{"id":18791,"date":"2020-05-29T11:20:29","date_gmt":"2020-05-29T04:20:29","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=18791"},"modified":"2025-01-08T20:58:58","modified_gmt":"2025-01-08T13:58:58","slug":"citalopram-cinasav","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/citalopram-cinasav\/","title":{"rendered":"Citalopram &#8211; Cinasav"},"content":{"rendered":"<p><strong>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: <\/strong><\/p>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <a href=\"https:\/\/pharmog.com\/wp\/citalopram\/\">Citalopram<\/a><\/strong><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u00f4\u0301c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin ch\u1ecdn l\u1ecdc (SSRIs)<\/em><\/p>\n<p><strong><em>Nh\u00f3m<\/em><\/strong> <strong><em>ph\u00e1p l\u00fd: <\/em><\/strong><em>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n<p><strong><em>M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): N06AB04.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong><\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c:<\/em><\/strong> Cinasav<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: C\u00f4ng ty c\u1ed5 ph\u1ea7n d\u01b0\u1ee3c ph\u1ea9m SaVi.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng: <\/strong><\/p>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Vi\u00ean n\u00e9n 20 mg.<\/p>\n<p><strong><em>Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong><em>CINASAV 10MG<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i vi\u00ean n\u00e9n bao phim c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Citalopram<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>10 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"442\" height=\"315\" class=\"wp-image-18792\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/05\/word-image-394.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/05\/word-image-394.png 442w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/05\/word-image-394-300x214.png 300w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/05\/word-image-394-225x160.png 225w\" sizes=\"auto, (max-width: 442px) 100vw, 442px\" \/><\/p>\n<p><strong>3. Video by Pharmog:<\/strong><\/p>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<p><strong>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng: <\/strong><\/p>\n<p><strong>4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Citalopram hydrobromid \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb tr\u1ea7m c\u1ea3m.<\/p>\n<p>Hi\u1ec7u qu\u1ea3 c\u1ee7a Citalopram trong \u0111i\u1ec1u tr\u1ecb tr\u1ea7m c\u1ea3m \u0111\u01b0\u1ee3c ch\u1ee9ng minh qua c\u00e1c th\u1eed nghi\u1ec7m c\u00f3 ki\u1ec3m so\u00e1t k\u00e9o d\u00e0i 4-6 tu\u1ea7n \u1edf c\u00e1c b\u1ec7nh nh\u00e2n ngo\u1ea1i tr\u00fa cho th\u1ea5y thu\u1ed1c \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi c\u00e1c th\u1ec3 lo\u1ea1i c\u1ee7a r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m n\u1eb7ng DSM-III v\u00e0 DSM-III-R (DSM: Diagnostic and Statistical Manual of Mental Dis Orders).<\/p>\n<p>T\u00e1c d\u1ee5ng ch\u1ed1ng tr\u1ea7m c\u1ea3m c\u1ee7a Citalopram \u1edf b\u1ec7nh nh\u00e2n tr\u1ea7m c\u1ea3m ph\u1ea3i nh\u1eadp vi\u1ec7n ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u0111\u1ea7y \u0111\u1ee7. Hi\u1ec7u qu\u1ea3 c\u1ee7a Citalopram trong vi\u1ec7c duy trl m\u1ed9t \u0111\u00e1p \u1ee9ng ch\u1ed1ng tr\u1ea7m c\u1ea3m cho \u0111\u1ebfn 24 tu\u1ea7n sau 6-8 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb c\u1ea5p t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong hai th\u1eed nghi\u1ec7m c\u00f3 ki\u1ec3m so\u00e1t v\u1edbi gi\u00e0 d\u01b0\u1ee3c. Tuy nhi\u00ean, n\u1ebfu \u0111\u00e3 ch\u1ecdn vi\u1ec7c s\u1eed d\u1ee5ng Citalopram l\u00e2u d\u00e0i, n\u00ean \u0111\u1ecbnh k\u1ef3 \u0111\u00e1nh gi\u00e1 l\u1ea1i t\u00ednh h\u1eefu \u00edch c\u1ee7a thu\u1ed1c \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n.<\/p>\n<p><strong>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/strong><\/p>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>D\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng. Citalopram n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y, v\u00e0o bu\u1ed5i s\u00e1ng ho\u1eb7c bu\u1ed5i t\u1ed1i, c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 th\u1ee9c \u0103n.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p><em>Ng\u01b0\u1eddi l\u1edbn:<\/em><\/p>\n<p>Li\u1ec1u \u0111i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u<\/p>\n<p>Li\u1ec1u kh\u1edfi \u0111\u1ea7u citalopram chl n\u00ean d\u00f9ng l\u00e0 20 mg m\u1ed7i ng\u00e0y, th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 t\u0103ng t\u1edbi m\u1ee9c li\u1ec1u 40 mg\/ng\u00e0y.<\/p>\n<p>Vi\u1ec7c t\u0103ng li\u1ec1u th\u01b0\u1eddng \u00e1p d\u1ee5ng l\u00e0 m\u1ed9t tu\u1ea7n kh\u00f4ng \u0111\u01b0\u1ee3c t\u0103ng qu\u00e1 20 mg. M\u1eb7c d\u00f9 v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n \u0111\u1ebfn li\u1ec1u 60 mg\/ng\u00e0y, nh\u01b0ng m\u1ed9t nghi\u00ean c\u1ee9u v\u1ec1 \u0111\u00e1p \u1ee9ng li\u1ec1u \u0111\u1ed1i v\u1edbi hi\u1ec7u qu\u1ea3 \u0111\u00e3 kh\u00f4ng ch\u1ee9ng minh \u0111\u01b0\u1ee3c khi d\u00f9ng 60 mg\/ng\u00e0y c\u00f3 l\u1ee3i hem so v\u1edbi li\u1ec1u 40 mg\/ng\u00e0y; do \u0111\u00f3 li\u1ec1u tr\u00ean 40 mg th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb cho nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u1eb7c bi\u1ec7t<\/em><\/p>\n<p>Li\u1ec1u 20 mg\/ng\u00e0y l\u00e0 li\u1ec1u khuy\u1ebfn c\u00e1o cho h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i v\u00e0 b\u1ec7nh nh\u00e2n suy gan.<\/p>\n<p>Li\u1ec1u chu\u1ea9n l\u00ean \u0111\u1ebfn 40 mg\/ng\u00e0y ch\u1ec9 d\u00f9ng cho b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c.<\/p>\n<p>Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho b\u1ec7nh nh\u00e2n suy th\u1eadn t\u1eeb nh\u1eb9 ho\u1eb7c trung b\u00ecnh. Citalopram n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng.<\/p>\n<p>Theo khuy\u1ebfn c\u00e1o c\u1ee7a c\u01a1 quan FDA M\u1ef9:<\/p>\n<p>Citalopram kh\u00f4ng n\u00ean d\u00f9ng li\u1ec1u cao h\u01a1n 20 mg\/ng\u00e0y \u1edf ng\u01b0\u1eddi tr\u00ean 60 tu\u1ed5i v\u00ec l\u00fd do g\u00e2y gia t\u0103ng nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3. C\u1ea3nh b\u00e1o \u0111\u1eb7c bi\u1ec7t: Ch\u00ec n\u00ean d\u00f9ng li\u1ec1u th\u1ea5p 20 mg cho b\u1ec7nh nh\u00e2n tr\u00ean 60 tu\u1ed5i.<\/p>\n<p>Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng citalopram \u1edf b\u1ea5t c\u1ee9 li\u1ec1u n\u00e0o cho m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ecdp tr\u1ea7m c\u1ea3m v\u00ec nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 c\u1ea3nh b\u00e1o n\u00e0y c\u00f3 th\u1ec3 c\u00f2n quan tr\u1ecdng h\u01a1n \u0111\u1ed5i v\u1edbi b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i b\u1ecb tr\u1ea7m c\u1ea3m.<\/p>\n<p>Citalopram kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng li\u1ec1u tr\u00ean 40 mg\/ng\u00e0y v\u00ec l\u00fd do k\u00e9o d\u00e0i kho\u1ea3ng QT v\u00e0 kh\u00f4ng mang l\u1ea1i l\u1ee3i \u00edch g\u00ec th\u00eam (v\u00ec kh\u00f4ng t\u0103ng th\u00eam hi\u1ec7u qu\u1ea3 ch\u1ed1ng tr\u1ea7m c\u1ea3m).<\/p>\n<p>Kh\u00f4ng d\u00f9ng cho b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng k\u00e9o d\u00e0i QT b\u1ea9m sinh, b\u1ec7nh nh\u00e2n b\u1ecb nh\u1ecbp tim ch\u1eadm, n\u1ed3ng \u0111\u1ed9 kali v\u00e0 magnesi trong m\u00e1u th\u1ea5p, b\u1ec7nh nh\u00e2n m\u1edbi b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p v\u00e0 b\u1ec7nh nh\u00e2n b\u1ecb suy tim m\u1ea5t b\u00f9.<\/p>\n<p>Citalopram c\u0169ng kh\u00f4ng d\u00f9ng cho b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng \u0111\u1ed3ng th\u1eddi m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y k\u00e9o d\u00e0i kho\u1ea3ng QT.<\/p>\n<p>Li\u1ec1u t\u1ed1i \u0111a citalopram 20 mg\/ng\u00e0y d\u00f9ng cho b\u1ec7nh nh\u00e2n suy gan, b\u1ec7nh nh\u00e2n tr\u00ean 60 tu\u1ed5i, b\u1ec7nh nh\u00e2n c\u00f3 \u00edt l\u01b0\u1ee3ng enzym cytochrom chuy\u1ec3n h\u00f3a CYP2C19 ho\u1eb7c c\u00e1c enzym \u1ee9c ch\u1ebf CYP2C19 kh\u00e1c, ho\u1eb7c b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng cimetidin. L\u00fd do: V\u00ec \u0111\u00e2y l\u00e0 c\u00e1c y\u1ebfu t\u1ed1 d\u1eabn \u0111\u1ebfn gia t\u0103ng n\u1ed3ng \u0111\u1ed9 citalopram trong m\u00e1u s\u1ebd d\u1eabn \u0111\u1ebfn gia t\u0103ng kho\u1ea3ng QT v\u00e0 g\u00e2y xo\u1eafn \u0111\u1ec9nh.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb cho ph\u1ee5 n\u1eef mang thai 3 th\u00e1ng cu\u1ed1i thai k\u1ef3<\/em><\/p>\n<p>Tr\u1ebb s\u01a1 sinh ti\u1ebfp x\u00fac v\u1edbi citalopram v\u00e0 c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin c\u00f3 ch\u1ecdn l\u1ecdc (SSRI: Selective Serotonin Reuptake Inhibitor) ho\u1eb7c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin &#8211; norepinephrin (SNRI: Serotonin<\/p>\n<p>Norepinephrine Reuptake Inhibitor) kh\u00e1c v\u00e0o 3 th\u00e1ng cu\u1ed1i, \u0111\u00e3 bi\u1ec3u hi\u1ec7n nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ea7n ph\u1ea3i n\u1eb1m vi\u1ec7n k\u00e9o d\u00e0i, h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p v\u00e0 nu\u00f4i \u0103n b\u1eb1ng \u1ed1ng. Khi \u0111i\u1ec1u tr\u1ecb cho ph\u1ee5 n\u1eef mang thai v\u1edbi citalopram trong 3 th\u00e1ng cu\u1ed1i, n\u00ean xem x\u00e9t c\u1ea9n th\u1eadn c\u00e1c r\u1ee7i ro ti\u1ec1m \u1ea9n v\u00e0 l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb. C\u00f3 th\u1ec3 xem x\u00e9t vi\u1ec7c gi\u1ea3m d\u1ea7n citalopram trong 3 th\u00e1ng cu\u1ed1i thai k\u1ef3.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb duy tr\u00ec<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb duy tr\u00ec th\u01b0\u1eddng ch\u00ec ph\u00f9 h\u1ee3p khi c\u00f3 c\u00e1c \u0111\u1ee3t c\u1ea5p c\u1ee7a b\u1ec7nh tr\u1ea7m c\u1ea3m c\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u00e0i th\u00e1ng ho\u1eb7c l\u00e2u h\u01a1n. Hi\u1ec7u qu\u1ea3 ch\u1ed1ng tr\u1ea7m c\u1ea3m c\u1ee7a citalopram \u0111\u01b0\u1ee3c duy tr\u00ec \u1eebong kho\u1ea3ng th\u1eddi gian l\u00ean \u0111\u1ebfn 24 tu\u1ea7n sau 6 ho\u1eb7c 8 tu\u1ea7n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb (t\u1ed5ng c\u1ed9ng 32 tu\u1ea7n).<\/p>\n<p><em>Tr\u1ebb em<\/em><\/p>\n<p>An to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 \u1edf \u1eeb\u1ebb em ch\u01b0a \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp<\/p>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>B\u1ec7nh nh\u00e2n qu\u00e1 m\u1eabn v\u1edbi citalopram ho\u1eb7c v\u1edbi b\u1ea5t c\u1ee9 th\u00e0nh ph\u1ea7n n\u00e0o kh\u00e1c c\u1ee7a thu\u1ed1c.<\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi cho b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf monoamin oxidase (MAO).<\/p>\n<p>D\u00f9ng li\u1ec1u citalopram cao h\u01a1n 20 mg\/ng\u00e0y \u1edf ng\u01b0\u1eddi tr\u00ean 60 tu\u1ed5i v\u00ec l\u00fd do g\u00e2y gia t\u0103ng nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/p>\n<p>D\u00f9ng citalopram \u1edf b\u1ea5t c\u1ee9 li\u1ec1u n\u00e0o cho m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p tr\u1ea7m c\u1ea3m v\u00ec nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3, nh\u1ea5t l\u00e0 v\u1edbi b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i b\u1ecb tr\u1ea7m c\u1ea3m ho\u1eb7c b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng k\u00e9o d\u00e0i QT b\u1ea9m sinh, b\u1ec7nh nh\u00e2n b\u1ecb nh\u1ecbp tim ch\u1eadm, n\u1ed3ng \u0111\u1ed9 kali v\u00e0 magnesi trong m\u00e1u th\u1ea5p, b\u1ec7nh nh\u00e2n m\u1edbi b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p v\u00e0 b\u1ec7nh nh\u00e2n b\u1ecb suy tim m\u1ea5t b\u00f9.<\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng \u0111\u1ed3ng th\u1eddi m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y k\u00e9o d\u00e0i kho\u1ea3ng QT.<\/p>\n<p>D\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi cimetidin, r\u01b0\u1ee3u<\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p><em>Kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c v\u00f3i c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf monoamin oxidase<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 c\u00e1c b\u00e1o c\u00e1o v\u1ec1 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng, \u0111\u00f4i khi g\u00e2y t\u1eed vong x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin (SSRI) \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf MAO, trong \u0111\u00f3 bao g\u1ed3m c\u00e1c ph\u1ea3n \u1ee9ng t\u0103ng th\u00e2n nhi\u1ec7t, c\u1ee9ng \u0111\u01a1, gi\u1eadt rung c\u01a1, b\u1ea5t \u1ed5n \u0111\u1ecbnh h\u1ec7 th\u1ea7n kinh t\u1ef1 ch\u1ee7 v\u1edbi nh\u1eefng bi\u1ebfn \u0111\u1ed9ng nhanh c\u00f3 th\u1ec3 c\u00f3 v\u1ec1 th\u1ec3 ch\u1ea5t v\u00e0 nh\u1eefng thay \u0111\u1ed5i tr\u1ea1ng th\u00e1i t\u00e2m th\u1ea7n bao g\u1ed3m k\u00edch \u0111\u1ed9ng c\u1ef1c \u0111oan ti\u1ebfn tri\u1ec3n \u0111\u1ebfn m\u00ea s\u1ea3ng v\u00e0 h\u00f4n m\u00ea.<\/p>\n<p>Nh\u1eefng ph\u1ea3n \u1ee9ng n\u00e0y c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ng\u01b0ng \u0111i\u1ec1u tr\u1ecb SSRI v\u00e0 b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng thu\u00f4c \u1ee9c ch\u1ebf MAO. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 cho th\u1ea5y c\u00e1c t\u00e1c \u0111\u1ed9ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 h\u1ed9i ch\u1ee9ng \u00e1c t\u00ednh do thu\u1ed1c an th\u1ea7n (NMS: Neuroleptic Malignant Syndrome).<\/p>\n<p>H\u01a1n n\u1eefa, d\u1eef li\u1ec7u h\u1ea1n ch\u1ebf trong nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p c\u00e1c thu\u1ed1c SSRI v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf MAO g\u1ee3i \u00fd r\u1eb1ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y ph\u1ed1i h\u1ecdp c\u00f3 th\u1ec3 l\u00e0m t\u0103ng huy\u1ebft \u00e1p v\u00e0 k\u00edch th\u00edch h\u00e0nh vi. Do \u0111\u00f3 c\u00f3 khuy\u1ebfn c\u00e1o l\u00e0 Citalopram kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t thu\u1ed1c \u1ee9c ch\u1ebf MAO ho\u1eb7c trong v\u00f2ng 14 ng\u00e0y k\u1ec3 t\u1eeb khi ng\u1eebng \u0111i\u1ec1u tr\u1ecb m\u1ed9t thu\u1ed1c \u1ee9c ch\u1ebf MAO. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 v\u1eady, c\u1ea7n \u00edt nh\u1ea5t 14 ng\u00e0y sau khi ng\u1eebng Citalopram m\u1edbi \u0111\u01b0\u1ee3c ph\u00e9p s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf MAO.<\/p>\n<p><em>T\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng x\u1ea5u \u0111i v\u00e0 nguy c\u01a1 t\u1ef1 t\u1eed<\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m n\u1eb7ng, c\u1ea3 ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em, b\u1ec7nh c\u1ea3nh tr\u1ea7m c\u1ea3m c\u00f3 th\u1ec3 x\u1ea5u \u0111i v\u00e0\/ho\u1eb7c xu\u1ea5t hi\u1ec7n \u00fd \u0111\u1ecbnh v\u00e0 h\u00e0nh vi t\u1ef1 s\u00e1t, d\u00f9 c\u00f3 ho\u1eb7c kh\u00f4ng d\u00f9ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00e0 nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 k\u00e9o d\u00e0i cho \u0111\u1ebfn khi b\u1ec7nh thuy\u00ean gi\u1ea3m \u0111\u00e1ng k\u1ec3, nguy\u00ean nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd bi\u1ec3u hi\u1ec7n b\u1ec7nh \u0111ang x\u1ea5u \u0111i, \u00fd \u0111\u1ecbnh v\u00e0 h\u00e0nh vi t\u1ef1 s\u00e1t, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u00e0o l\u00fac kh\u1edfi \u0111\u1ea7u qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u00e0ng thu\u1ed1c ho\u1eb7c t\u1ea1i th\u1eddi \u0111i\u1ec3m thay \u0111\u1ed5i (t\u0103ng ho\u1eb7c gi\u1ea3m) li\u1ec1u.<\/p>\n<p>V\u00ec kh\u1ea3 n\u0103ng g\u00e2y b\u1ec7nh c\u00f9ng l\u00fac gi\u1eefa c\u00e1c ch\u1ee9ng r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m n\u1eb7ng v\u00e0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n ho\u1eb7c r\u1ed1i lo\u1ea1n kh\u00f4ng do t\u00e2m th\u1ea7n, c\u1ea7n th\u1eadn \u1eeb\u1ecdng quan s\u00e1t tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 lo \u00e2u, k\u00edch \u0111\u1ed9ng, c\u01a1n ho\u1ea3ng lo\u1ea1n, m\u1ea5t ng\u1ee7, kh\u00f3 ch\u1ecbu, d\u1ec5 th\u00f9 \u0111\u1ecbch (g\u00e2y h\u1ea5n) b\u1ed1c \u0111\u1ed3ng, ng\u1ed3i\/n\u1eb1m kh\u00f4ng y\u00ean (t\u00e2m th\u1ea7n b\u1ea5t an), h\u01b0ng c\u1ea3m nh\u1eb9 v\u00e0 c\u01a1n h\u01b0ng c\u1ea3m, \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m cho ch\u1ee9ng r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m n\u1eb7ng c\u0169ng nh\u01b0 \u0111\u1ed1i v\u1edbi c\u00e1c chi \u0111\u1ecbnh kh\u00e1c, k\u1ec3 c\u00e0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n v\u00e0 r\u1ed1i lo\u1ea1n kh\u00f4ng do t\u00e2m th\u1ea7n. C\u1ea7n xem x\u00e9t \u0111\u1ec3 thay \u0111\u1ed5i ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb, trong \u0111\u00f3 c\u00f3 th\u1ec3 ng\u1eebng thu\u1ed1c, \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh x\u1ea5u \u0111i, n\u1ebfu quy\u1ebft \u0111\u1ecbnh ng\u1eebng \u0111i\u1ec1u tr\u1ecb, vi\u1ec7c d\u00f9ng thu\u1ed1c n\u00ean gi\u1ea3m d\u1ea7n, v\u00ec ng\u01b0ng \u0111\u1ed9t ng\u1ed9t c\u00f3 th\u1ec3 c\u00f3 li\u00ean quan t\u1edbi m\u1ed9t v\u00e0i tri\u1ec7u ch\u1ee9ng cai thu\u1ed1c<\/p>\n<p><strong><em>Th\u00e2n tr\u1ecdng<\/em><\/strong><\/p>\n<p><em>Ng\u01b0ng \u0111i\u1ec1u tr\u1ecb v\u1edbi Citalopram<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 x\u1ea3y ra sau khi Citalopram, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi ng\u01b0ng \u0111\u1ed9t ng\u1ed9t, bao g\u1ed3m nh\u1eefng bi\u1ec3u hi\u1ec7n sau \u0111\u00e2y: t\u00e2m tr\u1ea1ng b\u1ea5t an, d\u1ec5 c\u00e1u g\u1eaft, lo \u00e2u, ch\u00f3ng m\u1eb7t, r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c (v\u00ed d\u1ee5 d\u1ecb c\u1ea3m nh\u01b0 c\u00f3 c\u1ea3m gi\u00e1c \u0111i\u1ec7n gi\u1eadt), lo l\u1eafng, hoang mang, \u0111au \u0111\u1ea7u, h\u00f4n m\u00ea, r\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac, m\u1ea5t ng\u1ee7 v\u00e0 h\u01b0ng c\u1ea3m nh\u1eb9. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i c\u00e1c tri\u1ec7u ch\u1ee9ng khi ng\u01b0ng \u0111i\u1ec1u tr\u1ecb v\u1edbi Citalopram. N\u00ean gi\u1ea3m li\u1ec1u d\u1ea7n s\u1ebd t\u1ed1t h\u01a1n l\u00e0 ng\u01b0ng thu\u1ed1c \u0111\u1ed9t ng\u1ed9t. N\u1ebfu x\u1ea3y ra tri\u1ec7u ch\u1ee9ng kh\u00f4ng dung n\u1ea1p sau khi gi\u1ea3m li\u1ec1u ho\u1eb7c sau khi ng\u01b0ng \u0111i\u1ec1u tr\u1ecb, n\u00ean xem x\u00e9t s\u1eed d\u1ee5ng l\u1ea1i li\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh tr\u01b0\u1edbc \u0111\u00f3, r\u1ed3i ti\u1ebfp t\u1ee5c gi\u1ea3m li\u1ec1u nh\u01b0ng v\u1edbi t\u1ed1c \u0111\u1ed9 ch\u1eadm h\u01a1n<\/p>\n<p><em>Ch\u1ea3y m\u00e1u b\u1ea5t th\u01b0\u00f2ng<\/em><\/p>\n<p>Trong c\u00e1c b\u00e1o c\u00e1o \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 \u0111\u00e3 ghi nh\u1eadn c\u00f3 s\u1ef1 xu\u1ea5t hi\u1ec7n xu\u1ea5t huy\u1ebft \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c h\u01b0\u1edbng th\u1ea7n \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc ti\u1ebfp theo \u0111\u00e3 x\u00e1c minh \u0111\u01b0\u1ee3c m\u1ed1i quan h\u1ec7 gi\u1eefa vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c h\u01b0\u1edbng th\u1ea7n \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin v\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c c\u1ea3nh b\u00e1o v\u1ec1 nguy c\u01a1 ch\u1ea3y m\u00e1u khi s\u1eed d\u1ee5ng k\u1ebft h\u1ecdp Citalopram \u0111\u1ed3ng th\u1eddi v\u1edbi thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng Steroid (NSAID: non-steroidal anti-inflammatory drug), aspirin ho\u1eb7c c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn \u0111\u00f4ng m\u00e1u.<\/p>\n<p><em>H\u1ea1 natri m\u00e1u<\/em><\/p>\n<p>M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p h\u1ea1 natri m\u00e1u v\u00e0 ch\u1ee9ng t\u0103ng ti\u1ebft hormon ch\u1ed1ng b\u00e0i ni\u1ec7u kh\u00f4ng ph\u00f9 h\u1ecdp (SIADH: Syndrome of inappropriate antidiuretic hormone) \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi Citalopram. T\u1ea5t c\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n n\u00e0y c\u1ea7n ph\u1ea3i ng\u01b0ng Citalopram v\u00e0\/ho\u1eb7c c\u1ea7n s\u1ef1 can thi\u1ec7p c\u1ee7a y t\u1ebf.<\/p>\n<p><em>K\u00edch ho\u1ea1t c\u01a1n h\u01b0ng c\u1ea3m<\/em><\/p>\n<p>Trong c\u00e1c th\u1eed nghi\u1ec7m c\u1ee7a Citalopram, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n trong \u0111\u00f3 bao g\u1ed3m nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n l\u01b0\u1ee1ng c\u1ef1c \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 c\u00f3 t\u00ecnh tr\u1ea1ng k\u00edch ho\u1ea1t c\u01a1n h\u01b0ng c\u1ea3m nh\u1eb9 v\u1edbi t\u1ef7 l\u1ec7 0,2% trong s\u1ed1 1063 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Citalopram v\u00e0 kh\u00f4ng ai trong s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c nh\u1eadn gi\u1ea3 d\u01b0\u1ee3c b\u1ecb tri\u1ec7u ch\u1ee9ng n\u00e0y. K\u00edch ho\u1ea1t c\u01a1n h\u01b0ng c\u1ea3m c\u0169ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 chi\u1ebfm m\u1ed9t t\u1ef7 l\u1ec7 nh\u1ecf \u1edf c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m kh\u00e1c tr\u00ean th\u1ecb tr\u01b0\u1eddng. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c ch\u1ed1ng \u01b0\u1ea7m c\u1ea3m, Citalopram n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed h\u01b0ng c\u1ea3m (\u0111i\u00ean\/cu\u1ed3ng).<\/p>\n<p><em>C\u01a1n \u0111\u1ed9ng kinh<\/em><\/p>\n<p>M\u1eb7c d\u00f9 t\u00e1c d\u1ee5ng ch\u1ed1ng co gi\u1eadt c\u1ee7a Citalopram \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y trong c\u00e1c nghi\u00ean c\u1ee9u \u1eeb\u00ean \u0111\u1ed9ng v\u1eadt, nh\u01b0ng Citalopram v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u1edf b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n co gi\u1eadt. Trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u1ee7a Citalopram, co gi\u1eadt \u0111\u00e3 x\u1ea3y ra \u1edf 0,3% s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Citalopram v\u00e0 0,5% s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c nh\u1eadn gi\u1ea3 d\u01b0\u1ee3c. Gi\u1ed1ng nh\u01b0 c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m kh\u00e1c, Citalopram ph\u1ea3i s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed r\u1ed1i lo\u1ea1n co gi\u1eadt.<\/p>\n<p><em>S\u1eed d\u1ee5ng \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p>Kinh nghi\u1ec7m l\u00e2m s\u00e0ng c\u1ee7a Citalopram c\u00f2n gi\u1edbi h\u1ea1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc k\u00e8m m\u1ed9t s\u1ed1 b\u1ec7nh to\u00e0n th\u00e2n \u0111\u1ed3ng th\u1eddi. Khuy\u1ebfn c\u00e1o th\u1eadn tr\u1ecdng s\u1eed d\u1ee5ng Citalopram cho b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh ho\u1eb7c c\u00f3 \u0111i\u1ec1u ki\u1ec7n l\u00e0m thay \u0111\u1ed5i c\u01a1 ch\u1ebf hao \u0111\u1ed5i ch\u1ea5t ho\u1eb7c c\u00f3 ph\u1ea3n \u1ee9ng tr\u00ean huy\u1ebft \u0111\u1ed9ng. Citalopram ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed nh\u1ed3i m\u00e1u c\u01a1 tim g\u1ea7n \u0111\u00e2y ho\u1eb7c b\u1ec7nh tim kh\u00f4ng \u1ed5n \u0111\u1ecbnh<\/p>\n<p>V\u1edbi c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ecb suy gan, \u0111\u1ed9 thanh th\u1ea3i Citalopram gi\u1ea3m v\u00e0 n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng t\u0103ng l\u00ean. Vi\u1ec7c s\u1eed d\u1ee5ng Citalopram \u1edf b\u1ec7nh nh\u00e2n suy gan c\u1ea7n \u0111\u01b0\u1ee3c th\u1eadn h\u1ecdng v\u00e0 khuy\u1ebfn c\u00e1o d\u00f9ng li\u1ec1u t\u1ed1i \u0111a th\u1ea5p nh\u1ea5t<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>Do b\u1ea5t k\u1ef3 lo\u1ea1i thu\u1ed1c h\u01b0\u1edbng th\u1ea7n n\u00e0o c\u0169ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 ph\u00e1n \u0111o\u00e1n, kh\u1ea3 n\u0103ng t\u01b0 duy, kh\u1ea3 n\u0103ng ho\u1ea1t \u0111\u1ed9ng, n\u00ean b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c c\u1ea3nh b\u00e1o l\u00e0 kh\u00f4ng n\u00ean v\u1eadn h\u00e0nh m\u00e1y m\u00f3c nguy hi\u1ec3m, bao g\u1ed3m \u00f4 t\u00f4, cho \u0111\u1ebfn khi \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 li\u1ec7u ph\u00e1p Citalopram kh\u00f4ng c\u00f2n \u1ea3nh h\u01b0\u1eddng \u0111\u1ebfn kh\u1ea3 n\u0103ng c\u1ee7a m\u00ecnh \u0111\u1ec3 tham gia v\u00e0o c\u00e1c ho\u1ea1t \u0111\u1ed9ng nh\u01b0 v\u1eady.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/strong><\/p>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: C<\/p>\n<p>US FDA pregnancy category: C<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Trong c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt, Citalopram \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i tr\u00ean s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u00f4i\/b\u00e0o thai v\u00e0 sau sinh, bao g\u1ed3m c\u00e0 c\u00e1c hi\u1ec7u \u1ee9ng g\u00e2y qu\u00e1i thai, khi d\u00f9ng v\u1edbi li\u1ec1u cao h\u01a1n li\u1ec1u \u0111i\u1ec1u tr\u1ecb c\u1ee7a ng\u01b0\u1eddi.<\/p>\n<p>Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u \u0111\u1ea7y \u0111\u1ee7 v\u00e0 c\u1ecf ki\u1ec3m so\u00e1t \u1edf ph\u1ee5 n\u1eef c\u00f3 thai; do \u0111\u00f3, ch\u1ec9 n\u00ean s\u1eed d\u1ee5ng Citalopram trong qu\u00e1 tr\u00ecnh mang thai khi l\u1ee3i \u00edch cao h\u01a1n h\u1eb3n nguy c\u01a1 ti\u1ec1m \u1ea9n \u0111\u1ed1i v\u1edbi thai nhi.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Nh\u01b0 \u0111\u00e3 x\u1ea3y ra v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00e1c, Citalopram c\u00f3 b\u00e0i ti\u1ebft qua s\u1eefa m\u1eb9. Quy\u1ebft \u0111\u1ecbnh c\u00f3 n\u00ean ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb hay kh\u00f4ng ho\u1eb7c ng\u01b0ng cho con b\u00fa t\u00f9y thu\u1ed9c v\u00e0o nguy c\u01a1 \u0111\u1ed1i v\u1edbi \u1edf tr\u1ebb s\u01a1 sinh ho\u1eb7c c\u00e1c l\u1ecdn \u00edch \u1eebong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb Citalopram cho m\u1eb9.<\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng M\u1ed1i quan h\u1ec7 ti\u1ec1m \u1ea9n gi\u1eefa c\u00e1c li\u1ec1u u\u1ed1ng Citalopram v\u1edbi t\u1ef3 l\u1ec7 m\u1eafc c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m tra trong m\u1ed9t nghi\u00ean c\u1ee9u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1ea7m c\u1ea3m nh\u1eadn gi\u00e0 d\u01b0\u1ee3c ho\u1eb7c nh\u1eadn Citalopram \u1edf li\u1ec1u 10, 20, 40, v\u00e0 60 mg. Th\u1eed nghi\u1ec7m cho th\u1ea5y c\u00f3 \u0111\u00e1p \u1ee9ng t\u00edch c\u1ef1c v\u1edbi li\u1ec1u (p &lt;0,05) v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 sau \u0111\u00e2y: m\u1ec7t m\u1ecfi, b\u1ea5t l\u1ef1c, m\u1ea5t ng\u1ee7, t\u0103ng \u0111\u1ed5 m\u1ed3 h\u00f4i, bu\u1ed3n ng\u1ee7 v\u00e0 ng\u00e1p.<\/p>\n<p><em>Thay \u0111\u1ed5i th\u1ec3 tr\u1ecdng<\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng citalopram trong c\u00e1c th\u1eed nghi\u1ec7m c\u00f3 b\u1ecb gi\u1ea3m tr\u1ecdng l\u01b0\u1ee3ng kho\u1ea3ng 0,5 kg so v\u1edbi b\u1ec7nh nh\u00e2n d\u00f9ng g\u1ec9a d\u01b0\u1ee3c c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng kh\u00f4ng b\u1ecb thay \u0111\u1ed5i.<\/p>\n<p>Ph\u00e2n lo\u1ea1i t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i Ph\u1ed5 bi\u1ebfn&gt; 10%<\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: 1% \u0111\u1ebfn &lt; 10% \u00edt g\u1eb7p: 0,1% \u0111\u1ebfn &lt; 1%<\/p>\n<p>Hi\u1ebfm g\u1eb7p: 0,01% \u0111\u1ebfn &lt; 0,1%<\/p>\n<p>R\u1ea5t hi\u1ebfm g\u1eb7p: &lt; 0,01%<\/p>\n<p>Kh\u00f4ng r\u00f5 (t\u1ea7n su\u1ea5t kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c).<\/p>\n<p>Tim m\u1ea1ch<\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Nh\u1ecbp tim nhanh, t\u1ee5t huy\u1ebft \u00e1p th\u1ebf \u0111\u1ee9ng, h\u1ea1 huy\u1ebft \u00e1p.<\/p>\n<p>\u00edt g\u1eb7p: T\u0103ng huy\u1ebft \u00e1p, nh\u1ecbp tim ch\u1eadm, ph\u00f9 (chi), \u0111au th\u1eaft ng\u1ef1c, ngo\u1ea1i t\u00e2m thu, suy tim, \u0111\u1ecf b\u1eebng m\u1eb7t, nh\u1ed3i m\u00e1u c\u01a1 tim, tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: C\u01a1n thi\u1ebfu m\u00e1u tho\u00e1ng qua, vi\u00eam t\u0129nh m\u1ea1ch, rung nh\u0129, ng\u1eebng tim, block nh\u00e1nh.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n h\u00ea th\u1ea7n kinh trung \u01b0\u01a1ng v\u00e0 ngo\u1ea1i vi <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: D\u1ecb c\u1ea3m, \u0111au n\u1eeda \u0111\u1ea7u.<\/p>\n<p>\u00edt g\u1eb7p: T\u0103ng\/hi\u00e9u \u0111\u1ed9ng, ch\u00f3ng m\u1eb7t, t\u0103ng tr\u01b0\u01a1ng l\u1ef1c, r\u1ed1i lo\u1ea1n ngo\u1ea1i th\u00e1p, chu\u1ed9t r\u00fat ch\u00e2n, co th\u1eaft c\u01a1 b\u1eafp t\u1ef1 ph\u00e1t, t\u0103ng \u0111\u1ed9ng, \u0111au th\u1ea7n kinh, lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c, d\u00e1ng \u0111i b\u1ea5t th\u01b0\u1eddng, gi\u1ea3m c\u1ea3m gi\u00e1c, m\u1ea5t \u0111i\u1ec1u h\u00f2a.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: B\u1ea5t th\u01b0\u1eddng ph\u1ed1i h\u1ee3p, t\u0103ng c\u1ea3m gi\u00e1c, sa\/s\u1ee5p m\u00ed m\u1eaft, s\u1eefng s\u1edd.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft<\/em><\/p>\n<p>Hi\u1ebfm g\u1eb7p: Suy gi\u00e1p, b\u01b0\u1edbu c\u1ed5, to v\u00fa \u0111\u00e0n \u00f4ng.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: T\u0103ng ti\u1ebft n\u01b0\u1edbc b\u1ecdt, \u0111\u1ea7y h\u01a1i.<\/p>\n<p>\u00edt g\u1eb7p-. Vi\u00eam d\u1ea1 d\u00e0y, vi\u00eam d\u1ea1 d\u00e0y ru\u1ed9t, vi\u00eam mi\u1ec7ng, \u1ee3 h\u01a1i, tr\u0129, kh\u00f3 nu\u1ed1t, nghi\u1ebfn r\u0103ng, vi\u00eam n\u01b0\u1edbu, vi\u00eam th\u1ef1c qu\u1ea3n.<\/p>\n<p>Hi\u1ec3m g\u1eb7p-. Vi\u00eam \u0111\u1ea1i tr\u00e0ng, lo\u00e9t d\u1ea1 d\u00e0y, vi\u00eam t\u00fai m\u1eadt, s\u1ecfi m\u1eadt, vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng, \u1eeb\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n, vi\u00eam l\u01b0\u1ee1i, v\u00e0ng da, vi\u00eam t\u00fai th\u1eeba, xu\u1ea5t huy\u1ebft tr\u1ef1c tr\u00e0ng, n\u1ea5c c\u1ee5t.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n chung<\/em><\/p>\n<p>\u00edt g\u1eb7p: N\u00f3ng b\u1eebng m\u1eb7t, r\u00e9t run, kh\u00f4ng dung n\u1ea1p r\u01b0\u1ee3u, ng\u1ea5t, c\u00e1c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng c\u00fam.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Vi\u00eam m\u0169i do d\u1ecb \u1ee9ng.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n m\u00e1u v\u00e0 b\u1ea1ch huv\u1ebft<\/em><\/p>\n<p>\u00edt g\u1eb7p: Ban xu\u1ea5t huy\u1ebft, thi\u1ebfu m\u00e1u, ch\u1ea3y m\u00e1u cam, t\u0103ng b\u1ea1ch c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u, h\u1ea1ch to.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Thuy\u00ean t\u1eafc ph\u1ed5i, gi\u1ea3m b\u1ea1ch c\u1ea7u h\u1ea1t, t\u0103ng lympho b\u00e0o, gi\u1ea3m b\u1ea1ch c\u1ea7u lympho, thi\u1ebfu m\u00e1u t\u00e1n s\u1eafc (hypochromie), r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u, ch\u00e0y m\u00e1u n\u01b0\u1edbu.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n chuv\u1ec3n h\u00f3a v\u00e0 dinh d\u01b0\u1ee1ng <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Gi\u1ea3m c\u00e2n, t\u0103ng c\u00e2n<\/p>\n<p>\u00edt g\u1eb7p: T\u0103ng enzym gan, kh\u00e1t n\u01b0\u1edbc, kh\u00f4 m\u1eaft, t\u0103ng phosphatase ki\u1ec1m, dung n\u1ea1p glucose b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Nhi\u1ec5m bilirubin m\u00e1u, h\u1ea1 kali m\u00e1u, b\u00e9o ph\u00ec, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, vi\u00eam gan, m\u1ea5t n\u01b0\u1edbc.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n h\u00ea c\u01a1 x\u01b0\u01a1ng <\/em><\/p>\n<p>\u00edt g\u1eb7p: Vi\u00eam kh\u1edbp, y\u1ebfu c\u01a1, \u0111au x\u01b0\u01a1ng.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Vi\u00eam bao ho\u1ea1t d\u1ecbch, b\u1ec7nh lo\u00e3ng x\u01b0\u01a1ng.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n<\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Suy gi\u1ea3m t\u1eadp trung, m\u1ea5t tr\u00ed nh\u1edb, th\u1edd \u01a1, tr\u1ea7m c\u1ea3m, t\u0103ng th\u00e8m \u0103n, suy nh\u01b0\u1ee3c tr\u1ea7m tr\u1ecdng h\u01a1n, c\u1ed1 g\u1eafng t\u1ef1 t\u1eed, nh\u1ea7m l\u1eabn.<\/p>\n<p>\u00edt g\u1eb7p: T\u0103ng ham mu\u1ed1n t\u00ecnh d\u1ee5c, th\u00e1i \u0111\u1ed9 hung h\u0103ng, \u00e1c m\u1ed9ng, ph\u1ee5 thu\u1ed9c thu\u1ed1c, m\u1ea5t nh\u00e2n c\u00e1ch, \u1ea3o gi\u00e1c, h\u01b0ng ph\u1ea5n, tr\u1ea7m c\u1ea3m t\u00e2m th\u1ea7n, \u00e0o t\u01b0\u1eddng, hoang t\u01b0\u1eddng, r\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac, ho\u1ea3ng lo\u1ea1n, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: T\u00ecnh tr\u1ea1ng l\u01a1 m\u01a1, u u\u1ea5t.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n sinh s\u1ea3n n\u1eef <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: V\u00f4 kinh.<\/p>\n<p>\u00edt g\u1eb7p: \u0110a ti\u1ebft s\u1eefa, \u0111au v\u00fa, v\u00fa to, xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n h\u00ea h\u00f4 h\u1ea5p <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Ho.<\/p>\n<p>\u00edt g\u1eb7p: Vi\u00eam ph\u1ebf qu\u1ea3n, kh\u00f3 th\u1edd, vi\u00eam ph\u1ed5i.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: B\u1ec7nh hen suy\u1ec5n, vi\u00eam thanh qu\u1ea3n, co th\u1eaft ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ed5i, \u0111\u1eddm t\u0103ng.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n da v\u00e0 ph\u1ea7n ph\u1ee5 <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Ph\u00e1t ban, ng\u1ee9a.<\/p>\n<p>\u00edt g\u1eb7p: Ph\u1ea3n \u1ee9ng v\u1edbi \u00e1nh s\u00e1ng, n\u1ed5i m\u1ec1 \u0111ay, m\u1ee5n tr\u1ee9ng c\u00e1, da \u0111\u1ed5i m\u00e0u, ch\u00e0m, r\u1ee5ng t\u00f3c, vi\u00eam da, kh\u00f4 da, b\u1ec7nh v\u1ea9y n\u1ebfn.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: R\u1eadm l\u00f4ng, gi\u1ea3m ti\u1ebft m\u1ed3 h\u00f4i, n\u1ed5i h\u1eafc t\u1ed1, vi\u00eam gi\u00e1c m\u1ea1c, vi\u00eam m\u00f4 t\u1ebf b\u00e0o, ng\u1ee9a h\u1eadu m\u00f4n.<\/p>\n<p><em>Gi\u00e1c quan \u0111\u1eb7c bi\u1ec7t<\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Th\u00edch nghi b\u1ea5t th\u01b0\u1eddng, kh\u1ee9u gi\u00e1c l\u1ec7ch l\u1ea1c.<\/p>\n<p>\u00edt g\u1eb7p: \u00d9 tai, vi\u00eam k\u1ebft m\u1ea1c, \u0111au m\u1eaft.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Gi\u00e3n \u0111\u1ed3ng t\u1eed, s\u1ee3 \u00e1nh s\u00e1ng, nh\u00ecn \u0111\u00f4i, ch\u1ea3y n\u01b0\u1edbc m\u1eaft b\u1ea5t th\u01b0\u1eddng, \u0111\u1ee5c th\u1ee7y tinh th\u1ec3, m\u1ea5t v\u1ecb gi\u00e1c.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n h\u1ec7 ti\u1ebft ni\u1ec7u <\/em><\/p>\n<p>Th\u01b0\u1eddng g\u1eb7p: Ti\u1ec3u nhi\u1ec1u.<\/p>\n<p>\u00edt g\u1eb7p: T\u0103ng t\u1ea7n s\u1ed1 \u0111i ti\u1ec3u, ti\u1ec3u kh\u00f4ng t\u1ef1 ch\u00f9, b\u00ed ti\u1ec3u, ti\u1ec3u kh\u00f3.<\/p>\n<p>Hi\u1ebfm g\u1eb7p: Ph\u00f9, ti\u1ec3u ra m\u00e1u, thi\u1ec3u ni\u1ec7u, vi\u00eam b\u1ec3 th\u1eadn, s\u1ecfi th\u1eadn, \u0111au th\u1eadn.<\/p>\n<p><em>L\u1ea1m d\u1ee5ng v\u00e0 ph\u1ee5 thu\u1ed9c thu\u1ed1c<\/em><\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y vi\u1ec7c l\u1ea1m d\u1ee5ng citalopram l\u00e0 th\u1ea5p. Citalopram ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u m\u1ed9t c\u00e1ch c\u00f3 h\u1ec7 th\u1ed1ng tr\u00ean c\u01a1 th\u1ec3 ng\u01b0\u1eddi v\u1ec1 kh\u1ea3 n\u0103ng g\u00e2y l\u1ea1m d\u1ee5ng, dung n\u1ea1p, ho\u1eb7c nghi\u1ec7n. Kinh nghi\u1ec7m l\u00e2m s\u00e0ng khi s\u1eed d\u1ee5ng citalopram cho th\u1ea5y thu\u1ed1c kh\u00f4ng g\u00e2y l\u1ec7 thu\u1ed9c. Tuy nhi\u00ean, nh\u1eefng quan s\u00e1t n\u00e0y kh\u00f4ng c\u00f3 h\u1ec7 th\u1ed1ng v\u00e0 kh\u00f4ng th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c; do \u0111\u00f3, c\u00e1c b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb n\u00ean \u0111\u00e1nh gi\u00e1 c\u1ea9n th\u1eadn b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb Citalopram v\u1ec1 vi\u1ec7c l\u1ea1m d\u1ee5ng thu\u1ed1c v\u00e0 theo d\u00f5i ch\u1eb7t ch\u00ea c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y<\/p>\n<p><em>Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<p><strong>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/strong><\/p>\n<p>Ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. V\u1edbi c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 c\u1ea7n ng\u1eebng thu\u1ed1c. Tr\u01b0\u1eddng h\u1ee3p m\u1eabn c\u1ea3m n\u1eb7ng ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (gi\u1eef tho\u00e1ng kh\u00ed v\u00e0 d\u00f9ng epinephrin, th\u1edf oxygen, d\u00f9ng kh\u00e1ng histamin, corticoid&#8230;).<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n<p><em>Thu\u1ed1c t\u00e1c \u0111\u1ed9ng l\u00ean h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng<\/em><\/p>\n<p>Do Citalopram c\u00f3 t\u00e1c \u0111\u1ed9ng l\u00ean h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng n\u00ean c\u1ea7n th\u1eadn h\u1ecdng khi k\u00ea \u0111\u01a1n \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c c\u0169ng c\u00f3 t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp l\u00ean h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n<p><em>R\u01b0\u1ef1u<\/em><\/p>\n<p>M\u1eb7c d\u00f9 Citalopram kh\u00f4ng l\u00e0m t\u0103ng nh\u1eadn th\u1ee9c v\u00e0 t\u00e1c \u0111\u1ed9ng c\u1ee7a r\u01b0\u1ee3u hong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c thu\u1ed1c h\u01b0\u1edbng th\u1ea7n kh\u00e1c, vi\u1ec7c s\u1eed d\u1ee5ng r\u01b0\u1ee3u c\u1ee7a b\u1ec7nh nh\u00e2n h\u1ea7m c\u1ea3m \u0111ang nh\u1eadn Citalopram kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/p>\n<p><em>Thu\u1ed1c \u1ee9c ch\u1ebf monoamin oxidase<\/em><\/p>\n<p>Xem m\u1ee5c C\u00e1nh b\u00e1o v\u00e0 th\u1eadn h\u1ecdng kh\u1ec9 s\u1eed d\u1ee5ng.<\/p>\n<p><em>Thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7n t\u01b0\u1ecdmg \u0111\u00f4ng m\u00e1u (c\u00e1c NSAID, aspirin, warfarin, &#8230;)<\/em><\/p>\n<p>Serotonin \u0111\u01b0\u1ee3c ph\u00f3ng th\u00edch t\u1eeb ti\u1ec3u c\u1ea7u c\u00f3 vai tr\u00f2 quan h\u1ecdng hong vi\u1ec7c c\u1ea7m m\u00e1u. C\u00e1c nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc \u0111\u00e3 ch\u1ee9ng minh m\u1ed1i li\u00ean quan gi\u1eefa vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c h\u01b0\u1edbng th\u1ea7n \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin v\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a xu\u1ea5t huy\u1ebft \u0111\u01b0\u1eddng ti\u00eau h\u00f3a h\u00ean \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi m\u1ed9t NSAID ho\u1eb7c aspirin \u1ea9n ch\u1ee9a nguy c\u01a1 ch\u1ea3y m\u00e1u. Do \u0111\u00f3, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c c\u1ea3nh b\u00e1o v\u1ec1 vi\u1ec7c s\u1eeb d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u00f3 \u0111\u1ed3ng th\u1eddi v\u1edbi Citalopram.<\/p>\n<p>Cimetidin<\/p>\n<p>C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nh\u1eadn Citalopram (li\u1ec1u 40 mg\/ng\u00e0y hong 21 ng\u00e0y) \u0111\u01b0\u1ee3c d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi Cimetidin (li\u1ec1u 400 mg\/ ng\u00e0y hong 8 ng\u00e0y) \u0111\u00e3 l\u00e0m t\u0103ng 43% AUC v\u00e0 39% cmax c\u1ee7a Citalopram.<\/p>\n<p>Digoxin<\/p>\n<p>C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nh\u1eadn Citalopram (li\u1ec1u 40 mg\/ng\u00e0y hong 21 ng\u00e0y) \u0111\u01b0\u1ee3c d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi digoxin (li\u1ec1u duy nh\u1ea5t 1 mg) kh\u00f4ng th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a c\u00e0 Citalopram ho\u1eb7c digoxin.<\/p>\n<p>Lithi<\/p>\n<p>D\u00f9ng \u0111\u1ed3ng th\u1eddi Citalopram (40 mg\/ng\u00e0y hong 10 ng\u00e0y) v\u1edbi lithi (30 mmol\/ng\u00e0y hong 5 ng\u00e0y) kh\u00f4ng th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram ho\u1eb7c lithi. Tuy nhi\u00ean, n\u1ed3ng \u0111\u1ed9 lithi trong huy\u1ebft t\u01b0\u01a1ng n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p. V\u00ec lithi c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng serotonin c\u1ee7a Citalopram, n\u00ean c\u1ea7n th\u1eadn \u1eeb\u1ecdng khi d\u00f9ng chung Citalopram v\u00e0 lithi.<\/p>\n<p>Theophylin<\/p>\n<p>D\u00f9ng k\u1ebft h\u1ee3p Citalopram (40 mg\/ng\u00e0y trong v\u00f2ng 21 ng\u00e0y) v\u1edbi theophylin (li\u1ec1u duy nh\u1ea5t 300 mg) l\u00e0 ch\u1ea5t n\u1ec1n c\u1ee7a enzym CYP1A2 \u0111\u00e3 kh\u00f4ng l\u00e0m \u1ea3nh h\u01b0\u1eddng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a theophylin.<\/p>\n<p>T\u00e1c \u0111\u1ed9ng c\u1ee7a theophylin tr\u00ean d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1.<\/p>\n<p>Sumatriptan<\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o hi\u1ebfm g\u1eb7p m\u00f4 t\u00e0 b\u1ec7nh nh\u00e2n b\u1ecb suy nh\u01b0\u1ee3c t\u0103ng ph\u1ea3n x\u1ea1 v\u00e0 kh\u00f4ng hi\u1ec7u qu\u1ea3 khi s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p SSRI v\u1edbi sumatriptan. N\u1ebfu \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi sumatriptan v\u1edbi m\u1ed9t SSRI (v\u00ed d\u1ee5 fluoxetin, \u00dfuvoxamin, paroxetin, sertralin, Citalopram) c\u1ea7n ph\u1ea3i b\u1ea3o \u0111\u1ea3m v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng, gi\u00e1m s\u00e1t th\u00edch h\u1ecdp cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>Warfarin<\/p>\n<p>S\u1eed d\u1ee5ng Citalopram (li\u1ec1u 40 mg\/ng\u00e0y \u1eebong 21 ng\u00e0y) kh\u00f4ng \u1ea3nh h\u01b0\u1eddng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a warfarin. Th\u1eddi gian prothrombin \u0111\u00e3 t\u0103ng 5%, \u00fd ngh\u0129a l\u00e2m s\u00e0ng n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn.<\/p>\n<p>Carbamazepin<\/p>\n<p>D\u00f9ng k\u1ebft h\u1ecdp Citalopram (40 mg\/ng\u00e0y trong 14 ng\u00e0y) v\u1edbi Carbamazepin (li\u1ec1u 400 mg\/ng\u00e0y trong 35 ng\u00e0y) kh\u00f4ng th\u1ea5y \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Carbamazepin, l\u00e0 m\u1ed9t ch\u1ea5t n\u1ec1n c\u1ee7a enzym CYP3A4. M\u1eb7c d\u00f9 n\u1ed3ng \u0111\u1ed9 Cn\u00fan trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a Citalopram kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1eddng, nh\u01b0ng do t\u00ednh k\u00edch th\u00edch enzym c\u1ee7a Carbamazepin, n\u00ean xem x\u00e9t kh\u1ea3 n\u0103ng Carbamazepin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng thanh th\u00e0i Citalopram n\u1ebfu hai lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c d\u00f9ng chung.<\/p>\n<p>Triazolam<\/p>\n<p>D\u00f9ng k\u1ebft h\u1ecdp Citalopram (li\u1ec1u 40 mg\/ng\u00e0y trong 28 ng\u00e0y) v\u1edbi triazolam l\u00e0 ch\u1ea5t n\u1ec1n c\u1ee7a CYP3A4 (li\u1ec1u duy nh\u1ea5t 0,25 mg) kh\u00f4ng th\u1ea5y c\u00f3 \u00e0nh h\u01b0\u1eddng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a c\u1ea3 Citalopram ho\u1eb7c \u1eebiazolam.<\/p>\n<p>Ketoconazol<\/p>\n<p>D\u00f9ng k\u1ebft h\u1ee3p Citalopram (40 mg) v\u1edbi ketoconazol (200 mg) \u0111\u00e3 l\u00e0m gi\u1ea3m 21% v\u00e0 10% gi\u00e1 tr\u1ecb craax v\u00e0 AUC c\u1ee7a ketoconazol t\u01b0\u01a1ng \u1ee9ng, kh\u00f4ng th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1eddng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram.<\/p>\n<p>Thu\u1ed1c \u1ee9c ch\u1ebf enzym CYP3A4 v\u00e0 2C19<\/p>\n<p>Trong nghi\u00ean c\u1ee9u in vitro cho th\u1ea5y CYP3A4 v\u00e0 2C19 l\u00e0 enzym ch\u00ednh tham gia v\u00e0o qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a c\u1ee7a Citalopram. Tuy nhi\u00ean, vi\u1ec7c d\u00f9ng chung Citalopram (40 mg) v\u1edbi ketoconazol (200 mg), m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf m\u1ea1nh CYP3A4, kh\u00f4ng th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1eddng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram. VI Citalopram \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1eddi nhi\u1ec1u h\u1ec7 enzym, n\u00ean vi\u1ec7c \u1ee9c ch\u1ebf m\u1ed9t enzym duy nh\u1ea5t c\u00f3 th\u1ec3 kh\u00f4ng l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a Citalopram.<\/p>\n<p>Metoprolol<\/p>\n<p>D\u00f9ng Citalopram (li\u1ec1u 40 mg\/ng\u00e0y trong 22 ng\u00e0y) \u0111\u00e3 d\u1eabn \u0111\u1ebfn s\u1ef1 gia t\u0103ng g\u1ea5p hai l\u1ea7n \u1edf n\u1ed3ng \u0111\u1ed9 huy\u1ebft t\u01b0\u01a1ng c\u1ee7a c\u00e1c thu\u1ed1c ch\u1eb9n beta nh\u01b0 metoprolol. M\u1ee9c metoprolol trong huy\u1ebft t\u01b0\u01a1ng t\u0103ng c\u00f3 li\u00ean quan t\u1edbi gi\u1ea3m t\u00ednh ch\u1ecdn l\u1ecdc tr\u00ean tim (cardioselectivity). D\u00f9ng \u0111\u1ed3ng th\u1eddi Citalopram v\u1edbi metoprolol c\u00f3 t\u00e1c \u0111\u1ed9ng kh\u00f4ng \u0111\u00e1ng k\u1ec3 v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng \u1eeb\u00ean huy\u1ebft \u00e1p hay nh\u1ecbp tim.<\/p>\n<p>Imipramin v\u00e0 thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng kh\u00e1c (TCAs: Tricyclic Antidepressants)<\/p>\n<p>Tr\u1ecdng nghi\u00ean c\u1ee9u in vitro cho th\u1ea5y Citalopram l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf t\u01b0\u01a1ng \u0111\u1ed1i y\u1ebfu c\u1ee7a CYP2D6. D\u00f9ng \u0111\u1ed3ng th\u1eddi Citalopram (40 mg\/ng\u00e0y trong 10 ng\u00e0y) v\u1edbi imipramin (li\u1ec1u duy nh\u1ea5t 100 mg), m\u1ed9t ch\u1ea5t n\u1ec1n cho CYP2D6 kh\u00f4ng th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1eddng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 huy\u1ebft t\u01b0\u01a1ng c\u1ee7a imipramin ho\u1eb7c Citalopram. Tuy nhi\u00ean n\u1ed3ng \u0111\u1ed9 c\u1ee7a c\u00e1c chat chuy\u1ec3n h\u00f3a desipramin imipramin \u0111\u00e3 t\u0103ng kho\u1ea3ng 50%. \u00dd ngh\u0129a l\u00e2m s\u00e0ng c\u1ee7a s\u1ef1 thay \u0111\u1ed5i desipramin l\u00e0 kh\u00f4ng r\u00f5. Tuy nhi\u00ean, c\u1ea7n th\u1eadn tr\u1ecdng khi ch\u00ec \u0111\u1ecbnh d\u00f9ng chung TCAs v\u1edbi Citalopram.<\/p>\n<p><strong>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p><em>Tri\u1ec7u ch\u1ee9ng<\/em><\/p>\n<p>M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 b\u00e1o c\u00e1o v\u1ec1 qu\u00e1 li\u1ec1u g\u00e2y t\u1eed vong do Citalopram trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng li\u00ean quan \u0111\u1ebfn d\u00f9ng li\u1ec1u l\u00ean \u0111\u1ebfn 2000 mg, c\u00e1c b\u00e1o c\u00e1o li\u00ean quan \u0111\u1ebfn qu\u00e1 li\u1ec1u Citalopram \u0111\u00e3 g\u00e2y ch\u00fa \u00fd bao g\u1ed3m 12 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong: 10 ca \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ecdp v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0\/ho\u1eb7c r\u01b0\u1ee3u v\u00e0 2 ca d\u00f9ng m\u1ed9t minh Citalopram (3920 mg v\u00e0 2800 mg), c\u0169ng nh\u01b0 qu\u00e1 li\u1ec1u kh\u00f4ng g\u00e2y t\u1eed vong l\u00ean \u0111\u1ebfn 6000 mg.<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng \u0111i k\u00e8m qu\u00e1 li\u1ec1u Citalopram, d\u00f9ng m\u1ed9t minh ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c v\u00e0\/ho\u1eb7c r\u01b0\u1ee3u kh\u00e1c, bao g\u1ed3m ch\u00f3ng m\u1eb7t, v\u00e3 m\u1ed3 h\u00f4i, bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, run, bu\u1ed3n ng\u1ee7 v\u00e0 nh\u1ecbp tim nhanh. Trong tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm h\u01a1n, c\u00e1c tri\u1ec7u ch\u1ee9ng quan s\u00e1t bao g\u1ed3m m\u1ea5t \u1eeb\u00ed nh\u1edb, l\u00fa l\u1eabn, h\u00f4n m\u00ea, co gi\u1eadt, th\u1edf g\u1ea5p (t\u00e2ng th\u00f4ng kh\u00ed ph\u1ed5i), t\u00edm t\u00e1i, ti\u00eau c\u01a1 v\u00e2n v\u00e0 nh\u1eefng thay \u0111\u1ed5i ECG (bao g\u1ed3m k\u00e9o d\u00e0i kho\u1ea3ng QT, nh\u1ecbp n\u00fat, lo\u1ea1n nh\u1ecbp t\u00e2m th\u1ea5t v\u00e0 c\u00f3 th\u1ec3 c\u00f3 xo\u1eafn \u0111inh).<\/p>\n<p><em>X\u1eed tr\u00ed qu\u00e1 li\u1ec1u<\/em><\/p>\n<p>Thi\u1ebft l\u1eadp v\u00e0 duy tr\u00ec \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p \u0111\u00e0m b\u00e0o th\u00f4ng tho\u00e1ng v\u00e0 c\u1ea5p oxy \u0111\u1ea7y \u0111\u1ee7. N\u00ean xem x\u00e9t vi\u1ec7c l\u00e0m s\u1ea1ch d\u1ea1 d\u00e0y b\u1eb1ng c\u00e1ch th\u1ee5t r\u1eeda v\u00e0 s\u1eed d\u1ee5ng than ho\u1ea1t t\u00ednh. \u0110\u1ec1 ngh\u1ecb gi\u00e1m s\u00e1t c\u1ea9n th\u1eadn v\u1ec1 tim m\u1ea1ch v\u00e0 theo d\u00f5i c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n, c\u00f9ng v\u1edbi vi\u1ec7c ch\u0103m s\u00f3c tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ed7 \u1eef\u1ee3 chung. Do th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 c\u1ee7a Citalopram l\u1edbn, d\u00f9ng l\u1ee3i ti\u1ec3u c\u01b0\u1ee1ng b\u1ee9c, l\u1ecdc m\u00e1u, l\u1ecdc m\u00e1u h\u1ea5p ph\u1ee5 (hemoper\/usion) v\u00e0 thay m\u00e1u kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng mang l\u1ea1i l\u1ee3i \u00edch.<\/p>\n<p>Kh\u00f4ng c\u00f3 thu\u1ed1c gi\u1ea3i \u0111\u1ed9c \u0111\u1eb7c hi\u1ec7u cho citalopram.<\/p>\n<p>Trong vi\u1ec7c x\u1eed tr\u00ed qu\u00e1 li\u1ec1u, th\u01b0\u1eddng n\u00ean xem x\u00e9t kh\u1ea3 n\u0103ng tham gia c\u1ee7a nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00e1c, n\u1ebfu c\u00f3.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><\/p>\n<p><strong>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/strong><\/p>\n<p>C\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng c\u1ee7a Citalopram hydrobromid nh\u01b0 m\u1ed9t thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00e0 \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn ho\u1ea1t t\u00ednh c\u1ee7a serotonin trong h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (CNS: Central Nervous System) khi \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin (5-HT) c\u1ee7a CNS. C\u00e1c th\u1eed nghi\u1ec7m in vitro v\u00e0 in vivo \u1edf \u0111\u1ed9ng v\u1eadt cho th\u1ea5y Citalopram l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc cao s\u1ef1 t\u00e1i h\u1ea5p thu serotonin (SSRI = Selective Serotonin Reuptake Inhibitor) v\u00e0 \u1ea3nh h\u01b0\u1edfng r\u1ea5t nh\u1ecf \u0111\u1ebfn s\u1ef1 t\u00e1i h\u1ea5p thu norepinephrin (NE) v\u00e0 dopamin (DA) c\u1ee7a t\u1ebf b\u00e0o th\u1ea7n kinh. Kh\u1ea3 n\u0103ng dung n\u1ea1p \u1ee9c ch\u1ebf h\u1ea5p thu 5- HT kh\u00f4ng x\u1ea3y ra trong th\u1eddi gian d\u00e0i (14 ng\u00e0y) khi cho chu\u1ed9t c\u1ed1ng u\u1ed1ng Citalopram. Citalopram l\u00e0 m\u1ed9t h\u1ed7n h\u1ecdp \u0111\u1ed3ng ph\u00e2n racemic (50\/50) v\u00e0 s\u1ef1 \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu 5- HT c\u1ee7a Citalopram ch\u1ee7 y\u1ebfu l\u00e0 do ch\u1ea5t \u0111\u1ed3ng ph\u00e2n (S). Citalopram kh\u00f4ng c\u00f3 ho\u1eb7c c\u00f3 \u00e1i l\u1ef1c r\u1ea5t th\u1ea5p v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 5-HT1A, 5-HT2A, dopamin D1 v\u00e0 D2) v\u00e0 \u03b11-, \u03b12 v\u00e0 \u00df, histamin Hi, gamma aminobutyric acid (GABA), cholinergic muscarinic v\u00e0 benzodiazepin. S\u1ef1 \u0111\u1ed1i kh\u00e1ng c\u00e1c th\u1ee5 th\u1ec3 muscarinic, histaminergic v\u00e0 adrenergic \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 li\u00ean quan t\u1edbi t\u00e1c d\u1ee5ng kh\u00e1c nhau c\u1ee7a thu\u1ed1c kh\u00e1ng cholinergic, thu\u1ed1c an th\u1ea7n v\u00e0 \u1ea3nh h\u01b0\u1eddng \u0111\u1ebfn tim m\u1ea1ch c\u1ee7a c\u00e1c thu\u1ed1c h\u01b0\u1edbng th\u1ea7n kh\u00e1c<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Ng\u01b0\u1ee3c l\u1ea1i v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng v\u00e0 m\u1ed9t s\u1ed1 c\u00e1c SSRIs m\u1edbi, Citalopram kh\u00f4ng c\u00f3 ho\u1eb7c c\u00f3 \u00e1i l\u1ef1c r\u1ea5t th\u1ea5p v\u1edbi m\u1ed9t lo\u1ea1t c\u00e1c th\u1ee5 th\u1ec3 bao g\u1ed3m c\u00e1c th\u1ee5 th\u1ec3 5-HT 1A, 5- HT2, DA D1 v\u00e0 D2, \u03b11-, \u03b12-, \u03b1-adrenoceptors, histamin H1, muscarine cholinergic, benzodiazepin, v\u00e0 c\u00e1c th\u1ee5 th\u1ec3 opioid. M\u1ed9t lo\u1ea1t c\u00e1c th\u1eed nghi\u1ec7m in vivo ch\u1ee9c n\u0103ng trong c\u00e1c c\u01a1 quan c\u00e1ch ly c\u0169ng nh\u01b0 th\u1eed nghi\u1ec7m in vivo ch\u1ee9c n\u0103ng \u0111\u00e3 x\u00e1c nh\u1eadn thi\u1ebfu \u00e1p l\u1ef1c th\u1ee5 th\u1ec3. Vi\u1ec7c kh\u00f4ng c\u00f3 \u1ea3nh h\u01b0\u1edfng l\u00ean c\u00e1c th\u1ee5 th\u1ec3 c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch l\u00fd do t\u1ea1i sao Citalopram \u00edt g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p nh\u01b0 kh\u00f4 m\u00f4i, r\u1ed1i lo\u1ea1n b\u00e0ng quang v\u00e0 ru\u1ed9t, m\u1edd m\u1eaft, bu\u1ed3n ng\u1ee7, \u0111\u1ed9c t\u00ednh tr\u00ean tim v\u00e0 h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<p><strong>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/strong><\/p>\n<p>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc li\u1ec1u \u0111\u01a1n v\u00e0 \u0111a li\u1ec1u c\u1ee7a Citalopram tuy\u1ebfn t\u00ednh v\u00e0 t\u1ec9 l\u1ec7 thu\u1eadn trong kho\u1ea3ng li\u1ec1u d\u00f9ng 10-60 mg\/ng\u00e0y. Bi\u1ebfn \u0111\u1ed5i sinh h\u1ecdc c\u1ee7a Citalopram ch\u1ee7 y\u1ebfu x\u1ea3y ra \u1edf gan, th\u1eddi gian b\u00e1n th\u1ea3i trung binh kho\u1ea3ng 35 gi\u1edd. V\u1edbi li\u1ec1u d\u00f9ng m\u1ed7i ng\u00e0y m\u1ed9t l\u1ea7n, n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t \u0111\u01b0\u1ee3c tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh trong kho\u1ea3ng m\u1ed9t tu\u1ea7n. \u1ede tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh, m\u1ee9c \u0111\u1ed9 t\u00edch t\u1ee5 c\u1ee7a Citalopram trong huy\u1ebft t\u01b0\u01a1ng, d\u1ef1a tr\u00ean c\u00e1c chu k\u1ef3 b\u00e1n r\u00e3, d\u1ef1 ki\u1ebfn s\u1ebd g\u1ea5p 2,5 l\u1ea7n so v\u1edbi n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng sau khi nh\u1eadn m\u1ed9t li\u1ec1u duy nh\u1ea5t.<\/p>\n<p><em>H\u1ea5p thu v\u00e0 ph\u00e2n b\u1ed1<\/em><\/p>\n<p>Sau khi u\u1ed1ng m\u1ed9t li\u1ec1u duy nh\u1ea5t 40 mg Citalopram, n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh \u1eebong m\u00e1u \u0111\u1ea1t v\u00e0o kho\u1ea3ng 4 gi\u1edd. Sinh kh\u1ea3 d\u1ee5ng tuy\u1ec7t \u0111\u1ed1i c\u1ee7a Citalopram kho\u1ea3ng 80% so v\u1edbi m\u1ed9t li\u1ec1u ti\u00eam t\u0129nh m\u1ea1ch v\u00e0 qu\u00e1 tr\u00ecnh h\u1ea5p thu c\u1ee7a thu\u1ed1c kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi th\u1ee9c \u0103n. Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 c\u1ee7a Citalopram kho\u1ea3ng 12 1\/kg v\u00e0 c\u00e1c li\u00ean k\u1ebft c\u1ee7a Citalopram (CT), demethylcitalopram (DCT) v\u00e0 didemethylcitalopram (DDCT) v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t kho\u1ea3ng 80%.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a v\u00e0 th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>Sau li\u1ec1u ti\u00eam t\u0129nh m\u1ea1ch Citalopram, m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf c\u1ee7a thu\u1ed1c nh\u01b0 Citalopram v\u00e0 demethylcitalopram (DCT) \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong n\u01b0\u1edbc ti\u1ec3u, t\u01b0\u01a1ng \u1ee9ng chi\u1ebfm kho\u1ea3ng 10% v\u00e0 5%. \u0110\u1ed9 thanh th\u1ea3i to\u00e0n th\u00e2n c\u1ee7a Citalopram \u0111\u1ea1t 330 ml\/ph\u00fat, v\u1edbi kho\u1ea3ng 20% trong s\u1ed1 \u0111\u00f3 l\u00e0 do thanh th\u1ea3i qua th\u1eadn.<\/p>\n<p>Citalopram \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a th\u00e0nh citalopram-N-oxid, DCT, DDCT v\u00e0 m\u1ed9t d\u1eabn xu\u1ea5t kh\u1eed amin c\u1ee7a acid propionic. \u1edf ng\u01b0\u1eddi, c\u00e1c h\u1ecdp ch\u1ea5t ch\u00f9 y\u1ebfu trong huy\u1ebft t\u01b0\u01a1ng l\u00e0 d\u1ea1ng Citalopram kh\u00f4ng bi\u1ebfn \u0111\u1ed5i. \u1edf tr\u1ea1rig th\u00e1i \u1ed3n \u0111\u1ecbnh, n\u1ed3ng \u0111\u1ed9 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a Citalopram nh\u01b0 DCT v\u00e0 DDCT trong huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t t\u01b0\u01a1ng \u1ee9ng kho\u1ea3ng m\u1ed9t n\u1eeda (1\/2) v\u00e0 m\u1ed9t ph\u1ea7n m\u01b0\u1eddi (1\/10) so v\u1edbi thu\u1ed1c g\u1ed1c. C\u00e1c nghi\u00ean c\u1ee9u in vitro cho th\u1ea5y Citalopram m\u1ea1nh g\u1ea5p \u00edt nh\u1ea5t 8 l\u1ea7n so v\u1edbi c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a trong s\u1ef1 \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e0 kh\u00f4ng c\u00f3 kh\u00e0 n\u0103ng \u0111\u00f3ng g\u00f3p \u0111\u00e1ng k\u1ec3 v\u00e0o ho\u1ea1t t\u00ednh ch\u1ed1ng tr\u1ea7m c\u00e0m c\u1ee7a Citalopram.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u in vitro s\u1eed d\u1ee5ng c\u00e1c microsom gan ng\u01b0\u1eddi ch\u1ec9 ra r\u1eb1ng c\u00e1c isoenzym CYP3A4 v\u00e0 CYP2C19 \u0111\u00e3 tham gia v\u00e0o c\u00e1c ph\u1ea3n \u1ee9ng kh\u1eed N-methyl c\u1ee7a Citalopram.<\/p>\n<p><em>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u1eb7c bi\u1ec7t <\/em><\/p>\n<p><em>Tu\u1ed5i t\u00e1c<\/em><\/p>\n<p>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc Citalopram trong c\u00e1c c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng t\u1eeb 60 tu\u1ed5i tr\u1edd l\u00ean \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng tr\u1ebb h\u01a1n trong hai nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c t\u00ecnh nguy\u1ec7n vi\u00ean binh th\u01b0\u1eddng. Trong m\u1ed9t nghi\u00ean c\u1ee9u v\u1edbi li\u1ec1u duy nh\u1ea5t, AUC (Area under the curve) v\u00e0 th\u1eddi gian b\u00e1n h\u1ee7y c\u1ee7a Citalopram t\u0103ng \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i t\u01b0\u01a1ng \u1ee9ng b\u1eb1ng 30% v\u00e0 50%, trong khi m\u1ed9t nghi\u00ean c\u1ee9u \u0111a li\u1ec1u \u0111\u00e3 l\u00e0m t\u0103ng t\u01b0\u01a1ng \u1ee9ng 23% v\u00e0 30%. Li\u1ec1u 20 mg l\u00e0 li\u1ec1u khuy\u1ebfn c\u00e1o cho h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n cao tu\u1ed5i.<\/p>\n<p><em>Gi\u1edbi t\u00ednh<\/em><\/p>\n<p>Trong c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng, kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 n\u1ed3ng \u0111\u1ed9 Citalopram trong huy\u1ebft thanh \u1edf tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh gi\u1eefa nam v\u00e0 n\u1eef. Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc trong gi\u1edbi t\u00ednh c\u1ee7a c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a DCT v\u00e0 DDCT. Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u chinh li\u1ec1u tr\u00ean c\u01a1 s\u1edf gi\u1edbi t\u00ednh.<\/p>\n<p><em>Gi\u1ea3m ch\u1ee9c n\u0103ng gan<\/em><\/p>\n<p>\u0110\u1ed9 thanh th\u1ea3i c\u1ee7a Citalopram \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u00e3 gi\u1ea3m 37% v\u00e0 th\u1eddi gian b\u00e1n th\u1ea3i \u0111\u00e3 t\u0103ng g\u1ea5p \u0111\u00f4i \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy gi\u1ea3m ch\u1ee9c n\u0103ng gan so v\u1edbi ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. Li\u1ec1u 20 mg l\u00e0 li\u1ec1u khuy\u1ebfn c\u00e1o cho h\u1ea5u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n suy gan (xem Li\u1ec1u l\u01b0\u1ee3ng v\u00e0 C\u00e1ch d\u00f9ng).<\/p>\n<p><em>Gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn<\/em><\/p>\n<p>\u1edf b\u1ec7nh nh\u00e2n suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh, \u0111\u1ed9 thanh th\u1ea3i Citalopram \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u00e3 gi\u1ea3m 17% so v\u1edbi ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u00ecnh li\u1ec1u d\u00f9ng cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y. Kh\u00f4ng c\u00f3 th\u00f4ng tin v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn suy gi\u1ea3m nghi\u00eam tr\u1ecdng (\u0111\u1ed9 thanh th\u1ea3i Creatinin &lt; 20 ml\/ph\u00fat).<\/p>\n<p><em>T\u01b0\u01a1ng t\u00e1c thu\u1ed1c<\/em><\/p>\n<p>Trong c\u00e1c d\u1eef li\u1ec7u v\u1ec1 \u1ee9c ch\u1ebf enzym in vitro kh\u00f4ng th\u1ea5y c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf c\u1ee7a Citalopram tr\u00ean c\u00e1c cytochrom CYP3A4, CYP2C9, ho\u1eb7c CYP2E1, nh\u01b0ng cho th\u1ea5y c\u00f3 \u1ee9c ch\u1ebf y\u1ebfu l\u00ean Cytochrom CYP1A2, CYP2D6, v\u00e0 CYP2C19. Citalopram \u0111\u01b0\u1ee3c d\u1ef1 ki\u1ebfn s\u1ebd \u00edt c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a in vivo qua trung gian b\u1edfi c\u00e1c cytochrom tr\u00ean. Tuy nhi\u00ean, c\u00e1c d\u1eef li\u1ec7u in vivo v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p>V\u00ec CYP3A4 v\u00e0 CYP2C19 l\u00e0 c\u00e1c enzym ch\u00ednh tham gia v\u00e0o qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a c\u1ee7a Citalopram, n\u00ean c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf m\u1ea1nh CYP3A4 (v\u00ed d\u1ee5 ketoconazol, itraconazol, v\u00e0 kh\u00e1ng sinh macrolid) v\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf m\u1ea1nh CYP2C19 (v\u00ed d\u1ee5 omeprazo\u1ec9) c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u1ed9 thanh th\u00e0i c\u1ee7a Citalopram. Tuy nhi\u00ean, vi\u1ec7c d\u00f9ng chung Citalopram v\u1edbi c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf m\u1ea1nh CYP3A4 nh\u01b0 ketoconazol l\u1ea1i kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Citalopram.<\/p>\n<p>V\u00ec Citalopram \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1edfi nhi\u1ec1u h\u1ec7 enzym, n\u00ean s\u1ef1 \u1ee9c ch\u1ebf m\u1ed9t enzym duy nh\u1ea5t c\u00f3 th\u1ec3 kh\u00f4ng l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 \u0111\u1ed9 thanh th\u1ea3i Citalopram. M\u1ee9c \u0111\u1ed9 \u0111\u1ea1t \u1eeb\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh c\u1ee7a Citalopram kh\u00f4ng kh\u00e1c bi\u1ec7t nhi\u1ec1u trong chuy\u1ec3n h\u00f3a h\u1eb9p v\u00e0 chuy\u1ec3n h\u00f3a r\u1ed9ng c\u1ee7a CYP2D6 sau khi u\u1ed1ng \u0111a li\u1ec1u Citalopram, cho th\u1ea5y vi\u1ec7c d\u00f9ng chung Citalopram v\u1edbi m\u1ed9t thu\u1ed1c \u1ee9c ch\u1ebf CYP2D6 d\u01b0\u1eddng nh\u01b0 kh\u00f4ng c\u00f3 t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 l\u00ean l\u00e2m s\u00e0ng trong trao \u0111\u1ed5i ch\u1ea5t<\/p>\n<p><strong>5.3 Gi\u1ea3i th\u00edch: <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong>5.4 Thay th\u1ebf thu\u1ed1c : <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><\/p>\n<p><strong>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/strong><\/p>\n<p>&#8230;.<\/p>\n<p><strong>6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<p><strong>6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n<p>N\u01a1i kh\u00f4, tr\u00e1nh \u00e1nh s\u00e1ng, nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30\u00b0C.<\/p>\n<p><strong>6.4. Th\u00f4ng tin kh\u00e1c :<\/strong><\/p>\n<p>Kh\u00f4ng c\u00f3.<\/p>\n<p><strong>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Citalopram Ph\u00e2n lo\u1ea1i: Thu\u00f4\u0301c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin ch\u1ecdn l\u1ecdc (SSRIs) Nh\u00f3m ph\u00e1p l\u00fd: Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine) M\u00e3 ATC (Anatomical Therapeutic Chemical): N06AB04. Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c: Bi\u1ec7t d\u01b0\u1ee3c: Cinasav H\u00e3ng s\u1ea3n xu\u1ea5t : C\u00f4ng [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":18792,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","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":"default","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":[419],"tags":[632],"class_list":["post-18791","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-citalopram"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/18791","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=18791"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/18791\/revisions"}],"predecessor-version":[{"id":50132,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/18791\/revisions\/50132"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/18792"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=18791"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=18791"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=18791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}