{"id":29216,"date":"2023-05-07T10:44:34","date_gmt":"2023-05-07T03:44:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29216"},"modified":"2023-05-07T10:44:34","modified_gmt":"2023-05-07T03:44:34","slug":"11-loai-thuoc-gay-tac-dung-phu-nghiem-trong-o-nguoi-cao-tuoi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/07\/11-loai-thuoc-gay-tac-dung-phu-nghiem-trong-o-nguoi-cao-tuoi\/","title":{"rendered":"11 lo\u1ea1i thu\u1ed1c g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i"},"content":{"rendered":"

Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 11 lo\u1ea1i thu\u1ed1c ph\u1ed5 bi\u1ebfn m\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i th\u01b0\u1eddng s\u1eed d\u1ee5ng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng. Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd, nh\u01b0ng \u0111\u1ed3ng th\u1eddi c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 s\u1ee9c kh\u1ecfe y\u1ebfu. Ch\u00fang ta s\u1ebd \u0111i s\u00e2u v\u00e0o t\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a t\u1eebng lo\u1ea1i thu\u1ed1c v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p \u0111\u1ed1i ph\u00f3, gi\u00fap t\u0103ng c\u01b0\u1eddng ki\u1ebfn th\u1ee9c v\u00e0 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe cho ng\u01b0\u1eddi cao tu\u1ed5i.<\/strong><\/p>\n

1.Tu\u1ed5i t\u00e1c l\u00e0m t\u0103ng nguy c\u01a1 x\u1ea3y ra t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c\u00a0<\/strong><\/h2>\n

1.1 \u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c lo\u1ea1i thu\u1ed1c, t\u01b0\u01a1ng t\u00e1c v\u00e0 l\u1ecbch tr\u00ecnh s\u1eed d\u1ee5ng thu\u1ed1c\u00a0<\/span><\/h3>\n

Ng\u01b0\u1eddi l\u1edbn tu\u1ed5i<\/a> c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng m\u1eafc m\u1ed9t ho\u1eb7c nhi\u1ec1u b\u1ec7nh m\u00e3n t\u00ednh, ch\u1eb3ng h\u1ea1n nh\u01b0 huy\u1ebft \u00e1p cao , cholesterol cao, ti\u1ec3u \u0111\u01b0\u1eddng lo\u1ea1i 2 , b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, vi\u00eam kh\u1edbp , b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u00e3n t\u00ednh (COPD), tr\u1ea7m c\u1ea3m,… Nh\u1eefng t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd m\u00e3n t\u00ednh n\u00e0y c\u00f3 th\u1ec3 l\u00e0 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c m\u00e0 m\u1ed7i lo\u1ea1i thu\u1ed1c \u0111\u1ec1u c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 ti\u1ec1m \u1ea9n ri\u00eang v\u00e0 nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 t\u0103ng l\u00ean nhanh ch\u00f3ng. Ngo\u00e0i ra, khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi nhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u00f9ng l\u00fac ho\u1eb7c kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c li\u1ec1u qu\u00e1 ng\u1eafn, c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c thu\u1ed1c x\u1ea3y ra. M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c c\u00f3 y\u00eau c\u1ea7u v\u1ec1 th\u1eddi gian c\u1ee5 th\u1ec3 nh\u01b0 ph\u1ea3i d\u00f9ng tr\u01b0\u1edbc b\u1eefa \u0103n, c\u00f9ng v\u1edbi th\u1ee9c \u0103n, ho\u1eb7c tr\u01b0\u1edbc khi \u0111i ng\u1ee7 do \u0111\u00f3 d\u00f9ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c v\u00e0o c\u00e1c th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau trong ng\u00e0y c\u0169ng l\u00e0 y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng l\u00e0m t\u0103ng nguy c\u01a1 x\u1ea3y ra t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n\u00a0<\/span><\/p>\n

\"Ng\u01b0\u1eddi
Ng\u01b0\u1eddi cao tu\u1ed5i<\/figcaption><\/figure>\n

1.2 \u1ea2nh h\u01b0\u1edfng c\u1ee7a qu\u00e1 tr\u00ecnh thay \u0111\u1ed5i d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc\u00a0<\/span><\/h3>\n

Qu\u00e1 tr\u00ecnh l\u00e3o h\u00f3a b\u00ecnh th\u01b0\u1eddng \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i t\u00e1c \u0111\u1ed9ng v\u00e0 l\u00e0m thay \u0111\u1ed5i d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a thu\u1ed1c khi \u0111i v\u00e0o c\u01a1 th\u1ec3 l\u00e0m cho t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 nguy c\u01a1 x\u1ea3y ra cao h\u01a1n. C\u1ee5 th\u1ec3, khi l\u1edbn tu\u1ed5i, c\u01a1 th\u1ec3 s\u1ebd t\u00edch t\u1ee5 nhi\u1ec1u ch\u1ea5t b\u00e9o h\u01a1n so v\u1edbi x\u01b0\u01a1ng v\u00e0 c\u01a1 b\u1eafp do \u0111\u00f3 m\u1eb7c d\u00f9 c\u00e2n n\u1eb7ng v\u1eabn gi\u1eef nguy\u00ean nh\u01b0ng t\u1ec9 l\u1ec7 m\u1ee1 trong c\u01a1 th\u1ec3 t\u0103ng, l\u00e0 \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i \u0111\u1ec3 h\u00f2a tan c\u00e1c lo\u1ea1i thu\u1ed1c tan trong ch\u1ea5t b\u00e9o, t\u1eeb \u0111\u00f3 t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c k\u00e9o d\u00e0i h\u01a1n k\u1ec3 c\u1ea3 khi ng\u01b0ng s\u1eed d\u1ee5ng thu\u1ed1c. B\u00ecnh th\u01b0\u1eddng, t\u1ebf b\u00e0o c\u01a1 t\u00edch tr\u1eef nhi\u1ec1u n\u01b0\u1edbc h\u01a1n t\u1ebf b\u00e0o m\u1ee1, \u0111i\u1ec1u n\u00e0y \u0111\u1ed3ng ngh\u0129a \u1edf ng\u01b0\u1eddi cao tu\u1ed5i \u00edt c\u00f3 kh\u1ea3 n\u0103ng h\u00f2a tan c\u00e1c lo\u1ea1i thu\u1ed1c tan trong n\u01b0\u1edbc, v\u00ec v\u1eady m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c tr\u1edf n\u00ean qu\u00e1 c\u00f4 \u0111\u1eb7c trong m\u00e1u v\u00e0 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng. Gan l\u00e0 m\u1ed9t trong nh\u1eefng c\u01a1 quan quan tr\u1ecdng nh\u1ea5t trong c\u01a1 th\u1ec3 gi\u00fap chuy\u1ec3n h\u00f3a thu\u1ed1c nh\u01b0ng khi l\u1edbn tu\u1ed5i kh\u1ed1i l\u01b0\u1ee3ng gan nh\u1ecf h\u01a1n, l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn gan gi\u1ea3m v\u00e0 c\u00e1c enzyme ph\u00e2n h\u1ee7y c\u0169ng gi\u1ea3m l\u00e0m cho vi\u1ec7c thu\u1ed1c t\u00edch t\u1ee5 nhi\u1ec1u trong gan g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan. T\u01b0\u01a1ng t\u1ef1, \u1edf ng\u01b0\u1eddi cao tu\u1ed5i ch\u1ee9c n\u0103ng th\u1eadn c\u0169ng gi\u1ea3m do l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn th\u1eadn gi\u1ea3m n\u00ean n\u0103ng su\u1ea5t l\u00e0m vi\u1ec7c c\u1ee7a th\u1eadn tr\u1edf n\u00ean k\u00e9m hi\u1ec7u qu\u1ea3 trong th\u1ea3i tr\u1eeb thu\u1ed1c kh\u1ecfi c\u01a1 th\u1ec3\u00a0<\/span><\/p>\n

V\u00ec nh\u1eefng nguy\u00ean nh\u00e2n tr\u00ean, c\u01a1 th\u1ec3 ng\u01b0\u1eddi l\u1edbn tu\u1ed5i tr\u1edf n\u00ean nh\u1ea1y c\u1ea3m h\u01a1n v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 – nh\u01b0 nh\u1ea7m l\u1eabn, huy\u1ebft \u00e1p th\u1ea5p v\u00e0 t\u00e9 ng\u00e3 c\u00f3 th\u1ec3 \u0111\u1eb7c bi\u1ec7t nguy hi\u1ec3m n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t k\u1ecbp th\u1eddi v\u00e0 \u0111\u1ea7y \u0111\u1ee7. Vi\u1ec7c n\u1eafm r\u00f5 c\u00e1c thu\u1ed1c l\u00e0m t\u0103ng nh\u1ea1y c\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 c\u00f3 nh\u1eefng l\u1ef1a ch\u1ecdn thay th\u1ebf an to\u00e0n hi\u1ec7u qu\u1ea3 h\u01a1n.<\/span><\/p>\n

2.C\u00e1c thu\u1ed1c g\u00e2y nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/strong><\/h2>\n

2.1 Benadryl v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1ng Histamin kh\u00e1c<\/span><\/h3>\n

Thu\u1ed1c kh\u00e1ng histamin \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho c\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c nhau, bao g\u1ed3m d\u1ecb \u1ee9ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gi\u1ea5c ng\u1ee7. D\u00f9 v\u1eady, trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p tr\u00e1nh s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng histamin th\u1ebf h\u1ec7 th\u1ee9 nh\u1ea5t \u1edf ng\u01b0\u1eddi cao tu\u1ed5i. Nguy\u00ean nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 khi c\u01a1 th\u1ec3 c\u00f3 d\u1ea5u hi\u1ec7u l\u00e3o h\u00f3a, ch\u1ee9c n\u0103ng th\u1eadn b\u1ecb suy gi\u1ea3m v\u00e0 d\u1ec5 t\u00edch t\u1ee5 l\u01b0\u1ee3ng l\u1edbn thu\u1ed1c do qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i thu\u1ed1c k\u00e9m. T\u1eeb \u0111\u00f3, l\u00e0m t\u0103ng \u0111\u00e1ng k\u1ec3 nguy c\u01a1 m\u1eafc c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 bao g\u1ed3m t\u00e1o b\u00f3n, kh\u00f4 mi\u1ec7ng, l\u00fa l\u1eabn, ch\u00f3ng m\u1eb7t, b\u00ed ti\u1ec3u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan ho\u1eb7c th\u1eadn. C\u1ee5 th\u1ec3, Diphenhydramine (Benadryl) th\u01b0\u1eddng ph\u1ed5 bi\u1ebfn c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng Cholinergic nh\u01b0ng g\u00e2y suy gi\u1ea3m nh\u1eadn th\u1ee9c (l\u00fa l\u1eabn, m\u1ea5t tr\u00ed nh\u1edb, m\u00ea s\u1ea3ng) \u1edf ng\u01b0\u1eddi cao tu\u1ed5i. Ngo\u00e0i ra c\u00f2n c\u00e1c thu\u1ed1c c\u00f9ng nh\u00f3m g\u1ed3m Doxylamine (Unisom), Clorpheniramin (Chlor-Trimeton), Dimenhydrinate (Dramamine). H\u01a1n n\u1eefa, nh\u1eefng thu\u1ed1c kh\u00e1ng histamin n\u00e0y c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb v\u1ea5n \u0111\u1ec1 m\u1ea1ch th\u01b0\u1eddng d\u00f9ng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i nh\u01b0 Metoprolol. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i n\u00ean l\u1ef1a ch\u1ecdn c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1ng histamin m\u1edbi h\u01a1n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c tri\u1ec7u ch\u1ee9ng d\u1ecb \u1ee9ng: Cetirizine (Zyrtec), Fexofenadine (Allegra) ho\u1eb7c Loratadine (Claritin).<\/span><\/p>\n

2.2 Thu\u1ed1c ng\u1ee7\u00a0<\/span><\/h3>\n

Ch\u1ee9ng m\u1ea5t ng\u1ee7 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c theo toa \u0111\u01b0\u1ee3c g\u1ecdi chung l\u00e0 \u201cthu\u1ed1c Z\u201d, bao g\u1ed3m Eszopiclone (Lunesta), Zaleplon Sonata) v\u00e0 Zolpidem (Ambien). Nh\u01b0ng \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, ch\u00fang c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng nh\u01b0 m\u00ea s\u1ea3ng, t\u00e9 ng\u00e3 v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 nh\u1eadn th\u1ee9c. Ngo\u00e0i ra, c\u00e1c thu\u1ed1c ng\u1ee7 nh\u00f3m Benzodiazepin (BZD) c\u0169ng n\u00ean tr\u00e1nh khi s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gi\u1ea5c ng\u1ee7 \u1edf ng\u01b0\u1eddi cao tu\u1ed5i bao g\u1ed3m Estazolam, Triazolam (Halcion) v\u00e0 Temazepam (Restoril) khi g\u00e2y c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 t\u01b0\u01a1ng t\u1ef1. Do \u0111\u00f3, t\u1eadp trung v\u00e0o \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng m\u1ea5t ng\u1ee7 kh\u00f4ng d\u00f9ng thu\u1ed1c b\u1eb1ng c\u00e1ch thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng sinh ho\u1ea1t s\u1ebd ph\u00f9 h\u1ee3p hi\u1ec7u qu\u1ea3 h\u01a1n \u1edf ng\u01b0\u1eddi cao tu\u1ed5i.<\/span><\/p>\n

2.3 Thu\u1ed1c gi\u00e3n c\u01a1\u00a0<\/span><\/h3>\n

Thu\u1ed1c gi\u00e3n c\u01a1 c\u00f3 th\u1ec3 kh\u00f3 dung n\u1ea1p \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i do t\u00e1c d\u1ee5ng ph\u1ee5. \u0110\u1eb7c bi\u1ec7t, c\u00e1c thu\u1ed1c n\u00e0y g\u00e2y bu\u1ed3n ng\u1ee7, nguy c\u01a1 t\u00e9 ng\u00e3, t\u00e1o b\u00f3n v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 ti\u1ec3u ti\u1ec7n. Trong \u0111\u00f3, Carisoprodol (Soma), Cyclobenzaprine v\u00e0 Methocarbamol l\u00e0 m\u1ed9t v\u00e0i v\u00ed d\u1ee5 ph\u1ed5 bi\u1ebfn. V\u00ec v\u1eady, n\u00ean th\u1eed t\u1eadp th\u1ec3 d\u1ee5c v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 thay cho thu\u1ed1c gi\u00e3n c\u01a1.<\/span><\/p>\n

2.4 Thu\u1ed1c ch\u1ed1ng co th\u1eaft\u00a0<\/span><\/h3>\n

Co th\u1eaft trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn, th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c \u0111au ho\u1eb7c kh\u00f3 ch\u1ecbu trong.C\u00e1c thu\u1ed1c ch\u1ed1ng co th\u1eaft nh\u01b0 Dicyclomine v\u00e0 Hyoscyamine (Levsin) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y b\u1eb1ng c\u00e1ch gi\u00e3n c\u00e1c c\u01a1 b\u1ee5ng v\u00e0 gi\u1ea3m s\u1ef1 co th\u1eaft trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a th\u01b0\u1eddng xuy\u00ean x\u1ea3y ra khi c\u01a1 b\u1ee5ng co l\u1ea1i. Tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng t\u1ed1t trong ng\u01b0\u1eddi l\u1edbn tu\u1ed5i do s\u1ef1 thay \u0111\u1ed5i v\u1ec1 ch\u1ee9c n\u0103ng c\u01a1 th\u1ec3 li\u00ean quan \u0111\u1ebfn tu\u1ed5i t\u00e1c. H\u01a1n n\u1eefa, c\u00e1c thu\u1ed1c ch\u1ed1ng co th\u1eaft n\u00e0y c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 l\u00fa l\u1eabn, kh\u00f4 mi\u1ec7ng v\u00e0 t\u00e1o b\u00f3n, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng l\u00e2u d\u00e0i. V\u00ec v\u1eady, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u00e1nh s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y v\u00e0 n\u00ean t\u00ecm ki\u1ebfm c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c nh\u01b0 thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng, t\u1eadp th\u1ec3 d\u1ee5c, gi\u1ea3m stress ho\u1eb7c\u00a0 s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c (thu\u1ed1c gi\u1ea3m \u0111au, thu\u1ed1c t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn \u0111\u01b0\u1eddng ti\u00eau h\u00f3a).<\/span><\/p>\n

2.5 Seroquel v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n\u00a0<\/span><\/h3>\n

Thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u00ecnh tr\u1ea1ng t\u00e2m th\u1ea7n nh\u01b0 t\u00e2m th\u1ea7n ph\u00e2n li\u1ec7t v\u00e0 r\u1ed1i lo\u1ea1n l\u01b0\u1ee1ng c\u1ef1c. M\u1ed9t s\u1ed1 v\u00ed d\u1ee5 v\u1ec1 thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n bao g\u1ed3m Aripiprazole (Abilify), Quetiapine (Seroquel) v\u00e0 Risperidone (Risperdal). Seroquel c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb v\u1ea5n \u0111\u1ec1 v\u1ec1 gi\u1ea5c ng\u1ee7 \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. Tuy nhi\u00ean, thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u00e1ng lo ng\u1ea1i \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, bao g\u1ed3m nh\u1ea7m l\u1eabn, ch\u00f3ng m\u1eb7t, huy\u1ebft \u00e1p th\u1ea5p, c\u00e1c chuy\u1ec3n \u0111\u1ed9ng c\u01a1 th\u1ec3 kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ti\u1ec3u ti\u1ec7n. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m cho s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 s\u1ee9c kh\u1ecfe y\u1ebfu. Ngo\u00e0i ra, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 h\u00e0nh vi \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i m\u1eafc ch\u1ee9ng m\u1ea5t tr\u00ed nh\u1edb \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 t\u0103ng nguy c\u01a1 t\u1eed vong v\u00e0 \u0111\u1ed9t qu\u1ef5. V\u00ec v\u1eady, FDA \u0111\u00e3 \u0111\u01b0a ra c\u1ea3nh b\u00e1o nghi\u00eam ng\u1eb7t nh\u1ea5t \u0111\u1ec3 tr\u00e1nh s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n cho nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i n\u00e0y. Do \u0111\u00f3, trong tr\u01b0\u1eddng h\u1ee3p c\u1ee7a ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c cho c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 h\u00e0nh vi li\u00ean quan \u0111\u1ebfn ch\u1ee9ng m\u1ea5t tr\u00ed n\u00ean \u0111\u01b0\u1ee3c th\u1eed tr\u01b0\u1edbc s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n. Tuy nhi\u00ean, thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng cho m\u1ed9t s\u1ed1 m\u1ee5c \u0111\u00edch s\u1eed d\u1ee5ng nh\u1ea5t \u0111\u1ecbnh, v\u00e0 quy\u1ebft \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u01b0a ra d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa t\u00e2m th\u1ea7n.<\/span><\/p>\n

2.6 Thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng\u00a0<\/span><\/h3>\n

Thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng (TCA) \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng tr\u01b0\u1edbc \u0111\u00e2y \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb tr\u1ea7m c\u1ea3m, nh\u01b0ng hi\u1ec7n nay h\u1ea7u h\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c thay th\u1ebf b\u1edfi c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m m\u1edbi h\u01a1n. V\u00ec ch\u00fang \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 g\u00e2y ra nh\u1ea7m l\u1eabn, huy\u1ebft \u00e1p th\u1ea5p, an th\u1ea7n v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t \u0111\u00e1ng lo ng\u1ea1i \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. L\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n cho ng\u01b0\u1eddi l\u1edbn tu\u1ed5i l\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m m\u1edbi h\u01a1n v\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin c\u00f3 ch\u1ecdn l\u1ecdc (SSRIs) l\u00e0 m\u1ed9t v\u00ed d\u1ee5. Tuy nhi\u00ean, c\u0169ng c\u00f3 th\u1ec3 c\u00f3 c\u00e1c r\u1ee7i ro t\u01b0\u01a1ng t\u1ef1 v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y, v\u00ec v\u1eady c\u1ea7n th\u1eadn tr\u1ecdng v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1edfi b\u00e1c s\u0129 chuy\u00ean khoa.<\/span><\/p>\n

2.7 Thu\u1ed1c an th\u1ea7n\u00a0<\/span><\/h3>\n

Thu\u1ed1c an th\u1ea7n \u0111i\u1ec3n h\u00ecnh nh\u01b0 Phenobarbital, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng kinh ho\u1eb7c gi\u00fap ng\u1ee7 ngon. M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c k\u1ebft h\u1ee3p nh\u01b0 Butalbital, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u0111au ho\u1eb7c \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u. Tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 g\u00e2y ra nh\u1ea7m l\u1eabn v\u00e0 g\u00e2y nghi\u1ec7n, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. N\u1ebfu s\u1eed d\u1ee5ng qu\u00e1 li\u1ec1u, ch\u00fang c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng. Thay v\u00ec s\u1eed d\u1ee5ng thu\u1ed1c an th\u1ea7n v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c k\u1ebft h\u1ee3p \u0111\u1ec3 gi\u1ea3m \u0111au ho\u1eb7c \u0111i\u1ec1u tr\u1ecb<\/span><\/p>\n

ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i n\u00ean t\u00ecm c\u00e1c l\u1ef1a ch\u1ecdn thay th\u1ebf an to\u00e0n h\u01a1n: Lacosamide (Vimpat), Lamotrigine (Lamictal) v\u00e0 Levetiracetam (Keppra).<\/span><\/p>\n

2.8 Indomethacin<\/span><\/h3>\n

Indomethacin (Indocin) l\u00e0 thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAID). \u0110\u00f4i khi n\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u0111au do vi\u00eam kh\u1edbp v\u00e0 b\u1ec7nh g\u00fat, tuy nhi\u00ean c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y n\u00f3 c\u00f3 th\u1ec3 g\u00e2y nh\u1ea7m l\u1eabn, nghi\u00eam tr\u1ecdng h\u01a1n l\u00e0 t\u1ed5n th\u01b0\u01a1ng th\u1eadn v\u00e0 lo\u00e9t \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Do \u0111\u00f3, n\u1ebfu kh\u00f4ng ph\u1ea3i\u00a0s\u1eed d\u1ee5ng trong th\u1eddi gian ng\u1eafn th\u00ec ng\u01b0\u1eddi l\u1edbn tu\u1ed5i n\u00ean tr\u00e1nh d\u00f9ng NSAID.<\/span><\/p>\n

2.9 Thu\u1ed1c gi\u1ea3m \u0111au Opioid\u00a0<\/span><\/h3>\n

Thu\u1ed1c gi\u1ea3m \u0111au Opioid th\u01b0\u1eddng g\u00e2y nh\u1ea7m l\u1eabn v\u00e0 bu\u1ed3n ng\u1ee7 \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. T\u00e1o b\u00f3n, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ti\u1ec3u ti\u1ec7n v\u00e0 th\u1edf ch\u1eadm c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra. Trong \u0111\u00f3, Meperidine \u0111\u1eb7c bi\u1ec7t kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00ec c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng g\u00e2y l\u00fa l\u1eabn nghi\u00eam tr\u1ecdng. Ngo\u00e0i ra, n\u00ean tr\u00e1nh k\u1ebft h\u1ee3p c\u00e1c Opioid kh\u00e1c v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c: BZD, Gabapentin (Neurontin) v\u00e0 Pregabalin (Lyrica) v\u00ec \u1ef1 k\u1ebft h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng th\u1eadm ch\u00ed g\u00e2y t\u1eed vong.<\/span><\/p>\n

2.10 Thu\u1ed1c ch\u1eb9n Alpha<\/span><\/h3>\n

M\u1ed9t s\u1ed1 thu\u1ed1c ch\u1eb9n Alpha c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb huy\u1ebft \u00e1p cao nh\u01b0 Doxazosin (Cardura), Terazosin v\u00e0 Prazosin (Minipress). B\u00ecnh th\u01b0\u1eddng c\u00e1c thu\u1ed1c n\u00e0y ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch l\u00e0m gi\u00e3n c\u00e1c m\u1ea1ch m\u00e1u. Tuy nhi\u00ean, c\u00f3 th\u1ec3 x\u1ea3y ra t\u00ecnh tr\u1ea1ng h\u1ea1 huy\u1ebft \u00e1p th\u1ebf \u0111\u1ee9ng \u0111\u1eb7c bi\u1ec7t nguy hi\u1ec3m \u1edf ng\u01b0\u1eddi cao tu\u1ed5i, t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng nguy c\u01a1 ng\u1ea5t x\u1ec9u v\u00e0 t\u00e9 ng\u00e3. V\u00ec v\u1eady, c\u00e1c l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng bao g\u1ed3m thu\u1ed1c l\u1ee3i ti\u1ec3u Thiazid , thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin (ACE) ho\u1eb7c thu\u1ed1c ch\u1eb9n k\u00eanh Canxi.<\/span><\/p>\n

2.11 Sulfonylurea t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i<\/span><\/h3>\n

Glimepiride (Amaryl) ho\u1eb7c Glyburide (Diabeta) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap ki\u1ec3m so\u00e1t l\u01b0\u1ee3ng \u0111\u01b0\u1eddng trong m\u00e1u \u1edf b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng lo\u1ea1i 2. Tuy c\u00f9ng thu\u1ed9c nh\u00f3m thu\u1ed1c Sulfonylurea nh\u01b0ng th\u01b0\u1eddng t\u1ed3n t\u1ea1i trong c\u01a1 th\u1ec3 l\u00e2u h\u01a1n so v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f9ng nh\u00f3m. T\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a nh\u00f3m thu\u1ed1c n\u00e0y l\u00e0 h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft qu\u00e1 m\u1ee9c, nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 nghi\u00eam tr\u1ecdng h\u01a1n v\u00e0 k\u00e9o d\u00e0i h\u01a1n. N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, n\u00f3 c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi cao tu\u1ed5i. Glipizide (Glucotrol) l\u00e0 m\u1ed9t Sulfonylurea t\u00e1c d\u1ee5ng ng\u1eafn h\u01a1n c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n.<\/span><\/p>\n

3.K\u1ebft lu\u1eadn\u00a0<\/strong><\/h2>\n

Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng l\u1ef1a ch\u1ecdn an to\u00e0n h\u01a1n cho ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. Do \u0111\u00f3 c\u1ea7n tham kh\u1ea3o \u00fd ki\u1ebfn t\u1eeb c\u00e1c chuy\u00ean gia y t\u1ebf \u0111\u1ec3 c\u00f3 ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb b\u1ec7nh t\u1ed1t nh\u1ea5t \u1edf ng\u01b0\u1eddi cao tu\u1ed5i.<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 11 lo\u1ea1i thu\u1ed1c ph\u1ed5 bi\u1ebfn m\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i th\u01b0\u1eddng s\u1eed d\u1ee5ng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng. Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd, nh\u01b0ng \u0111\u1ed3ng th\u1eddi c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c […]<\/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":"\n11 lo\u1ea1i thu\u1ed1c g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/title>\n<meta name=\"description\" content=\"\u1ede ng\u01b0\u1eddi cao tu\u1ed5i, nh\u1eefng lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau nh\u01b0ng c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, 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