{"id":26730,"date":"2020-12-16T15:27:37","date_gmt":"2020-12-16T08:27:37","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=26730"},"modified":"2025-01-08T12:24:53","modified_gmt":"2025-01-08T05:24:53","slug":"vancomycin-vancomycin-vinphaco","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/vancomycin-vancomycin-vinphaco\/","title":{"rendered":"Vancomycin &#8211; Vancomycin Vinphaco"},"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> <\/strong><a href=\"https:\/\/pharmog.com\/wp\/vancomycin\/\"><strong>Vancomycin<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c Kh\u00e1ng sinh nho\u0301m glycopeptid.<\/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): A07AA09, J01XA01..<\/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> Vancomycin<\/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 V\u0129nh Ph\u00fac<\/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>L\u1ecd b\u1ed9t tinh khi\u1ebft \u0111\u00f4ng kh\u00f4 \u0111\u1ebf pha ti\u00eam 500 mg; 1 000 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>VANCOMYCIN 1g<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i l\u1ecd b\u1ed9t c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Vancomycin<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>100 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=\"564\" height=\"329\" class=\"wp-image-26731\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/12\/word-image-238.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/12\/word-image-238.png 564w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/12\/word-image-238-300x175.png 300w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/12\/word-image-238-274x160.png 274w\" sizes=\"auto, (max-width: 564px) 100vw, 564px\" \/><\/p>\n<p><strong>3. Video by Pharmog:<\/strong><\/p>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog SS1 - T\u1eadp 08] - D\u01b0\u1ee3c l\u00fd c\u00e1c thu\u1ed1c kh\u00e1ng sinh\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/0TIIfoiJFwA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\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>Vancomycin l\u00e0 kh\u00e1ng sinh ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong b\u1ec7nh vi\u1ec7n v\u00e0 ch\u1ec9 cho nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd, v\u00ec c\u00f3 nguy c\u01a1 cao v\u1ec1 c\u00e1c ph\u1ea3n \u1ee9ng kh\u00f4ng mong mu\u1ed1n.<\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n n\u1eb7ng do c\u00e1c ch\u1ee7ng vi khu\u1ea9n nh\u1ea1y c\u1ea3m v\u1edbi vancomycin trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n m\u00e1u kh\u00f3 \u0111i\u1ec1u tr\u1ecb do c\u00e1c vi khu\u1ea9n Gram d\u01b0\u01a1ng nh\u01b0 vi\u00eam m\u00e0ng trong tim nhi\u1ec5m khu\u1ea9n v\u00e0 vi\u00eam m\u00e0ng trong tim c\u00f3 l\u1eafp van nh\u00e2n t\u1ea1o.<\/p>\n<p>Vancomycin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi b\u1ec7nh d\u1ecb \u1ee9ng penicilin ho\u1eb7c \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb th\u1ea5t b\u1ea1i. N\u1ebfu \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng trong tim b\u1eb1ng benzylpenicilin ph\u1ed1i h\u1ee3p v\u1edbi aminoglycosid kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 sau 2 \u2013 3 ng\u00e0y, th\u00ec n\u00ean d\u00f9ng vancomycin. C\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi aminoglycosid ho\u1eb7c rifampicin \u0111\u1ec3 t\u0103ng hi\u1ec7u l\u1ef1c.<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n m\u00e1u n\u1eb7ng do t\u1ee5 c\u1ea7u m\u00e0 c\u00e1c kh\u00e1ng sinh kh\u00e1c kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng, nh\u01b0 nhi\u1ec5m khu\u1ea9n do S. aureus kh\u00e1ng isoxazolyl \u2013 penicilin, hay ph\u1ed5 bi\u1ebfn h\u01a1n l\u00e0 S. epidermidis kh\u00e1ng isoxa \u2013 penicilin.<\/p>\n<p>C\u00e1c nhi\u1ec5m khu\u1ea9n c\u1ea7u n\u1ed1i do Staphylococcus th\u01b0\u1eddng l\u00e0 S. epidermidis, nh\u01b0 tr\u01b0\u1eddng h\u1ee3p d\u1eabn l\u01b0u n\u00e3o th\u1ea5t v\u00e0 c\u1ea7u n\u1ed1i l\u1ecdc m\u00e1u. Vancomycin \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch v\u00e0 cho v\u00e0o d\u1ecbch th\u1ea9m t\u00e1ch.<\/p>\n<p>D\u00f9ng d\u1ef1 ph\u00f2ng vi\u00eam m\u00e0ng trong tim tr\u01b0\u1edbc ph\u1eabu thu\u1eadt \u0111\u1eb7c bi\u1ec7t l\u00e0 ph\u1eabu thu\u1eadt ph\u1ee5 khoa v\u00e0 \u0111\u01b0\u1eddng ru\u1ed9t cho c\u00e1c ng\u01b0\u1eddi b\u1ec7nh d\u1ecb \u1ee9ng penicilin.<\/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>Vancomycin \u0111\u01b0\u1ee3c truy\u1ec1n t\u0129nh m\u1ea1ch ch\u1eadm \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n to\u00e0n th\u00e2n. Thu\u1ed1c r\u1ea5t k\u00edch \u1ee9ng v\u1edbi m\u00f4 n\u00ean kh\u00f4ng \u0111\u01b0\u1ee3c ti\u00eam b\u1eafp.<\/p>\n<p>Truy\u1ec1n t\u0129nh m\u1ea1ch gi\u00e1n \u0111o\u1ea1n: Th\u00eam 10 ml n\u01b0\u1edbc v\u00f4 khu\u1ea9n \u0111\u1ec3 ti\u00eam trong \u1ed1ng dung m\u00f4i v\u00e0o l\u1ecd b\u1ed9t \u0111\u00f4ng kh\u00f4 ch\u1ee9a lg vancomycin, l\u1eafc cho tan ho\u00e0n to\u00e0n. Dung d\u1ecbch ch\u1ee9a 1,0 g vancomycin ph\u1ea3i \u0111\u01b0\u1ee3c pha lo\u00e3ng trong 200 ml dung d\u1ecbch ti\u00eam truy\u1ec1n dextrose 5% ho\u1eb7c natri clorid 0,9% \u0111\u1ec3 t\u1ea1o ra dung d\u1ecbch pha lo\u00e3ng c\u00f3 n\u1ed3ng d\u1ed9 vancomycin kh\u00f4ng qu\u00e1 5 mg\/ml v\u00e0 \u0111\u01b0\u1ee3c truy\u1ec1n t\u0129nh m\u1ea1ch ch\u1eadm trong \u00edt nh\u1ea5t 100 ph\u00fat. Dung d\u1ecbch sau khi pha lo\u00e3ng \u0111\u1ec3 ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ngay, ch\u1ec9 b\u1ea3o qu\u1ea3n t\u1ed1i \u0111a 24 gi\u1edd \u1edf nhi\u1ec7t \u0111\u1ed9 2 &#8211; 8\u00b0c. \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u1ea7n h\u1ea1n ch\u1ebf ch\u1ea5t l\u1ecfng, c\u00f3 th\u1ec3 truy\u1ec1n dung d\u1ecbch c\u00f3 n\u1ed3ng \u0111\u1ed9 vancomycin 10 mg\/ml, tuy nhi\u00ean s\u1ebd l\u00e0m t\u0103ng nguy c\u01a1 x\u1ea3y ra t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n.<\/p>\n<p>C\u1ea7n tr\u00e1nh ti\u00eam t\u0129nh m\u1ea1ch nhanh v\u00e0 trong khi truy\u1ec1n ph\u1ea3i theo d\u00f5i ch\u1eb7t ch\u1ebd d\u1ec3 ph\u00e1t hi\u1ec7n h\u1ea1 huy\u1ebft \u00e1p n\u1ebfu x\u1ea3y ra.<\/p>\n<p>Khi kh\u00f4ng th\u1ebf truy\u1ec1n t\u0129nh m\u1ea1ch gi\u00e1n \u0111o\u1ea1n, c\u00f3 th\u1ec3 truy\u1ec1n t\u0129nh m\u1ea1ch li\u00ean t\u1ee5c: Cho 1 &#8211; 2 gam vancomycin \u0111\u01b0\u1ee3c pha v\u00e0o dung d\u1ecbch glucose 5% ho\u1eb7c natri clorid 0,9% v\u1eeba \u0111\u1ee7 \u0111\u1ec3 truy\u1ec1n nh\u1ecf gi\u1ecdt trong 24 gi\u1edd.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>Li\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c t\u00ednh theo vancomycin base.<\/p>\n<p><em>V\u1edbi ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng: <\/em>500 mg, c\u1ee9 6 gi\u1edd m\u1ed9t l\u1ea7n ho\u1eb7c 1 g, c\u1ee9 12 gi\u1edd m\u1ed9t l\u1ea7n. \u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n do vi khu\u1ea9n nh\u1ea1y c\u1ea3m c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 48 &#8211; 72 gi\u1edd. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i v\u00e0 m\u1ee9c \u0111\u1ed9 nhi\u1ec5m khu\u1ea5n. Ng\u01b0\u1eddi b\u1ec7nh vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c do t\u1ee5 c\u1ea7u c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb \u00edt nh\u1ea5t 3 tu\u1ea7n.<\/p>\n<p><em>Tr\u1ebb em t\u1eeb 1 th\u00e1ng tu\u1ed5i tr\u1edf l\u00ean:<\/em> 10 mg\/kg, c\u1ee9 6 gi\u1edd m\u1ed9t l\u1ea7n. T\u1ed1i \u0111a 2 g\/ng\u00e0y.<\/p>\n<p><em>Tr\u1ebb s\u01a1 sinh:<\/em> Li\u1ec1u \u0111\u1ea7u ti\u00ean 15 mg\/kg, ti\u1ebfp theo l\u00e0 10 mg\/kg, c\u1ee9 12 gi\u1edd m\u1ed9t l\u1ea7n v\u1edbi tr\u1ebb d\u01b0\u1edbi 1 tu\u1ea7n tu\u1ed5i, ho\u1eb7c ti\u1ebfp theo l\u00e0 10 mg\/kg, c\u1ee9 8 gi\u1edd m\u1ed9t l\u1ea7n cho tr\u1ebb t\u1eeb 1 tu\u1ea7n t\u1edbi 1 th\u00e1ng tu\u1ed5i.<\/p>\n<p><em>V\u1edbi ng\u01b0\u1eddi suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn , tr\u1ebb \u0111\u1ebb non, v\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i<\/em><\/p>\n<p>C\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf ng\u01b0\u1eddi b\u1ec7nh c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn suy gi\u1ea3m, tr\u1ebb \u0111\u1ebb non v\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i. \u0110o n\u1ed3ng \u0111\u1ed9 vancomycin trong huy\u1ebft thanh c\u00f3 th\u1ec3 gi\u00fap \u00edch, \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi b\u1ecb b\u1ec7nh r\u1ea5t n\u1eb7ng.<\/p>\n<p>N\u1ebfu \u0111o \u0111\u01b0\u1ee3c ho\u1eb7c t\u00ednh \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c \u0111\u1ed9 thanh th\u1ea3i creatinin th\u00ec c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng ch\u1ebf \u0111\u1ed9 li\u1ec1u nh\u01b0 sau: D\u00f9ng m\u1ed9t li\u1ec1u kh\u1edfi \u0111\u1ea7u 15 mg\/kg, li\u1ec1u h\u00e0ng ng\u00e0y ti\u1ebfp theo (t\u00ednh b\u1eb1ng mg) g\u1ea5p 15 l\u1ea7n t\u1ed1c \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn (t\u00ednh b\u1eb1ng ml\/ph\u00fat), ng\u01b0\u1eddi b\u1ec7nh v\u00f4 ni\u1ec7u d\u00f9ng li\u1ec1u 1 g m\u1ed7i 7 \u0111\u1ebfn 10 ng\u00e0y.<\/p>\n<p><em>\u00d0\u1ed9 thanh th\u1ea3i creatinin c\u00f3 th\u1ec3 t\u00ednh theo creatinin huy\u1ebft thanh:<\/em><\/p>\n<p>Cho nam gi\u1edbi:<\/p>\n<p>\u00d0\u1ed9 thanh th\u1ea3i creatinin = th\u00e2n tr\u1ecdng (kg) x (140 &#8211; tu\u1ed5i ng\u01b0\u1eddi b\u1ec7nh)\/72 x n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh (mg\/100 ml)<\/p>\n<p>Cho n\u1eef gi\u1edbi:<\/p>\n<p>\u00d0\u1ed9 thanh th\u1ea3i creatinin = 0,85 x tr\u1ecb s\u1ed1 tr\u00ean<\/p>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Ng\u01b0\u1eddi m\u1eabn c\u1ea3m v\u1edbi vancomycin hay b\u1ea5t c\u1ee9 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c<\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p>D\u00f9ng vancomycin k\u00e9o d\u00e0i c\u00f3 th\u1ec3 l\u00e0m ph\u00e1t tri\u1ec3n qu\u00e1 m\u1ee9c c\u00e1c vi khu\u1ea9n kh\u00f4ng nh\u1ea1y c\u1ea3m, v\u00ec v\u1eady c\u1ea7n ph\u1ea3i theo d\u00f5i c\u1ea9n th\u1eadn.<\/p>\n<p>V\u1edbi c\u00e1c ng\u01b0\u1eddi b\u1ec7nh suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, c\u1ea7n ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u v\u00e0 theo d\u00f5i ch\u1ee9c n\u0103ng th\u1eadn ch\u1eb7t ch\u1ebd.<\/p>\n<p>C\u1ea7n tr\u00e1nh d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c thu\u1ed1c c\u00f3 \u0111\u1ed9c t\u00ednh cao tr\u00ean th\u1eadn v\u00e0 th\u00ednh gi\u00e1c. D\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi aminoglycosid g\u00e2y nguy c\u01a1 \u0111\u1ed9c cao v\u1edbi th\u1eadn, tuy nhi\u00ean v\u1eabn c\u1ea7n ph\u1ed1i h\u1ee3p thu\u1ed1c trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n n\u1eb7ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/p>\n<p>C\u1ea7n \u0111o ch\u1ee9c n\u0103ng th\u00ednh gi\u00e1c nhi\u1ec1u l\u1ea7n ph\u00f2ng nguy c\u01a1 \u0111\u1ed9c \u0111\u1ed1i v\u1edbi th\u00ednh gi\u00e1c khi d\u00f9ng vancomycin.<\/p>\n<p>Theo d\u00f5i s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u c\u00e1c ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng thu\u1ed1c k\u00e9o d\u00e0i ho\u1eb7c d\u00f9ng ph\u1ed1i h\u1ee3p thu\u1ed1c v\u00ec vancomycin c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh c\u00f3 h\u1ed3i ph\u1ee5c.<\/p>\n<p>Vancomycin g\u00e2y k\u00edch \u1ee9ng m\u00f4, n\u00ean b\u1eaft bu\u1ed9c ph\u1ea3i ti\u00eam t\u0129nh m\u1ea1ch. \u00d0au, \u1ea5n \u0111au v\u00e0 ho\u1ea1i t\u1eed x\u1ea3y ra n\u1ebfu ti\u00eam b\u1eafp ho\u1eb7c ti\u00eam ra ngo\u00e0i m\u1ea1ch.<\/p>\n<p>Vi\u00eam t\u1eafc t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 x\u1ea3y ra. Truy\u1ec1n t\u1ed1c \u0111\u1ed9 ch\u1eadm dung d\u1ecbch thu\u1ed1c pha lo\u00e3ng (2,5 \u0111\u1ebfn 5 mg\/ml) v\u00e0 thay \u0111\u1ed5i v\u1ecb tr\u00ed ti\u00eam gi\u00fap h\u1ea1n ch\u1ebf t\u1ea7n su\u1ea5t v\u00e0 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y.<\/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>Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y m\u1ed9t s\u1ed1 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn nh\u01b0 ban \u0111\u1ecf d\u1eef d\u1ed9i k\u00e8m ng\u1ee9a, h\u1ea1 huy\u1ebft \u00e1p, \u0111au th\u1eaft ng\u1ef1c, co th\u1eaft h\u1ec7 c\u01a1 l\u01b0ng, suy h\u00f4 h\u1ea5p. Do \u0111\u00f3 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c khi l\u00e1i xe, v\u1eadn h\u00e0nh m\u00e1y m\u00f3c ho\u1eb7c l\u00e0m vi\u1ec7c tr\u00ean cao.<\/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: B2<\/p>\n<p>US FDA pregnancy category: B (\u0111\u01b0\u01a1\u0300ng u\u00f4\u0301ng)<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Kinh nghi\u1ec7m l\u00e2m s\u00e0ng v\u00e0 c\u00e1c d\u1eef li\u1ec7u v\u1ec1 d\u00f9ng thu\u1ed1c cho ng\u01b0\u1eddi mang thai c\u00f2n \u00edt. Ch\u01b0a r\u00f5 thu\u1ed1c c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u1edbi kh\u1ea3 n\u0103ng sinh s\u1ea3n hay kh\u00f4ng.<\/p>\n<p>M\u1edbi c\u00f3 duy nh\u1ea5t m\u1ed9t nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng c\u00f3 \u0111\u1ed1i ch\u1ee9ng (1991), theo d\u00f5i kh\u1ea3 n\u0103ng g\u00e2y \u0111\u1ed9c tr\u00ean th\u1eadn v\u00e0 th\u00ednh gi\u00e1c cho tr\u1ebb s\u01a1 sinh c\u1ee7a 10 b\u00e0 m\u1eb9 d\u00f9ng vancomycin ti\u00eam t\u0129nh m\u1ea1ch trong l\u00fac mang thai. Kh\u00f4ng c\u00f3 tr\u01b0\u1eddng h\u1ee3p n\u00e0o b\u1ecb m\u1ea5t kh\u1ea3 n\u0103ng nghe v\u00e0 \u0111\u1ed9c v\u1edbi th\u1eadn do vancomycin. Thu\u1ed1c \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong m\u00e1u cu\u1ed1ng nhau. Tuy nhi\u00ean, s\u1ed1 l\u01b0\u1ee3ng ng\u01b0\u1eddi b\u1ec7nh trong nghi\u00ean c\u1ee9u n\u00e0y c\u00f2n \u00edt v\u00e0 thu\u1ed1c ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng trong 6 th\u00e1ng cu\u1ed1i c\u1ee7a thai k\u1ef3 n\u00ean ch\u01b0a r\u00f5 vancomycin c\u00f3 g\u00e2y h\u1ea1i cho thai nhi hay kh\u00f4ng. Ch\u1ec9 d\u00f9ng vancomycin cho ph\u1ee5 n\u1eef mang thai trong tr\u01b0\u1eddng h\u1ee3p th\u1eadt c\u1ea7n thi\u1ebft, cho nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh nhi\u1ec5m khu\u1ea5n r\u1ea5t n\u1eb7ng.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Vancomycin ti\u1ebft qua s\u1eefa m\u1eb9. \u1ea2nh h\u01b0\u1edfng c\u1ee7a vancomycin tr\u00ean tr\u1ebb \u0111ang b\u00fa m\u1eb9 c\u00f3 d\u00f9ng vancomycin ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5. Vancomycin \u0111\u01b0\u1ee3c h\u1ea5p thu r\u1ea5t \u00edt qua \u0111\u01b0\u1eddng u\u1ed1ng, khi \u1ed1ng ti\u00eau h\u00f3a b\u00ecnh th\u01b0\u1eddng, nguy\u00ean v\u1eb9n. Do v\u1eady, h\u1ea5p thu thu\u1ed1c v\u00e0o h\u1ec7 tu\u1ea7n ho\u00e0n c\u1ee7a tr\u1ebb kh\u00f4ng \u0111\u00e1ng k\u1ec3. Tuy v\u1eady, c\u00f3 ba v\u1ea5n \u0111\u1ec1 v\u1edbi tr\u1ebb \u0111ang b\u00fa s\u1eefa m\u1eb9: g\u00e2y bi\u1ebfn \u0111\u1ed5i vi khu\u1ea9n ch\u00ed \u0111\u01b0\u1eddng ru\u1ed9t, t\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp l\u00ean tr\u1ebb \u0111ang b\u00fa m\u1eb9 (v\u00ed d\u1ee5 nh\u01b0 ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng hay m\u1eabn c\u1ea3m) v\u00e0 l\u00e0m sai k\u1ebft qu\u1ea3 nu\u00f4i c\u1ea5y vi khu\u1ea9n. C\u0103n c\u1ee9 v\u00e0o t\u1ea7m quan tr\u1ecdng c\u1ee7a thu\u1ed1c \u0111\u1ed1i v\u1edbi b\u00e0 m\u1eb9 \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh ng\u1eebng thu\u1ed1c hay ng\u1eebng cho con b\u00fa.<\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n hay g\u1eb7p nh\u1ea5t v\u1edbi vancomycin l\u00e0 vi\u00eam t\u0129nh m\u1ea1ch v\u00e0 ph\u1ea3n \u1ee9ng gi\u1ea3 d\u1ecb \u1ee9ng. N\u1ebfu truy\u1ec1n thu\u1ed1c qu\u00e1 nhanh, c\u00f3 nguy c\u01a1 x\u1ea3y ra ph\u1ea3n \u1ee9ng r\u1ea5t nghi\u00eam tr\u1ecdng do gi\u1ea3i ph\u00f3ng histamin, \u0111\u00f3 l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng gi\u1ea3 d\u1ecb \u1ee9ng. C\u00e1c ph\u1ea3n \u1ee9ng n\u00e0y r\u1ea5t kh\u00f3 ph\u00e2n bi\u1ec7t v\u1edbi ph\u1ea3n \u1ee9ng t\u0103ng m\u1eabn c\u1ea3m mi\u1ec5n d\u1ecbch th\u1ef1c s\u1ef1.<\/p>\n<p><em>Th\u01b0\u1eddng g\u1eb7p, ADR &gt; 1\/100<\/em><\/p>\n<p>To\u00e0n th\u00e2n: Ph\u1ea3n \u1ee9ng gi\u1ea3 d\u1ecb \u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf 3% ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng thu\u1ed1c. C\u00f3 3 lo\u1ea1i ph\u1ea3n \u1ee9ng:<\/p>\n<p>Ban \u0111\u1ecf d\u1eef d\u1ed9i: H\u1ed9i ch\u1ee9ng c\u1ed5 \u0111\u1ecf hay ng\u01b0\u1eddi \u0111\u1ecf. Ban \u0111\u1ecf \u0111\u01b0\u1ee3c th\u1ea5y \u1edf h\u1ecdng, ph\u1ea7n ng\u1ef1c tr\u00ean v\u00e0 m\u1eb7t. Ph\u1ea3n \u1ee9ng da n\u00e0y c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n trong v\u00f2ng 10 ph\u00fat. M\u00e0y \u0111ay v\u00e0 ng\u1ee9a c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra. Ban \u0111\u1ecf s\u1ebd m\u1ea5t trong v\u00f2ng v\u00e0i gi\u1edd.<\/p>\n<p>H\u1ea1 huy\u1ebft \u00e1p: H\u1ea1 huy\u1ebft \u00e1p t\u00e2m thu, xu\u1ed1ng kho\u1ea3ng 20 \u2013 25%. Th\u1eadm ch\u00ed c\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p v\u00f4 t\u00e2m thu khi truy\u1ec1n thu\u1ed1c qu\u00e1 nhanh.<\/p>\n<p>\u00d0au v\u00e0 co th\u1eaft c\u01a1: Ng\u01b0\u1eddi b\u1ec7nh b\u1ecb c\u01a1n \u0111au c\u1ea5p \u1edf ng\u1ef1c v\u00e0 h\u1ec7 c\u01a1 sau l\u01b0ng. \u00d0i\u1ec7n t\u00e2m \u0111\u1ed3 v\u1eabn b\u00ecnh th\u01b0\u1eddng. Th\u1edf r\u00edt v\u00e0 suy h\u00f4 h\u1ea5p c\u00f3 th\u1ec3 x\u1ea3y ra.<\/p>\n<p>Nh\u1eefng ph\u1ea3n \u1ee9ng n\u00e0y l\u00e0nh t\u00ednh, t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 gi\u1ea3i ph\u00f3ng histamin. D\u00f9ng thu\u1ed1c kh\u00e1ng th\u1ee5 th\u1ec3 histamin \u2013 1, hydroxyzin 50 mg, hai gi\u1edd tr\u01b0\u1edbc khi truy\u1ec1n vancomycin s\u1ebd gi\u1ea3m b\u1edbt nguy c\u01a1 c\u1ee7a c\u00e1c ph\u1ea3n \u1ee9ng n\u00e0y. Vancomycin ph\u1ea3i \u0111\u01b0\u1ee3c truy\u1ec1n ch\u1eadm.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: Vi\u00eam t\u1eafc t\u0129nh m\u1ea1ch. Truy\u1ec1n thu\u1ed1c ch\u1eadm v\u00e0 pha lo\u00e3ng \u0111\u00fang c\u00e1ch dung d\u1ecbch truy\u1ec1n t\u1edbi n\u1ed3ng \u0111\u1ed9 2,5 \u2013 5 mg\/ml s\u1ebd gi\u1ea3m b\u1edbt \u0111\u00e1ng k\u1ec3 nguy c\u01a1 ph\u1ea3n \u1ee9ng n\u00e0y.<\/p>\n<p>Ti\u1ebft ni\u1ec7u \u2013 sinh d\u1ee5c: T\u0103ng creatinin v\u00e0 nitrogen huy\u1ebft thanh l\u00e0 bi\u1ec3u hi\u1ec7n \u0111\u1ed9c v\u00e0 t\u1ed5n th\u01b0\u01a1ng th\u1eadn.<\/p>\n<p><em>\u00cdt g\u1eb7p, 1\/1000 &lt; ADR &lt; 1\/100<\/em><\/p>\n<p>Da: Ph\u00e1t ban, m\u00e0y \u0111ay, ng\u1ee9a.<\/p>\n<p>Tai: Gi\u1ea3m kh\u1ea3 n\u0103ng nghe, ho\u1eb7c \u0111i\u1ebfc.<\/p>\n<p><em>Hi\u1ebfm g\u1eb7p, ADR&lt; 1\/1000<\/em><\/p>\n<p>To\u00e0n th\u00e2n: Ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7, s\u1ed1t, r\u00e9t run, ch\u00f3ng m\u1eb7t.<\/p>\n<p>M\u00e1u: Gi\u1ea3m ti\u1ec3u c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh.<\/p>\n<p>Da: Vi\u00eam da tr\u00f3c.<\/p>\n<p>Tai: \u00d9 tai.<\/p>\n<p>\u00d0\u00e3 c\u00f3 m\u1ed9t s\u1ed1 ca m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t c\u00f3 h\u1ed3i ph\u1ee5c ho\u1eb7c vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c. \u00d0\u1ed9c t\u00ednh tr\u00ean th\u00ednh gi\u00e1c c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c ho\u1eb7c v\u0129nh vi\u1ec5n. Ch\u1ee7 y\u1ebfu g\u1eb7p \u1edf ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng thu\u1ed1c qu\u00e1 li\u1ec1u, ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 b\u1ecb gi\u1ea3m th\u00ednh l\u1ef1c t\u1eeb tr\u01b0\u1edbc, v\u00e0 ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c thu\u1ed1c \u0111\u1ed9c v\u1edbi th\u00ednh gi\u00e1c kh\u00e1c nh\u01b0 c\u00e1c aminoglycosid.<\/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>\u0110\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 x\u1ea3y ra h\u1ed9i ch\u1ee9ng \u201cng\u01b0\u1eddi \u0111\u1ecf\u201d c\u1ea7n truy\u1ec1n thu\u1ed1c ch\u1eadm trong kho\u1ea3ng 60 ph\u00fat. D\u00f9ng thu\u1ed1c kh\u00e1ng histamin tr\u01b0\u1edbc khi truy\u1ec1n vancomycin l\u00e0m gi\u1ea3m b\u1edbt nguy c\u01a1 c\u1ee7a c\u00e1c ph\u1ea3n \u1ee9ng n\u00e0y. N\u1ebfu b\u1ecb t\u1ee5t huy\u1ebft \u00e1p n\u1eb7ng, c\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng histamin, corticosteroid, truy\u1ec1n d\u1ecbch.<\/p>\n<p>\u0110\u1ed9c t\u00ednh tr\u00ean th\u00ednh gi\u00e1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u b\u1eb1ng \u00f9 tai. Do v\u1eady ph\u1ea3i ng\u1eebng thu\u1ed1c ngay n\u1ebfu th\u1ea5y d\u1ea5u hi\u1ec7u n\u00e0y.<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam \u0111\u1ea1i tr\u00e0ng nh\u1eb9 s\u1ebd t\u1ef1 h\u1ebft khi ng\u1eebng thu\u1ed1c. Tuy nhi\u00ean c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u1ea7n truy\u1ec1n d\u1ecbch, \u0111i\u1ec7n gi\u1ea3i, b\u1ed5 sung protein v\u00e0 c\u00f3 th\u1ec3 c\u1ea7n d\u00f9ng kh\u00e1ng sinh th\u00edch h\u1ee3p (v\u00ed d\u1ee5 metronidazol)<\/p>\n<p><strong>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n<p>C\u00e1c thu\u1ed1c g\u00e2y m\u00ea d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi vancomycin c\u00f3 th\u1ec3 g\u00e2y ban \u0111\u1ecf, n\u00f3ng b\u1eebng gi\u1ed1ng ph\u1ea3n \u1ee9ng gi\u1ea3i ph\u00f3ng histamin v\u00e0 ph\u1ea3n \u1ee9ng d\u1ea1ng ph\u1ea3n v\u1ec7. N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh \u0111ang d\u00f9ng c\u1ea3 hai lo\u1ea1i thu\u1ed1c, c\u1ea7n k\u1ebft th\u00fac truy\u1ec1n vancomycin tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u kh\u1edfi m\u00ea.<\/p>\n<p>C\u00e1c thu\u1ed1c \u0111\u1ed9c v\u1edbi th\u1eadn v\u00e0 th\u00ednh gi\u00e1c (d\u00f9ng ngo\u00e0i ho\u1eb7c to\u00e0n th\u00e2n) d\u00f9ng \u0111\u1ed3ng th\u1eddi ho\u1eb7c ti\u1ebfp theo v\u1edbi vancomycin, v\u00ed d\u1ee5 nh\u01b0 amphotericin B, aminoglycosid, bacitracin, polymyxin B, colistin, viomycin hay cisplatin l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh tr\u00ean th\u1eadn v\u00e0 th\u00ednh gi\u00e1c, ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft v\u00e0 ph\u1ea3i theo d\u00f5i th\u1eadt c\u1ea9n th\u1eadn.<\/p>\n<p>Khi ph\u1ed1i h\u1ee3p vancomycin v\u1edbi dobutamin ho\u1eb7c dopamin c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 vancomycin huy\u1ebft thanh.<\/p>\n<p>Vancomycin l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng phong b\u1ebf th\u1ea7n kinh c\u01a1 c\u1ee7a c\u00e1c thu\u1ed1c gi\u00e3n c\u01a1 nh\u01b0 suxamethonium, vecuronium, rocuronium.<\/p>\n<p>D\u00f9ng vancomycin c\u00f9ng v\u1edbi ciclosporin, tacrolimus l\u00e0m gia t\u0103ng \u0111\u1ed9c t\u00ednh tr\u00ean th\u1eadn.<\/p>\n<p>Vancomycin khi d\u00f9ng c\u00f9ng v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u quai s\u1ebd l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh tr\u00ean tai. c\u1ea7n th\u1eadn tr\u1ecdng khi d\u00f9ng vancomycin v\u1edbi furosemid, v\u00ec c\u00f3 th\u1ec3 furosemid, \u0111\u01a1n thu\u1ea7n ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi theophylin, \u0111\u1ec1u l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 vancomycin huy\u1ebft thanh.<\/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>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p>D\u00f9ng thu\u1ed1c qu\u00e1 li\u1ec1u t\u0103ng nguy c\u01a1 g\u00e2y \u0111\u1ed9c c\u1ee7a thu\u1ed1c.<\/p>\n<p>X\u1eed l\u00fd: \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3, duy tr\u00ec m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn. Lo\u1ea1i b\u1ecf vancomycin b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ea9m ph\u00e2n \u00edt c\u00f3 hi\u1ec7u qu\u1ea3. L\u1ecdc m\u00e1u qua m\u00e0ng v\u00e0 qua ch\u1ea5t h\u1ea5p ph\u1ee5 gi\u00fap t\u0103ng t\u1ed1c \u0111\u1ed9 th\u1ea3i tr\u1eeb vancomycin.<\/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>M\u00e3 ATC: J01XA01.<\/p>\n<p>Vancomycin l\u00e0 kh\u00e1ng sinh c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea9n b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh sinh t\u1ed5ng h\u1ee3p v\u1ecf t\u1ebf b\u00e0o vi khu\u1ea9n. Vancomycin c\u00f2n t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn t\u00ednh th\u1ea5m m\u00e0ng t\u1ebf b\u00e0o v\u00e0 qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p RNA c\u1ee7a vi khu\u1ea9n. Cho t\u1edbi nay, ch\u01b0a c\u00f3 b\u00e1o c\u00e1o v\u1ec1 kh\u00e1ng ch\u00e9o c\u1ee7a vi khu\u1ea9n gi\u1eefa c\u00e1c kh\u00e1ng sinh kh\u00e1c v\u00e0 vancomycin.<\/p>\n<p><em>Ph\u1ed5 kh\u00e1ng khu\u1ea9n:<\/em><\/p>\n<p>Vancomycin c\u00f3 t\u00e1c d\u1ee5ng t\u1ed1t tr\u00ean c\u00e1c vi khu\u1ea9n Gram d\u01b0\u01a1ng \u01b0a kh\u00ed v\u00e0 k\u1ef5 kh\u00ed, bao g\u1ed3m: T\u1ee5 c\u1ea7u, g\u1ed3m Staphylococcus aureus, Staphylococcus epidermidis (k\u1ec3 c\u1ea3 c\u00e1c ch\u1ee7ng kh\u00e1ng methicilin kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t). li\u00ean c\u1ea7u, g\u1ed3m Streptococcus pneumoniae (k\u1ec3 c\u1ea3 ch\u1ee7ng \u0111\u00e3 kh\u00e1ng penicilin), Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus bovis, c\u1ea7u tr\u00e0ng khu\u1ea9n (v\u00ed d\u1ee5 Enterococcus faecalis) v\u00e0 Clostridiae.<\/p>\n<p>Vancomycin c\u00f3 t\u00e1c d\u1ee5ng in vitro tr\u00ean c\u00e1c vi khu\u1ea9n: Listeria monocytogenes,Lactobacillus spp., Actinomyces spp., Clostridium spp. v\u00e0 Bacillus spp.<\/p>\n<p>C\u00e1c vi khu\u1ea9n Gram \u00e2m \u0111\u1ec1u kh\u00e1ng l\u1ea1i vancomycin. Thu\u1ed1c kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng in vitro \u0111\u1ed1i v\u1edbi c\u00e1c tr\u1ef1c khu\u1ea9n Gram \u00e2m, Mycobacteria, n\u1ea5m.<\/p>\n<p>Clostridium difficile nh\u1ea1y c\u1ea3m t\u1ed1t v\u1edbi thu\u1ed1c, nh\u01b0ng \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 kh\u00e1ng thu\u1ed1c, vancomycin ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng khi c\u00e1c kh\u00e1ng sinh kh\u00e1c \u0111\u00e3 kh\u00f4ng c\u00f2n t\u00e1c d\u1ee5ng. Kh\u00f4ng d\u00f9ng vancomycin cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u00e0 Clostridium difficile \u0111\u00e3 ph\u00e1t tri\u1ec3n qu\u00e1 m\u1ee9c sau khi d\u00f9ng kh\u00e1ng sinh.<\/p>\n<p>N\u1ed3ng \u0111\u1ed9 t\u1ed1i thi\u1ec3u \u1ee9c ch\u1ebf (MIC) c\u1ee7a vancomycin \u0111\u1ed1i v\u1edbi h\u1ea7u h\u1ebft c\u00e1c ch\u1ee7ng nh\u1ea1y c\u1ea3m t\u1eeb 0,1 \u0111\u1ebfn 2,0 microgam\/ml. N\u1ed3ng \u0111\u1ed9 di\u1ec7t khu\u1ea9n c\u1ee7a thu\u1ed1c kh\u00f4ng cao h\u01a1n nhi\u1ec1u so v\u1edbi MIC. C\u00e1c ch\u1ee7ng vi khu\u1ea9n c\u00f3 MIC d\u01b0\u1edbi 4,0 microgam\/ml \u0111\u01b0\u1ee3c coi l\u00e0 nh\u1ea1y c\u1ea3m v\u1edbi vancomycin, c\u00e1c ch\u1ee7ng c\u00f3 MIC t\u1eeb 4,0 microgam\/ml \u0111\u1ebfn 16,0 microgam\/ml l\u00e0 nh\u1ea1y c\u1ea3m v\u1eeba ph\u1ea3i. C\u00e1c ch\u1ee7ng vi khu\u1ea9n c\u00f3 MIC t\u1eeb 16 microgam\/ml tr\u1edf l\u00ean \u0111\u01b0\u1ee3c x\u1ebfp l\u00e0 lo\u1ea1i kh\u00e1ng thu\u1ed1c.<\/p>\n<p>V\u1edbi c\u00e1c Enterococcus, vancomycin kh\u00f4ng c\u00f3 hi\u1ec7u l\u1ef1c cao nh\u01b0 v\u1edbi c\u00e1c Staphylococcus. Thu\u1ed1c ch\u1ec9 c\u00f3 t\u00e1c d\u1ee5ng k\u00ecm khu\u1ea9n.<\/p>\n<p><em>Kh\u1ea3 n\u0103ng kh\u00e1ng thu\u1ed1c<\/em><\/p>\n<p>t\u1ef7 l\u1ec7 kh\u1ea3 n\u0103ng \u0111\u1ec1 kh\u00e1ng c\u1ee7a m\u1ed7i ch\u1ee7ng vi khu\u1ea9n \u0111\u1ed1i v\u1edbi vancomycin c\u00f3 th\u1ec3 kh\u00e1c nhau \u1edf m\u1ed7i v\u00f9ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. \u0111\u1eb7c bi\u1ec7t khi b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng. Khi s\u1eed d\u1ee5ng vancomycin \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb, c\u1ea7n thi\u1ebft ph\u1ea3i tham kh\u1ea3o t\u00ednh kh\u00e1ng thu\u1ed1c c\u1ee7a vancomycin t\u1ea1i n\u01a1i \u0111i\u1ec1u tr\u1ecb ho\u1eb7c c\u00f3 th\u1ec3 d\u1ef1a v\u00e0o k\u1ebft qu\u1ea3 l\u00e0m kh\u00e1ng sinh \u0111\u1ed3 tr\u00ean m\u1eabu b\u1ec7nh ph\u1ea9m c\u1ee7a b\u1ec7nh nh\u00e2n<\/p>\n<p><em>C\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng<\/em><\/p>\n<p>C\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng c\u1ee7a vancomycin \u0111\u1ed1i v\u1edbi c\u00e1c ch\u1ee7ng Enterococcus v\u1eabn ch\u01b0a th\u1ef1c s\u1ef1 r\u00f5 r\u00e0ng. Tuy nhi\u00ean, nghi\u00ean c\u1ee9u in vitro cho th\u1ea5y khi kh\u00e1ng vancomycin \u1edf n\u1ed3ng \u0111\u1ed9 cao th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a m\u1ed9t protein c\u00f3 ki\u1ec3u h\u00ecnh g\u1ecdi l\u00e0 VanA. C\u00f2n kh\u00e1ng vancomycin \u1edf n\u1ed3ng \u0111\u1ed9 th\u1ea5p th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ki\u1ec3u h\u00ecnh kh\u00e1c, g\u1ecdi l\u00e0 VanB.<\/p>\n<p>\u0110\u1ed1i v\u1edbi ch\u1ee7ng Staphylococcus&#8217;. C\u00e1c nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 v\u00e0 nghi\u00ean c\u1ee9u in vitro \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 gi\u1ea3m nh\u1ea1y c\u1ea3m kh\u00e1ng sinh vancomycin v\u00e0 c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng c\u1ee7a thu\u1ed1c khi b\u1ec7nh nh\u00e2n b\u1ecb l\u00e2y truy\u1ec1n c\u00e1c ch\u1ee7ng Staphylococcus. Tr\u00ean in vitro cho th\u1ea5y gen VanA li\u00ean quan \u0111\u1ebfn t\u00ednh \u0111\u1ec1 kh\u00e1ng c\u1ee7a vancomycin trong ch\u1ee7ng Enterococcus c\u00f3 th\u1ec3 chuy\u1ec3n giao cho c\u00e1c vi khu\u1ea9n gram d\u01b0\u01a1ng nh\u01b0 S. Aureus, d\u1eabn \u0111\u1ebfn c\u00e1c ch\u1ee7ng vi khu\u1ea9n n\u00e0y kh\u00e1ng vancomycin<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Vancomycin c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea5n th\u00f4ng qua \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh sinh t\u1ed5ng h\u1ee3p v\u1ecf t\u1ebf b\u00e0o vi khu\u1ea5n b\u1eb1ng c\u00e1ch g\u1eafn v\u1edbi nh\u00f3m carboxyl \u1edf c\u00e1c ti\u1ebfu \u0111\u01a1n v\u1ecb peptid ch\u1ee9a D-alanyl-D-alanin t\u1ef1 do, t\u1eeb \u0111\u00f3 \u1ee9c ch\u1ebf peptidoglycan polymerase v\u00e0 ph\u1ea3n \u1ee9ng transpeptid. Vancomycin c\u00f2n t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn t\u00ednh th\u1ea5m m\u00e0ng t\u1ebf b\u00e0o v\u00e0 \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p RNA c\u1ee7a vi khu\u1ea5n. Do v\u1ecb tr\u00ed t\u00e1c d\u1ee5ng kh\u00e1c nhau, kh\u00f4ng x\u1ea3y ra kh\u00e1ng ch\u00e9o c\u1ee7a vi khu\u1ea5n gi\u1eefa c\u00e1c kh\u00e1ng sinh beta-lactam v\u00e0 vancomycin.<\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog E SS1 - Ep. 01] - Pharmacology of all Antibiotics\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/9bo1ZCykDso?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\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>Thu\u1ed1c \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n to\u00e0n th\u00e2n. Ti\u00eam b\u1eafp g\u00e2y \u0111au.<\/p>\n<p>Sau khi ti\u00eam t\u0129nh m\u1ea1ch, thu\u1ed1c \u0111\u01b0\u1ee3c ph\u00e2n b\u1ed1 trong c\u00e1c d\u1ecbch ngo\u1ea1i b\u00e0o. N\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf vi khu\u1ea9n \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u1ea1i d\u1ecbch m\u00e0ng ph\u1ed5i, d\u1ecbch m\u00e0ng ngo\u00e0i tim, d\u1ecbch c\u1ed5 tr\u01b0\u1edbng ho\u1ea1t d\u1ecbch, trong n\u01b0\u1edbc ti\u1ec3u, trong d\u1ecbch th\u1ea9m t\u00e1ch m\u00e0ng b\u1ee5ng, v\u00e0 trong m\u00f4 ti\u1ec3u nh\u0129. N\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong d\u1ecbch n\u00e3o t\u1ee7y r\u1ea5t th\u1ea5p khi m\u00e0ng n\u00e3o kh\u00f4ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 c\u1ee7a thu\u1ed1c x\u1ea5p x\u1ec9 60 l\u00edt\/70 kg (di\u1ec7n t\u00edch th\u00e2n th\u1ec3 b\u1eb1ng 1,73 m2). N\u1eeda \u0111\u1eddi c\u1ee7a thu\u1ed1c t\u1eeb 3 \u0111\u1ebfn 13 gi\u1edd, trung b\u00ecnh 6 gi\u1edd \u1edf ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 k\u00e9o d\u00e0i h\u01a1n \u1edf ng\u01b0\u1eddi b\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn v\u00e0 t\u1edbi 7 ng\u00e0y ho\u1eb7c h\u01a1n n\u1eefa \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn n\u1eb7ng. Khi n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng l\u00e0 10 \u2013 100 microgam\/ml, \u0111o b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p si\u00eau l\u1ecdc, th\u1ea5y c\u00f3 55% li\u1ec1u vancomycin li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng. Thu\u1ed1c h\u1ea7u nh\u01b0 kh\u00f4ng chuy\u1ec3n h\u00f3a.<\/p>\n<p>Vancomycin th\u1ea3i tr\u1eeb ch\u1ee7 y\u1ebfu qua th\u1eadn, v\u00ec v\u1eady ch\u1ee9c n\u0103ng th\u1eadn \u0111\u00f3ng vai tr\u00f2 r\u1ea5t quan tr\u1ecdng. \u1ede ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng, kho\u1ea3ng 70 \u2013 80% li\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb \u1edf d\u1ea1ng kh\u00f4ng \u0111\u1ed5i qua n\u01b0\u1edbc ti\u1ec3u trong v\u00f2ng 24 gi\u1edd. Kh\u00f4ng lo\u1ea1i b\u1ecf \u0111\u01b0\u1ee3c vancomycin b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ea9m t\u00e1ch m\u00e1u hay th\u1ea9m t\u00e1ch m\u00e0ng b\u1ee5ng.<\/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><strong>6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n<p>Dung d\u1ecbch vancomycin hydroclorid c\u00f3 pH acid n\u00ean t\u01b0\u01a1ng k\u1ef5 v\u1edbi c\u00e1c ch\u1ebf ph\u1ea9m ki\u1ec1m v\u00e0 c\u00e1c thu\u1ed1c kh\u00f4ng b\u1ec1n v\u1eefng \u1edf pH th\u1ea5p. \u0110\u00e3 th\u1ea5y c\u00f3 t\u01b0\u01a1ng k\u1ef5 gi\u1eefa vancomycin v\u1edbi aminophylin, aztreonam, barbiturat k\u1ec3 c\u1ea3 phenobarbiton, benzylpenicilin (\u0111\u1eb7c bi\u1ec7t l\u00e0 trong dung d\u1ecbch dextrose), ceftazidim, ceftriaxon, cloramphenicol natri, dexamethason natri phosphat, dung d\u1ecbch t\u0103ng th\u1ec3 t\u00edch huy\u1ebft t\u01b0\u01a1ng gelatin ho\u1eb7c polygelin, heparin natri, idarubicin, methicilin natri, natri bicarbonat, ticarcilin v\u00e0 warfarin natri. C\u00e1c b\u00e1o c\u00e1o v\u1ec1 t\u01b0\u01a1ng k\u1ef5 nhi\u1ec1u khi kh\u00f4ng th\u1ed1ng nh\u1ea5t. N\u1ed3ng \u0111\u1ed9 dung d\u1ecbch v\u00e0 th\u00e0nh ph\u1ea7n c\u00e1c dung d\u1ecbch d\u00f9ng pha lo\u00e3ng c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh t\u01b0\u01a1ng k\u1ef5.<\/p>\n<p><strong>6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n<p>N\u01a1i kh\u00f4 r\u00e1o, nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30\u00b0c, tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n<p>Dung d\u1ecbch sau khi pha lo\u00e3ng: Nhi\u1ec7t \u0111\u1ed9 t\u1eeb 2 &#8211; 8\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>Ho\u1eb7c HDSD Thu\u1ed1c.<\/p>\n<p><strong>7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/strong><\/p>\n<p>B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c s\u01b0u t\u1ea7m ho\u1eb7c vi\u1ebft b\u1edfi: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-tac-gia-bac-sy-do-my-linh\/\">B\u00e1c s\u0129 nhi khoa &#8211; \u0110\u1ed7 M\u1ef9 Linh.<\/a><\/p>\n<p>Ki\u1ec3m duy\u1ec7t , hi\u1ec7u \u0111\u00ednh v\u00e0 \u0111\u0103ng t\u1ea3i: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-ve-pharmog-team\/\">PHARMOG TEAM<\/a><\/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 : Vancomycin Ph\u00e2n lo\u1ea1i: Thu\u1ed1c Kh\u00e1ng sinh nho\u0301m glycopeptid. 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): A07AA09, J01XA01.. Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c: Bi\u1ec7t d\u01b0\u1ee3c: Vancomycin H\u00e3ng s\u1ea3n xu\u1ea5t : C\u00f4ng ty c\u1ed5 ph\u1ea7n d\u01b0\u1ee3c [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":26731,"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":[998],"class_list":["post-26730","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-vancomycin"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/26730","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\/8612"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=26730"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/26730\/revisions"}],"predecessor-version":[{"id":47215,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/26730\/revisions\/47215"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/26731"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=26730"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=26730"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=26730"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}