{"id":25741,"date":"2023-04-22T22:51:19","date_gmt":"2023-04-22T15:51:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25741"},"modified":"2023-04-22T22:51:19","modified_gmt":"2023-04-22T15:51:19","slug":"tuong-tac-thuoc-giua-cimetidin-va-warfarin","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/tuong-tac-thuoc-giua-cimetidin-va-warfarin\/","title":{"rendered":"T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Cimetidin v\u00e0 Warfarin"},"content":{"rendered":"<p><b>Cimetidin v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c kh\u00e1c nhau v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng kh\u00e1c nhau tr\u00ean c\u01a1 th\u1ec3. Tuy nhi\u00ean, khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng nhau, ch\u00fang c\u00f3 th\u1ec3 g\u00e2y ra t\u01b0\u01a1ng t\u00e1c thu\u1ed1c, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u0103ng nguy c\u01a1 ph\u00e1t tri\u1ec3n c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5. Do \u0111\u00f3, vi\u1ec7c theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c l\u00e0 c\u1ea7n thi\u1ebft khi s\u1eed d\u1ee5ng c\u1ea3 Cimetidin v\u00e0 Warfarin \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m nguy c\u01a1 t\u00e1c d\u1ee5ng ph\u1ee5.<\/b><\/p>\n<h2><b>1. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Cimetidin<\/b><\/h2>\n<h3><b>1.1 C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Cimetidin l\u00e0 m\u1ed9t thu\u1ed1c \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 H2 histamin. Cimetidin \u1ee9c ch\u1ebf c\u1ea1nh tranh v\u1edbi histamin t\u1ea1i th\u1ee5 th\u1ec3 H2 c\u1ee7a t\u1ebf b\u00e0o th\u00e0nh d\u1ea1 d\u00e0y, l\u00e0m gi\u1ea3m b\u00e0i ti\u1ebft v\u00e0 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 acid d\u1ea1 d\u00e0y c\u1ea3 \u1edf \u0111i\u1ec1u ki\u1ec7n c\u01a1 b\u1ea3n (khi \u0111\u00f3i) v\u00e0 khi \u0111\u01b0\u1ee3c k\u00edch th\u00edch b\u1edfi th\u1ee9c \u0103n, Insulin, Histamin, Pentagastrin v\u00e0 Cafein. B\u00e0i ti\u1ebft acid d\u1ea1 d\u00e0y c\u01a1 b\u1ea3n b\u1ecb \u1ee9c ch\u1ebf nhi\u1ec1u h\u01a1n b\u00e0i ti\u1ebft acid do k\u00edch th\u00edch b\u1edfi th\u1ee9c \u0103n.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cimetidin gi\u00e1n ti\u1ebfp l\u00e0m gi\u1ea3m b\u00e0i ti\u1ebft pepsin do l\u00e0m gi\u1ea3m th\u1ec3 t\u00edch d\u1ecbch d\u1ea1 d\u00e0y.<\/span><\/p>\n<figure id=\"attachment_26502\" aria-describedby=\"caption-attachment-26502\" style=\"width: 293px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-26502\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Cimetidin-293x300.jpg\" alt=\"Cimetidin\" width=\"293\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Cimetidin-293x300.jpg 293w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Cimetidin.jpg 389w\" sizes=\"(max-width: 293px) 100vw, 293px\" \/><figcaption id=\"caption-attachment-26502\" class=\"wp-caption-text\">Cimetidin<\/figcaption><\/figure>\n<h3><b>1.2 Ch\u1ec9 \u0111\u1ecbnh<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb ng\u1eafn ng\u00e0y (4 \u2013 8 tu\u1ea7n) \u0111\u1ec3 l\u00e0m li\u1ec1n lo\u00e9t t\u00e1 tr\u00e0ng ti\u1ebfn tri\u1ec3n v\u00e0 lo\u00e9t d\u1ea1 d\u00e0y l\u00e0nh t\u00ednh ti\u1ebfn tri\u1ec3n, bao g\u1ed3m c\u1ea3 lo\u00e9t do stress v\u00e0 do thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb duy tr\u00ec lo\u00e9t t\u00e1 tr\u00e0ng v\u1edbi li\u1ec1u th\u1ea5p sau khi \u1ed5 lo\u00e9t \u0111\u00e3 l\u00e0nh \u0111\u1ec3 gi\u1ea3m t\u00e1i ph\u00e1t.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb ng\u1eafn ng\u00e0y (12 tu\u1ea7n) khi vi\u00eam lo\u00e9t th\u1ef1c qu\u1ea3n \u1edf ng\u01b0\u1eddi b\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c tr\u1ea1ng th\u00e1i b\u1ec7nh l\u00fd t\u0103ng ti\u1ebft \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a nh\u01b0 <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/hoi-chung-zollinger-ellison-4871\/#:~:text=H%E1%BB%99i%20ch%E1%BB%A9ng%20Zollinger%20Ellison%20l%C3%A0,%2C%20gan%2C%20t%C3%BAi%20m%E1%BA%ADt%2C%E2%80%A6\">h\u1ed9i ch\u1ee9ng Zollinger-Ellison<\/a> (thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n), b\u1ec7nh t\u0103ng t\u1ebf b\u00e0o b\u00f3n (d\u01b0\u1ee1ng b\u00e0o) to\u00e0n th\u00e2n (systemic mastocytosis), b\u1ec7nh \u0111a u tuy\u1ebfn n\u1ed9i ti\u1ebft.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p kh\u00f3 ti\u00eau dai d\u1eb3ng (ph\u1ea3i lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng ung th\u01b0 d\u1ea1 d\u00e0y, nh\u1ea5t l\u00e0 \u1edf ng\u01b0\u1eddi cao tu\u1ed5i).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gi\u1ea3m nguy c\u01a1 h\u00edt ph\u1ea3i d\u1ecbch v\u1ecb acid khi g\u00e2y m\u00ea to\u00e0n th\u00e2n ho\u1eb7c khi sinh \u0111\u1ebb (h\u1ed9i ch\u1ee9ng Mendelson).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">D\u00f9ng c\u00f9ng thu\u1ed1c kh\u00e1ng histamin H1 \u0111\u1ec3 ph\u00f2ng ng\u1eeba v\u00e0 qu\u1ea3n l\u00fd m\u1ed9t s\u1ed1 t\u00ecnh tr\u1ea1ng d\u1ecb \u1ee9ng, m\u00e0y \u0111ay \u1edf nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111\u1ea7y \u0111\u1ee7 v\u1edbi thu\u1ed1c kh\u00e1ng histamin H1.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gi\u1ea3m t\u00ecnh tr\u1ea1ng k\u00e9m h\u1ea5p thu v\u00e0 m\u1ea5t d\u1ecbch \u1edf ng\u01b0\u1eddi c\u00f3 h\u1ed9i ch\u1ee9ng ru\u1ed9t ng\u1eafn v\u00e0 gi\u1ea3m s\u1ef1 gi\u00e1ng h\u00f3a enzym t\u1ee5y khi b\u1ed5 sung enzym n\u00e0y \u1edf ng\u01b0\u1eddi b\u1ecb thi\u1ebfu enzym.<\/span><\/li>\n<\/ul>\n<h3><b>1.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/b><\/h3>\n<p><b><i>Th\u01b0\u1eddng g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\">\u00a0 Ti\u00eau ch\u1ea3y v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a kh\u00e1c, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, ng\u1ee7 g\u00e0, m\u1ec7t m\u1ecfi, n\u1ed5i ban, ch\u1ee9ng to v\u00fa \u1edf \u0111\u00e0n \u00f4ng khi \u0111i\u1ec1u tr\u1ecb tr\u00ean 1 th\u00e1ng ho\u1eb7c d\u00f9ng li\u1ec1u cao<\/span><\/p>\n<p><b><i>\u00cdt g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> Ch\u1ee9ng b\u1ea5t l\u1ef1c khi d\u00f9ng li\u1ec1u cao k\u00e9o d\u00e0i, d\u00e1t s\u1ea7n, ban d\u1ea1ng tr\u1ee9ng c\u00e1, m\u00e0y \u0111ay, t\u0103ng enzym gan t\u1ea1m th\u1eddi t\u1ef1 h\u1ebft khi ng\u1eebng thu\u1ed1c, t\u0103ng creatinin huy\u1ebft.<\/span><\/p>\n<p><b><i>Hi\u1ebfm g\u1eb7p:<\/i><\/b><span style=\"font-weight: 400;\"> Tr\u1ea7m c\u1ea3m, k\u00edch \u0111\u1ed9ng, b\u1ed3n ch\u1ed3n, gi\u1ea3m b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n, ngh\u1ebdn d\u1eabn truy\u1ec1n nh\u0129 &#8211; th\u1ea5t, v\u00e0ng da, vi\u00eam t\u1ee5y c\u1ea5p, h\u1ed9i ch\u1ee9ng Stevens-Johnson, \u0111au c\u01a1,&#8230;<\/span><\/p>\n<h2><b>2. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Warfarin<\/b><\/h2>\n<h3><b>2.1 C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/b><\/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><b>2.2 Ch\u1ec9 \u0111\u1ecbnh<\/b><\/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><b>2.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/b><\/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;\"> Ti\u00eau 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><b>3. T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Cimetidin v\u00e0 Warfarin<\/b><\/h2>\n<h3><b>3.1 C\u01a1 ch\u1ebf<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Cimetidin \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a Warfarin \u1edf gan v\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng m\u00e1u c\u1ee7a n\u00f3 trong kho\u1ea3ng th\u1eddi gian t\u1eeb 1 \u0111\u1ebfn 2 tu\u1ea7n. S\u1ef1 t\u01b0\u01a1ng t\u00e1c n\u00e0y d\u01b0\u1eddng nh\u01b0 li\u00ean quan \u0111\u1ebfn R-warfarin \u00edt ho\u1ea1t \u0111\u1ed9ng h\u01a1n so v\u1edbi S-enantiomer ho\u1ea1t \u0111\u1ed9ng m\u1ea1nh h\u01a1n. T\u00e1c d\u1ee5ng n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng kh\u00e1c.<\/span><\/p>\n<h3><b>3.2 T\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra khi s\u1eed d\u1ee5ng Cimetidin v\u00e0 Warfarin c\u00f9ng nhau<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t k\u00ec d\u1ea5u hi\u1ec7u c\u1ee7a m\u1ed9t trong c\u00e1c tri\u1ec7u ch\u1ee9ng sau \u0111\u00e2y:<\/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<\/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 do \u0111\u00e1nh 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><b>3.3 Bi\u1ec7n ph\u00e1p x\u1eed l\u00fd<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">N\u00ean theo d\u00f5i INR (x\u00e9t nghi\u1ec7m m\u00e1u nh\u1eb1m \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng v\u00e0 qu\u00e1 tr\u00ecnh \u0111\u00f4ng m\u00e1u) ho\u1eb7c PT (x\u00e9t nghi\u1ec7m \u0111\u00f4ng m\u00e1u) v\u00e0 n\u00ean s\u1eed d\u1ee5ng li\u1ec1u Cimetidine th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3. M\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng Histamin-2 kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi \u00edt nguy c\u01a1 t\u01b0\u01a1ng t\u00e1c h\u01a1n.<\/span><\/p>\n<h3><b>3.4 M\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau<\/b><\/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><b>4. K\u1ebft lu\u1eadn<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Cimetidin v\u00e0 Warfarin l\u00e0 m\u1ed9t v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh v\u1ec1 t\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c l\u00ean nhau v\u00e0 nh\u1eefng h\u1eadu qu\u1ea3 c\u00f3 th\u1ec3 x\u1ea3y ra khi s\u1eed d\u1ee5ng ch\u00fang c\u00f9ng nhau. Vi\u1ec7c theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m nguy c\u01a1 ph\u00e1t tri\u1ec3n c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5.\u00a0<\/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>Cimetidin v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c kh\u00e1c nhau v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng kh\u00e1c nhau tr\u00ean c\u01a1 th\u1ec3. Tuy nhi\u00ean, khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng nhau, ch\u00fang c\u00f3 th\u1ec3 g\u00e2y ra t\u01b0\u01a1ng t\u00e1c thu\u1ed1c, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u0103ng nguy c\u01a1 ph\u00e1t tri\u1ec3n c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5. Do \u0111\u00f3, vi\u1ec7c theo [&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 Cimetidin v\u00e0 Warfarin - Vinmec<\/title>\n<meta name=\"description\" content=\"Cimetidin v\u00e0 Warfarin l\u00e0 hai lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c nhau. 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