuousrelease (Contin) immediate-release (IR) 14. Cac cp bt giam au 15. c tinh para 16. Cac thuc khang histamine 17. Vitamin nhom B 18. Tinh liu cho tre em 19. Thuc chen knh Ca, ACEi, nitrat, beta blocker 20. Xem lai cac loai thuc ha lipid huyt (statin, fibrat, resin) 21. Thuc ai thao ng, cac di ng cheo SU 22. Ung th va thuc chng ung th 23. Cac thuc gian ph quan dung trong hen va COPD 24. Glaucom goc hep va ong