{"id":1016,"date":"2026-05-19T09:51:55","date_gmt":"2026-05-19T02:51:55","guid":{"rendered":"https:\/\/opv.vn\/?post_type=product&p=1016"},"modified":"2026-05-19T09:51:55","modified_gmt":"2026-05-19T02:51:55","slug":"tydol-650","status":"publish","type":"product","link":"https:\/\/opv.vn\/en\/tydol-650\/","title":{"rendered":"TYDOL\u00ae 650"},"content":{"rendered":"

PH\u1ea6N I.<\/strong> H<\/strong>\u01af\u1edaNG D\u1eaaN S\u1eec D\u1ee4NG THU\u1ed0C CHO NG\u01af\u1edcI B\u1ec6NH<\/strong><\/p>\n

TH\u00c0NH PH\u1ea6N, H\u00c0M L\u01af\u1ee2NG C\u1ee6A THU\u1ed0C<\/strong>: <\/strong>M\u1ed7i vi\u00ean n\u00e9n bao phim ch\u1ee9a:<\/p>\n

– Ho\u1ea1t ch\u1ea5t<\/em>: Acetaminophen\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.650 mg<\/p>\n

– T\u00e1 d\u01b0\u1ee3c<\/em>: Tinh b\u1ed9t ng\u00f4, povidon K30, tinh b\u1ed9t ti\u1ec1n h\u1ed3 h\u00f3a, natri starch glycolat, gelatin, silic oxyd d\u1ea1ng keo khan, talc, magnesi stearat, opadry II white.<\/p>\n

M\u00d4 T\u1ea2 S\u1ea2N PH\u1ea8M:<\/strong><\/p>\n

Vi\u00ean n\u00e9n bao phim, h\u00ecnh thu\u00f4n d\u00e0i, m\u00e0u tr\u1eafng, c\u00f3 in ch\u1eef s\u1ed1 \u201cTydol 650\u201d m\u00e0u \u0111en tr\u00ean hai m\u1eb7t vi\u00ean.<\/p>\n

QUY C\u00c1CH \u0110\u00d3NG G\u00d3I:<\/strong><\/p>\n

H\u1ed9p 1 v\u1ec9 x 10 vi\u00ean n\u00e9n bao phim.<\/p>\n

H\u1ed9p 10 v\u1ec9 x 10 vi\u00ean n\u00e9n bao phim.<\/p>\n

THU\u1ed0C D\u00d9NG CHO B\u1ec6NH G\u00cc:<\/strong><\/p>\n

– H\u1ea1 s\u1ed1t.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb c\u00e1c c\u01a1n \u0111au nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh g\u1ed3m: nh\u1ee9c \u0111\u1ea7u, \u0111au do c\u1ea3m l\u1ea1nh v\u00e0 c\u1ea3m c\u00fam, \u0111au h\u1ecdng, \u0111au do h\u00e0nh kinh, \u0111au sau khi ti\u00eam ng\u1eeba hay nh\u1ed5 r\u0103ng, \u0111au r\u0103ng, \u0111au n\u1eeda \u0111\u1ea7u, \u0111au do vi\u00eam x\u01b0\u01a1ng kh\u1edbp.<\/p>\n

N\u00caN D\u00d9NG THU\u1ed0C N\u00c0Y NH\u01af TH\u1ebe N\u00c0O V\u00c0 LI\u1ec0U L\u01af\u1ee2NG:<\/strong><\/p>\n

C\u00e1ch d\u00f9ng:<\/em> D\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng.<\/p>\n

Li\u1ec1u d\u00f9ng:<\/em> U\u1ed1ng thu\u1ed1c c\u00e1ch m\u1ed7i 4-6 gi\u1edd n\u1ebfu c\u1ea7n<\/p>\n

– Ng\u01b0\u1eddi l\u1edbn: u\u1ed1ng 1 vi\u00ean. Kh\u00f4ng d\u00f9ng qu\u00e1 6 vi\u00ean\/ 24 gi\u1edd.<\/p>\n

– Tr\u1ebb em t\u1eeb 7-12 tu\u1ed5i: u\u1ed1ng \u00bd vi\u00ean. Kh\u00f4ng d\u00f9ng qu\u00e1 3 vi\u00ean trong 24 gi\u1edd.<\/p>\n

Kho\u1ea3ng c\u00e1ch t\u1ed1i thi\u1ec3u gi\u1eefa 2 l\u1ea7n u\u1ed1ng: 4 gi\u1edd.<\/p>\n

L\u01b0u \u00fd: Kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u1ec3 t\u1ef1 \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au qu\u00e1 10 ng\u00e0y \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 qu\u00e1 5 ng\u00e0y \u1edf tr\u1ebb em, ho\u1eb7c s\u1ed1t cao (39,5o<\/sup>C) qu\u00e1 3 ng\u00e0y tr\u1eeb khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129.<\/p>\n

KHI N\u00c0O KH\u00d4NG N\u00caN D\u00d9NG THU\u1ed0C N\u00c0Y:<\/strong><\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh qu\u00e1 m\u1eabn v\u1edbi acetaminophen ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c.<\/p>\n

Suy gan n\u1eb7ng.<\/p>\n

T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N:<\/strong><\/p>\n

\u00cdt g\u1eb7p:<\/em><\/p>\n

Ph\u00e1t ban, bu\u1ed3n n\u00f4n, n\u00f4n, lo\u1ea1n t\u1ea1o m\u00e1u (gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh, gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u), thi\u1ebfu m\u00e1u, b\u1ec7nh th\u1eadn, \u0111\u1ed9c t\u00ednh th\u1eadn khi d\u00f9ng thu\u1ed1c d\u00e0i ng\u00e0y.<\/p>\n

Hi\u1ebfm g\u1eb7p:<\/em><\/p>\n

Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n

N\u00caN TR\u00c1NH D\u00d9NG NH\u1eeeNG THU\u1ed0C HO\u1eb6C TH\u1ef0C PH\u1ea8M G\u00cc KHI \u0110ANG S\u1eec D\u1ee4NG THU\u1ed0C N\u00c0Y<\/strong>: <\/strong><\/p>\n

– Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u coumarin v\u00e0 d\u1eabn ch\u1ea5t indandion.<\/p>\n

– Phenothiazin.<\/p>\n

– R\u01b0\u1ee3u.<\/p>\n

– C\u00e1c thu\u1ed1c ch\u1ed1ng co gi\u1eadt (g\u1ed3m phenytoin, barbiturat, carbamazepin), isoniazid.<\/p>\n

C\u1ea6N L\u00c0M G\u00cc KHI M\u1ed8T L\u1ea6N QU\u00caN KH\u00d4NG D\u00d9NG THU\u1ed0C:<\/strong><\/p>\n

N\u1ebfu b\u1ea1n qu\u00ean d\u00f9ng thu\u1ed1c, d\u00f9ng n\u00f3 ngay khi b\u1ea1n nh\u1edb. N\u1ebfu th\u1eddi gian g\u1ea7n t\u1edbi li\u1ec1u k\u1ebf ti\u1ebfp, th\u00ec h\u00e3y b\u1ecf qua li\u1ec1u b\u1ecb qu\u00ean v\u00e0 d\u00f9ng li\u1ec1u k\u1ebf ti\u1ebfp theo k\u1ebf ho\u1ea1ch b\u00ecnh th\u01b0\u1eddng. Kh\u00f4ng n\u00ean g\u1ea5p \u0111\u00f4i li\u1ec1u d\u00f9ng.<\/p>\n

C\u1ea6N B\u1ea2O QU\u1ea2N THU\u1ed0C N\u00c0Y NH\u01af TH\u1ebe N\u00c0O:<\/strong><\/p>\n

\u1ede nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 300<\/sup>C, n\u01a1i kh\u00f4 r\u00e1o, tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n

NH\u1eeeNG D\u1ea4U HI\u1ec6U V\u00c0 TRI\u1ec6U CH\u1ee8NG KHI D\u00d9NG THU\u1ed0C QU\u00c1 LI\u1ec0U:<\/strong><\/p>\n

Tri\u1ec7u ch\u1ee9ng: <\/em><\/p>\n

Nhi\u1ec5m \u0111\u1ed9c acetaminophen c\u00f3 th\u1ec3 do d\u00f9ng m\u1ed9t li\u1ec1u \u0111\u1ed9c duy nh\u1ea5t, ho\u1eb7c do u\u1ed1ng l\u1eb7p l\u1ea1i li\u1ec1u l\u1edbn acetaminophen (v\u00ed d\u1ee5 7,5 \u2013 10 g m\u1ed7i ng\u00e0y, trong 1-2 ng\u00e0y ), ho\u1eb7c do u\u1ed1ng thu\u1ed1c d\u00e0i ng\u00e0y. Ho\u1ea1i t\u1eed gan ph\u1ee5 thu\u1ed9c li\u1ec1u l\u00e0 t\u00e1c d\u1ee5ng \u0111\u1ed9c c\u1ea5p t\u00ednh nghi\u00eam tr\u1ecdng nh\u1ea5t do qu\u00e1 li\u1ec1u v\u00e0 c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong.<\/p>\n

Bu\u1ed3n n\u00f4n, n\u00f4n, v\u00e0 \u0111au b\u1ee5ng th\u01b0\u1eddng x\u1ea3y ra trong v\u00f2ng 2-3 gi\u1edd sau khi u\u1ed1ng li\u1ec1u \u0111\u1ed9c c\u1ee7a thu\u1ed1c. Methemoglobin m\u00e1u, d\u1eabn \u0111\u1ebfn ch\u1ee9ng xanh t\u00edm da, ni\u00eam m\u1ea1c v\u00e0 m\u00f3ng tay l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u \u0111\u1eb7c tr\u01b0ng nhi\u1ec5m \u0111\u1ed9c c\u1ea5p t\u00ednh d\u1eabn ch\u1ea5t p-aminophenol; m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf sulfhemoglobin c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1ea3n sinh. Tr\u1ebb em c\u00f3 khuynh h\u01b0\u1edbng t\u1ea1o methemoglobin d\u1ec5 h\u01a1n ng\u01b0\u1eddi l\u1edbn sau khi u\u1ed1ng acetaminophen.<\/p>\n

Khi b\u1ecb ng\u1ed9 \u0111\u1ed9c n\u1eb7ng, ban \u0111\u1ea7u c\u00f3 th\u1ec3 c\u00f3 k\u00edch th\u00edch h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, k\u00edch \u0111\u1ed9ng, v\u00e0 m\u00ea s\u1ea3ng. Ti\u1ebfp theo c\u00f3 th\u1ec3 l\u00e0 \u1ee9c ch\u1ebf h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: s\u1eefng s\u1edd, h\u1ea1 th\u00e2n nhi\u1ec7t, m\u1ec7t l\u1ea3, th\u1edf nhanh, n\u00f4ng; m\u1ea1ch nhanh, y\u1ebfu, kh\u00f4ng \u0111\u1ec1u, huy\u1ebft \u00e1p th\u1ea5p v\u00e0 suy tu\u1ea7n ho\u00e0n. Tr\u1ee5y m\u1ea1ch do gi\u1ea3m oxy huy\u1ebft t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 do t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf trung t\u00e2m, t\u00e1c d\u1ee5ng n\u00e0y ch\u1ec9 x\u1ea3y ra v\u1edbi li\u1ec1u r\u1ea5t l\u1edbn. S\u1ed1c c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu gi\u00e3n m\u1ea1ch nhi\u1ec1u. C\u01a1n co gi\u1eadt ngh\u1eb9t th\u1edf g\u00e2y t\u1eed vong c\u00f3 th\u1ec3 x\u1ea3y ra. Th\u01b0\u1eddng h\u00f4n m\u00ea x\u1ea3y ra tr\u01b0\u1edbc khi ch\u1ebft \u0111\u1ed9t ng\u1ed9t ho\u1eb7c sau v\u00e0i ng\u00e0y h\u00f4n m\u00ea.<\/p>\n

D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng th\u01b0\u01a1ng t\u1ed5n gan tr\u1edf n\u00ean r\u00f5 r\u1ec7t trong v\u00f2ng 2 \u0111\u1ebfn 4 ng\u00e0y sau khi u\u1ed1ng li\u1ec1u \u0111\u1ed9c. Aminotransferase huy\u1ebft t\u01b0\u01a1ng t\u0103ng (\u0111\u00f4i khi t\u0103ng r\u1ea5t cao) v\u00e0 n\u1ed3ng \u0111\u1ed9 bilirubin trong huy\u1ebft t\u01b0\u01a1ng c\u0169ng c\u00f3 th\u1ec3 t\u0103ng; th\u00eam n\u1eefa, khi th\u01b0\u01a1ng t\u1ed5n gan lan r\u1ed9ng, th\u1eddi gian prothrombin s\u1ebd k\u00e9o d\u00e0i. C\u00f3 th\u1ec3 10% ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ng\u1ed9 \u0111\u1ed9c kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u \u0111\u00e3 c\u00f3 th\u01b0\u01a1ng t\u1ed5n gan nghi\u00eam tr\u1ecdng; trong s\u1ed1 \u0111\u00f3 10% \u0111\u1ebfn 20% cu\u1ed1i c\u00f9ng ch\u1ebft v\u00ec suy gan. Suy th\u1eadn c\u1ea5p c\u0169ng x\u1ea3y ra \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh. Sinh thi\u1ebft gan ph\u00e1t hi\u1ec7n ho\u1ea1i t\u1eed trung t\u00e2m ti\u1ec3u th\u00f9y tr\u1eeb v\u00f9ng quanh t\u0129nh m\u1ea1ch c\u1eeda. \u1ede nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng t\u1eed vong, th\u01b0\u01a1ng t\u1ed5n gan ph\u1ee5c h\u1ed3i sau nhi\u1ec1u tu\u1ea7n ho\u1eb7c nhi\u1ec1u th\u00e1ng.<\/p>\n

C\u1ea6N PH\u1ea2I L\u00c0M G\u00cc KHI D\u00d9NG THU\u1ed0C QU\u00c1 LI\u1ec0U KHUY\u1ebeN C\u00c1O:<\/strong><\/p>\n

Th\u00f4ng b\u00e1o ngay cho b\u00e1c s\u1ef9 ho\u1eb7c \u0111\u1ebfn b\u1ec7nh vi\u1ec7n g\u1ea7n nh\u1ea5t.<\/p>\n

Nh\u1edb mang theo nh\u00e3n thu\u1ed1c ho\u1eb7c l\u01b0\u1ee3ng thu\u1ed1c c\u00f2n l\u1ea1i \u0111\u1ec3 b\u00e1c s\u1ef9 bi\u1ebft thu\u1ed1c m\u00e0 b\u1ea1n \u0111\u00e3 d\u00f9ng.<\/p>\n

NH\u1eeeNG \u0110I\u1ec0U C\u1ea6N TH\u1eacN TR\u1eccNG KHI D\u00d9NG THU\u1ed0C N\u00c0Y:<\/strong><\/p>\n

Tham kh\u1ea3o \u00fd ki\u1ebfn b\u00e1c s\u1ef9 n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f4ng thuy\u00ean gi\u1ea3m ho\u1eb7c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb suy gan ho\u1eb7c suy th\u1eadn n\u1eb7ng.<\/p>\n

Ng\u01b0\u1eddi b\u1ecb phenylceton- ni\u1ec7u, b\u1ec7nh thi\u1ebfu m\u00e1u t\u1eeb tr\u01b0\u1edbc v\u00e0 u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u.<\/p>\n

Kh\u00f4ng d\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 ch\u1ee9a acetaminophen.<\/p>\n

\u0110\u00f4i khi c\u00f3 nh\u1eefng ph\u1ea3n \u1ee9ng da g\u1ed3m ban d\u00e1t s\u1ea7n ng\u1ee9a v\u00e0 m\u00e0y \u0111ay; nh\u1eefng ph\u1ea3n \u1ee9ng m\u1eabn c\u1ea3m kh\u00e1c g\u1ed3m ph\u00f9 thanh qu\u1ea3n, ph\u00f9 m\u1ea1ch v\u00e0 nh\u1eefng ph\u1ea3n \u1ee9ng ki\u1ec3u ph\u1ea3n v\u1ec7 c\u00f3 th\u1ec3 \u00edt khi x\u1ea3y ra. Gi\u1ea3m ti\u1ec3u c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u v\u00e0 gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u \u0111\u00e3 x\u1ea3y ra v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng nh\u1eefng d\u1eabn ch\u1ea5t p-aminophenol, \u0111\u1eb7c bi\u1ec7t khi d\u00f9ng k\u00e9o d\u00e0i c\u00e1c li\u1ec1u l\u1edbn. Gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh v\u00e0 ban xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u \u0111\u00e3 x\u1ea3y ra khi d\u00f9ng acetaminophen. Hi\u1ebfm g\u1eb7p m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t \u1edf ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng acetaminophen.<\/p>\n

U\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u00e2y t\u0103ng \u0111\u1ed9c t\u00ednh v\u1edbi gan c\u1ee7a acetaminophen, n\u00ean tr\u00e1nh ho\u1eb7c h\u1ea1n ch\u1ebf u\u1ed1ng r\u01b0\u1ee3u.<\/p>\n

Th\u1eddi k\u1ef3 mang thai v\u00e0 cho con b\u00fa:<\/strong> C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt kh\u00f4ng ph\u00e1t hi\u1ec7n b\u1ea5t c\u1ee9 nguy h\u1ea1i n\u00e0o \u0111\u1ebfn s\u1ef1 mang thai v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i thai-b\u00e0o thai. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi ch\u01b0a th\u1ea5y c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n c\u00f3 h\u1ea1i cho m\u1eb9 v\u00e0 tr\u1ebb \u0111ang b\u00fa m\u1eb9. Ch\u1ec9 d\u00f9ng acetaminophen \u1edf ng\u01b0\u1eddi mang thai khi th\u1eadt c\u1ea7n thi\u1ebft.<\/p>\n

\u1ea2nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c \u0111\u1ed1i v\u1edbi c\u00f4ng vi\u1ec7c:<\/strong> Ch\u01b0a ghi nh\u1eadn \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i ho\u1eb7c ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o v\u1ec1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c l\u00ean kh\u1ea3 n\u0103ng v\u1eadn h\u00e0nh m\u00e1y m\u00f3c, l\u00e1i t\u00e0u xe, ng\u01b0\u1eddi l\u00e0m vi\u1ec7c tr\u00ean cao v\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c.<\/p>\n

KHI N\u00c0O C\u1ea6N THAM V\u1ea4N B\u00c1C S\u1ef8, D\u01af\u1ee2C S\u1ef8:<\/strong><\/p>\n

Trong tr\u01b0\u1eddng h\u1ee3p qu\u00e1 li\u1ec1u ho\u1eb7c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n.<\/p>\n

Khi \u0111ang d\u00f9ng thu\u1ed1c kh\u00e1c ho\u1eb7c m\u1ed9t lo\u1ea1i th\u1ef1c ph\u1ea9m.<\/p>\n

N\u1ebfu c\u1ea7n th\u00eam th\u00f4ng tin xin h\u1ecfi \u00fd ki\u1ebfn b\u00e1c s\u1ef9 <\/strong>ho\u1eb7c<\/strong> d\u01b0\u1ee3c s\u1ef9<\/strong>.<\/p>\n

H\u1ea0N D\u00d9NG C\u1ee6A THU\u1ed0C: <\/strong>48 th\u00e1ng k\u1ec3 t\u1eeb ng\u00e0y s\u1ea3n xu\u1ea5t. Kh\u00f4ng d\u00f9ng thu\u1ed1c khi qu\u00e1 h\u1ea1n d\u00f9ng<\/p>\n

 <\/p>\n

PH\u1ea6N II. H\u01af\u1edaNG D\u1eaaN S\u1eec D\u1ee4NG THU\u1ed0C CHO C\u00c1N B\u1ed8 Y T\u1ebe<\/strong><\/p>\n

D\u01af\u1ee2C L\u1ef0C H\u1eccC<\/strong>:<\/strong><\/p>\n

Nh\u00f3m d\u01b0\u1ee3c l\u00fd<\/em>:<\/em> Gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t.<\/p>\n

M<\/em>\u00e3 ATC<\/em>:<\/em> N02BE01<\/p>\n

Acetaminophen l\u00e0 thu\u1ed1c gi\u1ea3m \u0111au \u2013 h\u1ea1 s\u1ed1t h\u1eefu hi\u1ec7u c\u00f3 th\u1ec3 thay th\u1ebf aspirin, tuy v\u1eady acetaminophen kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb vi\u00eam. V\u1edbi li\u1ec1u ngang nhau, acetaminophen c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au h\u1ea1 s\u1ed1t t\u01b0\u01a1ng t\u1ef1 nh\u01b0 aspirin. Acetaminophen l\u00e0m gi\u1ea3m th\u00e2n nhi\u1ec7t \u1edf ng\u01b0\u1eddi b\u1ec7nh s\u1ed1t nh\u01b0ng hi\u1ebfm khi l\u00e0m gi\u1ea3m th\u00e2n nhi\u1ec7t \u1edf ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. Acetaminophen, v\u1edbi li\u1ec1u \u0111i\u1ec1u tr\u1ecb, \u00edt t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn h\u1ec7 tim m\u1ea1ch v\u00e0 h\u00f4 h\u1ea5p, kh\u00f4ng l\u00e0m thay \u0111\u1ed5i c\u00e2n b\u1eb1ng acid \u2013 base, kh\u00f4ng g\u00e2y k\u00edch \u1ee9ng, x\u01b0\u1edbc ho\u1eb7c ch\u1ea3y m\u00e1u d\u1ea1 d\u00e0y nh\u01b0 khi d\u00f9ng aspirin v\u00e0 salicylat. Khi d\u00f9ng qu\u00e1 li\u1ec1u acetaminophen, ch\u1ea5t chuy\u1ec3n ho\u00e1 N-acetyl-p-benzoquinonimin g\u00e2y \u0111\u1ed9c n\u1eb7ng cho gan. Li\u1ec1u b\u00ecnh th\u01b0\u1eddng, acetaminophen dung n\u1ea1p t\u1ed1t kh\u00f4ng c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 aspirin. Tuy v\u1eady qu\u00e1 li\u1ec1u c\u1ea5p t\u00ednh (tr\u00ean 10 g) s\u1ebd l\u00e0m t\u1ed5n th\u01b0\u01a1ng gan g\u00e2y ch\u1ebft ng\u01b0\u1eddi.<\/p>\n

D\u01af\u1ee2C \u0110\u1ed8NG H\u1eccC<\/strong>:<\/strong><\/p>\n

Acetaminophen \u0111\u01b0\u1ee3c h\u1ea5p thu nhanh t\u1eeb \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u1edbi n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t \u0111\u01b0\u1ee3c kho\u1ea3ng t\u1eeb 10 – 60 ph\u00fat sau khi u\u1ed1ng. Acetaminophen \u0111\u01b0\u1ee3c ph\u00e2n b\u1ed1 trong h\u1ea7u h\u1ebft c\u00e1c m\u00f4 c\u1ee7a c\u01a1 th\u1ec3. Acetaminophen qua nhau thai v\u00e0 hi\u1ec7n di\u1ec7n trong s\u1eefa m\u1eb9. G\u1eafn k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng kh\u00f4ng \u0111\u00e1ng k\u1ec3 t\u1ea1i n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng nh\u01b0ng g\u1eafn k\u1ebft s\u1ebd t\u0103ng khi n\u1ed3ng \u0111\u1ed9 t\u0103ng. Th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a acetaminophen thay \u0111\u1ed5i t\u1eeb kho\u1ea3ng 1 \u0111\u1ebfn 3 gi\u1edd. Acetaminophen \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ch\u1ee7 y\u1ebfu \u1edf gan v\u00e0 b\u00e0i ti\u1ebft trong n\u01b0\u1edbc ti\u1ec3u ch\u1ee7 y\u1ebfu d\u01b0\u1edbi d\u1ea1ng li\u00ean h\u1ee3p glucuronid (60 – 80%) v\u00e0 li\u00ean h\u1ee3p sulphat (20 – 30%). \u00cdt h\u01a1n 5% \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i. M\u1ed9t ph\u1ea7n nh\u1ecf (d\u01b0\u1edbi 4%) \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a cytochrom P450<\/sub> th\u00e0nh ch\u1ea5t chuy\u1ec3n h\u00f3a. Tr\u01b0\u1eddng h\u1ee3p ng\u1ed9 \u0111\u1ed9c do d\u00f9ng li\u1ec1u cao, l\u01b0\u1ee3ng ch\u1ea5t chuy\u1ec3n h\u00f3a t\u0103ng l\u00ean v\u00e0 \u0111\u01b0\u1ee3c kh\u1eed \u0111\u1ed9c nh\u1edd li\u00ean h\u1ee3p v\u1edbi glutathion. Acetaminophen b\u1ecb N-hydroxyl h\u00f3a b\u1edfi cytochrom P450<\/sub> \u0111\u1ec3 t\u1ea1o n\u00ean N-acetyl-benzoquinonimin (NAPQ), m\u1ed9t ch\u1ea5t trung gian c\u00f3 t\u00ednh ph\u1ea3n \u1ee9ng cao. Ch\u1ea5t chuy\u1ec3n h\u00f3a n\u00e0y b\u00ecnh th\u01b0\u1eddng ph\u1ea3n \u1ee9ng v\u1edbi c\u00e1c nh\u00f3m sulfhydryl trong glutathion v\u00e0 b\u1ecb kh\u1eed ho\u1ea1t t\u00ednh. Tuy nhi\u00ean, n\u1ebfu u\u1ed1ng li\u1ec1u cao acetaminophen, ch\u1ea5t chuy\u1ec3n h\u00f3a n\u00e0y \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh v\u1edbi l\u01b0\u1ee3ng \u0111\u1ee7 \u0111\u1ec3 l\u00e0m c\u1ea1n ki\u1ec7t glutathion c\u1ee7a gan; trong t\u00ecnh tr\u1ea1ng \u0111\u00f3, ch\u1ea5t NAPQ kh\u00f4ng \u0111\u01b0\u1ee3c li\u00ean h\u1ee3p v\u1edbi glutathion g\u00e2y \u0111\u1ed9c cho t\u1ebf b\u00e0o gan, d\u1eabn \u0111\u1ebfn vi\u00eam v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed gan.<\/p>\n

CH\u1ec8 \u0110\u1ecaNH<\/strong>:<\/strong><\/p>\n

Acetaminophen l\u00e0 m\u1ed9t thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 h\u1ea1 s\u1ed1t.<\/p>\n

Acetaminophen \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong:<\/p>\n

– H\u1ea1 s\u1ed1t.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb c\u00e1c c\u01a1n \u0111au nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh g\u1ed3m: nh\u1ee9c \u0111\u1ea7u, \u0111au do c\u1ea3m l\u1ea1nh v\u00e0 c\u1ea3m c\u00fam, \u0111au h\u1ecdng, \u0111au do h\u00e0nh kinh, \u0111au sau khi ti\u00eam ng\u1eeba hay nh\u1ed5 r\u0103ng, \u0111au r\u0103ng, \u0111au n\u1eeda \u0111\u1ea7u, \u0111au do vi\u00eam x\u01b0\u01a1ng kh\u1edbp.<\/p>\n

C\u00c1CH D\u00d9NG<\/strong>, <\/strong>LI\u1ec0U D\u00d9NG<\/strong>:<\/strong><\/p>\n

C\u00e1ch d\u00f9ng:<\/em> D\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng.<\/p>\n

Li\u1ec1u d\u00f9ng<\/em>: U\u1ed1ng thu\u1ed1c c\u00e1ch m\u1ed7i 4-6 gi\u1edd n\u1ebfu c\u1ea7n<\/p>\n

– Ng\u01b0\u1eddi l\u1edbn: u\u1ed1ng 1 vi\u00ean. Kh\u00f4ng d\u00f9ng qu\u00e1 6 vi\u00ean\/ 24 gi\u1edd.<\/p>\n

– Tr\u1ebb em t\u1eeb 7-12 tu\u1ed5i: u\u1ed1ng \u00bd vi\u00ean. Kh\u00f4ng d\u00f9ng qu\u00e1 3 vi\u00ean trong 24 gi\u1edd.<\/p>\n

Kho\u1ea3ng c\u00e1ch t\u1ed1i thi\u1ec3u gi\u1eefa 2 l\u1ea7n u\u1ed1ng: 4 gi\u1edd.<\/p>\n

L\u01b0u \u00fd: Kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u1ec3 t\u1ef1 \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au qu\u00e1 10 ng\u00e0y \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 qu\u00e1 5 ng\u00e0y \u1edf tr\u1ebb em,\u00a0 ho\u1eb7c s\u1ed1t cao (39,5o<\/sup>C) qu\u00e1 3 ng\u00e0y tr\u1eeb khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129.<\/p>\n

CH\u1ed0NG CH\u1ec8 \u0110\u1ecaNH<\/strong>:<\/strong><\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh qu\u00e1 m\u1eabn v\u1edbi acetaminophen ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c.<\/p>\n

Suy gan n\u1eb7ng.<\/p>\n

L\u01afU \u00dd V\u00c0 TH\u1eacN TR\u1eccNG:<\/strong><\/p>\n

Th\u1eadn tr\u1ecdng v\u00e0 c\u1ea3nh b\u00e1o \u0111\u1eb7c bi\u1ec7t khi s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ee9a ho\u1ea1t ch\u1ea5t <\/strong>acetaminophen<\/strong>:<\/strong> B\u00e1c s\u0129 c\u1ea7n c\u1ea3nh b\u00e1o b\u1ec7nh nh\u00e2n v\u1ec1 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a ph\u1ea3n \u1ee9ng tr\u00ean da nghi\u00eam tr\u1ecdng nh\u01b0 h\u1ed9i ch\u1ee9ng Steven-Johnson (SJS), h\u1ed9i ch\u1ee9ng ho\u1ea1i t\u1eed da nhi\u1ec5m \u0111\u1ed9c (TEN), hay h\u1ed9i ch\u1ee9ng Lyell, h\u1ed9i ch\u1ee9ng ngo\u1ea1i ban m\u1ee5n m\u1ee7 to\u00e0n th\u00e2n c\u1ea5p t\u00ednh (AGEP).<\/p>\n

Tham kh\u1ea3o \u00fd ki\u1ebfn b\u00e1c s\u0129 n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f4ng thuy\u00ean gi\u1ea3m ho\u1eb7c trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh b\u1ecb suy gan ho\u1eb7c suy th\u1eadn n\u1eb7ng.<\/p>\n

Ng\u01b0\u1eddi b\u1ecb phenylceton- ni\u1ec7u, b\u1ec7nh thi\u1ebfu m\u00e1u t\u1eeb tr\u01b0\u1edbc v\u00e0 u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u.<\/p>\n

Kh\u00f4ng d\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 ch\u1ee9a acetaminophen.<\/p>\n

\u0110\u00f4i khi c\u00f3 nh\u1eefng ph\u1ea3n \u1ee9ng da g\u1ed3m ban d\u00e1t s\u1ea7n ng\u1ee9a v\u00e0 m\u00e0y \u0111ay; nh\u1eefng ph\u1ea3n \u1ee9ng m\u1eabn c\u1ea3m kh\u00e1c g\u1ed3m ph\u00f9 thanh qu\u1ea3n, ph\u00f9 m\u1ea1ch v\u00e0 nh\u1eefng ph\u1ea3n \u1ee9ng ki\u1ec3u ph\u1ea3n v\u1ec7 c\u00f3 th\u1ec3 \u00edt khi x\u1ea3y ra. Gi\u1ea3m ti\u1ec3u c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u v\u00e0 gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u \u0111\u00e3 x\u1ea3y ra v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng nh\u1eefng d\u1eabn ch\u1ea5t p-aminophenol, \u0111\u1eb7c bi\u1ec7t khi d\u00f9ng k\u00e9o d\u00e0i c\u00e1c li\u1ec1u l\u1edbn. Gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh v\u00e0 ban xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u \u0111\u00e3 x\u1ea3y ra khi d\u00f9ng acetaminophen. Hi\u1ebfm g\u1eb7p m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t \u1edf ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng acetaminophen.<\/p>\n

U\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u00e2y t\u0103ng \u0111\u1ed9c t\u00ednh v\u1edbi gan c\u1ee7a acetaminophen, n\u00ean tr\u00e1nh ho\u1eb7c h\u1ea1n ch\u1ebf u\u1ed1ng r\u01b0\u1ee3u.<\/p>\n

Th\u1eddi k\u1ef3 mang thai v\u00e0 cho con b\u00fa: <\/strong>Acetaminophen thu\u1ed9c v\u1ec1 ph\u00e2n nh\u00f3m B.<\/p>\n

C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt kh\u00f4ng ph\u00e1t hi\u1ec7n b\u1ea5t c\u1ee9 nguy h\u1ea1i n\u00e0o \u0111\u1ebfn s\u1ef1 mang thai v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i thai-b\u00e0o thai. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi ch\u01b0a th\u1ea5y c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n c\u00f3 h\u1ea1i cho m\u1eb9 v\u00e0 tr\u1ebb \u0111ang b\u00fa m\u1eb9. Ch\u1ec9 d\u00f9ng acetaminophen \u1edf ng\u01b0\u1eddi mang thai khi th\u1eadt c\u1ea7n thi\u1ebft.<\/p>\n

\u1ea2nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c \u0111\u1ed1i v\u1edbi c\u00f4ng vi\u1ec7c:<\/strong> Ch\u01b0a ghi nh\u1eadn \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i ho\u1eb7c ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o v\u1ec1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c l\u00ean kh\u1ea3 n\u0103ng v\u1eadn h\u00e0nh m\u00e1y m\u00f3c, l\u00e1i t\u00e0u xe, ng\u01b0\u1eddi l\u00e0m vi\u1ec7c tr\u00ean cao v\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c.<\/p>\n

T\u01af\u01a0NG T\u00c1C THU\u1ed0C<\/strong>:<\/strong><\/p>\n

U\u1ed1ng d\u00e0i ng\u00e0y li\u1ec1u cao acetaminophen l\u00e0m t\u0103ng nh\u1eb9 t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng c\u1ee7a coumarin v\u00e0 d\u1eabn ch\u1ea5t indandion.<\/p>\n

D\u00f9ng \u0111\u1ed3ng th\u1eddi acetaminophen v\u00e0 phenothiazin c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y h\u1ea1 s\u1ed1t nghi\u00eam tr\u1ecdng.<\/p>\n

U\u1ed1ng qu\u00e1 nhi\u1ec1u r\u01b0\u1ee3u v\u00e0 d\u00e0i ng\u00e0y l\u00e0m t\u0103ng nguy c\u01a1 acetaminophen g\u00e2y \u0111\u1ed9c cho gan.<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng co gi\u1eadt (g\u1ed3m phenytoin, barbiturat, carbamazepin), isoniazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a acetaminophen tr\u00ean gan.<\/p>\n

T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N<\/strong>:<\/strong><\/p>\n

\u00cdt g\u1eb7p, 1\/1000 < ADR < 1\/100 <\/em><\/p>\n

Ph\u00e1t ban, bu\u1ed3n n\u00f4n, n\u00f4n, lo\u1ea1n t\u1ea1o m\u00e1u (gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh, gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u), thi\u1ebfu m\u00e1u, b\u1ec7nh th\u1eadn, \u0111\u1ed9c t\u00ednh th\u1eadn khi d\u00f9ng thu\u1ed1c d\u00e0i ng\u00e0y.<\/p>\n

Hi\u1ebfm g\u1eb7p, ADR < 1\/1000 <\/em><\/p>\n

Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n

QU\u00c1 LI\u1ec0U V\u00c0 X\u1eec TR\u00cd<\/strong>:<\/strong><\/p>\n

Tri\u1ec7u ch\u1ee9ng: <\/em><\/p>\n

Nhi\u1ec5m \u0111\u1ed9c acetaminophen c\u00f3 th\u1ec3 do d\u00f9ng m\u1ed9t li\u1ec1u \u0111\u1ed9c duy nh\u1ea5t, ho\u1eb7c do u\u1ed1ng l\u1eb7p l\u1ea1i li\u1ec1u l\u1edbn acetaminophen (v\u00ed d\u1ee5 7,5 \u2013 10 g m\u1ed7i ng\u00e0y, trong 1-2 ng\u00e0y ), ho\u1eb7c do u\u1ed1ng thu\u1ed1c d\u00e0i ng\u00e0y. Ho\u1ea1i t\u1eed gan ph\u1ee5 thu\u1ed9c li\u1ec1u l\u00e0 t\u00e1c d\u1ee5ng \u0111\u1ed9c c\u1ea5p t\u00ednh nghi\u00eam tr\u1ecdng nh\u1ea5t do qu\u00e1 li\u1ec1u v\u00e0 c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong.<\/p>\n

Bu\u1ed3n n\u00f4n, n\u00f4n, v\u00e0 \u0111au b\u1ee5ng th\u01b0\u1eddng x\u1ea3y ra trong v\u00f2ng 2-3 gi\u1edd sau khi u\u1ed1ng li\u1ec1u \u0111\u1ed9c c\u1ee7a thu\u1ed1c. Methemoglobin m\u00e1u, d\u1eabn \u0111\u1ebfn ch\u1ee9ng xanh t\u00edm da, ni\u00eam m\u1ea1c v\u00e0 m\u00f3ng tay l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u \u0111\u1eb7c tr\u01b0ng nhi\u1ec5m \u0111\u1ed9c c\u1ea5p t\u00ednh d\u1eabn ch\u1ea5t p-aminophenol; m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf sulfhemoglobin c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1ea3n sinh. Tr\u1ebb em c\u00f3 khuynh h\u01b0\u1edbng t\u1ea1o methemoglobin d\u1ec5 h\u01a1n ng\u01b0\u1eddi l\u1edbn sau khi u\u1ed1ng acetaminophen.<\/p>\n

Khi b\u1ecb ng\u1ed9 \u0111\u1ed9c n\u1eb7ng, ban \u0111\u1ea7u c\u00f3 th\u1ec3 c\u00f3 k\u00edch th\u00edch h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, k\u00edch \u0111\u1ed9ng, v\u00e0 m\u00ea s\u1ea3ng. Ti\u1ebfp theo c\u00f3 th\u1ec3 l\u00e0 \u1ee9c ch\u1ebf h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: s\u1eefng s\u1edd, h\u1ea1 th\u00e2n nhi\u1ec7t, m\u1ec7t l\u1ea3, th\u1edf nhanh, n\u00f4ng; m\u1ea1ch nhanh, y\u1ebfu, kh\u00f4ng \u0111\u1ec1u, huy\u1ebft \u00e1p th\u1ea5p v\u00e0 suy tu\u1ea7n ho\u00e0n. Tr\u1ee5y m\u1ea1ch do gi\u1ea3m oxy huy\u1ebft t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 do t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf trung t\u00e2m, t\u00e1c d\u1ee5ng n\u00e0y ch\u1ec9 x\u1ea3y ra v\u1edbi li\u1ec1u r\u1ea5t l\u1edbn. S\u1ed1c c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu gi\u00e3n m\u1ea1ch nhi\u1ec1u. C\u01a1n co gi\u1eadt ngh\u1eb9t th\u1edf g\u00e2y t\u1eed vong c\u00f3 th\u1ec3 x\u1ea3y ra. Th\u01b0\u1eddng h\u00f4n m\u00ea x\u1ea3y ra tr\u01b0\u1edbc khi ch\u1ebft \u0111\u1ed9t ng\u1ed9t ho\u1eb7c sau v\u00e0i ng\u00e0y h\u00f4n m\u00ea.<\/p>\n

D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng th\u01b0\u01a1ng t\u1ed5n gan tr\u1edf n\u00ean r\u00f5 r\u1ec7t trong v\u00f2ng 2 \u0111\u1ebfn 4 ng\u00e0y sau khi u\u1ed1ng li\u1ec1u \u0111\u1ed9c. Aminotransferase huy\u1ebft t\u01b0\u01a1ng t\u0103ng (\u0111\u00f4i khi t\u0103ng r\u1ea5t cao) v\u00e0 n\u1ed3ng \u0111\u1ed9 bilirubin trong huy\u1ebft t\u01b0\u01a1ng c\u0169ng c\u00f3 th\u1ec3 t\u0103ng; th\u00eam n\u1eefa, khi th\u01b0\u01a1ng t\u1ed5n gan lan r\u1ed9ng, th\u1eddi gian prothrombin s\u1ebd k\u00e9o d\u00e0i. C\u00f3 th\u1ec3 10% ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ng\u1ed9 \u0111\u1ed9c kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u \u0111\u00e3 c\u00f3 th\u01b0\u01a1ng t\u1ed5n gan nghi\u00eam tr\u1ecdng; trong s\u1ed1 \u0111\u00f3 10% \u0111\u1ebfn 20% cu\u1ed1i c\u00f9ng ch\u1ebft v\u00ec suy gan. Suy th\u1eadn c\u1ea5p c\u0169ng x\u1ea3y ra \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh. Sinh thi\u1ebft gan ph\u00e1t hi\u1ec7n ho\u1ea1i t\u1eed trung t\u00e2m ti\u1ec3u th\u00f9y tr\u1eeb v\u00f9ng quanh t\u0129nh m\u1ea1ch c\u1eeda. \u1ede nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng t\u1eed vong, th\u01b0\u01a1ng t\u1ed5n gan ph\u1ee5c h\u1ed3i sau nhi\u1ec1u tu\u1ea7n ho\u1eb7c nhi\u1ec1u th\u00e1ng.<\/p>\n

\u0110i\u1ec1u tr\u1ecb<\/em>:<\/p>\n

Ch\u1ea9n \u0111o\u00e1n s\u1edbm r\u1ea5t quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb qu\u00e1 li\u1ec1u acetaminophen. C\u00f3 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p x\u00e1c \u0111\u1ecbnh nhanh n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng. Tuy v\u1eady, kh\u00f4ng \u0111\u01b0\u1ee3c tr\u00ec ho\u00e3n \u0111i\u1ec1u tr\u1ecb trong khi ch\u1edd \u0111\u1ee3i k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m n\u1ebfu b\u1ec7nh s\u1eed g\u1ee3i \u00fd l\u00e0 qu\u00e1 li\u1ec1u n\u1eb7ng. Khi nhi\u1ec5m \u0111\u1ed9c n\u1eb7ng, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 t\u00edch c\u1ef1c. C\u1ea7n r\u1eeda d\u1ea1 d\u00e0y trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p, t\u1ed1t nh\u1ea5t trong v\u00f2ng 4 gi\u1edd sau khi u\u1ed1ng. Li\u1ec7u ph\u00e1p gi\u1ea3i \u0111\u1ed9c ch\u00ednh l\u00e0 d\u00f9ng nh\u1eefng h\u1ee3p ch\u1ea5t sulfhydryl, c\u00f3 l\u1ebd t\u00e1c \u0111\u1ed9ng m\u1ed9t ph\u1ea7n do b\u1ed5 sung d\u1ef1 tr\u1eef glutathion \u1edf gan. N-acetylcystein c\u00f3 t\u00e1c d\u1ee5ng khi u\u1ed1ng ho\u1eb7c ti\u00eam t\u0129nh m\u1ea1ch. Ph\u1ea3i d\u00f9ng thu\u1ed1c gi\u1ea3i \u0111\u1ed9c ngay l\u1eadp t\u1ee9c, c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t n\u1ebfu ch\u01b0a \u0111\u1ebfn 36 gi\u1edd k\u1ec3 t\u1eeb khi u\u1ed1ng acetaminophen. \u0110i\u1ec1u tr\u1ecb v\u1edbi N-acetylcystein c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n khi cho thu\u1ed1c trong th\u1eddi gian d\u01b0\u1edbi 10 gi\u1edd sau khi u\u1ed1ng acetaminophen. Khi cho u\u1ed1ng, h\u00f2a lo\u00e3ng dung d\u1ecbch N-acetylcystein v\u1edbi n\u01b0\u1edbc ho\u1eb7c \u0111\u1ed3 u\u1ed1ng kh\u00f4ng c\u00f3 r\u01b0\u1ee3u \u0111\u1ec3 \u0111\u1ea1t dung d\u1ecbch 5% v\u00e0 ph\u1ea3i u\u1ed1ng trong v\u00f2ng 1 gi\u1edd sau khi pha. Cho u\u1ed1ng N-acetylcystein v\u1edbi li\u1ec1u \u0111\u1ea7u ti\u00ean l\u00e0 140 mg\/kg, sau \u0111\u00f3 cho ti\u1ebfp 17 li\u1ec1u n\u1eefa, m\u1ed7i li\u1ec1u 70 mg\/kg c\u00e1ch nhau 4 gi\u1edd m\u1ed9t l\u1ea7n. Ch\u1ea5m d\u1ee9t \u0111i\u1ec1u tr\u1ecb n\u1ebfu x\u00e9t nghi\u1ec7m acetaminophen trong huy\u1ebft t\u01b0\u01a1ng cho th\u1ea5y nguy c\u01a1 \u0111\u1ed9c h\u1ea1i gan th\u1ea5p. C\u0169ng c\u00f3 th\u1ec3 d\u00f9ng N-acetylcystein theo \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch: li\u1ec1u ban \u0111\u1ea7u l\u00e0 150 mg\/kg, pha trong 200 ml glucose 5%, ti\u00eam t\u0129nh m\u1ea1ch trong 15 ph\u00fat; sau \u0111\u00f3 truy\u1ec1n t\u0129nh m\u1ea1ch li\u1ec1u 50mg\/kg trong 500 ml glucose 5% trong 4 gi\u1edd; ti\u1ebfp theo l\u00e0 100 mg\/kg trong 1 l\u00edt dung d\u1ecbch trong v\u00f2ng 16 gi\u1edd ti\u1ebfp theo. N\u1ebfu kh\u00f4ng c\u00f3 dung d\u1ecbch glucose 5% th\u00ec c\u00f3 th\u1ec3 d\u00f9ng dung d\u1ecbch natri clorid 0,9%.<\/p>\n

T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a N-acetylcystein g\u1ed3m ban da (g\u1ed3m c\u1ea3 m\u00e0y \u0111ay, kh\u00f4ng y\u00eau c\u1ea7u ph\u1ea3i ng\u1eebng thu\u1ed1c), bu\u1ed3n n\u00f4n, n\u00f4n, \u1ec9a ch\u1ea3y, v\u00e0 ph\u1ea3n \u1ee9ng ki\u1ec3u ph\u1ea3n v\u1ec7.<\/p>\n

N\u1ebfu kh\u00f4ng c\u00f3 N-acetylcystein, c\u00f3 th\u1ec3 d\u00f9ng methionin. N\u1ebfu \u0111\u00e3 d\u00f9ng than ho\u1ea1t tr\u01b0\u1edbc khi d\u00f9ng methionin th\u00ec ph\u1ea3i h\u00fat than ho\u1ea1t ra kh\u1ecfi d\u1ea1 d\u00e0y tr\u01b0\u1edbc. Ngo\u00e0i ra c\u00f3 th\u1ec3 d\u00f9ng than ho\u1ea1t v\u00e0\/ho\u1eb7c thu\u1ed1c t\u1ea9y mu\u1ed1i do ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m h\u1ea5p th\u1ee5 acetaminophen.<\/p>\n

C\u00c1C D\u1ea4U HI\u1ec6U C\u1ea6N L\u01afU \u00dd V\u00c0 KHUY\u1ebeN C\u00c1O<\/strong>:<\/strong><\/p>\n

Kh\u00f4ng d\u00f9ng qu\u00e1 li\u1ec1u ch\u1ec9 \u0111\u1ecbnh.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

PH\u1ea6N I. H\u01af\u1edaNG D\u1eaaN S\u1eec D\u1ee4NG THU\u1ed0C CHO NG\u01af\u1edcI B\u1ec6NH TH\u00c0NH PH\u1ea6N, H\u00c0M L\u01af\u1ee2NG C\u1ee6A THU\u1ed0C: M\u1ed7i vi\u00ean n\u00e9n bao phim ch\u1ee9a: – Ho\u1ea1t ch\u1ea5t: Acetaminophen\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.650 mg – T\u00e1 d\u01b0\u1ee3c: Tinh b\u1ed9t ng\u00f4, povidon K30, tinh b\u1ed9t ti\u1ec1n h\u1ed3 h\u00f3a, natri starch glycolat, gelatin, silic oxyd d\u1ea1ng keo khan, talc, magnesi stearat, opadry II white….<\/p>\n","protected":false},"featured_media":804,"comment_status":"closed","ping_status":"open","template":"","meta":[],"product_cat":[39],"product_tag":[],"class_list":["post-1016","product","type-product","status-publish","has-post-thumbnail","hentry","product_cat-tydol-analgesics"],"_links":{"self":[{"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/product\/1016","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/comments?post=1016"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/media\/804"}],"wp:attachment":[{"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/media?parent=1016"}],"wp:term":[{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/product_cat?post=1016"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/opv.vn\/en\/wp-json\/wp\/v2\/product_tag?post=1016"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}