{"id":33242,"date":"2023-05-13T14:41:27","date_gmt":"2023-05-13T07:41:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33242"},"modified":"2023-05-13T14:41:27","modified_gmt":"2023-05-13T07:41:27","slug":"ipratropium","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/ipratropium\/","title":{"rendered":"Ipratropium: C\u1eadp nh\u1eadt trong \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

Ipratropium l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u1ed1i kh\u00e1ng muscarinic \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh (COPD) v\u00e0 kh\u00f3 th\u1edf do c\u00e1c vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p. Thu\u1ed1c n\u00e0y ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ch\u1eb7n ch\u1ea5t acetylcholine trong ph\u1ebf qu\u1ea3n, gi\u00fap l\u00e0m gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a ch\u00fang, gi\u1ea3m kh\u00f3 th\u1edf v\u00e0 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb \u0111\u1ee3t c\u1ea5p c\u1ee7a COPD.<\/strong><\/p>\n

1. T\u1ed5ng quan<\/strong><\/h1>\n

Ipratropium bromide (Atrovent) c\u00f3 s\u1eb5n \u1edf d\u1ea1ng thu\u1ed1c h\u00edt \u0111\u1ecbnh li\u1ec1u (MDI). M\u1ed7i l\u1ea7n k\u00edch ho\u1ea1t MDI cung c\u1ea5p 17 mcg ipratropium bromide v\u00e0 m\u1ed7i \u1ed1ng ch\u1ee9a 200 l\u1ea7n h\u00edt. Tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng c\u00f4ng th\u1ee9c MDI l\u1ea7n \u0111\u1ea7u, \u1ed1ng h\u00edt ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o kh\u00f4ng kh\u00ed hai l\u1ea7n; b\u01b0\u1edbc n\u00e0y n\u00ean \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i n\u1ebfu kh\u00f4ng s\u1eed d\u1ee5ng \u1ed1ng h\u00edt trong h\u01a1n 3 ng\u00e0y.<\/p>\n

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Ngu\u1ed3n: RxSpark<\/figcaption><\/figure>\n

2. D\u01b0\u1ee3c l\u00fd l\u00e2m s\u00e0ng<\/strong><\/h2>\n

2.1. Li\u1ec1u l\u01b0\u1ee3ng c\u1ee7a Ipratropium<\/strong><\/h3>\n

Li\u1ec1u khuy\u1ebfn c\u00e1o t\u1eeb MDI l\u00e0 2 nh\u00e1t x\u1ecbt 4 l\u1ea7n m\u1ed7i ng\u00e0y, th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng khi c\u1ea7n thi\u1ebft. \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u1ee3t c\u1ea5p COPD c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c t\u1ea1i khoa c\u1ea5p c\u1ee9u ho\u1eb7c b\u1ec7nh vi\u1ec7n, ipratropium c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u0103ng l\u00ean li\u1ec1u cao h\u01a1n (v\u00ed d\u1ee5: hai l\u1ea7n h\u00edt m\u1ed7i gi\u1edd cho hai \u0111\u1ebfn ba li\u1ec1u v\u00e0 sau \u0111\u00f3 c\u1ee9 sau hai \u0111\u1ebfn b\u1ed1n gi\u1edd ho\u1eb7c b\u1ed1n l\u1ea7n h\u00edt sau m\u1ed7i b\u1ed1n gi\u1edd), n\u1ebfu \u0111\u00e1p \u1ee9ng v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n l\u00e0 kh\u00f4ng \u0111\u1ee7.<\/p>\n

Ipratropium c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1eb1ng c\u00e1ch x\u00f4ng kh\u00ed dung. Dung d\u1ecbch ipratropium c\u00f3 d\u1ea1ng l\u1ecd 0.5 mg\/2.5 mL (0.02 ph\u1ea7n tr\u0103m) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c cung c\u1ea5p b\u1eb1ng c\u00e1ch phun kh\u00ed dung c\u1ee9 sau 4 – 6 gi\u1edd.<\/p>\n

2.2. Hi\u1ec7u qu\u1ea3 <\/strong><\/h3>\n

Ipratropium \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 l\u00e0m gi\u1ea3m kh\u00f3 th\u1edf, t\u0103ng kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c v\u00e0 c\u1ea3i thi\u1ec7n trao \u0111\u1ed5i kh\u00ed \u1edf b\u1ec7nh nh\u00e2n m\u1eafc COPD. Tuy nhi\u00ean, Ipratropium kh\u00f4ng c\u00f3 \u0111\u1eb7c t\u00ednh ch\u1ed1ng vi\u00eam v\u00e0 kh\u00f4ng l\u00e0m thay \u0111\u1ed5i l\u1ecbch s\u1eed t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh v\u1ec1 ch\u1ee9c n\u0103ng ph\u1ed5i ho\u1eb7c t\u1ef7 l\u1ec7 t\u1eed vong. \u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng nhanh b\u1eb1ng ipratropium ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh, v\u00e0 do \u0111\u00f3 hi\u1ec7u qu\u1ea3 c\u1ee7a n\u00f3 kh\u00f4ng b\u1ecb suy gi\u1ea3m sau nhi\u1ec1u n\u0103m s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean.<\/p>\n

Nghi\u00ean c\u1ee9u The Lung Health \u0111\u00e3 \u0111\u00e1nh gi\u00e1 ti\u1ec1n c\u1ee9u \u1ea3nh h\u01b0\u1edfng c\u1ee7a vi\u1ec7c ng\u1eebng h\u00fat thu\u1ed1c c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ipratropium \u0111\u1ed1i v\u1edbi s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i \u1edf 5887 nam v\u00e0 n\u1eef h\u00fat thu\u1ed1c m\u1eafc COPD. Trong nghi\u00ean c\u1ee9u mang t\u00ednh b\u01b0\u1edbc ngo\u1eb7t n\u00e0y, ipratropium \u0111\u01b0\u1ee3c ch\u1ecdn l\u00e0 thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn v\u00ec t\u1ea7n su\u1ea5t t\u00e1c d\u1ee5ng ph\u1ee5 th\u1ea5p, th\u1eddi gian t\u00e1c d\u1ee5ng t\u01b0\u01a1ng \u0111\u1ed1i d\u00e0i v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh \u1edf b\u1ec7nh nh\u00e2n m\u1eafc COPD . K\u1ebft qu\u1ea3 nh\u01b0 sau:<\/p>\n

Vi\u1ec7c s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean ipratropium bromide d\u1ea1ng h\u00edt (2 nh\u00e1t x\u1ecbt 3 l\u1ea7n m\u1ed7i ng\u00e0y t\u1eeb \u1ed1ng h\u00edt \u0111\u1ecbnh li\u1ec1u) l\u00e0m t\u0103ng FEV1 r\u00f5 r\u1ec7t v\u00e0o cu\u1ed1i n\u0103m \u0111\u1ea7u ti\u00ean. S\u1ef1 c\u1ea3i thi\u1ec7n t\u01b0\u01a1ng \u0111\u1ed1i n\u00e0y \u0111\u01b0\u1ee3c duy tr\u00ec trong \u00a04 n\u0103m ti\u1ebfp theo.<\/p>\n

S\u1ef1 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng ph\u1ed5i d\u01b0\u1eddng nh\u01b0 \u0111\u1ea3o ng\u01b0\u1ee3c trong v\u00f2ng v\u00e0i tu\u1ea7n sau khi ng\u1eebng ipratropium.<\/p>\n

Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y ph\u1ea3n \u00e1nh s\u1ef1 thay \u0111\u1ed5i t\u01b0\u01a1ng \u0111\u1ed1i ng\u1eafn h\u1ea1n, qua trung gian d\u01b0\u1ee3c l\u00fd trong ch\u1ee9c n\u0103ng ph\u1ed5i do thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n v\u00e0 h\u1ed7 tr\u1ee3 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n v\u00ec l\u1ee3i \u00edch tri\u1ec7u ch\u1ee9ng, bao g\u1ed3m gi\u1ea3m kh\u00f3 th\u1edf v\u00e0 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng ch\u1ecbu \u0111\u1ef1ng khi g\u1eafng s\u1ee9c. \u0110\u1ec3 so s\u00e1nh, kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, v\u00ec li\u1ec7u ph\u00e1p kh\u00f4ng l\u00e0m thay \u0111\u1ed5i l\u1ecbch s\u1eed t\u1ef1 nhi\u00ean c\u1ee7a ch\u1ee9ng r\u1ed1i lo\u1ea1n.<\/p>\n

2.3. Ipratropium so v\u1edbi ch\u1ea5t ch\u1ee7 v\u1eadn beta<\/strong><\/h3>\n

Trong COPD, ipratropium \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 v\u01b0\u1ee3t tr\u1ed9i so v\u1edbi ch\u1ea5t ch\u1ee7 v\u1eadn beta-adrenergic trong c\u1ea3 nghi\u00ean c\u1ee9u ng\u1eafn h\u1ea1n v\u00e0 d\u00e0i h\u1ea1n. V\u00ed d\u1ee5, trong m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, \u0111a trung t\u00e2m tr\u00ean 260 b\u1ec7nh nh\u00e2n m\u1eafc COPD nh\u01b0ng kh\u00f4ng b\u1ecb hen suy\u1ec5n ho\u1eb7c d\u1ecb \u1ee9ng, ipratropium m\u1ea1nh h\u01a1n \u1edf t\u00e1c d\u1ee5ng t\u1ed1i \u0111a v\u00e0 t\u00e1c d\u1ee5ng l\u00e2u h\u01a1n so v\u1edbi metaproterenol. Nh\u1eefng ph\u00e1t hi\u1ec7n t\u01b0\u01a1ng t\u1ef1 c\u0169ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u0111\u1ed1i v\u1edbi ipratropium bromide kh\u00ed dung . Ngo\u00e0i ra, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng ipratropium bromide g\u00e2y gi\u00e3n ph\u1ebf qu\u1ea3n \u0111\u00e1ng k\u1ec3 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c c\u01b0\u1eddng giao c\u1ea3m d\u1ea1ng h\u00edt.<\/p>\n

Li\u1ec7u ph\u00e1p Ipratropium c\u0169ng c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n COPD. Trong m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, \u0111a trung t\u00e2m tr\u00ean 223 b\u1ec7nh nh\u00e2n m\u1eafc COPD, hi\u1ec7u qu\u1ea3 c\u1ee7a ipratropium kh\u00ed dung (500 mcg) \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi albuterol kh\u00ed dung (2,5 mg) (m\u1ed7i lo\u1ea1i d\u00f9ng ba l\u1ea7n m\u1ed7i ng\u00e0y trong t\u1ed1i \u0111a 83 ng\u00e0y). M\u1eb7c d\u00f9 c\u1ea3i thi\u1ec7n l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf c\u1ea3 hai nh\u00f3m, nh\u00f3m ipratropium bromide c\u00f3 l\u1ee3i \u00edch v\u1ec1 tri\u1ec7u ch\u1ee9ng nhi\u1ec1u h\u01a1n v\u00e0 \u0111\u1ea1t \u0111i\u1ec3m cao h\u01a1n trong b\u1ea3ng c\u00e2u h\u1ecfi v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n

M\u1eb7c d\u00f9 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c ch\u1ee7 v\u1eadn beta-2 d\u1ea1ng h\u00edt n\u00f3i chung l\u00e0 nh\u1ecf, nh\u01b0ng ch\u00fang c\u00f3 th\u1ec3 g\u00e2y run kh\u00f3 ch\u1ecbu v\u1edbi li\u1ec1u l\u01b0\u1ee3ng c\u1ea7n thi\u1ebft \u0111\u1ec3 t\u1ea1o ra s\u1ef1 gi\u00e3n ph\u1ebf qu\u1ea3n trong COPD. Ngo\u00e0i ra, vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t ch\u1ee7 v\u1eadn beta-2 \u1edf b\u1ec7nh nh\u00e2n COPD c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi gi\u00e3n m\u1ea1ch ph\u1ed5i, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0m x\u1ea5u \u0111i s\u1ef1 ph\u00f9 h\u1ee3p th\u00f4ng kh\u00ed-t\u01b0\u1edbi m\u00e1u v\u00e0 d\u1eabn \u0111\u1ebfn gi\u1ea3m nh\u1eb9 PaO2 \u0111\u1ed9ng m\u1ea1ch. C\u00e1c t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i c\u1ee7a ipratropium bromide k\u1ebft h\u1ee3p v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 t\u1ed1i thi\u1ec3u c\u1ee7a n\u00f3 l\u00e0m cho thu\u1ed1c n\u00e0y tr\u1edf th\u00e0nh thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng cho b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) trong m\u00f4i tr\u01b0\u1eddng ngo\u1ea1i tr\u00fa.<\/p>\n

2.4. \u0110i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p \u00a0<\/strong><\/h3>\n
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\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Ngu\u1ed3n: McKesson Medical<\/strong><\/figcaption><\/figure>\n

Vi\u1ec7c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p thu\u1ed1c kh\u00e1ng muscarinic v\u00e0 thu\u1ed1c ch\u1ee7 v\u1eadn beta th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn gi\u00e3n ph\u1ebf qu\u1ea3n nhi\u1ec1u h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u01a1n l\u1ebb \u1edf b\u1ec7nh nh\u00e2n m\u1eafc COPD. V\u00ed d\u1ee5, m\u1ed9t th\u1eed nghi\u1ec7m ch\u00e9o tr\u00ean 863 b\u1ec7nh nh\u00e2n \u0111\u00e3 ph\u00e1t hi\u1ec7n ra r\u1eb1ng li\u1ec7u ph\u00e1p ph\u1ed1i h\u1ee3p v\u1edbi ipratropium-albuterol kh\u00ed dung d\u1eabn \u0111\u1ebfn th\u1ec3 t\u00edch th\u1edf ra g\u1eafng s\u1ee9c t\u1ed1i \u0111a trong m\u1ed9t gi\u00e2y (FEV1) cao h\u01a1n 24% so v\u1edbi ch\u1ec9 d\u00f9ng albuterol v\u00e0 cao h\u01a1n 37% so v\u1edbi \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u1edbi ipratropium \u0111\u01a1n tr\u1ecb li\u1ec7u. \u1ede b\u1ec7nh nh\u00e2n COPD, s\u1ef1 k\u1ebft h\u1ee3p n\u00e0y mang l\u1ea1i l\u1ee3i th\u1ebf \u0111i\u1ec1u tr\u1ecb ti\u1ec1m n\u0103ng so v\u1edbi albuterol \u0111\u01a1n \u0111\u1ed9c m\u00e0 kh\u00f4ng c\u00f3 nguy c\u01a1 gia t\u0103ng t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n

Th\u00f4ng th\u01b0\u1eddng, c\u00e1c t\u00e1c nh\u00e2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u1ed9t s\u1ef1 k\u1ebft h\u1ee3p c\u1ed1 \u0111\u1ecbnh, ch\u1eb3ng h\u1ea1n nh\u01b0 \u1ed1ng h\u00edt s\u01b0\u01a1ng m\u00f9 m\u1ec1m ipratropium-albuterol, m\u1ed9t l\u1ea7n h\u00edt b\u1ed1n l\u1ea7n m\u1ed9t ng\u00e0y. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 h\u00edt th\u00eam theo y\u00eau c\u1ea7u; tuy nhi\u00ean, t\u1ed5ng s\u1ed1 l\u1ea7n h\u00edt ph\u1ea3i kh\u00f4ng \u0111\u01b0\u1ee3c v\u01b0\u1ee3t qu\u00e1 6 l\u1ea7n trong 24 gi\u1edd. Khi ipratropium v\u00e0 albuterol \u0111\u01b0\u1ee3c d\u00f9ng ri\u00eang r\u1ebd, c\u00f3 r\u1ea5t \u00edt b\u1eb1ng ch\u1ee9ng cho th\u1ea5y n\u00ean d\u00f9ng hai lo\u1ea1i thu\u1ed1c theo tr\u00ecnh t\u1ef1 n\u00e0o v\u00e0 li\u1ec7u ch\u00fang n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng theo tr\u00ecnh t\u1ef1 ngay l\u1eadp t\u1ee9c hay n\u00ean c\u00e1ch nhau m\u1ed9t kho\u1ea3ng .<\/p>\n

M\u1ed9t s\u1ed1 l\u00fd do sinh l\u00fd t\u1ed3n t\u1ea1i \u0111\u1ed1i v\u1edbi l\u1ee3i \u00edch ti\u1ec1m n\u0103ng c\u1ee7a li\u1ec7u ph\u00e1p ph\u1ed1i h\u1ee3p ipratropium v\u00e0 ch\u1ea5t ch\u1ee7 v\u1eadn beta:<\/p>\n

    \n
  • Thu\u1ed1c \u0111\u1ed1i kh\u00e1ng Muscarin ch\u1ee7 y\u1ebfu t\u00e1c \u0111\u1ed9ng l\u00ean \u0111\u01b0\u1eddng th\u1edf l\u1edbn \u1edf g\u1ea7n, trong khi thu\u1ed1c c\u01b0\u1eddng giao c\u1ea3m t\u00e1c \u0111\u1ed9ng l\u00ean \u0111\u01b0\u1eddng th\u1edf nh\u1ecf \u1edf xa h\u01a1n.<\/li>\n
  • Hai nh\u00f3m thu\u1ed1c g\u00e2y gi\u00e3n ph\u1ebf qu\u1ea3n th\u00f4ng qua c\u00e1c c\u01a1 ch\u1ebf kh\u00e1c nhau: Thu\u1ed1c ch\u1ee7 v\u1eadn beta \u0111\u01b0\u1ee3c cho l\u00e0 g\u00e2y gi\u00e3n ph\u1ebf qu\u1ea3n b\u1eb1ng c\u00e1ch t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp l\u00ean c\u01a1 v\u00e0 ipratropium g\u00e2y gi\u00e3n ph\u1ebf qu\u1ea3n b\u1eb1ng c\u00e1ch gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c cholinergic.<\/li>\n
  • S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi thu\u1ed1c \u0111\u1ed1i kh\u00e1ng adrenergic v\u00e0 muscarinic gi\u00fap thu\u1ed1c kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng nhanh ch\u00f3ng v\u00e0 ho\u1ea1t \u0111\u1ed9ng k\u00e9o d\u00e0i c\u1ee7a thu\u1ed1c sau; hi\u1ec7u \u1ee9ng t\u1ed5ng h\u1ee3p c\u1ee7a ch\u00fang hi\u1ec7n di\u1ec7n \u1edf nh\u1eefng th\u1eddi \u0111i\u1ec3m trung gian.<\/li>\n<\/ul>\n

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

      \n
    • Raed A Dweik, MD, FACP, FCCP, FRCP(C), FCCM, FAHA, \u201cRole of muscarinic antagonist therapy in COPD\u201d, UPTODATE 2023.<\/li>\n<\/ul>\n
      usechatgpt init success<\/div>\n","protected":false},"excerpt":{"rendered":"

      Ipratropium l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u1ed1i kh\u00e1ng muscarinic \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh (COPD) v\u00e0 kh\u00f3 th\u1edf do c\u00e1c vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p. Thu\u1ed1c n\u00e0y ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ch\u1eb7n ch\u1ea5t acetylcholine trong ph\u1ebf qu\u1ea3n, gi\u00fap l\u00e0m gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a ch\u00fang, gi\u1ea3m kh\u00f3 th\u1edf v\u00e0 \u0111\u01b0\u1ee3c […]<\/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":"\nIpratropium: C\u1eadp nh\u1eadt trong \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Ipratropium l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u1ed1i kh\u00e1ng muscarinic \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh (COPD) v\u00e0 kh\u00f3 th\u1edf do c\u00e1c vi\u00eam\" \/>\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=\"Ipratropium: C\u1eadp nh\u1eadt trong \u0111i\u1ec1u tr\u1ecb - 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