{"id":27948,"date":"2021-01-08T18:57:10","date_gmt":"2021-01-08T11:57:10","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=27948"},"modified":"2025-01-08T11:52:51","modified_gmt":"2025-01-08T04:52:51","slug":"oxcarbazepine-kusapin","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/oxcarbazepine-kusapin\/","title":{"rendered":"Oxcarbazepine &#8211; Kusapin"},"content":{"rendered":"<p><em>Thu\u1ed1c Kusapin l\u00e0 thu\u1ed1c g\u00ec ? D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c Kusapin (Th\u00f4ng tin bao g\u1ed3m li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, th\u1eadn tr\u1ecdng, d\u01b0\u1ee3c l\u00fd&#8230;)<\/em><\/p>\n<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\/oxcarbazepine\/\"><strong>Oxcarbazepine<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c ch\u1ed1ng co gi\u1eadt, ch\u1ed1ng \u0111\u1ed9ng kinh<\/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): N03AF02.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong> <a href=\"https:\/\/pharmog.com\/wp\/oxcarbazepine-trileptal\/\">Trileptal<\/a><\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c:<\/em><\/strong> Kusapin<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: Kusum Healthcare Pvt. Ltd.<\/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: 300 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>KUSAPIN<\/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>Oxcarbazepine<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>300 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=\"407\" height=\"419\" class=\"wp-image-27949\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2021\/01\/word-image-307.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2021\/01\/word-image-307.png 407w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2021\/01\/word-image-307-291x300.png 291w\" sizes=\"auto, (max-width: 407px) 100vw, 407px\" \/><\/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>Kusapin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u00e1c c\u01a1n \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 \u0111\u1ed9ng kinh co c\u1ee9ng &#8211; gi\u1eadt rung to\u00e0n th\u1ec3 th\u1ee9 ph\u00e1t.<\/p>\n<p>Kusapin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111\u01a1n tr\u1ecb li\u1ec7u ho\u1eb7c \u0111a tr\u1ecb li\u1ec7u cho ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em &gt; 6 tu\u1ed5i.<\/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>Kusapin c\u00f3 th\u1ec3 d\u00f9ng c\u00f9ng ho\u1eb7c kh\u00f4ng c\u00f9ng v\u1edbi th\u1ee9c \u0103n.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>Oxcarbazepin th\u00edch h\u1ee3p cho vi\u1ec7c d\u00f9ng \u0111\u01a1n tr\u1ecb hay khi ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c. Trong \u0111\u01a1n tr\u1ecb c\u0169ng nh\u01b0 \u0111a tr\u1ecb, \u0111i\u1ec1u tr\u1ecb v\u1edbi Oxcarbazepine \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u d\u1ea7n d\u1ea7n v\u1edbi m\u1ed9t li\u1ec1u c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean l\u00e2m s\u00e0ng chia l\u00e0m 2 l\u1ea7n. Li\u1ec1u c\u00f3 th\u1ec3 t\u0103ng ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng cho b\u1ec7nh nh\u00e2n. Khi Kusapin thay th\u1ebf cho c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c, li\u1ec1u c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p n\u00ean gi\u1ea3m t\u1eeb t\u1eeb trong th\u1eddi gian kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin. Trong \u0111a tr\u1ecb li\u1ec7u, b\u1edfi v\u00ec t\u1ed5ng s\u1ed1 thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh cho b\u1ec7nh nh\u00e2n t\u0103ng l\u00ean v\u00e0 li\u1ec1u c\u1ee7a c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh d\u00f9ng k\u1ebft h\u1ee3p c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i gi\u1ea3m v\u00e0\/ho\u1eb7c li\u1ec1u c\u1ee7a Kusapin t\u0103ng ch\u1eadm h\u01a1n.<\/p>\n<p>Kusapin c\u00f3 th\u1ec3 d\u00f9ng c\u00f9ng ho\u1eb7c kh\u00f4ng c\u00f9ng v\u1edbi th\u1ee9c \u0103n.<\/p>\n<p>Li\u1ec1u \u0111\u1ec1 ngh\u1ecb sau \u0111\u01b0\u1ee3c \u0111\u01b0a cho nh\u1eefng b\u1ec7nh nh\u00e2n; khi kh\u00f4ng b\u1ecb suy th\u1eadn. Ki\u1ec3m so\u00e1t n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft thanh l\u00e0 kh\u00f4ng c\u1ea7n thi\u1ebft \u0111\u1ec3 t\u1ed1i \u01b0u h\u00f3a li\u1ec7u ph\u00e1p Kusapin.<\/p>\n<p><em>Ng\u01b0\u1eddi l\u1edbn:<\/em><\/p>\n<p>\u0110\u01a1n v\u00e0 \u0111a tr\u1ecb li\u1ec7u: Kusapin n\u00ean kh\u1edfi \u0111\u1ea7u v\u1edbi li\u1ec1u 600mg\/ ng\u00e0y (8-10mg\/kg\/ng\u00e0y) chia l\u00e0m 2 l\u1ea7n.<\/p>\n<p>N\u1ebfu \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh tr\u00ean l\u00e2m s\u00e0ng, li\u1ec1u c\u00f3 th\u1ec3 t\u0103ng t\u1ed1i \u0111a l\u00e0 600mg\/ng\u00e0y theo kho\u1ea3ng th\u1eddi gian h\u00e0ng tu\u1ea7n t\u1eeb li\u1ec1u kh\u1edfi \u0111\u1ea7u d\u00f9ng thu\u1ed1c \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng. Hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c quan s\u00e1t \u1edf nh\u1eefng li\u1ec1u trong kho\u1ea3ng gi\u1eefa 600mg\/ng\u00e0y v\u00e0 2400 mg\/ng\u00e0y.<\/p>\n<p>Li\u1ec1u d\u00f9ng h\u00e0ng ng\u00e0y t\u1eeb 600 \u0111\u1ebfn 2400mg\/ng\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea5y l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean ca l\u00e2m s\u00e0ng \u0111a tr\u1ecb li\u1ec7u c\u00f3 ki\u1ec3m so\u00e1t, m\u1eb7c d\u00f9 h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 dung n\u1ea1p li\u1ec1u 2400mg\/ng\u00e0y m\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 gi\u1ea3m c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi, ch\u1ee7 y\u1ebfu do t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 li\u00ean quan \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng. Li\u1ec1u h\u00e0ng ng\u00e0y tr\u00ean 2400mg\/ng\u00e0y ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u m\u1ed9t c\u00e1ch c\u00f3 h\u1ec7 th\u1ed1ng tr\u00ean c\u00e1c ca l\u00e2m s\u00e0ng.<\/p>\n<p><em>Ng\u01b0\u1eddi gi\u00e0<\/em><\/p>\n<p>\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i c\u00f3 suy ch\u1ee9c n\u0103ng th\u1eadn.<\/p>\n<p><em>Tr\u1ebb em<\/em><\/p>\n<p>Trong \u0111\u01a1n hay \u0111a tr\u1ecb li\u1ec7u: Kusapin n\u00ean \u0111\u01b0\u1ee3c kh\u1edfi \u0111\u1ea7u v\u1edbi li\u1ec1u 8-10mg\/kg\/ng\u00e0y \u0111\u01b0\u1ee3c chia 2 l\u1ea7n.<\/p>\n<p>Trong \u0111a tr\u1ecb li\u1ec7u, hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c th\u1ea5y \u1edf li\u1ec1u \u0111i\u1ec1u tr\u1ecb duy tr\u00ec trung b\u00ecnh kho\u1ea3ng 30mg\/kg\/ng\u00e0y. N\u1ebfu \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng, li\u1ec1u c\u00f3 th\u1ec3 t\u0103ng th\u00eam m\u1ed9t l\u01b0\u1ee3ng t\u1ed1i \u0111a l\u00e0 10mg\/kg\/ng\u00e0y theo c\u00e1c kho\u1ea3ng c\u00e1ch h\u00e0ng tu\u1ea7n k\u1ec3 t\u1eeb li\u1ec1u kh\u1edfi \u0111\u1ea7u \u0111\u1ebfn li\u1ec1u t\u1ed1i \u0111a 46mg\/kg\/ng\u00e0y, \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng mong mu\u1ed1n.<\/p>\n<p>Khi kh\u00f4ng th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ed9t li\u1ec1u ch\u00ednh x\u00e1c (mg\/kg) v\u1edbi c\u00e1c d\u1ea1ng vi\u00ean n\u00e9n c\u00f3 s\u1eb5n cho tr\u1ebb em v\u00e0 nh\u1ea5t thi\u1ebft ph\u1ea3i \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin, n\u00ean quy\u1ebft \u0111\u1ecbnh d\u00f9ng li\u1ec1u \u01b0\u1edbc l\u01b0\u1ee3ng theo t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p>Kusapin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng cho tr\u1ebb &gt; 6 tu\u1ed5i. T\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 tr\u00ean c\u00e1c ca l\u00e2m s\u00e0ng c\u00f3 ki\u1ec3m so\u00e1t li\u00ean quan \u0111\u1ebfn kho\u1ea3ng 230 tr\u1ebb em&lt; 6 tu\u1ed5i. Tuy nhi\u00ean, Kusapin kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho nh\u1eefng tr\u1ebb em &lt; 6 tu\u1ed5i b\u1edfi v\u00ec t\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp \u0111\u1ea7y \u0111\u1ee7.<\/p>\n<p>T\u1ea5t c\u1ea3 li\u1ec1u \u0111\u01b0\u1ee3c \u0111\u1ec3 ngh\u1ecb \u1edf tr\u00ean (ng\u01b0\u1eddi l\u1edbn, ng\u01b0\u1eddi gi\u00e0 v\u00e0 tr\u1ebb em) \u0111\u01b0\u1ee3c d\u1ef1a tr\u00ean li\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c ca l\u00e2m s\u00e0ng \u1edf t\u1ea5t c\u1ea3 c\u00e1c nh\u00f3m tu\u1ed5i. Tuy nhi\u00ean, li\u1ec1u kh\u1edfi \u0111\u1ea7u th\u1ea5p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t khi th\u00edch h\u1ee3p.<\/p>\n<p>B\u1ec7nh nh\u00e2n suy gan<\/p>\n<p>Kh\u00f4ng \u0111\u00f2i h\u1ecfi ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho b\u1ec7nh nh\u00e2n suy gan t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh. Kusapin ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng: b\u1edfi v\u1eady, ph\u1ea3i th\u1eadn trong khi \u0111\u01b0a li\u1ec1u cho b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng.<\/p>\n<p>B\u1ec7nh nh\u00e2n suy th\u1eadn<\/p>\n<p>O b\u1ec7nh nh\u00e2n suy th\u1eadn (\u0110\u1ed9 thanh th\u1ea3i creatinin &lt; 30ml\/ ph\u00fat), Kusapin n\u00ean kh\u1edfi \u0111\u1ea7u v\u1edbi 1\u20442 li\u1ec1u kh\u1edfi \u0111\u1ea7u th\u00f4ng th\u01b0\u1eddng (300mg\/ng\u00e0y) v\u00e0 t\u0103ng d\u00e2n \u00edt nh\u1ea5t trong kho\u1ea3ng th\u1eddi gian m\u1ed7i tu\u1ea7n, \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng mong mu\u1ed1n.<\/p>\n<p>C\u1ea7n ph\u1ea3i theo \u0111\u1ed1i ch\u1eb7t ch\u1ebd khi t\u0103ng t\u1eeb t\u1eeb li\u1ec1u cho b\u1ec7nh nh\u00e2n suy th\u1eadn.<\/p>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi ho\u1ea1t ch\u00e2t ho\u1eb7c b\u00e2t k\u1ef3 c\u00e1c t\u00e1 d\u01b0\u1ee3c n\u00e0o c\u1ee7a thu\u00f4c<\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p><em>Qu\u00e1 m\u1eabn c\u1ea3m:<\/em> Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn (t\u1ee9c th\u00ec) nh\u00f3m I bao g\u1ed3m ph\u00e1t ban, ng\u1ee9a, m\u00e0y \u0111ay, ph\u00f9 m\u1ea1ch v\u00e0 b\u00e1o c\u00e1o qu\u00e1 m\u1eabn \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c trong giai \u0111o\u1ea1n nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u. C\u00e1c tr\u01b0\u1eddng h\u1ee3p qu\u00e1 m\u1eabn v\u00e0 ph\u00f9 m\u1ea1ch li\u00ean quan \u0111\u1ebfn thanh qu\u1ea3n, thanh m\u00f4n, m\u00f4i v\u00e0 m\u00ed m\u1eaft \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf c\u00e1c b\u1ec7nh nh\u00e2n d\u00f9ng li\u1ec1u \u0111\u1ea7u ti\u00ean v\u00e0 li\u1ec1u ti\u1ebfp theo c\u1ee7a Kusapin. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng sau khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin, thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c ng\u01b0ng v\u00e0 \u0111i\u1ec1u tr\u1ecb thay th\u1ebf. B\u1ec7nh nh\u00e2n c\u00f3 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn \u0111\u1ed1i v\u1edbi carbamazepine \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o c\u00f3 kho\u1ea3ng 25-30% nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 th\u1ec3 c\u00f3 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn (nh\u01b0 ph\u1ea3n \u1ee9ng da n\u1eb7ng) v\u1edbi Kusapin. Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn, bao g\u1ed3m ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn x\u1ea3y ra tr\u00ean nhi\u1ec1u b\u1ed9 ph\u1eadn c\u0169ng c\u00f3 th\u1ec3 x\u00e3y ra tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed m\u1eabn c\u1ea3m v\u1edbi Carbamazepine. Ph\u1ea3n \u1ee9ng nh\u01b0 v\u1eady c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn da, gan, m\u00e1u v\u00e0 h\u1ec7 th\u1ed1ng b\u1ea1ch huy\u1ebft ho\u1eb7c c\u00e1c t\u1ed5 ch\u1ee9c kh\u00e1c, ho\u1eb7c theo t\u1eebng c\u00e1 th\u1ec3 ho\u1eb7c k\u1ebft h\u1ee3p trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p d\u1ecb \u1ee9ng h\u1ec7 th\u1ed1ng. N\u00f3i chung, n\u1ebfu c\u00f3 d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd v\u1ec1 s\u1ef1 qu\u00e1 m\u1eabn x\u1ea3y ra, n\u00ean ng\u1eebng Kusapin ngay l\u1eadp t\u1ee9c.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean da<\/em>: ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn tr\u00ean da n\u1eb7ng, bao g\u1ed3m h\u1ed9i ch\u1ee9ng Stevens-Johnson, ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec do nhi\u1ec5m \u0111\u1ed9c (h\u1ed9i ch\u1ee9ng Luella) v\u00e0 ban \u0111a d\u1ea1ng, \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o hi\u1ebfm khi x\u1ea3y ra khi k\u1ebft h\u1ee3p v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng Kusapin. B\u1ec7nh nh\u00e2n c\u00f3 d\u1ecb \u1ee9ng da n\u1eb7ng ph\u1ea3i \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n, b\u1edfi v\u00ec nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng v\u00e0 r\u1ea5t hi\u1ebfm khi d\u1eabn \u0111\u1ebfn t\u1eed vong. Kusapin li\u00ean quan \u0111\u1ebfn nh\u1eefng tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra tr\u00ean c\u1ea3 tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn. Th\u1eddi gian trung b\u00ecnh cho s\u1ef1 b\u1ed9c ph\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e0 19 ng\u00e0y. M\u1ed9t v\u1ea3i tr\u01b0\u1eddng h\u1ee3p c\u00e1 bi\u1ec7t c\u00f3 t\u00e1i ph\u00e1t ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng da tr\u1ea7m tr\u1ecdng khi d\u00f9ng th\u1eed l\u1ea1i v\u1edbi Kusapin \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. B\u1ec7nh nh\u00e2n ph\u00e1t tri\u1ec3n d\u1ecb \u1ee9ng da v\u1edbi Kusapin c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 ngay v\u00e0 ph\u1ea3i ng\u01b0ng ngay l\u1eadp t\u1ee9c Kusapin tr\u1eeb khi ban \u0111\u1ecf x\u1ea3y ra li\u00ean quan \u0111\u1ebfn thu\u1ed1c kh\u00f4ng r\u00f5 r\u00e0ng. Trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0ng \u0111i\u1ec1u tr\u1ecb, xem x\u00e9t thay th\u1ebf Kusapin b\u1eb1ng c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c \u0111\u1ec3 tr\u00e1nh c\u01a1n co gi\u1eadt r\u00fat, Kusapin kh\u00f4ng n\u00ean t\u00e1i s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh ce ng\u01b0ng \u0111i\u1ec1u tr\u1ecb do ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn x\u1ea3y ra.<\/p>\n<p><em>Gi\u1ea3m natri huy\u1ebft:<\/em> n\u1ed3ng \u0111\u1ed9 natri huy\u1ebft thanh d\u01b0\u1edbi 125mmol\/1, th\u00f4ng th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ec7nh v\u00e0 kh\u00f4ng \u0111\u00f2i h\u1ecfi ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t \u1edf 2,7% b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin. Kinh nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng cho th\u1ea5y n\u1ed3ng \u0111\u1ed9 natri huy\u1ebft thanh tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng khi gi\u1ea3m li\u1ec1u Kusapin, ng\u01b0ng ho\u1eb7c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch d\u00e8 d\u1eb7t (nh\u01b0 h\u1ea1n ch\u1ebf b\u1ed5 sung d\u1ecbch). B\u1ec7nh nh\u00e2n \u0111\u00e3 b\u1ecb suy th\u1eadn t\u1eeb tr\u01b0\u1edbck\u1ebft h\u1ee3p v\u1edbi n\u1ed3ng \u0111\u1ed9 natrI th\u1ea5p ho\u1eb7c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 natri (nh\u01b0 thu\u1ed1c l\u1ee3i ti\u1ec3u, desmopressin) c\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c NSAID (nh\u01b0 Indometacin), c\u1ea7n ph\u1ea3i \u0111o n\u1ed3ng \u0111\u1ed9 natri huy\u1ebft thanh tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. Sau \u0111\u00f3, kho\u1ea3ng 2 tu\u1ea7n sau khi \u0111i\u1ec1u tr\u1ecb v\u00e0 h\u00e0ng th\u00e1ng trong 3 th\u00e1ng \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean sau \u0111\u00f3, ho\u1eb7c theo nhu c\u1ea7u \u0111i\u1ec5u tr\u1ecb, n\u1ed3ng \u0111\u1ed9 natri huy\u1ebft thanh ph\u1ea3i \u0111\u01b0\u1ee3c \u0111o. Nh\u1eefng y\u1ebfu t\u1ed5 nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 \u0111\u1eb7c bi\u1ec7t x\u1ea3y ra tr\u00ean b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i. \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m natri huy\u1ebft, ph\u01b0\u01a1ng ph\u00e1p t\u01b0\u01a1ng t\u1ef1 \u0111\u1ec1 ki\u1ec3m so\u00e1t natri ph\u1ea3i \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd. N\u00f3i chung, n\u1ebfu c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng g\u1ee3i \u00fd v\u1ec1 s\u1ef1 gi\u1ea3m natri huy\u1ebft x\u1ea3y ra trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin, ph\u1ea3i c\u00e2n nh\u1eafc vi\u1ec7c \u0111o natri huy\u1ebft. C\u00e1c b\u1ec7nh nh\u00e2n kh\u00e1c c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 natri huy\u1ebft gi\u1ed1ng nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a c\u00e1c x\u00e9t nghi\u1ec7m th\u00f4ng th\u01b0\u1eddng. T\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 suy tim v\u00e0 \u0111au tim th\u1ee9 ph\u00e1t \u0111\u01b0\u1ee3c \u0111o c\u00e2n n\u1eb7ng th\u01b0\u1eddng xuy\u00ean \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ef1 gi\u1eef n\u01b0\u1edbc. Trong tr\u01b0\u1eddng h\u1ee3p gi\u1eef n\u01b0\u1edbc ho\u1eb7c t\u00ecnh tr\u1ea1ng tim tr\u1edf l\u00ean x\u1ea5u \u0111i, ph\u1ea3i ki\u1ec3m tra natri huy\u1ebft. N\u1ebfu c\u00f3 gi\u1ea3m natri huy\u1ebft, h\u1ea1n ch\u1ebf n\u01b0\u1edbc \u0111\u01b0a v\u00e0o l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p l\u00e0m gi\u1ea3m n\u01b0\u1edbc r\u1ea5t quan tr\u1ecdng. B\u1edfi v\u00ec oxcarbazepin c\u00f3 th\u1ec3, r\u1ea5t hi\u1ebfm khi, d\u1eabn t\u1edbi suy gi\u1ea3m s\u1ef1 d\u1eabn truy\u1ec1n c\u1ee7a tim, b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n s\u1ef1 d\u1eabn truy\u1ec1n tr\u01b0\u1edbc \u0111\u00f3 (nh\u01b0 ngh\u1ebdn nh\u0129 th\u1ea5t, lo\u1ea1n nh\u1ecbp tim) ph\u1ea3i \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea7n th\u1eadn.<\/p>\n<p><em>Ch\u1ee9c n\u0103ng gan:<\/em> R\u1ea5t hi\u1ebfm c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam gan \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o, m\u00e0 trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u h\u1ebft b\u1ec7nh. Khi b\u1ecb nghi ng\u1edd b\u1ec7nh v\u1ec1 gan, ph\u1ea3i \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan v\u00e0 xem x\u00e9t ng\u01b0ng d\u00f9ng Kusapin.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean m\u00e1u<\/em>: r\u1ea5t hi\u1ebfm c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ecb m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t, thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o v\u00e0 thi\u1ebfu m\u00e1u to\u00e0n ph\u1ea7n \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea5y \u1edf c\u00e1c b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin trong khi d\u00f9ng thu\u1ed1c. Xem x\u00e9t ng\u01b0ng d\u00f9ng thu\u1ed1c n\u1ebfu c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 s\u1ef1 suy t\u1ee7y x\u01b0\u01a1ng \u0111ang ph\u00e1t tri\u1ec3n.<\/p>\n<p><em>H\u00e0nh vi t\u1ef1 s\u00e1t:<\/em><\/p>\n<p>Y ngh\u0129 v\u00e0 h\u00e0nh vi t\u1ef1 s\u00e1t \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh trong m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p. M\u1ed9t nghi\u00ean c\u1ee9u t\u1ed5ng th\u1ec3 c\u1ee7a ca c\u00f3 ki\u1ec3m so\u00e1t so v\u1edbi nh\u00f3m ch\u1ee9ng ng\u1eabu nhi\u00ean d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh c\u0169ng \u0111\u00e3 cho th\u1ea5y l\u00e0m t\u0103ng nh\u1eb9 nguy c\u01a1 c\u1ee7a \u00fd ngh\u0129 v\u00e0 h\u00e0nh vi t\u1ef1 s\u00e1t. C\u01a1 ch\u1ebf c\u1ee7a nh\u1eefng nguy c\u01a1 n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft. S\u1ed1 li\u1ec7u c\u00f3 s\u1eb5n kh\u00f4ng lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng s\u1ef1 t\u0103ng nguy c\u01a1 n\u00e0y x\u1ea3y ra \u0111\u1ed1i v\u1edbi Oxcarbazepine.<\/p>\n<p>B\u1edfi v\u1eady b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t d\u1ea5u hi\u1ec7u c\u1ee7a h\u00e0nh vi v\u00e0 \u00fd ngh\u0129a t\u1ef1 t\u1eed v\u00e0 xem x\u00e9t vi\u1ec7c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p. B\u1ec7nh nh\u00e2n (v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n) \u0111\u01b0\u1ee3c khuy\u00ean t\u01b0 v\u1ea5n b\u00e1c s\u0129 v\u1ec1 s\u1ef1 ph\u00e1t tri\u1ec3n d\u1ea5u hi\u1ec7u c\u1ee7a \u00fd ngh\u0129 ho\u1eb7c h\u00e0nh vi t\u1ef1 t\u1eed ph\u00e1t tri\u1ec3n.<\/p>\n<p><em>Thu\u1ed1c hormone ch\u1ed1ng th\u1ee5 thai:<\/em> b\u1ec7nh nh\u00e2n n\u1eef \u1edf tu\u1ed5i mang thai n\u00ean \u0111\u01b0\u1ee3c c\u1ea3nh b\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi Kusapin c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c hormone ch\u1ed1ng th\u1ee5 thai l\u00e0m m\u1ea5t t\u00e1c d\u1ee5ng ch\u1ed1ng th\u1ee5 thai c\u1ee7a thu\u1ed1c. Khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin, khuy\u1ebfn c\u00e1o n\u00ean s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c ch\u1ed1ng th\u1ee5 thai kh\u00f4ng b\u1ed5 sung hormone.<\/p>\n<p><em>R\u01b0\u1ee3u<\/em>: Ph\u1ea3i th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng r\u01b0\u1ee3u c\u00f9ng v\u1edbi Kusapin do t\u00e1c d\u1ee5ng g\u00e2y ng\u1ee7 c\u1ed9ng d\u1ed3n c\u00f3 th\u1ec3 X\u00e2y ra.<\/p>\n<p><em>Ng\u01b0ng d\u00f9ng:<\/em> C\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c, Kusapin n\u00ean ng\u01b0ng t\u1eeb t\u1eeb \u0111\u1ec3 l\u00e0m gi\u1ea3m thi\u1ec3u nguy c\u01a1 l\u00e0m t\u0103ng t\u1ea7n su\u1ea5t \u0111\u1ed9ng kinh.<\/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>S\u1eed d\u1ee5ng Kusapin li\u00ean quan \u0111\u1ebfn t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n nh\u01b0 ch\u00f3ng m\u1eb7t, ng\u1ee7 g\u00e0 ng\u1ee7 g\u1eadt. B\u1edfi v\u1eady, b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c khuy\u00ean r\u1eb1ng n\u0103ng l\u1ef1c v\u1ec1 th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m th\u1ea7n cho vi\u1ec7c v\u1eadn h\u00e0nh m\u00e1y m\u00f3c ho\u1eb7c l\u00e1i xe c\u00f3 th\u1ec3 b\u1ecb suy gi\u1ea3m.<\/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: D<\/p>\n<p>US FDA pregnancy category: C<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Nguy c\u01a1 li\u00ean quan \u0111\u1ebfn ch\u1ee9ng \u0111\u1ed9ng kinh v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh n\u00f3i chung:<\/p>\n<p>Ng\u01b0\u1eddi ta th\u1ea5y r\u1eb1ng con c\u1ee7a ph\u1ee5 n\u1eef m\u1eafc ch\u1ee9ng \u0111\u1ed9ng kinh th\u01b0\u1eddng th\u1ea5y t\u1ec9 l\u1ec7 b\u1ecb d\u1ecb t\u1eadt l\u1edbn h\u01a1n 2-3 l\u1ea7n so v\u1edbi t\u1ec9 l\u1ec7 c\u1ee7a kho\u1ea3ng 3% d\u00e2n s\u1ed1 chung.<\/p>\n<p>\u1ede ng\u01b0\u1eddi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, s\u1ef1 t\u0103ng v\u1ec1 \u0111\u1ecb t\u1eadt \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea5y \u1edf tr\u01b0\u1eddng h\u1ee3p \u0111a tr\u1ecb li\u1ec7u; tuy nhi\u00ean, m\u1ee9c \u0111\u1ed9 m\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb v\u00e0\/ho\u1eb7c b\u1ec7nh g\u00e2y ra v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1.<\/p>\n<p>H\u01a1n n\u1eefa, Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh hi\u1ec7u qu\u1ea3 l\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c ng\u1eaft qu\u00e3ng, b\u1edfi v\u1eady b\u1ec7nh s\u1ebd tr\u1edf l\u00ean x\u1ea5u h\u01a1n cho c\u1ea3 b\u00e0o thai v\u00e0 ng\u01b0\u1eddi m\u1eb9.<\/p>\n<p>Nguy c\u01a1 li\u00ean quan \u0111\u1ebfn Oxcarbqzepine:<\/p>\n<p>D\u1eef li\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 th\u00f4ng s\u1ed1 \u0111\u1ed9ng h\u1ecdc trong th\u1eddi gian mang thai v\u1eabn ch\u01b0a \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 g\u00e2y qu\u00e1i thai c\u1ee7a Oxcarbazepine. Tr\u00ean nghi\u00ean c\u1ee9u \u0111\u1ed9ng v\u1eadt, t\u1ec9 l\u1ec7 ch\u1ebft \u1edf b\u00e0o thai t\u0103ng, l\u00e0m ch\u1eadm s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 qu\u00e1i thai \u0111\u01b0\u1ee3c quan s\u00e1t \u1edf m\u1ee9c \u0111\u1ed9 li\u1ec1u g\u00e2y \u0111\u1ed9c cho m\u1eb9.<\/p>\n<p>Xem x\u00e9t nh\u1eefng d\u1eef li\u1ec7u n\u00e0y:<\/p>\n<p>N\u1ebfu ph\u1ee5 n\u1eef d\u00f9ng Kusapin mang thai ho\u1eb7c l\u00ean k\u1ebf ho\u1ea1ch mang thai, c\u1ea7n ph\u1ea3i \u0111\u00e1nh gi\u00e1 l\u1ea1i c\u1ea7n th\u1eadn vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y. N\u00ean \u0111\u01b0a li\u1ec1u c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ed1i thi\u00eau v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u01a1n \u0111\u1ed9c b\u1ea5t c\u1ee9 l\u00fac n\u00e0o ph\u1ea3i \u0111\u01b0\u1ee3c \u01b0u ti\u00ean \u00edt nh\u1ea5t trong 3 th\u00e1ng \u0111\u1ea7u th\u1eddi k\u1ef3 mang thai.<\/p>\n<p>B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 kh\u1ea3 n\u0103ng c\u1ee7a nguy c\u01a1 t\u0103ng d\u1ecb t\u1eadt v\u00e0 t\u1ea1o c\u01a1 h\u1ed9i cho t\u1ea7m so\u00e1t ti\u1ec1n s\u1ea3n.<\/p>\n<p>Trong th\u1eddi gian mang thai, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb Oxcarbazepine ch\u1ed1ng \u0111\u1ed9ng kinh c\u00f3 hi\u1ec7u qu\u1ea3 kh\u00f4ng \u0111\u01b0\u1ee3c ng\u01b0ng t\u1ea1m th\u1eddi, b\u1edfi v\u00ec s\u1ef1 tr\u1ea7m tr\u1ecdng c\u1ee7a b\u1ec7nh l\u00e0m nguy h\u1ea1i cho c\u1ea3 ng\u01b0\u1eddi m\u1eb9 v\u00e0 thai nhi.<\/p>\n<p>Ki\u1ec3m so\u00e1t v\u00e0 ph\u00f2ng b\u1ec7nh:<\/p>\n<p>Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 thi\u1ebfu acid folic, g\u00f3p ph\u1ea7n v\u00e0o nguy c\u01a1 cho d\u1ecb t\u1eadt c\u1ee7a thai nhi. B\u1ed5 sung acid folic \u0111\u01b0\u1ee3c \u0111\u1ec3 ngh\u1ecb tr\u01b0\u1edbc v\u00e0 trong khi mang thai. B\u1edfi v\u00ec hi\u1ec7u qu\u1ea3 c\u1ee7a vi\u1ec7c b\u1ed5 sung n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh, ph\u1ea3i ch\u1ea9n \u0111o\u00e1n ti\u1ec1n s\u1ea3n c\u1ee5 th\u1ec3 th\u1eadm ch\u00ed c\u1ea3 \u1edf nh\u1eefng ph\u1ee5 n\u1eef \u0111\u01b0\u1ee3c b\u1ed5 sung acid folic. C\u00e1c s\u1ed1 li\u1ec7u t\u1eeb m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf ph\u1ee5 n\u1eef ch\u1ec9 ra r\u1eb1ng n\u1ed3ng \u0111\u1ed9 huy\u1ebft thanh c\u1ee7a ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh Oxcarbazepine., d\u1eabn ch\u1ea5t 10-monohydroxy (MHD), c\u00f3 th\u1ec3 gi\u1ea3m t\u1eeb t\u1eeb trong th\u1eddi gian mang thai.\u0110\u00e1p \u1ee9ng l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb ph\u1ea3i ki\u1ec3m so\u00e1t ch\u1eb7t ch\u1ebd \u1edf ph\u1ee5 n\u1eef \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin trong th\u1eddi gian mang thai \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o duy tr\u00ec \u0111\u01b0\u1ee3c s\u1ef1 ki\u1ec3m so\u00e1t \u0111\u1ed1i v\u1edbi c\u00e1c c\u01a1n tai bi\u1ebfn.<\/p>\n<p>Ph\u1ea3i xem x\u00e9t s\u1ef1 thay \u0111\u1ed5i n\u1ed3ng \u0111\u1ed9 MHD trong huy\u1ebft thanh. N\u1ebfu li\u1ec1u t\u0103ng trong th\u1eddi gian mang thai, n\u1ed3ng \u0111\u1ed9 MHD sau sinh c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t cho vi\u1ec7c ki\u1ec3m so\u00e1t.<\/p>\n<p>Tr\u1ebb m\u1edbi sinh:<\/p>\n<p>R\u1ed3i lo\u1ea1n m\u00e1u \u1edf tr\u1ebb m\u1edbi sinh g\u00e2y ra b\u1edfi c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. Do th\u1eadn tr\u1ecdng, vitamin K1 n\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a gi\u1ed1ng nh\u01b0 l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p ph\u00f2ng b\u1ec7nh trong v\u00e0i tu\u1ea7n cu\u1ed1i c\u1ee7a ph\u1ee5 n\u1eef mang thai v\u00e0 cho \u0111\u1ebfn khi sinh.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Oxcarbazepine v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh (MHD) \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua s\u1eefa m\u1eb9. T\u1ec9 l\u1ec7 n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong s\u1eefa v\u00e0 m\u00e1u l\u00e0 0,5 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y cho c\u1ea3 2 ch\u1ea5t. T\u00e1c d\u1ee5ng tr\u00ean tr\u1ebb em ph\u01a1i nhi\u1ec5m v\u1edbi Kusapin b\u1edfi con \u0111\u01b0\u1eddng n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft. B\u1edfi v\u1eady, Kusapin kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa.<\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n chung nh\u1ea5t \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 bu\u1ed3n ng\u1ee7, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, ch\u1ee9ng nh\u00ecn \u0111\u00f4i, n\u00f4n, bu\u1ed3n n\u00f4n v\u00e0 m\u1ec7t m\u1ecfi x\u1ea3y ra &gt;10% b\u1ec7nh nh\u00e2n.<\/p>\n<p>C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n x\u1ea3y ra \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng c\u01a1 th\u1ec3 dya tr\u00ean c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1\u1ed7n t\u1eeb c\u00e1c ca l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 li\u00ean quan \u0111\u1ebfn Kusapin. H\u01a1n n\u1eefa, nh\u1eefng b\u00e1o c\u00e1o c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng d\u1ef1a tr\u00ean nh\u1eefng kinh nghi\u1ec7m v\u1ec1 t\u00e1c d\u1ee5ng ph\u1ee5 t\u1eeb c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ch\u1ec9 r\u00f5 v\u00e0 xem x\u00e9t t\u1eeb kinh nghi\u1ec7m trong c\u00e1c nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u.<\/p>\n<p>D\u1ef1 \u0111o\u00e1n v\u1ec1 t\u1ea7n su\u1ea5t *: &#8211; R\u1ea5t th\u01b0\u1eddng xuy\u00ean: 1\/10; th\u01b0\u1eddng xuy\u00ean: 1\/100 &#8211; &lt; 1\/10; Kh\u00f4ng th\u01b0\u1eddng xuy\u00ean: 1\/1000 &#8211; &lt; 1\/100; Hi\u1ec3m: 1\/10.000 &#8211; &lt;1\/1.000; R\u1ea5t hi\u1ebfm: &lt;1\/10.000; ch\u01b0a bi\u1ebft: kh\u00f4ng th\u1ebf d\u1ef1 \u0111o\u00e1n t\u1eeb s\u1ed1 li\u1ec7u s\u1eb5n c\u00f3.<\/p>\n<p>Trong m\u1ed7i nh\u00f3m t\u1ea7n su\u1ea5t, t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n tr\u00ecnh b\u00e0y theo m\u1ee9c \u0111\u1ed9 gi\u1ea3m d\u1ea7n c\u1ee7a m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u1ec7 th\u1ed1ng m\u00e1u v\u00e0 b\u1ea1ch huy\u1ebft<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Gi\u1ea3m b\u1ea1ch c\u1ea7u<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Gi\u1ea3m ti\u1ec3u c\u1ea7u<\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng \u0111\u01b0\u1ee3c bi\u1ebft<\/td>\n<td>Suy gi\u1ea3m t\u1ee7y x\u01b0\u01a1ng, thi\u1ebfu m\u00e1u tr\u1ea7m tr\u1ecdng, m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t, thi\u1ebfu m\u00e1u to\u00e0n b\u1ed9, gi\u1ea3m t\u1ebf b\u00e0o trung t\u00ednh<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u1ec7 mi\u1ec5n d\u1ecbch<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Qu\u00e1 m\u1eabn \u0111\u1eb7c tr\u01b0ng b\u1edfi \u0111\u1eb7c \u0111i\u1ec3m nh\u01b0 ph\u00e1t ban, s\u1ed1t. C\u00e1c t\u1ed5 ch\u1ee9c kh\u00e1c ho\u1eb7c h\u1ec7 th\u1ea3ng kh\u00e1c c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1eddng nh\u01b0 m\u00e1u, h\u1ec7 t\u1ebf b\u00e0o b\u1ea1ch huy\u1ebft, gan, c\u01a1 v\u00e0 kh\u1edbp, h\u1ec7 th\u1ea7n k\u1ec9nh, th\u1eadn, ph\u1ed5i, ph\u00f9 m\u1ea1ch.<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft<\/td>\n<td>Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a v\u00e0 dinh du\u1ee1ng<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Gi\u1ea3m natri huy\u1ebft<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Gi\u1ea3m natri huy\u1ebft li\u00ean quan \u0111\u1ebfn d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng nh\u01b0 tai bi\u1ebfn m\u1ea1ch m\u00e1u, r\u1ed1i lo\u1ea1n, m\u1ee9c \u0111\u1ed9 t\u1ec9nh t\u00e1o b\u1ecb gi\u1ea3m s\u00fat, b\u1ec7nh n\u00e3o, roi lo\u1ea1n t\u1ea7m nh\u00ecn, bu\u1ed3n n\u00f4n, n\u00f4n<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft<\/td>\n<td>Gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng c\u1ee7a tuy\u1ebfn gi\u00e1p<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n v\u1ec1 t\u00e2m th\u1ea7n<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Tr\u1ea1ng th\u00e1i r\u1ed1i lo\u1ea1n, tr\u1ea7m c\u1ea3m, l\u00e3nh c\u1ea3m, b\u1ed1i r\u1ed1i (nh\u01b0 c\u0103ng th\u1eb3ng)<\/td>\n<\/tr>\n<tr>\n<td><strong>H\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Bu\u1ed3n ng\u1ee7, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t<\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>M\u1ea5t \u0111i\u1ec1u h\u00f2a v\u1eadn \u0111\u1ed9ng, r\u00f9ng m\u00ecnh, ch\u1ee9ng gi\u1eadt c\u1ea7u m\u1eaft, r\u1ed1i lo\u1ea1n s\u1ef1 t\u1eadp trung, hay qu\u00ean<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n v\u1ec1 m\u1eaft<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ch\u1ee9ng nh\u00ecn \u0111\u00f4i<\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Nh\u00ecn m\u1edd, r\u1ed1i lo\u1ea1n t\u1ea7m nh\u00ecn<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n tai v\u00e0 tai trong<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ch\u1ecfng m\u1eb7t<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n tim m\u1ea1ch<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Ch\u1ee9ng lo\u1ea1n nh\u1ecbp tim, ngh\u1ebdn nh\u0129 th\u1ea5t<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n m\u1ea1ch<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft<\/td>\n<td>T\u0103ng huy\u1ebft \u00e1p<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ch\u00f3ng m\u1eb7t, bu\u1ed3n n\u00f4n<\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ti\u00eau ch\u1ea3y, t\u00e1o b\u00f3n, \u0111au b\u1ee5ng<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Vi\u00eam t\u1ee5y v\u00e0\/ho\u1eb7c lipase v\u00e0 ho\u1eb7c t\u0103ng amylase.<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n gan m\u1eadt<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ph\u00e1t ban, s\u1ef1 r\u1ee5ng t\u00f3c, tr\u1ee9ng c\u00e1<\/td>\n<\/tr>\n<tr>\n<td>Kh\u00f4ng th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>M\u00e0y \u0111ay<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Ph\u00f9 m\u1ea1ch, h\u1ed9i ch\u1ee9ng Stevens-Johnson, ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec (h\u1ed9i ch\u1ee9ng Lyell), ban \u0111\u1ecf nhi\u1ec1u d\u1ea1ng.<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n c\u01a1 x\u01b0\u01a1ng kh\u1edbp, m\u00f4 li\u00ean k\u1ebft v\u00e0 x\u01b0\u01a1ng<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm<\/td>\n<td>Ban \u0111\u1ecf lupus h\u1ec7 th\u1ed1ng<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n chung v\u00e0 t\u00ecnh tr\u1ea1ng t\u1ea1i v\u1ecb tr\u00ed d\u00f9ng thu\u1ed1c<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>M\u1ec7t m\u1ecfi<\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng xuy\u00ean<\/td>\n<td>Ch\u1ee9ng ban \u0111\u1ecf.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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>C\u1ea3m \u1ee9ng enzim:<\/em><\/p>\n<p>Oxcarbazepine v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh d\u01b0\u1ee3c h\u1ecdc (d\u1eabn ch\u1ea5t monhohydroxy, MHD) l\u00e0 ch\u1ea5t c\u1ea3m \u1ee9ng y\u1ebfu tr\u00ean in vitro v\u00e0 in vivo c\u1ee7a c\u00e1c enzyme CYP3A4 v\u00e0 CYP3A5 c\u1ee7a cytochrom P450 ch\u1ecbu tr\u00e1ch nhi\u1ec7m chuy\u1ec3n h\u00f3a m\u1ed9t s\u1ed1 l\u1edbn c\u00e1c thu\u1ed1c nh\u01b0 c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch (nh\u01b0 ciclosporin, tacrolimus), ch\u1ed1ng th\u1ee5 thai \u0111\u01b0\u1eddng u\u1ed1ng (xem d\u01b0\u1edbi \u0111\u00e2y), v\u00e0 m\u1ed9t s\u1ed1 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c (nh\u01b0 carbazepine) k\u1ebft qu\u1ea3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 huy\u1ebft thanh c\u1ee7a c\u00e1c thu\u1ed1c n\u00e0y (xem b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u1ed5ng h\u1ee3p c\u00e1c t\u01b0\u01a1ng t\u00e1c x\u00e2y ra gi\u1eefa thu\u1ed1c v\u00e0 v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c).<\/p>\n<p>Tr\u00ean In vitro, Oxcarbazepine v\u00e0 MHD l\u00e0 ch\u1ea5t c\u1ea3m \u1ee9ng y\u1ebfu c\u1ee7a UDP-glucuronyl transferase (t\u00e1c d\u1ee5ng tr\u00ean c\u00e1c enzyme \u0111\u1eb7c tr\u01b0ng trong nh\u00f3m n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft). Do v\u1eady, tr\u00ean in vivo Oxcarbazepine v\u00e0 MHD c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng th\u00fac \u0111\u1ea9y nh\u1ecf \u0111\u1ed1i v\u1edbi chuy\u1ec3n h\u00f3a c\u1ee7a nh\u1eefng thu\u1ed1c chuy\u1ec3n ho\u00e1t ch\u1ee7 y\u1ebfu b\u1edfi s\u1ef1 li\u00ean k\u1ebft qua UDP-glucuronyl transferase. Khi kh\u1edfi \u0111\u1ea7u v\u1edbi Kusapin ho\u1eb7c thay \u0111\u1ed5i li\u1ec1u, c\u00f3 th\u1ec3 m\u1eaft 2-3 tu\u1ea7n \u0111\u1ec1 \u0111\u1ea1t \u0111\u01b0\u1ee3c n\u1ed3ng \u0111\u1ed9 c\u1ea3m \u1ee9ng m\u1edbi.<\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0ng \u0111i\u1ec1u tr\u1ecb v\u1edbi Kusapin, gi\u1ea3m li\u1ec1u d\u00f9ng k\u1ebft h\u1ee3p c\u00f3 th\u1ec3 l\u00e0 c\u1ea7n thi\u1ebft v\u00e0 n\u00ean \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh ph\u1ee5 thu\u1ed1c v\u00e0o l\u00e2m s\u00e0ng v\u00e0\/ho\u1eb7c s\u1ef1 ki\u1ec3m so\u00e1t n\u1ed3ng \u0111\u1ed9 huy\u1ebft thanh. S\u1ef1 gi\u1ea3m li\u1ec1u c\u00f3 l\u1ebd ph\u1ea3i l\u00e0m t\u1eeb t\u1eeb trong v\u00f2ng 2-3 tu\u1ea7n sau khi ng\u01b0ng thu\u1ed1c.<\/p>\n<p><em>Ch\u1ed1ng th\u1ee5 thai ki\u1ec3u hormone.<\/em><\/p>\n<p>Kusapin \u0111\u01b0\u1ee3c cho th\u1ea5y c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn 2 th\u00e0nh ph\u1ea7n Ethinylestradiol (EE) v\u00e0 levonorgestrel (LNG), c\u1ee7a thu\u1ed1c ch\u1ed1ng th\u1ee5 thai \u0111\u01b0\u1eddng u\u1ed1ng. Gi\u00e1 tr\u1ecb AUC trung b\u00ecnh c\u1ee7a EE v\u00e0 LNG gi\u1ea3m kho\u1ea3ng 48- 52% v\u00e0 32-52% t\u01b0\u01a1ng \u1ee9ng. B\u1edfi v\u1eady, s\u1eed d\u1ee5ng \u0111\u1ed1ng th\u1eddi Kusapin v\u1edbi thu\u1ed1c ch\u1ed1ng th\u1ee5 thai ki\u1ec3u hormone c\u00f3 th\u1ec3 l\u00e0m b\u1ea5t ho\u1ea1t c\u00e1c thu\u1ed1c ch\u1ed1ng th\u1ee5 thai n\u00e0y. Ph\u1ea3i s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ed1ng th\u1ee5 thai \u0111\u00e1ng tin c\u1eady kh\u00e1c.<\/p>\n<p><em>\u1ee9c ch\u1ebf enzyme.<\/em><\/p>\n<p>Oxcarbazepine v\u00e0 MHD \u1ee9c ch\u1ebf CYP2C19. B\u1edfi v\u1eady, s\u1ef1 t\u01b0\u01a1ng t\u00e1c c\u00f3 th\u1ec3 t\u0103ng khi s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p li\u1ec1u cao Kusapin v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c m\u00e0 ch\u1ee7 y\u1ebfu chuy\u1ec3n h\u00f3a b\u1edfi CYP2C19 (nh\u01b0 phenytoin). N\u1ed3ng \u0111\u1ed9 Phenytotin t\u0103ng l\u00ean t\u1edbi 40% khi Kusapin \u0111\u01b0\u1ee3c \u0111\u01b0a \u1edf li\u1ec1u &gt; 1200 mg\/ng\u00e0y (xem b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u1ed5ng h\u1ee3p c\u00e1c t\u01b0\u01a1ng t\u00e1c x\u1ea3y ra gi\u1eefa thu\u1ed1c v\u00e0 v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c).<\/p>\n<p>Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, ph\u1ea3i \u0111\u00f2i h\u1ecfi gi\u1ea3m li\u1ec1u k\u1ebft h\u1ee3p c\u1ee7a phenytoin.<\/p>\n<p><em>C\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh.<\/em><\/p>\n<p>Nguy c\u01a1 x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c gi\u1eefa Kusapin v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 tr\u00ean l\u00e2m s\u00e0ng. \u1ea2nh h\u01b0\u1edfng c\u1ee7a nh\u1eefng t\u01b0\u01a1ng t\u00e1c n\u00e0y \u0111\u1ed1i v\u1edbi AUC v\u00e0 Cmin \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p \u1edf b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y.<\/p>\n<p>T\u1ed5ng h\u1ee3p s\u1ef1 t\u01b0\u01a1ng t\u00e1c gi\u1eefa Kusapin v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh kh\u00e1c.<\/p>\n<table>\n<tbody>\n<tr>\n<td>Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh<\/td>\n<td>\u1ea2nh h\u01b0\u1eddng c\u1ee7a Kusapin l\u00ean c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh<\/td>\n<td>\u1ea2nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh l\u00ean MHD<\/td>\n<\/tr>\n<tr>\n<td>S\u1eed d\u1ee5ng k\u1ebft h\u1ecdp<\/td>\n<td>N\u1ed3ng \u0111\u1ed9<\/td>\n<td>N\u1ed3ng \u0111\u1ed9<\/td>\n<\/tr>\n<tr>\n<td>Carbamazepine<\/td>\n<td>Gi\u1ea3m 0-22 %<\/td>\n<td>Gi\u1ea3m 40%<\/td>\n<\/tr>\n<tr>\n<td>Clobazam<\/td>\n<td>Ch\u01b0a nghi\u00ean c\u1ee9u<\/td>\n<td>Kh\u00f4ng \u1ea3nh h\u01b0\u1edfng<\/td>\n<\/tr>\n<tr>\n<td>Felbamate<\/td>\n<td>Ch\u01b0a nghi\u00ean c\u1ee9u<\/td>\n<td>Kh\u00f4ng \u1ea3nh h\u01b0\u1edfng<\/td>\n<\/tr>\n<tr>\n<td>Lamotrigine<\/td>\n<td>Gi\u1ea3m nh\u1eb9 *<\/td>\n<td>Kh\u00f4ng \u1ea3nh h\u01b0\u1edfng<\/td>\n<\/tr>\n<tr>\n<td>Phenobarbitone<\/td>\n<td>T\u0103ng 14-15%<\/td>\n<td>Gi\u1ea3m 30-31%<\/td>\n<\/tr>\n<tr>\n<td>Phenytoin<\/td>\n<td>T\u0103ng 0-40%<\/td>\n<td>Gi\u1ea3m 29-35%<\/td>\n<\/tr>\n<tr>\n<td>Acid Valproic<\/td>\n<td>Kh\u00f4ng \u1ea3nh h\u01b0\u1edfng<\/td>\n<td>Gi\u1ea3m 0-18%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>K\u1ebft qu\u1ea3 ban \u0111\u1ea7u ch\u1ec9 ra r\u1eb1ng Oxcarbazepine c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 Lamotrigine, c\u00f3 th\u1ec3 c\u00f3 \u00fd ngh\u0129a \u1edf tr\u1ebb em, nh\u01b0ng nguy c\u01a1 x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c c\u1ee7a Oxcarbazepine xu\u1ea5t hi\u1ec7n \u1edf th\u1ea5p h\u01a1n so v\u1edbi quan s\u00e1t khi d\u00f9ng c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c c\u1ea3m \u1ee9ng enzyme (carbazepine, phenobarbitone, v\u00e0 phenytoin).<\/p>\n<p>Ch\u1ea5t c\u1ea3m \u1ee9ng m\u1ea1nh enzyme cytochrome P450 (nh\u01b0 carbazepine, phenytoin v\u00e0 phenobarbitone) \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea5y l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 huy\u1ebft thanh c\u1ee7a MHD (29-40%) \u1edf ng\u01b0\u1eddi l\u1edbn; tr\u1ebb em 4-12 tu\u1ed5i, \u0111\u1ed9 thanh th\u1ea3i MHD t\u0103ng kho\u1ea3ng 35% khi \u0111\u01b0a 1 trong 3 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh c\u1ea3m \u1ee9ng enzyme so v\u1edbi \u0111\u01a1n tr\u1ecb li\u1ec7u. S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi Kusapin v\u00e0 Lamotrigine l\u00e0m c\u1ed9ng h\u1ee3p nguy c\u01a1 t\u0103ng t\u00e1c d\u1ee5ng ph\u1ee5 (n\u00f4n, bu\u1ed3n ng\u1ee7, ch\u00f3ng m\u1eb7t v\u00e0 \u0111au \u0111\u1ea7u). Khi 1 ho\u1eb7c m\u1ed9t v\u00e0i thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi c\u00f9ng v\u1edbi Kusapin, \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u c\u1ea9n th\u1eadn v\u00e0\/ho\u1eb7c ki\u1ec3m so\u00e1t n\u1ed3ng \u0111\u1ed9 huy\u1ebft thanh c\u00f3 th\u1ebf ph\u1ea3i xem x\u00e9t trong m\u1ed7i tr\u01b0\u1eddng h\u1ee3p, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n nhi \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi Lamotrigine.<\/p>\n<p>Kh\u00f4ng quan s\u00e1t th\u1ea5y s\u1ef1 t\u1ef1 c\u1ea3m \u1ee9ng x\u1ea3y ra v\u1edbi Kusapin.<\/p>\n<p><em>T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c<\/em><\/p>\n<p>Cimitidine, erythromycin, viloxazine, wayfaring v\u00e0 \u0111extropropoxyphene kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a MHD.<\/p>\n<p>T\u01b0\u01a1ng t\u00e1c gi\u1eefa Oxearbazepine v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf MAO l\u00e0 v\u1ec1 m\u1eb7t l\u00ed thuy\u1ebft d\u1ef1a tr\u00ean m\u1ed1i li\u00ean quan v\u1ec1 c\u1ea5u tr\u00fac c\u1ee7a Oxcarbazepine v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m 3 v\u00f2ng.<\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m 3 v\u00f2ng \u0111\u00e3 \u0111\u01b0\u1ee3c xem x\u00e9t trong c\u00e1c ca l\u00e2m s\u00e0ng v\u00e0 kh\u00f4ng th\u1ea5y c\u00f3 t\u01b0\u01a1ng t\u00e1c li\u00ean quan v\u1ec1 l\u00e2m s\u00e0ng n\u00e0o \u0111\u01b0\u1ee3c quan s\u00e1t.<\/p>\n<p>S\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a Lithium v\u00e0 oxcarbazepine c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y \u0111\u1ed9c t\u00ednh \u0111\u1ed1i v\u1edbi th\u1ea7n kinh.<\/p>\n<p><strong>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p>Tr\u01b0\u1eddng h\u1ee3p c\u00e1 bi\u1ec7t c\u1ee7a qu\u00e1 li\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. Li\u1ec1u t\u1ed1i \u0111a \u0111\u01b0\u1ee3c \u0111\u01b0a kho\u1ea3ng 24.000mg. T\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u1ec1u h\u1ed3i ph\u1ee5c v\u1edbi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng. Tri\u1ec7u ch\u1ee9ng qu\u00e1 li\u1ec1u bao g\u1ed3m bu\u1ed3n ng\u1ee7, ch\u00f3ng m\u1eb7t, n\u00f4n, bu\u1ed3n n\u00f4n, ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, gi\u1ea3m natri huy\u1ebft, ch\u1ee9ng m\u1ea5t \u0111i\u1ec1u h\u00f2a, ch\u1ee9ng gi\u1eadt c\u1ea7u m\u1eaft. Kh\u00f4ng c\u00f3 thu\u1ed1c gi\u1ea3i \u0111\u1ed9c \u0111\u1eb7c hi\u1ec7u. \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi th\u00edch h\u1ee3p. Lo\u1ea1i b\u1ecf thu\u1ed1c kh\u1ecfi d\u1ea1 d\u1ea7y b\u1eb1ng c\u00e1ch r\u1eeda d\u1ea1 d\u00e0y v\u00e0\/ho\u1eb7c b\u1ea5t ho\u1ea1t b\u1eb1ng thai ho\u1ea1t t\u00ednh n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc.<\/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>Trong nh\u1eefng nghi\u00ean c\u1ee9u d\u01b0\u1ee3c l\u00fd tr\u00ean s\u00fac v\u1eadt, oxcarbazepine v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a d\u1eabn xu\u1ea5t monohydroxy (MHD) bi\u1ec3u hi\u1ec7n t\u00e1c d\u1ee5ng ch\u1ed1ng co gi\u1eadt m\u1ea1nh v\u00e0 h\u1eefu hi\u1ec7u, cho th\u1ea5y r\u0103ng thu\u1ed1c tr\u1ecb li\u1ec7u h\u1eefu hi\u1ec7u ch\u1ee7 y\u1ebfu tr\u00ean \u0111\u1ed9ng kinh d\u1ea1ng co c\u1ee9ng c\u01a1n l\u1edbn ho\u1eb7c c\u01a1n nh\u1ecf.<\/p>\n<p>M\u1eb7c d\u00f9 c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c c\u1ee7a t\u00e1c \u0111\u1ed9ng c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u bi\u1ebft m\u1ed9t c\u00e1ch ch\u1ec9 ti\u1ebft, ng\u01b0\u1eddi ta cho r\u0103ng c\u00e1c thu\u1ed1c trong nh\u00f3m n\u00e0y t\u00e1c \u0111\u1ed9ng b\u1eb1ng c\u00e1ch thay \u0111\u1ed5i ho\u1ea1t t\u00ednh c\u1ee7a ch\u1ea5t trung gian c\u01a1 b\u1ea3n c\u1ee7a k\u00edch th\u00edch th\u1ea7n kinh, c\u1ee5 th\u1ec3 l\u00e0 k\u00eanh ion c\u1ee7a \u0111i\u1ec7n th\u1ebf v\u00e0 c\u1ee7a d\u1eabn truy\u1ec1n th\u1ea7n kinh trong n\u00e3o. Theo nh\u1eefng kh\u00e1m ph\u00e1 g\u1ea7n \u0111\u00e2y, oxcarbazepine v\u00e0 MHD c\u00f3 th\u1ec3 c\u00f3 t\u00e1c \u0111\u1ed9ng ch\u1ed1ng co gi\u1eadt b\u1eb1ng c\u00e1ch phong b\u1ebf k\u00eanh natri ph\u1ee5 thu\u1ed9c \u0111i\u1ec7n th\u1ebf trong n\u00e3o.<\/p>\n<p>\u1ede n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb, c\u1ea3 hai h\u1ee3p ch\u1ea5t l\u00e0m gi\u1edbi h\u1ea1n \u0111\u00f2ng ch\u1ea3y l\u1eb7p \u0111i l\u1eb7p l\u1ea1i v\u1edbi t\u1ea7n su\u1ea5t cao k\u00e9o d\u00e0i c\u1ee7a ho\u1ea1t \u0111\u1ed9ng ph\u1ee5 thu\u1ed9c natri tr\u00ean t\u1ebf b\u00e0o th\u1ea7n kinh chu\u1ed9t trong m\u1eabu c\u1ea5y t\u1ebf b\u00e0o, t\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o \u1ee9c ch\u1ebf s\u1ef1 lan truy\u1ec1n ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed9ng kinh t\u1eeb \u1ed5 g\u00e2y \u0111\u1ed9ng kinh. Th\u00eam v\u00e0o \u0111\u00f3, b\u1eb1ng ch\u1ee9ng t\u1eeb m\u1ed9t nghi\u00ean c\u1ee9u in vitro \u1edf nh\u1eefng l\u00e1t c\u1eaft c\u1ee7a h\u1ed3i h\u1ea3i m\u00e3 chu\u1ed9t cho th\u1ea5y r\u1eb1ng ho\u1ea1t \u0111\u1ed9ng ch\u1ed1ng \u0111\u1ed9ng kinh c\u1ee7a \u0111\u1ed3ng ph\u00e2n racemic MHD, v\u00e0 c\u1ea3 hai c\u1ea5u h\u00ecnh c\u1ee7a n\u00f3 c\u0169ng \u0111\u01b0\u1ee3c c\u00e2n b\u1eb1ng b\u1edfi k\u00eanh kali.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Trong nh\u1eefng nghi\u00ean c\u1ee9u d\u01b0\u1ee3c l\u00fd tr\u00ean s\u00fac v\u1eadt, oxcarbazepine v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a d\u1eabn xu\u1ea5t monohydroxy (MHD) bi\u1ec3u hi\u1ec7n t\u00e1c d\u1ee5ng ch\u1ed1ng co gi\u1eadt m\u1ea1nh v\u00e0 h\u1eefu hi\u1ec7u, cho th\u1ea5y r\u1eb1ng thu\u1ed1c tr\u1ecb li\u1ec7u h\u1eefu hi\u1ec7u ch\u1ee7 y\u1ebfu tr\u00ean \u0111\u1ed9ng kinh d\u1ea1ng co c\u1ee9ng c\u01a1n l\u1edbn ho\u1eb7c c\u01a1n nh\u1ecf. M\u1eb7c d\u00f9 c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c c\u1ee7a t\u00e1c \u0111\u1ed9ng c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u bi\u1ebft m\u1ed9t c\u00e1ch chi ti\u1ebft, ng\u01b0\u1eddi ta cho r\u1eb1ng c\u00e1c thu\u1ed1c trong nh\u00f3m n\u00e0y t\u00e1c \u0111\u1ed9ng b\u1eb1ng c\u00e1ch thay \u0111\u1ed5i ho\u1ea1t t\u00ednh c\u1ee7a ch\u1ea5t trung gian c\u01a1 b\u1ea3n c\u1ee7a k\u00edch th\u00edch th\u1ea7n kinh, c\u1ee5 th\u1ec3 l\u00e0 k\u00eanh ion c\u1ee7a \u0111i\u1ec7n th\u1ebf v\u00e0 c\u1ee7a d\u1eabn truy\u1ec1n th\u1ea7n kinh trong n\u00e3o. Theo nh\u1eefng kh\u00e1m ph\u00e1 g\u1ea7n \u0111\u00e2y, oxcarbazepine v\u00e0 MHD c\u00f3 th\u1ec3 c\u00f3 t\u00e1c \u0111\u1ed9ng ch\u1ed1ng co gi\u1eadt b\u1eb1ng c\u00e1ch phong b\u1ebf k\u00eanh natri ph\u1ee5 thu\u1ed9c \u0111i\u1ec7n th\u1ebf trong n\u00e3o. \u1ede n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb, c\u1ea3 hai h\u1ee3p ch\u1ea5t l\u00e0m gi\u1edbi h\u1ea1n d\u00f2ng ch\u1ea3y l\u1eb7p \u0111i l\u1eb7p l\u1ea1i v\u1edbi t\u1ea7n su\u1ea5t cao k\u00e9o d\u00e0i c\u1ee7a ho\u1ea1t \u0111\u1ed9ng ph\u1ee5 thu\u1ed9c natri tr\u00ean t\u1ebf b\u00e0o th\u1ea7n kinh chu\u1ed9t trong m\u1eabu c\u1ea5y t\u1ebf b\u00e0o, t\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o \u1ee9c ch\u1ebf s\u1ef1 lan truy\u1ec1n ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed9ng kinh t\u1eeb \u1ed5 g\u00e2y \u0111\u1ed9ng kinh. Th\u00eam v\u00e0o \u0111\u00f3, b\u1eb1ng ch\u1ee9ng t\u1eeb m\u1ed9t nghi\u00ean c\u1ee9u in vitro \u1edf nh\u1eefng l\u00e1t c\u1eaft c\u1ee7a h\u1ed3i h\u1ea3i m\u00e3 chu\u1ed9t cho th\u1ea5y r\u1eb1ng ho\u1ea1t \u0111\u1ed9ng ch\u1ed1ng \u0111\u1ed9ng kinh c\u1ee7a \u0111\u1ed3ng ph\u00e2n racemic MHD, v\u00e0 c\u1ea3 hai c\u1ea5u h\u00ecnh c\u1ee7a n\u00f3 c\u0169ng \u0111\u01b0\u1ee3c c\u00e2n b\u1eb1ng b\u1edfi k\u00eanh kali.<\/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><em>H\u1ea5p thu<\/em><\/p>\n<p>Oxcarbazepine \u0111\u01b0\u1ee3c h\u1ea5p thu nhanh ch\u00f3ng v\u00e0 ho\u00e0n to\u00e0n qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Thu\u1ed1c \u0111\u01b0\u1ee3c kh\u1eed nhanh ch\u00f3ng v\u00e0 h\u1ea7u nh\u01b0 ho\u00e0n to\u00e0n th\u00e0nh ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh d\u01b0\u1ee3c l\u00fd 10, 11-dihydro-10 hydroxy-carbamazepine (d\u1eabn xu\u1ea5t monohydroxy, MHD), ch\u1ea5t n\u00e0y \u0111\u1ea1t \u0111\u1ebfn c\u00e1c n\u1ed3ng \u0111\u1ed9 cao h\u01a1n v\u00e0i l\u1ea7n trong huy\u1ebft t\u01b0\u01a1ng so v\u1edbi thu\u1ed1c d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i. Kh\u1ea3 d\u1ee5ng to\u00e0n th\u00e2n c\u1ee7a MHD t\u0103ng nh\u1eb9 nh\u01b0ng ch\u1ec9 c\u00f3 \u00fd ngh\u0129a khi oxcarbazepine \u0111\u01b0\u1ee3c d\u00f9ng chung v\u1edbi th\u1ee9c \u0103n.<\/p>\n<p><em>Ph\u00e2n b\u1ed1<\/em><\/p>\n<p>Ch\u1ec9 m\u1ed9t ph\u1ea7n r\u1ea5t nh\u1ecf (40%) ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh MHD g\u1eafn v\u1edbi protein huy\u1ebft thanh, ch\u1ee7 y\u1ebfu v\u1edbi albumin. Th\u1ec3 t\u00edch ph\u00e2n ph\u1ed1i l\u00e0 0,7-0,8 1\u2044kg (MHD).<\/p>\n<p>Do b\u1ecb kh\u1eed nhanh ch\u00f3ng, n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft thanh c\u1ee7a oxcarbazepine c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1ecf qua v\u00e0 ch\u1ee7 y\u1ebfu x\u00e9t \u0111\u1ebfn ch\u1ea5t chuy\u1ec3n h\u00f3a MHD. D\u00f9ng c\u00e1c li\u1ec1u duy nh\u1ea5t 150 \u0111\u1ebfn 600 mg oxcarbazepine, di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong n\u1ed3ng \u0111\u1ed9 trung b\u00ecnh trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a MHD c\u00f3 t\u01b0\u01a1ng quan tuy\u1ebfn t\u00ednh v\u1edbi li\u1ec1u l\u01b0\u1ee3ng: n\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trung b\u00ecnh trong huy\u1ebft t\u01b0\u01a1ng sau c\u00e1c li\u1ec1u 300 v\u00e0 600 mg \u1edf d\u1ea1ng vi\u00ean n\u00e9n t\u01b0\u01a1ng \u1ee9ng l\u00e0 13,9 v\u00e0 23,6 mmol\/l. N\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t \u0111\u01b0\u1ee3c trong v\u00f2ng 4 gi\u1edd<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>Oxcarbazepine \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a r\u1ed9ng r\u00e3i \u1edf ng\u01b0\u1eddi, d\u01b0\u1edbi 1% li\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c \u0111\u1ea3o th\u1ea3i trong n\u01b0\u1edbc ti\u1ec3u d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i. Thu\u1ed1c b\u1ecb kh\u1eed nhanh ch\u00f3ng th\u00e0nh MHD c\u00f3 ho\u1ea1t t\u00ednh d\u01b0\u1ee3c l\u00fd nh\u01b0 l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a ch\u1ee7 y\u1ebfu. C\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a ph\u1ee5 l\u00e0 c\u00e1c ch\u1ea5t li\u00ean h\u1ee3p glucuronic v\u00e0 sulfate tr\u1ef1c ti\u1ebfp c\u1ee7a oxcarbazepine v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a 10, 11-dihydro-10, 11-dihydroxy<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>Th\u1eddi gian b\u00e1n h\u1ee7y \u0111\u00e0o th\u1ea3i c\u1ee7a MHD trong huy\u1ebft t\u01b0\u01a1ng ng\u01b0\u1eddi trung b\u00ecnh l\u00e0 9 gi\u1edd, sau khi d\u00f9ng c\u00e1c li\u1ec1u duy nh\u1ea5t oxcarbazepine ; thanh th\u1ea3i to\u00e0n ph\u1ea7n trong huy\u1ebft t\u01b0\u01a1ng l\u00e0 3,6 l\/gi\u1edd. Khi u\u1ed1ng nhi\u1ec1u li\u1ec1u li\u00ean ti\u1ebfp oxcarbazepine, d\u01b0\u1ee3c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c d\u1ea1ng nguy\u00ean v\u1eb9n v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a n\u00f3 kh\u00f4ng thay \u0111\u1ed5i, cho th\u1ea5y kh\u00f4ng c\u00f3 t\u00edch t\u1ee5 thu\u1ed1c. Oxcarbazepine \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i ho\u00e0n to\u1ea3n ; h\u01a1n 95% li\u1ec1u d\u00f9ng, ch\u1ee7 y\u1ebfu d\u01b0\u1edbi d\u1ea1ng c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a, xu\u1ea5t hi\u1ec7n trong n\u01b0\u1edbc ti\u1ec3u trong v\u00f2ng 10 ng\u00e0y. C\u00e1c d\u1ea1ng t\u1ef1 do v\u00e0 li\u00ean h\u1ee3p c\u1ee7a MHD chi\u1ebfm 60% l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i qua th\u1eadn v\u00e0 ph\u1ea7n ch\u1ea5t chuy\u1ec3n h\u00f3a li\u00ean h\u1ee3p ph\u1ee5 chi\u1ebfm kho\u1ea3ng 5-15% cho m\u1ed7i 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><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>B\u1ea3o qu\u1ea3n n\u01a1i kh\u00f4 r\u00e1o, 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>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>Thu\u1ed1c Kusapin l\u00e0 thu\u1ed1c g\u00ec ? D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c Kusapin (Th\u00f4ng tin bao g\u1ed3m li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, th\u1eadn tr\u1ecdng, d\u01b0\u1ee3c l\u00fd&#8230;) 1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Oxcarbazepine Ph\u00e2n lo\u1ea1i: Thu\u1ed1c ch\u1ed1ng co gi\u1eadt, ch\u1ed1ng [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":27949,"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":[1079],"class_list":["post-27948","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-oxcarbazepine"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/27948","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=27948"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/27948\/revisions"}],"predecessor-version":[{"id":46794,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/27948\/revisions\/46794"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/27949"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=27948"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=27948"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=27948"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}