{"id":22083,"date":"2023-04-19T23:11:27","date_gmt":"2023-04-19T16:11:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22083"},"modified":"2023-04-20T11:23:33","modified_gmt":"2023-04-20T04:23:33","slug":"huong-dan-ve-dieu-tri-nguoi-benh-tim-mach-mac-covid-19","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/huong-dan-ve-dieu-tri-nguoi-benh-tim-mach-mac-covid-19\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn v\u1ec1 \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh tim m\u1ea1ch m\u1eafc COVID-19"},"content":{"rendered":"

Nhi\u1ec5m COVID-19<\/a> c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u1ea5p ho\u1eb7c l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch c\u00f3 t\u1eeb tr\u01b0\u1edbc. C\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch x\u1ea3y ra \u1edf ng\u01b0\u1eddi nhi\u1ec5m COVID-19 kh\u00e1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng khi nhi\u1ec5m SARS, MERS, v\u00e0 c\u00fam. <\/span>\u0110i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh tim m\u1ea1ch m\u1eafc COVID-19 c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t v\u00e0 ch\u1ec9 \u0111\u1ea1o c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa tim m\u1ea1ch v\u00e0 b\u00e1c s\u0129 chuy\u00ean khoa nhi\u1ec5m tr\u00f9ng.\u00a0<\/strong><\/p>\n

\"Nhi\u1ec5m
Nhi\u1ec5m COVID-19 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u1ea5p<\/figcaption><\/figure>\n

1. \u1ea2nh h\u01b0\u1edfng nhi\u1ec5m COVID v\u1edbi ng\u01b0\u1eddi c\u00f3 b\u1ec7nh n\u1ec1n tim m\u1ea1ch<\/h2>\n

\u2022<\/span>\u00a0<\/span>Nhi\u1ec5m COVID-19 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u1ea5p ho\u1eb7c l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch c\u00f3 t\u1eeb tr\u01b0\u1edbc. C\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch x\u1ea3y ra \u1edf ng\u01b0\u1eddi nhi\u1ec5m COVID-19 kh\u00e1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng khi nhi\u1ec5m SARS, MERS, v\u00e0 c\u00fam, bao g\u1ed3m: t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim, vi\u00eam c\u01a1 tim, h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p, r\u1ed1i lo\u1ea1n nh\u1ecbp tim, suy tim v\u00e0 b\u1ec7nh c\u01a1 tim, s\u1ed1c tim (\u0111\u01a1n thu\u1ea7n ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi ARDS), thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch.<\/span><\/p>\n

\u2022<\/span>\u00a0<\/span>T\u00ecnh tr\u1ea1ng y\u1ebfu m\u1ec7t khi nhi\u1ec5m COVID-19 d\u1ec5 g\u00e2y do d\u1ef1 khi d\u00f9ng c\u00e1c thu\u1ed1c tim m\u1ea1ch th\u01b0\u1eddng quy, nh\u01b0 c\u00e1c thu\u1ed1c kh\u00e1ng ti\u1ec3u c\u1ea7u, c\u00e1c thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m.. v\u00e0 nh\u01b0 v\u1eady s\u1ebd l\u00e0m t\u0103ng nguy c\u01a1 c\u00e1c bi\u1ebfn c\u1ed1 nh\u01b0 b\u1ec7nh m\u1ea1ch v\u00e0nh ho\u1eb7c suy tim.<\/span><\/p>\n

\u2022<\/span>\u00a0<\/span>D\u1ec5 c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00f4ng n\u1eb7ng khi nhi\u1ec5m COVID-19, v\u00ec v\u1eady c\u1ea7n l\u01b0u \u00fd d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i v\u00e0 t\u1ea7m so\u00e1t thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/span><\/p>\n

\u2022<\/span>\u00a0<\/span>\u1ede ng\u01b0\u1eddi c\u00f3 suy tim ho\u1eb7c \u0111\u00e3 qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch, vi\u1ec7c truy\u1ec1n d\u1ecbch \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb khi b\u1ecb nhi\u1ec5m COVID-19 c\u1ea7n th\u1eadn tr\u1ecdng v\u00e0 theo d\u00f5i s\u00e1t.<\/span><\/p>\n

\u2022<\/span>\u00a0<\/span>Tri\u1ec7u ch\u1ee9ng v\u00e0 b\u1ec7nh c\u1ea3nh nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p c\u00f3 th\u1ec3 b\u1ecb coi nh\u1eb9 ho\u1eb7c ch\u1ea9n \u0111o\u00e1n nh\u1ea7m trong b\u1ec7nh c\u1ea3nh nhi\u1ec5m COVID-19, do \u0111\u00f3 d\u1ec5 d\u1eabn t\u1edbi b\u1ecf s\u00f3t v\u00e0 x\u1eed tr\u00ed kh\u00f4ng k\u1ecbp th\u1eddi.<\/span><\/p>\n

2. M\u1ed9t s\u1ed1 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb COVID-19 \u1ea3nh h\u01b0\u1edfng tr\u00ean tim m\u1ea1ch<\/h2>\n

T<\/span>\u00ecm ki\u1ebfm v\u00e0 theo d\u00f5i c\u00e1c \u1ea3nh h\u01b0\u1edfng ti\u1ec1m t\u00e0ng tr\u00ean tim m\u1ea1ch c\u1ee7a m\u1ed9t s\u1ed1 thu\u1ed1c c\u00f3 th\u1ec3 d\u00f9ng khi \u0111i\u1ec1u tr\u1ecb COVID-19\u00a0<\/span><\/p>\n

B\u1ea3ng 1. \u0110\u1ed9c t\u00ednh v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 ti\u1ec1m t\u00e0ng tr\u00ean tim m\u1ea1ch<\/span><\/b>\u00a0<\/span><\/b>c\u1ee7a thu\u1ed1c \u0111i\u1ec1u tr\u1ecb COVID-19.<\/span><\/b><\/p>\n

(Ghi ch\u00fa: nh\u1eefng thu\u1ed1c \u0111\u00e1nh d\u1ea5u (*) \u0111ang trong qu\u00e1 tr\u00ecnh th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, ch\u1ec9 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb khi c\u00f3 h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf)<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Thu\u1ed1c<\/span><\/b><\/p>\n<\/td>\n

\n

C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/span><\/b><\/p>\n<\/td>\n

\n

Thu\u1ed1c c\u00f3<\/span><\/b>\u00a0\u00a0<\/b>t\u01b0\u01a1ng t\u00e1c<\/span><\/b><\/p>\n<\/td>\n

\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean tim m\u1ea1ch<\/span><\/b><\/p>\n<\/td>\n<\/tr>\n

Ribavirin (*)<\/span><\/td>\n\u1ee8c ch\u1ebf sao ch\u00e9p RNA v\u00e0 DNA\u00a0<\/span>virus<\/td>\nCh\u1ed1ng \u0111\u00f4ng<\/span><\/td>\nCh\u01b0a r\u00f5<\/span><\/td>\n<\/tr>\n
Lopinavir\/ Ritonavir (*)<\/span><\/td>\nLopinavir\u00a0\u1ee9c ch\u1ebf\u00a0<\/span>protease\/ Ritonavir\u00a0\u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a\u00a0<\/span>CYP3,\u00a0g\u00e2y t\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0<\/span>lopinavir<\/td>\nKh\u00e1ng ti\u1ec3u c\u1ea7u<\/span><\/p>\n

Kh\u00e1ng \u0111\u00f4ng<\/span><\/p>\n

Statin<\/span><\/p>\n

Thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp<\/span><\/td>\n

Thay \u0111\u1ed5i d\u1eabn truy\u1ec1n trong tim: k\u00e9o d\u00e0i kho\u1ea3ng QTc, bloc nh\u0129 th\u1ea5t \u0111\u1ed9 cao, xo\u1eafn \u0111\u1ec9nh<\/span><\/td>\n<\/tr>\n
Redemsevir (*)<\/span><\/td>\n\u1ee8c ch\u1ebf\u00a0<\/span>polymerase<\/p>\n

RNA\u00a0t\u01b0\u01a1ng t\u1ef1 nucleotid<\/span><\/td>\n

Kh\u00f4ng r\u00f5<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\n<\/tr>\n
Bevacizumab<\/span><\/td>\n\u1ee8c ch\u1ebf VEGF, \u0111\u1ec3 gi\u1ea3m t\u00ednh th\u1ea5m m\u00f4 v\u00e0 ph\u00f9 ph\u1ed5i<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\n–\u00a0\u0110\u1ed9c tr\u1ef1c ti\u1ebfp l\u00ean c\u01a1 tim, tr\u1ea7m tr\u1ecdng th\u00eam b\u1ec7nh c\u01a1 tim<\/span><\/p>\n

–\u00a0T\u0103ng huy\u1ebft \u00e1p (THA) n\u1eb7ng<\/span><\/p>\n

–\u00a0Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i<\/span><\/td>\n<\/tr>\n

Chloroquine\/<\/span><\/p>\n

Hydroxy chloroquine (*)<\/span><\/td>\n

Thay \u0111\u1ed5i pH n\u1ed9i th\u1ec3 v\u1ed1n c\u1ea7n \u0111\u1ec3 virus x\u00e2m nh\u1eadp t\u1ebf b\u00e0o<\/span><\/td>\nThu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp<\/span><\/td>\n–\u00a0\u0110\u1ed9c tr\u1ef1c ti\u1ebfp l\u00ean c\u01a1 tim, tr\u1ea7m tr\u1ecdng th\u00eam b\u1ec7nh c\u01a1 tim<\/span><\/p>\n

–\u00a0Thay \u0111\u1ed5i d\u1eabn truy\u1ec1n trong tim, bloc nh\u0129 th\u1ea5t, bloc nh\u00e1nh, xo\u1eafn \u0111\u1ec9nh, rung th\u1ea5t, nh\u1ecbp nhanh th\u1ea5t<\/span><\/td>\n<\/tr>\n

Eculizumab<\/span><\/td>\n\u1ee8c ch\u1ebf ho\u1ea1t h\u00f3a b\u1ed5 th\u1ec3<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\nTHA, nh\u1ecbp nhanh, ph\u00f9 ngo\u1ea1i vi<\/span><\/td>\n<\/tr>\n
Fingolimod<\/span><\/td>\n\u1ee8c ch\u1ebf\u00a0<\/span>TB lympho do\u00a0\u0111i\u1ec1u ho\u00e0\u00a0<\/span>sphingosine-1 phosphat<\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\n–\u00a0THA, bloc nh\u0129 th\u1ea5t \u0111\u1ed9\u00a0<\/span>1\u00ad2,\u00a0nh\u1ecbp ch\u1eadm, k\u00e9o d\u00e0i QTc,<\/span><\/p>\n

–\u00a0Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: sau h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p, \u0111\u1ed9t qu\u1ef5 c\u1ea5p, suy tim m\u1ea5t b\u00f9 c\u1ea5p; bloc nh\u0129 th\u1ea5t \u0111\u1ed9 cao, suy n\u00fat xoang, QTc >= 500 ms<\/span><\/td>\n<\/tr>\n

Interferon<\/span><\/td>\nHo\u1ea1t h\u00f3a h\u1ec7 mi\u1ec5n d\u1ecbch<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\n–\u00a0\u0110\u1ed9c tr\u1ef1c ti\u1ebfp l\u00ean c\u01a1 tim, tr\u1ea7m tr\u1ecdng th\u00eam b\u1ec7nh c\u01a1 tim<\/span><\/p>\n

–\u00a0T\u1ee5t HA, r\u1ed1i lo\u1ea1n nh\u1ecbp, b\u1ec7nh c\u01a1 tim, NMCT<\/span><\/td>\n<\/tr>\n

Pirfenidone<\/span><\/td>\nCh\u1ed1ng x\u01a1 h\u00f3a, \u1ee9c ch\u1ebf\u00a0<\/span>IL-1B\/IL-4\u00a0gi\u1ea3m\u00a0<\/span>cytokine\u00a0l\u00ean ph\u1ed5i<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\nKh\u00f4ng r\u00f5<\/span><\/td>\n<\/tr>\n
Methyl prednisolone<\/td>\nThay \u0111\u1ed5i b\u1ed9c l\u1ed9\u00a0<\/span>gene\u00a0l\u00e0m gi\u1ea3m vi\u00eam<\/span><\/td>\nKh\u00e1ng \u0111\u00f4ng<\/span><\/td>\n\u1ee8 d\u1ecbch; r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i,<\/span>\u00a0<\/span>THA<\/span><\/td>\n<\/tr>\n
Tocilizumab<\/td>\n\u1ee8c ch\u1ebf th\u1ee5 th\u1ec3 IL-6<\/span><\/td>\nC\u00f3 th\u1ec3 t\u0103ng chuy\u1ec3n h\u00f3a c\u00e1c thu\u1ed1c<\/span><\/td>\nTHA, t\u0103ng cholesterol m\u00e1u, kh\u00f4ng r\u00f5 t\u00e1c d\u1ee5ng tr\u00ean kho\u1ea3ng QTc<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

3. C\u00e1ch ch\u1ec9nh li\u1ec1u\u00a0 <\/span><\/b>khi\u00a0<\/b>d\u00f9ng thu\u1ed1c\u00a0<\/span><\/b>tim\u00a0<\/b>m\u1ea1ch v\u1edbi thu\u1ed1c \u0111i\u1ec1u tr\u1ecb\u00a0<\/span><\/b>COVID-19.<\/b><\/h2>\n

B\u1ea3ng 2<\/span><\/b>.\u00a0<\/b>Ch\u1ec9nh li\u1ec1u v\u00e0 l\u01b0u \u00fd\u00a0<\/span><\/b>khi\u00a0<\/b>d\u00f9ng thu\u1ed1c\u00a0<\/span><\/b>tim\u00a0<\/b>m\u1ea1ch v\u1edbi thu\u1ed1c \u0111i\u1ec1u tr\u1ecb\u00a0<\/span><\/b>COVID-19.<\/b><\/p>\n

(Ghi\u00a0ch\u00fa: nh\u1eefng thu\u1ed1c \u0111\u00e1nh d\u1ea5u\u00a0<\/span>(*)\u00a0\u0111ang\u00a0<\/span>trong\u00a0qu\u00e1 tr\u00ecnh th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, ch\u1ec9 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb\u00a0<\/span>khi\u00a0c\u00f3 h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9\u00a0<\/span>Y\u00a0t\u1ebf)<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
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Thu\u1ed1c<\/span><\/b><\/p>\n<\/td>\n

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T\u01b0\u01a1ng t\u00e1c \u0111\u1eb7c hi\u1ec7u<\/span><\/b><\/p>\n<\/td>\n

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C\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c v\u00e0 c\u00e1ch ch\u1ec9nh li\u1ec1u<\/span><\/b><\/p>\n<\/td>\n

\n

L\u01b0u \u00fd<\/span><\/b><\/p>\n<\/td>\n<\/tr>\n

Ribavirin*<\/td>\nKh\u00e1ng \u0111\u00f4ng<\/span><\/p>\n

–\u00a0<\/span>Warfarin<\/td>\n

Kh\u00f4ng r\u00f5 c\u01a1 ch\u1ebf:<\/span><\/p>\n

– Kh\u00f4ng c\u1ea7n ch\u1ec9nh li\u1ec1u<\/span><\/td>\n

Theo d\u00f5i INR<\/span><\/td>\n<\/tr>\n
Lopinavir\/<\/p>\n

Ritonavir*<\/td>\n

Kh\u00e1ng \u0111\u00f4ng<\/span><\/p>\n

– Apixaban<\/p>\n

– Rivaroxanan<\/td>\n

\u1ee8c ch\u1ebf CYP3A4:<\/span><\/p>\n

–\u00a0Gi\u1ea3m n\u1eeda li\u1ec1u apixaban (ko d\u00f9ng n\u1ebfu \u0111ang d\u00f9ng li\u1ec1u 2.5mg\/)<\/span><\/p>\n

–\u00a0Kh\u00f4ng d\u00f9ng c\u00f9ng\u00a0<\/span>rivaroxaban<\/td>\n

C\u00f3 th\u1ec3 d\u00f9ng dabigatran ho\u1eb7c warfarin nh\u01b0ng c\u1ea7n th\u1eadn tr\u1ecdng<\/span><\/td>\n<\/tr>\n
Kh\u00e1ng ti\u1ec3u c\u1ea7u<\/span><\/p>\n

–\u00a0Clopidogrel<\/span><\/p>\n

–Ticagrelor<\/span><\/td>\n

\u1ee8c ch\u1ebf CYP3A4<\/span><\/p>\n

–\u00a0Gi\u1ea3m t\u00e1c d\u1ee5ng clopidogrel n\u00ean kh\u00f4ng d\u00f9ng c\u00f9ng<\/span><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>T\u0103ng t\u00e1c d\u1ee5ng ticagrelor n\u00ean kh\u00f4ng d\u00f9ng c\u00f9ng<\/span><\/td>\n

C\u00e2n nh\u1eafc d\u00f9ng prasugrel n\u1ebfu ko c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh. N\u1ebfu d\u00f9ng c\u00e1c kh\u00e1ng ti\u1ec3u c\u1ea7u kh\u00e1c, c\u1ea7n XN ho\u1ea1t t\u00ednh ti\u1ec3u c\u1ea7u<\/span><\/td>\n<\/tr>\n
Statin<\/span><\/p>\n

–\u00a0Atorvastatin<\/span><\/p>\n

–\u00a0Rosuvastatin<\/span><\/p>\n

–\u00a0Lovastatin<\/span><\/p>\n

–\u00a0Simvastatin<\/span><\/td>\n

–\u00a0\u1ee8c ch\u1ebf OATTP1B1 v\u00e0 BCRP: li\u1ec1u rosuvastatin t\u1ed1i \u0111a 10 mg\/ng\u00e0y<\/span><\/p>\n

–\u00a0\u1ee8c ch\u1ebf CYP3A4: Li\u1ec1u atorvastatin t\u1ed1i \u0111a 20mg\/ng\u00e0y<\/span><\/p>\n

Kh\u00f4ng d\u00f9ng lova\/simv<\/span><\/td>\n

Kh\u1edfi li\u1ec1u<\/span>\u00a0<\/span>rosu\/ator<\/span>\u00a0<\/span>\u00a0th\u1ea5p<\/span>\u00a0<\/span>nh\u1ea5t, t\u0103ng d\u1ea7n.<\/span><\/p>\n

C\u00f3 th\u1ec3 d\u00f9ng<\/span>\u00a0<\/span>pravastatin<\/span>\u00a0<\/span>ho\u1eb7c<\/span><\/p>\n

pitavastatin<\/span><\/td>\n<\/tr>\n

R\u1ed1i lo\u1ea1n nh\u1ecbp tim<\/span><\/p>\n

–\u00a0Thu\u1ed1c k\u00e9o d\u00e0i QTc<\/span><\/p>\n

–\u00a0Digoxin<\/span><\/td>\n

\u1ee8c ch\u1ebf P-glycoprotein Theo d\u00f5i n\u1ed3ng \u0111\u1ed9 digoxin \u0111\u1ec3 gi\u1ea3m li\u1ec1u<\/span><\/td>\nTh\u1eadn tr\u1ecdng khi ph\u1ea3i d\u00f9ng c\u00f9ng c\u00e1c thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp<\/span><\/td>\n<\/tr>\n
Chloroquine<\/p>\n

\/Hydroxy chloroquine*<\/td>\n

Ch\u1eb9n beta giao c\u1ea3m: metoprol, carvediolol, propanolol, labetalol R\u1ed1i lo\u1ea1n nh\u1ecbp tim<\/span><\/p>\n

–\u00a0Thu\u1ed1c k\u00e9o d\u00e0i QTc<\/span><\/p>\n

– Digoxin<\/td>\n

–\u00a0\u1ee8c ch\u1ebf CYP2D6: c\u00f3 th\u1ec3 c\u1ea7n gi\u1ea3m li\u1ec1u ch\u1eb9n beta<\/span><\/p>\n

–\u00a0\u1ee8c ch\u1ebf P-glycoprotein Theo d\u00f5i n\u1ed3ng \u0111\u1ed9\u00a0<\/span>digoxin\u00a0\u0111\u1ec3 gi\u1ea3m li\u1ec1u<\/span><\/td>\n

Th\u1eadn tr\u1ecdng khi ph\u1ea3i d\u00f9ng c\u00f9ng c\u00e1c thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp<\/span><\/td>\n<\/tr>\n
Fingolimod<\/td>\n–\u00a0C\u00e1c thu\u1ed1c ch\u1eadm nh\u1ecbp\u00a0<\/span>tim:\u00a0ch\u1eb9n\u00a0<\/span>beta,\u00a0ch\u1eb9n\u00a0<\/span>canxi, ivabradine<\/p>\n

–\u00a0R\u1ed1i lo\u1ea1n nh\u1ecbp:\u00a0<\/span>k\u00e9o\u00a0d\u00e0i QTc: nh\u00f3m IA v\u00e0 III<\/span><\/td>\n

\u1ee8c ch\u1ebf th\u1ee5 th\u1ec3 sphingosine 1 phosphat \u1edf c\u01a1 nh\u0129: kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng thu\u1ed1c r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u00f3m IA\u00a0<\/span>hay\u00a0III<\/span><\/td>\nD\u00f9ng th\u1eadn tr\u1ecdng \u0111\u1ed1i v\u1edbi thu\u1ed1c k\u00e9o d\u00e0i QT<\/span><\/td>\n<\/tr>\n
Methylpred nisolone<\/span><\/td>\nCh\u1ed1ng \u0111\u00f4ng:<\/span><\/p>\n

–\u00a0<\/span>Warfarin<\/td>\n

Kh\u00f4ng r\u00f5 c\u01a1 ch\u1ebf: c\u1ea7n ch\u1ec9nh theo INR<\/span><\/td>\nTheo d\u00f5i INR<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

Nhi\u1ec5m COVID-19 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u1ea5p ho\u1eb7c l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch c\u00f3 t\u1eeb tr\u01b0\u1edbc. C\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch x\u1ea3y ra \u1edf ng\u01b0\u1eddi nhi\u1ec5m COVID-19 kh\u00e1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng khi nhi\u1ec5m SARS, MERS, v\u00e0 c\u00fam. \u0110i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh tim m\u1ea1ch […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,32],"tags":[3],"yoast_head":"\nH\u01b0\u1edbng d\u1eabn v\u1ec1 \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh tim m\u1ea1ch m\u1eafc COVID-19<\/title>\n<meta name=\"description\" content=\"Nhi\u1ec5m COVID-19 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u1ea5p ho\u1eb7c l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch c\u00f3 t\u1eeb tr\u01b0\u1edbc. 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