CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

BNG CHM IM THC T TT NGHIP

H v tn sinh vin: NG QUC CNG
Lp: 09TDS64
M s sinh vin: 3109132490
Cn b trc tip hng dn ti 2 c s:
NGUYN TH THU H v DS NGUYN TH TUYT HNG
Gio vin b mn PT nhm thc tp: V TH THU H
Thi gian thc tp:
Tun 1 :

T ngy :

Tun 2 :

T ngy : 30/05/2011 n ngy : 04/06/2011

STT
A
1
2
3
B
1
2

23/05/2011 n ngy : 28/05/2011

NI DUNG
THI HC TP CA SINH VIN
o c
Tc phong
Chuyn cn
NI DUNG BI BO CO
Hnh thc
Ni dung
TNG CNG

IM TI A
4
2
1
1
6
2
4
10

IM THC

( Sinh vin t > 60% s im mi t t thc tp )

XC NHN CA C S THC TP
(K tn ng du )

NHN XT CA C S THC TP

NHN XT CA GIO VIN HNG DN

MC LC

Ni dung bi bo co thc tp ti trung tm y t

Phn 1:Tng quan v c s thc tp
1/Tng quan v c s th tp

2/Nhim v v quy m t chc

3/Ch tiu k hoch v thnh tch hot ng
4/ Chc nng v nhim v ca dc s trung cp ti c s

Phn 2 : Kt qu th tp
1/ hoch cung ng thuc v kinh ph mua thuc
2/ Cc loi s sch
3/ Danh mc thuc chng trnh
4/ Quy trnh cp pht thuc v mt s thuc thit yu
5/ Tham gia hng dn s dng thuc an ton v hp l

Phn 3 : Kt lun

LI M U

Trang

T VIT KHC NHAU

TUN 1 :
PHN I: Tng quan v c s thc tp .
1.1. Tn V a Ch n V Thc Tp
-Tn : UBND Q4 TRUNG TM Y T D PHNG Q4
-a ch: 24 L VN LINH , PHNG : 12 , QUN : 4
T : 38 262 207

EMAIL : ttyt.q4@.hcm.gov.vn

1.2. Nhim v v quy m t chc ti Trung Tm Y T D Phng:

Nhim v: .
- m bo cung cp thuc men, ha cht y c y kp thi p ng yu cu iu
tr.

- T chc qun l cp pht thuc, ha cht, y c.

- Thc hin kim sot, kim tra.
- Bo qun thuc men, ha cht, y c.
- Hng dn s dng thuc, kim tra theo di vic dng thuc hp l, an ton,
thng tin t vn v thuc.

Quy m: ti c s c 5 ngi lm vic

1. BS . NGUYN TH PH TH : Trng Trm
-

Qun l v c trch nhim lnh o trm y t

Ch o cc cng tc hot ng ca trm

Khm v iu tr cho cc bnh nhn ngoi tr

Quan h ban ngnh

2. Y S . HUNH MINH TUN

- Qun l cc chng trnh bnh dch , lao
3. DC TRUNG . NGUYN TH THU H

Qun l v dc , thuc tr em , thuc cp cu , h tr v chng trnh

dch bnh . Ph trch cp pht thuc, hng dn bnh nhn s dng

thuc
-

Cng tc dc

Qun l cc bnh st rt, bnh tm thn

4. IU DNG . HUNH TH LIN PHNG

- Qun l chng trnh tim chng
-

X tr cp cu cc vt thng

Qun l chng trnh dinh dng cho tr em

5. N H SINH . NGUYN TH THANH THY

- Qun l chng trnh k hoch ha gia nh
-

Ph trch khm v khoa sn

1.3 C s vt cht:
A. Tng trt:

- Snh chung
- Phng tim nga
- Phng khm ngoi da liu
- Phng thay bng .

B . Lu 1 :

-Phng siu m
- Phng khm ni
- Phng khm ph khoa
- Phng khm nha khoa .

C . Lu 2 :
- Phng x-quang

1.3.Ch tiu k hoch v thnh tch hot ng :

A. Cng tc dc:
- D tr cung ng thuc hng thng.
- Lp s sch, quyt ton thuc.
- Theo di s dng thuc - vt t tiu hao ha cht.
- Ph bin v tp hun cc ti liu ca b y t.
- Bnh bnh n v n thuc.
- Thng tin thuc, theo di ADR.

- Thc hin 3 kim tra, 5 i chiu.

B . Cng tc tuyn truyn gio dc sc khe

Cng tc tuyn truyn gio dc sc khe c tuyn truyn bng cch

tuyn truyn cng ng bng cc hnh thc sau:
Truyn thng i chng trc tip
i pht thanh (vit bi, ti liu).
Bn tin ca phng ( truyn thng trc tip trng hc, truyn
thng trc tip phng).
Cp pht ti liu (t bm, t ri)
Tp hun cng tc vin

Mt s hot ng tuyn truyn

Phng chng st xut huyt
Phng chng st rt
Cm gia cm H1N1
Phng v iu tr bnh lao
Thc n cho tr tng la tui
Cch chm sc ph n c thai

C . Cng tc phng chng HIV/AIDS

-

Ban ch o phng chng HIV/AIDS v phng chng t nn ma ty, mi

dm phng 12 xy dng k hoch t chc cc hot ng hng ng

thng hnh ng quc gia phng, chng HIV/AIDS ti phng 12, nm

2011 nh sau:
Treo bng rn, khu hiu Sng lnh mnh, thy chung khng
b ly nhim HIV, Phng chng HIV l bo v chnh bn v gia
nh bn, Nhit lit hng ng ngy th gii phng chng
AIDS
Chng trnh thng tin, gio dc v truyn thng thay bng hnh
vi
Phn pht min ph bao cao su theo nm

D . Chc nng v nhim v ca dc s trung cp ti Trung Tm Y T D

Phng:

- Lp k hoch d tr mua lnh thuc thch hp thc hin c thy l c

thuc v c dng c cn thit
- Tm vn quay vng thuc, t chc quy bn thuc ti trm. m bo
thuc thit yu nht l thuc ti cn
- Tuyn truyn v hng dn nhn dn dng thuc an ton v hp l. Vn
ng trng v s dng thuc nam trong nhn dn
- Qun l kim k thng k, thuc v dng c y t c s sch theo di xut
nhp
- Thit lp mi quan h vi cc c quan chnh quyn nhn dn thuc x
- Lp s theo di kim tra nh k v ngh mua b sung khi cn thit
- Qun l s lng thuc ti t thuc ca trm
- Hng dn s dng thuc an ton hp l cho ngi dn
- Thng k s sch: d tr, xut nhp, tn ca thuc.
- Lm bo co tng hp.
- Cp pht thuc cho bnh nhn.
- Theo di hn dng ca thuc.

PHN II: KT QU THC TP.

2.1. K hoch cung ng thuc v kinh ph mua thuc:

A. D tr v d tr b sung:
D tr :
Thuc hng thn :
- D tr tng qu.
- Cch d tr : nhn vin trm tnh ton s ngi bnh trong a bn phng
12 tng cng s lng thuc cn xin d tr.
Thuc ngi ln v thuc tr em :
- c cp theo s nhu cu thc t.
Nhp:
- Thuc c nhp t trung tm y t d phng Q4 .
- Phiu lnh thuc phi c y 4 ch k : ngi lp phiu, trng trm,
trng khoa dc v th kho.
- Sau khi lnh thuc, ngi lnh thuc s x mt phn phiu lu li trung tm
y t d phng , ci phiu s c gi li cho trm y t.
Xut :
Thuc hng tm thn :
- c cp cho ngi bnh c s bnh nhn trong a bn phng.
Thuc ngi ln v tr em :
- Thuc tr em c cp khi tr n khm bnh c bo him y t hoc em
theo s khm cha bnh.
- Thuc ngi ln c cp hn ch, dnh cho mt s i tng c bit.
Tn :
- Thuc c kim k hng thng
- Tn cui thng trc s c ghi vo d u thng tip theo trong s theo
di xut, nhp, tn.

PHN TRNG DC L CHN BNG XUT NHP TN

B. Cc loi s sch (ni dung v mc ch):

1. S khm bnh :
- Ni dung: Ghi chp cc bnh nhn n khm v cha bnh tt

c cc c s y t, phng hoc cm phng, nm tnh hnh

bnh nhn n c s y t, bao gm cc bnh nhn n khm ti
trm y t hoc khm ti nh.
- Mc ch: Da vo s ny cn b y t phng tng hp s lng

bnh nhn n khm hng thng.

2. S tim chng :
- Ni dung: Qun l v theo di tr em trong din tim chng m

rng ti a phng.
3. S tm thn :
- Ni dung : Theo di v qun l sc khe ca cc bnh nhn
mc bnh tm thn ti a phng.
4. S khm thai : theo di v qun l cc thai ph a phng.

5. S vng gia v truyn thng IOD : ti thm v kho st tnh hnh

IOD ti phng 12, thc hin chng trnh phng chng cc ri loi
thiu IOD .

2. 3 /Sp xp, trnh by, quy trnh cp thuc

a/ Danh mc thuc cp cu, thuc thit yu, thuc Bo him y t

 Danh mc thuc cp cu
STT
1
1
2
1
1
2
Thuc tim
mch
1.
2
3
4
Thuc ng

Tn thuc
n v
Hm lng
Atropin 0,25mg ng
0,25mg
Danh mc thuc gim au, h st
Acemol E
Vin
100 mg
Paracetamol
Vin
500 mg
Thuc chng d ng, mn cm
Clopheniramine Vin
4 mg
Thuc hng tm thn
Diazepam
Vin
5mg
Diazepam
ng
10mg/2 ml

Nifedipin
Captoril
Atenolol
ISDN

Vin
Vin
Vin
Vin

tiu ha
1

Alluminium

Gi

2
3

phosphalugel
Omeprazol
Dopasmin

Vin
Vin

20 mg
40 mg

ng

5 mg/2ml

Thuc tr hen v phi

1
Salbutamol
iu chnh

Ghi ch

20 mg
25 mg
50 mg
10 mg

nc v cht
in gii
1
Glucose 5%
Chai
2
Nacl 0,9%
Chai
3
Lactato ringer
Chai
Danh mc thuc thit yu
STT
1

500 ml
500 ml
500 ml

Tn thuc
n v
Hm lng
Thuc khng sinh (dng tim)
Gentamycin
ng
80 mg

Ghi ch

1
2
3
4
5
6
7
1
2
3
4
1
2
1
2
1
2
3
1

Thuc khng sinh (dng ung)

Amoxicillin
Vin
500mg,250mg
Cotrim
Vin
960 mg,180mg
Erythromycin Vin
500mg,250mg
Doxycillin
Vin
100 mg
Ciprofloxacin Vin
250 mg
Ampicillin
Vin
500mg, 250mg
Tetracylin
Vin
500 mg
Thuc h nhit, gim au
Efferalgan
Vin
500mg
codein
Diclofenac
Vin
50 mg
Taganyl
Vin
500 mg
Spasmaverin
Vin
40 mg
Thuc d dy, ng rut
Sorbitol
Gi
Cimetidin
Vin
300 mg
Thuc huyt p tim mch
Nifedipin
vin
100mg
Stugeron
Vin
25 mg
Nhm h hp
Terpin codein Vin
100 mg
Salbutamol
Vin
2 mg
Asmin
Vin
Thuc b
Vitamin C
Vin
250 mg,

500mg
Vin
Vin
Vin
vin
Dung dch tim truyn
1
Ringer lactat
Chai
500 ml
2
Dextro 5%
Chai
50 ml
3
Natri 0,9%
Chai
500 ml
Thuc bo him y t
2
3
4
5

Magne B6
Vitamin AD
Vitamin E
Vitamin 3B

STT

Tn thuc

Ch nh

Tc dng ph

Chng ch
nh

Nhm thuc h hp

Bromhexin 4

Vim ph

mg, 8mg

qun cp v

Bun nn nh

Qu mn, ph
n c thai

mn, vim h
hp,gin ph
2

Terpin codein

qun
Ho khan, long

100 mg

m, vim ph chng mt,

Salbutamol

au u,

Mn cm, ph
n c thai, tr

qun, ho do

bun nn, nn, <3t, suy gan,

bnh tai mi

to bn, mch

hng, ho do d

nhanh, h HA

ng
Hen suyn

th ng
Run, nhc

hen suyn

Mn cm

u, tim mch,
hi hp, vp
b.mt ng,

bun mn
Nhm h st, gim au, khng vim
Paracetamol
Gim au
D ng, hoi

Diclofenac 50

Vim khp:

t gan
Ri lon tiu

gan nng
Mn cm, ph

mg

vim xng

hoa, vim lot

n c thai v

khp, h

d dy

cho con b,

Prednisolone

Qu mn, bnh

khp, au lng
lot d dy.
Khng vim
Tng tit kali8, Lot d dy t
gi natri, ph

trng, long
xng, bnh

Meloxicam

Gim au,

Ri lon tiu

tm thn nng
Lot d dy t

7,5mg

khng vim

ha, vim lot

trng, ph n

(vim khp

d dy t trng c thai cho con

thp khp, au

b, mn cm

c, au bng
5

Acid

kinh
Gim au,

D ng, mn

Tin s lot d

acetylsalicylic

khng vim

nga, m ay,

dy t trng,

trong cc

kh th, kch

mn cm, hen

trng hp

ng, chy mu suyn.

au u, au

ko di

rng,au c,
nga chng
huyt khi tnh
mch ng

Cefaclor

mch
Khng sinh
Nhim khun

Tiu chy,

250mg

ng h hp,

bun nn,

nhim khun

nhc u, ni

tai mi hng,

m ay

Mn cm

vim xoang,
vim
2

Erythromycin

amian
Vim ph

Ri lon tiu

500 mg

qun, vim

ha, d ng,

xoang, nhim

ni m ay,

trng ta mi

lon nhp tim

Ciprofloxacin

hng
Tr cc nhim

Ri lon tiu

500 mg

khun ng ha

n c thai v

h hp, nhim

cho con b

khun huyt,
tit niu, thn,

Mn cm

Qu mn, ph

Ofloxacin

tuyn tin lit..

Nhim khun Tiu chy,

200mg

ng h hp

Mn cm

bun nn, ni
m ay, ph
Quink sc

Amoxicillin

Nhim trng

phn v
Ri lon tiu

do cc vi

ha, suy thn,

khun nhy

d ng, ph

cm nh

quinke

Mn cm

nhim trng
ng h hp
trn phi, vim
amyan, vim

Vitamin C

hng..
Nhm thuc b
Phng v iu Ri lon tiu
tr bnh

ha, au d

Scorbut, chy

dy, tiu chy,

mu chn

suy thn

Si thn

rng, tng sc
2

Vitamin AD

Magne B6

khng
B sung

Tng calci

vitamin cho tr huyt

calci, bnh

b ci xng,

nhn nm bt

qung g,

ng, tng

gim th lc
Vim dy thn

Thn kinh

kinh, nn ma, ngoi vi

run c
Nhm thuc

D ng, si

calci mu
Mn cm

d dy
1

Omeprazol

Lot d dy, t Ri lon tiu

2mg

trng, tro

Mn cm

ha

ngc d dy
2

Varogel

thc qun
Lot d dy, t Ri lon tiu

Mn cm, suy

trng

thn

ha, mt
phospho huyt
(dng lu)

Nhm nhun
trng tiu ha
1

Sorbitol

To bn, ri

Tiu chy, au Bnh kt

lon tiu ha

bng

trng, hi
chng tc v
au bng
khng r

2
3

Diosmectite

Tiu chy cp

Antibio

v mn tnh
Cn bng h vi Bun nn,
khun ng

To bn

nguyn nhn
Mn cm
Mn cm

nn, d ng

rut, tiu chy,

au bng kh
tiu
Nhm khng
histamin
1.

Cetirizin 10mg Vim mi d

Nhc u,

Mn cm, ph

ng, mt,.

chng mt,

n c thai, tr

chy nc

kh ming,

<6 tui

mt, d ng

chn n, tng

thuc, thc n, tit bt

cn trng cm,
ni m ay

b/ Nhm thuc chng trnh khc

STT
1

Tn chng trnh

Tn thuc, hm

Phng chng lao

lng
Streptomycin 1g
Isoniazid 300mg
Ethambutol 400
mg
Turbezid
Rifamycin 150

Chm sc sc khe

mg
Aminazin 25mg

tm thn

Habperid 1,5mg
Amitriptylin

Ghi ch

25mg
Phenobarbital 100
3

Chm sc sc khe

mg
No-spa 40 mg

sinh sn

Amoxcillin
500mg

Phng chng phong

Rifampicin
150mg,300mg
Dapson 50mg,
100mg
Clofazimin
50mg,100mg

- Ti c s ch cp pht thuc chng trnh tm thn , cn chng trnh lao v

st rt ch theo di ch khng cp pht thuc .
1.Thuc chng Trnh Lao:
STT
Tn thuc, Hm lng
1
Streptomycin1g
2
Tuberzid 150/75/400mg
3
Rh(Turbe) 150/100mg
4
PZA
5
Ethambutol 400mg
6
INH(Isoniazid) 300mg
7
Nc ct5ml
8
ng bm 5cc
9
Cotrim 960
10
Acide Chlorhyric PA
11
Gng tay size M
12
Khu trang y t
13
L m
14
Lam knh h/72
15
Lu lng nh k
16
Que cy nha
17
Cn 90
18 Kanamycin
19 Levofloxacin

n v
L
Vin
vin
Vin
Vin
vin
ng
ci
Vin
lt
i
Ci
ci
Hp
ci
que
lit
L
Vin

20
21
22
23

Prothionamid
Cycloserin
PAS
Capastat

Vin
Vin
Gi
L

2.Thuc chng trnh St Rt:

STT
Tn thuc, Hm lng
1
Artesunate 50mg
2
Primaquine 13.2mg
3
Chloroquine 250mg
Cv artecan (Dihydro artemisinin 40mg+Piperaquin phosphat
4
320mg)
Artirakin 360mg (Dihydro artemisinin 40mg+Piperaquin
5
phosphat 320mg)
6
Lancet
7
Lam knh
8
Gim sa
9
Du soi M

n v
ng
Vin
Vin
Vin
Vin
Ci
Ci
Lt
Lt

3. Thuc chng trnh tm thn:

STT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

Tn Thuc- Hm Lng qui cch

Aminazine 25mg
Amtriptyline 25mg
Chlopromazine 10mg
Carbatol 200mg
Diazepam 5mg
Haloperidol 2mg
Levomeppromazin 25mg
Phnobarbital 100mg
Sperifar (Risperidon) 2 mg
Rileptid (Risperidon) 2 mg
Olanzapin (olandus) 10mg
Ozapine 10mg
Solan(olanzapine) 10mg
Intas Flunil(Fluoxetin) 20mg
Flutonin((Fluoxetin) 20mg
Trihexyphenidyl

n V
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin
Vin

4. Thuc hng tm thn:

STT
1
Diazepam 5mg
2
Phnobarbital 100mg

Tn thuc

n v
Vin
Vin

5. Vaccin v VTTH chng trnh:

STT
Tn thuc
1
BCG
2
DTP
3
VAT
OPV
4
ROUVAX
5
NUC CT
6
VGB
7
Quinvaxem
8
Bm tim BCG
9
Bm tim 0.5ml
10 Bm tim 5ml
11 Bng gn
12 Hp an ton
13 Cn700
14 Clincare
15 Phich vaccin
16 Nhit k di 30-500C
17 Ch th ng bng

Ch nh
Lao
Bch hu, ho g , ung vn
Un vn
Bi lit,sabin
Si
Vim gan B

n v
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Cy
Cy
Cy
kg
Ci
Lt
Lt
Ci
Ci
Ci

Vaccin v VTTH dch v:

STT
1
2
3
4
5
6
7
8
9
10
11
12

Tn Vaccin v VTTH
MMR II 0.5ml
trimovax
Priorix
Hiberix
Act-Hib
Okavax
Typhimvi
Avaxim 80 UI
Avaxim UI 80
Epaxal 0.5ml
Engerix-B 20mcg
Engerix-B 10mcg

Ch nh
Si , Quai b ,RuBeLLa
Si , Quai b ,RuBeLLa
Si , Quai b ,RuBeLLa
Vim mn no m
Vim mn no m
Thy u
Thng hn
Vim gan A
Vim gan A
Vim gan A
Vim gan B
Vim gan B

n v
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu

13
14
15
16
17

Hepavax-gene 1ml TF
Hepavax-gene 0.5ml
Meningo A+C
No NB 1ml
Tetract-Hib

Vim gan B
Vim gan B
Vim no m cu
Vim no nht bn
Bch hu +ho g + un

Liu
Liu
Liu
Liu
Liu

18

Ttritanrix

vn+vim mn no m
Bch hu+ho g + un

Liu

19

Infanrix hexa

vn+ vim gan B

Bch hu + ho g+ un

Liu

vn+phng bi lit+vim
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

VAT
Fluarix
Verorab
Pneumo 23
Vaxigrip 0.5ml
Vaxigrip 0.25ml
Infexal V
Twinrix 1ml
Hbvax Pro
Pebvax HIB
Gasdasil 0.5ml
Cervarix
Tetanea 1500 IU/1ml
Rotarix 1ml
Bm 1ml
Bm 3 ml
Bm insulin 1ml
Cn 900
Bng gn

gan B+ vim mn no m
Un vn
Cm
Nga di
Vim phi
Cm
Cm
Cm
Vim gan A+B
Vim gan B
Vim mn no m
Nga ung th c t cung
Nga ung th c t cung
Un vn
Tiu chy

Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Liu
Ci
Ci
Ci
Lt
kg

6.Thuc cp cu:
STT
1
2
3
4
5
6
7

Tn thuc Hm Lng
Adrenalin 1mg/1ml
Kortimed(Hydrocortisone 100mg)
Oresol 27.9g
Primperan(Bidiperan)10mg
Atropine sulfat ml
Seduxen 10mg/2ml
Lidocain 2% 2ml

n v
ng
ng
gi
ng
ng
ng
ng

c/ Sp xp v trnh by thuc
Cch sp xp thuc
Thuc c sp xp theo nguyn tc:
-

Ba d : d thy , d ly , d kim tra .

Nm chng

Chng mi mt, chut

Chng nng m
Chng chy n
Chng qu hn dng
Chng h hao, mt mt
Cch trnh by thuc
-

Trnh by thuc gn gng, sch s

Nhn thuc hng ra ngoi d ly

Thuc c sp xp theo nhm iu tr

Thuc c sp xp hn dng ngn nm ngoi v trn d ly

d/ Quy trnh cp thuc

-

Trc khi thc hin cp pht thuc phi thc hin

+ Ba kim tra
o Th thc n, phiu lnh thuc, liu dng, cch dng
o Nhn thuc, hn dng thuc
o Cht lng thuc bng cm quan
+ Ba i chiu
o Tn thuc n, phiu vi nhn thuc
o Nng , hm lng thuc n, phiu vi s thuc s giao

o S lng, s khon trn n, phiu vi s thuc sp giao

o Phiu thuc lu phi c ch k ca bnh nhn.

2.3. Tham gia hng dn s dng thuc hp l an ton :

- Cc loi thuc s dng trong n thuc bnh n
HAI N THUC PHI LM KHC NHAU
Y BAN NHN DN Q4
TRUNG TM Y T D PHNG
N THUC
H tn: .....................................................................Tui : ....................
Gii tnh: ..............................................................Cn nng:...............
a ch: .. ..............................................................................................
S th BHYT:........................................................................................................
Chun on: ............................................................................................
1.
Ngy: ln, mi ln:.
2.
Ngy: . ln, mi ln:
................
3.
Ngy: ln, mi ln: ..........................
4.
.
Ngy: ln, mi ln:
................................
5
Ngy:............................................................ln, mi ln:....................................
Ngy.thng.Nm 2011
Bnh nhn.
Bc s khm bnh

H tn cha m:
Ngy ti khm:
Khm li mang theo n ny
Nhn xt s dng thuc an ton hp l ?
- Cc loi thuc s dng trong n u hp l
Y BAN NHN DN Q4
TRUNG TM Y T D PHNG
N THUC
H tn: ........................................................................Tui : ....................
Gii tnh: .........................................................Cn nng:...............
a ch: ....................................................................................
S th BHYT:........................................................................................................
Chun on: .................................................................................
1.
Ngy: . ln, mi ln:.................................................
2. B
Ngy: ln, mi ln:.. ..
3
Ngy:............................................................ln, mi ln:....................................
4
Ngy:............................................................ln, mi ln:....................................
5
Ngy:............................................................ln, mi ln:....................................
Ngy.thng.Nm 2011
Bnh nhn.
Bc s khm bnh
H tn cha me:
Ngy ti khm:
Khm li mang theo n ny

Nhn xt s dng thuc an ton hp l ?

- Cc loi thuc s dng trong n u hp l

4 THEO DI PHN NG C HI CA THUC.

-

Ti trm y t cha ghi nhn c trng hp phn ng c hi no ca

thuc i vi ngi bnh

Bng bo co phn ng c hi ca thuc.

bo co phn ng c hi ca thuc
( SUSPECTED ADVERSE DRUG REACTION
REPORT)

Tn n v:
M s bo co ca n v:
M s bo co ca Trung tm( do
b phn ca trung tm qun l)

I.
Thng tin v phn n c hi
Thng tin bnh nhn:
H
Dn
Cn
Chiu cao Tui
Gii
Ngy bt u phn ng
v
tc
nng
tnh
Ngy
Thng
Nm
tn
M t phn ng v nhn xt (bao gm kt qu xt nghim)
II.
Thng tin v thuc nghi ng gy ADR
Tn cc Hm
Liu
S ln
ng
Ngy diu
L sn Tn nh
thuc
lng
dng
dng(ngy
dng
tr(ngy thng xut
sn xut
nghi
hoc
mt ln tun thng)
nm)
-Hn
ngh
nng
dng
Bt
Kt

u
thc

Chn on v ch nh iu tr
Ti s dng thuc

Cc triu chng c gp li
Khng xut hin triu chng c

III.

Cc thuc dng ng thi v bnh s

Cc thuc dng ng thi v s ngy s dng (ngoi tr cc thuc iu tr
phn ng

IV.

Cch x tr ADR
Ngng dng thuc

S dng cc thuc khc

Tin trin tt
iu tr

Phi tip tc

Khng c tin trin Khng bit

Tin trin tt
Phi tip tc
iu tr

Khng c tin trin Khng bit

V.
Kt qu sau khi x tr(nh gi ca bc s iu tr)
Hi phc khng c di chng.
Cht do ADR
Hi phc c di chng
Cht khng lin quan ti
Khng hi phc
thuc
Khng xc nh
VI.
Phn bnh lun ca bc s iu tr
VII.
Phn thm nh ADR
nh gi lin quan dn ADR
kin ca n v y t

Chun on v ch nh iu tr
Ti s dng thuc

kin ca chuyn gia

Cc triu chng c gp li
Khng xut hin triu chng c

III.
Cc thuc dng ng thi v bnh s
Cc thuc dng ng thi v s ngy s dng(ngoi tr cc thuc diu tr phn ng)
IV.
Cch x tr ADR
Ngng dng thuc
Tin trin tt Phi tip tc iu tr
S dng cc thuc khc

Khng c tin trin Khng bit

Tin trin tt
Phi tip tc iu

tr
Khng c tin trin Khng bit
V.
Kt qu sau x tr(nh gi ca bc s iu tr)
Hi phc khng c di chng.
Cht do ADR
Hi phc c di chng
Cht khng lin quan ti thuc
Khng hi phc
Khng xc nh
VI.
Phn bnh lun ca bc s diu tr
VII.
Phn thm nh ADR
nh gi lin quan dn
kin ca n v y t
ADR

kin ca chuyn gia

kin ca chuyn gia thm nh(Phn dnh ring cho thm nh ADR)
VIII.
Thng tin v ngi bo co
Tn:
Chc v:
S in thoi:
S Fax:
a ch email:
Dang bo co: Ln du / B sung
Ngy bo co:
K tn:
Bo co xin gi v mt trong hai a ch di dy:
TRUNG TM THEO DI TC DNG C
TRUNG TM THNG TIN THUC
HI CA THUC
V THEO DI TC DNG C HI
48 HAI B TRNG, Q.HON KIM, H
CA THUC- PHA NAM
NI, VIT NAM.
200 C BC, Q1, TPHCM, VIT NAM
T:048245292 HOC
T:088373332 HOC
FAX:048256911
FAX:08836790
Ghi ch :
-

Bo co ny c gi ng thi n Trung tan ADR , nh sn xut v

lu tr ti c s y t .

Cc bo co sau khi c Hi ng chuyn mn thm nh ADR tng

hp , phn loi v thm nh s c phn hi hng nm cho cc n
v Y t .

5. VN THUC NAM
-

Ti trm y t khng c din tch trng cy thuc nam , nhng

vn c treo nhng bc tranh , nh v cc cy thuc nam thng
dng b con c th tham kho . Sau y l mt s hnh nh
cy thuc nam v cng dng ca chng :
T TM MY CY THUC NAM CHN VO

C. KT LUN
T VIT KHC NHAU