{"id":26335,"date":"2023-04-22T22:55:43","date_gmt":"2023-04-22T15:55:43","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26335"},"modified":"2023-04-22T22:55:43","modified_gmt":"2023-04-22T15:55:43","slug":"7-tuong-tac-xay-ra-khi-su-dung-ketorolac-can-chu-y","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/7-tuong-tac-xay-ra-khi-su-dung-ketorolac-can-chu-y\/","title":{"rendered":"7 t\u01b0\u01a1ng t\u00e1c x\u1ea3y ra khi s\u1eed d\u1ee5ng Ketorolac c\u1ea7n ch\u00fa \u00fd"},"content":{"rendered":"

Ketorolac<\/a> l\u00e0 thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid ( NSAID ) \u0111i\u1ec1u tr\u1ecb \u0111au v\u00e0 s\u01b0ng. Nh\u01b0ng n\u00f3 h\u01a1i kh\u00e1c so v\u1edbi c\u00e1c NSAID kh\u00e1c. Ketorolac ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1eddi gian ng\u1eafn \u0111\u1ec3 gi\u1ea3m \u0111au v\u1eeba \u0111\u1ebfn n\u1eb7ng, nh\u01b0 sau ph\u1eabu thu\u1eadt. M\u1eb7c d\u00f9 Ketorolac ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng trong v\u00e0i ng\u00e0y, nh\u01b0ng v\u1eabn c\u00f3 m\u1ed9t s\u1ed1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u1ea7n bi\u1ebft trong qu\u00e1 tr\u00ecnh s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 tr\u00e1nh l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 v\u00e0 xu\u1ea5t hi\u1ec7n c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n<\/strong><\/p>\n

1.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 NSAIDs<\/strong><\/h2>\n

Tr\u00e1nh s\u1eed d\u1ee5ng Ketorolac v\u1edbi c\u00e1c NSAIDs kh\u00e1c c\u00f9ng l\u00fac. C\u00e1c NSAIDs bao g\u1ed3m Aspirin , Naproxen (Aleve) v\u00e0 Ibuprofen (Advil, Motrin),…H\u1ea7u h\u1ebft c\u00e1c NSAID ho\u1ea1t \u0111\u1ed9ng nh\u01b0 nhau v\u1ec1 c\u01a1 ch\u1ebf n\u00ean g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 t\u01b0\u01a1ng t\u1ef1 nhau. Khi k\u1ebft h\u1ee3p s\u1eed d\u1ee5ng Ketorolac v\u1edbi c\u00e1c NSAID kh\u00e1c l\u00e0m t\u0103ng nguy c\u01a1 v\u00e0 t\u0103ng t\u00ednh tr\u1ea7m tr\u1ecdng c\u1ee7a c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5, ch\u1eb3ng h\u1ea1n nh\u01b0 t\u1ed5n th\u01b0\u01a1ng th\u1eadn, t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y, ru\u1ed9t,…). NSAIDs \u0111\u00f4i khi n\u1eb1m trong th\u00e0nh ph\u1ea7n c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c (thu\u1ed1c c\u1ea3m l\u1ea1nh, thu\u1ed1c kh\u00e1ng acid, thu\u1ed1c gi\u1ea3m \u0111au b\u1ee5ng kinh,…)<\/span><\/p>\n

\"NSAIDs\"
NSAIDs<\/figcaption><\/figure>\n

2.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 nh\u00f3m thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i\u00a0<\/strong><\/h2>\n

Thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ng\u0103n ng\u1eeba c\u1ee5c m\u00e1u \u0111\u00f4ng. C\u00f3 hai ph\u00e2n nh\u00f3m thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i: thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u v\u00e0 thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u. Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh \u0111\u00f4ng m\u00e1u, do \u0111\u00f3 l\u00e0m gi\u1ea3m s\u1ef1 h\u00ecnh th\u00e0nh Fibrin v\u00e0 ng\u0103n ng\u1eeba c\u1ee5c m\u00e1u \u0111\u00f4ng h\u00ecnh th\u00e0nh v\u00e0 ph\u00e1t tri\u1ec3n, ch\u1eb3ng h\u1ea1n Warfarin, Rivaroxaban. C\u00e1c ch\u1ea5t ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u ng\u0103n ng\u1eeba ti\u1ec3u c\u1ea7u v\u00f3n c\u1ee5c v\u00e0 c\u0169ng ng\u0103n ng\u1eeba c\u1ee5c m\u00e1u \u0111\u00f4ng h\u00ecnh th\u00e0nh v\u00e0 ph\u00e1t tri\u1ec3n nh\u01b0 Clopidogrel, Ticagrelor. Khi s\u1eed d\u1ee5ng \u0111\u01a1n l\u1ebb, Ketorolac g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t huy\u1ebft \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Do \u0111\u00f3 khi ph\u1ed1i h\u1ee3p chung v\u1edbi thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i c\u00e0ng l\u00e0m cho nguy c\u01a1 n\u00e0y cao h\u01a1n. \u0110\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 tim c\u00f3 th\u1ec3 b\u1ecb ch\u1ea3y m\u00e1u nghi\u00eam tr\u1ecdng ho\u1eb7c c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn tim<\/span><\/p>\n

3.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Probenecid v\u00e0 Ketorolac<\/strong><\/h2>\n

Probenecid th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u00e1c c\u01a1n g\u00fat c\u1ea5p trong th\u1eddi gian d\u00e0i. B\u1ec7nh g\u00fat l\u00e0 m\u1ed9t d\u1ea1ng \u0111au kh\u1edbp v\u00e0 s\u01b0ng t\u1ea5y do n\u1ed3ng \u0111\u1ed9 axit uric cao trong c\u01a1 th\u1ec3, Probenecid t\u00e1c \u0111\u1ed9ng tr\u00ean th\u1eadn \u0111\u1ec3 lo\u1ea1i b\u1ecf axit uric d\u01b0 th\u1eeba trong c\u01a1 th\u1ec3 v\u00e0 gi\u00fap gi\u1ea3m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 axit uric ng\u0103n ch\u1eb7n t\u00e1c nh\u00e2n ch\u00ednh h\u00ecnh th\u00e0nh b\u1ec7nh g\u00fat. Khi s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Probenecid v\u00e0 Ketorolac, Probenecid ng\u0103n th\u1eadn \u0111\u00e0o th\u1ea3i Ketorolac l\u00e0m cho l\u01b0\u1ee3ng Ketorolac trong c\u01a1 th\u1ec3 t\u0103ng \u0111\u00e1ng k\u1ec3, d\u1eabn \u0111\u1ebfn t\u0103ng nguy c\u01a1 m\u1eafc c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng c\u1ee7a Ketorolac l\u00ean th\u1eadn v\u00e0 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a<\/span><\/p>\n

4.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 thu\u1ed1c ch\u1ed1ng cao huy\u1ebft \u00e1p<\/strong><\/h2>\n

Khi s\u1eed d\u1ee5ng Ketorolac, t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c l\u00e0m t\u0103ng huy\u1ebft \u00e1p v\u00e0 l\u00e0m cho t\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c ch\u1ed1ng cao huy\u1ebft \u00e1p tr\u00ean c\u01a1 th\u1ec3 gi\u1ea3m hi\u1ec7u qu\u1ea3. Ngo\u00e0i ra ph\u1ed1i h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 g\u00e2y th\u00eam g\u00e1nh n\u1eb7ng cho th\u1eadn v\u00ec c\u1ea3 NSAIDs v\u00e0 nh\u00f3m thu\u1ed1c ch\u1ed1ng cao huy\u1ebft \u00e1p \u0111\u1ec1u g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng th\u1eadn. C\u00e1c thu\u1ed1c ch\u1ed1ng cao huy\u1ebft \u00e1p c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn bao g\u1ed3m: ph\u00e2n nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf chuy\u1ec3n angiotensin (ACE) (Lisinopril, Captopril), nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin II (ARB) (Losartan,…), nh\u00f3m thu\u1ed1c l\u1ee3i ti\u1ec3u (Furosemid, Hydroclorothiazid)<\/span><\/p>\n

5.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m<\/strong><\/h2>\n

Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m \u0111\u1ec1u g\u00e2y t\u01b0\u01a1ng t\u00e1c v\u1edbi Ketorolac. C\u1ee5 th\u1ec3 trong \u0111\u00f3, nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu Serotonin c\u00f3 ch\u1ecdn l\u1ecdc (SSRI) l\u00e0 lo\u1ea1i thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng g\u1ed3m Citalopram, Fluoxetin, Paroxetin,…. Tuy r\u1eb1ng c\u00e1c SSRIs ng\u0103n kh\u00f4ng cho Serotonin \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu b\u1edfi c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh v\u00e0 gi\u00fap n\u00e3o x\u1eed l\u00fd Serotonin hi\u1ec7u qu\u1ea3 \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng tr\u1ea7m c\u1ea3m lo l\u1eafng nh\u01b0ng n\u00f3 c\u0169ng \u0111\u01b0\u1ee3c ch\u1ee9ng minh g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 t\u0103ng nguy c\u01a1 ch\u1ea3y m\u00e1u v\u00e0 c\u00f3 r\u1ee7i ro cao tr\u00ean h\u1ec7 ti\u00eau h\u00f3a. N\u1ebfu d\u00f9ng chung, nguy c\u01a1 ch\u1ea3y m\u00e1u d\u1ea1 d\u00e0y cao h\u01a1n so v\u1edbi ch\u1ec9 d\u00f9ng ri\u00eang t\u1eebng lo\u1ea1i thu\u1ed1c. S\u1ef1 k\u1ebft h\u1ee3p c\u0169ng c\u00f3 th\u1ec3 g\u00e2y lo\u00e9t d\u1ea1 d\u00e0y trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p<\/span><\/p>\n

6.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 Lithium<\/strong><\/h2>\n

Lithium \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng r\u1ed1i lo\u1ea1n l\u01b0\u1ee1ng c\u1ef1c v\u00e0 c\u00e1c c\u01a1n h\u01b0ng c\u1ea3m.N\u00f3 c\u00f3 r\u1ea5t nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n v\u00e0 c\u1ea7n ph\u1ea3i theo d\u00f5i th\u01b0\u1eddng xuy\u00ean n\u1ed3ng \u0111\u1ed9 Lithium trong m\u00e1u, do \u0111\u00f3 Lithium khi s\u1eed d\u1ee5ng g\u00e2y t\u01b0\u01a1ng t\u00e1c v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c, bao g\u1ed3m c\u1ea3 Ketorolac. Khi d\u00f9ng Lithium, c\u00e1c t\u1ed5n th\u01b0\u01a1ng th\u1eadn x\u1ea3y ra cho b\u1ec7nh nh\u00e2n n\u00ean s\u1ef1 k\u1ebft h\u1ee3p Ketorolac v\u00e0 Lithium c\u00f3 th\u1ec3 khi\u1ebfn n\u1ed3ng \u0111\u1ed9 Lithium trong m\u00e1u t\u0103ng qu\u00e1 cao kh\u00f4ng ch\u1ec9 khi\u1ebfn th\u1eadn t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng \u0111\u00e0o th\u1ea3i m\u00e0 c\u00f2n d\u1eabn \u0111\u1ebfn nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng do Lithium t\u1ef1 do trong c\u01a1 th\u1ec3 nhi\u1ec1u nh\u01b0 l\u00fa l\u1eabn, run<\/span><\/p>\n

7.T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Ketorolac v\u00e0 Methotrexat<\/strong><\/h2>\n

Methotrexate l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u1ed5 bi\u1ebfn \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 b\u1ec7nh v\u1ea9y n\u1ebfn. Methotrexate n\u1eb1m trong nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 thu\u1ed1c ch\u1ed1ng chuy\u1ec3n h\u00f3a v\u00e0 ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n DNA v\u00e0 ng\u0103n ch\u1eb7n c\u00e1c t\u1ebf b\u00e0o m\u1edbi sinh s\u1ea3n. B\u1eb1ng c\u00e1ch n\u00e0y, Methotrexate ng\u0103n ch\u1eb7n s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 m\u1edbi v\u00e0 c\u0169ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u01b0ng t\u1ea5y. D\u00f9 v\u1eady nh\u01b0ng Methotrexate c\u0169ng c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 n\u00ean x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c, trong \u0111\u00f3 c\u00f3 Ketorolac. B\u00ecnh th\u01b0\u1eddng Methotrexate \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i ch\u1ee7 y\u1ebfu qua \u0111\u01b0\u1eddng ni\u1ec7u v\u00e0 Ketorolac l\u00e0m cho Methotrexate t\u00edch t\u1ee5 trong m\u00e1u. N\u1ed3ng \u0111\u1ed9 Methotrexate cao c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng, bao g\u1ed3m s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u th\u1ea5p<\/span><\/p>\n

\u0110\u00f4i khi m\u1ed9t s\u1ed1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u00f3 th\u1ec3 l\u00e0m cho t\u01b0\u01a1ng t\u00e1c Ketorolac nghi\u00eam tr\u1ecdng h\u01a1n do \u0111\u00f3 c\u1ea7n li\u00ean h\u1ec7 v\u00e0 th\u00f4ng b\u00e1o v\u1edbi c\u00e1c chuy\u00ean gia y t\u1ebf v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111ang d\u00f9ng \u0111\u1ec3 gi\u00fap cho vi\u1ec7c qu\u1ea3n l\u00fd r\u1ee7i ro x\u1ea3y ra v\u1edbi c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t ch\u1eb7t ch\u1ebd<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Ketorolac l\u00e0 thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid ( NSAID ) \u0111i\u1ec1u tr\u1ecb \u0111au v\u00e0 s\u01b0ng. Nh\u01b0ng n\u00f3 h\u01a1i kh\u00e1c so v\u1edbi c\u00e1c NSAID kh\u00e1c. Ketorolac ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1eddi gian ng\u1eafn \u0111\u1ec3 gi\u1ea3m \u0111au v\u1eeba \u0111\u1ebfn n\u1eb7ng, nh\u01b0 sau ph\u1eabu thu\u1eadt. M\u1eb7c d\u00f9 Ketorolac ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng trong v\u00e0i ng\u00e0y, nh\u01b0ng v\u1eabn c\u00f3 […]<\/p>\n","protected":false},"author":54,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12],"tags":[],"yoast_head":"\n7 t\u01b0\u01a1ng t\u00e1c x\u1ea3y ra khi s\u1eed d\u1ee5ng Ketorolac c\u1ea7n ch\u00fa \u00fd - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u1ec7c s\u1eed d\u1ee5ng Ketorolac c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 gi\u1ea3m s\u00e1t c\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c thu\u1ed1c nghi\u00eam tr\u1ecdng\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"7 t\u01b0\u01a1ng t\u00e1c x\u1ea3y ra khi s\u1eed d\u1ee5ng Ketorolac c\u1ea7n ch\u00fa \u00fd - 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