{"id":32167,"date":"2023-05-13T14:47:32","date_gmt":"2023-05-13T07:47:32","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32167"},"modified":"2023-05-13T14:47:32","modified_gmt":"2023-05-13T07:47:32","slug":"varenicline","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/varenicline\/","title":{"rendered":"Varenicline v\u00e0 Bupropion – t\u00e1c d\u1ee5ng trong cai thu\u1ed1c l\u00e1"},"content":{"rendered":"

C\u00e1c li\u1ec7u ph\u00e1p thay th\u1ebf kh\u00f4ng Nicotin\u00a0 \u0111ang tr\u1edf th\u00e0nh m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 gi\u00fap ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c l\u00e1 b\u1ecf th\u00f3i quen n\u00e0y. C\u00e1c thu\u1ed1c thay th\u1ebf Nicotin c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u tri\u1ec7u ch\u1ee9ng cai thu\u1ed1c l\u00e1, gi\u00fap gi\u1ea3m \u0111\u1ed9ng l\u1ef1c s\u1eed d\u1ee5ng thu\u1ed1c l\u00e1 v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng trong qu\u00e1 tr\u00ecnh b\u1ecf thu\u1ed1c. C\u00e1c lo\u1ea1i thu\u1ed1c thay th\u1ebf Nicotin nh\u01b0 Bupropion v\u00e0 Varenicline c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap gi\u1ea3m tri\u1ec7u ch\u1ee9ng cai thu\u1ed1c l\u00e1.<\/strong><\/p>\n

1. Li\u1ec7u ph\u00e1p thay th\u1ebf kh\u00f4ng Nicotin b\u1eb1ng Varenicline (Champix)<\/strong><\/h1>\n

Varenicline hi\u1ec7n kh\u00f4ng c\u00f3 s\u1eb5n. N\u00f3 \u0111\u00e3 b\u1ecb thu h\u1ed3i \u0111\u1ec3 \u0111\u1ec1 ph\u00f2ng v\u00ec t\u1ea1p ch\u1ea5t \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong thu\u1ed1c. V\u1eabn ch\u01b0a bi\u1ebft li\u1ec7u n\u00f3 c\u00f3 kh\u1ea3 d\u1ee5ng tr\u1edf l\u1ea1i trong t\u01b0\u01a1ng lai hay kh\u00f4ng.<\/p>\n

\"\"<\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: The Pharmaceutical Journal<\/strong><\/p>\n

1.1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a Varenicline\u00a0<\/strong><\/h3>\n

Qu\u00e1 m\u1eabn v\u1edbi ho\u1ea1t ch\u1ea5t ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c<\/p>\n

1.2. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a Varenicline\u00a0<\/strong><\/h3>\n

Varenicline li\u00ean k\u1ebft v\u1edbi \u00e1i l\u1ef1c v\u00e0 t\u00ednh ch\u1ecdn l\u1ecdc cao t\u1ea1i c\u00e1c th\u1ee5 th\u1ec3 acetylcholine nicotinic t\u1ebf b\u00e0o th\u1ea7n kinh \u03b14\u03b22, n\u01a1i n\u00f3 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t ch\u1ea5t ch\u1ee7 v\u1eadn t\u1eebng ph\u1ea7n – m\u1ed9t h\u1ee3p ch\u1ea5t c\u00f3 c\u1ea3 ho\u1ea1t t\u00ednh ch\u1ee7 v\u1eadn, v\u1edbi hi\u1ec7u qu\u1ea3 n\u1ed9i t\u1ea1i th\u1ea5p h\u01a1n nicotin v\u00e0 ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed1i kh\u00e1ng khi c\u00f3 nicotin.<\/p>\n

C\u00e1c nghi\u00ean c\u1ee9u \u0111i\u1ec7n sinh l\u00fd invitro v\u00e0 nghi\u00ean c\u1ee9u h\u00f3a h\u1ecdc th\u1ea7n kinh invivo \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng varenicline li\u00ean k\u1ebft v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 acetylcholine nicotinic \u03b14\u03b22 c\u1ee7a t\u1ebf b\u00e0o th\u1ea7n kinh v\u00e0 k\u00edch th\u00edch ho\u1ea1t \u0111\u1ed9ng qua trung gian th\u1ee5 th\u1ec3, nh\u01b0ng \u1edf m\u1ee9c \u0111\u1ed9 th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi nicotin. Nicotine c\u1ea1nh tranh tr\u00ean c\u00f9ng m\u1ed9t \u03b14\u03b22 nAChR c\u1ee7a con ng\u01b0\u1eddi – v\u1ecb tr\u00ed li\u00ean k\u1ebft m\u00e0 varenicline c\u00f3 \u00e1i l\u1ef1c cao h\u01a1n. Do \u0111\u00f3, varenicline c\u00f3 th\u1ec3 ng\u0103n ch\u1eb7n hi\u1ec7u qu\u1ea3 kh\u1ea3 n\u0103ng k\u00edch ho\u1ea1t ho\u00e0n to\u00e0n th\u1ee5 th\u1ec3 \u03b14\u03b22 v\u00e0 h\u1ec7 th\u1ed1ng dopamin mesolimbic c\u1ee7a nicotin, c\u01a1 ch\u1ebf th\u1ea7n kinh l\u00e0m c\u01a1 s\u1edf c\u1ee7ng c\u1ed1 v\u00e0 ph\u1ea7n th\u01b0\u1edfng khi h\u00fat thu\u1ed1c.<\/p>\n

Hi\u1ec7u qu\u1ea3 c\u1ee7a CHAMPIX trong vi\u1ec7c cai thu\u1ed1c l\u00e1 l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a ho\u1ea1t \u0111\u1ed9ng ch\u1ee7 v\u1eadn t\u1eebng ph\u1ea7n c\u1ee7a varenicline t\u1ea1i th\u1ee5 th\u1ec3 nicotinic \u03b14\u03b22 n\u01a1i li\u00ean k\u1ebft c\u1ee7a n\u00f3 t\u1ea1o ra t\u00e1c d\u1ee5ng \u0111\u1ee7 \u0111\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng th\u00e8m thu\u1ed1c v\u00e0 cai nghi\u1ec7n (ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u1ea5t ch\u1ee7 v\u1eadn), \u0111\u1ed3ng th\u1eddi d\u1eabn \u0111\u1ebfn gi\u1ea3m h\u00fat thu\u1ed1c b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n nicotin li\u00ean k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 \u03b14\u03b22 (ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed1i kh\u00e1ng).<\/p>\n

1.3. Li\u1ec1u d\u00f9ng Varenicline\u00a0<\/strong><\/h3>\n

Li\u1ec7u ph\u00e1p thay th\u1ebfkh\u00f4ng Nicotin b\u1eb1ng Varenicline c\u00f3\u00a0 li\u1ec1u khuy\u1ebfn c\u00e1o l\u00e0 1 mg \/2 l\u1ea7n m\u1ed7i ng\u00e0y sau khi chu\u1ea9n \u0111\u1ed9 trong 1 tu\u1ea7n nh\u01b0 sau:<\/p>\n

    \n
  • Ng\u00e0y 1 \u2013 3: 0.5 mg m\u1ed7i ng\u00e0y m\u1ed9t l\u1ea7n<\/li>\n
  • Ng\u00e0y 4 \u2013 7: 0.5 mg x 2 l\u1ea7n\/ng\u00e0y<\/li>\n
  • Ng\u00e0y 8 \u2013 K\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb: 1 mg x 2 l\u1ea7n\/ng\u00e0y<\/li>\n<\/ul>\n

    Li\u1ec1u CHAMPIX th\u01b0\u1eddng n\u00ean b\u1eaft \u0111\u1ea7u t\u1eeb 1-2 tu\u1ea7n tr\u01b0\u1edbc ng\u00e0y ng\u01b0ng thu\u1ed1c l\u00e1. B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng CHAMPIX trong 12 tu\u1ea7n.<\/p>\n

    \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 cai thu\u1ed1c l\u00e1 th\u00e0nh c\u00f4ng sau 12 tu\u1ea7n, c\u00f3 th\u1ec3 xem x\u00e9t th\u00eam m\u1ed9t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb 12 tu\u1ea7n v\u1edbi CHAMPIX 1 mg\/ 2 l\u1ea7n m\u1ed7i ng\u00e0y \u0111\u1ec3 duy tr\u00ec cai nghi\u1ec7n.<\/p>\n

    M\u1ed9t c\u00e1ch ti\u1ebfp c\u1eadn d\u1ea7n d\u1ea7n \u0111\u1ec3 b\u1ecf h\u00fat thu\u1ed1c v\u1edbi CHAMPIX n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t cho nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang kh\u00f4ng th\u1ec3 ho\u1eb7c s\u1eb5n s\u00e0ng t\u1eeb b\u1ecf \u0111\u1ed9t ng\u1ed9t. B\u1ec7nh nh\u00e2n n\u00ean gi\u1ea3m h\u00fat thu\u1ed1c trong 12 tu\u1ea7n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecbv\u00e0 b\u1ecf thu\u1ed1c khi h\u1ebft th\u1eddi gian \u0111i\u1ec1u tr\u1ecb \u0111\u00f3. Sau \u0111\u00f3, b\u1ec7nh nh\u00e2n n\u00ean ti\u1ebfp t\u1ee5c d\u00f9ng CHAMPIX th\u00eam 12 tu\u1ea7n n\u1eefa trong t\u1ed5ng s\u1ed1 24 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/p>\n

    B\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 ch\u1ecbu \u0111\u1ef1ng \u0111\u01b0\u1ee3c c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i c\u1ee7a CHAMPIX c\u00f3 th\u1ec3 gi\u1ea3m li\u1ec1u t\u1ea1m th\u1eddi ho\u1eb7c v\u0129nh vi\u1ec5n xu\u1ed1ng 0.5 mg\/ 2 l\u1ea7n m\u1ed7i ng\u00e0y<\/p>\n

    1.4. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Varenicline\u00a0<\/strong><\/h3>\n

    C\u00e1c nghi\u00ean c\u1ee9u invitro ch\u1ec9 ra r\u1eb1ng varenicline kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m thay \u0111\u1ed5i d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a c\u00e1c h\u1ee3p ch\u1ea5t \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ch\u1ee7 y\u1ebfu b\u1edfi c\u00e1c enzym cytochrom P450.<\/p>\n

    H\u01a1n n\u1eefa, do s\u1ef1 chuy\u1ec3n h\u00f3a c\u1ee7a varenicline chi\u1ebfm ch\u01b0a \u0111\u1ebfn 10% \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a n\u00f3, n\u00ean c\u00e1c ho\u1ea1t ch\u1ea5t \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng cytochrom P450 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m thay \u0111\u1ed5i d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a varenicline v\u00e0 do \u0111\u00f3 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u CHAMPIX.<\/p>\n

    C\u00e1c nghi\u00ean c\u1ee9u in vitro ch\u1ee9ng minh r\u1eb1ng varenicline kh\u00f4ng \u1ee9c ch\u1ebf c\u00e1c protein v\u1eadn chuy\u1ec3n qua th\u1eadn c\u1ee7a con ng\u01b0\u1eddi \u1edf n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3, c\u00e1c ho\u1ea1t ch\u1ea5t \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i qua th\u1eadn (v\u00ed d\u1ee5: metformin) d\u01b0\u1eddng nh\u01b0 kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi varenicline.<\/p>\n

    1.5. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a \u00a0Varenicline<\/strong><\/h3>\n
      \n
    • R\u1ed1i lo\u1ea1n m\u1eaft<\/strong>: Vi\u00eam k\u1ebft m\u1ea1c, \u0111au m\u1eaft Scotoma, \u0111\u1ed5i m\u00e0u c\u1ee7ng m\u1ea1c, gi\u00e3n \u0111\u1ed3ng t\u1eed, s\u1ee3 \u00e1nh s\u00e1ng, c\u1eadn th\u1ecb, ch\u1ea3y n\u01b0\u1edbc m\u1eaft t\u0103ng,\u2026<\/li>\n
    • R\u1ed1i lo\u1ea1n tai v\u00e0 m\u00ea \u0111\u1ea1o x\u01b0\u01a1ng<\/strong> : \u00d9 tai hi\u1ebfm g\u1eb7p<\/li>\n
    • R\u1ed1i lo\u1ea1n tim<\/strong>: \u00cdt g\u1eb7p nh\u1ed3i m\u00e1u c\u01a1 tim, \u0111au th\u1eaft ng\u1ef1c, nh\u1ecbp tim nhanh, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c. Hi\u1ebfm g\u1eb7p rung nh\u0129, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 ST ch\u00eanh xu\u1ed1ng, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 bi\u00ean \u0111\u1ed9 s\u00f3ng T gi\u1ea3m.<\/li>\n
    • R\u1ed1i lo\u1ea1n m\u1ea1ch m\u00e1u<\/strong>: Hi\u1ebfm g\u1eb7p t\u0103ng huy\u1ebft \u00e1p, b\u1ed1c h\u1ecfa<\/li>\n
    • R\u1ed1i lo\u1ea1n h\u00f4 h\u1ea5p, l\u1ed3ng ng\u1ef1c v\u00e0 trung th\u1ea5t:<\/strong> Kh\u00f3 th\u1edf, ho, vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean, t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, ch\u1ee9ng kh\u00f3 ph\u00e1t \u00e2m, vi\u00eam m\u0169i d\u1ecb \u1ee9ng, ng\u1ee9a h\u1ecdng, ch\u1ea3y n\u01b0\u1edbc m\u0169i, \u0111au d\u00e2y thanh qu\u1ea3n, ng\u1ee7 ng\u00e1y,\u2026<\/li>\n
    • R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/strong> : Bu\u1ed3n n\u00f4n r\u1ea5t ph\u1ed5 bi\u1ebfn. Th\u01b0\u1eddng g\u1eb7p tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n, n\u00f4n m\u1eeda, t\u00e1o b\u00f3n, ti\u00eau ch\u1ea3y, ch\u01b0\u1edbng b\u1ee5ng, \u0111au b\u1ee5ng, \u0111au r\u0103ng, kh\u00f3 ti\u00eau, \u0111\u1ea7y h\u01a1i, kh\u00f4 mi\u1ec7ng. Hi\u1ebfm \u0111\u1ea1i ti\u1ec7n ra m\u00e1u, vi\u00eam d\u1ea1 d\u00e0y, thay \u0111\u1ed5i th\u00f3i quen \u0111\u1ea1i ti\u1ec7n, \u1ee3 h\u01a1i, vi\u00eam mi\u1ec7ng, \u0111au n\u01b0\u1edbu, n\u00f4n ra m\u00e1u, ph\u00e2n b\u1ea5t th\u01b0\u1eddng,\u2026<\/li>\n
    • R\u1ed1i lo\u1ea1n da v\u00e0 m\u00f4 d\u01b0\u1edbi da<\/strong>:\u00a0 Ph\u00e1t ban, ng\u1ee9a, ban \u0111\u1ecf, m\u1ee5n tr\u1ee9ng c\u00e1, t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i, \u0111\u1ed5 m\u1ed3 h\u00f4i ban \u0111\u00eam. Hi\u1ebfm g\u1eb7p ph\u1ea3n \u1ee9ng da nghi\u00eam tr\u1ecdng, bao g\u1ed3m H\u1ed9i ch\u1ee9ng Stevens Johnson v\u00e0 h\u1ed3ng ban \u0111a d\u1ea1ng, ph\u00f9 m\u1ea1ch,\u2026<\/li>\n
    • R\u1ed1i lo\u1ea1n c\u01a1 x\u01b0\u01a1ng v\u00e0 m\u00f4 li\u00ean k\u1ebft<\/strong>:\u00a0 \u0110au kh\u1edbp, \u0111au c\u01a1, \u0111au l\u01b0ng, co th\u1eaft c\u01a1, \u0111au c\u01a1 x\u01b0\u01a1ng ng\u1ef1c, c\u1ee9ng kh\u1edbp,\u2026.<\/li>\n
    • R\u1ed1i lo\u1ea1n th\u1eadn v\u00e0 ti\u1ebft ni\u1ec7u<\/strong>: \u0110\u00e1i bu\u1ed1t, \u0111\u00e1i \u0111\u00eam, \u0111\u01b0\u1eddng ni\u1ec7u, \u0111a ni\u1ec7u<\/li>\n
    • R\u1ed1i lo\u1ea1n h\u1ec7 sinh s\u1ea3n<\/strong>: rong kinh, t\u0103ng ti\u1ebft d\u1ecbch \u00e2m \u0111\u1ea1o, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c,\u2026.<\/li>\n<\/ul>\n

      1.6. C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u1eb7c bi\u1ec7t<\/strong><\/h3>\n

      1.6.1. R\u1ed1i lo\u1ea1n th\u1ea7n kinh<\/strong><\/p>\n

      Thay \u0111\u1ed5i h\u00e0nh vi ho\u1eb7c suy ngh\u0129, lo l\u1eafng, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, thay \u0111\u1ed5i t\u00e2m tr\u1ea1ng, h\u00e0nh vi hung h\u0103ng, tr\u1ea7m c\u1ea3m, \u00fd t\u01b0\u1edfng v\u00e0 h\u00e0nh vi t\u1ef1 t\u1eed v\u00e0 n\u1ed7 l\u1ef1c t\u1ef1 t\u1eed \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ed1 g\u1eafng b\u1ecf thu\u1ed1c l\u00e1 h\u00fat thu\u1ed1c v\u1edbi CHAMPIX.<\/p>\n

      C\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng n\u00ean bi\u1ebft v\u1ec1 kh\u1ea3 n\u0103ng xu\u1ea5t hi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng t\u00e2m th\u1ea7n kinh nghi\u00eam tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n c\u1ed1 g\u1eafng b\u1ecf h\u00fat thu\u1ed1c c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb. N\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh t\u00e2m th\u1ea7n nghi\u00eam tr\u1ecdng x\u1ea3y ra trong khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng varenicline, b\u1ec7nh nh\u00e2n n\u00ean ng\u1eebng varenicline ngay l\u1eadp t\u1ee9c<\/p>\n

      1.6.2. Ti\u1ec1n s\u1eed r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n<\/strong><\/p>\n

      Ng\u1eebng h\u00fat thu\u1ed1c, c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c, c\u00f3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng tr\u1ea7m tr\u1ecdng th\u00eam c\u1ee7a b\u1ec7nh t\u00e2m th\u1ea7n ti\u1ec1m \u1ea9n (v\u00ed d\u1ee5: tr\u1ea7m c\u1ea3m).<\/p>\n

      1.6.3. Co gi\u1eadt<\/strong><\/p>\n

      Trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u00e0 kinh nghi\u1ec7m sau khi \u0111\u01b0a thu\u1ed1c ra th\u1ecb tr\u01b0\u1eddng, \u0111\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c c\u01a1n \u0111\u1ed9ng kinh \u1edf b\u1ec7nh nh\u00e2n b\u1ecb ho\u1eb7c kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed \u0111\u1ed9ng kinh, \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng CHAMPIX. CHAMPIX n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng trong b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed \u0111\u1ed9ng kinh ho\u1eb7c c\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m ng\u01b0\u1ee1ng \u0111\u1ed9ng kinh.<\/p>\n

      1.6.4. Y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch<\/strong><\/p>\n

      B\u1ec7nh nh\u00e2n d\u00f9ng CHAMPIX n\u00ean \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn th\u00f4ng b\u00e1o cho b\u00e1c s\u0129 c\u1ee7a h\u1ecd v\u1ec1 c\u00e1c tri\u1ec7u ch\u1ee9ng m\u1edbi ho\u1eb7c x\u1ea5u \u0111i c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng tim m\u1ea1ch v\u00e0 t\u00ecm ki\u1ebfm s\u1ef1 ch\u0103m s\u00f3c y t\u1ebf ngay l\u1eadp t\u1ee9c n\u1ebfu h\u1ecd g\u1eb7p c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng nh\u1ed3i m\u00e1u c\u01a1 tim ho\u1eb7c \u0111\u1ed9t qu\u1ef5.<\/p>\n

      2. Li\u1ec7u ph\u00e1p thay th\u1ebfkh\u00f4ng Nicotin b\u1eb1ng Bupropion (Zyban)<\/strong><\/h2>\n

      Bupropion (t\u00ean th\u01b0\u01a1ng hi\u1ec7u Zyban) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ban \u0111\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng tr\u1ea7m c\u1ea3m, nh\u01b0ng sau \u0111\u00f3 n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n l\u00e0 c\u00f3 th\u1ec3 gi\u00fap b\u1ecf h\u00fat t \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/strong><\/p>\n

      \"\"<\/p>\n

      \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: Canadian Pharmacy World<\/strong><\/p>\n

      2.1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h3>\n
        \n
      • B\u1ec7nh nh\u00e2n \u0111ang b\u1ecb \u0111\u1ed9ng kinh ho\u1eb7c t\u1eebng b\u1ecb \u0111\u1ed9ng kinh.<\/li>\n
      • Ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u<\/li>\n
      • L\u1ea1m d\u1ee5ng r\u01b0\u1ee3u<\/li>\n
      • B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft ho\u1eb7c insulin<\/li>\n
      • \u0110ang d\u00f9ng c\u00e1c thu\u1ed1c nh\u01b0 theophylline, thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00e0 corticosteroid to\u00e0n th\u00e2n.<\/li>\n
      • Ti\u1ec1n s\u1eed ch\u00e1n \u0103n v\u00e0 ch\u1ee9ng cu\u1ed3ng \u0103n, ho\u1ea1i t\u1eed gan n\u1eb7ng ho\u1eb7c r\u1ed1i lo\u1ea1n l\u01b0\u1ee1ng c\u1ef1c.<\/li>\n<\/ul>\n

        2.2. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/strong><\/h3>\n

        Bupropion l\u00e0 m\u1ed9t thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u00f3 c\u1ea5u tr\u00fac t\u01b0\u01a1ng t\u1ef1 nh\u01b0 diethylpropion, m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf s\u1ef1 th\u00e8m \u0103n. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng ch\u1ed1ng tr\u1ea7m c\u1ea3m c\u1ee7a bupropion v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u \u0111\u1ea7y \u0111\u1ee7, nh\u01b0ng bupropion \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu dopamin, noradrenaline v\u00e0 serotonin trong h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 nicotin kh\u00f4ng c\u1ea1nh tranh v\u00e0 \u1edf n\u1ed3ng \u0111\u1ed9 cao s\u1ebd \u1ee9c ch\u1ebf s\u1ef1 k\u00edch ho\u1ea1t c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh noradrenergic trong c\u01a1 th\u1ec3.<\/p>\n

        Kh\u00f4ng r\u00f5 t\u00e1c d\u1ee5ng n\u00e0o trong s\u1ed1 n\u00e0y gi\u1ea3i th\u00edch cho ho\u1ea1t \u0111\u1ed9ng ch\u1ed1ng h\u00fat thu\u1ed1c c\u1ee7a thu\u1ed1c, nh\u01b0ng vi\u1ec7c \u1ee9c ch\u1ebf gi\u1ea3m m\u1ee9c \u0111\u1ed9 dopamin v\u00e0 noradrenaline trong h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng x\u1ea3y ra khi cai nicotin c\u00f3 th\u1ec3 r\u1ea5t quan tr\u1ecdng. T\u00e1c d\u1ee5ng ch\u1ed1ng h\u00fat thu\u1ed1c c\u1ee7a bupropion d\u01b0\u1eddng nh\u01b0 kh\u00f4ng li\u00ean quan \u0111\u1ebfn t\u00e1c d\u1ee5ng ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00ec bupropion c\u00f3 hi\u1ec7u qu\u1ea3 nh\u01b0 m\u1ed9t li\u1ec7u ph\u00e1p cai thu\u1ed1c l\u00e1 \u1edf nh\u1eefng ng\u01b0\u1eddi h\u00fat thu\u1ed1c c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 tr\u1ea7m c\u1ea3m.<\/p>\n

        2.3. Li\u1ec1u d\u00f9ng<\/strong><\/h3>\n

        Bupropion \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng V\u01b0\u01a1ng qu\u1ed1c Anh d\u01b0\u1edbi d\u1ea1ng vi\u00ean n\u00e9n 150 mg gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i b\u1eb1ng \u0111\u01b0\u1eddng u\u1ed1ng. M\u1ed9t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i 8 tu\u1ea7n. Nh\u1eefng ng\u01b0\u1eddi h\u00fat thu\u1ed1c n\u00ean b\u1eaft \u0111\u1ea7u d\u00f9ng bupropion m\u1ed9t tu\u1ea7n tr\u01b0\u1edbc ng\u00e0y d\u1ef1 \u0111\u1ecbnh b\u1ecf thu\u1ed1c. N\u00ean gi\u1ea3m li\u1ec1u \u2014 ngh\u0129a l\u00e0 m\u1ed9t vi\u00ean m\u1ed7i ng\u00e0y \u2014 cho ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy gan ho\u1eb7c suy th\u1eadn.<\/p>\n

        2.4. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/strong><\/h3>\n

        Bupropion \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng 3 gi\u1edd sau khi u\u1ed1ng, v\u1edbi n\u1ed3ng \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh \u0111\u1ea1t \u0111\u01b0\u1ee3c trong v\u00f2ng 8 ng\u00e0y. N\u00f3 c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y l\u00e0 20 gi\u1edd v\u00e0 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a \u1edf gan b\u1edfi cytochrom p450.<\/p>\n

        2.5. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a li\u1ec7u ph\u00e1p thay th\u1ebfkh\u00f4ng Nicotin b\u1eb1ng bupropion\u00a0<\/strong><\/h3>\n
          \n
        • Kh\u00f4 mi\u1ec7ng<\/li>\n
        • Kh\u00f3 ng\u1ee7 (m\u1ea5t ng\u1ee7)<\/li>\n
        • Nh\u1ee9c \u0111\u1ea7u<\/li>\n
        • T\u00e1o b\u00f3n<\/li>\n
        • Kh\u00f3 t\u1eadp trung<\/li>\n
        • Ch\u00f3ng m\u1eb7t<\/li>\n<\/ul>\n

          2.6. C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u1eb7c bi\u1ec7t kh\u00e1c<\/strong><\/h3>\n
            \n
          • B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/strong>\u2014Ng\u1eebng h\u00fat thu\u1ed1c l\u00e0 bi\u1ec7n ph\u00e1p can thi\u1ec7p quan tr\u1ecdng nh\u1ea5t \u0111\u1ed1i v\u1edbi b\u1ec7nh n\u00e0y. Bupropion \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 v\u00e0 dung n\u1ea1p t\u1ed1t \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n n\u00e0y.<\/li>\n
          • B\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9<\/strong>\u2014Ng\u1eebng h\u00fat thu\u1ed1c l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ec7n ph\u00e1p can thi\u1ec7p quan tr\u1ecdng nh\u1ea5t \u0111\u1ed1i v\u1edbi b\u1ec7nh n\u00e0y. Bupropion kh\u00f4ng b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ho\u1eb7c ph\u1ea3i th\u1eadn tr\u1ecdng tr\u1eeb b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft ho\u1eb7c insulin (th\u1eadn tr\u1ecdng) ho\u1eb7c b\u1ec7nh nh\u00e2n d\u00f9ng propafenone ho\u1eb7c flecainide (n\u00ean gi\u1ea3m li\u1ec1u thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp).<\/li>\n
          • Ph\u1ee5 n\u1eef mang thai<\/strong>\u2014Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o v\u1ec1 bupropion \u1edf ph\u1ee5 n\u1eef mang thai. Do \u0111\u00f3, Bupropion kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng trong th\u1eddi k\u1ef3 mang thai.<\/li>\n<\/ul>\n

            2.7. L\u01b0u \u00fd khi d\u00f9ng li\u1ec7u ph\u00e1p thay th\u1ebfkh\u00f4ng Nicotin b\u1eb1ng Bupropion<\/strong><\/h3>\n
              \n
            • Bupropion kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf monoamine oxidase v\u00e0 ng\u01b0ng \u00edt nh\u1ea5t 14 ng\u00e0y tr\u01b0\u1edbc khi d\u00f9ng bupropion.<\/li>\n
            • Bupropion t\u01b0\u01a1ng t\u00e1c v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, bao g\u1ed3m m\u1ed9t s\u1ed1 thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m, thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp nh\u00f3m IC v\u00e0 thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n.<\/li>\n<\/ul>\n

              Ngu\u1ed3n tham kh\u1ea3o<\/strong><\/p>\n

                \n
              • \u201cStop smoking treatments\u201d, NHS,<\/em> \u00a02022<\/li>\n
              • \u201cBupropion and other non-nicotine pharmacotherapies\u201d, ABC of smoking cessation<\/em>, 2004 Feb 28, 328(7438): 509\u2013511.<\/li>\n
              • \u201cChampix, INN-varenicline\u201d, European Medicines Agency<\/em><\/li>\n<\/ul>\n

                 <\/p>\n

                usechatgpt init success<\/div>\n","protected":false},"excerpt":{"rendered":"

                C\u00e1c li\u1ec7u ph\u00e1p thay th\u1ebf kh\u00f4ng Nicotin\u00a0 \u0111ang tr\u1edf th\u00e0nh m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 gi\u00fap ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c l\u00e1 b\u1ecf th\u00f3i quen n\u00e0y. C\u00e1c thu\u1ed1c thay th\u1ebf Nicotin c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u tri\u1ec7u ch\u1ee9ng cai thu\u1ed1c l\u00e1, gi\u00fap gi\u1ea3m \u0111\u1ed9ng l\u1ef1c s\u1eed d\u1ee5ng thu\u1ed1c l\u00e1 v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng trong qu\u00e1 […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[],"yoast_head":"\nVarenicline v\u00e0 Bupropion - t\u00e1c d\u1ee5ng trong cai thu\u1ed1c l\u00e1<\/title>\n<meta name=\"description\" content=\"C\u00e1c li\u1ec7u ph\u00e1p thay th\u1ebf kh\u00f4ng Nicotin\u00a0\u0111ang tr\u1edf th\u00e0nh m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 gi\u00fap ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c l\u00e1 b\u1ecf th\u00f3i quen n\u00e0y. 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