{"id":3994,"date":"2019-02-12T15:49:18","date_gmt":"2019-02-12T08:49:18","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=3994"},"modified":"2025-01-08T22:27:44","modified_gmt":"2025-01-08T15:27:44","slug":"oxaliplatin","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/oxaliplatin\/","title":{"rendered":"Oxaliplatin"},"content":{"rendered":"

Thu\u1ed1c Oxaliplatin 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 Oxaliplatin (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…)<\/em><\/p>\n

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

Ho\u1ea1t ch\u1ea5t :<\/em> <\/strong>Oxaliplatin<\/strong><\/a><\/p>\n

Ph\u00e2n lo\u1ea1i: <\/em><\/strong>Thu\u1ed1c ch\u1ed1ng ung th\u01b0, d\u1eabn ch\u1ea5t platin.<\/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): L01XA03.<\/p>\n

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

Generic <\/em><\/strong>: Sindoxplatin\u00a0 ,Openit ,Oxaliplatino Actavis, Oxaliplatin Invagen<\/a> , Oxaltie, CKDBelloxa injection<\/a> , A.T Oxaliplatin , Lyoxatin , Lyoxatin F50<\/a>, Oxaliplatin “Ebewe”<\/a>, Oxaliplatin Injection USP, Oxaplat<\/a>, Oxaliplatin , Oxitan ,Oxaliplatin Kabi<\/a> , Oxuba, O-Plat , Oxtapin, Planitox<\/a>, Atitein Inj<\/a>., Kolbino Injection<\/a>, Liplatin<\/a> , Oxarich<\/a>, Wilfen<\/a> , Zildox, Norameg<\/a>, Oxaliplatin Medac<\/a>, Oxaliplatin, Crisapla<\/a>, Carutuse Inj. , Oxaliplatin, Oxaliplatin Onkovis , Sunoxiplat , Yuhanoxaliplatin Injection\u00a0 ,DBL Oxaliplatin, Oxaliplatin Hospira<\/a><\/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

L\u1ecd thu\u1ed1c b\u1ed9t pha ti\u00eam ch\u1ee9a 50 mg, 100 mg.<\/p>\n

L\u1ecd dung d\u1ecbch ti\u00eam n\u1ed3ng \u0111\u1ed9 5 mg\/ml (10 ml, 20 ml, 40 ml).<\/p>\n

Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n\n\n\n\n\n\n
\n

OXALTIE 50MG<\/em><\/strong><\/p>\n<\/td>\n

\u00a0<\/td>\n<\/tr>\n
\n

M\u1ed7i ml dung d\u1ecbch \u0111\u1eadm \u0111\u1eb7c c\u00f3 ch\u1ee9a:<\/em><\/p>\n<\/td>\n

\u00a0<\/td>\n<\/tr>\n
\n

Oxaliplatin<\/p>\n<\/td>\n

\n

………………………….<\/p>\n<\/td>\n

\n

5 mg<\/p>\n<\/td>\n<\/tr>\n

\n

T\u00e1 d\u01b0\u1ee3c<\/p>\n<\/td>\n

\n

………………………….<\/p>\n<\/td>\n

\n

v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/p>\n<\/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

\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n

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\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n

\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

\u0110i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i tr\u00e0ng giai \u0111o\u1ea1n III:<\/em><\/p>\n

Oxaliplatin k\u1ebft h\u1ee3p v\u1edbi fluorouracil v\u00e0 leucovorin \u0111\u01b0\u1ee3c d\u00f9ng trong ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i tr\u00e0ng giai \u0111o\u1ea1n III tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u00e3 ph\u1eabu thu\u1eadt tri\u1ec7t c\u0103n. Ch\u1ec9 \u0111\u1ecbnh n\u00e0y d\u1ef1a tr\u00ean l\u1ee3i \u00edch v\u1ec1 kh\u1ea3 n\u0103ng s\u1ed1ng th\u00eam quan s\u00e1t \u0111\u01b0\u1ee3c khi so s\u00e1nh gi\u1eefa ph\u00e1c \u0111\u1ed3 k\u1ebft h\u1ee3p oxaliplatin, fluorouracil v\u00e0 leucovortin v\u1edbi ph\u00e1c \u0111\u1ed3 ch\u1ec9 ph\u1ed1i h\u1ee3p fluorouracil v\u00e0 leucovorin.<\/p>\n

\u0110i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng mu\u1ed9n :<\/em><\/p>\n

Li\u1ec7u ph\u00e1p h\u00e0ng \u0111\u1ea7u:<\/em><\/p>\n

Oxaliplatin \u0111\u01b0\u1ee3c d\u00f9ng ph\u1ed1i h\u1ee3p v\u1edbi fluorouracil v\u00e0 leucovorin \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng mu\u1ed9n, tr\u01b0\u1edbc \u0111\u00f3 ch\u01b0a \u0111i\u1ec1u tr\u1ecb, ch\u01b0a ph\u1eabu thu\u1eadt.<\/p>\n

Li\u1ec7u ph\u00e1p h\u00e0ng th\u1ee9 hai:<\/em><\/p>\n

Ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng mu\u1ed9n t\u00e1i ph\u00e1t ho\u1eb7c ti\u1ebfn tri\u1ec3n trong v\u00f2ng 6 th\u00e1ng sau li\u1ec7u ph\u00e1p h\u00e0ng \u0111\u1ea7u v\u1edbi ph\u1ed1i h\u1ee3p fluorouracil, leucovorin v\u00e0 irinotecan. Hi\u1ec7n nay ch\u01b0a c\u00f3 d\u1eef li\u1ec7u cho th\u1ea5y l\u1ee3i \u00edch l\u00e2m s\u00e0ng.<\/p>\n

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

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

Oxaliplatin \u0111\u01b0\u1ee3c d\u00f9ng theo \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch trong th\u1eddi gian 2 gi\u1edd. Ho\u00e0n nguy\u00ean v\u00e0 pha lo\u00e3ng d\u1ea1ng thu\u1ed1c b\u1ed9t pha ti\u00eam v\u00e0 pha lo\u00e3ng ch\u1ebf ph\u1ea9m d\u1ea1ng dung d\u1ecbch ngay tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng.<\/p>\n

Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng dung d\u1ecbch natri clorid ho\u1eb7c c\u00e1c lo\u1ea1i dung d\u1ecbch c\u00f3 ch\u1ee9a clorid \u0111\u1ec3 h\u00f2a tan v\u00e0 pha lo\u00e3ng. Kh\u00f4ng d\u00f9ng kim ti\u00eam v\u00e0 b\u1ed9 d\u1ee5ng c\u1ee5 ti\u00eam truy\u1ec1n b\u1eb1ng nh\u00f4m v\u00ec nh\u00f4m c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1 h\u1ee7y d\u1eabn ch\u1ea5t platin.<\/p>\n

Cho 10 ml (v\u00e0o l\u1ecd thu\u1ed1c ch\u1ee9a 50 mg oxaliplatin) ho\u1eb7c 20 ml (v\u00e0o l\u1ecd thu\u1ed1c ch\u1ee9a 100 mg oxaliplatin) n\u01b0\u1edbc c\u1ea5t pha ti\u00eam ho\u1eb7c dung d\u1ecbch dextrose \u0111\u1ec3 \u0111\u01b0\u1ee3c dung d\u1ecbch thu\u1ed1c c\u00f3 n\u1ed3ng \u0111\u1ed9 5 mg\/ml. Thu\u1ed1c \u0111\u00e3 ho\u00e0n nguy\u00ean c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh l\u00ean \u0111\u1ebfn 24 gi\u1edd. C\u00f3 th\u1ec3 d\u00f9ng ch\u1ebf ph\u1ea9m d\u1ea1ng dung d\u1ecbch c\u00f3 n\u1ed3ng \u0111\u1ed9 5 mg\/ml.<\/p>\n

Tr\u01b0\u1edbc khi d\u00f9ng, l\u1ea5y li\u1ec1u thu\u1ed1c \u0111\u00e3 t\u00ednh to\u00e1n t\u1eeb dung d\u1ecbch n\u1ed3ng \u0111\u1ed9 5 mg\/ml v\u00e0 pha lo\u00e3ng v\u00e0o 250 – 500 ml dung d\u1ecbch dextrose 5%. Dung d\u1ecbch \u0111\u00e3 pha lo\u00e3ng c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh l\u00ean t\u1edbi 24 gi\u1edd v\u00e0 \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng kho\u1ea3ng 6 gi\u1edd. Dung d\u1ecbch \u0111\u00e3 pha ph\u1ea3i \u0111\u01b0\u1ee3c ki\u1ec3m tra c\u1ea3m quan tr\u01b0\u1edbc khi ti\u00eam, b\u1ecf l\u1ecd thu\u1ed1c n\u1ebfu th\u1ea5y c\u00f3 v\u1ea5n ho\u1eb7c chuy\u1ec3n m\u00e0u.<\/p>\n

Kh\u00f4ng \u0111\u01b0\u1ee3c tr\u1ed9n l\u1eabn ho\u1eb7c \u0111\u01b0a chung c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0o c\u00f9ng d\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch v\u1edbi oxaliplatin. Tr\u01b0\u1edbc khi truy\u1ec1n oxaliplatin ho\u1eb7c c\u00e1c thu\u1ed1c d\u00f9ng \u0111\u1ed3ng th\u1eddi, ph\u1ea3i l\u00e0m s\u1ea1ch d\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch b\u1eb1ng dung d\u1ecbch dextrose 5%.<\/p>\n

Tr\u00e1nh ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi thu\u1ed1c trong qu\u00e1 tr\u00ecnh pha ch\u1ebf. N\u1ebfu dung d\u1ecbch thu\u1ed1c ti\u1ebfp x\u00fac v\u1edbi da, ni\u00eam m\u1ea1c ph\u1ea3i r\u1eeda s\u1ea1ch da b\u1eb1ng x\u00e0 ph\u00f2ng v\u00e0 n\u01b0\u1edbc, r\u1eeda ni\u00eam m\u1ea1c b\u1eb1ng c\u00e1ch x\u1ea3 nhi\u1ec1u n\u01b0\u1edbc.<\/p>\n

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

Li\u1ec1u chung:<\/em><\/p>\n

Do ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p oxaliplatin, fluorouracil v\u00e0 leucovorin g\u00e2y ra t\u1ef7 l\u1ec7 bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n \u1edf c\u1ea5p \u0111\u1ed9 3\/4 cao h\u01a1n so v\u1edbi ph\u00e1c \u0111\u1ed3 ch\u1ec9 g\u1ed3m fluorouracil v\u00e0 leucovorin n\u00ean tr\u01b0\u1edbc m\u1ed7i chu tr\u00ecnh ph\u00e1c \u0111\u1ed3 2 ng\u00e0y c\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng n\u00f4n nh\u00f3m \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc serotoninergic (nh\u01b0, dolasetron, granisetron, ondansetron) ph\u1ed1i h\u1ee3p ho\u1eb7c kh\u00f4ng v\u1edbi dexamethason.<\/p>\n

Ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p oxaliplatin, fluorouracil v\u00e0 leucovorin (FOLFOX 4) \u0111\u01b0\u1ee3c d\u00f9ng trong 2 ng\u00e0y li\u00ean t\u1ee5c. Ph\u00e1c \u0111\u1ed3 2 ng\u00e0y c\u00f3 th\u1ec3 nh\u1eafc l\u1ea1i sau 2 tu\u1ea7n.<\/p>\n

Ng\u00e0y 1,<\/em> oxaliplatin 85 mg\/m2<\/sup> v\u00e0 leucovorin 200 mg\/m2<\/sup> (pha lo\u00e3ng b\u1eb1ng dextrose 5%) \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ed3ng th\u1eddi (trong 2 t\u00fai d\u1ecbch truy\u1ec1n ri\u00eang, s\u1eed d\u1ee5ng b\u1ed9 ch\u1ea1c Y), truy\u1ec1n t\u0129nh m\u1ea1ch trong 2 gi\u1edd. Ti\u1ebfp theo, fluorouracil 400 mg\/m2<\/sup> ti\u00eam tr\u1ef1c ti\u1ebfp v\u00e0o t\u0129nh m\u1ea1ch trong 2 – 4 ph\u00fat v\u00e0 sau \u0111\u00f3 truy\u1ec1n t\u0129nh m\u1ea1ch fluorouracil 600 mg\/m2<\/sup> (pha lo\u00e3ng v\u1edbi 500 ml dextrose 5%) trong 22 gi\u1edd.<\/p>\n

Ng\u00e0y 2<\/em> (kh\u00f4ng d\u00f9ng oxaliplatin), leucovorin 200 mg\/m2<\/sup> truy\u1ec1n t\u0129nh m\u1ea1ch trong 2 gi\u1edd. Ti\u1ebfp theo, fluorouracil 400 mg\/m2<\/sup> ti\u00eam tr\u1ef1c ti\u1ebfp v\u00e0o t\u0129nh m\u1ea1ch trong 2 – 4 ph\u00fat v\u00e0 sau \u0111\u00f3 truy\u1ec1n t\u0129nh m\u1ea1ch fluorouracil 600 mg\/m2<\/sup> (pha lo\u00e3ng v\u1edbi 500 ml dextrose 5%) trong 22 gi\u1edd.<\/p>\n

\u0110\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng giai \u0111o\u1ea1n III sau ph\u1eabu thu\u1eadt tri\u1ec7t c\u0103n, d\u00f9ng 12 chu tr\u00ecnh (6 th\u00e1ng). Tr\u00ean b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng mu\u1ed9n, khuy\u1ebfn c\u00e1o d\u00f9ng ph\u00e1c \u0111\u1ed3 n\u00e0y cho \u0111\u1ebfn khi xu\u1ea5t hi\u1ec7n d\u1ea5u hi\u1ec7u ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh ho\u1eb7c \u0111\u1ed9c t\u00ednh kh\u00f4ng dung n\u1ea1p \u0111\u01b0\u1ee3c c\u1ee7a thu\u1ed1c.<\/p>\n

\u0110\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng mu\u1ed9n ho\u1eb7c \u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng, c\u00f3 th\u1ec3 d\u00f9ng ph\u00e1c \u0111\u1ed3 thay th\u1ebf (v\u00ed d\u1ee5, FOLFOX 6 c\u1ea3i bi\u1ebfn). Ph\u00e1c \u0111\u1ed3 FOLFOX 6 c\u1ea3i bi\u1ebfn c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng trong 2 ng\u00e0y li\u00ean ti\u1ebfp. Oxaliplatin 85 mg\/m2<\/sup> v\u00e0 leucovorin 400 mg\/m2<\/sup> (ho\u1eb7c 350 mg\/m2<\/sup>, pha lo\u00e3ng b\u1eb1ng dextrose 5%) \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ed3ng th\u1eddi (trong 2 t\u00fai d\u1ecbch truy\u1ec1n ri\u00eang, s\u1eed d\u1ee5ng b\u1ed9 ch\u1ea1c Y), truy\u1ec1n t\u0129nh m\u1ea1ch trong 2 gi\u1edd. Ti\u1ebfp theo, fluorouracil 400 mg\/m2<\/sup> ti\u00eam t\u0129nh m\u1ea1ch trong 5 ph\u00fat. Sau \u0111\u00f3 truy\u1ec1n t\u0129nh m\u1ea1ch fluorouracil 1 200 mg\/m2<\/sup>\/ng\u00e0y trong 2 ng\u00e0y (v\u00ed d\u1ee5 d\u00f9ng 2 400 mg\/m2<\/sup> truy\u1ec1n t\u0129nh m\u1ea1ch trong 46 – 48 gi\u1edd). T\u1ed5ng li\u1ec1u fluorouracil 2 800 mg\/m2<\/sup>\/chu tr\u00ecnh.<\/p>\n

Li\u1ec1u c\u1ea3i bi\u1ebfn \u0111\u1ec3 gi\u1ea3m \u0111\u1ed9c t\u00ednh :<\/em><\/p>\n

C\u00f3 th\u1ec3 ph\u1ea3i thay \u0111\u1ed5i li\u1ec1u ho\u1eb7c th\u1eddi gian truy\u1ec1n oxaliplatin \u0111\u1ec3 h\u1ea1n ch\u1ebf m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a thu\u1ed1c (nh\u01b0 \u0111\u1ed9c t\u00ednh tr\u00ean th\u1ea7n kinh c\u1ea3m gi\u00e1c, ti\u00eau h\u00f3a v\u00e0 h\u1ec7 t\u1ea1o m\u00e1u). T\u0103ng th\u1eddi gian truy\u1ec1n oxaliplatin t\u1eeb 2 gi\u1edd l\u00ean 6 gi\u1edd c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u \u0111\u1ed9c t\u00ednh c\u1ea5p; kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh th\u1eddi gian truy\u1ec1n c\u1ee7a fluorouracil ho\u1eb7c leucovorin.<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng giai \u0111o\u1ea1n III:<\/em><\/p>\n

Tr\u00ean b\u1ec7nh nh\u00e2n ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng giai \u0111o\u1ea1n III (\u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 sau ph\u1eabu thu\u1eadt) c\u00f3 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n tr\u00ean th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i bi\u00ean dai d\u1eb3ng c\u1ea5p \u0111\u1ed9 2, gi\u1ea3m li\u1ec1u oxaliplatin xu\u1ed1ng c\u00f2n 75 mg\/m2<\/sup> v\u00e0 xem x\u00e9t vi\u1ec7c ng\u1eebng thu\u1ed1c n\u1ebfu \u0111\u1ed9c t\u00ednh \u1edf c\u1ea5p \u0111\u1ed9 3. Kh\u00f4ng c\u1ea7n thay \u0111\u1ed5i li\u1ec1u fluorouracil ho\u1eb7c leucovorin.<\/p>\n

Tr\u00ean b\u1ec7nh nh\u00e2n ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng giai \u0111o\u1ea1n III (\u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 sau ph\u1eabu thu\u1eadt) c\u00f3 \u0111\u1ed9c t\u00ednh tr\u00ean ti\u00eau h\u00f3a c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4 (xu\u1ea5t hi\u1ec7n ngay c\u1ea3 khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh c\u1ea5p \u0111\u1ed9 4, gi\u1ea3m ti\u1ec3u c\u1ea7u c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4, c\u1ea7n gi\u1ea3m li\u1ec1u oxaliplatin xu\u1ed1ng c\u00f2n 75 mg\/m2<\/sup> v\u00e0 gi\u1ea3m li\u1ec1u fluorouracil 20% (v\u00ed d\u1ee5 300 mg\/m2<\/sup> ti\u00eam t\u0129nh m\u1ea1ch v\u00e0 500 mg\/m2<\/sup> truy\u1ec1n t\u0129nh m\u1ea1ch trong 22 gi\u1edd). D\u00f9ng li\u1ec1u ti\u1ebfp theo ph\u1ea3i ch\u1eadm l\u1ea1i khi s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u trung t\u00ednh > 1 500\/mm3<\/sup> v\u00e0 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u > 75 000\/mm3<\/sup>.<\/p>\n

\u0110i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng mu\u1ed9n:<\/em><\/p>\n

Tr\u00ean b\u1ec7nh nh\u00e2n ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng ti\u1ebfn tri\u1ec3n c\u00f3 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n tr\u00ean th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i bi\u00ean dai d\u1eb3ng c\u1ea5p \u0111\u1ed9 2, c\u1ea7n gi\u1ea3m li\u1ec1u oxaliplatin xu\u1ed1ng c\u00f2n 65 mg\/m2<\/sup> v\u00e0 xem x\u00e9t vi\u1ec7c ng\u1eebng thu\u1ed1c n\u1ebfu \u0111\u1ed9c t\u00ednh \u1edf c\u1ea5p \u0111\u1ed9 3. Kh\u00f4ng c\u1ea7n thay \u0111\u1ed5i li\u1ec1u fluorouracil ho\u1eb7c leucovorin.<\/p>\n

Tr\u00ean b\u1ec7nh nh\u00e2n ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng mu\u1ed9n (\u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 sau ph\u1eabu thu\u1eadt) c\u00f3 \u0111\u1ed9c t\u00ednh tr\u00ean ti\u00eau h\u00f3a c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4 (xu\u1ea5t hi\u1ec7n ngay c\u1ea3 khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh c\u1ea5p \u0111\u1ed9 4, gi\u1ea3m ti\u1ec3u c\u1ea7u c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4, c\u1ea7n gi\u1ea3m li\u1ec1u oxaliplatin xu\u1ed1ng c\u00f2n 65 mg\/m2<\/sup> v\u00e0 gi\u1ea3m li\u1ec1u fluorouracil 20% (v\u00ed d\u1ee5 300 mg\/m2<\/sup> ti\u00eam t\u0129nh m\u1ea1ch trong 2 – 4 ph\u00fat v\u00e0 500 mg\/m2<\/sup> truy\u1ec1n t\u0129nh m\u1ea1ch trong 22 gi\u1edd). D\u00f9ng li\u1ec1u ti\u1ebfp theo ph\u1ea3i ch\u1eadm l\u1ea1i khi s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u trung t\u00ednh > 1 500\/mm3<\/sup> v\u00e0 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u > 75 000\/mm3<\/sup>.<\/p>\n

Ch\u01b0a c\u00f3 \u0111\u00e1nh gi\u00e1 v\u1ec1 t\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u l\u1ef1c c\u1ee7a thu\u1ed1c tr\u00ean b\u1ec7nh nh\u00e2n suy th\u1eadn. Cho \u0111\u1ebfn nay, ch\u01b0a c\u00f3 khuy\u1ebfn c\u00e1o v\u1ec1 hi\u1ec7u ch\u1ec9nh li\u1ec1u tr\u00ean b\u1ec7nh nh\u00e2n suy th\u1eadn. Ng\u01b0\u1eddi suy th\u1eadn c\u00f3 \u0111\u1ed9 thanh th\u1ea3i creatinin < 30 ml\/ph\u00fat, AUC t\u0103ng 190%, kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>\n

Kh\u00f4ng c\u1ea7n hi\u1ec7u ch\u1ec9nh li\u1ec1u \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n suy gan.<\/p>\n

Kh\u00f4ng c\u1ea7n hi\u1ec7u ch\u1ec9nh li\u1ec1u \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n cao tu\u1ed5i (tr\u00ean 65 tu\u1ed5i) d\u00f9ng ph\u1ed1i h\u1ee3p oxaliplatin, fluorouracil v\u00e0 leucovorin trong ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea1i – tr\u1ef1c tr\u00e0ng mu\u1ed9n.<\/p>\n

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

M\u1eabn c\u1ea3m v\u1edbi oxaliplatin, c\u00e1c d\u1eabn ch\u1ea5t platin v\u00e0 b\u1ea5t k\u00ec th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c.<\/p>\n

Ng\u01b0\u1eddi mang thai, th\u1eddi k\u1ef3 cho con b\u00fa.<\/p>\n

Suy th\u1eadn n\u1eb7ng (Cl < 30 ml\/ph\u00fat).<\/p>\n

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

Do \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c ch\u1ed1ng ung th\u01b0 n\u00ean ph\u1ea3i th\u1eadn tr\u1ecdng khi ti\u1ebfp x\u00fac v\u1edbi thu\u1ed1c v\u00e0 ch\u1ea5t th\u1ea3i t\u1eeb thu\u1ed1c (b\u01a1m kim ti\u00eam, l\u1ecd \u0111\u1ef1ng…). S\u1eed d\u1ee5ng g\u0103ng tay, m\u1eb7t n\u1ea1 ho\u1eb7c k\u00ednh b\u1ea3o h\u1ed9 khi ti\u1ebfp x\u00fac v\u1edbi thu\u1ed1c. Oxaliplatin ph\u1ea3i do b\u00e1c s\u0129 chuy\u00ean khoa, c\u00f3 kinh nghi\u1ec7m gi\u00e1m s\u00e1t s\u1eed d\u1ee5ng.<\/p>\n

Do oxaliplatin n\u1eb1m trong ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p v\u1edbi fluorouracil v\u00e0 leucovorin n\u00ean c\u1ea7n xem x\u00e9t th\u00f4ng tin li\u00ean quan (th\u1eadn tr\u1ecdng, c\u1ea3nh b\u00e1o v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh) c\u1ee7a c\u00e1c thu\u1ed1c n\u00e0y.<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1eb1ng oxaliplatin th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi hai lo\u1ea1i r\u1ed1i lo\u1ea1n th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i bi\u00ean s\u01a1 c\u1ea5p. Th\u1eddi gian v\u00e0 m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a b\u1ec7nh gia t\u0103ng theo li\u1ec1u. R\u1ed1i lo\u1ea1n th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i bi\u00ean x\u1ea3y ra \u0111\u1ed1i v\u1edbi 92% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p oxaliplatin v\u1edbi fluorouracil v\u00e0 leucovorin \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3 ung th\u01b0 \u0111\u1ea1i tr\u00e0ng.<\/p>\n

R\u1ed1i lo\u1ea1n th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i bi\u00ean c\u1ea5p t\u00ednh \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o tr\u00ean 56% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n d\u1ecb c\u1ea3m, lo\u1ea1n c\u1ea3m, gi\u1ea3m c\u1ea3m gi\u00e1c \u1edf b\u00e0n tay, b\u00e0n ch\u00e2n, v\u00f9ng quanh mi\u1ec7ng ho\u1eb7c h\u1ecdng, c\u1ee9ng h\u00e0m, r\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c, r\u1ed1i lo\u1ea1n v\u1eadn ng\u00f4n, \u0111au m\u1eaft, v\u00e0 c\u1ea3m gi\u00e1c t\u1ee9c ng\u1ef1c. C\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y xu\u1ea5t hi\u1ec7n trong v\u00f2ng v\u00e0i gi\u1edd cho \u0111\u1ebfn 1 – 2 ng\u00e0y sau khi d\u00f9ng thu\u1ed1c, c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c (trong v\u00f2ng 14 ng\u00e0y) v\u00e0 c\u00f3 th\u1ec3 t\u00e1i ph\u00e1t \u1edf nh\u1eefng li\u1ec1u k\u1ebf ti\u1ebfp. Do c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y th\u01b0\u1eddng t\u0103ng n\u1eb7ng khi ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t \u0111\u1ed9 l\u1ea1nh (bao g\u1ed3m c\u1ea3 lo\u1ea1n c\u1ea3m h\u1ea7u – h\u1ecdng – thanh qu\u1ea3n) n\u00ean c\u1ea7n t\u01b0 v\u1ea5n cho b\u1ec7nh nh\u00e2n tr\u00e1nh \u0111\u1ed3 \u0103n, th\u1ee9c u\u1ed1ng l\u1ea1nh, tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t \u0111\u1ed9 l\u1ea1nh, \u0111i g\u0103ng tay khi c\u1ea7m c\u00e1c v\u1eadt l\u1ea1nh.<\/p>\n

Khi truy\u1ec1n oxaliplatin, kh\u00f4ng \u0111\u01b0\u1ee3c ch\u01b0\u1eddm l\u1ea1nh \u0111\u1ec3 d\u1ef1 ph\u00f2ng vi\u00eam ni\u00eam m\u1ea1c. C\u00f3 th\u1ec3 k\u00e9o d\u00e0i th\u1eddi gian truy\u1ec1n thu\u1ed1c \u0111\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 lo\u1ea1n c\u1ea3m h\u1ea7u – h\u1ecdng – thanh qu\u1ea3n.<\/p>\n

Lo\u1ea1i r\u1ed1i lo\u1ea1n th\u1ea7n kinh c\u1ea3m gi\u00e1c dai d\u1eb3ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o tr\u00ean 48% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p, tri\u1ec7u ch\u1ee9ng dai d\u1eb3ng h\u01a1n (tr\u00ean 14 ng\u00e0y), th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y (nh\u01b0 vi\u1ebft, c\u00e0i \u00e1o, nu\u1ed1t, \u0111i l\u1ea1i), nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n n\u1ebfu ng\u1eebng thu\u1ed1c.<\/p>\n

C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba \u0111\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 v\u00e0 m\u1ee9c \u0111\u1ed9 \u0111\u1ed9c t\u00ednh tr\u00ean th\u1ea7n kinh c\u1ee7a oxaliplatin bao g\u1ed3m d\u00f9ng ch\u1ebf \u0111\u1ed9 li\u1ec1u oxaliplatin c\u00e1ch qu\u00e3ng v\u00e0 c\u00e1c thu\u1ed1c \u0111i\u1ec1u bi\u1ebfn th\u1ea7n kinh (nh\u01b0 amifostin, carbamazepin, gabapentin, glutathion) cho \u0111\u1ebfn nay v\u1eabn ch\u01b0a \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng.<\/p>\n

Truy\u1ec1n t\u0129nh m\u1ea1ch calci gluconat v\u00e0 magnesi sulfat tr\u01b0\u1edbc v\u00e0 sau khi truy\u1ec1n oxaliplatin c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u1ed9c t\u00ednh th\u1ea7n kinh nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng \u00e2m t\u00ednh \u0111\u1ed1i v\u1edbi \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng v\u00e0 ho\u1ea1t t\u00ednh ch\u1ed1ng ung th\u01b0.<\/p>\n

Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y x\u01a1 h\u00f3a ph\u1ed5i. N\u1ebfu th\u1ea5y c\u00e1c bi\u1ec3u hi\u1ec7n h\u00f4 h\u1ea5p kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c (nh\u01b0 ho khan, kh\u00f3 th\u1edf, th\u00e2m nhi\u1ec5m tr\u00ean X-quang ph\u1ed5i), ph\u1ea3i t\u1ea1m ng\u1eebng thu\u1ed1c cho t\u1edbi khi lo\u1ea1i \u0111\u01b0\u1ee3c x\u01a1 h\u00f3a ph\u1ed5i.<\/p>\n

Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c gan (bao g\u1ed3m suy gan v\u00e0 vi\u00eam gan). Xem x\u00e9t kh\u1ea3 n\u0103ng r\u1ed1i lo\u1ea1n m\u1ea1ch gan (bao g\u1ed3m c\u1ea3 t\u1eafc t\u0129nh m\u1ea1ch), \u0111\u1eb7c bi\u1ec7t tr\u00ean nh\u1eefng ng\u01b0\u1eddi t\u0103ng huy\u1ebft \u00e1p k\u1ecbch ph\u00e1t ho\u1eb7c t\u0103ng enzym gan. Tr\u01b0\u1edbc m\u1ed7i chu tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1eb1ng oxaliplatin n\u00ean l\u00e0m x\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan.<\/p>\n

Ng\u01b0\u1eddi s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p oxaliplatin, fluorouracil v\u00e0 leucovorin th\u01b0\u1eddng hay g\u1eb7p gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00e0 ch\u1ea3y m\u00e1u h\u01a1n so v\u1edbi ph\u00e1c \u0111\u1ed3 ch\u1ec9 g\u1ed3m fluorouracil v\u00e0 leucovorin. C\u1ea7n x\u00e9t nghi\u1ec7m c\u00f4ng th\u1ee9c m\u00e1u (v\u00ed d\u1ee5 c\u00f4ng th\u1ee9c b\u1ea1ch c\u1ea7u, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u) v\u00e0 sinh h\u00f3a m\u00e1u (bao g\u1ed3m ALT, AST, bilirubin v\u00e0 creatinin) tr\u01b0\u1edbc m\u1ed7i chu tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n

B\u1ec7nh nh\u00e2n s\u1eed d\u00f9ng \u0111\u1ed3ng th\u1eddi ph\u00e1c \u0111\u1ed3 ch\u1ee9a oxaliplatin, fluorouracil v\u00e0 leucovorin v\u1edbi thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1eddng u\u1ed1ng c\u1ea7n gi\u00e1m s\u00e1t ch\u1eb7t ch\u1ebd th\u1eddi gian prothrombin v\u00e0 INR (International Normalized Ratio – ch\u1ec9 s\u1ed1 b\u00ecnh th\u01b0\u1eddng h\u00f3a qu\u1ed1c t\u1ebf).<\/p>\n

S\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi suy th\u1eadn v\u00ec thu\u1ed1c c\u00f3 th\u1ec3 t\u0103ng \u0111\u1ed9c t\u00ednh tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y.<\/p>\n

Khi truy\u1ec1n li\u00ean t\u1ee5c, n\u00ean d\u00f9ng d\u1eabn xu\u1ea5t taxan (docetaxel, paclitaxel) tr\u01b0\u1edbc c\u00e1c d\u1eabn xu\u1ea5t platin (carboplatin, cisplatin, oxaliplatin) \u0111\u1ec3 h\u1ea1n ch\u1ebf nguy c\u01a1 suy t\u1ee7y v\u00e0 gia t\u0103ng hi\u1ec7u l\u1ef1c t\u00e1c d\u1ee5ng.<\/p>\n

S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi oxaliplatin v\u1edbi 5-fluorouracil c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n tr\u00ean gan v\u00e0 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. B\u1ec7nh nh\u00e2n cao tu\u1ed5i th\u01b0\u1eddng nh\u1ea1y c\u1ea3m h\u01a1n v\u1edbi m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a thu\u1ed1c bao g\u1ed3m ti\u00eau ch\u1ea3y, m\u1ea5t n\u01b0\u1edbc, h\u1ea1 kali huy\u1ebft, gi\u1ea3m b\u1ea1ch c\u1ea7u, m\u1ec7t m\u1ecfi, ng\u1ea5t.<\/p>\n

Hi\u1ec7u l\u1ef1c v\u00e0 t\u00ednh an to\u00e0n c\u1ee7a oxaliplatin \u0111\u1ed1i v\u1edbi tr\u1ebb em ch\u01b0a \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp.<\/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

C\u1ea7n th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh 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

Nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt th\u00ed nghi\u1ec7m v\u1edbi m\u1ee9c li\u1ec1u b\u1eb1ng m\u1ed9t ph\u1ea7n m\u01b0\u1eddi li\u1ec1u d\u00f9ng tr\u00ean ng\u01b0\u1eddi cho th\u1ea5y, thu\u1ed1c l\u00e0m gi\u1ea3m kh\u1ed1i l\u01b0\u1ee3ng thai, gi\u1ea3m c\u1ed1t h\u00f3a v\u00e0 l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 ch\u1ebft ph\u00f4i thai.<\/p>\n

Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi mang thai. N\u00ean t\u01b0 v\u1ea5n cho ph\u1ee5 n\u1eef tr\u00e1nh mang thai, s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai trong th\u1eddi gian d\u00f9ng thu\u1ed1c v\u00e0 cho t\u1edbi 4 th\u00e1ng sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng oxaliplatin. N\u1ebfu d\u00f9ng thu\u1ed1c trong th\u1eddi k\u00ec mang thai, ph\u1ea3i c\u1ea3nh b\u00e1o nguy c\u01a1 t\u1ed5n h\u1ea1i \u0111\u1ebfn thai nhi.<\/p>\n

\u0110\u1ed1i v\u1edbi nam gi\u1edbi, tr\u00e1nh c\u00f3 con trong th\u1eddi gian d\u00f9ng thu\u1ed1c v\u00e0 cho t\u1edbi 6 th\u00e1ng sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng oxaliplatin. Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y v\u00f4 sinh v\u0129nh vi\u1ec5n \u1edf nam gi\u1edbi. Tr\u01b0\u1edbc khi kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, b\u00e1c s\u0129 c\u1ea7n t\u01b0 v\u1ea5n cho nam gi\u1edbi mu\u1ed1n c\u00f3 con theo h\u01b0\u1edbng l\u01b0u gi\u1eef tinh tr\u00f9ng.<\/p>\n

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

Kh\u00f4ng r\u00f5 oxaliplatin c\u00f3 ph\u00e2n b\u1ed1 v\u00e0o s\u1eefa m\u1eb9 hay kh\u00f4ng. N\u00ean ng\u1eebng nu\u00f4i con b\u1eb1ng s\u1eefa m\u1eb9 trong th\u1eddi gian d\u00f9ng thu\u1ed1c.<\/p>\n

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

T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n v\u1edbi t\u1ef7 l\u1ec7 tr\u00ean 1% \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o:<\/p>\n

Th\u1ea7n kinh trung \u01b0\u01a1ng: M\u1ec7t m\u1ecfi (61%), s\u1ed1t (25%), \u0111au (14%), \u0111au \u0111\u1ea7u (13%), m\u1ea5t ng\u1ee7 (11%), ch\u00f3ng m\u1eb7t (7%).<\/p>\n

Ti\u00eau h\u00f3a: Bu\u1ed3n n\u00f4n (64%), ti\u00eau ch\u1ea3y (46%), n\u00f4n (37%), \u0111au b\u1ee5ng (31%), t\u00e1o b\u00f3n (31%), ch\u00e1n \u0103n (20%), vi\u00eam mi\u1ec7ng (14%), kh\u00f3 ti\u00eau (7%), r\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c (5%), \u0111\u1ea7y h\u01a1i (3%), vi\u00eam ni\u00eam m\u1ea1c (1%), tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y – th\u1ef1c qu\u1ea3n (1%), kh\u00f3 nu\u1ed1t (c\u1ea5p 1% \u0111\u1ebfn 2%).<\/p>\n

H\u1ec7 t\u1ea1o m\u00e1u: Thi\u1ebfu m\u00e1u (64%, c\u1ea5p \u0111\u1ed9 3\/4: 1%), gi\u1ea3m ti\u1ec3u c\u1ea7u (30%, c\u1ea5p \u0111\u1ed9 3\/4: 3%), gi\u1ea3m b\u1ea1ch c\u1ea7u (13%), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh (7%).<\/p>\n

Gan: T\u0103ng AST (54%, c\u1ea5p \u0111\u1ed9 3\/4: 4%), t\u0103ng ALT (36%, c\u1ea5p \u0111\u1ed9 3\/4: 1%), t\u0103ng bilirubin to\u00e0n ph\u1ea7n (13%, c\u1ea5p \u0111\u1ed9 3\/4: 5%).<\/p>\n

Th\u1ea7n kinh c\u01a1 v\u00e0 x\u01b0\u01a1ng: B\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean (ph\u1ee5 thu\u1ed9c li\u1ec1u, 76%, c\u1ea5p: 64%, c\u1ea5p \u0111\u1ed9 3\/4: 5%, dai d\u1eb3ng: 43%, c\u1ea5p \u0111\u1ed9 3\/4: 3%), \u0111au l\u01b0ng (11%), chu\u1ed9t r\u00fat (9%), \u0111au kh\u1edbp (7%).<\/p>\n

H\u00f4 h\u1ea5p: Kh\u00f3 th\u1edf (13%), ho (11%), nhi\u1ec5m khu\u1ea5n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean (7%), vi\u00eam m\u0169i (6%), ch\u1ea3y m\u00e1u cam (2%), vi\u00eam h\u1ea7u h\u1ecdng (2%), lo\u1ea1n c\u1ea3m h\u1ea7u h\u1ecdng thanh qu\u1ea3n (c\u1ea5p \u0111\u1ed9 3\/4: 1% \u0111\u1ebfn 2%).<\/p>\n

Tim m\u1ea1ch: Ph\u00f9 (10%), \u0111au ng\u1ef1c (5%), ph\u00f9 ngo\u1ea1i vi (5%), huy\u1ebft kh\u1ed1i t\u1eafc m\u1ea1ch (2%).<\/p>\n

N\u1ed9i ti\u1ebft v\u00e0 chuy\u1ec3n h\u00f3a: M\u1ea5t n\u01b0\u1edbc (5%), gi\u1ea3m kali huy\u1ebft (3%).<\/p>\n

Ti\u1ebft ni\u1ec7u: Ti\u1ec3u kh\u00f3 (1%).<\/p>\n

M\u1eaft: R\u1ed1i lo\u1ea1n ti\u1ebft n\u01b0\u1edbc m\u1eaft (1%).<\/p>\n

Th\u1eadn: T\u0103ng creatinin huy\u1ebft thanh (5% – 10%).<\/p>\n

T\u1ea1i ch\u1ed7: Ph\u1ea3n \u1ee9ng ch\u1ed7 ti\u00eam (9%).<\/p>\n

Kh\u00e1c: Ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng (3%), m\u1eabn c\u1ea3m (2% – 3%), n\u1ea5c (2%).<\/p>\n

Ngo\u00e0i ra, khi d\u00f9ng \u0111\u01a1n tr\u1ecb li\u1ec7u ho\u1eb7c ph\u00e1c \u0111\u1ed3 ph\u1ed1i h\u1ee3p c\u00f2n g\u1eb7p m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n nghi\u00eam tr\u1ecdng ho\u1eb7c \u0111e d\u1ecda t\u00ednh m\u1ea1ng (t\u1ef7 l\u1ec7 d\u01b0\u1edbi 1%) nh\u01b0: Suy th\u1eadn c\u1ea5p, t\u0103ng phosphatase ki\u1ec1m, ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7, s\u1ed1c ph\u1ea3n v\u1ec7…<\/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\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng m\u1eabn c\u1ea3m kh\u00e1c (c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4) x\u1ea3y ra \u0111\u1ed1i v\u1edbi 2 – 3% b\u1ec7nh nh\u00e2n. Ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n nh\u01b0 co th\u1eaft ph\u1ebf qu\u1ea3n, ban da, h\u1ea1 huy\u1ebft \u00e1p, ng\u1ee9a, \u0111\u1ecf da v\u00e0\/ho\u1eb7c m\u00e0y \u0111ay c\u00f3 th\u1ec3 x\u1ea3y ra sau khi d\u00f9ng thu\u1ed1c v\u00e0i ph\u00fat v\u00e0 \u1edf b\u1ea5t k\u00ec chu tr\u00ecnh \u0111i\u1ec1u tr\u1ecb n\u00e0o. Ki\u1ec3m so\u00e1t b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3, \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng b\u1eb1ng adrenalin, corticosteroid v\u00e0 kh\u00e1ng histamin. N\u1ebfu c\u1ea7n, ph\u1ea3i ng\u1eebng \u0111i\u1ec1u tr\u1ecb.<\/p>\n

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

Oxaliplatin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a natalizumab, v\u1eafc xin s\u1ed1ng. Tr\u00e1nh ph\u1ed1i h\u1ee3p oxaliplatin v\u1edbi natalizumab, v\u1eafc xin s\u1ed1ng. Tr\u00e1nh ph\u1ed1i h\u1ee3p c\u00e1c thu\u1ed1c g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o (trong \u0111\u00f3 c\u00f3 oxaliplatin) v\u1edbi clozapin do gia t\u0103ng nguy c\u01a1 m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t.<\/p>\n

D\u00f9ng ph\u00e1c \u0111\u1ed3 oxaliplatin k\u1ebft h\u1ee3p v\u1edbi fluorouracil v\u00e0 leucovorin \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u c\u00f3 kh\u1ea3 n\u0103ng k\u00e9o d\u00e0i th\u1eddi gian prothrombin v\u00e0 INR. B\u1ec7nh nh\u00e2n s\u1eed d\u00f9ng \u0111\u1ed3ng th\u1eddi ph\u00e1c \u0111\u1ed3 ch\u1ee9a oxaliplatin, fluorouracil v\u00e0 leucovorin v\u1edbi thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1eddng u\u1ed1ng c\u1ea7n gi\u00e1m s\u00e1t ch\u1eb7t ch\u1ebd th\u1eddi gian prothrombin v\u00e0 INR.<\/p>\n

Ph\u1ed1i h\u1ee3p oxaliplatin v\u1edbi aminoglycosid, polymyxin, capreomycin, thu\u1ed1c l\u1ee3i ti\u1ec3u c\u00f3 th\u1ec3 l\u00e0m gia t\u0103ng nguy c\u01a1 \u0111\u1ed9c th\u1eadn v\u00e0 \u0111\u1ed9c t\u00ednh tr\u00ean tai.<\/p>\n

Trastuzumab c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a oxaliplatin. Echinacea l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a oxaliplatin.<\/p>\n

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

Ch\u01b0a c\u00f3 thu\u1ed1c gi\u1ea3i \u0111\u1ed9c. Ngo\u00e0i gi\u1ea3m ti\u1ec3u c\u1ea7u, c\u00e1c tri\u1ec7u ch\u1ee9ng qu\u00e1 li\u1ec1u c\u00f3 th\u1ec3 l\u00e0 ph\u1ea3n \u1ee9ng m\u1eabn c\u1ea3m, \u1ee9c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a, \u0111\u1ed9c th\u1ea7n kinh. C\u1ea7n theo d\u00f5i ng\u01b0\u1eddi b\u1ec7nh v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng. Li\u1ec1u t\u1ed1i \u0111a oxaliplatin \u0111\u00e3 cho truy\u1ec1n m\u1ed9t li\u1ec1u duy nh\u1ea5t l\u00ean t\u1edbi 825 mg.<\/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

Oxaliplatin l\u00e0 m\u1ed9t thu\u1ed1c ch\u1ed1ng ung th\u01b0 ch\u1ee9a platin, thu\u1ed9c nh\u00f3m thu\u1ed1c alkyl h\u00f3a. Thu\u1ed1c l\u00e0 m\u1ed9t ph\u1ee9c h\u1ee3p organoplatin, g\u1ed3m m\u1ed9t nguy\u00ean t\u1eed platin ph\u1ee9c h\u1ee3p v\u1edbi 1,2 diamino-cyclohexan (DACH) v\u00e0 m\u1ed9t ligan oxalat kh\u00f4ng b\u1ec1n.<\/p>\n

Oxaliplatin c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng u carcinom \u0111\u1ea1i tr\u00e0ng in vivo.<\/em> Ho\u1ea1t t\u00ednh hi\u1ec7p \u0111\u1ed3ng ch\u1ed1ng t\u0103ng sinh t\u1ebf b\u00e0o c\u1ee7a oxaliplatin v\u00e0 fluorouracil \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh in vitro<\/em> v\u00e0 in vivo<\/em> \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 m\u1eabu u c\u1ee7a \u0111\u1ea1i tr\u00e0ng, v\u00fa, b\u1ec7nh b\u1ea1ch c\u1ea7u.<\/p>\n

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

Oxaliplatin \u0111\u01b0\u1ee3c bi\u1ebfn \u0111\u1ed5i kh\u00f4ng th\u00f4ng qua enzym trong d\u1ecbch sinh l\u00fd th\u00e0nh m\u1ed9t s\u1ed1 ph\u1ee9c h\u1ee3p c\u00f3 ho\u1ea1t t\u00ednh nh\u1ea5t th\u1eddi, bao g\u1ed3m monoaquo DACH platin v\u00e0 diaquo DACH platin b\u1eb1ng c\u00e1ch chuy\u1ec3n ch\u1ed7 ligand oxalat. C\u00e1c ph\u1ee9c h\u1ee3p n\u00e0y li\u00ean k\u1ebft \u0111\u1ed3ng h\u00f3a tr\u1ecb v\u1edbi c\u00e1c chu\u1ed7i base \u0111\u1eb7c hi\u1ec7u c\u1ee7a DNA t\u1ea1o th\u00e0nh li\u00ean k\u1ebft ch\u00e9o v\u1edbi DNA \u1edf c\u00f9ng s\u1ee3i (intrastrand) v\u00e0 \u0111\u1ed1i s\u1ee3i (interstrand). C\u00e1c li\u00ean k\u1ebft ch\u00e9o \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh \u1edf v\u1ecb tr\u00ed N7 c\u1ee7a 2 guanin k\u1ec1 nhau (GG), adenin-guanin k\u1ec1 nhau (AG) v\u00e0 gi\u1eefa 2 guanin xen k\u1ebd 1 nucleotid (GNG). C\u00e1c li\u00ean k\u1ebft ch\u00e9o n\u00e0y \u1ee9c ch\u1ebf DNA sao ch\u00e9p v\u00e0 phi\u00ean m\u00e3. M\u1ed9t v\u00e0i ch\u1ee9ng c\u1ee9 cho th\u1ea5y s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a DACH c\u1ee7a oxaliplatin c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u1edbn v\u00e0o \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p DNA v\u00e0 \u0111\u1ed9c t\u00ednh t\u1ebf b\u00e0o so v\u1edbi cisplatin v\u00e0 l\u00e0m m\u1ea5t kh\u00e1ng ch\u00e9o gi\u1eefa oxaliplatin v\u00e0 cisplatin. Oxaliplatin kh\u00f4ng c\u00f3 t\u00ednh \u0111\u1eb7c hi\u1ec7u \u0111\u1ed1i v\u1edbi c\u00e1c pha c\u1ee7a chu tr\u00ecnh t\u1ebf b\u00e0o.<\/p>\n

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

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

Oxaliplatin bi\u1ebfn \u0111\u1ed5i nhanh v\u00e0 r\u1ed9ng nh\u1edd qu\u00e1 tr\u00ecnh sinh chuy\u1ec3n h\u00f3a kh\u00f4ng th\u00f4ng qua enzym th\u00e0nh m\u1ed9t lo\u1ea1t c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a trung gian c\u00f3 ho\u1ea1t t\u00ednh ch\u1ee9a g\u1ed1c platin. C\u00e1c th\u00f4ng s\u1ed1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc ch\u1ee7 y\u1ebfu \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c ch\u1ea5t n\u00e0y, kh\u00f4ng ph\u1ea3i c\u1ee7a ch\u1ea5t m\u1eb9.<\/p>\n

Ph\u00e2n b\u1ed1: <\/em>Sau khi truy\u1ec1n t\u0129nh m\u1ea1ch 2 gi\u1edd, kho\u1ea3ng 15% oxaliplatin t\u1ed3n t\u1ea1i trong tu\u1ea7n ho\u00e0n chung, 85% ph\u00e2n b\u1ed1 nhanh v\u00e0o c\u00e1c t\u1ed5 ch\u1ee9c trong c\u01a1 th\u1ec3 v\u00e0 th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u. Ph\u1ea7n c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ch\u1ee9a platin ph\u00e2n b\u1ed1 v\u00e0o c\u00e1c m\u00f4 ngo\u1ea1i vi ch\u1ee7 y\u1ebfu g\u1eafn kh\u00f4ng thu\u1eadn ngh\u1ecbch v\u00e0 t\u1eadp trung trong h\u1ed3ng c\u1ea7u, kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh. Kho\u1ea3ng 90% platin trong tu\u1ea7n ho\u00e0n chung g\u1eafn kh\u00f4ng thu\u1eadn ngh\u1ecbch v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng, (ch\u1ee7 y\u1ebfu v\u1edbi albumin v\u00e0 g- globulin). Ho\u1ea1t t\u00ednh ch\u1ed1ng ung th\u01b0 c\u1ee7a oxaliplatin ch\u1ec9 th\u1ec3 hi\u1ec7n \u1edf c\u00e1c lo\u1ea1i ch\u1ea5t ch\u1ee9a platin c\u00f3 trong ph\u1ea7n huy\u1ebft t\u01b0\u01a1ng si\u00eau l\u1ecdc (lo\u1ea1i ch\u1ea5t \u0111\u00e3 \u0111\u01b0\u1ee3c sinh chuy\u1ec3n h\u00f3a, kh\u00f4ng g\u1eafn k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng). Tuy nhi\u00ean, ch\u01b0a thi\u1ebft l\u1eadp \u0111\u01b0\u1ee3c m\u1ed1i li\u00ean quan d\u01b0\u1ee3c l\u1ef1c h\u1ecdc gi\u1eefa n\u1ed3ng \u0111\u1ed9 c\u00e1c lo\u1ea1i ch\u1ea5t ch\u1ee9a platin d\u01b0\u1edbi d\u1ea1ng n\u00e0y v\u1edbi t\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u l\u1ef1c c\u1ee7a oxaliplatin.<\/p>\n

Chuy\u1ec3n h\u00f3a:<\/em> Thu\u1ed1c chuy\u1ec3n h\u00f3a nhanh v\u00e0 r\u1ed9ng nh\u1edd qu\u00e1 tr\u00ecnh sinh chuy\u1ec3n h\u00f3a kh\u00f4ng th\u00f4ng qua enzym. Nghi\u00ean c\u1ee9u in vitro<\/em> cho th\u1ea5y, qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a kh\u00f4ng th\u00f4ng qua trung gian cytochrom. Trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a ng\u01b0\u1eddi d\u00f9ng oxaliplatin \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c 17 ch\u1ea5t chuy\u1ec3n h\u00f3a ch\u1ee9a g\u1ed1c platin, trong \u0111\u00f3 c\u00f3 m\u1ed9t s\u1ed1 d\u1eabn ch\u1ea5t g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o nh\u01b0, monocloro 1,2-diaminocyclohexan (DACH) platin, dicloro DACH platin, monoaquo DACH platin, diaquo DACH platin v\u00e0 m\u1ed9t s\u1ed1 d\u1eabn ch\u1ea5t kh\u00f4ng g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o.<\/p>\n

Th\u1ea3i tr\u1eeb:<\/em> Th\u1ea3i tr\u1eeb ch\u1ee7 y\u1ebfu qua n\u01b0\u1edbc ti\u1ec3u. \u0110\u1ed9 thanh th\u1ea3i th\u1eadn c\u1ee7a platin d\u1ea1ng t\u1ef1 do t\u1ef7 l\u1ec7 thu\u1eadn v\u1edbi t\u1ed1c \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn (GFR). Sau khi truy\u1ec1n t\u0129nh m\u1ea1ch 2 gi\u1edd m\u1ed9t li\u1ec1u duy nh\u1ea5t, c\u00e1c d\u1eabn ch\u1ea5t platin th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u v\u00e0 qua ph\u00e2n v\u1edbi t\u1ef7 l\u1ec7 t\u01b0\u01a1ng \u1ee9ng kho\u1ea3ng 54% v\u00e0 2% trong v\u00f2ng 5 ng\u00e0y. C\u00e1c d\u1eabn ch\u1ea5t platin ph\u00e2n b\u1ed1 v\u00e0 th\u1ea3i tr\u1eeb theo 3 pha. Trong \u0111\u00f3 c\u00f3 2 pha ph\u00e2n b\u1ed1 ng\u1eafn v\u1edbi n\u1eeda \u0111\u1eddi l\u1ea7n l\u01b0\u1ee3t l\u00e0 0,43 gi\u1edd v\u00e0 16,8 gi\u1edd v\u00e0 1 pha th\u1ea3i tr\u1eeb d\u00e0i v\u1edbi n\u1eeda \u0111\u1eddi kho\u1ea3ng 391 gi\u1edd.<\/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

N\u01b0\u1edbc c\u1ea5t pha ti\u00eam.<\/p>\n

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

Oxaliplatin \u0111\u01b0\u1ee3c ho\u00e0n nguy\u00ean v\u00e0 pha lo\u00e3ng b\u1eb1ng n\u01b0\u1edbc c\u1ea5t pha ti\u00eam ho\u1eb7c dung d\u1ecbch dextrose 5%.<\/p>\n

Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng dung d\u1ecbch natri clorid ho\u1eb7c c\u00e1c lo\u1ea1i dung d\u1ecbch c\u00f3 ch\u1ee9a clorid \u0111\u1ec3 h\u00f2a tan v\u00e0 pha lo\u00e3ng. Kh\u00f4ng d\u00f9ng kim ti\u00eam, b\u1ed9 d\u1ee5ng c\u1ee5 ti\u00eam truy\u1ec1n b\u1eb1ng nh\u00f4m \u0111\u1ec3 ho\u00e0n nguy\u00ean v\u00e0 pha lo\u00e3ng v\u00ec nh\u00f4m c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1 h\u1ee7y d\u1eabn ch\u1ea5t platin.<\/p>\n

Oxaliplatin kh\u00f4ng t\u01b0\u01a1ng h\u1ee3p v\u1edbi c\u00e1c dung d\u1ecbch v\u00e0 thu\u1ed1c c\u00f3 t\u00ednh ki\u1ec1m (v\u00ed d\u1ee5 fluorouracil) n\u00ean kh\u00f4ng \u0111\u01b0\u1ee3c tr\u1ed9n l\u1eabn ho\u1eb7c \u0111\u01b0a chung c\u00e1c thu\u1ed1c n\u00e0y v\u00e0o c\u00f9ng d\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch v\u1edbi oxaliplatin. Tr\u01b0\u1edbc khi \u0111\u01b0a c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0o, ph\u1ea3i l\u00e0m s\u1ea1ch d\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch b\u1eb1ng dung d\u1ecbch dextrose 5%.<\/p>\n

Oxaliplatin n\u1ed3ng \u0111\u1ed9 0,5 mg\/ml k\u1ebft h\u1ee3p v\u1edbi diazepam n\u1ed3ng \u0111\u1ed9 5 mg\/ml t\u1ea1o t\u1ee7a tr\u1eafng \u0111\u1ee5c ngay sau khi ph\u1ed1i h\u1ee3p.<\/p>\n

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

L\u1ecd thu\u1ed1c \u0111\u01b0\u1ee3c b\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (15 – 30 o<\/sup>C), kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1ec3 \u0111\u00f4ng l\u1ea1nh.<\/p>\n

Ch\u1ebf ph\u1ea9m d\u1ea1ng dung d\u1ecbch ph\u1ea3i b\u1ea3o qu\u1ea3n tr\u00e1nh \u00e1nh s\u00e1ng nh\u01b0ng sau khi \u0111\u00e3 pha lo\u00e3ng kh\u00f4ng c\u1ea7n tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n

Dung d\u1ecbch \u0111\u00e3 pha lo\u00e3ng c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh l\u00ean t\u1edbi 24 gi\u1edd v\u00e0 \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng kho\u1ea3ng 6 gi\u1edd. \u1eda n\u1ed3ng \u0111\u1ed9 3 g\/l\u00edt, thu\u1ed1c c\u00f3 th\u1ec3 \u1ed5n \u0111\u1ecbnh \u00edt nh\u1ea5t 5 ng\u00e0y \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng.<\/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

7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/strong><\/p>\n

B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c s\u01b0u t\u1ea7m ho\u1eb7c vi\u1ebft b\u1edfi: B\u00e1c s\u0129 nhi khoa – \u0110\u1ed7 M\u1ef9 Linh.<\/a><\/p>\n

Ki\u1ec3m duy\u1ec7t , hi\u1ec7u \u0111\u00ednh v\u00e0 \u0111\u0103ng t\u1ea3i: PHARMOG TEAM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Thu\u1ed1c Oxaliplatin 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 Oxaliplatin (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…) 1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Oxaliplatin Ph\u00e2n lo\u1ea1i: Thu\u1ed1c ch\u1ed1ng ung th\u01b0, d\u1eabn […]<\/p>\n","protected":false},"author":8612,"featured_media":28269,"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":[1091],"class_list":["post-3994","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-thuoc-a-z","tag-oxaliplatin"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/3994","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=3994"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/3994\/revisions"}],"predecessor-version":[{"id":28270,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/3994\/revisions\/28270"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/28269"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=3994"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=3994"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=3994"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}