{"id":3219,"date":"2025-02-11T08:26:06","date_gmt":"2025-02-11T01:26:06","guid":{"rendered":"https:\/\/hienbacsi.com\/?p=3219"},"modified":"2025-02-11T09:02:24","modified_gmt":"2025-02-11T02:02:24","slug":"thuoc-gay-doc-cho-than-cap-nhat-nhanh","status":"publish","type":"post","link":"https:\/\/hienbacsi.com\/index.php\/2025\/02\/11\/thuoc-gay-doc-cho-than-cap-nhat-nhanh\/","title":{"rendered":"Thu\u1ed1c G\u00e2y \u0110\u1ed9c Cho Th\u1eadn \u2013 C\u1eadp Nh\u1eadt Nhanh"},"content":{"rendered":"\n

ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n<\/mark><\/strong><\/p>\n\n\n\n

T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU \u0110H CORSE C\u1ed9ng Ho\u00e0 Ph\u00e1p<\/mark><\/strong><\/p>\n\n\n\n

Th\u1eadn \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c l\u1ecdc m\u00e1u v\u00e0 b\u00e0i ti\u1ebft c\u00e1c ch\u1ea5t \u0111\u1ed9c ra kh\u1ecfi c\u01a1 th\u1ec3. Tuy nhi\u00ean, nhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn theo nhi\u1ec1u c\u01a1 ch\u1ebf kh\u00e1c nhau, d\u1eabn \u0111\u1ebfn suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, th\u1eadm ch\u00ed suy th\u1eadn c\u1ea5p (AKI). D\u01b0\u1edbi \u0111\u00e2y l\u00e0 t\u1ed5ng quan v\u1ec1 c\u00e1c nh\u00f3m thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y \u0111\u1ed9c th\u1eadn v\u00e0 c\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u00fang.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

1. Nh\u00f3m thu\u1ed1c v\u00e0 c\u01a1 ch\u1ebf g\u00e2y \u0111\u1ed9c th\u1eadn<\/p>\n\n\n\n

1.1. NSAIDs (Thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng steroid)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: NSAIDs \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p prostaglandin, l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn th\u1eadn, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 g\u00e2y thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 t\u1ea1i th\u1eadn, t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p (AKI) v\u00e0 vi\u00eam k\u1ebd th\u1eadn.<\/p>\n\n\n\n

1.2. Aminoglycosides (Kh\u00e1ng sinh nh\u00f3m aminoglycoside)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: T\u00edch t\u1ee5 trong \u1ed1ng l\u01b0\u1ee3n g\u1ea7n c\u1ee7a th\u1eadn, g\u00e2y stress oxy h\u00f3a v\u00e0 ho\u1ea1i t\u1eed \u1ed1ng th\u1eadn.<\/p>\n\n\n\n

1.3. Vancomycin<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: L\u00e0m r\u1ed1i lo\u1ea1n qu\u00e1 tr\u00ecnh t\u00e1i h\u1ea5p thu t\u1ea1i bi\u1ec3u m\u00f4 \u1ed1ng th\u1eadn g\u1ea7n v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng ty th\u1ec3 c\u1ee7a t\u1ebf b\u00e0o n\u00e0y.<\/p>\n\n\n\n

1.4. ACE inhibitors (Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin \u2013 ACEi)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: Gi\u1ea3m \u00e1p l\u1ef1c l\u1ecdc c\u1ea7u th\u1eadn b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf angiotensin II, t\u1eeb \u0111\u00f3 l\u00e0m gi\u1ea3m t\u01b0\u1edbi m\u00e1u th\u1eadn.<\/p>\n\n\n\n

1.5. Thu\u1ed1c l\u1ee3i ti\u1ec3u nh\u00f3m Loop v\u00e0 Thiazide<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: G\u00e2y m\u1ea5t n\u01b0\u1edbc v\u00e0 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, d\u1eabn \u0111\u1ebfn suy th\u1eadn tr\u01b0\u1edbc th\u1eadn (prerenal AKI).<\/p>\n\n\n\n

1.6. Cyclosporine v\u00e0 Tacrolimus (Thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: G\u00e2y co m\u1ea1ch t\u1ea1i th\u1eadn, d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng th\u1eadn m\u1ea1n t\u00ednh.<\/p>\n\n\n\n

1.7. Cisplatin v\u00e0 Carboplatin (Thu\u1ed1c h\u00f3a tr\u1ecb nh\u00f3m platin)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: K\u1ebft tinh trong \u1ed1ng th\u1eadn, g\u00e2y t\u1eafc ngh\u1ebdn v\u00e0 t\u1ed5n th\u01b0\u01a1ng.<\/p>\n\n\n\n

1.8. Acyclovir (Thu\u1ed1c kh\u00e1ng virus nh\u00f3m nucleoside analogues)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: K\u1ebft t\u1ee7a trong \u1ed1ng th\u1eadn, g\u00e2y b\u1ec7nh th\u1eadn do tinh th\u1ec3 (crystal nephropathy).<\/p>\n\n\n\n

1.9. Lithium<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: T\u00edch l\u0169y trong t\u1ebf b\u00e0o \u1ed1ng g\u00f3p, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ADH, g\u00e2y r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a n\u01b0\u1edbc.<\/p>\n\n\n\n

1.10. Tenofovir Disoproxil (Thu\u1ed1c kh\u00e1ng virus HIV \u2013 HBV)<\/p>\n\n\n\n

\u2022 C\u01a1 ch\u1ebf: G\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn ch\u1ee7 y\u1ebfu qua \u0111\u1ed9c t\u00ednh \u1ed1ng th\u1eadn. Thu\u1ed1c kh\u00f3 b\u1ecb \u0111\u00e0o th\u1ea3i ra kh\u1ecfi t\u1ebf b\u00e0o do b\u1ecb c\u1ea3n tr\u1edf b\u1edfi protein \u0111a kh\u00e1ng thu\u1ed1c (MRP4), d\u1eabn \u0111\u1ebfn t\u00edch l\u0169y n\u1ed9i b\u00e0o, g\u00e2y h\u1ed9i ch\u1ee9ng Fanconi.<\/p>\n\n\n\n

2. T\u1ed5ng k\u1ebft v\u00e0 khuy\u1ebfn ngh\u1ecb l\u00e2m s\u00e0ng<\/p>\n\n\n\n

\u2022 Khi k\u00ea \u0111\u01a1n c\u00e1c thu\u1ed1c tr\u00ean, c\u1ea7n \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc v\u00e0 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n

\u2022 Theo d\u00f5i s\u00e1t c\u00e1c ch\u1ec9 s\u1ed1: Creatinine huy\u1ebft thanh, eGFR, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong m\u00e1u (n\u1ebfu c\u00f3 th\u1ec3).<\/p>\n\n\n\n

\u2022 C\u1ea7n th\u1eadn tr\u1ecdng khi ph\u1ed1i h\u1ee3p c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 g\u00e2y \u0111\u1ed9c th\u1eadn nh\u01b0 NSAIDs + ACEi + l\u1ee3i ti\u1ec3u (b\u1ed9 ba nguy hi\u1ec3m).<\/p>\n\n\n\n

\u2022 U\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 b\u00f9 d\u1ecbch h\u1ee3p l\u00fd khi s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 g\u00e2y k\u1ebft tinh ho\u1eb7c m\u1ea5t n\u01b0\u1edbc.<\/p>\n\n\n\n

Nh\u1eadn di\u1ec7n v\u00e0 ph\u00f2ng ng\u1eeba s\u1edbm c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m thi\u1ec3u bi\u1ebfn ch\u1ee9ng tr\u00ean th\u1eadn v\u00e0 t\u1ed1i \u01b0u h\u00f3a hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n

ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n – chuy\u00ean gia gan m\u1eadt<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU \u0110H CORSE C\u1ed9ng Ho\u00e0 Ph\u00e1p Th\u1eadn \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c l\u1ecdc m\u00e1u v\u00e0 b\u00e0i ti\u1ebft c\u00e1c ch\u1ea5t \u0111\u1ed9c…<\/p>\n","protected":false},"author":1,"featured_media":3221,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[131],"tags":[67,88],"jetpack_featured_media_url":"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/02\/img_3945-1.jpg","_links":{"self":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3219"}],"collection":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/comments?post=3219"}],"version-history":[{"count":2,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3219\/revisions"}],"predecessor-version":[{"id":3222,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3219\/revisions\/3222"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media\/3221"}],"wp:attachment":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media?parent=3219"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/categories?post=3219"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/tags?post=3219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}