{"id":2425,"date":"2023-04-13T19:56:19","date_gmt":"2023-04-13T12:56:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2425"},"modified":"2023-04-17T14:42:10","modified_gmt":"2023-04-17T07:42:10","slug":"thuoc-te-trong-dieu-tri-nha-khoa-goc-nhin-tong-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/thuoc-te-trong-dieu-tri-nha-khoa-goc-nhin-tong-quan\/","title":{"rendered":"Thu\u1ed1c t\u00ea trong \u0111i\u1ec1u tr\u1ecb nha khoa &#8211; G\u00f3c nh\u00ecn t\u1ed5ng quan."},"content":{"rendered":"<p><strong>B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p nh\u1eefng ki\u1ebfn th\u1ee9c c\u01a1 b\u1ea3n v\u1ec1 thu\u1ed1c t\u00ea \u0111\u01b0\u1ee3c d\u00f9ng trong nha khoa. Nha s\u0129 c\u1ea7n c\u00f3 hi\u1ec3u bi\u1ebft t\u1ed5ng quan v\u1ec1 c\u00e1c nh\u00f3m thu\u1ed1c, \u0111\u01b0\u1eddng d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ch\u00fang nh\u1eb1m h\u1ed7 tr\u1ee3 \u0111i\u1ec1u tr\u1ecb t\u1ed1t.<\/strong><\/p>\n<h2>1. Th\u00e0nh ph\u1ea7n c\u1ea5u t\u1ea1o thu\u1ed1c t\u00ea<\/h2>\n<ul>\n<li>Thu\u1ed1c t\u00ea s\u1eed d\u1ee5ng d\u01b0\u1edbi d\u1ea1ng dung d\u1ecbch, bao g\u1ed3m:\n<ul>\n<li>Ch\u1ea5t co m\u1ea1ch.<\/li>\n<li>Ch\u1ea5t l\u00e0m v\u1eefng dung d\u1ecbch (acide ho\u1ea3).<\/li>\n<li>Ch\u1ea5t \u0111\u1ec7m (gi\u1eef v\u1eefng pH).<\/li>\n<li>Ch\u1ea5t kh\u1eed tr\u00f9ng.<\/li>\n<li>Ch\u1ea5t m\u00e0u hay hyaluronidase \u0111\u1ec3 ph\u00e2n t\u00e1n nhanh thu\u1ed1c t\u00ea.<\/li>\n<\/ul>\n<\/li>\n<li>Ti\u00eau chu\u1ea9n c\u1ee7a m\u1ed9t thu\u1ed1c t\u00ea l\u00fd t\u01b0\u1edfng\n<ul>\n<li>Sau khi t\u00e1c d\u1ee5ng xong, t\u00e1c d\u1ee5ng c\u1ee7a n\u00f3 t\u1ea1i ch\u1ed7 v\u00e0 to\u00e0n th\u00e2n b\u1ecb m\u1ea5t \u0111i ho\u00e0n to\u00e0n.<\/li>\n<li>Kh\u00f4ng k\u00edch th\u00edch t\u1ea1i ch\u1ed7 v\u00e0 kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 t\u1ea1i ch\u1ed7.<\/li>\n<li>\u00cdt \u0111\u1ed9c cho c\u01a1 th\u1ec3.<\/li>\n<li>T\u00e1c d\u1ee5ng s\u1edbm v\u00e0 k\u00e9o d\u00e0i.<\/li>\n<li>\u0110\u1ee7 t\u00ea \u1edf n\u1ed3ng \u0111\u1ed9 kh\u00f4ng g\u00e2y \u0111\u1ed9c.<\/li>\n<li>C\u00f3 th\u1ec3 thoa t\u1ea1i ch\u1ed7 c\u0169ng t\u00ea.<\/li>\n<li>Kh\u00f4ng g\u00e2y d\u1ecb \u1ee9ng.<\/li>\n<li>\u00d4n \u0111\u1ecbnh khi pha trong dung d\u1ecbch, khi v\u00e0o c\u01a1 th\u1ec3 th\u00ec \u0111\u01b0\u1ee3c \u0111\u1ea3o th\u1ea3i d\u1ec5 d\u00e0ng<\/li>\n<li>C\u00f3 th\u1ec3 v\u00f4 khu\u1ea9n b\u1eb1ng nhi\u1ec7t m\u00e0 kh\u00f4ng h\u1ecfng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/h2>\n<p>Trong t\u1ed5 ch\u1ee9c thu\u1ed1c t\u00ea t\u1ed3n t\u1ea1i d\u01b0\u1edbi hai d\u1ea1ng: d\u1ea1ng t\u1ef1 do v\u00e0 d\u1ea1ng li\u00ean k\u1ebft v\u1edbi c\u00e1c proteine (proteine huy\u1ebft t\u01b0\u01a1ng v\u00e0 m\u00f4: albumine, alpha-1-glycoproteine). Ch\u1ec9 c\u00f3 c\u00e1c ph\u00e2n t\u1eed t\u1ef1 do m\u1edbi c\u00f3 t\u00e1c d\u1ee5ng sinh h\u1ecdc phong b\u1ebf th\u1ea7n kinh c\u0169ng nh\u01b0 l\u00e0 g\u00e2y \u0111\u1ed9c cho c\u01a1 th\u1ec3. \u1ede tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb b\u00fa m\u1eb9, n\u1ed3ng \u0111\u1ed9 c\u1ee7a c\u00e1c albumine huy\u1ebft t\u01b0\u01a1ng v\u00e0 alpha-1-glycoproteine gi\u1ea3m l\u00e0m thay \u0111\u1ed5i t\u1ef7 l\u1ec7 c\u1ee7a th\u00e0nh ph\u1ea7n thu\u1ed1c t\u1ef1 do. Alpha-1-glycoproteine c\u00f3 \u00e1i t\u00ednh m\u1ea1nh v\u1edbi thu\u1ed1c nh\u01b0ng albumine th\u00ec ng\u01b0\u1ee3c l\u1ea1i. T\u1ef7 l\u1ec7 alpha-1-glycoproteine t\u0103ng theo tu\u1ed5i, th\u1ea5p \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c gi\u00e1 tr\u1ecb c\u1ee7a ng\u01b0\u1eddi l\u1edbn v\u00e0o l\u00fac 6 th\u00e1ng. Do \u0111\u00f3, n\u1ebfu d\u00f9ng bupivacaine c\u00f9ng li\u1ec1u nh\u01b0 nhau th\u00ec th\u00e0nh ph\u1ea7n thu\u1ed1c t\u00ea t\u1ef1 do c\u1ee7a tr\u1ebb s\u01a1 sinh cao h\u01a1n 6 l\u1ea7n so v\u1edbi tr\u1ebb \u0111ang b\u00fa s\u1eefa m\u1eb9. N\u1ebfu d\u00f9ng lidocaine th\u00ec th\u00e0nh ph\u1ea7n t\u1ef1 do \u1edf tr\u1ebb nh\u1ecf cao h\u01a1n ng\u01b0\u1eddi l\u1edbn 2 l\u1ea7n.<\/p>\n<p>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a thu\u1ed1c t\u00ea ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 khu\u1ebfch t\u00e1n t\u1ea1i ch\u1ed7, khu\u1ebfch t\u00e1n h\u1ec7 th\u1ed1ng v\u00e0 chuy\u1ec3n ho\u00e1. \u1ede tr\u1ebb em, g\u00e2y t\u00ea v\u00f9ng thi thu\u1ed1c d\u1ec5 d\u00e0ng khu\u1ebfch t\u00e1n h\u01a1n v\u00ec \u00edt c\u00f3 t\u1ed5 ch\u1ee9c m\u1ee1, \u1edf ng\u01b0\u1eddi l\u1edbn, th\u00e2n c\u00e1c d\u00e2y th\u1ea7n kinh th\u01b0\u1eddng b\u1ecb m\u1ee1 bao b\u1ecdc xung quanh.<\/p>\n<p>T\u1ed1c \u0111\u1ed9 h\u1ea5p thu thu\u1ed1c ph\u1ee5 thu\u1ed9c v\u00e0o tu\u1ed5i (l\u01b0u l\u01b0\u1ee3ng m\u00e1u qua tim v\u00e0 t\u1ea1i ch\u1ed7) v\u00e0 m\u1eadt \u0111\u1ed9 mao m\u1ea1ch t\u1ea1i ch\u1ed7 ti\u00eam. L\u01b0u l\u01b0\u1ee3ng m\u00e1u \u1edf tr\u1ebb em cao h\u01a1n c\u1ee7a ng\u01b0\u1eddi l\u1edbn, do v\u1eady, t\u1ed1c \u0111\u1ed9 h\u1ea5p th\u1ee5 thu\u1ed1c t\u00ea c\u1ee7a tr\u1ebb em c\u0169ng cao h\u01a1n. \u1ede m\u1eb7t, m\u1eadt \u0111\u1ed9 mao m\u1ea1ch d\u00e0y \u0111\u1eb7c n\u00ean \u0111\u01b0\u1ee3c h\u1ea5p thu r\u1ea5t nhanh.<\/p>\n<p>Vi\u00eam nhi\u1ec5m l\u00e0m toan ho\u00e1 t\u1ed5 ch\u1ee9c v\u00e0 gi\u1ea3i ph\u00f3ng c\u00e1c ch\u1ea5t ho\u1ea1t ho\u00e1 th\u1ea7n kinh (histamine, prostaglandin,&#8230;). C\u00e1c thay \u0111\u1ed5i n\u00e0y l\u00e0m gi\u1ea3m t\u00ednh tan trong m\u1edf c\u1ee7a thu\u1ed1c t\u1ebf.<\/p>\n<h2>3. Ph\u00e2n lo\u1ea1i thu\u1ed1c t\u00ea<\/h2>\n<p>C\u00f3 hai nh\u00f3m thu\u1ed1c t\u00ea l\u00e0 nh\u00f3m ester v\u00e0 nh\u00f3m amide. Tuy nhi\u00ean nh\u00f3m amide \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i h\u01a1n<\/p>\n<h3>3.1. Nh\u00f3m ester<\/h3>\n<figure id=\"attachment_2433\" aria-describedby=\"caption-attachment-2433\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2433\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/B-300x225.webp\" alt=\"thuoc-te-1\" width=\"300\" height=\"225\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/B-300x225.webp 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/B-1024x768.webp 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/B-768x576.webp 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/B.webp 1152w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-2433\" class=\"wp-caption-text\">Thu\u1ed1c t\u00ea d\u1ea1ng n\u00e0y \u0111\u00e3 c\u00f3 m\u1eb7t t\u1eeb r\u1ea5t l\u00e2u, hi\u1ec7n nay \u00e1p d\u1ee5ng v\u00e0o d\u1ea1ng thu\u1ed1c t\u00ea b\u1ec1 m\u1eb7t (Benzocaine)<\/figcaption><\/figure>\n<p>Nh\u00f3m ester l\u00e0 nh\u00f3m c\u1ed5 \u0111i\u1ec3n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e2u nh\u1ea5t v\u00e0 g\u1ea7n \u0111\u00e2y \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, g\u1ed3m c\u00e1c thu\u1ed1c nh\u01b0 procaine, benzocaine, tetracaine,&#8230;<\/p>\n<p>C\u1ea5u tr\u00fac ho\u00e1 h\u1ecdc bao g\u1ed3m:<br \/>\n&#8211; M\u1ed9t nh\u00e2n th\u01a1m \u01b0a m\u1ee1, \u01b0a n\u01b0\u1edbc.<br \/>\n&#8211; M\u1ed9t chu\u1ed7i trung gian ch\u1ee9a c\u00e1c m\u1ed1i n\u1ed1i ester.<br \/>\n&#8211; M\u1ed9t nh\u00f3m amino \u01b0a n\u01b0\u1edbc.<\/p>\n<h3>3.2. Nh\u00f3m amide<\/h3>\n<figure id=\"attachment_2436\" aria-describedby=\"caption-attachment-2436\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2436\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NRG_Lidocaine_Carpule_grande-300x200.webp\" alt=\"thuoc-te-2\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NRG_Lidocaine_Carpule_grande-300x200.webp 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NRG_Lidocaine_Carpule_grande.webp 600w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-2436\" class=\"wp-caption-text\">Th\u01b0\u1eddng d\u1ea1ng thu\u1ed1c Lidocaine c\u00f3 k\u1ebft h\u1ee3p th\u00eam ch\u1ea5t co m\u1ea1ch l\u00e0m t\u0103ng hi\u1ec7u qu\u1ea3 t\u00ea<\/figcaption><\/figure>\n<p>G\u1ed3m c\u00e1c thu\u1ed1c nh\u01b0 lidocaine, mepivacaine, prilocaine, articaine&#8230;<\/p>\n<p>C\u1ea5u tr\u00fac ho\u00e1 h\u1ecdc bao g\u1ed3m:<br \/>\n&#8211; M\u1ed9t nh\u00e2n th\u01a1m \u01b0a m\u1ee1, \u01b0a n\u01b0\u1edbc.<br \/>\n&#8211; M\u1ed9t chu\u1ed7i trung gian ch\u1ee9a c\u00e1c m\u1ed1i n\u1ed1i amide.<br \/>\n&#8211; M\u1ed9t nh\u00f3m amino \u01b0a n\u01b0\u1edbc.<\/p>\n<p>Nh\u00ecn chung, c\u00e1c thu\u1ed1c t\u00ea \u0111\u1ec1u c\u00f3 t\u00ednh ki\u1ec1m nh\u1eb9 n\u00ean \u00edt tan trong n\u01b0\u1edbc. Tuy nhi\u00ean, khi g\u1eb7p acide hydrochloric thi s\u1ebd t\u1ea1o th\u00e0nh mu\u1ed1i tan trong n\u01b0\u1edbc. Khi s\u1ea3n xu\u1ea5t ng\u01b0\u1eddi ta c\u1ed1 gi\u1eef t\u00ednh th\u0103ng b\u1eb1ng \u01b0a n\u01b0\u1edbc v\u00e0 \u01b0a m\u1ee1.<\/p>\n<p>Ng\u00e0y nay c\u00e1c thu\u1ed1c t\u00ea ch\u00ednh \u0111\u1ec1u c\u00f3 m\u1ed9t s\u1ed1 \u0111\u1eb7c t\u00ednh nh\u01b0 sau:<br \/>\n&#8211; L\u00e0 ch\u1ea5t t\u1ed5ng h\u1ee3p c\u00f3 ch\u1ee9a nh\u00f3m amino.<br \/>\n&#8211; Khi g\u1eb7p acide m\u1ea1nh th\u00ec t\u1ea1o th\u00e0nh mu\u1ed1i v\u00e0 tan trong n\u01b0\u1edbc.<br \/>\n&#8211; Ch\u1ea5t ki\u1ec1m s\u1ebd thu\u1ef7 ph\u00e2n mu\u1ed1i v\u00e0 t\u1ea1o ra c\u00e1c base alkaloide tan trong m\u1ee1.<br \/>\n&#8211; C\u00e1c mu\u1ed1i t\u1ea1o ra b\u1edfi c\u00e1c thu\u1ed1c t\u00ea c\u00f3 t\u00e1c d\u1ee5ng toan t\u00ednh v\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i b\u1ec1n v\u1eefng, ch\u00fang s\u1ebd b\u1ecb thu\u1ef7 ph\u00e2n b\u1edfi c\u00e1c ester c\u1ee7a huy\u1ebft t\u01b0\u01a1ng v\u00e0 b\u1ecb kh\u1eed \u0111\u1ed9c \u1edf gan.<br \/>\n&#8211; C\u00e1c t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c sau m\u1ed9t th\u1eddi gian s\u1ebd m\u1ea5t.<br \/>\n&#8211; T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c epinephrin v\u00e0 c\u00e1c d\u1eabn ch\u1ea5t c\u1ee7a n\u00f3.<br \/>\n&#8211; Kh\u00f4ng t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c mu\u1ed1i kim lo\u1ea1i nh\u01b0 thu\u1ef7 ng\u00e2n, b\u1ea1c,&#8230;<br \/>\n&#8211; C\u00f9ng m\u1ed9t c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng v\u1edbi th\u1ea7n kinh d\u1eabn truy\u1ec1n.<br \/>\n&#8211; N\u1ebfu trong huy\u1ebft t\u01b0\u01a1ng c\u00f3 n\u1ed3ng \u0111\u1ed9 cao th\u00ec g\u00e2y \u0111\u1ed9c cho c\u01a1 th\u1ec3. \u1ede li\u1ec1u g\u00e2y t\u00ea kh\u00f4ng g\u00e2y \u0111\u1ed9c ho\u1eb7c k\u00edch th\u00edch cho c\u01a1 th\u1ec3.<\/p>\n<p>Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea trong nha khoa l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p h\u1eefu hi\u1ec7u \u0111\u1ec3 gi\u1ea3m \u0111au v\u00e0 c\u1ea3m gi\u00e1c nh\u1ea1y c\u1ea3m trong qu\u00e1 tr\u00ecnh ti\u1ebfn h\u00e0nh c\u00e1c th\u1ee7 t\u1ee5c nha khoa. Tuy nhi\u00ean, \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n khi s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea, b\u1ec7nh nh\u00e2n th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt nha khoa c\u1ea7n ph\u1ea3i th\u00f4ng b\u00e1o cho nha s\u0129 ho\u1eb7c b\u00e1c s\u0129 r\u0103ng h\u00e0m m\u1eb7t v\u1ec1 b\u1ea5t k\u1ef3 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe ho\u1eb7c thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng \u0111\u1ec3 tr\u00e1nh c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n. Vi\u1ec7c th\u00f4ng b\u00e1o v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe v\u00e0 thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng s\u1ebd gi\u00fap c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 quy\u1ebft \u0111\u1ecbnh li\u1ec7u c\u00f3 s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea hy kh\u00f4ng, \u0111\u1ed3ng th\u1eddi v\u1edbi \u0111\u00f3 s\u1ebd \u0111\u01b0a ra li\u1ec1u l\u01b0\u1ee3ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p s\u1eed d\u1ee5ng ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng c\u00e1 th\u1ec3 b\u1ec7nh.<\/p>\n<p>Ngu\u1ed3n: Nha khoa c\u01a1 s\u1edf t\u1eadp 2 &#8211; NXB Gi\u00e1o d\u1ee5c Vi\u1ec7t Nam<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p nh\u1eefng ki\u1ebfn th\u1ee9c c\u01a1 b\u1ea3n v\u1ec1 thu\u1ed1c t\u00ea \u0111\u01b0\u1ee3c d\u00f9ng trong nha khoa. Nha s\u0129 c\u1ea7n c\u00f3 hi\u1ec3u bi\u1ebft t\u1ed5ng quan v\u1ec1 c\u00e1c nh\u00f3m thu\u1ed1c, \u0111\u01b0\u1eddng d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ch\u00fang nh\u1eb1m h\u1ed7 tr\u1ee3 \u0111i\u1ec1u tr\u1ecb t\u1ed1t. 1. Th\u00e0nh ph\u1ea7n c\u1ea5u t\u1ea1o thu\u1ed1c t\u00ea Thu\u1ed1c t\u00ea [&hellip;]<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thu\u1ed1c t\u00ea trong \u0111i\u1ec1u tr\u1ecb nha khoa - G\u00f3c nh\u00ecn t\u1ed5ng quan. - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p nh\u1eefng ki\u1ebfn th\u1ee9c c\u01a1 b\u1ea3n v\u1ec1 thu\u1ed1c t\u00ea \u0111\u01b0\u1ee3c d\u00f9ng trong nha khoa. 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