{"id":11036,"date":"2019-05-31T15:54:33","date_gmt":"2019-05-31T08:54:33","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=11036"},"modified":"2025-01-08T23:23:54","modified_gmt":"2025-01-08T16:23:54","slug":"chronotherapy-thoi-diem-dung-thuoc-quan-trong-the-nao","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/chronotherapy-thoi-diem-dung-thuoc-quan-trong-the-nao\/","title":{"rendered":"Chronotherapy- Th\u1eddi \u0111i\u1ec3m d\u00f9ng thu\u1ed1c quan tr\u1ecdng th\u1ebf n\u00e0o ?"},"content":{"rendered":"

Theo Namudinsider<\/strong><\/em><\/p>\n

Thu\u1ed1c d\u00f9ng \u0111\u1ec3 ch\u1eefa ho\u1eb7c ph\u00f2ng b\u1ec7nh, nh\u01b0ng n\u1ebfu b\u1ec7nh nh\u00e2n v\u00f4 t\u00ecnh qu\u00ean ho\u1eb7c kh\u00f4ng th\u1ec3 tu\u00e2n th\u1ee7 theo \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u00e1c s\u0129 th\u00ec c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng. \u0110\u1eb7c bi\u1ec7t, \u0111\u1ed1i v\u1edbi nh\u1eefng d\u00f2ng thu\u1ed1c nh\u01b0 kh\u00e1ng sinh, thu\u1ed1c kh\u00e1ng \u0111\u00f4ng, thu\u1ed1c tr\u00e1nh thai, thu\u1ed1c tr\u1ecb hen suy\u1ec5n\u2026vi\u1ec7c \u0111\u1ea3m b\u1ea3o u\u1ed1ng thu\u1ed1c theo \u0111\u00fang th\u1eddi gian quy \u0111\u1ecbnh m\u1ed7i ng\u00e0y l\u00e0 c\u1ef1c k\u00ec quan tr\u1ecdng \u0111\u1ec3 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch t\u1ed1t nh\u1ea5t c\u00f3 th\u1ec3.<\/em><\/p>\n

V\u00ec sao ph\u1ea3i d\u00f9ng thu\u1ed1c \u0111\u00fang th\u1eddi \u0111i\u1ec3m ?<\/strong><\/p>\n

T\u1ea5t c\u1ea3 nh\u00e2n vi\u00ean y t\u1ebf \u0111\u1ec1u hi\u1ec3u r\u00f5 v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a s\u1ef1 tu\u00e2n th\u1ee7\u00a0quy t\u1eafc 5 \u0111\u00fang<\/strong>\u00a0(\u0111\u00fang b\u1ec7nh, \u0111\u00fang thu\u1ed1c, \u0111\u00fang li\u1ec1u, \u0111\u00fang c\u00e1ch v\u00e0 \u0111\u00fang th\u1eddi gian) khi \u0111i\u1ec1u tr\u1ecb m\u1ed9t b\u1ec7nh l\u00fd. Trong khi nh\u1eefng nguy\u00ean t\u1eafc c\u00f2n l\u1ea1i d\u1ec5 ki\u1ec3m so\u00e1t, th\u00ec u\u1ed1ng thu\u1ed1c v\u00e0o \u0111\u00fang th\u1eddi gian quy \u0111\u1ecbnh l\u1ea1i ph\u1ee5 thu\u1ed9c kh\u00e1 nhi\u1ec1u v\u00e0o t\u00ednh ch\u1ee7 quan c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

M\u1ed9t vi\u00ean thu\u1ed1c khi \u0111i v\u00e0o c\u01a1 th\u1ec3 c\u1ea7n tr\u1ea3i qua 4 giai \u0111o\u1ea1n ch\u00ednh: h\u1ea5p thu, v\u1eadn chuy\u1ec3n, chuy\u1ec3n h\u00f3a v\u00e0 th\u1ea3i tr\u1eeb.<\/p><\/blockquote>\n

\u0110\u1ec3 c\u00f3 th\u1ec3 t\u1ed1i \u01b0u h\u00f3a hi\u1ec7u qu\u1ea3 c\u1ee7a m\u00ecnh, thu\u1ed1c c\u1ea7n ph\u1ea3i c\u00f3 m\u1eb7t trong m\u00e1u t\u1ea1i th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p v\u1edbi nh\u1ecbp \u0111i\u1ec7u sinh h\u1ecdc c\u1ee7a c\u01a1 th\u1ec3. D\u00f9ng thu\u1ed1c qu\u00e1 s\u1edbm khi\u1ebfn n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong m\u00e1u qu\u00e1 cao, ng\u01b0\u1ee3c l\u1ea1i qu\u00ean ho\u1eb7c u\u1ed1ng thu\u1ed1c tr\u1ec5 gi\u1edd c\u00f3 th\u1ec3 khi\u1ec5n n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong m\u00e1u b\u1ecb th\u1ea5p, g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c. Th\u00eam v\u00e0o \u0111\u00f3, u\u1ed1ng thu\u1ed1c sai gi\u1edd c\u00f2n c\u00f3 th\u1ec3 khi\u1ebfn ng\u01b0\u1eddi b\u1ec7nh ch\u1ecbu nhi\u1ec1u \u1ea3nh h\u01b0\u1edfng t\u1eeb t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.<\/p>\n

Theo ti\u1ebfn s\u0129 Michael Smolensky ( \u0110H Texas \u2013 M\u1ef9 ), nh\u1ecbp sinh h\u1ecdc c\u01a1 th\u1ec3 ng\u01b0\u1eddi thay \u0111\u1ed5i theo ng\u00e0y, theo m\u00f9a, theo chu k\u1ef3 kinh nguy\u1ec7t v\u00e0 c\u1ea3 theo n\u0103m. Ng\u00e0nh khoa h\u1ecdc nghi\u00ean c\u1ee9u v\u1ec1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a th\u1eddi gian l\u00ean hi\u1ec7u qu\u1ea3 thu\u1ed1c l\u00e0 Chronotheraphy. Theo \u0111\u00f3, nh\u1ecbp sinh h\u1ecdc trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chia th\u00e0nh 4 d\u1ea1ng ch\u00ednh l\u00e0:<\/p>\n

    \n
  1. Ultradian: chu k\u1ef3 ng\u1eafn h\u1ea1n trong ng\u00e0y. Th\u01b0\u1eddng \u00e1p d\u1ee5ng cho t\u1ebf b\u00e0o th\u1ea7n kinh (1ph\u1ea7n ngh\u00ecn gi\u00e2y) hay m\u1ed9t gi\u1ea5c ng\u1ee7 ph\u00fat.<\/li>\n
  2. Circadian: chu k\u1ef3 k\u00e9o d\u00e0i 24 ti\u1ebfng. V\u00ed d\u1ee5 d\u1ec5 th\u1ea5y nh\u1ea5t l\u00e0 th\u00f3i quen \u0111i ng\u1ee7 ho\u1eb7c \u0111i b\u1ed9 h\u1eb1ng n\u00e0y<\/li>\n
  3. Infradian: chu k\u1ef3 d\u00e0i h\u01a1n m\u1ed9t ng\u00e0y, c\u00f3 th\u1ec3 theo tu\u1ea7n ho\u1eb7c theo th\u00e1ng. Chu k\u1ef3 kinh nguy\u1ec7t l\u00e0 m\u1ed9t v\u00ed d\u1ee5 \u0111i\u1ec3n h\u00ecnh.<\/li>\n
  4. Seasonal: chu k\u1ef3 theo m\u00f9a. \u0110\u00e2y \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh tr\u1ea7m c\u1ea3m v\u1ec1 m\u00f9a \u0111\u00f4ng.<\/li>\n<\/ol>\n

    Nh\u1ecbp sinh h\u1ecdc \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a b\u1edfi m\u1ed9t nh\u00f3m c\u00e1c t\u1ebf b\u00e0o suprachiasmatic nucleus \u2013 nh\u00e2n tr\u00ean ch\u00e9o \u2013 (SCN) thu\u1ed9c v\u00f9ng n\u00e3o hypothalamus. To\u00e0n b\u1ed9 c\u00e1c qu\u00e1 tr\u00ecnh sinh l\u00fd c\u1ee7a c\u01a1 th\u1ec3 bao g\u1ed3m c\u1ea3 nhi\u1ec7t \u0111\u1ed9 v\u00e0 s\u1ea3n sinh hormone \u0111\u1ec1u \u0111\u01b0\u1ee3c \u0111i\u1ec1u ti\u1ebft b\u1edfi SCN. V\u00ec th\u1ebf, t\u00f9y v\u00e0o t\u1eebng th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau trong ng\u00e0y m\u00e0 c\u01a1 th\u1ec3 s\u1ebd c\u00f3 nh\u1eefng \u0111\u00e1p \u1ee9ng kh\u00e1c nhau v\u1edbi c\u00f9ng m\u1ed9t lo\u1ea1i thu\u1ed1c. U\u1ed1ng thu\u1ed1c sai th\u1eddi \u0111i\u1ec3m, kh\u00f4ng nh\u1eefng l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 m\u00e0 c\u00f2n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh dung n\u1ea1p v\u00e0 t\u0103ng t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.<\/p>\n

    T\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n v\u1edbi b\u1ec7nh l\u00fd \u0111i k\u00e8m c\u1ee5 th\u1ec3, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c theo nh\u1ecbp sinh h\u1ecdc kh\u00e1c nhau s\u1ebd \u0111\u01b0a \u0111\u1ebfn nh\u1eefng k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb kh\u00f4ng gi\u1ed1ng nhau. \u1ede b\u1ec7nh nh\u00e2n c\u00f3 cholesterol trong m\u00e1u cao, s\u1eed d\u1ee5ng thu\u1ed1c statin sau b\u1eefa t\u1ed1i s\u1ebd gi\u00fap gi\u1ea3m LDL-C hi\u1ec7u qu\u1ea3 h\u01a1n v\u00ec cholesterol \u0111\u01b0\u1ee3c s\u1ea3n sinh trong gan nhi\u1ec1u nh\u1ea5t v\u00e0o th\u1eddi \u0111i\u1ec3m gi\u1eefa khuya. B\u1ec7nh nh\u00e2n vi\u00eam m\u0169i d\u1ecb \u1ee9ng th\u01b0\u1eddng bi\u1ec3n hi\u1ec7u b\u1eb1ng vi\u1ec7c h\u1eaft h\u01a1i, ngh\u1eb9t ho\u1eb7c ch\u1ea3y n\u01b0\u1edbc m\u0169i. Nhi\u1ec1u nghi\u00ean c\u1ee9u cho th\u1ea5y, d\u00f9ng thu\u1ed1c kh\u00e1ng histamine v\u00e0o bu\u1ed5i s\u00e1ng s\u1ebd kh\u00f4ng hi\u1ec7u qu\u1ea3 nh\u01b0 s\u1eed d\u1ee5ng c\u00f9ng m\u1ed9t l\u01b0\u1ee3ng thu\u1ed1c v\u00e0o bu\u1ed5i chi\u1ec1u. T\u01b0\u01a1ng t\u1ef1 v\u1eady, b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y khi d\u00f9ng thu\u1ed1c v\u00e0o bu\u1ed5i t\u1ed1i kh\u00f4ng nh\u1eefng gi\u00fap gi\u1ea3m ti\u1ebft axit hi\u1ec7u qu\u1ea3, m\u00e0 c\u00f2n \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh l\u00e0nh v\u1ebft vi\u00eam v\u00e0 gi\u1ea3m nguy c\u01a1 b\u1ecb t\u00e1i ph\u00e1t.<\/p>\n

    D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 \u0111i\u1ec3n h\u00ecnh kh\u00e1c v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u00fang th\u1eddi \u0111i\u1ec3m s\u1ebd gi\u00fap b\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb t\u1ed1t h\u01a1n:<\/p>\n

    \"\"Hen ph\u1ebf qu\u1ea3n :\u00a0<\/strong>Th\u1ed1ng k\u00ea cho th\u1ea5y, bi\u1ec3u hi\u1ec7n c\u1ee7a hen suy\u1ec5n nh\u01b0 co th\u1eaft ph\u1ebf qu\u1ea3n hay ngh\u1eb9t \u0111\u01b0\u1eddng \u1ed1ng th\u1edf c\u00f3 xu h\u01b0\u1edbng x\u1ea3y ra v\u00e0o ban \u0111\u00eam nhi\u1ec1u g\u1ea5p 50-100 l\u1ea7n so v\u1edbi ban ng\u00e0y. Do \u0111\u00f3, \u0111\u1ed1i v\u1edbi b\u1ec7nh hen suy\u1ec5n, m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 \u0111\u1ec3 gi\u00e3n ph\u1ebf qu\u1ea3n v\u00e0o bu\u1ed5i s\u00e1ng s\u1edbm. B\u1ec7nh nh\u00e2n c\u1ea7n u\u1ed1ng thu\u1ed1c v\u00e0o bu\u1ed5i t\u1ed1i h\u00f4m tr\u01b0\u1edbc, \u0111\u1ec3 thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh v\u00e0o s\u00e1ng h\u00f4m sau khi ph\u1ebf qu\u1ea3n \u0111ang co l\u1ea1i.<\/p>\n

    B\u1ec7nh nh\u00e2n hen suy\u1ec5n d\u00f9ng thu\u1ed1c bu\u1ed5i t\u1ed1i c\u0169ng c\u00f3 th\u1ec3 ng\u1ee7 ngon h\u01a1n, h\u1ea1n ch\u1ebf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ecb th\u1ee9c gi\u1ea5c gi\u1eefa khuya v\u00ec ho kh\u00f2 kh\u00e8 v\u00e0 kh\u00f3 th\u1edf. D\u00f9ng thu\u1ed1c glucocorticoid nh\u01b0 methyl prednisolone \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0o l\u00fac 3h gi\u1edd khuya s\u1ebd hi\u1ec7u qu\u1ea3 h\u01a1n l\u00fac 8h s\u00e1ng.<\/p>\n

    T\u01b0\u01a1ng t\u1ef1, theophylline d\u1ea1ng ph\u00f3ng th\u00edch ch\u1eadm d\u00f9ng v\u00e0o bu\u1ed5i t\u1ed1i s\u1ebd gi\u00fap ki\u1ec3m so\u00e1t b\u1ec7nh t\u1ed1t h\u01a1n c\u00e1c th\u1eddi gia kh\u00e1c trong ng\u00e0y.<\/p>\n

    B\u1ec7nh v\u1ec1 x\u01b0\u01a1ng kh\u1edbp \u00a0:\u00a0<\/strong>Nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam x\u01b0\u01a1ng kh\u1edbp (osteoarthritis) hay b\u1ecb \u0111au nhi\u1ec1u v\u00e0o bu\u1ed5i \u0111\u00eam h\u01a1n l\u00e0 ban ng\u00e0y. Ng\u01b0\u1ee3c l\u1ea1i, b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p (rheumatoid arthritis) l\u1ea1i hay b\u1ecb \u0111au nh\u1ee9c v\u00e0o bu\u1ed5i s\u00e1ng. C\u1ea3 hai b\u1ec7nh l\u00ed \u0111\u1ec1u s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAID) v\u00e0 corticosteroids, tuy nhi\u00ean th\u1eddi gian u\u1ed1ng thu\u1ed1c s\u1ebd ph\u1ea3i kh\u00e1c nhau \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong m\u00e1u \u0111\u1ea1t m\u1ee9c cao nh\u1ea5t khi c\u01a1n \u0111au c\u0169ng \u1edf ng\u01b0\u1ee1ng cao t\u01b0\u01a1ng t\u1ef1.<\/p>\n

    Do \u0111\u00f3, tuy c\u00f9ng m\u1ed9t thu\u1ed1c nh\u01b0ng b\u1ec7nh nh\u00e2n vi\u00eam x\u01b0\u01a1ng kh\u1edbp s\u1ebd u\u1ed1ng v\u00e0o bu\u1ed5i tr\u01b0a ho\u1eb7c x\u1ebf chi\u1ec1u trong khi nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p s\u1ebd d\u00f9ng thu\u1ed1c sau b\u1eefa t\u1ed1i.<\/p>\n

    Ung th\u01b0:\u00a0<\/strong>Ung th\u01b0 l\u00e0 c\u0103n b\u1ec7nh g\u00e2y s\u1ee3 h\u00e3i cho c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh v\u00e0 th\u00e2n nh\u00e2n. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 l\u00e0 m\u1ed9t qu\u00e3ng \u0111\u01b0\u1eddng d\u00e0i, \u0111\u00f2i h\u1ecfi ti\u1ec1n b\u1ea1c, th\u1eddi gian, c\u00f4ng s\u1ee9c v\u00e0 c\u1ea3 ngh\u1ecb l\u1ef1c \u0111\u1ec3 v\u01b0\u1ee3t qua nh\u1eefng ng\u00e0y x\u1ea1 tr\u1ecb m\u1ec7t m\u1ecfi. V\u00ec t\u1ebf b\u00e0o ung th\u01b0 kh\u00f4ng c\u00f3 qu\u00e1 nhi\u1ec1u kh\u00e1c bi\u1ebft trong c\u1ea5u tr\u00fac so v\u1edbi t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng, nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p tr\u1ecb li\u1ec7u nh\u1eafm v\u00e0o t\u1ebf b\u00e0o ung th\u01b0 c\u0169ng s\u1ebd g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c t\u1ebf b\u00e0o c\u00f2n l\u1ea1i.<\/p>\n

    Nh\u1eefng c\u1ea3i ti\u1ebfn trong y h\u1ecdc hi\u1ec7n \u0111\u1ea1i kh\u00f4ng ch\u1ec9 gi\u00fap t\u00ecm ra \u0111\u01b0\u1ee3c nhi\u1ec1u lo\u1ea1i thu\u1ed1c m\u1edbi, m\u00e0 c\u00f2n c\u00f3 nhi\u1ec1u ph\u00e1t hi\u1ec7n m\u1edbi t\u1eeb nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7n t\u1ea1i \u0111\u1ec3 gi\u1ea3m \u0111au \u0111\u1edbn cho b\u1ec7nh nh\u00e2n ung th\u01b0 trong \u0111\u00f3 c\u00f3 ph\u01b0\u01a1ng ph\u00e1p chronotherapy \u2013 \u00e1p d\u1ee5ng th\u1eddi gian s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 t\u0103ng hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

    \"\"<\/p>\n

    C\u00e1c nh\u00e0 khoa h\u1ecdc tin r\u1eb1ng, nh\u1ecbp \u0111i\u1ec7u sinh h\u1ecdc c\u1ee7a m\u1ed9t t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng kh\u00e1c v\u1edbi m\u1ed9t t\u1ebf b\u00e0o ung th\u01b0. M\u1ed7i t\u1ebf b\u00e0o \u0111\u1ec1u c\u00f3 c\u01a1 ch\u1ebf th\u1ea3i tr\u1eeb \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c v\u00e0 \u0111\u1ea9y thu\u1ed1c tr\u1edf ng\u01b0\u1ee3c l\u1ea1i v\u00e0o m\u00f4. C\u01a1 ch\u1ebf n\u00e0y \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a b\u1edfi m\u1ed9t gen ho\u1ea1t \u0111\u1ed9ng theo chu k\u00ec. N\u1ebfu c\u00f3 th\u1ec3 \u0111\u01b0a thu\u1ed1c v\u00e0o c\u01a1 th\u1ec3 sao cho th\u1eddi gian thu\u1ed1c \u0111\u1ea1t n\u1ed1ng \u0111\u1ed9 cao nh\u1ea5t tr\u00f9ng v\u1edbi th\u1eddi gian c\u01a1 ch\u1ebf th\u1ea3i \u0111\u1ed9c \u0111ang di\u1ec5n ra \u1edf c\u00e1c t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng c\u0169ng v\u1edbi t\u1ea7n su\u1ea5t cao nh\u1ea5t nh\u01b0ng l\u1ea1i th\u1ea5p \u1edf t\u1ebf b\u00e0o ung th\u01b0, s\u1ebd gi\u00fap vi\u1ec7c \u0111i\u1ec1u tr\u1ecb tr\u1edf n\u00ean hi\u1ec7u qu\u1ea3 v\u00e0 \u00edt g\u00e2y \u0111au \u0111\u1edbn h\u01a1n cho b\u1ec7nh nh\u00e2n.<\/p>\n

    N\u00f3i c\u00e1ch kh\u00e1c, chronotheraphy gi\u00fap x\u00e1c \u0111\u1ecbnh th\u1eddi gian thu\u1ed1c c\u00f3 th\u1ec3 t\u1ea5n c\u00f4ng v\u00e0o t\u1ebf b\u00e0o ung th\u01b0 nh\u01b0ng kh\u00f4ng g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1eefng t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh xung quanh. Nhi\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean doxorubicin v\u00e0 cisplatin cho th\u1ea5y s\u1eed d\u1ee5ng thu\u1ed1c t\u1ea1i c\u00e1c th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p gi\u00fap gi\u1ea3m \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c, t\u0103ng m\u1ee9c \u0111\u1ed9 dung n\u1ea1p v\u00e0 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb. Tuy nhi\u00ean, \u0111\u00e2y v\u1eabn \u0111ang l\u00e0 gi\u1ea3 thuy\u1ebft \u0111\u01b0\u1ee3c \u0111\u1eb7t ra \u1edf hi\u1ec7n t\u1ea1i, v\u1eabn ch\u01b0a c\u00f3 m\u1ed9t nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng n\u00e0o ch\u00ednh th\u1ee9c \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 v\u1ec1 m\u1ee9c \u0111\u1ed9 \u1ea3nh h\u01b0\u1edfng c\u1ee7a th\u1eddi gian u\u1ed1ng thu\u1ed1c \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0.<\/p>\n

    C\u00e1c b\u1ec7nh tim m\u1ea1ch:\u00a0<\/strong>C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t qu\u1ecb c\u0169ng ch\u1ecbu \u1ea3nh h\u01b0\u1edfng t\u1eeb nh\u1ecbp sinh h\u1ecdc. C\u00e1c c\u01a1n nh\u1ed3i m\u00e1u c\u00f3 xu h\u01b0\u1edbng x\u1ea3y ra v\u00e0o bu\u1ed5i s\u00e1ng, sau khi v\u1eeba th\u1ee9c d\u1eady. \u0110i\u1ec1u n\u00e0y c\u00f3 li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh t\u0103ng \u00e1p l\u1ef1c mao m\u1ea1ch, t\u0103ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u v\u00e0 gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng ti\u00eau s\u1ee3i huy\u1ebft th\u01b0\u1eddng di\u1ec5n ra v\u00e0o ban ng\u00e0y, v\u00e0 ch\u1eadm l\u1ea1i v\u00e0o ban \u0111\u00eam. C\u00e1c thu\u1ed1c tim m\u1ea1ch s\u1ebd hi\u1ec7u qu\u1ea3 nh\u1ea5t khi \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh t\u1ea1i th\u1eddi \u0111i\u1ec3m c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u00f3 xu h\u01b0\u1edbng d\u1ec5 x\u1ea3y ra nh\u1ea5t, th\u01b0\u1eddng l\u00e0 v\u00e0o \u0111\u1ea7u bu\u1ed5i s\u00e1ng khi huy\u1ebft \u00e1p t\u0103ng cao v\u00e0 c\u01a1n \u0111au th\u1eaft ng\u1ef1c d\u1ec5 b\u1ecb kh\u1edfi ph\u00e1t.<\/p>\n

    \"\"<\/p>\n

    Verapamil l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u1eb9n k\u00eanh canxi, \u00a0\u0111\u01b0\u1ee3c ph\u00f3ng th\u00edch 4-5 gi\u1edd sau khi u\u1ed1ng v\u00e0 duy tr\u00ec n\u1ed3ng \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh trong kho\u1ea3ng 18 gi\u1edd sau \u0111\u00f3. Khi d\u00f9ng v\u00e0o bu\u1ed5i t\u1ed1i, n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c s\u1ebd r\u01a1i v\u00e0o l\u00fac 4h s\u00e1ng \u0111\u1ebfn 12h tr\u01b0a h\u00f4m sau, t\u01b0\u01a1ng \u1ee9ng v\u1edbi kho\u1ea3ng th\u1eddi gian huy\u1ebft \u00e1p cao v\u00e0 nh\u1ecbp tim nhanh. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c tr\u00ean thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n quinapril cho th\u1ea5y, s\u1eed d\u1ee5ng thu\u1ed1c v\u00e0o bu\u1ed5i t\u1ed1i tr\u01b0\u1edbc khi ng\u1ee7 gi\u00fap \u1ee9c ch\u1ebf hi\u1ec7u qu\u1ea3 ACE (angiotensin converting enzyme) v\u00e0 gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch.<\/p>\n

    D\u00f9ng thu\u1ed1c theo nh\u1ecbp sinh h\u1ecdc c\u0169ng \u0111\u00f3ng g\u00f3p v\u00e0o s\u1ef1 ra \u0111\u1eddi v\u00e0 ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i thu\u1ed1c ph\u00f3ng th\u00edch ch\u1eadm, \u0111\u1ea3m b\u1ea3o n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c trong m\u00e1u \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh v\u00e0 th\u00edch h\u1ee3p v\u1edbi c\u00e1c chu k\u00ec sinh h\u1ecdc trong c\u01a1 th\u1ec3. Nh\u1eefng thu\u1ed1c c\u00f3 c\u01a1 ch\u1ebf ph\u00f3ng th\u00edch ho\u1ea1t ch\u1ea5t v\u00e0o m\u00e1u \u0111\u1eb7c bi\u1ec7t nh\u01b0 verapamil ng\u00e0y c\u00e0ng ch\u1ee9ng minh \u0111\u01b0\u1ee3c \u01b0u th\u1ebf c\u1ee7a m\u00ecnh trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng.<\/p>\n

    T\u1ed5ng k\u1ebft l\u1ea1i cho c\u00e2u h\u1ecfi \u1edf \u0111\u1ea7u b\u00e0i vi\u1ebft, vi\u1ec7c d\u00f9ng thu\u1ed1c \u0111\u00fang th\u1eddi \u0111i\u1ec3m \u0111\u00f3ng vai tr\u00f2 c\u1ef1c k\u00ec quan tr\u1ecdng trong hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh. V\u00ec c\u01a1 th\u1ec3 ch\u00fang ta ho\u1ea1t \u0111\u1ed9ng theo nh\u1ecbp sinh h\u1ecdc, s\u1ef1 c\u00f3 m\u1eb7t t\u1ea1i \u0111\u00fang th\u1eddi \u0111i\u1ec3m s\u1ebd gi\u00fap thu\u1ed1c t\u1ed1i \u0111a h\u00f3a hi\u1ec7u qu\u1ea3 v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng hay \u00a0t\u00e1c d\u1ee5ng ph\u1ee5. Chronotherapy v\u1eabn \u0111ang l\u00e0 m\u1ed9t l\u0129nh v\u1ef1c m\u1edbi, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0. Tuy v\u1eady, \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh l\u00fd th\u00f4ng th\u01b0\u1eddng kh\u00e1c, l\u1eddi khuy\u00ean t\u1ed1t nh\u1ea5t l\u00e0 b\u1ec7nh nh\u00e2n n\u00ean u\u1ed1ng thu\u1ed1c theo \u0111\u00fang ch\u1ec9 d\u1eabn c\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t.<\/p>\n

    Tham kh\u1ea3o:\u00a0healthline.com<\/a>\u00a0|\u00a0medicinenet.com<\/a>\u00a0|\u00a0medicaldaily.com<\/a>\u00a0|\u00a0medscape.com<\/a>\u00a0|\u00a0idosi.org<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Theo Namudinsider Thu\u1ed1c d\u00f9ng \u0111\u1ec3 ch\u1eefa ho\u1eb7c ph\u00f2ng b\u1ec7nh, nh\u01b0ng n\u1ebfu b\u1ec7nh nh\u00e2n v\u00f4 t\u00ecnh qu\u00ean ho\u1eb7c kh\u00f4ng th\u1ec3 tu\u00e2n th\u1ee7 theo \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u00e1c s\u0129 th\u00ec c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng. \u0110\u1eb7c bi\u1ec7t, \u0111\u1ed1i v\u1edbi nh\u1eefng d\u00f2ng thu\u1ed1c nh\u01b0 kh\u00e1ng sinh, thu\u1ed1c kh\u00e1ng \u0111\u00f4ng, thu\u1ed1c tr\u00e1nh thai, thu\u1ed1c tr\u1ecb […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[373],"tags":[],"class_list":["post-11036","post","type-post","status-publish","format-standard","hentry","category-duoc-lam-sang"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11036","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=11036"}],"version-history":[{"count":1,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11036\/revisions"}],"predecessor-version":[{"id":11038,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11036\/revisions\/11038"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=11036"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=11036"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=11036"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}