13

S7(6/2011)
C nhiu dng thuc: Tim, Ung, Dng
ngoi. Trong : Thuc ung v thuc dng
ngoi c nhiu dng thuc khc nhau.
* Thuc ung c nhiu dng thuc
nht nh: -Thuc vin (vin nn, vin nn
bao ng, vin bao tan trong rut, vin
nhng vv.) -Thuc nc (Nh dch, Sir,
Dung dch) -Thuc gi. Thuc cm.
*Thuc dng ngoi: Vin t m o.
Thuc nc nh mt, nh tai. Thuc m:
tra mt, bi ngoi. Thuc phun sng xt
mi, vv.
QUY CH S DNG THUC KHNG SINH:
Trn th gii nc no cng quy nh:
Khng sinh l loi thuc phi c bc s
khm bnh k n, mi c mua (hoc
cp) v s dng.
Nhng tai bin do s dng thuc
khng sinh:
1/D ng, (trng hp nng l sc phn
v dn n t vong)
2/Lon khun ng rut, gy a chy
hoc ri lon tiu ha
3/ Ln thuc, nguy him hn l tng s loi
vi khun khng thuc
4/ Nhim c ph bin l hi gan, thn.
-Nhim c chn lc trn b phn c th:
ic (streptomycin,gentamycin); t gn
gt chn (nhm quinolon) ; Suy ty dn n
t vong (chloramphenicol); Vim nhiu dy
thn kinh (rimifon); Hng men rng (tet-
racyclin); Mt bch cu ht (sulfamid),vv.
Trong nhng tai bin do khng sinh k
trn th D ng chim t l ln nht.
C trng hp mt n sinh b ngt xu
do ngi phi hi Penicillin khi xem y t tim
Penicillin cho bn Bv Mai Hng (1975).
Hoc mt trng hp dng thuc nh mt
Chloramphenicol, sau khi nh thuc, ngi
bnh b sng tm mt my, phi vo bnh
vin Bch Mai cp cu (1999). Nhng
trng hp ny d ng thuc l do c a
ca ngi bnh, thuc loi bt kh khng.
Cn nhng trng hp ng trch nh: Tr
em b hng men rng (rng vng sut i)
v m ung thuc Tetracyclin khi mang thai
(do m thiu hiu bit t mua thuc dng
hoc bc s thiu st, khng bit ngi bnh
mang thai). Tr em b ic do tim Strepto-
mycin qu liu bc s quy nh (do y t thiu
tinh thn trch nhim), vv.
AN TON, HIU QU CHO NGI DNG THUC
KHNG SINH
Vi ngi bnh:
- Mun dng thuc khng sinh hy n
Bc s khm bnh, k n.
- Trc khi dng thuc phi: Xem li n
bc s ghi. c t hng dn s dng
thuc (c trong hp thuc).
- Khi dng thuc phi: khong cch
gi.ng liu. liu trnh. Tun th
nghim cc iu cm k
Vi thy thuc:
- Phi xc nh c tc nhn gy bnh
bng cc phng php xt nghim (khng
on m) chn loi thuc thch hp.
- Phi kim tra k tnh trng ngi
bnh:Tin s d ng thuc; Bnh gan, thn;
Ph n c thai (c bit l 3 thng u) hoc
ang thi k cho con b; Tr di 6 tui;
Ngi cao tui Cc thuc ang phi dng.
- Phi ghi trong n y cc hng
dn dng thuc v cc iu cm k
UNG THUC KHNG SINH TH NO TH TT ?
1/ Ung thuc ng liu, ng
khong cch gi, m bo trong c
th lc no cng lng thuc chng
chi vi vi khun. V d:trong n bc s
ghi: ung 2 ln/ ngy th khong cch gi
mi ln ung thuc l 12 (24 gi/2) Ung
3 ln/ ngy, khong cch gi l 8 (24gi/3)
Ung thuc s ngy bc s ghi trong n
(l mt liu trnh) thng l 7 hoc 10 ngy.
2/ Nhng loi khng sinh phi ung trong
ba n: L cc loi thuc kch thch ng
tiu ha, thuc khng b gim hp thu
do thc n, nh: Metronidazol, Tinidazol.
-Doxycyclin, Tetracyclin. -Ciprofoxacin,
Norfoxacin, Ofoxacin (thng bc s ghi
trong n thuc).
3/ Nhng loi khng sinh phi ung xa
ba n (tr cc loi thuc ghi trn mc
3) Trc ba n 2 gi hoc sau ba n 3
gi; do cc loi thuc ny b gim hp thu
do thc n hoc km bn vng trong mi
trng dch v.
4/ Ring loi vin bao tan trong rut: th
ung lc no cng c.
KING K
- Trong thi gian dng thuc khng sinh,
khng nn ung thuc trnh thai, m phi
dng cc bin php trnh thai khc
- Khng ung bia, ru (nc cha etha-
nol) khi dng mt s thuc khng sinh nh:
Thuc chng lao.Thuc cha Metronda-
zol (cc dng: ung, tim, t m o).
Erythromycin, Tetracyclin. Cephalosporin,
Clindamycin.n
TH NO CHO AN TON
DS TRN XUN THUYT
DU NG THUO C KHA NG SINH
TRN TH TRNG NC TA HIN C 17 NHM THUC KHNG SINH VI
KHONG 500 TN THUC GC V HNG NGN TN BIT DC KHC NHAU
S DNG THUC AN TON HIU QU