{"id":1721,"date":"2023-04-08T12:52:51","date_gmt":"2023-04-08T05:52:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=1721"},"modified":"2023-04-17T10:20:35","modified_gmt":"2023-04-17T03:20:35","slug":"frusemide","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/08\/frusemide\/","title":{"rendered":"10 quan ni\u1ec7m sai l\u1ea7m v\u1ec1 Frusemide"},"content":{"rendered":"

Hi\u1ec7n nay, Frusemide v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u00ecnh tr\u1ea1ng t\u0103ng \u1ee9 d\u1ecbch v\u00e0 t\u0103ng huy\u1ebft \u00e1p. Ngo\u00e0i ra, n\u00f3 c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00e1c b\u1ec7nh l\u00fd c\u1ea5p t\u00ednh kh\u00e1c. Tuy nhi\u00ean, c\u0169ng nh\u01b0 b\u1ea5t k\u1ef3 lo\u1ea1i thu\u1ed1c n\u00e0o kh\u00e1c, vi\u1ec7c s\u1eed d\u1ee5ng Frusemide c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 khi\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng tr\u1edf n\u00ean h\u1ea1n, k\u00e8m theo \u0111\u00f3 c\u00f2n\u00a0 c\u00f3 m\u1ed9t s\u1ed1 quan \u0111i\u1ec3m sai l\u1ea7m v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng Frusemide trong l\u00e2m s\u00e0ng. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 10 quan \u0111i\u1ec3m sai l\u1ea7m th\u01b0\u1eddng g\u1eb7p trong l\u00e2m s\u00e0ng.<\/strong><\/p>\n

1. Frusemide l\u00e0 thu\u1ed1c g\u00ec?<\/h1>\n

Frusemide l\u00e0 lo\u1ea1i thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf b\u1ec7nh nh\u00e2n n\u1eb7ng. Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc Co-Transporter Na+\/K+\/2Cl\u2212 tr\u00ean m\u00e0ng Luminal \u1edf nh\u00e1nh l\u00ean c\u1ee7a quai Henle. \u0110\u1ec3 \u0111\u1ebfn n\u01a1i t\u00e1c \u0111\u1ed9ng, furosemide \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 b\u1edfi t\u1ebf b\u00e0o th\u1eadn tr\u01b0\u1edbc \u0111\u00f3 th\u00f4ng qua c\u00e1c v\u1eadn chuy\u1ec3n anion h\u1eefu c\u01a1 v\u00e0 sau \u0111\u00f3 \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft \u0111\u1ebfn m\u00e0ng Luminal t\u1eeb \u0111\u00f3 \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n \u0111\u1ebfn \u1ed1ng th\u1eadn xa. Frusemide g\u00e2y m\u1ea5t n\u01b0\u1edbc nhi\u1ec1u h\u01a1n l\u00e0 m\u1ea5t natri, d\u1eabn \u0111\u1ebfn n\u01b0\u1edbc ti\u1ec3u tr\u1edf n\u00ean lo\u00e3ng h\u01a1n. S\u1ef1 kh\u00e1ng thu\u1ed1c l\u1ee3i ti\u1ec3u kh\u00f4ng ph\u1ea3i l\u00e0 \u0111i\u1ec1u hi\u1ebfm g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n nh\u1eadn li\u1ec7u tr\u00ecnh k\u00e9o d\u00e0i v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u quai. H\u01a1n n\u1eefa, c\u00f3 lo ng\u1ea1i r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng, bao g\u1ed3m t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p (AKI). \u0110i\u1ec1u n\u00e0y \u0111\u00e3 g\u00e2y ra s\u1ef1 b\u1ea5t an cho c\u00e1c B\u00e1c s\u0129 trong vi\u1ec7c s\u1eed d\u1ee5ng frusemide m\u1ed9t c\u00e1ch an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n nguy k\u1ecbch c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 AKI. \u1ede \u0111\u00e2y, ch\u00fang t\u00f4i gi\u1ea3i quy\u1ebft 10 quan ni\u1ec7m sai l\u1ea7m v\u1ec1 frusemide v\u00e0 \u1ee9ng d\u1ee5ng c\u1ee7a n\u00f3 \u1edf b\u1ec7nh nh\u00e2n nguy k\u1ecbch.<\/p>\n

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Minh h\u1ecda qu\u00e1 tr\u00ednh t\u00e1c d\u1ee5ng c\u1ee7a l\u1ee3i ti\u1ec3u Frusemide Ngu\u1ed3n: Derange Physiology<\/figcaption><\/figure>\n

2. 10 QUAN \u0110I\u1ec2M SAI L\u1ea6M V\u1ec0 FRUSEMIDE<\/h2>\n

2.1. QUAN \u0110I\u1ebeM 1<\/strong>: Frusemide g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p.<\/em><\/p>\n

\u0110i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng \u0111\u00fang.<\/strong><\/p>\n

Frusemide \u00a0g\u00e2y th\u00fac \u0111\u1ea9y l\u1ee3i ti\u1ec3u v\u00e0 \u0111\u1eb7c bi\u1ec7t c\u00f3 l\u1ee3i \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u0111ang b\u1ecb qu\u00e1 t\u1ea3i d\u1ecbch. Tuy nhi\u00ean, c\u00f3 quan ni\u1ec7m ph\u1ed5 bi\u1ebfn r\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u c\u00f3 th\u1ec3 g\u00e2y ra AKI. Tr\u00ean th\u1ef1c t\u1ebf, ch\u1ec9 c\u00f3 v\u00e0i nghi\u00ean c\u1ee9u \u0111\u00e3 x\u00e1c \u0111\u1ecbnh vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 cho AKI. Tuy nhi\u00ean, h\u1ea7u h\u1ebft c\u00e1c b\u00e1o c\u00e1o kh\u00f4ng ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nhau c\u1ee7a AKI v\u00e0 bao g\u1ed3m b\u1ec7nh nh\u00e2n c\u00f3 AKI do thi\u1ebfu n\u01b0\u1edbc c\u01a1 th\u1ec3. R\u1ea5t c\u00f3 th\u1ec3 vi\u1ec7c s\u1eed d\u1ee5ng kh\u00f4ng \u0111\u00fang c\u00e1ch thu\u1ed1c l\u1ee3i ti\u1ec3u \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n n\u00e0y g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 ti\u1ebfn tri\u1ec3n \u0111\u1ebfn AKI. Tuy nhi\u00ean, khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u00fang c\u00e1ch \u1edf b\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 t\u1ea3i d\u1ecbch, frusemide th\u1ef1c s\u1ef1 c\u00f3 th\u1ec3 gi\u00fap h\u1ed3i ph\u1ee5c AKI, c\u00f3 l\u1ebd do gi\u1ea3i quy\u1ebft t\u1eafc ngh\u1ebdn n\u1ed9i th\u1eadn v\u00e0 gi\u1ea3m ti\u00eau th\u1ee5 oxy c\u1ee7a th\u1eadn.<\/p>\n

2.2. QUAN \u0110I\u1ec2M 2<\/strong>: Frusemide c\u00f9ng v\u1edbi d\u1ecbch c\u00f3 th\u1ec3 ng\u0103n ng\u1eeba AKI \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao.<\/em><\/p>\n

\u0110i\u1ec1u \u0111\u00f3 c\u00f3 th\u1ec3 kh\u00f4ng ph\u1ea3i.<\/strong><\/p>\n

C\u00f3 m\u1ed9t quan \u0111i\u1ec3m ph\u1ed5 bi\u1ebfn r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi frusemide v\u00e0 truy\u1ec1n d\u1ecbch s\u1ebd l\u00e0m t\u0103ng l\u1ee3i ti\u1ec3u m\u00e0 kh\u00f4ng g\u00e2y gi\u1ea3m th\u1ec3 t\u00edch m\u00e1u. Tr\u00ean th\u1ef1c t\u1ebf, c\u00e1c h\u1ec7 th\u1ed1ng hydrat h\u00f3a ph\u00f9 h\u1ee3p t\u1ef1 \u0111\u1ed9ng s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u v\u00e0 d\u1ecbch c\u01a1 th\u1ec3 c\u00f9ng nhau t\u1ed3n t\u1ea1i \u0111\u1ec3 ng\u0103n ng\u1eeba AKI li\u00ean quan \u0111\u1ebfn thu\u1ed1c c\u1ea3n quang (CA-AKI). Trong khi m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 nh\u1eadn th\u1ea5y t\u1ef7 l\u1ec7 m\u1eafc CA-AKI gi\u1ea3m, c\u00e1c nghi\u00ean c\u1ee9u \u1edf b\u1ec7nh nh\u00e2n m\u1eafc AKI kh\u00f4ng ch\u1ee9ng minh \u0111\u01b0\u1ee3c t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i \u0111\u1ed1i v\u1edbi s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a AKI. N\u00f3i chung, truy\u1ec1n d\u1ecbch n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m th\u1ec3 t\u00edch m\u00e1u n\u1ed9i m\u1ea1ch v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u n\u00ean \u0111\u01b0\u1ee3c d\u00e0nh ri\u00eang cho b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng th\u1ec3 t\u00edch m\u00e1u n\u1ed9i m\u1ea1ch.<\/p>\n

2.3. QUAN \u0110I\u1ec2M 3<\/strong>: Frusemide b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p.<\/em><\/p>\n

\u0110i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng \u0111\u00fang.<\/strong><\/p>\n

Frusemide \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 t\u1ea3i d\u1ecbch, bao g\u1ed3m c\u1ea3 nh\u1eefng ng\u01b0\u1eddi m\u1eafc AKI. Tuy nhi\u00ean, c\u00f3 th\u1ec3 c\u1ea7n d\u00f9ng li\u1ec1u cao h\u01a1n trong AKI, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf AKI n\u1eb7ng khi nguy c\u01a1 kh\u00e1ng thu\u1ed1c l\u1ee3i ti\u1ec3u c\u0169ng cao h\u01a1n. Frusemide c\u0169ng c\u00f3 vai tr\u00f2 trong vi\u1ec7c ki\u1ec3m so\u00e1t t\u0103ng kali m\u00e1u. Cu\u1ed1i c\u00f9ng, frusemide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n AKI khi \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng \u1ed1ng th\u1eadn v\u00e0 nguy c\u01a1 ti\u1ebfn tri\u1ec3n \u0111\u1ebfn c\u00e1c giai \u0111o\u1ea1n cao h\u01a1n c\u1ee7a AKI (Frusemide Stress Test).<\/p>\n

2.4. QUAN \u0110I\u1ec2M 4<\/strong>: Frusemide c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t ch\u1ee9c n\u0103ng th\u1eadn<\/em><\/p>\n

\u0110i\u1ec1u n\u00e0y kh\u00f4ng \u0111\u00fang.<\/strong><\/p>\n

Frusemide c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn l\u1ee3i ti\u1ec3u \u0111\u00e1ng k\u1ec3 \u1edf b\u1ec7nh nh\u00e2n AKI. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y ph\u1ea3i \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u cho th\u1ea5y c\u00e1c t\u1ebf b\u00e0o \u1ed1ng th\u1eadn \u0111ang ho\u1ea1t \u0111\u1ed9ng, ch\u1ee9 kh\u00f4ng ph\u1ea3i l\u00e0 t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i tr\u1ef1c ti\u1ebfp c\u1ee7a frusemide \u0111\u1ed1i v\u1edbi ch\u1ee9c n\u0103ng th\u1eadn. Li\u1ec1u l\u1eb7p l\u1ea1i c\u1ee7a frusemide, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf li\u1ec1u cao v\u00e0 \u1edf b\u1ec7nh nh\u00e2n v\u00f4 ni\u1ec7u, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 gia t\u0103ng \u0111\u00e1ng k\u1ec3 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5, \u0111\u1eb7c bi\u1ec7t l\u00e0 nhi\u1ec5m \u0111\u1ed9c tai. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 t\u1ea3i d\u1ecbch, nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u, vi\u1ec7c s\u1eed d\u1ee5ng frusemide l\u1eb7p l\u1ea1i kh\u00f4ng c\u00f3 vai tr\u00f2 g\u00ec. Trong t\u00ecnh hu\u1ed1ng n\u00e0y, n\u00ean c\u00e2n nh\u1eafc lo\u1ea1i b\u1ecf d\u1ecbch b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p ngo\u00e0i c\u01a1 th\u1ec3.<\/p>\n

2.5. QUAN \u0110I\u1ec2M 5<\/strong>: Frusemide s\u1ebd t\u00e1c d\u1ee5ng t\u1ed1t h\u01a1n khi c\u00f3 Albumin.<\/em><\/p>\n

\u0110i\u1ec1u n\u00e0y c\u00f2n t\u00f9y v\u00e0o tr\u01b0\u1eddng h\u1ee3p.<\/strong><\/p>\n

Trong huy\u1ebft t\u01b0\u01a1ng, frusemide g\u1eafn k\u1ebft nhi\u1ec1u v\u1edbi protein v\u00e0 gi\u1ea3m albumin m\u00e1u nghi\u00eam tr\u1ecdng c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c gi\u1ea3m b\u00e0i ti\u1ebft frusemide v\u00e0o l\u00f2ng \u1ed1ng th\u1eadn. B\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 vi\u1ec7c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p albumin v\u00e0 frusemide c\u00f2n \u00edt. Trong m\u1ed9t nghi\u00ean c\u1ee9u bao g\u1ed3m nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 gan v\u00e0 c\u1ed5 tr\u01b0\u1edbng, vi\u1ec7c s\u1eed d\u1ee5ng h\u1ed7n h\u1ee3p thu\u1ed1c l\u1ee3i ti\u1ec3u quai v\u00e0 albumin (40 mg frusemide v\u00e0 25 g albumin) kh\u00f4ng l\u00e0m t\u0103ng ph\u1ea3n \u1ee9ng th\u1ea3i natri. Ng\u01b0\u1ee3c l\u1ea1i, m\u1ed9t nghi\u00ean c\u1ee9u ch\u00e9o ng\u1eabu nhi\u00ean c\u00f3 ki\u1ec3m so\u00e1t \u1edf 24 b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh (CKD) v\u00e0 gi\u1ea3m albumin m\u00e1u cho th\u1ea5y l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u t\u0103ng \u0111\u00e1ng k\u1ec3 khi s\u1eed d\u1ee5ng frusemide v\u00e0 albumin. Tuy nhi\u00ean, sau 24 gi\u1edd, kh\u00f4ng c\u00f2n s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 n\u00e0o n\u1eefa. M\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p bao g\u1ed3m 10 nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ee9ng minh kh\u1ea3 n\u0103ng ki\u1ec3m so\u00e1t c\u00e2n b\u1eb1ng d\u1ecbch t\u1ed1t h\u01a1n khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi frusemide v\u00e0 albumin \u1edf b\u1ec7nh nh\u00e2n h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft. C\u00e1c nghi\u00ean c\u1ee9u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 n\u1ed3ng \u0111\u1ed9 protein trong m\u00e1u b\u00ecnh th\u01b0\u1eddng l\u00e0 kh\u00f4ng thuy\u1ebft ph\u1ee5c, ch\u1ec9 ra r\u1eb1ng kh\u00f4ng c\u00f3 l\u1ee3i \u00edch tr\u1ef1c ti\u1ebfp n\u00e0o c\u1ee7a vi\u1ec7c truy\u1ec1n k\u1ebft h\u1ee3p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n

2.6. QUAN \u0110I\u1ec2M 6<\/strong>. Truy\u1ec1n Frusemide hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n l\u00e0 Bolus Frusemide<\/em>.<\/p>\n

\u0110i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng \u0111\u00fang<\/strong><\/p>\n

M\u1ed9t s\u1ed1 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 ki\u1ec3m so\u00e1t (RCT) v\u00e0 ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p cho th\u1ea5y vi\u1ec7c truy\u1ec1n l\u1ee3i ti\u1ec3u li\u00ean t\u1ee5c d\u1ec5 d\u00e0ng h\u01a1n khi so v\u1edbi \u0111i\u1ec1u tr\u1ecb bolus ng\u1eaft qu\u00e3ng, nh\u01b0ng kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n, bao g\u1ed3m t\u1ef7 l\u1ec7 t\u1eed vong, th\u1eddi gian n\u1eb1m vi\u1ec7n, hi\u1ec7u qu\u1ea3 ch\u1ee9c n\u0103ng th\u1eadn ho\u1eb7c r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.<\/p>\n

2.7. QUAN \u0110I\u1ec2M 7<\/strong>: Frusemide c\u00f3 th\u1ec3 ng\u0103n ng\u1eeba bi\u1ec7n ph\u00e1p thay th\u1ebf th\u1eadn<\/em><\/p>\n

\u0110i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng th\u1ec3<\/strong><\/p>\n

Frusemide c\u00f3 vai tr\u00f2 g\u00e2y l\u1ee3i ti\u1ec3u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 t\u1ea3i d\u1ecbch. N\u1ebfu \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u, vi\u1ec7c s\u1eed d\u1ee5ng frusemide c\u00f3 th\u1ec3 k\u00e9o d\u00e0i th\u1eddi gian tr\u01b0\u1edbc khi c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u RRT. M\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u quai c\u00f3 li\u00ean quan \u0111\u1ebfn th\u1eddi gian RRT ng\u1eafn h\u01a1n. Tuy nhi\u00ean, frusemide kh\u00f4ng \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn c\u01a1 h\u1ed9i ph\u1ee5c h\u1ed3i th\u1eadn. M\u1ed9t th\u1eed nghi\u1ec7m th\u00ed \u0111i\u1ec3m (nghi\u00ean c\u1ee9u SPARK) so s\u00e1nh frusemide li\u1ec1u th\u1ea5p v\u1edbi gi\u1ea3 d\u01b0\u1ee3c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc AKI s\u1edbm v\u00e0 kh\u00f4ng t\u00ecm th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 AKI n\u1eb7ng h\u01a1n ho\u1eb7c nhu c\u1ea7u RRT.<\/p>\n

2.8. QUAN \u0110I\u1ec2M 8<\/strong>: Frusemide gi\u00fap c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng v\u00f4 ni\u1ec7u \u1edf b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb thay th\u1ebfth\u1eadn.<\/em><\/p>\n

\u0110i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng \u0111\u00fang.<\/strong><\/p>\n

\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng \u0111i\u1ec1u tr\u1ecb thay th\u1ebf th\u1eadn, t\u0103ng b\u00e0i ni\u1ec7u l\u00e0 l\u00fd do ph\u1ed5 bi\u1ebfn \u0111\u1ec3 ng\u1eebng \u0111i\u1ec1u tr\u1ecb thay th\u1ebf th\u1eadn v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch n\u00e0y. Tuy nhi\u00ean, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y thu\u1ed1c l\u1ee3i ti\u1ec3u c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c c\u1ea3i thi\u1ec7n \u0111\u1ed9 thanh th\u1ea3i creatinin ho\u1eb7c k\u00edch th\u00edch ph\u1ee5c h\u1ed3i th\u1eadn. Tuy nhi\u00ean, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng frusemide c\u0169ng li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 nhi\u1ec5m \u0111\u1ed9c tai cao h\u01a1n, m\u1ed9t nguy c\u01a1 c\u00f3 th\u1ec3 \u0111\u1eb7c bi\u1ec7t li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n v\u00f4 ni\u1ec7u c\u00f3 nguy c\u01a1 t\u00edch l\u0169y frusemide cao h\u01a1n.<\/p>\n

2.9. QUAN \u0110I\u1ec2M 9<\/strong>: L\u1ee3i ti\u1ec3u do Frusemide g\u00e2y ra sau AKI \u0111\u1ed3ng ngh\u0129a ph\u1ee5c h\u1ed3i th\u1eadn ho\u00e0n to\u00e0n.<\/em><\/p>\n

\u0110i\u1ec1u n\u00e0y kh\u00f4ng \u0111\u00fang.<\/strong><\/p>\n

M\u1eb7c d\u00f9 s\u1eed d\u1ee5ng frusemide c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u (UO) \u1edf b\u1ec7nh nh\u00e2n m\u1eafc AKI, nh\u01b0ng l\u1ee3i ti\u1ec3u do frusemide g\u00e2y ra sau AKI kh\u00f4ng \u0111\u01b0\u1ee3c coi l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a s\u1ef1 ph\u1ee5c h\u1ed3i th\u1eadn ho\u00e0n to\u00e0n v\u00e0 v\u0129nh vi\u1ec5n. Ngay c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n ch\u1ec9 tr\u1ea3i qua m\u1ed9t \u0111\u1ee3t AKI v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng b\u00e0i ti\u1ebft v\u1eabn c\u00f3 nguy c\u01a1 m\u1eafc CKD v\u00e0 t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong.<\/p>\n

2.10. QUAN \u0110I\u1ec2M 10<\/strong>: N\u00ean ng\u1eebng s\u1eed d\u1ee5ng Frusemide n\u1ebfu creatinine huy\u1ebft thanh t\u0103ng l\u00ean, cho th\u1ea5y ch\u1ee9c n\u0103ng th\u1eadn x\u1ea5u \u0111i.<\/em><\/p>\n

\u0110i\u1ec1u n\u00e0y kh\u00f4ng nh\u1ea5t thi\u1ebft l\u00e0 \u0111\u00fang<\/strong><\/p>\n

Nhi\u1ec1u b\u1ec7nh nh\u00e2n b\u1ecb suy tim c\u1ea5p g\u00e2y t\u0103ng creatinine huy\u1ebft thanh t\u1eeb 0,3 mg\/dl tr\u1edf l\u00ean trong khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c t\u1ef1 \u0111\u1ed9ng hi\u1ec3u l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a ch\u1ee9c n\u0103ng th\u1eadn x\u1ea5u \u0111i th\u1ef1c s\u1ef1 (Worsening Renal Function -WRF) li\u00ean quan \u0111\u1ebfn k\u1ebft qu\u1ea3 suy gi\u1ea3m. V\u00ec creatinine \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft thanh, n\u00ean s\u1ef1 gia t\u0103ng ri\u00eang l\u1ebb c\u1ee7a creatinine huy\u1ebft thanh k\u1ebft h\u1ee3p v\u1edbi s\u1ef1 gia t\u0103ng hematocrit c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u01a1n gi\u1ea3n l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a vi\u1ec7c gi\u1ea3m th\u1ec3 t\u00edch n\u1ed9i m\u1ea1ch v\u00e0 gi\u1ea3m xung huy\u1ebft hi\u1ec7u qu\u1ea3. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0, n\u00f3 c\u0169ng c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 WRF gi\u1ea3 . M\u1ed9t t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y trong th\u1eed nghi\u1ec7m FACTT, trong \u0111\u00f3 li\u1ec7u ph\u00e1p truy\u1ec1n d\u1ecbch h\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng li\u1ec1u thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u00e1ng k\u1ec3 \u0111\u00e3 c\u1ea3i thi\u1ec7n vi\u1ec7c cai m\u00e1y th\u1edf nh\u01b0ng c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c t\u0103ng creatinine huy\u1ebft thanh g\u1ea7n 0,3 mg\/dl. M\u1eb7c d\u00f9 v\u1eady, y\u00eau c\u1ea7u c\u1ee7a RRT th\u1eadm ch\u00ed c\u00f2n th\u1ea5p h\u01a1n trong nh\u00f3m n\u00e0y.<\/p>\n

Frusemide th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m t\u1ea3i d\u1ecbch v\u00e0 gi\u1ea3m \u00e1p l\u1ef1c trong c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch v\u00e0 th\u1eadn, gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng tim v\u00e0 gi\u1ea3m t\u00ecnh tr\u1ea1ng ph\u00f9 n\u1ec1. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u00fang c\u00e1ch v\u00e0 c\u00e2n nh\u1eafc k\u1ebft h\u1ee3p v\u1edbi vi\u1ec7c cung c\u1ea5p \u0111\u1ee7 d\u1ecbch \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n nguy k\u1ecbch.<\/p>\n","protected":false},"excerpt":{"rendered":"

Hi\u1ec7n nay, Frusemide v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u00ecnh tr\u1ea1ng t\u0103ng \u1ee9 d\u1ecbch v\u00e0 t\u0103ng huy\u1ebft \u00e1p. Ngo\u00e0i ra, n\u00f3 c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00e1c b\u1ec7nh l\u00fd c\u1ea5p t\u00ednh kh\u00e1c. Tuy nhi\u00ean, c\u0169ng nh\u01b0 b\u1ea5t k\u1ef3 lo\u1ea1i thu\u1ed1c n\u00e0o kh\u00e1c, vi\u1ec7c s\u1eed d\u1ee5ng Frusemide c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"\n10 quan ni\u1ec7m sai l\u1ea7m v\u1ec1 Frusemide - Vinmec<\/title>\n<meta name=\"description\" content=\"Frusemide l\u00e0 lo\u1ea1i thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf b\u1ec7nh nh\u00e2n nguy k\u1ecbch. 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