{"id":25162,"date":"2023-04-22T10:05:14","date_gmt":"2023-04-22T03:05:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25162"},"modified":"2023-04-22T10:05:14","modified_gmt":"2023-04-22T03:05:14","slug":"tuong-tac-thuoc-giua-omeprazol-va-warfarin","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/tuong-tac-thuoc-giua-omeprazol-va-warfarin\/","title":{"rendered":"T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Omeprazol v\u00e0 Warfarin"},"content":{"rendered":"<p><strong>Omeprazol v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn d\u1ea1 d\u00e0y v\u00e0 tim m\u1ea1ch. Tuy nhi\u00ean, khi hai lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng nhau, c\u00f3 th\u1ec3 x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 c\u1ee7a Warfarin.\u00a0<\/strong><\/p>\n<h2><strong>1. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Omeprazol<\/strong><\/h2>\n<h3><strong>1.1 C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/strong><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-omeprazole-cong-dung-chi-dinh-va-luu-y-khi-dung\/\">Omeprazol<\/a> l\u00e0 m\u1ed9t Benzimidazol \u0111\u00e3 g\u1eafn c\u00e1c nh\u00f3m th\u1ebf, c\u00f3 c\u1ea5u tr\u00fac v\u00e0 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 Pantoprazol, Lansoprazol, Esomeprazol. Omeprazol l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf s\u1ef1 b\u00e0i ti\u1ebft acid c\u1ee7a d\u1ea1 d\u00e0y do \u1ee9c ch\u1ebf h\u1ec7 enzym hydro\/kali adenosin triphosphatase (H+\/K+ ATPase) c\u00f2n g\u1ecdi l\u00e0 b\u01a1m proton \u1edf t\u1ebf b\u00e0o th\u00e0nh c\u1ee7a d\u1ea1 d\u00e0y. U\u1ed1ng h\u00e0ng ng\u00e0y m\u1ed9t li\u1ec1u duy nh\u1ea5t 20 mg Omeprazol t\u1ea1o \u0111\u01b0\u1ee3c s\u1ef1 \u1ee9c ch\u1ebf ti\u1ebft acid d\u1ea1 d\u00e0y m\u1ea1nh v\u00e0 hi\u1ec7u qu\u1ea3. T\u00e1c d\u1ee5ng t\u1ed1i \u0111a \u0111\u1ea1t \u0111\u01b0\u1ee3c sau 4 ng\u00e0y \u0111i\u1ec1u tr\u1ecb. \u1ede b\u1ec7nh nh\u00e2n lo\u00e9t t\u00e1 tr\u00e0ng, c\u00f3 th\u1ec3 duy tr\u00ec vi\u1ec7c gi\u1ea3m 80% acid d\u1ecbch v\u1ecb trong 24 gi\u1edd.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Omeprazol c\u00f3 th\u1ec3 k\u00ecm h\u00e3m \u0111\u01b0\u1ee3c vi khu\u1ea9n <em>Helicobacter pylori<\/em> \u1edf ng\u01b0\u1eddi b\u1ec7nh lo\u00e9t t\u00e1 tr\u00e0ng v\u00e0\/ho\u1eb7c vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c b\u1ecb nhi\u1ec5m vi khu\u1ea9n n\u00e0y. Ph\u1ed1i h\u1ee3p Omeprazol v\u1edbi m\u1ed9t s\u1ed1 thu\u1ed1c kh\u00e1ng khu\u1ea9n (th\u00ed d\u1ee5 Clarithromycin, Amoxicilin) c\u00f3 th\u1ec3 ti\u1ec7t tr\u1eeb <em>H. pylori<\/em> k\u00e8m theo li\u1ec1n \u1ed5 lo\u00e9t v\u00e0 thuy\u00ean gi\u1ea3m b\u1ec7nh l\u00e2u d\u00e0i.<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_22888\" aria-describedby=\"caption-attachment-22888\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-22888\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Omeprazol-300x300.jpg\" alt=\"Omeprazole\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Omeprazol-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Omeprazol-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Omeprazol-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Omeprazol.jpg 822w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-22888\" class=\"wp-caption-text\">Omeprazole<\/figcaption><\/figure>\n<h3><strong>1.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00f3 ti\u00eau do t\u0103ng ti\u1ebft acid.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n. B\u1ec7nh lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u1ed9i ch\u1ee9ng Zollinger \u2013 Ellison.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng lo\u00e9t do stress, lo\u00e9t do thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid.<\/span><\/li>\n<\/ul>\n<h3><strong>1.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/strong><\/h3>\n<p><b><i>Th\u01b0\u1eddng g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> Nh\u1ee9c \u0111\u1ea7u, bu\u1ed3n ng\u1ee7, ch\u00f3ng m\u1eb7t, \u1ec9a ch\u1ea3y, bu\u1ed3n n\u00f4n, n\u00f4n, \u0111au b\u1ee5ng, t\u00e1o b\u00f3n, tr\u01b0\u1edbng b\u1ee5ng.<\/span><\/p>\n<p><b><i>\u00cdt g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> M\u1ea5t ng\u1ee7, r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c, m\u1ec7t m\u1ecfi, m\u00e0y \u0111ay, ng\u1ee9a, n\u1ed5i ban, t\u0103ng transaminase nh\u1ea5t th\u1eddi<\/span><\/p>\n<p><b><i>Hi\u1ebfm g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> \u0110\u1ed5 m\u1ed3 h\u00f4i, ph\u00f9 ngo\u1ea1i bi\u00ean, qu\u00e1 m\u1eabn bao g\u1ed3m ph\u00f9 m\u1ea1ch, s\u1ed1t ph\u1ea3n v\u1ec7, gi\u1ea3m b\u1ea1ch c\u1ea7u, gi\u1ea3m ti\u1ec3u c\u1ea7u, thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft t\u1ef1 mi\u1ec5n, vi\u00eam th\u1eadn k\u1ebd, vi\u00eam d\u1ea1 d\u00e0y,&#8230;<\/span><\/p>\n<h2><strong>2. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Warfarin<\/strong><\/h2>\n<h3><strong>2.1 C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/strong><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Warfarin l\u00e0 thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u nh\u00f3m Coumarin.\u00a0 Warfarin ng\u0103n c\u1ea3n t\u1ed5ng h\u1ee3p m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u \u1edf gan g\u1ed3m c\u00f3 y\u1ebfu t\u1ed1 II (prothrombin), VII (proconvertin), IX (y\u1ebfu t\u1ed1 Chrismas ho\u1eb7c th\u00e0nh ph\u1ea7n thromboplastin huy\u1ebft t\u01b0\u01a1ng) v\u00e0 X (y\u1ebfu t\u1ed1 Stuart- Prower) b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf t\u00e1i sinh vitamin K kh\u1eed, ch\u1ea5t n\u00e0y c\u1ea7n thi\u1ebft \u0111\u1ec3 gamma-carboxyl h\u00f3a m\u1ed9t s\u1ed1 ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a acid glutamic trong protein ti\u1ec1n th\u00e2n c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u \u0111\u00f3. Kh\u00f4ng c\u00f3 vitamin K kh\u1eed, carboxyl h\u00f3a c\u00e1c ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a acid glutamic \u1edf c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u II, VII, IX v\u00e0 X kh\u00f4ng th\u1ec3 ti\u1ebfn h\u00e0nh \u0111\u01b0\u1ee3c v\u00e0 c\u00e1c protein n\u00e0y kh\u00f4ng th\u1ec3 tr\u1edf th\u00e0nh \u0111\u01b0\u1ee3c c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u c\u00f3 ho\u1ea1t t\u00ednh.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Warfarin c\u0169ng \u1ee9c ch\u1ebf c\u00e1c protein C v\u00e0 S ch\u1ed1ng \u0111\u00f4ng m\u00e1u. Kh\u00f4ng gi\u1ed1ng Heparin, Warfarin kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng m\u00e1u in vitro.<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_25169\" aria-describedby=\"caption-attachment-25169\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-25169\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Warfarin-1-300x300.png\" alt=\"Warfarin\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Warfarin-1-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Warfarin-1-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Warfarin-1.png 463w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-25169\" class=\"wp-caption-text\">Warfarin<\/figcaption><\/figure>\n<h3><strong>2.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h3>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh tim d\u1ec5 g\u00e2y ngh\u1ebdn m\u1ea1ch:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng c\u00e1c bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i ngh\u1ebdn m\u1ea1ch do rung nh\u0129 (k\u00e9o d\u00e0i ho\u1eb7c k\u1ecbch ph\u00e1t)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh van hai l\u00e1 (k\u00e8m rung nh\u0129)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Van nh\u00e2n t\u1ea1o (nh\u1ea5t l\u00e0 van nh\u00e2n t\u1ea1o th\u1ebf h\u1ec7 \u0111\u1ea7u ho\u1eb7c van c\u01a1 h\u1ecdc).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Nh\u1ed3i m\u00e1u c\u01a1 tim:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng c\u00e1c bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i ngh\u1ebdn m\u1ea1ch do nh\u1ed3i m\u00e1u c\u01a1 tim bi\u1ebfn ch\u1ee9ng: Huy\u1ebft kh\u1ed1i n\u1ed9i t\u00e2m m\u1ea1c, lo\u1ea1n n\u0103ng th\u1ea5t tr\u00e1i n\u1eb7ng, lo\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ea5t tr\u00e1i g\u00e2y t\u1eafc m\u1ea1ch, ti\u1ebfp n\u1ed1i Heparin.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng nh\u1ed3i m\u00e1u c\u01a1 tim t\u00e1i ph\u00e1t, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng dung n\u1ea1p Aspirin.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u v\u00e0 ngh\u1ebdn m\u1ea1ch ph\u1ed5i c\u0169ng nh\u01b0 d\u1ef1 ph\u00f2ng t\u00e1i ph\u00e1t, ti\u1ebfp n\u1ed1i Heparin.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 ngh\u1ebdn m\u1ea1ch ph\u1ed5i trong ph\u1eabu thu\u1eadt kh\u1edbp h\u00e1ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u1ef1 ph\u00f2ng c\u1ee5c m\u00e1u \u0111\u00f4ng trong cathete.<\/span><\/li>\n<\/ul>\n<h3><strong>2.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/strong><\/h3>\n<p><b><i>Th\u01b0\u1eddng g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> Ch\u1ea3y m\u00e1u<\/span><\/p>\n<p><b><i>\u00cdt g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> \u1ec8a ch\u1ea3y, ban \u0111\u1ecf, r\u1ee5ng t\u00f3c.<\/span><\/p>\n<p><b><i>Hi\u1ebfm g\u1eb7p: <\/i><\/b><span style=\"font-weight: 400;\">Vi\u00eam m\u1ea1ch, da ho\u1ea1i t\u1eed khu tr\u00fa, c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebf thi\u1ebfu h\u1ee5t b\u1ea9m sinh protein C ho\u1eb7c S, gan t\u1ed5n th\u01b0\u01a1ng.<\/span><\/p>\n<h2><strong>3. T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Omeprazol v\u00e0 Warfarin<\/strong><\/h2>\n<h3><strong>3.1 C\u01a1 ch\u1ebf<\/strong><\/h3>\n<p><span style=\"font-weight: 400;\">D\u00f9ng \u0111\u1ed3ng th\u1eddi Omeprazol (thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton) v\u00e0 Warfarin s\u1ebd l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng h\u1ea1 prothromin huy\u1ebft c\u1ee7a Wafarin. Do s\u1ef1 \u1ee9c ch\u1ebf PPI c\u1ee7a CYP450 2C19 v\u00e0\/ho\u1eb7c 3A4, c\u00e1c isoenzym ch\u1ecbu tr\u00e1ch nhi\u1ec7m m\u1ed9t ph\u1ea7n cho vi\u1ec7c thanh th\u1ea3i chuy\u1ec3n h\u00f3a c\u1ee7a ch\u1ea5t \u0111\u1ed3ng ph\u00e2n R(+) k\u00e9m ho\u1ea1t t\u00ednh sinh h\u1ecdc c\u1ee7a Warfarin. \u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 th\u1eddi gian\u00a0 t\u0103ng INR v\u00e0 prothrombin \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng Warfarin v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton c\u00f3 b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng. Trong m\u1ed9t nghi\u00ean c\u1ee9u, 21 \u0111\u1ed1i t\u01b0\u1ee3ng gi\u1edbi t\u00ednh nam tr\u1ebb tu\u1ed5i v\u00e0 kh\u1ecfe m\u1ea1nh \u0111\u01b0\u1ee3c cho s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi Omeprazole 20 mg\/ng\u00e0y v\u00e0 Warfarin (li\u1ec1u l\u01b0\u1ee3ng ri\u00eang l\u1ebb) trong 2 tu\u1ea7n \u0111\u00e3 l\u00e0m t\u0103ng 12% n\u1ed3ng \u0111\u1ed9 trung b\u00ecnh trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a R(+) Warfarin so v\u1edbi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi gi\u1ea3 d\u01b0\u1ee3c. N\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a ch\u1ea5t \u0111\u1ed3ng ph\u00e2n S(-) kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng v\u00e0 kh\u00f4ng c\u00f3 thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng v\u1ec1 th\u1eddi gian \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1ee3c ghi nh\u1eadn.\u00a0<\/span><\/p>\n<h3><strong>3.2 T\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra khi s\u1eed d\u1ee5ng Omeprazol v\u00e0 Warfarin c\u00f9ng nhau<\/strong><\/h3>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o sau \u0111\u00e2y:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u01b0ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nh\u1ee9c \u0111\u1ea7u<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u00f3ng m\u1eb7t<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Suy nh\u01b0\u1ee3c\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea3y m\u00e1u k\u00e9o d\u00e0i do v\u1ebft c\u1eaft<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u0103ng l\u01b0\u1ee3ng kinh nguy\u1ec7t<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea3y m\u00e1u \u00e2m \u0111\u1ea1o<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea3y m\u00e1u cam<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea3y m\u00e1u n\u01b0\u1edbu r\u0103ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ea3y m\u00e1u b\u1ea5t th\u01b0\u1eddng ho\u1eb7c b\u1ea7m t\u00edm<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">N\u01b0\u1edbc ti\u1ec3u \u0111\u1ecf ho\u1eb7c n\u00e2u<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ph\u00e2n \u0111\u1ecf ho\u1eb7c \u0111en<\/span><\/li>\n<\/ul>\n<h3><strong>3.3 Bi\u1ec7n ph\u00e1p x\u1eed l\u00fd<\/strong><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\">Theo d\u00f5i ch\u1eb7t ch\u1ebd b\u1ec7nh nh\u00e2n trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi Warfarin v\u1edbi Omeprazol<\/span><\/li>\n<li><span style=\"font-weight: 400;\">INR n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m tra th\u01b0\u1eddng xuy\u00ean\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng Warfarin cho ph\u00f9 h\u1ee3p<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Thay th\u1ebf thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng kh\u00e1c.\u00a0<\/span><\/li>\n<\/ul>\n<h3><strong>3.4 M\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau<\/strong><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drug: V\u1eeba ph\u1ea3i\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">WebMD: Nghi\u00eam tr\u1ecdng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medscape: Nghi\u00eam tr\u1ecdng<\/span><\/li>\n<\/ul>\n<h2><strong>4. K\u1ebft lu\u1eadn<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Omeprazol v\u00e0 Warfarin c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 c\u1ee7a Warfarin v\u00e0 t\u0103ng nguy c\u01a1 ch\u1ea3y m\u00e1u. Do \u0111\u00f3, n\u00ean\u00a0 theo d\u00f5i ch\u1eb7t ch\u1ebd n\u1ed3ng \u0111\u1ed9 Warfarin trong m\u00e1u \u0111\u1ec3 tr\u00e1nh c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ngu\u1ed3n: D\u01b0\u1ee3c th\u01b0 Qu\u1ed1c gia Vi\u1ec7t Nam, Drug.com<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Omeprazol v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn d\u1ea1 d\u00e0y v\u00e0 tim m\u1ea1ch. Tuy nhi\u00ean, khi hai lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng nhau, c\u00f3 th\u1ec3 x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 c\u1ee7a Warfarin.\u00a0 1. Th\u00f4ng tin [&hellip;]<\/p>\n","protected":false},"author":53,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Omeprazol v\u00e0 Warfarin - Vinmec<\/title>\n<meta name=\"description\" content=\"Omeprazol v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn d\u1ea1 d\u00e0y v\u00e0 tim m\u1ea1ch. 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