\u2026<\/span><\/li>\n<\/ul>\n1.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/b><\/h3>\n
Th\u01b0\u1eddng g\u1eb7p:<\/i><\/b> Ch\u00f3ng m\u1eb7t, m\u1ec7t m\u1ecfi, b\u1ec7nh n\u00e3o, \u0111\u1ed9ng kinh, s\u1ed1t, \u1edbn l\u1ea1nh, \u0111au kh\u1edbp, vi\u00eam m\u1ea1ch, ban \u0111\u1ecf da, r\u1ee5ng t\u00f3c, t\u0103ng ho\u1eb7c gi\u1ea3m s\u1eafc t\u1ed1 da, lo\u00e9t mi\u1ec7ng, s\u01b0ng l\u01b0\u1ee1i, vi\u00eam n\u01b0\u1edbu, bu\u1ed3n n\u00f4n, n\u00f4n, \u0111i ngo\u00e0i, ch\u00e1n \u0103n, th\u1ee7ng ru\u1ed9t, gi\u1ea3m b\u1ea1ch c\u1ea7u, ti\u1ec3u c\u1ea7u, xu\u1ea5t huy\u1ebft,…<\/span><\/p>\n\u00cdt g\u1eb7p:<\/i><\/b> H\u1ed9i ch\u1ee9ng th\u1ea7n kinh c\u1ea5p, s\u1ed1c ph\u1ea3n v\u1ec7, vi\u00eam ch\u00e2n r\u0103ng, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, gi\u1ea3m s\u1ee9c \u0111\u1ec1 kh\u00e1ng v\u1edbi nhi\u1ec5m khu\u1ea9n, ban \u0111\u1ecf \u0111a d\u1ea1ng, suy gan, r\u1ed1i lo\u1ea1n lympho b\u00e0o, ho\u1ea1i t\u1eed x\u01b0\u01a1ng v\u00e0 ho\u1ea1i t\u1eed m\u00f4, vi\u00eam m\u00e0ng ngo\u00e0i tim, v\u1ea9y n\u1ebfn, \u0111\u1ed9ng kinh, h\u1ed9i ch\u1ee9ng Stevens-Johnson, t\u1eafc m\u1ea1ch huy\u1ebft kh\u1ed1i.<\/span><\/p>\n2. Th\u00f4ng tin chung v\u1ec1 thu\u1ed1c Allopurinol<\/b><\/h2>\n2.1 C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/b><\/h3>\n
Allopurinol v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a oxipurinol l\u00e0m gi\u1ea3m s\u1ea3n xu\u1ea5t acid uric do \u1ee9c ch\u1ebf xanthin oxidase l\u00e0 enzym chuy\u1ec3n hypoxanthin th\u00e0nh xanthin v\u00e0 chuy\u1ec3n xanthin th\u00e0nh acid uric. Do \u0111\u00f3 Allopurinol l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 acid uric c\u1ea3 trong huy\u1ebft thanh v\u00e0 trong n\u01b0\u1edbc ti\u1ec3u. N\u1ed3ng \u0111\u1ed9 xanthin oxidase kh\u00f4ng thay \u0111\u1ed5i khi d\u00f9ng Allopurinol k\u00e9o d\u00e0i. Allopurinol c\u0169ng l\u00e0m t\u0103ng t\u00e1i s\u1eed d\u1ee5ng hypoxanthin v\u00e0 xanthin \u0111\u1ec3 t\u1ed5ng h\u1ee3p acid nucleic v\u00e0 nucleotid, k\u1ebft qu\u1ea3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 nucleotid d\u1eabn t\u1edbi \u1ee9c ch\u1ebf ng\u01b0\u1ee3c l\u1ea7n n\u1eefa t\u1ed5ng h\u1ee3p purin. N\u1ed3ng \u0111\u1ed9 acid uric trong huy\u1ebft thanh th\u01b0\u1eddng gi\u1ea3m c\u00f3 \u00fd ngh\u0129a trong v\u00f2ng 2 \u2013 3 ng\u00e0y sau khi d\u00f9ng thu\u1ed1c, \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 th\u1ea5p nh\u1ea5t sau 1 \u2013 3 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u00e0 tr\u1edf l\u1ea1i gi\u00e1 tr\u1ecb nh\u01b0 tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb sau khi ng\u1eebng thu\u1ed1c 1 \u2013 2 tu\u1ea7n. <\/span>Khi s\u1eed d\u1ee5ng Allopurinol, l\u01b0\u1ee3ng acid uric trong n\u01b0\u1edbc ti\u1ec3u c\u0169ng s\u1ebd gi\u1ea3m, v\u00e0 c\u00e1c ch\u1ea5t xanthin v\u00e0 hypoxanthin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong n\u01b0\u1edbc ti\u1ec3u thay v\u00ec ch\u1ec9 c\u00f3 acid uric nh\u01b0 b\u00ecnh th\u01b0\u1eddng. Vi\u1ec7c gi\u1ea3m l\u01b0\u1ee3ng acid uric trong n\u01b0\u1edbc ti\u1ec3u v\u00e0 t\u0103ng s\u1ef1 ph\u00e2n t\u00e1n c\u1ee7a c\u00e1c ch\u1ea5t xanthin v\u00e0 hypoxanthin gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh tinh th\u1ec3 urat trong n\u01b0\u1edbc ti\u1ec3u, do \u0111\u00f3 gi\u00fap gi\u1ea3m nguy c\u01a1 b\u1ec7nh g\u00fat<\/p>\nG\u1ea7n \u0111\u00e2y, Allopurinol \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c g\u1ed1c t\u1ef1 do superoxid (stress oxy ho\u00e1) trong m\u1ed9t s\u1ed1 ph\u1eabu thu\u1eadt v\u1ec1 tim, \u0111\u00e3 c\u00f3 m\u1ed9t s\u1ed1 k\u1ebft qu\u1ea3. Allopurinol li\u1ec1u th\u1ea5p c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o m\u1ed9t s\u1ed1 ph\u00e1c \u0111\u1ed3 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch trong gh\u00e9p th\u1eadn ho\u1eb7c l\u00e0 th\u00e0nh ph\u1ea7n c\u1ee7a dung d\u1ecbch b\u1ea3o qu\u1ea3n th\u1eadn. Allopurinol \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p v\u1edbi Pentavalent antimony \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Leishmania n\u1ed9i t\u1ea1ng. Ngo\u00e0i ra, Allopurinol c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u01a1n b\u00e0o v\u00e0 \u0111\u01b0\u1ee3c d\u00f9ng trong b\u1ec7nh do Trypanosoma ch\u00e2u M\u1ef9.<\/span><\/p>\n2.2 Ch\u1ec9 \u0111\u1ecbnh<\/b><\/h3>\n
\u0110i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i t\u0103ng acid uric m\u00e1u do vi\u00eam kh\u1edbp g\u00fat m\u1ea1n t\u00ednh. B\u1ec7nh s\u1ecfi th\u1eadn do acid uric (k\u00e8m theo ho\u1eb7c kh\u00f4ng k\u00e8m theo vi\u00eam kh\u1edbp do g\u00fat).<\/span><\/p>\n\u0110i\u1ec1u tr\u1ecb s\u1ecfi calci oxalat t\u00e1i ph\u00e1t \u1edf nam c\u00f3 b\u00e0i ti\u1ebft urat trong n\u01b0\u1edbc ti\u1ec3u tr\u00ean 800 mg\/ng\u00e0y v\u00e0 750 mg\/ng\u00e0y.<\/span><\/p>\nT\u0103ng acid uric m\u00e1u khi d\u00f9ng h\u00f3a tr\u1ecb li\u1ec7u \u0111i\u1ec1u tr\u1ecb ung th\u01b0 trong b\u1ec7nh b\u1ea1ch c\u1ea7u, lympho, u \u00e1c t\u00ednh \u0111\u1eb7c.<\/span><\/p>\n2.3 T\u00e1c d\u1ee5ng ph\u1ee5<\/b><\/h3>\n
Th\u01b0\u1eddng g\u1eb7p:<\/i><\/b> Ban, d\u00e1t s\u1ea7n, ng\u1ee9a, vi\u00eam da tr\u00f3c v\u1ea9y, m\u00e0y \u0111ay, ban \u0111\u1ecf, eczema, xu\u1ea5t huy\u1ebft.<\/span><\/p>\n\u00cdt g\u1eb7p:<\/i><\/b> T\u0103ng phosphatase ki\u1ec1m, AST, ALT, gan to c\u00f3 h\u1ed3i ph\u1ee5c, ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o gan, vi\u00eam gan, suy gan, t\u0103ng bilirubin m\u00e1u, v\u00e0ng da.<\/span><\/p>\nHi\u1ebfm g\u1eb7p: <\/i><\/b>Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn n\u1eb7ng, s\u1ed1t, \u1edbn l\u1ea1nh, to\u00e1t m\u1ed3 h\u00f4i, kh\u00f3 ch\u1ecbu, bong m\u00f3ng, lichen ph\u1eb3ng, ph\u00f9 m\u1eb7t, ph\u00f9 da, r\u1ee5ng t\u00f3c, ch\u1ea3y m\u00e1u cam. Gi\u1ea3m b\u1ea1ch c\u1ea7u ho\u1eb7c t\u0103ng b\u1ea1ch c\u1ea7u, t\u0103ng b\u1ea1ch c\u1ea7u \u01b0a eosin, gi\u1ea3m b\u1ea1ch c\u1ea7u h\u1ea1t, gi\u1ea3m ti\u1ec3u c\u1ea7u, xu\u1ea5t huy\u1ebft, \u1ee9c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng, \u0111\u00f4ng m\u00e1u r\u1ea3i r\u00e1c trong m\u1ea1ch r\u1ea3i, b\u1ec7nh h\u1ea1ch b\u1ea1ch huy\u1ebft, thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o, thi\u1ebfu m\u00e1u tan m\u00e1u. Bu\u1ed3n n\u00f4n, n\u00f4n, \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y, t\u00e1o b\u00f3n, \u0111\u1ea7y h\u01a1i, t\u1eafc ngh\u1ebdn ru\u1ed9t, vi\u00eam tr\u1ef1c tr\u00e0ng, r\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c, vi\u00eam mi\u1ec7ng, kh\u00f3 ti\u00eau, ch\u00e1n \u0103n, vi\u00eam d\u1ea1 d\u00e0y, ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, vi\u00eam t\u1ee5y xu\u1ea5t huy\u1ebft, s\u01b0ng tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt, ph\u00f9 l\u01b0\u1ee1i. \u0110au kh\u1edbp, \u0111\u1ee5c th\u1ee7y tinh th\u1ec3, vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c, r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c. B\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean, vi\u00eam d\u00e2y th\u1ea7n kinh, d\u1ecb c\u1ea3m, \u0111au \u0111\u1ea7u, c\u01a1n co gi\u1eadt, \u0111\u1ed9ng kinh, gi\u1eadt c\u01a1, gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c, k\u00edch \u0111\u1ed9ng, thay \u0111\u1ed5i t\u00ecnh tr\u1ea1ng t\u00e2m th\u1ea7n, nh\u1ed3i m\u00e1u n\u00e3o, h\u00f4n m\u00ea, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1, li\u1ec7t, run, ng\u1ee7 g\u00e0, ch\u00f3ng m\u1eb7t, tr\u1ea7m c\u1ea3m, l\u1eabn l\u1ed9n, m\u1ea5t ng\u1ee7, suy nh\u01b0\u1ee3c, ch\u1ee9ng v\u00fa to \u1edf nam, t\u0103ng huy\u1ebft \u00e1p, suy th\u1eadn.<\/span><\/p>\n3. T\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate v\u00e0 Allopurinol<\/b><\/h2>\n3.1 C\u01a1 ch\u1ebf<\/b><\/h3>\n
Allopurinol l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a Methotrexate b\u1edfi c\u01a1 ch\u1ebf ch\u01b0a r\u00f5 r\u00e0ng. Nh\u01b0ng s\u1ef1 k\u1ebft h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ea1ch c\u1ea7u, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 suy t\u1ee7y.<\/span><\/p>\n3.2 T\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra khi s\u1eed d\u1ee5ng Methotrexate v\u00e0 Alloburinol c\u00f9ng nhau<\/b><\/h3>\n
T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p nh\u01b0: \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n, m\u1ec7t m\u1ecfi, suy nh\u01b0\u1ee3c, kh\u00f3 ch\u1ecbu.<\/span><\/p>\n3.3 Bi\u1ec7n ph\u00e1p x\u1eed l\u00fd t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate v\u00e0 Alloburinol<\/b><\/h3>\n
\u0110\u1ec3 x\u1eed l\u00fd t\u01b0\u01a1ng t\u00e1c thu\u1ed1c gi\u1eefa Methotrexate v\u00e0 Allopurinol, c\u00e1c bi\u1ec7n ph\u00e1p sau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng:<\/span><\/p>\n\n- \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng: \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng Methotrexate ho\u1eb7c Allopurinol \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.\u00a0<\/span><\/li>\n
- Thay \u0111\u1ed5i th\u1eddi gian s\u1eed d\u1ee5ng: Thay \u0111\u1ed5i th\u1eddi gian s\u1eed d\u1ee5ng Methotrexate v\u00e0 Allopurinol \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/span><\/li>\n
- Chuy\u1ec3n sang thu\u1ed1c kh\u00e1c: Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, b\u00e1c s\u0129 c\u00f3 th\u1ec3 khuy\u00ean b\u1ec7nh nh\u00e2n chuy\u1ec3n sang s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1c thay v\u00ec Methotrexate v\u00e0 Allopurinol \u0111\u1ec3 tr\u00e1nh t\u01b0\u01a1ng t\u00e1c thu\u1ed1c g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5.<\/span><\/li>\n
- Gi\u00e1m s\u00e1t s\u1ee9c kh\u1ecfe: B\u00e1c s\u0129 c\u1ea7n th\u01b0\u1eddng xuy\u00ean ki\u1ec3m tra s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n khi s\u1eed d\u1ee5ng Methotrexate v\u00e0 Allopurinol \u0111\u1ed3ng th\u1eddi \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/span><\/li>\n<\/ul>\n
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
Drug: Kh\u00f4ng c\u00f3<\/span><\/p>\nWebMD: V\u1eeba ph\u1ea3i<\/span><\/p>\nMedscape: V\u1eeba ph\u1ea3i<\/span><\/p>\nNgu\u1ed3n: D\u01b0\u1ee3c th\u01b0 Qu\u1ed1c gia Vi\u1ec7t Nam<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"Methotrexate v\u00e0 Allopurinol l\u00e0 hai lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi, ch\u00fang c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi nhau v\u00e0 g\u00e2y ra nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n. Methotrexate l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1ng ung th\u01b0 v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 […]<\/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":"\n
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