{"id":4057,"date":"2019-02-12T16:08:57","date_gmt":"2019-02-12T09:08:57","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=4057"},"modified":"2025-01-08T22:27:40","modified_gmt":"2025-01-08T15:27:40","slug":"temozolomide","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/temozolomide\/","title":{"rendered":"Temozolomide"},"content":{"rendered":"<p><em>Thu\u1ed1c Temozolomid 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 Temozolomid (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><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_81 ez-toc-wrap-left counter-hierarchy ez-toc-counter ez-toc-white ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">N\u1ed9i dung ch\u00ednh<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#1-ten-hoat-chat-va-biet-duoc\" >1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#2-dang-bao-che-%e2%80%93-ham-luong\" >2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#3-video-by-pharmog\" >3. Video by Pharmog:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#4-ung-dung-lam-sang\" >4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#41-chi-dinh\" >4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#42-lieu-dung-%e2%80%93-cach-dung\" >4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#43-chong-chi-dinh\" >4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#44-than-trong\" >4.4 Th\u1eadn tr\u1ecdng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\" >4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#46-tac-dung-khong-mong-muon-adr\" >4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#47-huong-dan-cach-xu-tri-adr\" >4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#48-tuong-tac-voi-cac-thuoc-khac\" >4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#49-qua-lieu-va-xu-tri\" >4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#5-co-che-tac-dung-cua-thuoc\" >5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#51-duoc-luc-hoc\" >5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#52-duoc-dong-hoc\" >5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#53-giai-thich\" >5.3 Gi\u1ea3i th\u00edch:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#54-thay-the-thuoc\" >5.4 Thay th\u1ebf thu\u1ed1c :<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#6-phan-thong-tin-kem-theo-cua-thuoc\" >6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#61-danh-muc-ta-duoc\" >6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#62-tuong-ky\" >6.2. T\u01b0\u01a1ng k\u1ef5 :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#63-bao-quan\" >6.3. B\u1ea3o qu\u1ea3n:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#64-thong-tin-khac\" >6.4. Th\u00f4ng tin kh\u00e1c :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#65-tai-lieu-tham-khao\" >6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/pharmog.com\/wp\/temozolomide\/#7-nguoi-dang-tai-tac-gia\" >7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/a><\/li><\/ul><\/nav><\/div>\n\n<h1><span class=\"ez-toc-section\" id=\"1-ten-hoat-chat-va-biet-duoc\"><\/span>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <\/strong><a href=\"https:\/\/pharmog.com\/wp\/temozolomide\/\"><strong>Temozolomide<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c ch\u1ed1ng ung th\u01b0.<\/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): L01AX03.<\/p>\n<p><strong>Brand name<em>:<\/em><\/strong> <a href=\"https:\/\/pharmog.com\/wp\/temozolomide-temodal\/\">Temodal<\/a><\/p>\n<p><strong>Generic <\/strong>: Temoside , <a href=\"https:\/\/pharmog.com\/wp\/temozolomide-venutel\/\">Venutel<\/a>, Encepur , Temozolomid Ribosepharm , Benzomide, Zolotem , Temobela, Temorel , Gliotem<\/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<h1><span class=\"ez-toc-section\" id=\"2-dang-bao-che-%e2%80%93-ham-luong\"><\/span>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Vi\u00ean nang\/n\u00e9n: 5 mg, 10mg, 20 mg, 50mg, 100 mg, 140 mg, 180 mg, 250 mg.<\/p>\n<p>L\u1ecd thu\u1ed1c ti\u00eam: 100 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>TEMOSIDE 100<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i vi\u00ean nang c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Temozolomide<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>100 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"411\" height=\"403\" class=\"wp-image-37284\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/02\/word-image-73.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/02\/word-image-73.png 411w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/02\/word-image-73-300x294.png 300w\" sizes=\"auto, (max-width: 411px) 100vw, 411px\" \/><\/p>\n<h1><span class=\"ez-toc-section\" id=\"3-video-by-pharmog\"><\/span>3. Video by Pharmog:<span class=\"ez-toc-section-end\"><\/span><\/h1>\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<h1><span class=\"ez-toc-section\" id=\"4-ung-dung-lam-sang\"><\/span>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"41-chi-dinh\"><\/span>4.1. Ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><em>U nguy\u00ean b\u00e0o th\u1ea7n kinh \u0111\u1ec7m \u0111a h\u00ecnh (glioblastoma multiforme): <\/em>Temozolomid \u0111\u01b0\u1ee3c d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi l\u1edbn m\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n u nguy\u00ean b\u00e0o \u0111\u1ec7m \u0111a h\u00ecnh. Thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb duy tr\u00ec.<\/p>\n<p><em>U t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a (anaplastic astrocytoma): <\/em>Temozolomid \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a kh\u00e1ng thu\u1ed1c \u1edf ng\u01b0\u1eddi l\u1edbn, giai \u0111o\u1ea1n b\u1ec7nh ti\u1ebfn tri\u1ec3n sau \u0111i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u b\u1eb1ng nitrosoure v\u00e0 procarbazin.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"42-lieu-dung-%e2%80%93-cach-dung\"><\/span>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>Temozolomid \u0111\u01b0\u1ee3c d\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<p>Li\u1ec1u ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch trong v\u00f2ng 90 ph\u00fat b\u1eb1ng v\u1edbi li\u1ec1u d\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng. \u0110\u00e3 thi\u1ebft l\u1eadp \u0111\u01b0\u1ee3c t\u01b0\u01a1ng \u0111\u01b0\u01a1ng sinh h\u1ecdc c\u1ee7a ch\u1ebf ph\u1ea9m d\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 \u0111\u01b0\u1eddng ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch trong v\u00f2ng 90 ph\u00fat. Th\u1eddi gian ti\u00eam truy\u1ec1n ng\u1eafn h\u01a1n ho\u1eb7c d\u00e0i h\u01a1n c\u00f3 th\u1ec3 kh\u00f4ng t\u1ed1i \u01b0u ho\u1eb7c l\u00e0m gia t\u0103ng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n.<\/p>\n<p>Khi d\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng, temozolomid \u0111\u01b0\u1ee3c d\u00f9ng ng\u00e0y m\u1ed9t l\u1ea7n, nu\u1ed1t nguy\u00ean vi\u00ean v\u1edbi m\u1ed9t c\u1ed1c n\u01b0\u1edbc \u0111\u1ea7y. N\u1ebfu nang thu\u1ed1c v\u00f4 t\u00ecnh b\u1ecb m\u1edf, c\u1ea7n h\u1ebft s\u1ee9c th\u1eadn tr\u1ecdng \u0111\u1ec3 kh\u00f4ng h\u00edt ph\u1ea3i thu\u1ed1c ho\u1eb7c ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi da v\u00e0 ni\u00eam m\u1ea1c. Trong tr\u01b0\u1eddng h\u1ee3p nang thu\u1ed1c b\u1ecb v\u1ee1, d\u00f9ng g\u0103ng tay v\u00e0 k\u00ednh b\u1ea3o h\u1ed9 \u0111\u1ec3 tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi thu\u1ed1c. N\u00ean u\u1ed1ng v\u00e0o l\u00fac \u0111\u00f3i \u0111\u1ec3 h\u1ea1n ch\u1ebf bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n. Th\u1eddi \u0111i\u1ec3m ph\u00f9 h\u1ee3p \u0111\u1ec3 u\u1ed1ng thu\u1ed1c l\u00e0 tr\u01b0\u1edbc khi \u0111i ng\u1ee7. C\u00f3 th\u1ec3 u\u1ed1ng thu\u1ed1c ch\u1ed1ng n\u00f4n tr\u01b0\u1edbc ho\u1eb7c ngay sau khi u\u1ed1ng temozolomid.<\/p>\n<p>B\u00e1c s\u0129 n\u00ean x\u00e1c \u0111\u1ecbnh ngay s\u1ed1 l\u01b0\u1ee3ng vi\u00ean nang theo t\u1eebng lo\u1ea1i h\u00e0m l\u01b0\u1ee3ng m\u00e0 b\u1ec7nh nh\u00e2n s\u1ebd ph\u1ea3i d\u00f9ng d\u1ef1a tr\u00ean li\u1ec1u thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n (v\u00ed d\u1ee5 li\u1ec1u 275 mg\/ng\u00e0y, d\u00f9ng 5 ng\u00e0y s\u1ebd \u0111\u01b0\u1ee3c chia th\u00e0nh n\u0103m vi\u00ean 250 mg, n\u0103m vi\u00ean 20 mg v\u00e0 n\u0103m vi\u00ean 5 mg). M\u1ed7i lo\u1ea1i vi\u00ean \u0111\u01b0\u1ee3c chia v\u00e0o t\u1eebng h\u1ed9p ri\u00eang v\u00e0 d\u00e1n nh\u00e3n ph\u00f9 h\u1ee3p. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 d\u1eabn chi ti\u1ebft v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 lo\u1ea1i vi\u00ean ph\u1ea3i u\u1ed1ng trong t\u1eebng h\u1ed9p \u0111\u1ec3 c\u00f3 li\u1ec1u d\u00f9ng \u0111\u00fang cho m\u1ed9t ng\u00e0y.<\/p>\n<p>Temozolomid d\u00f9ng theo \u0111\u01b0\u1eddng ti\u00eam ph\u1ea3i \u0111\u01b0\u1ee3c pha ngay tr\u01b0\u1edbc khi d\u00f9ng. N\u1ebfu l\u1ecd thu\u1ed1c kh\u00f4ng may b\u1ecb m\u1edf, c\u1ea7n h\u1ebft s\u1ee9c th\u1eadn tr\u1ecdng \u0111\u1ec3 kh\u00f4ng h\u00edt ph\u1ea3i thu\u1ed1c ho\u1eb7c ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi da v\u00e0 ni\u00eam m\u1ea1c. Trong tr\u01b0\u1eddng h\u1ee3p l\u1ecd thu\u1ed1c b\u1ecb v\u1ee1, d\u00f9ng g\u0103ng tay v\u00e0 k\u00ednh b\u1ea3o h\u1ed9 \u0111\u1ec3 tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi thu\u1ed1c.<\/p>\n<p>Tr\u01b0\u1edbc khi pha, ph\u1ea3i \u0111\u01b0a l\u1ecd thu\u1ed1c v\u1ec1 nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng. Cho 41 ml n\u01b0\u1edbc c\u1ea5t pha ti\u00eam v\u00e0o l\u1ecd thu\u1ed1c ch\u1ee9a 100 mg temozolomid \u0111\u1ec3 \u0111\u01b0\u1ee3c dung d\u1ecbch thu\u1ed1c c\u00f3 n\u1ed3ng \u0111\u1ed9 2,5 mg\/ml, xoay nh\u1eb9 l\u1ecd thu\u1ed1c cho tan h\u1ebft, kh\u00f4ng l\u1eafc. Dung d\u1ecbch \u0111\u00e3 pha c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (25 <sup>o<\/sup>C) t\u1edbi 14 gi\u1edd (bao g\u1ed3m c\u1ea3 th\u1eddi gian truy\u1ec1n). Dung d\u1ecbch \u0111\u00e3 pha ph\u1ea3i \u0111\u01b0\u1ee3c ki\u1ec3m tra c\u1ea3m quan tr\u01b0\u1edbc khi ti\u00eam, n\u1ebfu th\u1ea5y l\u1ecd thu\u1ed1c c\u00f3 v\u1ea5n ph\u1ea3i b\u1ecf. Kh\u00f4ng n\u00ean pha lo\u00e3ng ti\u1ebfp dung d\u1ecbch \u0111\u00e3 pha tr\u01b0\u1edbc khi d\u00f9ng. S\u1eed d\u1ee5ng k\u0129 thu\u1eadt v\u00f4 khu\u1ea9n \u0111\u1ec3 l\u1ea5y m\u1ed9t l\u1ea7n m\u1ed9t th\u1ec3 t\u00edch thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ednh to\u00e1n li\u1ec1u d\u00f9ng trong s\u1ed1 40 ml dung d\u1ecbch thu\u1ed1c \u0111\u00e3 pha trong l\u1ecd chuy\u1ec3n v\u00e0o t\u00fai truy\u1ec1n r\u1ed7ng b\u1eb1ng ch\u1ea5t li\u1ec7u polyvinylchlorid (PVC), dung t\u00edch 250 ml. Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u v\u1ec1 t\u01b0\u01a1ng h\u1ee3p gi\u1eefa dung d\u1ecbch thu\u1ed1c v\u1edbi t\u00fai truy\u1ec1n kh\u00f4ng ph\u1ea3i PVC. Temozolomid \u0111\u01b0\u1ee3c d\u00f9ng theo \u0111\u01b0\u1eddng ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch trong v\u00f2ng 90 ph\u00fat b\u1eb1ng b\u01a1m truy\u1ec1n. D\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch c\u1ea7n \u0111\u01b0\u1ee3c l\u00e0m s\u1ea1ch tr\u01b0\u1edbc v\u00e0 sau m\u1ed7i l\u1ea7n truy\u1ec1n temozolomid. Kh\u00f4ng \u0111\u01b0a c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0o c\u00f9ng d\u00e2y truy\u1ec1n t\u0129nh m\u1ea1ch v\u1edbi temozolomid.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p><em>U nguy\u00ean b\u00e0o th\u1ea7n kinh \u0111\u1ec7m \u0111a h\u00ecnh:<\/em><\/p>\n<p><em>Giai \u0111o\u1ea1n ph\u1ed1i h\u1ee3p :<\/em> \u0110\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb, li\u1ec1u \u0111i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u theo \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c ti\u00eam t\u0129nh m\u1ea1ch c\u1ee7a temozolomid l\u00e0 75 mg\/ m<sup>2<\/sup> b\u1ec1 m\u1eb7t da\/ng\u00e0y, trong 42 ng\u00e0y, ph\u1ed1i h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb t\u1ea1i ch\u1ed7 (60 Gy cho l\u00e0m 30 ph\u00e2n \u0111o\u1ea1n). Kh\u00f4ng khuy\u1ebfn c\u00e1o gi\u1ea3m li\u1ec1u trong giai \u0111o\u1ea1n ph\u1ed1i h\u1ee3p nh\u01b0ng c\u00f3 th\u1ec3 ph\u1ea3i t\u1ea1m ng\u1eebng ho\u1eb7c ng\u1eebng h\u1eb3n vi\u1ec7c d\u00f9ng thu\u1ed1c n\u1ebfu xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh.<\/p>\n<p>N\u00ean l\u00e0m x\u00e9t nghi\u1ec7m c\u00f4ng th\u1ee9c m\u00e1u tr\u01b0\u1edbc v\u00e0 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb (h\u00e0ng tu\u1ea7n) b\u1eb1ng temozolomid. Ti\u00eau ch\u00ed quy\u1ebft \u0111\u1ecbnh ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c bao g\u1ed3m: B\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh tuy\u1ec7t \u0111\u1ed1i (ANC) &gt; 1 500\/ mm<sup>3<\/sup>, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u &gt; 100 000\/mm<sup>3<\/sup> v\u00e0 xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u c\u1ea5p \u0111\u1ed9 1 ho\u1eb7c kh\u00f4ng n\u1eb7ng (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n). N\u1ebfu \u0111\u1ea1t, n\u00ean th\u1ef1c hi\u1ec7n tr\u1ecb li\u1ec7u b\u1eb1ng temozolomid li\u00ean t\u1ee5c h\u00e0ng ng\u00e0y trong 42 ng\u00e0y (c\u00f3 th\u1ec3 l\u00ean t\u1edbi 49 ng\u00e0y).<\/p>\n<p>N\u00ean t\u1ea1m ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid n\u1ebfu ANC trong kho\u1ea3ng 500 &#8211; 1 499\/mm<sup>3<\/sup>, ho\u1eb7c s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong kho\u1ea3ng 10000 \u2013 99000\/mm<sup>3<\/sup>, ho\u1eb7c xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u \u1edf c\u1ea5p \u0111\u1ed9 2 (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n). C\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c tr\u1edf l\u1ea1i khi t\u1ea5t c\u1ea3 c\u00e1c ti\u00eau ch\u00ed tr\u00ean \u0111\u1ec1u \u0111\u1ea1t y\u00eau c\u1ea7u.<\/p>\n<p>Ng\u1eebng h\u1eb3n vi\u1ec7c d\u00f9ng thu\u1ed1c khi ANC &lt; 500\/mm<sup>3<\/sup>, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u &lt; 10 000\/mm<sup>3<\/sup>, ho\u1eb7c xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u \u1edf c\u1ea5p \u0111\u1ed9 3 v\u00e0 4 (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n). Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t k\u1ef3 bi\u1ec3u hi\u1ec7n \u0111\u1ed9c t\u00ednh n\u00e0o m\u00f4 t\u1ea3 \u1edf tr\u00ean s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng c\u00e1c ch\u1ebf \u0111\u1ed9 tr\u1ecb li\u1ec7u ph\u1ed1i h\u1ee3p c\u00f3 ch\u1ee9a temozolomid v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e9p \u00e1p d\u1ee5ng tr\u1ecb li\u1ec7u duy tr\u00ec.<\/p>\n<p><em>Giai \u0111o\u1ea1n duy tr\u00ec:<\/em> 4 tu\u1ea7n sau khi b\u1ec7nh nh\u00e2n ho\u00e0n th\u00e0nh tr\u1ecb li\u1ec7u ph\u1ed1i h\u1ee3p, b\u1eaft \u0111\u1ea7u ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb duy tr\u00ec, g\u1ed3m t\u1edbi 6 chu tr\u00ecnh n\u1ebfu dung n\u1ea1p \u0111\u01b0\u1ee3c. Trong th\u1eddi k\u1ef3 \u0111i\u1ec1u tr\u1ecb duy tr\u00ec, li\u1ec1u temozolomid cho ng\u00e0y 1 l\u1ea7n trong 5 ng\u00e0y, ti\u1ebfp theo l\u00e0 th\u1eddi gian ngh\u1ec9 thu\u1ed1c 23 ng\u00e0y trong 1 chu tr\u00ecnh 28 ng\u00e0y.<\/p>\n<p>Chu tr\u00ecnh 1 d\u00f9ng li\u1ec1u kh\u1edfi \u0111\u1ea7u u\u1ed1ng ho\u1eb7c ti\u00eam t\u0129nh m\u1ea1ch 150 mg\/ m<sup>2<\/sup> b\u1ec1 m\u1eb7t da\/ng\u00e0y m\u1ed9t l\u1ea7n, 5 ng\u00e0y li\u00ean t\u1ee5c, ti\u1ebfp theo l\u00e0 th\u1eddi gian ngh\u1ec9 thu\u1ed1c 23 ng\u00e0y.<\/p>\n<p>Li\u1ec1u c\u1ee7a chu tr\u00ecnh ti\u1ebfp theo \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c. X\u00e9t nghi\u1ec7m c\u00f4ng th\u1ee9c m\u00e1u tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb v\u00e0o ng\u00e0y 1 v\u00e0 v\u00e0o ng\u00e0y 22 (21 ng\u00e0y sau khi d\u00f9ng li\u1ec1u temozolomid \u0111\u1ea7u ti\u00ean) v\u00e0 sau \u0111\u00f3 theo d\u00f5i h\u00e0ng tu\u1ea7n. Kh\u00f4ng d\u00f9ng thu\u1ed1c ti\u1ebfp n\u1ebfu kh\u00f4ng \u0111\u1ea1t ti\u00eau ch\u00ed: ANC &gt; 1 500\/mm<sup>3<\/sup>, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u &gt; 100 000\/mm<sup>3<\/sup> v\u00e0 xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u c\u1ea5p \u0111\u1ed9 1 ho\u1eb7c kh\u00f4ng n\u1eb7ng (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n).<\/p>\n<p>\u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u00e1c ti\u00eau ch\u00ed sau chu tr\u00ecnh 1, c\u00f3 th\u1ec3 t\u0103ng li\u1ec1u l\u00ean 200 mg\/m<sup>2<\/sup> b\u1ec1 m\u1eb7t da\/ng\u00e0y m\u1ed9t l\u1ea7n, d\u00f9ng 5 ng\u00e0y li\u00ean t\u1ee5c cho chu tr\u00ecnh 2 v\u00e0 duy tr\u00ec m\u1ee9c li\u1ec1u n\u00e0y cho c\u00e1c chu tr\u00ecnh ti\u1ebfp theo n\u1ebfu \u0111\u1ea1t ti\u00eau ch\u00ed d\u00f9ng thu\u1ed1c.<\/p>\n<p>\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c trong chu tr\u00ecnh 1, kh\u00f4ng n\u00ean t\u0103ng li\u1ec1u \u1edf chu tr\u00ecnh 2 c\u0169ng nh\u01b0 c\u00e1c chu tr\u00ecnh ti\u1ebfp theo. N\u1ebfu c\u00f3 b\u1ea5t k\u00ec \u0111\u1ed9c t\u00ednh n\u00e0o sau \u0111\u00e2y, n\u00ean gi\u1ea3m 50 mg\/m<sup>2 <\/sup>cho m\u1ee9c li\u1ec1u temozolomid h\u00e0ng ng\u00e0y (v\u00ed d\u1ee5 t\u1eeb 150 mg\/m<sup>2<\/sup> xu\u1ed1ng 100 mg\/m<sup>2<\/sup>, ho\u1eb7c t\u1eeb 200 mg\/m<sup>2<\/sup> xu\u1ed1ng 150 mg\/m<sup>2<\/sup>) \u0111\u1ed1i v\u1edbi chu tr\u00ecnh ti\u1ebfp theo: ANC &lt; 1 000\/mm<sup>3<\/sup>, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u &lt; 50 000\/mm<sup>3<\/sup>, ho\u1eb7c ho\u1eb7c xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u \u1edf c\u1ea5p \u0111\u1ed9 3 (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n). C\u1ea7n ph\u1ea3i d\u1ef1a tr\u00ean m\u1ee9c th\u1ea5p nh\u1ea5t c\u1ee7a c\u00f4ng th\u1ee9c m\u00e1u v\u00e0 \u0111\u1ed9c t\u00ednh n\u1eb7ng nh\u1ea5t kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u c\u1ee7a chu tr\u00ecnh tr\u01b0\u1edbc \u0111\u1ec3 gi\u1ea3m li\u1ec1u cho chu tr\u00ecnh ti\u1ebfp theo. N\u00ean ng\u1eebng h\u1eb3n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid khi c\u00f3 b\u1ea5t k\u00ec ti\u00eau ch\u00ed n\u00e0o sau \u0111\u00e2y: Li\u1ec1u gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi 100 mg\/m<sup>2<\/sup> do \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c \u1edf chu tr\u00ecnh tr\u01b0\u1edbc, sau khi gi\u1ea3m li\u1ec1u t\u00e1i xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u \u1edf c\u1ea5p \u0111\u1ed9 3 (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n) ho\u1eb7c xu\u1ea5t hi\u1ec7n \u0111\u1ed9c t\u00ednh kh\u00f4ng ph\u1ea3i tr\u00ean h\u1ec7 t\u1ea1o m\u00e1u \u1edf c\u1ea5p \u0111\u1ed9 4 (ngo\u1ea1i tr\u1eeb r\u1ee5ng t\u00f3c, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n).<\/p>\n<p><em>U t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a:<\/em><\/p>\n<p><em>Li\u1ec1u kh\u1edfi \u0111\u1ea7u:<\/em> 150 mg\/m<sup>2<\/sup>\/ng\u00e0y trong 5 ng\u00e0y, l\u1eb7p l\u1ea1i li\u1ec1u c\u00e1ch nhau 28 ng\u00e0y.<\/p>\n<p><em>C\u00e1c li\u1ec1u ti\u1ebfp theo:<\/em> 100 &#8211; 200 mg\/m<sup>2<\/sup>\/ng\u00e0y trong 5 ng\u00e0y cho m\u1ed7i chu tr\u00ecnh \u0111i\u1ec1u tr\u1ecb, d\u1ef1a dung n\u1ea1p huy\u1ebft h\u1ecdc.<\/p>\n<p>ANC &lt; 1 000\/mm<sup>3<\/sup> ho\u1eb7c ti\u1ec3u c\u1ea7u &lt; 50 000\/mm<sup>3<\/sup> v\u00e0o ng\u00e0y 22 ho\u1eb7c ng\u00e0y 29 (ng\u00e0y 1 c\u1ee7a chu tr\u00ecnh sau): Ho\u00e3n \u0111i\u1ec1u tr\u1ecb cho t\u1edbi khi<\/p>\n<p>ANC &gt; 1 500\/mm<sup>3<\/sup> v\u00e0 ti\u1ec3u c\u1ea7u &gt; 100 000\/mm<sup>3<\/sup>; gi\u1ea3m li\u1ec1u kho\u1ea3ng 50 mg\/m<sup>2<\/sup>\/ng\u00e0y cho chu tr\u00ecnh sau.<\/p>\n<p>ANC t\u1eeb 1 000 &#8211; 1 500\/mm<sup>3<\/sup> ho\u1eb7c ti\u1ec3u c\u1ea7u 50 000 &#8211; 100 000\/mm<sup>3 <\/sup>v\u00e0o ng\u00e0y 22 ho\u1eb7c ng\u00e0y 29 (ng\u00e0y 1 c\u1ee7a chu tr\u00ecnh sau): Ho\u00e3n \u0111i\u1ec1u tr\u1ecb cho t\u1edbi khi ANC &gt; 1 500\/mm<sup>3<\/sup> v\u00e0 ti\u1ec3u c\u1ea7u &gt; 100 000; duy tr\u00ec li\u1ec1u kh\u1edfi \u0111\u1ea7u.<\/p>\n<p>ANC &gt; 1 500\/mm<sup>3<\/sup> v\u00e0 ti\u1ec3u c\u1ea7u &gt; 100 000\/mm<sup>3<\/sup> v\u00e0o ng\u00e0y 22 ho\u1eb7c ng\u00e0y 29 (ng\u00e0y 1 c\u1ee7a chu tr\u00ecnh sau): T\u0103ng li\u1ec1u t\u1edbi ho\u1eb7c duy tr\u00ec li\u1ec1u 200 mg\/m<sup>2<\/sup>\/ng\u00e0y cho chu tr\u00ecnh sau.<\/p>\n<p>C\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid \u0111\u1ebfn khi b\u1ec7nh ti\u1ebfn tri\u1ec3n. \u0110\u00e3 thi\u1ebft l\u1eadp \u0111\u01b0\u1ee3c ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid l\u00ean t\u1edbi 2 n\u0103m.<\/p>\n<p><em>Ng\u01b0\u1eddi suy gan v\u00e0 suy th\u1eadn:<\/em><\/p>\n<p>S\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi suy gan v\u00e0 suy th\u1eadn n\u1eb7ng. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi suy gan nh\u1eb9 v\u00e0 v\u1eeba, d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a thu\u1ed1c t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. \u0110\u1ed9 thanh th\u1ea3i c\u1ee7a thu\u1ed1c c\u0169ng kh\u00f4ng thay \u0111\u1ed5i tr\u00ean nh\u1eefng ng\u01b0\u1eddi c\u00f3 Cl trong kho\u1ea3ng 36 &#8211; 130 ml\/ph\u00fat\/m<sup>2<\/sup>.<\/p>\n<p><em>Ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 ph\u1ee5 n\u1eef:<\/em><\/p>\n<p>\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a, ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 ph\u1ee5 n\u1eef c\u00f3 nguy c\u01a1 x\u1ea3y ra suy t\u1ee7y cao h\u01a1n. Tuy nhi\u00ean, ch\u01b0a c\u00f3 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u n\u00e0o kh\u00e1c ngo\u00e0i vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u d\u1ef1a tr\u00ean ANC v\u00e0 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u.<\/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<h2><span class=\"ez-toc-section\" id=\"43-chong-chi-dinh\"><\/span>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>M\u1eabn c\u1ea3m v\u1edbi temozolomid v\u00e0 b\u1ea5t k\u00ec th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c. M\u1eabn c\u1ea3m v\u1edbi dacarbazin (v\u00ec c\u1ea3 hai thu\u1ed1c \u0111\u1ec1u b\u1ecb chuy\u1ec3n h\u00f3a th\u00e0nh MTIC).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"44-than-trong\"><\/span>4.4 Th\u1eadn tr\u1ecdng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Do \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c 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&#8230;). 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.<\/p>\n<p>\u0110\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 d\u00f9ng thu\u1ed1c kh\u00f4ng \u0111\u00fang li\u1ec1u, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c d\u00f9ng d\u1ea1ng b\u00e0o ch\u1ebf ph\u00f9 h\u1ee3p v\u1edbi m\u1ee9c li\u1ec1u h\u00e0ng ng\u00e0y v\u00e0 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn chi ti\u1ebft v\u1ec1 ch\u1ebf \u0111\u1ed9 li\u1ec1u d\u00f9ng.<\/p>\n<p>Tr\u00ean t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng temozolomid, gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00e0 gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh l\u00e0 c\u00e1c \u0111\u1ed9c t\u00ednh ph\u1ee5 thu\u1ed9c li\u1ec1u. Gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u k\u00e9o d\u00e0i c\u00f3 th\u1ec3 g\u00e2y ra thi\u1ebfu m\u00e1u b\u1ea5t s\u1ea3n, \u0111\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed9c t\u00ednh \u1edf m\u1ee9c \u0111\u1ed9 nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng. Tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u nguy\u00ean b\u00e0o \u0111\u1ec7m th\u1ea7n kinh \u0111a h\u00ecnh m\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, b\u1ea5t th\u01b0\u1eddng v\u1ec1 ti\u1ec3u c\u1ea7u \u1edf c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4, k\u1ec3 c\u1ea3 gi\u1ea3m ti\u1ec3u c\u1ea7u x\u1ea3y ra \u1edf 14% b\u1ec7nh nh\u00e2n v\u00e0 b\u1ea5t th\u01b0\u1eddng v\u1ec1 b\u1ea1ch c\u1ea7u trung t\u00ednh \u1edf c\u1ea5p \u0111\u1ed9 3 ho\u1eb7c 4, k\u1ec3 c\u1ea3 gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh x\u1ea3y ra \u1edf 8% b\u1ec7nh nh\u00e2n. Tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a, nguy c\u01a1 gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00e0\/ho\u1eb7c gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh c\u1ea5p \u0111\u1ed9 4 x\u1ea3y ra cao h\u01a1n \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 ph\u1ee5 n\u1eef. \u0110\u1ed9c t\u00ednh th\u01b0\u1eddng x\u1ea3y ra v\u00e0o cu\u1ed1i chu tr\u00ecnh, b\u1ea5t th\u01b0\u1eddng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n sau 26 ng\u00e0y v\u00e0 b\u1ea5t th\u01b0\u1eddng b\u1ea1ch c\u1ea7u trung t\u00ednh sau 28 ng\u00e0y c\u1ee7a chu tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. C\u00e1c \u0111\u1ed9c t\u00ednh n\u00e0y th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf nh\u1eefng chu tr\u00ecnh \u0111\u1ea7u ti\u00ean, ph\u1ee5c h\u1ed3i trong v\u00f2ng 14 ng\u00e0y v\u00e0 kh\u00f4ng t\u00edch l\u0169y. C\u00f3 th\u1ec3 ph\u1ea3i nh\u1eadp vi\u1ec7n, truy\u1ec1n m\u00e1u ho\u1eb7c ng\u1eebng thu\u1ed1c \u0111\u1ec3 gi\u1ea3i quy\u1ebft nguy c\u01a1 suy t\u1ee7y. C\u1ea7n \u0111\u1ecbnh k\u00ec ki\u1ec3m tra c\u00f4ng th\u1ee9c m\u00e1u, \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u, t\u1ea1m ng\u1eebng ho\u1eb7c ng\u1eebng tr\u1ecb li\u1ec7u \u0111\u1ec3 gi\u1ea3m \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c.<\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm g\u1eb7p h\u1ed9i ch\u1ee9ng lo\u1ea1n s\u1ea3n t\u1ee7y v\u00e0 u \u00e1c t\u00ednh th\u1ee9 ph\u00e1t, bao g\u1ed3m c\u1ea3 b\u1ea1ch c\u1ea7u c\u1ea5p d\u00f2ng t\u1ee7y.<\/p>\n<p>C\u00f3 th\u1ec3 g\u1eb7p vi\u00eam ph\u1ed5i do <em>Pneumocystis jiroveci (Pneumocystis carinii<\/em>), nguy c\u01a1 gia t\u0103ng khi ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb c\u00f3 ch\u1ee9a corticoid ho\u1eb7c khi d\u00f9ng thu\u1ed1c d\u00e0i ng\u00e0y. Gi\u00e1m s\u00e1t ch\u1eb7t ch\u1ebd kh\u1ea3 n\u0103ng vi\u00eam ph\u1ed5i do <em>Pneumocystis jiroveci<\/em> (<em>Pneumocystis carinii<\/em>) tr\u00ean t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n. C\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng vi\u00eam ph\u1ed5i do <em>Pneumocystis jiroveci<\/em> \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n x\u1ea1 tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi ph\u00e1c \u0111\u1ed3 d\u00f9ng temozolomid 42 ng\u00e0y; ti\u1ebfp t\u1ee5c d\u1ef1 ph\u00f2ng tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m lympho b\u00e0o cho \u0111\u1ebfn khi c\u1ea3i thi\u1ec7n (c\u1ea5p \u0111\u1ed9 1 ho\u1eb7c h\u01a1n).<\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 kh\u1ea3 n\u0103ng t\u00e1i ho\u1ea1t \u0111\u1ed9ng c\u1ee7a vi\u00eam gan virus B g\u00e2y t\u1eed vong tr\u00ean ng\u01b0\u1eddi d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u nguy\u00ean b\u00e0o th\u1ea7n kinh \u0111\u1ec7m. C\u1ea7n s\u00e0ng l\u1ecdc vi\u00eam gan v\u00e0 d\u00f9ng thu\u1ed1c kh\u00e1ng virus \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng cho b\u1ec7nh nh\u00e2n d\u00f9ng temozolomid.<\/p>\n<p><em>S\u1eed d\u1ee5ng \u1edf b\u1ec7nh nh\u00e2n suy ch\u1ee9c n\u0103ng gan ho\u1eb7c th\u1eadn:<\/em><\/p>\n<p>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a temozolomide l\u00e0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng khi so s\u00e1nh gi\u1eefa b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng gan b\u00ecnh th\u01b0\u1eddng v\u1edbi b\u1ec7nh nh\u00e2n suy gan nh\u1eb9 v\u00e0 trung b\u00ecnh. Ch\u01b0a c\u00f3 d\u1eef li\u1ec7u c\u00f3 gi\u00e1 tr\u1ecb khi d\u00f9ng Temodal v\u1edbi b\u1ec7nh nh\u00e2n suy ch\u1ee9c n\u0103ng gan nghi\u00eam tr\u1ecdng (Child&#8217;s lo\u1ea1i III) ho\u1eb7c suy ch\u1ee9c n\u0103ng th\u1eadn. D\u1ef1a v\u00e0o c\u00e1c t\u00ednh ch\u1ea5t d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a temozolomide, kh\u00f4ng ch\u1eafc c\u1ea7n gi\u1ea3m li\u1ec1u cho b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n n\u1eb7ng ch\u1ee9c n\u0103ng gan ho\u1eb7c th\u1eadn. Tuy nhi\u00ean, v\u1eabn c\u1ea7n th\u1eadn tr\u1ecdng khi d\u00f9ng Temodal cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng tr\u00ean.<\/p>\n<p><em>S\u1eed d\u1ee5ng \u1edf tr\u1ebb em: <\/em><\/p>\n<p>U nguy\u00ean b\u00e0o th\u1ea7n kinh \u0111a d\u1ea1ng: Ch\u01b0a c\u00f3 kinh nghi\u1ec7m l\u00e2m s\u00e0ng khi d\u00f9ng Temodal \u1edf tr\u1ebb em d\u01b0\u1edbi 3 n\u0103m tu\u1ed5i. Kinh nghi\u1ec7m c\u00f2n h\u1ea1n ch\u1ebf khi d\u00f9ng cho tr\u1ebb em tr\u00ean 3 n\u0103m tu\u1ed5i b\u1ecb u nguy\u00ean b\u00e0o th\u1ea7n kinh \u0111\u1ec7m. U s\u1eafc t\u1ed1: ch\u01b0a c\u00f3 kinh nghi\u1ec7m l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 18 tu\u1ed5i.<\/p>\n<p><em>S\u1eed d\u1ee5ng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i:<\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n cao tu\u1ed5i (&gt; 70 tu\u1ed5i) c\u00f3 t\u0103ng nguy c\u01a1 gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh v\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u so v\u1edbi b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i.<\/p>\n<p><em>B\u1ec7nh nh\u00e2n nam: <\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n nam khi d\u00f9ng Temodal c\u1ea7n \u00e1p d\u1ee5ng Ph\u01b0\u01a1ng ph\u00e1p ng\u1eeba thai h\u1eefu hi\u1ec7u. Temozolomide c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng \u0111\u1ed9c v\u1edbi di truy\u1ec1n. V\u00ec v\u1eady, nam gi\u1edbi d\u00f9ng temozolomide c\u1ea7n \u0111\u01b0\u1ee3c d\u1eb7n d\u00f2 kh\u00f4ng \u0111\u01b0\u1ee3c c\u00f3 con trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb, k\u1ec3 c\u1ea3 trong v\u00f2ng 6 th\u00e1ng sau khi \u0111\u00e3 ng\u1eebng d\u00f9ng thu\u1ed1c v\u00e0 y\u00eau c\u1ea7u gi\u1eef \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng tr\u01b0\u1edbc khi kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, v\u00ec c\u00f3 kh\u1ea3 n\u0103ng v\u00f4 sinh kh\u00f4ng h\u1ed3i ph\u1ee5c do d\u00f9ng temozolomide.<\/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>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<h2><span class=\"ez-toc-section\" id=\"45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\"><\/span>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<span class=\"ez-toc-section-end\"><\/span><\/h2>\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: D<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c cho b\u00e0o thai. Tr\u00ean \u0111\u1ed9ng v\u1eadt th\u00ed nghi\u1ec7m, thu\u1ed1c g\u00e2y d\u1ecb t\u1eadt thai v\u00e0 \u0111\u1ed9c ph\u00f4i \u1edf m\u1ee9c li\u1ec1u th\u1ea5p h\u01a1n li\u1ec1u d\u00f9ng tr\u00ean ng\u01b0\u1eddi. Kh\u00f4ng n\u00ean mang thai trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. 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<p>\u0110\u1ed1i v\u1edbi nam gi\u1edbi, tr\u00e1nh c\u00f3 con \u00edt nh\u1ea5t 6 th\u00e1ng sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Kh\u00f4ng r\u00f5 temozolomid 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 v\u00ec kh\u1ea3 n\u0103ng nguy c\u01a1 tr\u00ean nh\u0169 nhi.<\/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<h2><span class=\"ez-toc-section\" id=\"46-tac-dung-khong-mong-muon-adr\"><\/span>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Tr\u00ean b\u1ec7nh nh\u00e2n u n\u00e3o, r\u1ea5t kh\u00f3 ph\u00e2n bi\u1ec7t ADR c\u1ee7a thu\u1ed1c tr\u00ean TKTW v\u1edbi tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh ti\u1ebfn tri\u1ec3n.<\/p>\n<p>Tr\u00ean nh\u1eefng ng\u01b0\u1eddi d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u nguy\u00ean b\u00e0o \u0111\u1ec7m \u0111a h\u00ecnh m\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, c\u00e1c ADR th\u01b0\u1eddng g\u1eb7p nh\u1ea5t bao g\u1ed3m r\u1ee5ng t\u00f3c, m\u1ec7t m\u1ecfi, bu\u1ed3n n\u00f4n, n\u00f4n, ch\u00e1n \u0103n, \u0111au \u0111\u1ea7u, t\u00e1o b\u00f3n. Kho\u1ea3ng m\u1ed9t n\u1eeda (49%) s\u1ed1 ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c tr\u1ea3i qua \u00edt nh\u1ea5t m\u1ed9t t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n nghi\u00eam tr\u1ecdng ho\u1eb7c \u0111e d\u1ecda t\u00ednh m\u1ea1ng, ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 m\u1ec7t m\u1ecfi (13%), co gi\u1eadt (6%), \u0111au \u0111\u1ea7u (5%), gi\u1ea3m ti\u1ec3u c\u1ea7u (5%).<\/p>\n<p>Tr\u00ean nh\u1eefng ng\u01b0\u1eddi d\u00f9ng temozolomid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u t\u1ebf b\u00e0o h\u00ecnh sao m\u1ea5t bi\u1ec7t h\u00f3a, c\u00e1c ADR th\u01b0\u1eddng g\u1eb7p nh\u1ea5t bao g\u1ed3m bu\u1ed3n n\u00f4n, n\u00f4n, \u0111au \u0111\u1ea7u, m\u1ec7t m\u1ecfi. ADR th\u01b0\u1eddng \u1edf m\u1ee9c \u0111\u1ed9 nh\u1eb9 v\u00e0 v\u1eeba. Tri\u1ec7u ch\u1ee9ng bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n m\u1ee9c \u0111\u1ed9 n\u1eb7ng g\u1eb7p v\u1edbi t\u1ef7 l\u1ec7 t\u01b0\u01a1ng \u1ee9ng l\u00e0 10% v\u00e0 6% s\u1ed1 ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c.<\/p>\n<p>Nh\u1eefng ng\u01b0\u1eddi d\u00f9ng temozolomid theo \u0111\u01b0\u1eddng ti\u00eam truy\u1ec1n c\u00f3 th\u1ec3 g\u1eb7p m\u1ed9t s\u1ed1 ADR kh\u00f4ng c\u00f3 \u1edf ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c theo \u0111\u01b0\u1eddng u\u1ed1ng nh\u01b0 \u0111au, k\u00edch \u1ee9ng, ng\u1ee9a, n\u00f3ng r\u00e1t, s\u01b0ng, ban da t\u1ea1i ch\u1ed7 ti\u00eam, xu\u1ea5t huy\u1ebft v\u00e0 t\u1ee5 m\u00e1u.<\/p>\n<p><em>T\u1ef7 l\u1ec7 g\u1eb7p ADR \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o nh\u01b0 sau:<\/em><\/p>\n<p><em>Tim m\u1ea1ch<\/em>: Ph\u00f9 ngo\u1ea1i vi (11%).<\/p>\n<p><em>TKTW<\/em>: M\u1ec7t m\u1ecfi (34 &#8211; 61%), \u0111au \u0111\u1ea7u (23 &#8211; 41%), \u0111\u1ed9ng kinh (6 &#8211; 23%), li\u1ec7t n\u1eeda ng\u01b0\u1eddi (18%), s\u1ed1t (13%), ch\u00f3ng m\u1eb7t (5 &#8211; 12%), m\u1ea5t \u0111i\u1ec1u v\u1eadn (11%), m\u1ea5t tr\u00ed nh\u1edb (10%), m\u1ea5t ng\u1ee7 (4 &#8211; 10%), ng\u1ee7 g\u00e0 (9%), m\u1ea5t \u0111i\u1ec1u h\u00f2a (8%), li\u1ec7t nh\u1eb9 (8%), lo \u00e2u (7%), suy gi\u1ea3m tr\u00ed nh\u1edb (7%), tr\u1ea7m c\u1ea3m (6%), l\u1eabn (5%).<\/p>\n<p><em>Da li\u1ec5u<\/em>: R\u1ee5ng t\u00f3c (55%), \u0111\u1ecf da (8 &#8211; 13%), ng\u1ee9a (5 &#8211; 8%), kh\u00f4 da (5%), ban \u0111\u1ecf (1%).<\/p>\n<p><em>Ti\u00eau h\u00f3a<\/em>: Bu\u1ed3n n\u00f4n (49 &#8211; 53%, c\u1ea5p \u0111\u1ed9 3\/4: 1 &#8211; 10%), n\u00f4n (29 &#8211; 42%, c\u1ea5p \u0111\u1ed9 3\/4: 2 &#8211; 6%), t\u00e1o b\u00f3n (22 &#8211; 33%), ch\u00e1n \u0103n (9 &#8211; 27%), ti\u00eau ch\u1ea3y (10 &#8211; 16%), vi\u00eam mi\u1ec7ng (9%), \u0111au b\u1ee5ng (5 &#8211; 9%), kh\u00f3 nu\u1ed1t (7%), r\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c (5%), t\u0103ng c\u00e2n (5%).<\/p>\n<p><em>H\u1ec7 t\u1ea1o m\u00e1u:<\/em> Gi\u1ea3m lympho b\u00e0o (c\u1ea5p \u0111\u1ed9 3\/4: 55%), gi\u1ea3m ti\u1ec3u c\u1ea7u (c\u1ea5p \u0111\u1ed9 3\/4: Ng\u01b0\u1eddi l\u1edbn: 4 &#8211; 19%; tr\u1ebb em: 25%), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh (c\u1ea5p \u0111\u1ed9 3\/4: Ng\u01b0\u1eddi l\u1edbn: 8 &#8211; 14%; tr\u1ebb em: 20%), gi\u1ea3m b\u1ea1ch c\u1ea7u (c\u1ea5p \u0111\u1ed9 3\/4: 11%), thi\u1ebfu m\u00e1u (c\u1ea5p \u0111\u1ed9 3\/4: 4%).<\/p>\n<p><em>Th\u1ea7n kinh c\u01a1 v\u00e0 x\u01b0\u01a1ng<\/em>: Y\u1ebfu c\u01a1 (7 &#8211; 13%), d\u1ecb c\u1ea3m (9%), \u0111au l\u01b0ng (8%), \u0111i kh\u1eadp khi\u1ec5ng (6%), \u0111au kh\u1edbp (6%), \u0111au c\u01a1 (5%).<\/p>\n<p><em>N\u1ed9i ti\u1ebft v\u00e0 chuy\u1ec3n h\u00f3a<\/em>: T\u0103ng n\u0103ng v\u1ecf tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn (8%), \u0111au ng\u1ef1c (\u1edf ph\u1ee5 n\u1eef: 6%).<\/p>\n<p><em>Ti\u1ebft ni\u1ec7u<\/em>: M\u1ea5t ch\u1ee7 \u0111\u1ed9ng (8%), nhi\u1ec5m khu\u1ea9n ti\u1ebft ni\u1ec7u (8%), ti\u1ec3u r\u1eaft (6%).<\/p>\n<p><em>M\u1eaft<\/em>: Nh\u00ecn m\u1edd (5 &#8211; 8%), song th\u1ecb (5%), gi\u1ea3m th\u1ecb l\u1ef1c (5%).<\/p>\n<p><em>H\u00f4 h\u1ea5p<\/em>: Vi\u00eam h\u1ecdng (8%), nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean (8%), ho (5 &#8211; 8%), vi\u00eam xoang (6%), kh\u00f3 th\u1edf (5%).<\/p>\n<p><em>Kh\u00e1c<\/em>: Nhi\u1ec5m virus (11%), ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng (\u0111\u1ebfn 3%).<\/p>\n<p><em>Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<h2><span class=\"ez-toc-section\" id=\"47-huong-dan-cach-xu-tri-adr\"><\/span>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>C\u00f3 kh\u1ea3 n\u0103ng g\u1eb7p nhi\u1ec5m khu\u1ea9n c\u01a1 h\u1ed9i nh\u01b0 vi\u00eam ph\u1ed5i do <em>Pneumocystis jiroveci (Pneumocystis carnii)<\/em> tr\u00ean b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng temozolomid. Nguy c\u01a1 c\u00e0ng cao khi th\u1eddi gian \u0111i\u1ec1u tr\u1ecb c\u00e0ng k\u00e9o d\u00e0i. C\u1ea7n \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng (v\u00ed d\u1ee5 d\u00f9ng pentamidin d\u1ea1ng h\u00edt ho\u1eb7c co-trimoxazol theo \u0111\u01b0\u1eddng u\u1ed1ng) cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n d\u00f9ng ph\u00e1c \u0111\u1ed3 temozolomid 42 ng\u00e0y k\u1ebft h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb. Tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng gi\u1ea3m lympho b\u00e0o trong giai \u0111o\u1ea1n \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p, c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng cho \u0111\u1ebfn khi ph\u1ee5c h\u1ed3i. Ph\u1ea3i gi\u00e1m s\u00e1t ch\u1eb7t ch\u1ebd nguy c\u01a1 vi\u00eam ph\u1ed5i do <em>Pneumocystis jiroveci (Pneumocystis carnii)<\/em> \u0111\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n d\u00f9ng temozolomid, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 d\u00f9ng k\u1ebft h\u1ee3p corticoid.<\/p>\n<p>C\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c ch\u1ed1ng n\u00f4n \u0111\u1ebf gi\u1ea3m b\u1edbt tri\u1ec7u ch\u1ee9ng bu\u1ed3n n\u00f4n, n\u00f4n.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"48-tuong-tac-voi-cac-thuoc-khac\"><\/span>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Temozolomid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a natalizumab, v\u1eafc xin s\u1ed1ng.<\/p>\n<p>Tr\u00e1nh ph\u1ed1i h\u1ee3p temozolomid v\u1edbi natalizumab, v\u1eafc xin s\u1ed1ng.<\/p>\n<p>Tr\u00e1nh ph\u1ed1i h\u1ee3p c\u00e1c thu\u1ed1c g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o (trong \u0111\u00f3 c\u00f3 temozolomid) v\u1edbi clozapin do gia t\u0103ng nguy c\u01a1 m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t.<\/p>\n<p>Valproat l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 huy\u1ebft t\u01b0\u01a1ng c\u1ee7a temozolomid.<\/p>\n<p>Trastuzumab c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a temozolomid.<\/p>\n<p>Temozolomid c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a v\u1eafc xin b\u1ea5t ho\u1ea1t.<\/p>\n<p>Echinacea l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9\/t\u00e1c d\u1ee5ng c\u1ee7a temozolomid.<\/p>\n<p>Temozolomid v\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a MTIC ch\u1ec9 chuy\u1ec3n h\u00f3a t\u1ed1i thi\u1ec3u qua isoenzym gan. Ch\u01b0a r\u00f5 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a c\u00e1c thu\u1ed1c c\u00f3 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn enzym chuy\u1ec3n h\u00f3a \u1edf gan v\u1edbi temozolomid.<\/p>\n<p>Ch\u01b0a r\u00f5 \u1ea3nh h\u01b0\u1edfng c\u1ee7a carbamazepin v\u00e0 co\u00adtrimoxazol \u0111\u1ebfn \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a temozolomid, tuy nhi\u00ean n\u00ean l\u01b0u \u00fd kh\u1ea3 n\u0103ng t\u0103ng \u0111\u1ed9c t\u00ednh huy\u1ebft h\u1ecdc (v\u00ed d\u1ee5 thi\u1ebfu m\u00e1u b\u1ea5t s\u1ea3n).<\/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<h2><span class=\"ez-toc-section\" id=\"49-qua-lieu-va-xu-tri\"><\/span>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p qu\u00e1 li\u1ec1u, \u0111\u00e1nh gi\u00e1 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a m\u00e1u.\u00a0C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi c\u1ea7n thi\u1ebft.<\/p>\n<h1><span class=\"ez-toc-section\" id=\"5-co-che-tac-dung-cua-thuoc\"><\/span>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"51-duoc-luc-hoc\"><\/span>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Temozolomid l\u00e0 thu\u1ed1c ch\u1ed1ng ung th\u01b0, d\u1eabn xu\u1ea5t t\u1eeb imidazotetrazin. Thu\u1ed1c temozolomide \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh ung th\u01b0 n\u00e3o. \u0110\u00e2y l\u00e0 m\u1ed9t thu\u1ed1c h\u00f3a tr\u1ecb li\u1ec7u ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch l\u00e0m ch\u1eadm s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o ung th\u01b0. Thu\u1ed1c n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh ung th\u01b0 kh\u00e1c nh\u01b0 ung th\u01b0 x\u01b0\u01a1ng.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Temozolomid l\u00e0 m\u1ed9t ti\u1ec1n thu\u1ed1c kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd cho t\u1edbi khi b\u1ecb th\u1ee7y ph\u00e2n <em>in vivo<\/em> th\u00e0nh ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a temozolomid l\u00e0 5-(3-methyltriazen-1-yl) imidazol-4-carboxamid (MTIC) t\u00e1c d\u1ee5ng l\u00ean nhi\u1ec1u pha c\u1ee7a chu k\u00ec t\u1ebf b\u00e0o. MTIC g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o theo c\u01a1 ch\u1ebf c\u1ee7a t\u00e1c nh\u00e2n alkyl h\u00f3a, t\u1ea1i v\u1ecb tr\u00ed O<sup>6<\/sup> v\u00e0 N<sup>7<\/sup> c\u1ee7a guanin trong ADN.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<h2><span class=\"ez-toc-section\" id=\"52-duoc-dong-hoc\"><\/span>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><em>H\u1ea5p thu:<\/em> Temozolomid h\u1ea5p thu nhanh v\u00e0 ho\u00e0n to\u00e0n qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, sinh kh\u1ea3 d\u1ee5ng theo \u0111\u01b0\u1eddng u\u1ed1ng x\u1ea5p x\u1ec9 100%. Thu\u1ed1c \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng trong v\u00f2ng 1 gi\u1edd sau khi u\u1ed1ng. Th\u1ee9c \u0103n l\u00e0m gi\u1ea3m t\u1ed1c \u0111\u1ed9 v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1ea5p thu.<\/p>\n<p><em>Ph\u00e2n b\u1ed1:<\/em> Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 c\u1ee7a thu\u1ed1c m\u1eb9 l\u00e0 0,4 l\u00edt\/kg, t\u1ef7 l\u1ec7 g\u1eafn k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng kho\u1ea3ng 15%. Thu\u1ed1c x\u00e2m nh\u1eadp t\u1ed1t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o nh\u01b0ng ch\u01b0a r\u00f5 c\u00f3 ph\u00e2n b\u1ed1 v\u00e0o s\u1eefa m\u1eb9 hay kh\u00f4ng.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em>: Temozolomid l\u00e0 ti\u1ec1n thu\u1ed1c, \u0111\u01b0\u1ee3c bi\u1ebfn \u0111\u1ed5i nhanh nh\u1edd qu\u00e1 tr\u00ecnh th\u1ee7y ph\u00e2n kh\u00f4ng th\u00f4ng qua enzym t\u1ea1i pH sinh l\u00fd th\u00e0nh MTIC. Sau \u0111\u00f3, MTIC \u0111\u01b0\u1ee3c th\u1ee7y ph\u00e2n ti\u1ebfp th\u00e0nh 5-amino- imidazol-4-carboxamid (AIC) v\u00e0 chuy\u1ec3n th\u00e0nh methyl hydrazin. Cytocrom P<sub>450<\/sub> c\u00f3 vai tr\u00f2 kh\u00f4ng \u0111\u00e1ng k\u1ec3 trong qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a c\u1ee7a temozolomid v\u00e0 MTIC.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em>: Sau 7 ng\u00e0y, kho\u1ea3ng 38% li\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb, ch\u1ee7 y\u1ebfu qua n\u01b0\u1edbc ti\u1ec3u v\u00e0 kho\u1ea3ng d\u01b0\u1edbi 1% qua ph\u00e2n. N\u1eeda \u0111\u1eddi c\u1ee7a temozolomid kho\u1ea3ng 1,8 gi\u1edd; n\u1eeda \u0111\u1eddi bi\u1ec3u ki\u1ebfn c\u1ee7a c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a MTIC v\u00e0 AIC l\u1ea7n l\u01b0\u1ee3t l\u00e0 2,1 v\u00e0 2,6 gi\u1edd.<\/p>\n<p>D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi suy gan m\u1ee9c \u0111\u1ed9 nh\u1eb9 v\u00e0 v\u1eeba t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng gan b\u00ecnh th\u01b0\u1eddng. \u0110\u1ed9 thanh th\u1ea3i c\u1ee7a temozolomid kh\u00f4ng b\u1ecb thay \u0111\u1ed5i tr\u00ean nh\u1eefng ng\u01b0\u1eddi c\u00f3 Cl trong kho\u1ea3ng 36 &#8211; 130 ml\/ph\u00fat\/m<sup>2<\/sup>. Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a temozolomid tr\u00ean ng\u01b0\u1eddi suy th\u1eadn n\u1eb7ng (Cl &lt; 36 ml\/ph\u00fat\/m<sup>2<\/sup>) v\u00e0 tr\u00ean b\u1ec7nh nh\u00e2n th\u1ea5m t\u00e1ch.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"53-giai-thich\"><\/span>5.3 Gi\u1ea3i th\u00edch:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"54-thay-the-thuoc\"><\/span>5.4 Thay th\u1ebf thu\u1ed1c :<span class=\"ez-toc-section-end\"><\/span><\/h2>\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<h1><span class=\"ez-toc-section\" id=\"6-phan-thong-tin-kem-theo-cua-thuoc\"><\/span>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"61-danh-muc-ta-duoc\"><\/span>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"62-tuong-ky\"><\/span>6.2. T\u01b0\u01a1ng k\u1ef5 :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"63-bao-quan\"><\/span>6.3. B\u1ea3o qu\u1ea3n:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Vi\u00ean nang \u0111\u01b0\u1ee3c b\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (15 &#8211; 30 <sup>o<\/sup>C).<\/p>\n<p>L\u1ecd thu\u1ed1c ti\u00eam \u0111\u01b0\u1ee3c b\u1ea3o qu\u1ea3n \u1edf 2 &#8211; 8 <sup>o<\/sup>C. Dung d\u1ecbch \u0111\u00e3 pha c\u00f3 th\u1ec3 b\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (25 <sup>o<\/sup>C) t\u1edbi 14 gi\u1edd (bao g\u1ed3m c\u1ea3 th\u1eddi gian truy\u1ec1n).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"64-thong-tin-khac\"><\/span>6.4. Th\u00f4ng tin kh\u00e1c :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Kh\u00f4ng c\u00f3.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"65-tai-lieu-tham-khao\"><\/span>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>Ho\u1eb7c HDSD Thu\u1ed1c.<\/p>\n<h1><span class=\"ez-toc-section\" id=\"7-nguoi-dang-tai-tac-gia\"><\/span>7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<span class=\"ez-toc-section-end\"><\/span><\/h1>\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 Temozolomid 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 Temozolomid (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 : Temozolomide Ph\u00e2n lo\u1ea1i: Thu\u1ed1c ch\u1ed1ng ung th\u01b0. Nh\u00f3m [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":37285,"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":[2],"tags":[1469,1468],"class_list":["post-4057","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-thuoc-a-z","tag-temozolomid","tag-temozolomide"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/4057","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=4057"}],"version-history":[{"count":4,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/4057\/revisions"}],"predecessor-version":[{"id":9277,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/4057\/revisions\/9277"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/37285"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=4057"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=4057"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=4057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}