23/ Ethambutol

-DH: Hthu: tt g ung.

Pb: r ng,thm tt vao HC,qua nhau thai sa
me,dich nao tuy khi mang nao bi vim
-TD,c ch: kim trc khun lao, td manh nht vao goan
nhn ln
.p hp Ethambutol vs rifampicin & INH =>td hi p
ng
C ch: c ch s nh p acid mycolic vao vach tb vk
lao,lam rl qua trinh tao vach t bao.
.tao chelat vi cac kim loai va canh tranh
vi polyamin lam rl tng hp acid nhn.
-C: tri lao cac th ,nht la vk lao d khang
streptomycin va INH.phai phi hp vi cac thuc tri
lao khac theo phac .
-Tdkmm: thi giac: vim or teo dy tkinh thi giac,giam thi
lc,loan thi, khng phn bi t c mau o va xanh la cy;
.khac: rlth,di ng,st,au khp,nhc u,chong m t,
-cc: BN di ng,tre em<5tui,ng co cac bnh mt
Pyrazinamid
-dh: hthu qua g tiu hoa,pb:tt vao c th,nh n i
bao,gan,phi,th n,nhau thai,sa me dich nao tuy khi
mang nao bi vim.
-td,c ch:td di t khun ph t 5-5,5 va co td yu ph
trung tinh.td vi moi th lao nhng tt nht la cac vk lao
trong cac ai thc bao vi thuc thm tt vao n i bao
-c:lao cac th,p hp theo phac
-tdkmm: c vi gan => cc,tng acid uic mau nn d
gy cac cn gut cp,=>cc, bun nn,nn
-cc:suy gan,th n, acid uric mau cao, RL chuyn hoa
porphyrin.
24/u ,nhc im of thuc:
INH
u im
D
-hthu: hthu qua nhiu g=>

dung trong bao ch

h
-pb: +rng,tt ca cac m va
dich c th=> fam vi tri
r ng.+ n trong nao tng
ung huyt tg=>tri tot lao
mang nao

t
d

-c.hoa:t p acetyl hoa qua

gan nhanh hay ch m
tuy vao
d.truyn=>ti n vic tdoi
anh gia hlc o thuc
hi u chinh liu
-thao tr:tgain td
dai=>kcach liu dung
ngn=>ko fai uong nhiu ln
trong ngay
-va kim khun,va di t
khun=>tgia c ca 2 g tn
cng va duy tri,
-td tt all dang lao=>cd cho
all th lao

Rifampicin
u im
-hthu:skd cao
-pb:-r n g,vao cac m va
dich,nht la fi va dich
PQ=>td cao tren 2c quan
nay.
-qua mang nao vim vao
dich nao tuy=>tri c
vim mang nao
-c.hoa :p acetyl hoa

dh

Td

-ks f r ng,td tt vs chung

mycobacterium=>c tri
lao,phong vim mang nao
va nk n ng do staphy..
khang methicillin
-khang thuc o vk lao thp
hn vk khac=>tri lao
tot ,nk n ng cung tt

Nhc im
Thc n va
antacid lam
giam
hthu=>dung
cach xa ba
an it nht 1 h
=>td kmm vi
Tk va tm
thn=>cc v
ng kinh,rltt
-c.hoa:qua
gan= p acetyl
hoa huy tb gan
=> c vi
gan=>cc vs
ng bi gan n ng
-cc vs ng bi
b nh th n
n ng
-nhiu td fu
-chi dung vs
VK lao ma
khng c dung
vi vk khac

Nhc im
-t n lam ch m
va giam hthu
thuc =>tranh
an=>th n
trong vs
PNMT,cho con
bu
=>gy au
u,m t moi
=> c vs gan,
RL chuyn hoa
porphyrin
=>sp thai tr
mau o ra cac
dich(m hi,nc
tiu
Gy cam ng
P450=>lam
giam td nhiu
thuc khi dung
thi.

19. Ss penicilin v ph td
Pen t nhin
-ph hep,td chu yu tren Gr+ ,
1s Gr-Gr+:tu cu,lin cu,ph cu,trc
khun un van,hoai th sinh
hi,than,bach hu,xon khun
giang mai
-Gr-:l u cu, noa m cu
P khang
-ph r ng hn,-td tot trn vk
penicilinase(Pen
khang penae,-td kem Pen G trn
M)
vk ko tit penae,-kng td trn Gmethicilin,oxacili
n
Pen A(ph r ng)
-f r ng,td tren ca G+,G-,
(amoicillin,ampici
-Gr+ tt Pen t nhin,nhng ko
llin
td tren vk tit penase
-G- td trn chunng a khi va ki
khi:E.coli,
entercocci,salmonella,shigella, la
ks la chon tri enterococci.
Pen khang
-ph ging Pen A nhng r n g
Pseudomonas
hn.-td trn ca
enterobacter,bateroides,proteuind
ol(+),klebsiella pseudomonas
khang pen A(bi tla
pseudomonas) va 1 s G- khac
Pen fhp vs
La nhng cht co cu truc tt
betalactamas
beta-lactam nhng co hoat tinh
kk rt yu,vi v y ko dung n

c trong lm sang.
Amoxicilin vs a.clavulanic(4:1)
ph td trn Staphylococci,
E.coli...; Ticarcilin vs
a.clavulanic(3:100)g ph td trn
trc khun g- a khi: staph.aueu,
bacteroides.

Suy Tim:
1. Ploai thuc tri Suy tim
Digoxin , ss Digoxin vs AMPv
Loan nhip tim
2. i n th h ng of c tim
3. c ch gy loan nhip tim; cch td of thuc tri LNT
Ploai 4 nhom thuc tri Loan nhip tim
4. Quinidin__Lidocain__Amiodaron
au tht ngc
5. Nhom thuc, Nitroglycerin( Nitrat hu c)
Thuc chen knh Canxi/ tri CTN
Tng huyt ap
6. 5 nhom thuc tri THA
Tb thuc c ch men chuyn (RAA) /tri THA
7. u ,nhc im thuc/tri THA
_Li ni u_chen B-adrenagic__chen knh canxi
Li tiu
8. Ploai_Furosemid_Hydroclrothiazid_Spironolacton
And u ,nhc im of 3thuc trn
9. Ss Thiazid _vs_Quai
tri Thiu mau
10. St, va ch phm
11. Acid Folic (B9)__Vitamin B12
12. Erythropoetin
Khang Sinh
13. 5 c ch td of KS, kiu khang,khang KS
14. Ng.tc sd KS
15.cac Penicilin
16. Cephalosporin ( 3 th h )
17. Cabapenem__Co-Trimoxazol
18. Macrolid(Erydromycin)
Fluoroquinolon __ Aminoglycosid
ss. 19. nhom Penicilin __
20. nhom cephalopsorin
. nhom Quinolon
Lao
21.Ng.tc sd thuc chng lao
22. Isoniazid__Rifampicin
23. Ethambutol__Pyrazinamid
24. u nhc im Iso,Rifampicin
St ret
25. phn loai nhom
TB, Quinin Cloroquin
26. SS, 2 thuc
Ly amip
27. tb Metronidazol _ dehydroemetin, Diloxanid
28. ss 2 thuc trn
Giun san
29. Mebendazol_Thiabendazol_ Praziquantel
30. Diethylcarbamazin__Niclosamid
Nm
31. Ketoconazol__Fluconazol
Virus: 32. Acyclovir_Zidovudin
Ung th: 33.Methotrexat__Flurouracil
34. Cyclophosphamid_acaloid da can
Vitamin: 35.phn loai , chung of vitamin tan trong
du,nc
36. vit A-D-E
37.Vit C-B6_B1
ng mau: 38: vitaminK va thuc khang vit K
39: Heparin( cao&thp pt)
N i tit:
40.Glucocorticoid
41.u ,nhc
Hydrocorticoid_Prednisolon_dexamethson
42.insulin
43.Hormon tuyn giap
44. thuc tranh thai

25. phn loai :

7..Phn loai thuc tri st ret:
-thuc ct cn st(thuc di t th phn li t trong hng
cu): quinin,
chloroquin, mefloquin,artemisinin,
artesunat,haloantrin.....
-thuc chng tai phat (di t th v tinh chu ky ngoai
hng cu cua P.vivax va P.malariae):primaquin
-thuc chng ly truyn (di t giao t): primaquin
-thuc d phong (di t th v tinh chu ky tin hng
cu): chloroquin , cloguanid,pyimethamin,
Fansidar,mefloquin.
Quinin
-DH: hthu g uong and tiem, phn b nhiu vao
gan,lach,phi,qua c nhau thai sa me.c.hoa gan, thai
tr qua nc tiu,
-TD,c ch:- vi ks trung st ret:quinin co td di t th
phn li t trong mau o all kst st ret.thuc ct cn nhanh
va it bi khang.co td ca vi kst a khang cloroquin.
Quinin cung di t c th giao t of P.vivax va P.malarie
C ch: nhn quinolein trong pt quinin gn vao chui
ADN o kst lam mt knng tach i va sao chep ma di
truyn.
-trn tktw: liu nho +, liu cao c ch gy bun ngu
, giam au,td hng vs thuc (-) tktw khac.
-trn thn nhi t: ha st
-tun hoan: liu cao gy (-) tim,gian mach, ha HA.
-trn cn: tng co bop c trn t cung
-tiu hoa: tng tit dich tiu hoa,jup an ngon d tiu
-C: di t th phn li t trong mau,bi t la P.falciparum
khang chloroquin va cac thuc khac. Thuc nn dung
fhp vs primaquin va sulfadoxin.
-TDkmm: thg g p nhc u,bun nn,nn,rl thi giac,
chong m t,u tai, thiu mau tan mau, giam bc, mt bc
hat, giam tiu cu va ha g huyt. Ban da, kho th... qua
liu gy rlth,rl thi giac,tl tim mach va rltk,
-CC: BN u tai,vim dy tk thi giac,nhc c va PNCT

-Cphm: quinamin,quinine lafran(dang mui sulfat,HCL

Quinoform dang mui format vin nen,vin bao
Quinoserum dang mui dihydroclorid vin nen,dd tim
Chloroquin
-DH: hthu tt g ung,tim bp va di da,phn b:
vao m.thuc vao c dich nao tuy,thai va sa me.C.hoa
chinh la desethylchloroquin.thai tr ch m qua nc tiu
-TD,c ch: -vi kst st ret:thuc di t th v tinh g
tin hng cu va trong hc, th giao t of cac kst st ret.td
ct cn sret nhanh va tgian ban thai keo dai hn quinin,
nn thuc thg dung d phong va tri ct cn st ret do
P.vivax va P.malarie., thuc ko co td trn goan ngoai hc
nn chng tai phat,phai php vi primaquin.- td
khac:di t san la gan va amip gan, (-) min dich nn
dung tri vim khp dang thp,lupus ban o,rl ch.hoa
porphyrin.
C ch td: cac kst tiu hoa hemoglobin of tb v t chu
,gphong ra m t s cht la st,FP IX,acid amin,hem.
Thuc co td di t kst sret c ch sau:
+c ch qua trinh polyme hoa,lam thiu hemozoin va
tich luy hem gy c cho kst.
+tao php chloroquin-FP IX gy tiu huy mang tb va
di t kst.
+ do la base yu, nn khi xm nh p vao n i bao tao h
m lam mt knng tiu hoa hemoglobin o kst.
-C: d phong va tri sret(tr vugn P.falciparum khang
thuc). tri amip gan va san la gan. tri vim a khp
dang thp va lupus ban o.
-TDkmm: liu tri sret gy rl tiu hoa nhe,chan n,nhc
u. Liu cao gy rl tiu hoa nhiu, c vs tk va tthn
nh vim dy tk ngoai bin, rl thinh giac, thi giac,tn
thng da, suy tim, thiu mau tan mau.
-cc:mn cam vs thuc,b nh vong mac,pmthai,th n
trong vs ng b nh gan,mau va rltk
-ch phm: chloroquin(nivaquin,delagyl) vin 250mg
27 Metronidazol
-dh:hthu tt g ung,xm nh p vao cac m va dich c
th,chuyn hoa gan bng p oxy hoa,thai tr qua nc
tiu,
-td,cch: td tt vs amip trong va ngoai ru t , ca th cp
va man,.vs ly amip ru t thuc co td yu hn do kho
xm nh p vao ai trang.td tt vs Trichomonas
vaginalis,Giardia cac vk ky khi gr- nhng ko td trn vk
a khi.
Cch: nhom nitro of metronidazol bi kh b protein v n
chuyn electron or bi ferredoxin. Metronidazol dang
kh pha v cu truc xon of ADN,tiu di t vk va sv t
n bao.
-C: tri ly amip cac th: amip ru t ,amip gan va amip
cac m.- tri nhim Tri. Vaginalis va cac b nh do sv t
bao khac.-tri NK rng mi ng,tieu hoa, bung,phu
khoa.-d fong phu thu t g tiu hoa,phu khoa.
-tdkmm: thg g p : chan n,bun nn,nn,kh
mi ng,tiu chay,nhc u,mi ng co vi kim loai,-n ng
:co gi t,mt iu hoa,b nh nao,giam bc,rlng mau.
-cc:mn cam vs thuc.BN ngkinh.,rl ng mau,PN
mang thai 3thang u,cho con bu.
-chphm: Flagyl ,klion vin nen,thuc at,dich truyn,
dang gel
Dehydrometin
-dh:thuc gy kich ng g tiu hoa nn chi dung dang
vin bao di t amip ru t .tim tinh mach gy c vs
tim nn thg dung g tim bp su. Thuc khuch tan tt
vao m, ttrung gan,lach,phi,th n.thai tr qua th n,
-td:thuc di t amip chu yu ngoai ru t ,it cotd vs amip
trong long ru t ,vi v y thuc thg dung phi hp vs
chloroquin trj cac thp bn ko dung c dn xut
nitronimidazol.thuc ko di t c th bao t.
C ch: thuc (-) s di chuyn of ribosom doc theo
ARNm, c ch tng hp ARN do o c ch ko hi phuc
s tng hp protein of amip.
-chi inh: dtri amip ru t va amip gan
.chi nn dung khi cac thuc an toan hn ko th dung
c.phi hp vs thuc tri kem tri t n gc va chng
ly truyn b nh
-tdkmm: tiu hoa:bun nn,nn, ia chay,
Trn tim mach: loan nhip ,suy tim sung huyt,
Thn kinh c: yu c,moi c,run nht la c chi va c
han ch tdkmm fai dung kem V.b1, va strychnin.
-cc: B nh tim mach,th n,vim a dy tk, pn co thai.
-ch phm: ng tim 30mg/mL,20mg/ml
Diloxanid
-dh:thg dung dang mui furoat.sau khi ung ,thuc vao
ru t thuy phn tao diloxanid bae va acid furoic.chi co
diloxanid c hp thu vao mau va phn hp thu nay c
thai tr qua nc tiu trong vong 48h.
-td va cch: diloxanid la dn xut dicloroacetanilid,co
tdung chu yu la di t ami tronglong ru t .thuc co hi u
qua cao vs th ken.
Cch: c ch tng hp protein of amip
-C:tri amip ru t va amip th ken.
-Tdkmm:thg g p la nn,kh mi ng, tiu chay,nga,may
ay
-Cc: PNMT ,tre em <2tui
Ch phm vin nen 500mg.
Diethylcarbamazin
-dh:hthu tt qua g tiu hoa,thai tr qua nc tiu,
Nu pH nc tiu kim ,thuc thai tr ch m
-td,cch: la dn xut piperazin,co td di t cac loai giun
trng thanh va u trung of m t s loai giun chi
W.bancrofti,Brugia maleyi, Loa loa,nhng ko co td vs
W.bancrofti trong th thuy tinh.
C ch: - lam giam h ng va gy li t c giun do gy
u cc hoa, lam giun ri khoi vi tri c tru ri bi tng ra
ngoai;-lam thay i mang ngoai of u trung giun chi
,laml b m t phi tao iu ki n thu n li cho h
thng khang th o v t chu tiu di t.thun lam tng phan
ng vim va min dich trn ngi.
-c: tri cac loai giun chi: W.bancrofti. B.malayi.L.loa,
dtri lin tuc trong 2-3 nm. tri O.volvolus. 2 tun.
-tdkmm:-do thuc: thg g p: nhc u,kho chiu, chan
n,m t moi,it g p bun nn,nn,chong m t.- do giun:

gy phu,nga,tn thng thi giac,st,nhc u,rlth,kho

chiu
- giam tdkmm fai dung liu tng dn va dung cac
corticoid or cac thuc khang histamin H1 trcs d fong
Ch phm: Banocid,Notezin vin nen,dang mui citrat.
Niclosamid
-DH.It hp thu qua ru t => iu tri san KS/ru t
-TD: co td vi cac loai san dy
-khng co td vi u trung cac m ngoai ru t
-c ch Td vao khu chuyn hoa NL of san.
+ c ch tng hp Adenosin Triphospat ty th
+ c ch s hp thu glucose cua san
->u san va cac t san bi cht-> ra ngoai theo phn.
-C:
Niclosamid c dung khi bi n him san bo, san ca va
san ln (nn dung praziquantel khi bi nhim u trung san
ln)
Dung iu tri san dy rut khi khng co praziquantel
34.Cyclophosphamid
-dh:dung g ung, pb r n g,vao c dich nao tuy,nhau
thai,sa me lam ah n TK ,cc vi PNMT va cho con
bu.
-td,cch:vao c th ,thuc C.hoa =>gc alkyl,gc nay lk
CHT vi guanin vtriN7 of ca 2 mach pt ADN =>lk
cheo gia 2 mach=>1ft or gia 2 ft=>ngn can s
tach i va sao chep ma=>c tng hp ADN,ARN
,protein,tb ung th ko nhn ln. Ko tng c.
-tdkmm: c vs mau, giam bc hat, tiu cu,=>cc suy
tuy-bun nn,nn, xh bang quang =>cc suy th n n ng
Vim bq,vim g ni u cp/.
. liu cao gy c vs tim,rl n i tit.
-c:ung th carcinom carcom,ung th bung trng,t
cugn.vu,ung th ph quan,ngoai bao tk..- tri b nh bach
cu,u lympho Hodgkin va ko Hodgkin.- vim a
khpdang thp,lupus ban o,b nh t min va cy ghep
c quan.
-cc:ng mang thai,cho con bu,ng suy tuy, suy th n
n ng,vim bq-g ni u cp.
Cac Alcaloid da can
-dh: tim TM, ko vao dich nao tuy,phn b r ng rai
khp c th,t p trung nh gan,lach,m t,thai tr qua
m t,nc tiu.
-td,cch:chng ung th kim tb,c ch c hi u pha hi u
Mo chu ky tb.
Cch: thuc gn vao tubulin nn ngn can tao vi cu
truc hinh ng,la thanh phn quan trong of thi gian fhn
va c ch s tach i of nhim sc th.
-c: ung th: xng ,c vn,vu,t cung, fi tb nho, tuyn
giap, BC cp, b nh Hodgkin, u lympho ko hodgkin, u
ngoai bao TK.
-tdkmm: c vs TK: co gi t, di cam ,giam mt trng
lc, mt phan xam su., rlth, hh, giam bc, tc.
-cc: suy tuy, b nh tk, chiu xa tia x vung TM ca va
gan. NK, nhim virus, PNMT, cho con bu, mn cam, ko
dung cung mytomycin,phenytoin.

35. vitamin
-phn loai: vitamin tan trong du:co 4 cht la vitamin
A,D,E,K. Vitamin tan trong nc: vitamin
nhomB(b1,b2,b6,b12,...) vit C,vitaminh PP...
- c im chung vitamin tan trong du:
*-hp thu cung vs cac cht m vao vong tuan hoan
chung,vi v y khi c th ko hp thu c m thi ko hp thu
c vitamin.- qtrinh hthu oi hoi fai co acid m t lam cht
nhu hoa vi m ko tan c trong mau,do o, mun thuc
hthu tt thi nn ung trogn or sau ba n, -khi dung qua
liu ko thai tr ht qua th n ma tich luy chu yu gan
va m m vi v y , khi dung liu caova keo dai se gy
c tinh, c bi t la vitamin A, D.- do tich luy trong c
thnn cac tri u chng thiu thg xut hin ch m, vi v y
ko cn b sung hang ngay dui dang thuc.-tng i
bn vng vs nhi t, ko bi pha huy trong qua trin nu
nng.
-vitamin tan trong nc:
* hp thu trc tip qua thanh ru t vao mau,ko cn cht
nhu hoa.-loc c qua cu th n va thai tr qua nc tiu khi
tha.-vi ko tich luy trong c th nn noi chung it gy
c .-ko bn nn d thiu, vi v y phai b sung hang
ngay.

Vit K(ng mau toan

thn)

Thuc khang Vit K(dx

coumarin,indandion)

T
d
/
c
c
h

-lam ng mau bng

cach:+cac tcht of
yt mau II,VII,IX,X
(PIVKA) chi co
htinh
khi
gc
glutamat of no c
carboxyl hoa bi h
microsom gan. Vit K
hhoa
h
thng
enzym microsom
gan=> PIVKA c
carboxyl
hoa=>
chuyn thanh yt
ng mau

-ctruc gn ging vitK.

(-) canh tranh epoxid
reductas,=>can tr vit
Kepixid=>vitK=>chng
ng.-thuc khang lai
td of vitK,td/cac yt
ng mau gan=>chi
co td in vivo

-chay mau do giam

prothombin th fat

Phong va tri cac

b nh huyt khi tc

T
d
k
m
m

sau ng c thuc
coumarin,salicylatl.
+chay mau tre s
sinh,chay mau do
dung
thucchng
ng,co th kem
hthu vitKor thiu
vitK,chun bi cho ng
b nh sp m

mach tt heparin

-tim bp:gy chai

cng vung tim,tim
TM
fai
tim
ch m,nhanh gy co
tht KQ,tim p
nhanh,tim
tai.tr
ssinh thiu thang
dung liu cao gy
tng bilirubin huyt,
thiu mau tan mau,
RLth kich ng nim
mac,bun nn

-chay mau khi qua

liu.co th gy say
thai,thai lu.liu cao
lu=> Rl thm thu
,mao mach =>hoai t
da, vungngc chi
di;di ng vim
st,ni mn, tng bc
a eosim,giam bc
hat,nc tiu o.

Heparin (chng ng mau)

-td,c ch:-antithrombin III lam mt hlc of
thrombinIII=>chng ng mau,-heparin tao fc vs
antithrombin III=>tng td ln 1000 ln =>cac yt ng
mau 9,10,11,12 va thrombin mthi u lc =>mau ko
ong
-td: =>chng huyt khi nhe
=>liu cao lam tng lk fibrinogen vs TC =>hthanh
cac vi kt t p tc =>gaim tc. =>heparin M thp htinh cao
hn va chuyn bi t hn, it tg tac vs tc va chi c chyt
10, hoat hoa=>giam nguy c chay mau=> chng
vim/c
ch
p
qua
mn/khang
hi,
serotonin,bardykinin/c ch tit aldosterron va /lam gp
lipoproteinlipase m=> ha triglycrit huyt tg.
-c: phong va cha b nh tc nghen mach:vim TM
huyt khi,tc mach fi , vim mach vanh.(dung c
PNCT,cho con bu).
-Heparin M thp dung ngn huyt khi cac m sau
phu thu t , -dung /th nhi m in vitro, -tng lipid mau.
-tdkmm: -chay mau:xh tiu hoa,ai ra mau,chay mau
khp=> T.hoa= protamin 1 mg protamin SO4. t/hoa c
100vi heparin.-di ng :giam tc,heparin M thp it lam
giam tc, va it c hn Heparin M cao. Rung toc,loang
xg,gay xg t fat

Antacid
-C: Lam diu cac triu chng do tng acid da day (chng
nong, chua, y bung kho tiu do tng acid).
Tng acid da day do loet da day, ta trang.
Phong va iu tri loet va chay mau da day ta trang do
stress.
iu tri triu chng trao ngc da day - thc quan.
Tng phosphat mau: cung vi ch n it phosphat.
Tuy nhin, dung thuc khang acid cha nhm lam
cht gn vi phosphat (nhm loai phosphat ) co th dn
n nhim c nhm ngi suy thn. Nn dung thuc
khac.
-Chng chi inh :Mn cam vi nhm hydroxyd.
Giam phosphat mau
. tre nho tui vi nguy c nhim c nhm, c bit tre
mt nc hoc bi suy thn.
-th n trong: Cn dung thn trong vi ngi co suy tim
sung huyt, suy thn, phu, x gan va ch n it natri va
vi ngi mi bi chay mau ng tiu hoa.
Ngi cao tui, do bnh tt hoc do iu tri thuc co th
bi tao bon va phn rn. Cn thn trong v tng tac
thuc.
Kim tra inh ky nng phosphat trong qua trinh iu
tri lu dai.

Ngoai ra GC con (-) dong bc a nhn,n nhn,lympho

bao i vao m khi fat p vim.
*chng di ng: khi di nguyn xnh p vao c th no s
khp hi u vs khang thIgE.Phc hp nay se gn vao b
m t of dng bao va bc lam hhoa phospholipaseC.
Phospholipase C xtac cho qtrin chuyn PID thanh
diacylglycerol va inositol triphosphat lam thay i tinh
thm of dng bao va lam v bc.gphong ra cac cht
trung gian of p di ng nh histamin,serotonin,
bradykinin.
GC c Phospholipasse C do o lam giam gphong
histamin va cac cht trung gian hoa hoc gy di ng.
Phosphatidyl insoitol diphosphat (-)

PhospholipaseC
<= PC
IP3,DAG
ti tinh thm of mang
GP histamin,serotonin
* c ch min dich: GC (-) MD do lam giam slng TB
lympho ,c ch cnng thc bao, c san xut khang th ,
c gphong va td of cac enzym tiu th, c hoa hng
n g bc, c ch di chuyn of bc
-c: tri thay th (suy vo TT),tri cac b nh t min
(lupus ban o h thng,VKDT,thp tim),di ng,sc fan
v ,cac b nh lquan vs di ng nh HPQ,vim mui,. Vim
khp,c,da. Chun oan h i chng cushing.
-tdkmm:tng g huyt=>t,n ng thm b nh t.-RL
phn b m,-teo c, xg khp,nhc c,-do gi nc va
Na+,=> fu,tng HA.- bn chn,ao giac,mt ngu, -Loet
dd ta trang.suy tt cp khi ngng t ng t.
-cc:loet dd tt,mn cam,nhim nm,virus,ang dung
vaccin sng. th n trong: td,fu,cao HA,loang xg.
Insulin
++Td va c ch
+Trn CH glucid giam glucose mau do:
-giup glucose d nhm nhp vao t bao,c bit la cac t
bao gan,cm m bng cach lam giau cht vn chuyn
glucose mang t bao
+c ch:
-insulin kt hp vi recetor
-tao tin hiu n nang d tr cha cht vn chuyn trong
t bao
-nang di chuyn ti mang t bao
Nang dinh vao mang t bao,hng cht vn chuyn
glucose ra ngoai,hoa vao t bao
-glucose vao t bao vi tc nhanh
-[glucose] ni bao tng->y inlusin ra khoi receptor
-cht vn chuyn thu hi v nang d tr
-thuc y tng hp va c ch phn huy glycogen bng
kt tinh glycogen synthetase,
-khi thiu insulin->t bao khng s dung c glucose
va cung khng chuyn than glycogen d tr gan->tng
glucose mau va niu
+trn CH lipid
-tng tng hp va d tr lipid gan
-ngn phn giai m va (-)tao cac cht cetonic->giam
nng acid beo t do va glycerol trong huyt tong
+trn CH protid
-thuc y ng hoa protid bng cach :lam aa d xm
nhp vao t bao d tng hp pro
++C:ai g typI,-T typ II khi thuc tng hp ko co
hi u qua, -Tre gy yu,kem n, suy dd, RL C.hoa g
(truyn Glucose kt hp insulin).-gy cn shock insulin
tri tm thn = tao cn ha glu huyt manh va t
ng t.
++ tdkmm: ha g huyt,di ng(neen dung prednisolon
trc).-teo m m or phi ai m m tai ch tim. Ha K+
huyt do kt Na+/K+/ATPase

Glucocorticoid
-DH:-hthu tt g tiu hoa,dung qua nhiu g khac:tim
bp,TM,duoi da,phun mu,bi.-Pb: all cac m,qua nhau
thai va sa me it.-Lk chu yu vs globulin.C.hoa
gan,thai tr th n
+Td: * trn chuyn ha:
-glucid:tng tao glycogen,tng tao glucose t pro va
aa,tng tng hp glicagan,giam insulin->T
-protid: (-).thuc y di hoa protid->teo c,xp xng,
-lipid: vn chuyn phn b lipid->cushing
-mui nc:tng thai K+,tng tai hp thu Na+ va H2O>phu,THA
*+trn c quan va tuyn
-TKT:kich thich->bn chn,mt ngu,ao giac
-tiu hoa :tng tit dich vi,giam tit cht nhay->loet da
day-ta trang
-mau :giam BC a acid/base,lympho,mona,tng
HC,TC,BC trung tinh,tng ng mau
-t chc hat: c ch->chm lanh vt thng
*Tac dung chng vim: GP (-) Phopholipase A2
thng qua kt tng hp lipocortin,lam giam tng hp ca
leucotrien va Prostaglandin.
Phn loai mang
(-)
(+)
phospholipaseA2 <= Lipocortin <= GC
a.arachidonic

cox ___________Cox _______________ Lox

ThromboxanA2 Prostaglandin
leucotrien

Kt t p tiu cu vim
co tht kpq
Kt bai tit dich
Nhy dd