{"id":2744,"date":"2018-11-16T15:48:21","date_gmt":"2018-11-16T08:48:21","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=2744"},"modified":"2025-01-08T22:05:43","modified_gmt":"2025-01-08T15:05:43","slug":"gemcitabine","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/gemcitabine\/","title":{"rendered":"Gemcitabine"},"content":{"rendered":"

1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: <\/strong><\/p>\n

Ho\u1ea1t ch\u1ea5t :<\/em> Gemcitabine\u00a0<\/strong><\/p>\n

Ph\u00e2n lo\u1ea1i: <\/em><\/strong>Thu\u1ed1c ch\u1ed1ng ung th\u01b0, nh\u00f3m ch\u1ed1ng chuy\u1ec3n h\u00f3a, nucleosid pyrimidin t\u1ed1ng h\u1ee3p.<\/em><\/p>\n

Nh\u00f3m<\/em><\/strong> ph\u00e1p l\u00fd: <\/em><\/strong>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n

M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): L01BC05.<\/p>\n

Brand name:<\/em><\/strong> Gemzar<\/a>.<\/p>\n

Generic <\/em><\/strong>: Gemcisan,Gemcitabine Onkovis 1000mg,Gemcitabine Onkovis 200mg,Gitrabin 1g,Gitrabin 200mg<\/a>,Neotabine Inj 200mg,CKDGemtan injection 1g,CKDGemtan injection 200mg<\/a>,Bigemax 1g,Bigemax 200<\/a>,Gabapro,Gemcired 1000,Gemcired 200,Gemcitabin “Ebewe”,Gemcitabin Ebewe 200mg<\/a>,Gemzar,Gemar inj 200mg,Citafine 1g,Kalbezar 200mg,Gemcitabine Hydrochloride,Gemcitabine Hydrochloride 200mg,Gemita RTU 1g\/26,3ml,Gemita 1g,Gemita 200mg<\/a>,Gemhope,DBL Gemcitabine 1g,DBL Gemcitabine 200mg,DBL Gemcitabine for injection,DBL Gemcitabine injection 1g\/26,3ml,Gemibine 1000,Gemibine 200,Gemtabine<\/a>,Gemcitac 1g,Gemcitac 200,Gemcit<\/a>,Abingem 200,Abingem-1gm<\/a>,Gemcitabine Medac,Gemcitapar,Gemcitabine PCH\u00a0,Gemcitabine Teva 1000mg,Gemcitabine Teva 2000mg,Gemcitabine Teva 200mg<\/a>,Sungemtaz 1g,Sungemtaz 200mg,Santabin ,Gemmis,Geme TTY,Blomidex-1000,Blomindex-200,Gemnil 1000mg\/vial,Gemnil 200mg\/vial,Yuhangemcitabine Injection<\/a>,Zenozar 1000,<\/p>\n

2. D\u1ea1ng b\u00e0o ch\u1ebf – H\u00e0m l\u01b0\u1ee3ng: <\/strong><\/p>\n

D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n

Thu\u1ed1c b\u1ed9t: 200 mg; 1 g; 1,5 g; 2 g d\u00f9ng \u0111\u1ec3 pha dung d\u1ecbch ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n

Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n\n\n\n\n\n\n
DBL GEMCITABINE INJECTION<\/em><\/strong><\/td>\n<\/td>\n<\/tr>\n
M\u1ed7i l\u1ecd b\u1ed9t pha ti\u00eam truy\u1ec1n c\u00f3 ch\u1ee9a:<\/em><\/td>\n<\/td>\n<\/tr>\n
Gemcitabine<\/td>\n………………………….<\/td>\n200 mg<\/td>\n<\/tr>\n
T\u00e1 d\u01b0\u1ee3c<\/td>\n………………………….<\/td>\nv\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\"\"<\/p>\n

3. Video by Pharmog:<\/strong><\/p>\n

[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n

————————————————<\/p>\n

\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n

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\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n

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\u25ba Website: pharmog.com<\/p>\n

4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng: <\/strong><\/p>\n

4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n

K\u1ebft h\u1ee3p v\u1edbi carboplatin \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ec3u m\u00f4 bu\u1ed3ng tr\u1ee9ng ti\u1ebfn tri\u1ec3n \u1edf b\u1ec7nh nh\u00e2n b\u1ecb t\u00e1i ph\u00e1t \u00edt nh\u1ea5t 6 th\u00e1ng sau tr\u1ecb li\u1ec7u b\u1eb1ng thu\u1ed1c c\u00f3 platin.<\/p>\n

K\u1ebft h\u1ee3p v\u1edbi paclitaxel trong \u0111i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u ung th\u01b0 v\u00fa di c\u0103n sau th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c ph\u00e1c \u0111\u1ed3 k\u1ebft h\u1ee3p c\u00f3 anthracyclin, tr\u1eeb khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh.<\/p>\n

\u0110i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn t\u1ee5y giai \u0111o\u1ea1n cu\u1ed1i ho\u1eb7c ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn t\u1ee5y t\u1ea1i ch\u1ed7 ti\u1ebfn tri\u1ec3n (ung th\u01b0 kh\u00f4ng th\u1ec3 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c giai \u0111o\u1ea1n II ho\u1eb7c III), ho\u1eb7c ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn t\u1ee5y di c\u0103n (giai \u0111o\u1ea1n IV). Thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng cho \u0111i\u1ec1u tr\u1ecb b\u01b0\u1edbc 1 ho\u1eb7c b\u01b0\u1edbc 2 cho b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng fluorouracil tr\u01b0\u1edbc \u0111\u00f3. K\u1ebft h\u1ee3p v\u1edbi cisplatin trong \u0111i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u ung th\u01b0 ph\u1ed1i kh\u00f4ng ph\u1ea3i t\u1ebf b\u00e0o nh\u1ecf kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c, ti\u1ebfn tri\u1ec3n t\u1ea1i ch\u1ed7 (giai \u0111o\u1ea1n IIIA ho\u1eb7c IIIB) ho\u1eb7c c\u00f3 di c\u0103n (giai \u0111o\u1ea1n IV).<\/p>\n

Ung th\u01b0 b\u00e0ng quang.<\/p>\n

4.2. Li\u1ec1u d\u00f9ng – C\u00e1ch d\u00f9ng:<\/strong><\/p>\n

C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n

Thu\u1ed1c ph\u1ea3i do th\u1ea7y thu\u1ed1c chuy\u00ean khoa c\u00f3 kinh nghi\u1ec7m v\u1ec1 thu\u1ed1c ch\u1ed1ng ung th\u01b0 ch\u1ec9 \u0111\u1ecbnh v\u00e0 theo d\u00f5i \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Pha thu\u1ed1c: Pha thu\u1ed1c b\u1eb1ng dung d\u1ecbch natri clorid 0,9% \u0111\u1ec3 \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong dung d\u1ecbch (kh\u00f4ng c\u00f3 ch\u1ea5t b\u1ea3o qu\u1ea3n) l\u00e0 38 mg\/ml (n\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a 40 mg\/ml; kh\u00f4ng pha \u0111\u1eb7c h\u01a1n v\u00ec thu\u1ed1c kh\u00f4ng h\u00f2a tan h\u1ebft). V\u1edbi l\u1ecd ch\u1ee9a 200 mg b\u1ed9t: th\u00eam 5 ml dung d\u1ecbch natri clorid 0,9%. V\u1edbi l\u1ecd ch\u1ee9a 1 000 mg th\u00eam v\u00e0o 25 ml natri clorid 0,9%. Th\u1ec3 t\u00edch to\u00e0n ph\u1ea7n sau \u0111\u00f3 l\u00e0 5,26 ml v\u1edbi l\u1ecd ch\u1ee9a 200 mg; l\u00e0 26,3 ml v\u1edbi l\u1ecd ch\u1ee9a 1 000 mg. N\u1ed3ng \u0111\u1ed9 gemcitabin c\u00f3 trong \u0111\u00f3 l\u00e0 38 mg\/ml (t\u00ednh c\u1ea3 th\u1ec3 t\u00edch c\u1ee7a thu\u1ed1c b\u1ed9t \u0111\u00e3 b\u1ecb cho\u00e1n ch\u1ed7). L\u1eafc m\u1ea1nh \u0111\u1ec3 thu\u1ed1c h\u00f2a tan h\u1ebft. Sau \u0111\u00f3 pha lo\u00e3ng ti\u1ebfp b\u1eb1ng natri clorid 0,9% \u0111\u1ec3 \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 0,1 mg\/ml. Ph\u1ea3i mang c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n b\u1ea3o h\u1ed9 (\u00e1o blouse, g\u0103ng, kh\u1ea5u trang, k\u00ednh) khi pha thu\u1ed1c trong ph\u00f2ng k\u00edn, c\u00f3 ki\u1ec3m tra \u00e1p su\u1ea5t. N\u1ebfu b\u1ecb thu\u1ed1c d\u00e2y v\u00e0o m\u1eaft, v\u00e0o da ph\u1ea3i r\u1eeda ngay b\u1eb1ng nhi\u1ec1u n\u01b0\u1edbc.<\/p>\n

Tr\u01b0\u1edbc khi truy\u1ec1n thu\u1ed1c ph\u1ea3i ki\u1ec3m tra b\u1eb1ng m\u1eaft xem c\u00f3 t\u1ee7a v\u00e0 b\u1ecb bi\u1ebfn m\u00e0u kh\u00f4ng. N\u1ebfu c\u00f3 t\u1ee7a th\u00ec kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng. Thu\u1ed1c kh\u00f4ng s\u1eed d\u1ee5ng v\u00e0 l\u1ecd, b\u01a1m kim ti\u00eam, d\u00e2y truy\u1ec1n… ph\u1ea3i h\u1ee7y theo \u0111\u00fang quy tr\u00ecnh. Gemcitabin ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed7i tu\u1ea7n m\u1ed9t l\u1ea7n, m\u1ed7i l\u1ea7n truy\u1ec1n trong 30 ph\u00fat. Kh\u00f4ng truy\u1ec1n l\u00e2u qu\u00e1 60 ph\u00fat v\u00ec l\u00e0m t\u0103ng t\u00edch t\u1ee5 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh d\u1eabn \u0111\u1ebfn t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c. Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng qu\u00e1 1 l\u1ea7n trong tu\u1ea7n. N\u1ebfu d\u00f9ng tu\u1ea7n 5 ng\u00e0y li\u00ean ti\u1ebfp, b\u1ec7nh nh\u00e2n kh\u00f4ng dung n\u1ea1p m\u00e0 bi\u1ec3u hi\u1ec7n l\u00e0 h\u1ea1 huy\u1ebft \u00e1p v\u00e0 xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng nh\u01b0 b\u1ecb c\u00fam ch\u1ec9 \u1edf li\u1ec1u 10 mg\/m2<\/sup>\/ng\u00e0y. N\u1ebfu d\u00f9ng tu\u1ea7n 2 l\u1ea7n, li\u1ec1u dung n\u1ea1p t\u1ed1i \u0111a ch\u1ec9 l\u00e0 65 mg\/m2<\/sup> khi truy\u1ec1n tr\u00ean 30 ph\u00fat v\u00e0 l\u00e0 150 mg\/m2<\/sup> khi ti\u00eam tr\u00ean 5 ph\u00fat. Trong ph\u00e1c \u0111\u1ed3 n\u00e0y, \u0111\u1ed9c t\u00ednh xu\u1ea5t hi\u1ec7n l\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u, tri\u1ec7u ch\u1ee9ng nh\u01b0 b\u1ecb c\u00fam v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 suy nh\u01b0\u1ee3c. N\u1ebfu thu\u1ed1c b\u1ecb tho\u00e1t m\u1ea1ch th\u00ec ph\u1ea3i ng\u1eebng truy\u1ec1n ngay; chuy\u1ec3n sang truy\u1ec1n \u1edf t\u0129nh m\u1ea1ch kh\u00e1c.<\/p>\n

Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n

Ung th\u01b0 ph\u1ed5i kh\u00f4ng ph\u1ea3i t\u1ebf b\u00e0o nh\u1ecf:<\/em><\/p>\n

D\u00f9ng m\u1ed9t m\u00ecnh: Li\u1ec1u khuy\u00ean d\u00f9ng l\u00e0 1 000 mg\/m2<\/sup> m\u1ed7i l\u1ea7n; tu\u1ea7n 1 l\u1ea7n trong 3 tu\u1ea7n; ngh\u1ec9 1 tu\u1ea7n (chu k\u1ef3 4 tu\u1ea7n). C\u00f3 th\u1ec3 ph\u1ea3i ch\u1ec9nh li\u1ec1u c\u1ee7a chu k\u1ef3 ho\u1eb7c cho m\u1ed9t chu k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

D\u00f9ng k\u1ebft h\u1ee3p: Li\u1ec1u khuy\u00ean d\u00f9ng l\u00e0 1 000 mg\/m2<\/sup>, 1 l\u1ea7n v\u00e0o c\u00e1c ng\u00e0y 1, 8, 15 c\u1ee7a chu k\u1ef3 28 ng\u00e0y. C\u0169ng c\u00f3 th\u1ec3 theo ph\u00e1c \u0111\u1ed3 1 250 mg\/m2<\/sup>\/ng\u00e0y v\u00e0o c\u00e1c ng\u00e0y 1 v\u00e0 8 c\u1ee7a chu k\u1ef3 21 ng\u00e0y. C\u00f3 th\u1ec3 ph\u1ea3i ch\u1ec9nh li\u1ec1u cho li\u1ec1u ti\u1ebfp theo trong 1 chu k\u1ef3 ho\u1eb7c cho m\u1ed9t chu k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft. D\u00f9ng cisplatin v\u1edbi li\u1ec1u t\u1eeb 75 -100 mg\/m2<\/sup>; 3 tu\u1ea7n 1 l\u1ea7n.<\/p>\n

Ung th\u01b0 t\u1ee5y:<\/em><\/p>\n

Li\u1ec1u khuy\u00ean d\u00f9ng l\u00e0 1 000 mg\/m2<\/sup>; tu\u1ea7n 1 l\u1ea7n trong 7 tu\u1ea7n li\u00ean ti\u1ebfp r\u1ed3i ngh\u1ec9 1 tu\u1ea7n. Sau \u0111\u00f3 theo chu k\u1ef3 4 tu\u1ea7n: M\u1ed7i tu\u1ea7n d\u00f9ng 1 l\u1ea7n trong 3 tu\u1ea7n li\u00ean ti\u1ebfp r\u1ed3i ngh\u1ec9 1 tu\u1ea7n. C\u00f3 th\u1ec3 ph\u1ea3i ch\u1ec9nh li\u1ec1u cho l\u1ea7n ti\u1ebfp theo trong 1 chu k\u1ef3 ho\u1eb7c cho m\u1ed9t chu k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

Ung th\u01b0 b\u00e0ng quang:<\/em><\/p>\n

Li\u1ec1u khuy\u00ean d\u00f9ng l\u00e0 1 000 mg\/m2<\/sup>; truy\u1ec1n v\u00e0o c\u00e1c ng\u00e0y 1, 8, 15 trong chu k\u1ef3 28 ng\u00e0y, k\u1ebft h\u1ee3p v\u1edbi cisplatin. Cisplatin \u0111\u01b0\u1ee3c d\u00f9ng v\u1edbi li\u1ec1u 70 mg\/m2<\/sup> v\u00e0o ng\u00e0y 1 hay ng\u00e0y 2 c\u1ee7a m\u1ed7i chu k\u1ef3 28 ng\u00e0y. D\u00f9ng cisplatin sau khi \u0111\u00e3 truy\u1ec1n gemcitabin. L\u1eb7p l\u1ea1i chu k\u1ef3 n\u00e0y. \u0110\u01b0a thu\u1ed1c v\u00e0o b\u00e0ng quang: 2 000 mg (pha trong 100 ml n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd), gi\u1eef thu\u1ed1c trong b\u00e0ng quang 1 gi\u1edd; 2 l\u1ea7n m\u1ed7i tu\u1ea7n trong 3 tu\u1ea7n. C\u1ee9 m\u1ed7i 4 tu\u1ea7n l\u1ea1i l\u1eb7p l\u1ea1i. D\u00f9ng \u00edt nh\u1ea5t 2 chu k\u1ef3 nh\u01b0 v\u1eady.<\/p>\n

Ung th\u01b0 v\u00fa (tr\u1ecb li\u1ec7u k\u1ebft h\u1ee3p v\u1edbi paclitaxel):<\/em><\/p>\n

Truy\u1ec1n paclitaxel (175 mg\/m2<\/sup>) v\u00e0o ng\u00e0y 1 trong 3 gi\u1edd; sau \u0111\u00f3 truy\u1ec1n t\u0129nh m\u1ea1ch gemcitabin (1 250 mg\/m2<\/sup>) trong 30 ph\u00fat v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 8 c\u1ee7a chu k\u1ef3 21 ng\u00e0y. C\u00f3 th\u1ec3 ph\u1ea3i ch\u1ec9nh li\u1ec1u trong 1 chu k\u1ef3 ho\u1eb7c cho m\u1ed9t chu k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft. Tr\u01b0\u1edbc khi \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u1ecb li\u1ec7u, b\u1ec7nh nh\u00e2n ph\u1ea3i c\u00f3 s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u h\u1ea1t > 1 500\/mm3<\/sup>.<\/p>\n

Ung th\u01b0 bu\u1ed3ng tr\u1ee9ng (tr\u1ecb li\u1ec7u k\u1ebft h\u1ee3p v\u1edbi carboplatin):<\/em><\/p>\n

Li\u1ec1u gemcitabin \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng l\u00e0 1 000 mg\/m2<\/sup> v\u00e0o c\u00e1c ng\u00e0y 1 v\u00e0 8 c\u1ee7a chu k\u1ef3 21 ng\u00e0y. Carboplatin \u0111\u01b0\u1ee3c truy\u1ec1n v\u00e0o ng\u00e0y 1, sau khi \u0111\u00e3 truy\u1ec1n xong gemcitabin. Li\u1ec1u carboplatin \u0111\u01b0\u1ee3c t\u00ednh sao cho \u0111\u1ea1t \u0111\u01b0\u1ee3c di\u1ec7n t\u00edch v\u00f9ng d\u01b0\u1edbi \u0111\u01b0\u1eddng cong n\u1ed3ng \u0111\u1ed9 – th\u1eddi gian (AUC) l\u00e0 4,0 mg\/ml X ph\u00fat. C\u00f3 th\u1ec3 ph\u1ea3i ch\u1ec9nh li\u1ec1u gemcitabin cho li\u1ec1u sau trong 1 chu k\u1ef3 ho\u1eb7c cho m\u1ed9t chu k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u do t\u00e1c d\u1ee5ng \u0111\u1ed9c kh\u00f4ng l\u00ean huy\u1ebft h\u1ecdc c\u1ee7a thu\u1ed1c: <\/em><\/p>\n

T\u00e1c d\u1ee5ng \u0111\u1ed9c kh\u00f4ng l\u00ean huy\u1ebft h\u1ecdc: Ph\u1ea3i theo d\u00f5i h\u1ed9i ch\u1ee9ng t\u0103ng ur\u00ea do tan huy\u1ebft v\u00e0 ng\u1eebng ngay gemcitabin \u1edf b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu m\u00e1u c\u00f3 tan huy\u1ebft do b\u1ec7nh vi m\u1ea1ch, t\u0103ng bilirubin huy\u1ebft thanh ho\u1eb7c LDH, t\u0103ng h\u1ed3ng c\u1ea7u l\u01b0\u1edbi, gi\u1ea3m ti\u1ec3u c\u1ea7u n\u1eb7ng c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 suy th\u1eadn.<\/p>\n

Gi\u1ea3m 50% li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 bu\u1ed3ng tr\u1ee9ng ti\u1ebfn tri\u1ec3n b\u1ecb \u0111\u1ed9c t\u00ednh kh\u00f4ng l\u00ean huy\u1ebft h\u1ecdc \u0111\u1ed9 3 ho\u1eb7c \u0111\u1ed9 4 (tr\u1eeb bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n). Gi\u1ea3m 50% li\u1ec1u ho\u1eb7c ng\u1eebng d\u00f9ng thu\u1ed1c \u1edf b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 v\u00fa di c\u0103n b\u1ecb \u0111\u1ed9c t\u00ednh kh\u00f4ng l\u00ean huy\u1ebft h\u1ecdc \u0111\u1ed9 3 ho\u1eb7c \u0111\u1ed9 4 (tr\u1eeb bu\u1ed3n n\u00f4n, n\u00f4n).<\/p>\n

Ph\u1ea3i ng\u1eebng ho\u1eb7c gi\u1ea3m 50% li\u1ec1u gemcitabin \u1edf b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 ph\u1ed1i kh\u00f4ng ph\u1ea3i t\u1ebf b\u00e0o nh\u1ecf b\u1ecb \u0111\u1ed9c t\u00ednh kh\u00f4ng l\u00ean huy\u1ebft h\u1ecdc \u0111\u1ed9 3 ho\u1eb7c \u0111\u1ed9 4 (tr\u1eeb bu\u1ed3n n\u00f4n, n\u00f4n, r\u1ee5ng t\u00f3c).<\/p>\n

Ng\u1eebng ngay d\u00f9ng thu\u1ed1c v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (l\u1ee3i ni\u1ec7u, corticosteroid) \u1edf b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u1ed9c n\u1eb7ng \u1edf ph\u1ed1i.<\/p>\n

Ph\u1ea3i gi\u1ea3m li\u1ec1u ho\u1eb7c t\u1ea1m ng\u1eebng d\u00f9ng gemcitabin n\u1ebfu b\u1ecb c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u1eb7ng v\u00e0 gi\u1ea3i quy\u1ebft c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 (tr\u1eeb n\u00f4n v\u00e0 bu\u1ed3n n\u00f4n).<\/p>\n

\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u do t\u00e1c d\u1ee5ng \u0111\u1ed9c l\u00ean huy\u1ebft h\u1ecdc c\u1ee7a thu\u1ed1c:<\/em> \u0110\u1ed9c t\u00ednh l\u00ean huy\u1ebft h\u1ecdc l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh gi\u1edbi h\u1ea1n li\u1ec1u d\u00f9ng gemcitabin trong \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Ung th\u01b0 bu\u1ed3ng tr\u1ee9ng ti\u1ebfn tri\u1ec3n:<\/em> Li\u1ec1u trong m\u1ed9t chu k\u1ef3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u h\u1ea1t v\u00e0 ti\u1ec3u c\u1ea7u v\u00e0o ng\u00e0y th\u1ee9 8. Kh\u00f4ng c\u1ea7n ch\u1ec9nh li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n c\u00f3 s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u trung t\u00ednh > 1500\/mm3<\/sup>; s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u > 100 000\/mm3<\/sup>. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t 1 000 – 1 499\/mm3<\/sup> v\u00e0\/ho\u1eb7c ti\u1ec3u c\u1ea7u 75 000 – 99 999\/mm3<\/sup>: Gi\u1ea3m 50% li\u1ec1u. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t < 1 000\/mm3<\/sup> v\u00e0\/ho\u1eb7c ti\u1ec3u c\u1ea7u < 75 000\/mm3<\/sup>: Ng\u1eebng d\u00f9ng thu\u1ed1c.<\/p>\n

Trong tr\u1ecb li\u1ec7u k\u1ebft h\u1ee3p v\u1edbi carboplatin, li\u1ec1u gemcitabin \u1edf c\u00e1c chu k\u1ef3 ti\u1ebfp theo \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo m\u1ee9c \u0111\u1ed9 b\u1ecb \u0111\u1ed9c t\u00ednh. Li\u1ec1u gemcitabin \u1edf c\u00e1c chu k\u1ef3 k\u1ebf ti\u1ebfp gi\u1ea3m c\u00f2n 800 mg\/m2<\/sup> v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 8 n\u1ebfu c\u00f3 1 trong c\u00e1c bi\u1ec3u hi\u1ec7n \u0111\u1ed9c sau: S\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u h\u1ea1t < 500 \/mm3<\/sup> trong h\u01a1n 5 ng\u00e0y ho\u1eb7c < 100\/mm3<\/sup> trong h\u01a1n 3 ng\u00e0y, s\u1ed1t c\u00f3 gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh, ti\u1ec3u c\u1ea7u < 25 000\/mm3<\/sup> ho\u1eb7c c\u00f3 th\u1ec3 l\u00f9i chu k\u1ef3 h\u01a1n 1 tu\u1ea7n do \u0111\u1ed9c t\u00ednh. N\u1ebfu m\u1ed9t trong c\u00e1c \u0111\u1ed9c t\u00ednh v\u1eabn t\u00e1i xu\u1ea5t hi\u1ec7n sau khi \u0111\u00e3 gi\u1ea3m li\u1ec1u ban \u0111\u1ea7u th\u00ec ch\u1ec9 truy\u1ec1n 800 mg\/m2 <\/sup>gemcitabin v\u00e0o ng\u00e0y 1 cho chu k\u1ef3 sau.<\/p>\n

Ung th\u01b0 v\u00fa di c\u0103n<\/em>: Li\u1ec1u \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u h\u1ea1t v\u00e0 ti\u1ec3u c\u1ea7u v\u00e0o ng\u00e0y th\u1ee9 8. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t > 1200\/mm3<\/sup>, ti\u1ec3u c\u1ea7u >75 000\/mm3<\/sup>: Kh\u00f4ng c\u1ea7n ch\u1ec9nh li\u1ec1u. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t 1 000 – 1 199\/mm3<\/sup> ho\u1eb7c ti\u1ec3u c\u1ea7u 50 000 – 75 000\/mm3<\/sup>: d\u00f9ng 75% li\u1ec1u. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t 700 – 999\/mm3<\/sup> v\u00e0 ti\u1ec3u c\u1ea7u < 50 000\/mm3<\/sup>: Ng\u1eebng d\u00f9ng thu\u1ed1c.<\/p>\n

Ung th\u01b0 t\u1ee5y v\u00e0 ung th\u01b0 ph\u1ed1i kh\u00f4ng ph\u1ea3i t\u1ebf b\u00e0o nh\u1ecf<\/em>: B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t > 1 000\/mm3<\/sup> v\u00e0 ti\u1ec3u c\u1ea7u > 100 000\/mm3<\/sup>: Kh\u00f4ng c\u1ea7n ch\u1ec9nh li\u1ec1u. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t 500 – 999\/mm3<\/sup> ho\u1eb7c ti\u1ec3u c\u1ea7u 50 000 – 99 999\/mm3<\/sup>: D\u00f9ng 75% li\u1ec1u. B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea1ch c\u1ea7u h\u1ea1t < 500\/mm3<\/sup> ho\u1eb7c ti\u1ec3u c\u1ea7u < 50 000\/mm3<\/sup>: Ng\u1eebng thu\u1ed1c cho \u0111\u1ebfn khi s\u1ed1 l\u01b0\u1ee3ng c\u00e1c t\u1ebf b\u00e0o v\u01b0\u1ee3t c\u00e1c m\u1ee9c tr\u00ean.<\/p>\n

B\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i:<\/em> Gemcitabine dung n\u1ea1p t\u1ed1t \u1edf b\u1ec7nh nh\u00e2n tr\u00ean 65 tu\u1ed5i. Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u1ea7n ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, m\u1eb7c d\u00f9 tu\u1ed5i t\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u1ed9 thanh th\u1ea3i v\u00e0 th\u1eddi gian b\u00e1n h\u1ee7y c\u1ee7a gemcitabine.<\/p>\n

Suy gan v\u00e0 th\u1eadn<\/em>: c\u1ea9n th\u1eadn khi d\u00f9ng gemcitabine cho b\u1ec7nh nh\u00e2n suy gi\u1ea3m ch\u1ee9c n\u0103ng gan ho\u1eb7c th\u1eadn. Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u tr\u00ean b\u1ec7nh nh\u00e2n suy gan ho\u1eb7c suy th\u1eadn n\u1eb7ng.<\/p>\n

Tr\u1ebb em:<\/em> Gemcitabine ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u1edf tr\u1ebb em.<\/p>\n

4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n

D\u1ecb \u1ee9ng v\u1edbi gemcitabin hydroclorid.<\/p>\n

4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n

\u1ede ng\u01b0\u1eddi cao tu\u1ed5i, \u0111\u1ed9 thanh th\u1ea3i thu\u1ed1c gi\u1ea3m v\u00e0 n\u1eeda \u0111\u1eddi c\u1ee7a thu\u1ed1c k\u00e9o d\u00e0i h\u01a1n n\u00ean c\u00f3 th\u1ec3 ph\u1ea3i gi\u1ea3m li\u1ec1u.<\/p>\n

Ph\u1ee5 n\u1eef c\u00f3 \u0111\u1ed9 thanh th\u1ea3i thu\u1ed1c th\u1ea5p h\u01a1n v\u00e0 c\u00f3 n\u1eeda \u0111\u1eddi thu\u1ed1c l\u00e2u h\u01a1n n\u00ean ph\u1ea3i theo d\u00f5i \u0111\u1ec3 gi\u1ea3m li\u1ec1u n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

Ng\u01b0\u1eddi b\u1ecb suy gan, ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed vi\u00eam gan, ng\u01b0\u1eddi b\u1ecb di c\u0103n \u1edf gan, ng\u01b0\u1eddi b\u1ecb x\u01a1 gan, nghi\u1ec7n r\u01b0\u1ee3u v\u00ec thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m cho b\u1ec7nh c\u0169 n\u1eb7ng l\u00ean.<\/p>\n

Ng\u01b0\u1eddi b\u1ecb suy th\u1eadn.<\/p>\n

Ph\u1ea3i theo d\u00f5i c\u00f4ng th\u1ee9c m\u00e1u to\u00e0n ph\u1ea7n, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u tr\u01b0\u1edbc m\u1ed7i l\u1ea7n d\u00f9ng.<\/p>\n

X\u00e1c \u0111\u1ecbnh ch\u1ee9c n\u0103ng gan v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc m\u1ed7i l\u1ea7n d\u00f9ng thu\u1ed1c, \u0111\u1ecbnh k\u1ef3 v\u00e0 sau khi ng\u1eebng thu\u1ed1c.<\/p>\n

Theo d\u00f5i \u0111i\u1ec7n gi\u1ea3i bao g\u1ed3m c\u1ea3 kali, magnesi, calci khi k\u1ebft h\u1ee3p v\u1edbi tr\u1ecb li\u1ec7u b\u1eb1ng cisplatin.<\/p>\n

Th\u1eddi gian truy\u1ec1n k\u00e9o d\u00e0i v\u00e0 s\u1ed1 l\u1ea7n d\u00f9ng thu\u1ed1c t\u0103ng l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh.<\/p>\n

Gemcitabine c\u00f3 th\u1ec3 g\u00e2y \u1ee9c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng v\u1edbi bi\u1ec3u hi\u1ec7n gi\u1ea3m b\u1ea1ch c\u1ea7u, ti\u1ec3u c\u1ea7u v\u00e0 thi\u1ebfu m\u00e1u. Tuy nhi\u00ean hi\u1ec7n t\u01b0\u1ee3ng \u1ee9c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng ch\u1ec9 l\u00e0 ng\u1eafn h\u1ea1n, th\u01b0\u1eddng kh\u00f4ng c\u1ea7n gi\u1ea3m li\u1ec1u v\u00e0 hi\u1ebfm khi ph\u1ea3i ng\u01b0ng thu\u1ed1c.<\/p>\n

Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn: ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 hi\u1ebfm khi x\u1ea3y ra<\/p>\n

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

Gemcitabine \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 g\u00e2y ch\u1ee9ng ng\u1ee7 g\u00e0, t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh. Khi b\u1ec7nh nh\u00e2n \u1edf t\u00ecnh tr\u1ea1ng ng\u1ee7 g\u00e0 kh\u00f4ng n\u00ean l\u00e1i xe, \u0111i\u1ec1u khi\u1ec3n m\u00e1y m\u00f3c.<\/p>\n

4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/strong><\/p>\n

X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n

AU TGA pregnancy category: D<\/p>\n

US FDA pregnancy category: D<\/p>\n

Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n

Thu\u1ed1c \u0111\u1ed9c v\u1edbi thai, c\u00f3 th\u1ec3 g\u00e2y qu\u00e1i thai, l\u00e0m thai ch\u1ebft (tr\u00ean th\u1ef1c nghi\u1ec7m). N\u1ebfu d\u00f9ng cho b\u1ec7nh nh\u00e2n mang thai ho\u1eb7c c\u00f3 thai trong th\u1eddi gian tr\u1ecb li\u1ec7u th\u00ec ph\u1ea3i th\u00f4ng b\u00e1o cho b\u1ec7nh nh\u00e2n bi\u1ebft nguy c\u01a1 \u0111\u1ed1i v\u1edbi thai.<\/p>\n

Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n

Kh\u00f4ng r\u00f5 thu\u1ed1c c\u00f3 qua s\u1eefa kh\u00f4ng, c\u1ea7n c\u00e2n nh\u1eafc l\u1ee3i h\u1ea1i c\u1ee7a thu\u1ed1c v\u00e0 nguy c\u01a1 v\u1edbi tr\u1ebb \u0111ang b\u00fa m\u1eb9.<\/p>\n

4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n

R\u1ea5t th\u01b0\u1eddng g\u1eb7p, ADR > 10\/100<\/em><\/p>\n

Tim m\u1ea1ch: Ph\u00f9 ngo\u1ea1i vi (20%), ph\u00f9 (13%).<\/p>\n

TKTW: \u0110au (10 – 48%), s\u1ed1t (30 – 41%), ng\u1ee7 g\u00e0 (5 – 11%).<\/p>\n

Da: N\u1ed5i m\u1ea5n (24 – 30%), r\u1ee5ng t\u00f3c (15 – 18%), ng\u1ee9a (13%).<\/p>\n

Ti\u00eau h\u00f3a: Bu\u1ed3n n\u00f4n\/n\u00f4n (64 – 71%), t\u00e1o b\u00f3n (10 – 31%), \u1ec9a ch\u1ea3y (19 – 30%), vi\u00eam mi\u1ec7ng (10 – 14%).<\/p>\n

Huy\u1ebft h\u1ecdc: Thi\u1ebfu m\u00e1u (65 – 73%; \u0111\u1ed9 4: 1 – 3%), gi\u1ea3m b\u1ea1ch c\u1ea7u (62 – 71%), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh (61 – 63%; \u0111\u1ed9 4: 6 – 7%), gi\u1ea3m ti\u1ec3u c\u1ea7u (24 – 47%), xu\u1ea5t huy\u1ebft (4 – 17%). \u1ee8c ch\u1ebf t\u1ee7y l\u00e0 nguy\u00ean nh\u00e2n l\u00e0m h\u1ea1n ch\u1ebf li\u1ec1u.<\/p>\n

Gan: T\u0103ng transaminase (67 – 78%), t\u0103ng phosphatase ki\u1ec1m (55 – 77%), t\u0103ng bilirubin (13 – 26%).<\/p>\n

Th\u1eadn: Protein ni\u1ec7u (10 – 45%), \u0111\u00e1i ra m\u00e1u (13 – 35%), t\u0103ng nit\u01a1 ur\u00ea huy\u1ebft (8 – 16%).<\/p>\n

H\u00f4 h\u1ea5p: Kh\u00f3 th\u1edf (6 – 23%).<\/p>\n

Kh\u00e1c: H\u1ed9i ch\u1ee9ng gi\u1ed1ng c\u00fam (19%), nhi\u1ec5m khu\u1ea5n (8 – 16%).<\/p>\n

Th\u01b0\u1eddng g\u1eb7p, 1\/100 < ADR < 10\/100 <\/em><\/p>\n

T\u1ea1i ch\u1ed7: K\u00edch \u1ee9ng t\u1ea1i ch\u1ed7 ti\u00eam (4%).<\/p>\n

Th\u1ea7n kinh – c\u01a1 – x\u01b0\u01a1ng: Lo\u1ea1n c\u1ea3m (2 – 10%).<\/p>\n

Th\u1eadn: T\u0103ng creatinin (2 – 8%).<\/p>\n

H\u00f4 h\u1ea5p: Co th\u1eaft ph\u1ebf qu\u1ea3n (< 2%).<\/p>\n

\u00cdt g\u1eb7p, ADR <1\/100<\/em><\/p>\n

H\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, ph\u1ea3n v\u1ec7, ch\u00e1n \u0103n, lo\u1ea1n nh\u1ecbp tim, n\u1ed1i ph\u1ecfng \u1edf da, vi\u00eam m\u00f4, tai bi\u1ebfn m\u1ea1ch n\u00e3o, suy tim sung huy\u1ebft, run c\u01a1, ho, vi\u00eam bong, \u0111\u1ed1 m\u1ed3 h\u00f4i, ho\u1ea1i t\u1eed, t\u0103ng GGT, nh\u1ee9c \u0111\u1ea7u, h\u1ed9i ch\u1ee9ng t\u0103ng ur\u00ea huy\u1ebft t\u00e1n, ph\u1ea3n \u1ee9ng \u0111\u1ed9c \u1edf gan, t\u0103ng huy\u1ebft \u00e1p, m\u1ea5t ng\u1ee7, vi\u00eam ph\u1ed1i k\u1ebd, suy gan, m\u1ec7t m\u1ecfi, nh\u1ed3i m\u00e1u c\u01a1 tim, vi\u00eam m\u1ea1ch ngo\u1ea1i vi, \u0111i\u1ec3m xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da, ph\u00f9 ph\u1ed1i, h\u1ed9i ch\u1ee9ng vi\u00eam sau chi\u1ebfu x\u1ea1, suy th\u1eadn, suy h\u00f4 h\u1ea5p, vi\u00eam m\u0169i, nhi\u1ec5m khu\u1ea5n huy\u1ebft, lo\u1ea1n nh\u1ecbp tr\u00ean th\u1ea5t, m\u1ec7t nh\u1ecdc.<\/p>\n

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

4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/strong><\/p>\n

Ph\u1ea7n l\u1edbn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 hay g\u1eb7p c\u1ee7a gemcitabin l\u00e0 c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i v\u00e0 kh\u00f4ng \u0111\u00f2i h\u1ecfi ph\u1ea3i ng\u1eebng h\u1eb3n tr\u1ecb li\u1ec7u d\u00f9 c\u00f3 th\u1ec3 ph\u1ea3i gi\u1ea3m li\u1ec1u ho\u1eb7c t\u1ea1m ng\u1eebng d\u00f9ng thu\u1ed1c.<\/p>\n

C\u1ea7n theo d\u00f5i b\u1ec7nh nh\u00e2n \u0111\u1ecbnh k\u1ef3 v\u1ec1 huy\u1ebft h\u1ecdc (c\u00f4ng th\u1ee9c m\u00e1u, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u), \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan, th\u1eadn, ph\u1ed1i, nh\u1ea5t l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 ho\u1eb7c \u0111ang c\u00f3 b\u1ec7nh \u1edf c\u00e1c c\u01a1 quan n\u00e0y.<\/p>\n

N\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb t\u00e1c d\u1ee5ng ph\u1ee5 th\u00ec ph\u1ea3i \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 th\u00edch h\u1ee3p; c\u00f3 th\u1ec3 ph\u1ea3i xem x\u00e9t vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u trong chu k\u1ef3 ho\u1eb7c \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf chu k\u1ef3 k\u1ebf ti\u1ebfp.<\/p>\n

4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n

Gemcitabin l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a bleomycin, fluorouracil, natalizumab, v\u1eafc xin (s\u1ed1ng).<\/p>\n

Gemcitabin l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a v\u1eafc xin (b\u1ea5t ho\u1ea1t), thu\u1ed1c kh\u00e1ng vitamin K.<\/p>\n

Trastuzumab l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a gemcitabin. Echinacea l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a gemcitabin.<\/p>\n

T\u01b0\u01a1ng t\u00e1c v\u1edbi chi\u1ebfu x\u1ea1:<\/em><\/p>\n

X\u1ea1 tr\u1ecb \u0111\u1ed3ng th\u1eddi ho\u1eb7c c\u00e1ch nhau < 7 ng\u00e0y: \u0110\u1ed9c t\u00ednh ph\u1ee5 thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1, nh\u1ea5t l\u00e0 v\u00e0o li\u1ec1u gemcitabin, t\u1ea7n su\u1ea5t d\u00f9ng, li\u1ec1u chi\u1ebfu x\u1ea1, c\u00e1ch l\u00ean k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb, m\u00f4 \u0111\u00edch, th\u1ec3 t\u00edch b\u1ecb chi\u1ebfu x\u1ea1. C\u1ea7n \u0111\u1eb7c bi\u1ec7t ch\u00fa \u00fd \u1edf b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 ph\u1ed1i kh\u00f4ng ph\u1ea3i t\u1ebf b\u00e0o nh\u1ecf v\u00ec \u0111\u00e3 th\u1ea5y gemcitabin l\u00e0m t\u0103ng nh\u1ea1y c\u1ea3m v\u1edbi tia x\u1ea1 d\u1eabn \u0111\u1ebfn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u1eb7ng c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng (vi\u00eam th\u1ef1c qu\u1ea3n, vi\u00eam ph\u1ed1i, nh\u1ea5t l\u00e0 \u1edf b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u00edch b\u1ecb chi\u1ebfu x\u1ea1 l\u1edbn). C\u00f3 th\u1ec3 k\u1ebft h\u1ee3p gemcitabin li\u1ec1u th\u1ea5p v\u1edbi chi\u1ebfu x\u1ea1 li\u1ec1u th\u1ea5p (gemcitabin: 600 mg\/m2<\/sup> 4 l\u1ea7n; cisplatin: 80 mg\/m2<\/sup>, 2 l\u1ea7n; chi\u1ebfu x\u1ea1 66Gy) trong chu k\u1ef3 6 tu\u1ea7n v\u1edbi \u0111\u1ed9c t\u00ednh c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c.<\/p>\n

X\u1ea1 tr\u1ecb kh\u00f4ng \u0111\u1ed3ng th\u1eddi ho\u1eb7c c\u00e1ch nhau > 7 ng\u00e0y: Kh\u00f4ng th\u1ea5y c\u00f3 t\u0103ng \u0111\u1ed9c t\u00ednh n\u1ebfu gemcitabin \u0111\u01b0\u1ee3c d\u00f9ng tr\u01b0\u1edbc chi\u1ebfu x\u1ea1 tr\u00ean 7 ng\u00e0y, ngo\u00e0i t\u00e1i ph\u00e1t ph\u1ea3n \u1ee9ng do chi\u1ebfu x\u1ea1 (radiation recall reaction).<\/p>\n

4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng qu\u00e1 li\u1ec1u l\u00e0 \u1ee9c ch\u1ebf t\u1ee7y, lo\u1ea1n c\u1ea3m, vi\u00eam ni\u00eam m\u1ea1c, lo\u00e9t da, n\u1ed1i man, c\u00e1c tri\u1ec7u ch\u1ee9ng n\u1eb7ng c\u1ee7a t\u00e1c d\u1ee5ng ph\u1ee5. Kh\u00f4ng c\u00f3 thu\u1ed1c \u0111\u1eb7c tr\u1ecb ng\u1ed9 \u0111\u1ed9c gemcitabin. \u0110i\u1ec1u tr\u1ecb qu\u00e1 li\u1ec1u l\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ed7 tr\u1ee3. N\u1ebfu s\u1edbm th\u00ec c\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c ch\u1ed1ng n\u00f4n v\u00e0 thu\u1ed1c ch\u1ed1ng \u1ec9a ch\u1ea3y \u0111\u1ec3 gi\u1ea3m nh\u1eb9 tri\u1ec7u ch\u1ee9ng.<\/p>\n

Theo d\u00f5i c\u00e2n b\u1eb1ng n\u01b0\u1edbc – \u0111i\u1ec7n gi\u1ea3i \u1edf b\u1ec7nh nh\u00e2n b\u1ecb m\u1ea5t n\u01b0\u1edbc, n\u00f4n ho\u1eb7c \u1ec9a ch\u1ea3y n\u1eb7ng.<\/p>\n

V\u1edbi t\u1ee7y x\u01b0\u01a1ng b\u1ecb \u1ee9c ch\u1ebf: D\u00f9ng c\u00e1c y\u1ebfu t\u1ed1 k\u00edch th\u00edch t\u1ea1o b\u1ea1ch c\u1ea7u (filgrastim 5 microgam\/kg\/ng\u00e0y ti\u00eam d\u01b0\u1edbi da ho\u1eb7c truy\u1ec1n t\u0129nh m\u1ea1ch trong 15 – 30 ph\u00fat.<\/p>\n

5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><\/p>\n

5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/strong><\/p>\n

Gemcitabin l\u00e0 ch\u1ea5t ch\u1ed1ng chuy\u1ec3n h\u00f3a pyrimidin, c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf t\u1ed1ng h\u1ee3p DNA do \u1ee9c ch\u1ebf DNA polymerase v\u00e0 ribonucleotid reductase \u0111\u1eb7c hi\u1ec7u cho pha S c\u1ee7a chu k\u1ef3 ph\u00e2n b\u00e0o. Trong t\u1ebf b\u00e0o, gemcitabin b\u1ecb phosphoryl h\u00f3a b\u1edfi deoxycytidin kinase th\u00e0nh gemcitabin monophosphat; ch\u1ea5t n\u00e0y l\u1ea1i b\u1ecb phosphoryl h\u00f3a th\u00e0nh c\u00e1c d\u1eabn ch\u1ea5t c\u00f3 ho\u1ea1t t\u00ednh l\u00e0 gemcitabin diphosphat v\u00e0 gemcitabin triphosphat. Gemcitabin diphosphat \u1ee9c ch\u1ebf ribonucleotid reductase n\u00ean \u1ee9c ch\u1ebf t\u1ed1ng h\u1ee3p DNA c\u00f2n gemcitabin triphosphat g\u1eafn v\u00e0o DNA v\u00e0 \u1ee9c ch\u1ebf DNA polymerase.<\/p>\n

T\u00e1c d\u1ee5ng \u0111\u1ed9c t\u1ebf b\u00e0o \u0111\u1ed1i v\u1edbi c\u00e1c m\u1eabu t\u1ebf b\u00e0o nu\u00f4i c\u1ea5y : <\/em><\/p>\n

Gemcitabine c\u00f3 \u0111\u1ed9c t\u00ednh \u0111\u00e1ng k\u1ec3 tr\u00ean nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o u c\u1ee7a ng\u01b0\u1eddi v\u00e0 chu\u1ed9t \u0111\u01b0\u1ee3c nu\u00f4i c\u1ea5y. T\u00e1c d\u1ee5ng \u0111\u1ed9c t\u1ebf b\u00e0o \u0111\u1eb7c tr\u01b0ng \u1edf giai \u0111o\u1ea1n ranh gi\u1edbi G1\/S. In vitro, t\u00e1c d\u1ee5ng \u0111\u1ed9c t\u1ebf b\u00e0o c\u1ee7a gemcitabine ph\u1ee5 thu\u1ed9c v\u00e0o n\u1ed3ng \u0111\u1ed9 v\u00e0 th\u1eddi gian d\u00f9ng thu\u1ed1c.<\/p>\n

T\u00e1c d\u1ee5ng kh\u00e1ng u trong c\u00e1c m\u1eabu ti\u1ec1n l\u00e2m s\u00e0ng : <\/em><\/p>\n

\u0110\u1ed1i v\u1edbi c\u00e1c m\u1eabu kh\u1ed1i u \u1edf lo\u00e0i v\u1eadt t\u00e1c d\u1ee5ng kh\u00e1ng u c\u1ee7a gemcitabine ph\u1ee5 thu\u1ed9c th\u1eddi bi\u1ec3u d\u00f9ng thu\u1ed1c. Khi d\u00f9ng li\u1ec1u m\u1ed7i ng\u00e0y, gemcitabine g\u00e2y ch\u1ebft v\u1eadt th\u00ed nghi\u1ec7m m\u00e0 t\u00e1c d\u1ee5ng kh\u00e1ng u r\u1ea5t \u00edt. Tr\u00e1i l\u1ea1i, khi d\u00f9ng li\u1ec1u c\u00e1ch 3 ho\u1eb7c 4 ng\u00e0y 1 l\u1ea7n, gemcitabine \u1edf li\u1ec1u kh\u00f4ng g\u00e2y ch\u1ebft l\u1ea1i c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng u r\u1ea5t t\u1ed1t tr\u00ean nhi\u1ec1u lo\u1ea1i u \u1edf chu\u1ed9t.<\/p>\n

C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n

Gemcitabine (dFdC) \u0111\u01b0\u1ee3c bi\u1ebfn d\u01b0\u1ee1ng trong t\u1ebf b\u00e0o b\u1edfi men nucleoside kinase th\u00e0nh diphosphate (dFdCDP) v\u00e0 triphosphate (dFdCTP) nucleoside ho\u1ea1t t\u00ednh. T\u00e1c d\u1ee5ng \u0111\u1ed9c t\u1ebf b\u00e0o c\u1ee7a gemcitabine l\u00e0 do dFdCDP v\u00e0 dFdCTP \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p ADN. Tr\u01b0\u1edbc h\u1ebft, dFdCDP \u1ee9c ch\u1ebf men ribonucleotide reductase, l\u00e0 men duy nh\u1ea5t x\u00fac t\u00e1c c\u00e1c ph\u1ea3n \u1ee9ng t\u1ea1o ra deoxynucleoside triphosphate \u0111\u1ec3 t\u1ed5ng h\u1ee3p ADN. \u1ee8c ch\u1ebf men n\u00e0y s\u1ebd l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 deoxynucleoside n\u00f3i chung, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ed3ng \u0111\u1ed9 dCTP. Th\u1ee9 hai l\u00e0, dFdCTP c\u1ea1nh tranh v\u1edbi dCTP \u0111\u1ec3 g\u1eafn v\u00e0o ADN (self-potentiation). T\u01b0\u01a1ng t\u1ef1, m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf gemcitabine c\u0169ng c\u00f3 th\u1ec3 g\u1eafn v\u00e0o ARN. Nh\u01b0 v\u1eady, gi\u1ea3m n\u1ed3ng \u0111\u1ed9 n\u1ed9i b\u00e0o c\u1ee7a dCTP khi\u1ebfn cho vi\u1ec7c g\u1eafn dFdCTP v\u00e0 ADN d\u1ec5 d\u00e0ng h\u01a1n. Th\u1ef1c ch\u1ea5t ADN polymerase epsilon kh\u00f4ng th\u1ec3 lo\u1ea1i b\u1ecf gemcitabine v\u00e0 s\u1eeda l\u1ea1i chu\u1ed7i ADN \u0111ang ph\u00e1t tri\u1ec3n. Sau khi gemcitabine g\u1eafn v\u00e0o ADN, 1 nucleotide n\u1eefa g\u1eafn th\u00eam v\u00e0o chu\u1ed7i ADN \u0111ang ph\u00e1t tri\u1ec3n. Sau khi g\u1eafn th\u00eam nucleotide n\u00e0y, s\u1ef1 t\u1ed5ng h\u1ee3p ADN th\u1ef1c s\u1ef1 b\u1ecb \u1ee9c ch\u1ebf ho\u00e0n to\u00e0n (masked chain termination). Sau khi g\u1eafn v\u00e0o ADN, gemcitabine th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh h\u1ee7y di\u1ec7t t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh \u0111\u1ecbnh tr\u01b0\u1edbc, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 “apoptosis”.<\/p>\n

[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n

5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/strong><\/p>\n

Sau khi \u0111\u01b0\u1ee3c truy\u1ec1n t\u0129nh m\u1ea1ch, gemcitabin nhanh ch\u00f3ng r\u1eddi kh\u1ecfi m\u00e1u v\u00e0 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1edfi cytidin deaminase \u1edf gan, th\u1eadn, m\u00e1u v\u00e0 c\u00e1c m\u00f4 kh\u00e1c. Th\u1eddi gian \u0111\u1ea1t \u0111\u1ec9nh huy\u1ebft t\u01b0\u01a1ng l\u00e0 30 ph\u00fat sau khi truy\u1ec1n xong.<\/p>\n

Ph\u00e2n b\u1ed1: N\u1ebfu truy\u1ec1n d\u01b0\u1edbi 70 ph\u00fat: 50 l\u00edt\/m2<\/sup>; truy\u1ec1n l\u00e2u: 370 l\u00edt\/m2<\/sup>. Thu\u1ed1c \u00edt g\u1eafn v\u00e0o protein huy\u1ebft t\u01b0\u01a1ng. Gemcitabin \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a trong t\u1ebf b\u00e0o b\u1edfi c\u00e1c nucleosid kinase th\u00e0nh c\u00e1c diphosphat v\u00e0 triphosphat nucleosid c\u00f3 ho\u1ea1t t\u00ednh. Ph\u1ee5 n\u1eef c\u00f3 \u0111\u1ed9 thanh th\u1ea3i thu\u1ed1c th\u1ea5p h\u01a1n 25% so v\u1edbi nam gi\u1edbi.<\/p>\n

N\u1eeda \u0111\u1eddi th\u1ea3i tr\u1eeb c\u1ee7a gemcitabin n\u1ebfu th\u1eddi gian truy\u1ec1n < 1 gi\u1edd: 42 – 94 ph\u00fat; n\u1ebfu th\u1eddi gian truy\u1ec1n 3 – 4 gi\u1edd: 4 – 10,5 gi\u1edd. N\u1eeda \u0111\u1eddi th\u1ea3i tr\u1eeb kh\u1ecfi t\u1ebf b\u00e0o c\u1ee7a gemcitabin triphosphat l\u00e0 0,7 – 12 gi\u1edd. Thu\u1ed1c \u0111\u01b0\u1ee3c \u0111ao th\u1ea3i ch\u1ee7 y\u1ebfu qua n\u01b0\u1edbc ti\u1ec3u (92 – 98%, ch\u1ee7 y\u1ebfu d\u01b0\u1edbi d\u1ea1ng ch\u1ea5t chuy\u1ec3n h\u00f3a uracil kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh) v\u00e0 qua ph\u00e2n (< 1%).<\/p>\n

5.3 Gi\u1ea3i th\u00edch: <\/strong><\/p>\n

Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n

5.4 Thay th\u1ebf thu\u1ed1c : <\/strong><\/p>\n

Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n

*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n

C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o – 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

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

6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><\/p>\n

6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/strong><\/p>\n

Mannitol (200 mg ho\u1eb7c 1 g) , sodium acetate (12.5 mg ho\u1eb7c 62.5 mg)<\/p>\n

6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n

Gemcitabin hydroclorid t\u01b0\u01a1ng k\u1ef5 v\u1eadt l\u00fd v\u1edbi aciclovir natri, amphotericin B, cefoperazon natri, cefotaxim natri, furosemid, ganciclovir natri, imipenem c\u00f3 cilastatin natri, irinotecan, methotrexat natri, methylprednisolon natri sucinat, mezlocilin natri, mitomycin, piperacilin natri, piperacilin c\u00f3 tazobactam, proclorperazin edisilat.<\/p>\n

Kh\u00f4ng pha thu\u1ed1c b\u1eb1ng c\u00e1c dung m\u00f4i kh\u00e1c ngo\u00e0i natri clorid 0,9%. Kh\u00f4ng tr\u1ed9n thu\u1ed1c v\u1edbi b\u1ea5t k\u1ef3 thu\u1ed1c n\u00e0o kh\u00e1c.<\/p>\n

6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n

B\u1ea3o qu\u1ea3n l\u1ecd thu\u1ed1c b\u1ed9t nguy\u00ean v\u1eb9n \u1edf nhi\u1ec7t \u0111\u1ed9 20 – 25 \u00b0C.<\/p>\n

Dung d\u1ecbch thu\u1ed1c \u0111\u1eadm \u0111\u1eb7c (38 mg\/ml) on \u0111\u1ecbnh trong v\u00f2ng 35 ng\u00e0y. Dung d\u1ecbch pha lo\u00e3ng trong natri clorid 0,9% on \u0111\u1ecbnh trong 7 ng\u00e0y \u1edf nhi\u1ec7t \u0111\u1ed9 23 \u00b0C v\u00e0 tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n

Tuy nhi\u00ean, nh\u00e0 s\u1ea3n xu\u1ea5t khuy\u00ean n\u00ean s\u1eed d\u1ee5ng c\u1ea3 2 dung d\u1ecbch tr\u00ean trong v\u00f2ng 24 gi\u1edd. Kh\u00f4ng \u0111\u1ec3 trong t\u1ee7 l\u1ea1nh v\u00ec g\u00e2y k\u1ebft tinh.<\/p>\n

6.4. Th\u00f4ng tin kh\u00e1c :<\/strong><\/p>\n

Kh\u00f4ng c\u00f3.<\/p>\n

6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n

D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n

Ho\u1eb7c HDSD Thu\u1ed1c.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Gemcitabine\u00a0 Ph\u00e2n lo\u1ea1i: Thu\u1ed1c ch\u1ed1ng ung th\u01b0, nh\u00f3m ch\u1ed1ng chuy\u1ec3n h\u00f3a, nucleosid pyrimidin t\u1ed1ng h\u1ee3p. 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): L01BC05. Brand name: Gemzar. Generic : Gemcisan,Gemcitabine Onkovis 1000mg,Gemcitabine Onkovis […]<\/p>\n","protected":false},"author":1,"featured_media":25997,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[2],"tags":[942],"class_list":["post-2744","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-thuoc-a-z","tag-gemcitabine"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/2744","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=2744"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/2744\/revisions"}],"predecessor-version":[{"id":25998,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/2744\/revisions\/25998"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/25997"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=2744"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=2744"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=2744"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}