{"id":29990,"date":"2023-06-22T15:07:59","date_gmt":"2023-06-22T08:07:59","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29990"},"modified":"2023-06-22T15:07:59","modified_gmt":"2023-06-22T08:07:59","slug":"10-loai-thuoc-co-the-lam-tang-nguy-co-ton-thuong-gan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/22\/10-loai-thuoc-co-the-lam-tang-nguy-co-ton-thuong-gan\/","title":{"rendered":"10 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan"},"content":{"rendered":"<p><strong>Gan l\u00e0 m\u1ed9t trong nh\u1eefng c\u01a1 quan quan tr\u1ecdng nh\u1ea5t c\u1ee7a c\u01a1 th\u1ec3, c\u00f3 nhi\u1ec1u ch\u1ee9c n\u0103ng kh\u00e1c nhau bao g\u1ed3m gi\u00fap ti\u00eau h\u00f3a th\u1ee9c \u0103n, l\u1ecdc c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i kh\u1ecfi m\u00e1u, s\u1ea3n xu\u1ea5t m\u1eadt v\u00e0 \u0111i\u1ec1u h\u00f2a m\u1ee9c \u0111\u01b0\u1eddng trong m\u00e1u. Tuy nhi\u00ean, nhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng cho gan, khi\u1ebfn cho c\u01a1 quan n\u00e0y kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3 m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 danh s\u00e1ch 10 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan, v\u00e0 v\u00ec v\u1eady, c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a b\u00e1c s\u0129 v\u00e0 tu\u00e2n th\u1ee7 \u0111\u1ea7y \u0111\u1ee7 c\u00e1c ch\u1ec9 \u0111\u1ecbnh v\u00e0 li\u1ec1u l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn s\u1ee9c kh\u1ecfe.1.Gi\u1edbi thi\u1ec7u chung\u00a0<\/strong><\/p>\n<h2><strong>1.Gi\u1edbi thi\u1ec7u chung\u00a0<\/strong><\/h2>\n<h3><span style=\"font-weight: 400;\">1.1 S\u01a1 l\u01b0\u1ee3c v\u1ec1 gi\u1ea3i ph\u1eabu Gan\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Gan n\u1eb1m \u1edf ph\u1ea7n tr\u00ean b\u00ean ph\u1ea3i c\u1ee7a khoang b\u1ee5ng, b\u00ean d\u01b0\u1edbi c\u01a1 ho\u00e0nh v\u00e0 tr\u00ean d\u1ea1 d\u00e0y, th\u1eadn ph\u1ea3i v\u00e0 ru\u1ed9t. Gan n\u1eb7ng kho\u1ea3ng 1,3 kg v\u00e0 \u0111\u01b0\u1ee3c cung c\u1ea5p m\u00e1u t\u1eeb 2 ngu\u1ed3n ri\u00eang bi\u1ec7t: (1) M\u00e1u gi\u00e0u oxy ch\u1ea3y v\u00e0o t\u1eeb \u0111\u1ed9ng m\u1ea1ch gan, (2) M\u00e1u gi\u00e0u ch\u1ea5t dinh d\u01b0\u1ee1ng ch\u1ea3y t\u1eeb t\u0129nh m\u1ea1ch c\u1eeda\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Gan g\u1ed3m 2 th\u00f9y ch\u00ednh v\u00e0 c\u1ea3 2 th\u00f9y \u0111\u1ec1u \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh 1000 th\u00f9y nh\u1ecf. C\u00e1c ti\u1ec3u th\u00f9y \u0111\u01b0\u1ee3c n\u1ed1i v\u1edbi \u1ed1ng d\u1eabn nh\u1ecf n\u1ed1i v\u1edbi c\u00e1c \u1ed1ng d\u1eabn l\u1edbn h\u01a1n \u0111\u1ec3 t\u1ea1o th\u00e0nh \u1ed1ng gan chung. \u1ed0ng gan chung v\u1eadn chuy\u1ec3n m\u1eadt do c\u00e1c t\u1ebf b\u00e0o gan t\u1ea1o ra \u0111\u1ebfn t\u00fai m\u1eadt v\u00e0 t\u00e1 tr\u00e0ng (ph\u1ea7n \u0111\u1ea7u ti\u00ean c\u1ee7a ru\u1ed9t non) qua \u1ed1ng m\u1eadt chung<\/span><\/p>\n<figure id=\"attachment_30216\" aria-describedby=\"caption-attachment-30216\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-30216\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Gan-300x169.jpg\" alt=\"Gan\" width=\"300\" height=\"169\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Gan-300x169.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Gan-768x432.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Gan.jpg 800w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-30216\" class=\"wp-caption-text\">Gan<\/figcaption><\/figure>\n<h3><span style=\"font-weight: 400;\">1.2 Ch\u1ee9c n\u0103ng c\u1ee7a Gan\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Gan l\u00e0 c\u01a1 quan th\u1ef1c hi\u1ec7n h\u01a1n 500 ch\u1ee9c n\u0103ng quan tr\u1ecdng trong \u0111\u00f3 m\u1ed9t s\u1ed1 ch\u1ee9c n\u0103ng ph\u1ed5 bi\u1ebfn l\u00e0:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ea3n xu\u1ea5t m\u1eadt, gi\u00fap lo\u1ea1i b\u1ecf ch\u1ea5t th\u1ea3i v\u00e0 ph\u00e2n h\u1ee7y ch\u1ea5t b\u00e9o trong ru\u1ed9t non trong qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0S\u1ea3n xu\u1ea5t m\u1ed9t s\u1ed1 protein cho huy\u1ebft t\u01b0\u01a1ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ea3n xu\u1ea5t Cholesterol v\u00e0 Protein \u0111\u1eb7c bi\u1ec7t \u0111\u1ec3 gi\u00fap v\u1eadn chuy\u1ec3n ch\u1ea5t b\u00e9o qua c\u01a1 th\u1ec3<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chuy\u1ec3n \u0111\u1ed5i Cholesterol d\u01b0 th\u1eeba th\u00e0nh Glycogen d\u1ef1 tr\u1eef v\u00e0 t\u1ea1o Glucose khi c\u01a1 th\u1ec3 c\u1ea7n gi\u00fap c\u00e2n b\u1eb1ng\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110i\u1ec1u ch\u1ec9nh n\u1ed3ng \u0111\u1ed9 acid amin trong m\u00e1u<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chuy\u1ec3n \u0111\u1ed5i amoniac \u0111\u1ed9c h\u1ea1i th\u00e0nh ur\u00ea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110i\u1ec1u h\u00f2a \u0111\u00f4ng m\u00e1u\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ea1o c\u00e1c y\u1ebfu t\u1ed1 mi\u1ec5n d\u1ecbch \u0111\u1ec3 ch\u1ed1ng nhi\u1ec5m tr\u00f9ng huy\u1ebft\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gi\u1ea3i ph\u00f3ng Bilirubin tr\u00e1nh s\u1ef1 t\u00edch t\u1ee5<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Gan c\u0169ng \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c chuy\u1ec3n h\u00f3a thu\u1ed1c\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1.3 M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng gan<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn l\u00e0m d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng gan bao g\u1ed3m: \u0111au b\u1ee5ng, b\u1ee5ng s\u01b0ng ho\u1eb7c ch\u01b0\u1edbng b\u1ee5ng, m\u00e0u n\u01b0\u1edbc ti\u1ec3u \u0111\u1eadm, bu\u1ed3n n\u00f4n, gi\u1ea3m c\u00e2n b\u1ea5t th\u01b0\u1eddng, v\u00e0ng da v\u00e0 m\u1eaft\u00a0<\/span><\/p>\n<figure id=\"attachment_30218\" aria-describedby=\"caption-attachment-30218\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-30218\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Ton-thuong-gan-300x200.jpg\" alt=\"T\u1ed5n th\u01b0\u01a1ng gan\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Ton-thuong-gan-300x200.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Ton-thuong-gan.jpg 600w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-30218\" class=\"wp-caption-text\">T\u1ed5n th\u01b0\u01a1ng gan<\/figcaption><\/figure>\n<h2><strong>2.C\u00e1c lo\u1ea1i thu\u1ed1c l\u00e0m t\u0103ng nguy c\u01a1 <a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/ton-thuong-gan-do-thuoc-la-gi\/\">t\u1ed5n th\u01b0\u01a1ng gan\u00a0<\/a><\/strong><\/h2>\n<h3><span style=\"font-weight: 400;\">2.1 Tylenol\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Tylenol (Acetaminophen) l\u00e0 thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 h\u1ea1 s\u1ed1t kh\u00f4ng k\u00ea \u0111\u01a1n (OTC) ph\u1ed5 bi\u1ebfn. M\u1eb7c d\u00f9 thu\u1ed1c th\u01b0\u1eddng kh\u00f4ng g\u00e2y \u0111\u1ed9c cho gan khi li\u1ec1u \u0111\u01b0\u1ee3c d\u00f9ng n\u1eb1m trong li\u1ec1u khuy\u1ebfn c\u00e1o v\u00e0 ch\u1ec9 th\u1ec9nh tho\u1ea3ng m\u1edbi d\u00f9ng. Tuy nhi\u00ean n\u1ebfu li\u1ec1u l\u01b0\u1ee3ng l\u1edbn \u00e0\/ho\u1eb7c s\u1eed d\u1ee5ng l\u00e2u d\u00e0i c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan. Tr\u00ean th\u1ef1c t\u1ebf, ch\u1ec9 m\u1ed9t li\u1ec1u l\u01b0\u1ee3ng l\u1edbn Tylenol c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan hay c\u00f2n g\u1ecdi l\u00e0 qu\u00e1 li\u1ec1u Tylenol. Tylenol c\u0169ng c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan n\u1ebfu d\u00f9ng qu\u00e1 th\u01b0\u1eddng xuy\u00ean \u2014 \u0111\u1eb7c bi\u1ec7t l\u00e0 trong th\u1eddi gian d\u00e0i. V\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c ch\u00fa \u00fd \u1edf c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng h\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh nghi\u00eam tr\u1ecdng, r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan t\u1eeb tr\u01b0\u1edbc. \u0110\u1ed1i t\u01b0\u1ee3ng s\u1eed d\u1ee5ng thu\u1ed1c c\u00f3 th\u1ec3 gi\u1ea3m nguy c\u01a1 m\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan li\u00ean quan \u0111\u1ebfn Tylenol khi kh\u00f4ng d\u00f9ng nhi\u1ec1u h\u01a1n li\u1ec1u l\u01b0\u1ee3ng khuy\u1ebfn ngh\u1ecb t\u1ed1i \u0111a (4000mg\/ng\u00e0y), tr\u00e1nh u\u1ed1ng r\u01b0\u1ee3u khi d\u00f9ng thu\u1ed1c, tr\u00e1nh d\u00f9ng c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au c\u00f3 ch\u1ee9a Acetaminophen kh\u00e1c chung l\u00fac<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.2 Thu\u1ed1c kh\u00e1ng sinh (Augmentin)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Augmentin (Amoxicillin\/Clavulanate) l\u00e0 m\u1ed9t lo\u1ea1i kh\u00e1ng sinh ph\u1ed5 bi\u1ebfn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, tai v\u00e0 da. \u0110\u00e2y l\u00e0 lo\u1ea1i kh\u00e1ng sinh c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan nh\u1ea5t. T\u1ed5n th\u01b0\u01a1ng gan th\u01b0\u1eddng x\u1ea3y ra trong v\u00f2ng v\u00e0i ng\u00e0y \u0111\u1ebfn 8 tu\u1ea7n sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Augmentin. \u0110i\u1ec1u n\u00e0y c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nam gi\u1edbi, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i v\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 d\u00f9ng Augmentin nhi\u1ec1u l\u1ea7n li\u00ean ti\u1ebfp nh\u01b0ng kh\u00f4ng g\u00e2y ra t\u00e1c d\u1ee5ng l\u00e2u d\u00e0i khi ng\u01b0ng s\u1eed d\u1ee5ng thu\u1ed1c<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.3 NSAID (Diclofenac)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAID) th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 gi\u1ea3m \u0111au, kh\u00e1ng vi\u00eam v\u00e0 gi\u1ea3m s\u1ed1t. Diclofenac l\u00e0 m\u1ed9t trong nh\u1eefng NSAID c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan nh\u1ea5t. Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, t\u1ed5n th\u01b0\u01a1ng \u0111\u1ee7 nghi\u00eam tr\u1ecdng \u0111\u1ec3 l\u00e0m t\u0103ng c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan (LFT) nh\u01b0ng kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng. LFT \u0111o men gan (protein) v\u00e0 s\u1ed1 l\u01b0\u1ee3ng t\u0103ng l\u00ean cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng gan c\u00f3 th\u1ec3 x\u1ea3y ra. T\u1ed5n th\u01b0\u01a1ng gan nghi\u00eam tr\u1ecdng hi\u1ebfm g\u1eb7p h\u01a1n nh\u01b0ng nguy c\u01a1 cao h\u01a1n \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef v\u00e0 v\u1edbi li\u1ec1u l\u01b0\u1ee3ng l\u1edbn h\u01a1n v\u00e0\/ho\u1eb7c s\u1eed d\u1ee5ng l\u00e2u d\u00e0i (h\u01a1n 4 tu\u1ea7n). Diclofenac c\u0169ng c\u00f3 d\u1ea1ng b\u00f4i ngo\u00e0i da, ch\u1eb3ng h\u1ea1n nh\u01b0 gel, kem v\u00e0 mi\u1ebfng d\u00e1n nh\u01b0ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan th\u1ea5p h\u01a1n<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.4 Amiodarone<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Amiodarone (Pacerone) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp tim. S\u1ef1 gia t\u0103ng LFT x\u1ea3y ra \u1edf 50% tr\u01b0\u1eddng h\u1ee3p d\u00f9ng Amiodarone khi s\u1eed d\u1ee5ng l\u00e2u d\u00e0i. Tuy nhi\u00ean, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, Amiodarone c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan nghi\u00eam tr\u1ecdng h\u01a1n, \u01b0\u1edbc t\u00ednh 1% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c. Do \u0111\u00f3, FDA c\u1ea3nh b\u00e1o nghi\u00eam tr\u1ecdng v\u1ec1 nguy c\u01a1 thu\u1ed1c khi s\u1eed d\u1ee5ng. T\u1ed5n th\u01b0\u01a1ng gan li\u00ean quan \u0111\u1ebfn Amiodarone ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf nh\u1eefng ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c v\u1edbi li\u1ec1u l\u01b0\u1ee3ng cao h\u01a1n v\u00e0 trong th\u1eddi gian d\u00e0i v\u00e0 c\u1ea7n th\u01b0\u1eddng xuy\u00ean ki\u1ec3m tra ch\u1ec9 s\u1ed1 LFT \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o r\u1eb1ng vi\u1ec7c \u0111i\u1ec1u tr\u1ecb<\/span><\/p>\n<p><span style=\"font-weight: 400;\">2.5 Allopurinol<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Allopurinol (Zyloprim) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ng\u1eeba b\u1ec7nh g\u00fat b\u00f9ng ph\u00e1t. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi c\u0169ng d\u00f9ng n\u00f3 \u0111\u1ec3 ng\u0103n ng\u1eeba m\u1ed9t s\u1ed1 lo\u1ea1i s\u1ecfi th\u1eadn. V\u00e0, hi\u1ebfm g\u1eb7p h\u01a1n, nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh ung th\u01b0 d\u00f9ng n\u00f3 \u0111\u1ec3 ng\u0103n ng\u1eeba m\u1ed9t bi\u1ebfn ch\u1ee9ng g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u. Allopurinol c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 gia t\u0103ng LFT nh\u1eb9, \u1edf kho\u1ea3ng 6% ng\u01b0\u1eddi d\u00f9ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan nh\u01b0 l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a t\u00ecnh tr\u1ea1ng r\u1ed9ng h\u01a1n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ph\u1ea3n \u1ee9ng thu\u1ed1c v\u1edbi h\u1ed9i ch\u1ee9ng t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng to\u00e0n th\u00e2n (DRESS)<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.6 Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh (Phenytoin)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh \u0111\u1ee9ng \u0111\u1ea7u nhi\u1ec1u danh s\u00e1ch l\u00e0 nguy\u00ean nh\u00e2n ti\u1ec1m \u1ea9n g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan. Phenytoin (Dilantin) l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t cho c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan v\u00e0 suy gan. <\/span><span style=\"font-weight: 400;\">Nh\u01b0ng s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng gan li\u00ean quan \u0111\u1ebfn thu\u1ed1c v\u1eabn c\u00f2n kh\u00e1 hi\u1ebfm; n\u00f3 x\u1ea3y ra v\u1edbi t\u1ef7 l\u1ec7 ch\u01b0a \u0111\u1ebfn 1 tr\u00ean 1.000 ng\u01b0\u1eddi d\u00f9ng Phenytoin. T\u1ed5n th\u01b0\u01a1ng gan th\u01b0\u1eddng x\u1ea3y ra t\u1eeb 2 \u0111\u1ebfn 8 tu\u1ea7n sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c v\u00e0 h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng n\u00e0y s\u1ebd kh\u1ecfi trong v\u00f2ng 1 \u0111\u1ebfn 2 th\u00e1ng sau khi ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. C\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan l\u00e0 Acid valproic (Depakene), Carbamazepine (Tegretol) v\u00e0 Lamotrigine (Lamictal)<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.7 Isoniazid<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Isoniazid l\u00e0 m\u1ed9t lo\u1ea1i kh\u00e1ng sinh c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c ng\u0103n ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh lao. Nh\u01b0ng n\u00f3 l\u00e0 m\u1ed9t trong 10 lo\u1ea1i thu\u1ed1c c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan nhi\u1ec1u nh\u1ea5t \u1edf c\u00e1c qu\u1ed1c gia. T\u0103ng LFT c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn 20% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng Isoniazid nh\u01b0ng ch\u1ec9 c\u00f3 kho\u1ea3ng 1% ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng gan th\u1ef1c s\u1ef1. H\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 gan li\u00ean quan \u0111\u1ebfn Isoniazid \u0111\u1ec1u nh\u1eb9 v\u00e0\/ho\u1eb7c kh\u1ecfi trong v\u00f2ng 1 tu\u1ea7n sau khi ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c nh\u01b0ng thu\u1ed1c c\u0169ng c\u00f3 c\u1ea3nh b\u00e1o v\u1ec1 nguy c\u01a1 vi\u00eam gan n\u1eb7ng. Nguy c\u01a1 suy gan li\u00ean quan \u0111\u1ebfn Isoniazid cao h\u01a1n \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef, ng\u01b0\u1eddi da \u0111en, nh\u1eefng ng\u01b0\u1eddi \u0111ang c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 gan v\u00e0 nh\u1eefng ng\u01b0\u1eddi u\u1ed1ng r\u01b0\u1ee3u h\u00e0ng ng\u00e0y<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.8 Azathioprine<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Azathioprine (Imuran) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c c\u1ed1 t\u00ecnh \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch, th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau khi c\u1ea5y gh\u00e9p n\u1ed9i t\u1ea1ng v\u00e0 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng t\u1ef1 mi\u1ec5n d\u1ecbch. Azathioprine c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng gan: t\u0103ng LFT nh\u1eb9 t\u1eeb 1-5 n\u0103m sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. \u0110\u1ed9c t\u00ednh gan li\u00ean quan \u0111\u1ebfn Azathioprine ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p. Ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Azathioprine th\u01b0\u1eddng s\u1ebd gi\u1ea3i quy\u1ebft nh\u1eefng v\u1ea5n \u0111\u1ec1 n\u00e0y<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.9 Methotrexate\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Methotrexate th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00e0 c\u00e1c b\u1ec7nh t\u1ef1 mi\u1ec5n d\u1ecbch n\u00ean \u0111\u01b0\u1ee3c c\u1ea3nh b\u00e1o v\u1ec1 nguy c\u01a1 nhi\u1ec5m \u0111\u1ed9c gan. M\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. Li\u1ec1u cao \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m t\u0103ng LFT nh\u01b0ng li\u1ec1u cao kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng th\u01b0\u1eddng xuy\u00ean. M\u1eb7c d\u00f9 li\u1ec1u u\u1ed1ng h\u00e0ng ng\u00e0y th\u1ea5p kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra nh\u1eefng thay \u0111\u1ed5i LFT l\u1edbn nh\u01b0ng c\u00f3 th\u1ec3 khi\u1ebfn c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng s\u1eed d\u1ee5ng c\u00f3 nguy c\u01a1 m\u1eafc b\u1ec7nh gan nhi\u1ec5m m\u1ee1 ho\u1eb7c ti\u1ec1n s\u1eed t\u1ed5n th\u01b0\u01a1ng gan ph\u1ed5 bi\u1ebfn \u1edf nh\u1eefng ng\u01b0\u1eddi s\u1eed d\u1ee5ng qu\u00e1 nhi\u1ec1u r\u01b0\u1ee3u ho\u1eb7c b\u00e9o ph\u00ec\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2.10 Thu\u1ed1c tr\u1ecb ung th\u01b0 kh\u00e1c\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Nhi\u1ec1u lo\u1ea1i thu\u1ed1c tr\u1ecb ung th\u01b0 &#8211; bao g\u1ed3m h\u00f3a tr\u1ecb v\u00e0 t\u00e1c nh\u00e2n n\u1ed9i ti\u1ebft t\u1ed1 &#8211; c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan. Trong \u0111\u00f3 c\u00f3 Pembrolizumab (Keytruda) v\u00e0 Nivolumab (Opdivo), nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch (ICI) gi\u00fap h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u00e1c \u0111\u1ed9ng l\u00ean c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 nh\u01b0ng \u0111\u00f4i khi h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng nh\u1ea7m l\u1eabn v\u00e0o c\u00e1c t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh, \u0111i\u1ec1u n\u00e0y g\u00e2y vi\u00eam gan \u1edf 6% s\u1ed1 ng\u01b0\u1eddi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ICI<\/span><\/p>\n<h2><strong>3.K\u1ebft lu\u1eadn<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">N\u1ebfu \u0111ang d\u00f9ng m\u1ed9t trong nh\u1eefng lo\u1ea1i thu\u1ed1c tr\u00ean c\u00f3 nguy c\u01a1 g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 li\u00ean quan \u0111\u1ebfn gan v\u00e0 xu\u1ea5t hi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng vi\u00eam gan k\u00e9o d\u00e0i, \u0111\u1ed1i t\u01b0\u1ee3ng s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea7n n\u00ean tham kh\u1ea3o v\u00e0 trao \u0111\u1ed5i v\u1edbi c\u00e1c chuy\u00ean gia y t\u1ebf \u0111\u1ec3 ki\u1ec3m tra ch\u1ec9 s\u1ed1 LFT c\u0169ng nh\u01b0 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111\u00fang \u0111\u1eafn trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Gan l\u00e0 m\u1ed9t trong nh\u1eefng c\u01a1 quan quan tr\u1ecdng nh\u1ea5t c\u1ee7a c\u01a1 th\u1ec3, c\u00f3 nhi\u1ec1u ch\u1ee9c n\u0103ng kh\u00e1c nhau bao g\u1ed3m gi\u00fap ti\u00eau h\u00f3a th\u1ee9c \u0103n, l\u1ecdc c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i kh\u1ecfi m\u00e1u, s\u1ea3n xu\u1ea5t m\u1eadt v\u00e0 \u0111i\u1ec1u h\u00f2a m\u1ee9c \u0111\u01b0\u1eddng trong m\u00e1u. Tuy nhi\u00ean, nhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng cho [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>10 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan - Vinmec<\/title>\n<meta name=\"description\" content=\"M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng cho gan, khi\u1ebfn cho c\u01a1 quan n\u00e0y kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3 m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3.\" \/>\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=\"10 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng gan - 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