{"id":58494,"date":"2023-04-23T16:53:57","date_gmt":"2023-04-23T09:53:57","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=58494"},"modified":"2025-01-07T16:44:21","modified_gmt":"2025-01-07T09:44:21","slug":"hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/","title":{"rendered":"Hydrochlorothiazide + Olmesartan &#8211; Zokora-HCTZ\/Andirel-HCTZ"},"content":{"rendered":"<h1><span class=\"ez-toc-section\" id=\"thong-tin-to-huong-dan-su-dung-cua-thuoc-zokora-hctz-andirel-hctz\"><\/span>Th\u00f4ng tin t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c Zokora-HCTZ, Andirel-HCTZ<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><em>D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a Thu\u1ed1c Zokora-HCTZ, Andirel-HCTZ (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\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#thong-tin-to-huong-dan-su-dung-cua-thuoc-zokora-hctz-andirel-hctz\" >Th\u00f4ng tin t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c Zokora-HCTZ, Andirel-HCTZ<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#3-video-by-pharmog\" >3. Video by Pharmog:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#4-ung-dung-lam-sang\" >4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#41-chi-dinh\" >4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#43-chong-chi-dinh\" >4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#44-than-trong\" >4.4 Th\u1eadn tr\u1ecdng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#53-hieu-qua-lam-sang\" >5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#54-du-lieu-tien-lam-sang\" >5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-3'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#62-tuong-ky\" >6.2. T\u01b0\u01a1ng k\u1ef5 :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#63-bao-quan\" >6.3. B\u1ea3o qu\u1ea3n:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#64-thong-tin-khac\" >6.4. Th\u00f4ng tin kh\u00e1c :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#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-2'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan-zokora-hctz-andirel-hctz\/#7-nguoi-dang-tai-tac-gia\" >7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<h2><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><\/h2>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em><\/strong> <a href=\"https:\/\/pharmog.com\/wp\/hydrochlorothiazide-olmesartan\/\"><strong>Hydrochlorothiazide + Olmesartan<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p.<\/em> <em>Da\u0323ng k\u00ea\u0301t h\u01a1\u0323p<\/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): C09DA08.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong><\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c:<\/em><\/strong> Zokora-HCTZ, Andirel-HCTZ<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: C\u00f4ng ty C\u1ed5 ph\u1ea7n D\u01b0\u1ee3c ph\u1ea9m \u0110\u1ea1t Vi Ph\u00fa<\/p>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" crossorigin=\"anonymous\"><\/script><br \/>\n<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>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script><\/p>\n<h2><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><\/h2>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Vi\u00ean n\u00e9n bao phim, m\u1ed7i vi\u00ean ch\u1ee9a Olmesartan medoxomil 20mg; Hydroclorothiazid 12.5 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>ZOKORA-HCTZ 20\/12,5<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i vi\u00ean n\u00e9n bao phim c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Olmesartan<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>20 mg<\/td>\n<\/tr>\n<tr>\n<td>Hydrochlorothiazide<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>12.5 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\" class=\"alignnone wp-image-58496\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2023\/04\/zokora-hctz-20-125-hydrochlorothiazide-olmesar.png\" alt=\"Zokora-HCTZ 20\/12,5 (Hydrochlorothiazide + Olmesartan)\" width=\"770\" height=\"415\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2023\/04\/zokora-hctz-20-125-hydrochlorothiazide-olmesar.png 970w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2023\/04\/zokora-hctz-20-125-hydrochlorothiazide-olmesar-300x162.png 300w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2023\/04\/zokora-hctz-20-125-hydrochlorothiazide-olmesar-768x414.png 768w\" sizes=\"auto, (max-width: 770px) 100vw, 770px\" \/><\/p>\n<h2><span class=\"ez-toc-section\" id=\"3-video-by-pharmog\"><\/span>3. Video by Pharmog:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><a id=\"post-58494-_Hlk112189828\"><\/a><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog SS1 - T\u1eadp 11] - D\u01b0\u1ee3c l\u00fd v\u1ec1 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/F1Pl4DO5flA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<h2><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><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"41-chi-dinh\"><\/span>4.1. Ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ph\u1ed1i h\u1ee3p olmesartan medoxomil v\u00e0 hydroclorothiazid \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/p>\n<p>Vi\u00ean k\u1ebft h\u1ee3p kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/p>\n<h3><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><\/h3>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>Thu\u1ed1c d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng. U\u1ed1ng nguy\u00ean vi\u00ean v\u1edbi nhi\u1ec1u n\u01b0\u1edbc (v\u00ed d\u1ee5: M\u1ed9t ly n\u01b0\u1edbc). Kh\u00f4ng \u0111\u01b0\u1ee3c nhai vi\u00ean thu\u1ed1c v\u00e0 n\u00ean u\u1ed1ng thu\u1ed1c \u0111\u1ec1u \u0111\u1eb7n v\u00e0o c\u00f9ng m\u1ed9t th\u1eddi \u0111i\u1ec3m trong ng\u00e0y.<\/p>\n<p>Thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c u\u1ed1ng c\u00f9ng ho\u1eb7c kh\u00f4ng c\u00f9ng v\u1edbi b\u1eefa \u0103n.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p><em>Ng\u01b0\u1eddi l\u1edbn<\/em><\/p>\n<p>Li\u1ec1u khuy\u1ebfn c\u00e1o c\u1ee7a vi\u00ean k\u1ebft h\u1ee3p l\u00e0 1 vi\u00ean x 1 l\u1ea7n\/ ng\u00e0y.<\/p>\n<p>Vi\u00ean k\u1ebft h\u1ee3p \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n ng\u01b0\u1eddi l\u1edbn c\u00f3 huy\u1ebft \u00e1p kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t th\u00edch h\u1ee3p v\u1edbi olmesartan medoxomil d\u00f9ng ri\u00eang l\u1ebb. C\u00f3 th\u1ec3 t\u0103ng li\u1ec1u l\u00ean 40 mg\/ 25 mg n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n<p>Vi\u00ean k\u1ebft h\u1ee3p \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n ng\u01b0\u1eddi l\u1edbn c\u00f3 huy\u1ebft \u00e1p kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t th\u00edch h\u1ee3p v\u1edbi hydroclorothizid d\u00f9ng ri\u00eang l\u1ebb ho\u1eb7c b\u1ec7nh nh\u00e2n g\u1eb7p nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n l\u00e0m h\u1ea1n ch\u1ebf li\u1ec1u c\u1ee7a hydroclorothiazid. C\u00f3 th\u1ec3 t\u0103ng li\u1ec1u l\u00ean 40 mg\/ 25 mg n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n<p>\u0110\u1ec3 thu\u1eadn ti\u1ec7n, b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng olmesartan medoxomil v\u00e0 hydroclorothiazid ri\u00eang l\u1ebb c\u00f3 th\u1ec3 chuy\u1ec3n qua s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p v\u1edbi li\u1ec1u t\u01b0\u01a1ng t\u1ef1.<\/p>\n<p><em>Ng\u01b0\u1eddi cao tu\u1ed5i ( &gt; 65 tu\u1ed5i)<\/em><\/p>\n<p>\u1ede ng\u01b0\u1eddi cao tu\u1ed5i li\u1ec1u k\u1ebft h\u1ee3p gi\u1ed1ng li\u1ec1u d\u00e0nh cho ng\u01b0\u1eddi l\u1edbn.<\/p>\n<p>Theo d\u00f5i ch\u1eb7t ch\u1ebd huy\u1ebft \u00e1p b\u1ec7nh nh\u00e2n.<\/p>\n<p><em>Suy th\u1eadn<\/em><\/p>\n<p>Li\u1ec1u t\u1ed1i \u0111a c\u1ee7a olmesartan medoxomil \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn nh\u1eb9 v\u00e0 v\u1eeba (Clcr 30 &#8211; 60 mL\/ ph\u00fat) l\u00e0 20 mg x 1 l\u1ea7n\/ ng\u00e0y.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng cho b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng (Clcr &lt; 30 mL\/ ph\u00fat).<\/p>\n<p><em>Suy gan<\/em><\/p>\n<p>S\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n suy gan nh\u1eb9. Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn ch\u1eb7t ch\u1ebd \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n suy gan \u0111ang s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u v\u00e0 ho\u1eb7c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c. \u1ede b\u1ec7nh nh\u00e2n suy gan v\u1eeba, li\u1ec1u kh\u1edfi \u0111\u1ea7u c\u1ee7a olmesartan medoxomil l\u00e0 10 mg x 1 l\u1ea7n\/ ng\u00e0y v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng qu\u00e1 20 mg x 1 l\u1ea7n\/ ng\u00e0y.<\/p>\n<p>Kh\u00f4ng c\u00f3 kinh nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb olmesartan medoxomil \u1edf b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng ZOKORA-HCTZ 20\/12,5 cho b\u1ec7nh nh\u00e2n suy gan v\u1eeba v\u00e0 n\u1eb7ng.<\/p>\n<p><em>Tr\u1ebb em<\/em><\/p>\n<p>An to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a vi\u00ean k\u1ebft h\u1ee3p \u1edf tr\u1ebb d\u01b0\u1edbi 18 tu\u1ed5i ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. Kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u l\u00e2m s\u00e0ng.<\/p>\n<h3><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><\/h3>\n<p>Qu\u00e1 m\u1eabn v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c ho\u1eb7c d\u1eabn ch\u1ea5t c\u1ee7a sulfonamid.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng cho b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng ZOKORA-HCTZ 20\/12,5 cho b\u1ec7nh nh\u00e2n suy th\u1eadn \u1edf t\u1ea5t c\u1ea3 c\u00e1c m\u1ee9c \u0111\u1ed9.<\/p>\n<p>H\u1ea1 kali m\u00e1u k\u00e9o d\u00e0i, t\u0103ng calci m\u00e1u, h\u1ea1 natri m\u00e1u v\u00e0 t\u0103ng uric m\u00e1u c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng cho b\u1ec7nh nh\u00e2n suy gan, Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng ZOKORA-HCTZ 20\/12,5 cho b\u1ec7nh nh\u00e2n suy gan v\u1eeba v\u00e0 n\u1eb7ng, \u1ee9 m\u1eadt v\u00e0 r\u1ed1i lo\u1ea1n t\u1eafc m\u1eadt.<\/p>\n<p>Ba th\u00e1ng gi\u1eefa v\u00e0 cu\u1ed1i c\u1ee7a thai k\u1ef3.<\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi vi\u00ean k\u1ebft h\u1ee3p v\u1edbi c\u00e1c ch\u1ebf ph\u1ea9m ch\u1ee9a aliskiren b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 suy th\u1eadn (GFR &lt; 60 mL\/ ph\u00fat\/ 1,73m2).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"44-than-trong\"><\/span>4.4 Th\u1eadn tr\u1ecdng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>Gi\u1ea3m th\u1ec3 t\u00edch m\u00e1u n\u1ed9i m\u1ea1ch<\/em><\/p>\n<p>H\u1ea1 huy\u1ebft \u00e1p c\u00f3 tri\u1ec7u ch\u1ee9ng, \u0111\u1eb7c bi\u1ec7t sau khi s\u1eed d\u1ee5ng li\u1ec1u \u0111\u1ea7u ti\u00ean, c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m th\u1ec3 t\u00edch m\u00e1u v\u00e0\/ ho\u1eb7c gi\u1ea3m natri m\u00e1u do s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u, ch\u1ebf \u0111\u1ed9 \u0103n ki\u00eang \u00edt mu\u1ed1i, ti\u00eau ch\u1ea3y ho\u1eb7c n\u00f4n \u00f3i. Ph\u1ea3i kh\u1eafc ph\u1ee5c c\u00e1c t\u00ecnh tr\u1ea1ng n\u00e0y tr\u01b0\u1edbc khi cho b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p.<\/p>\n<p>C\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c g\u00e2y k\u00edch th\u00edch h\u1ec7 renin-angiotensin-aldosteron.<\/p>\n<p>\u1ede b\u1ec7nh nh\u00e2n c\u00f3 tr\u01b0\u01a1ng l\u1ef1c m\u1ea1ch m\u00e1u v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn ph\u1ee5 thu\u1ed9c ch\u1ee7 y\u1ebfu tr\u00ean ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ec7 renin-angiotensin-aldosteron (v\u00ed d\u1ee5 nh\u01b0 b\u1ec7nh nh\u00e2n b\u1ecb suy tim sung huy\u1ebft ho\u1eb7c b\u1ecb suy th\u1eadn, bao g\u1ed3m h\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn), \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ea1 huy\u1ebft \u00e1p c\u1ea5p, t\u0103ng nit\u01a1 m\u00e1u, thi\u1ec3u ni\u1ec7u ho\u1eb7c hi\u1ebfm khi suy th\u1eadn c\u1ea5p.<\/p>\n<p><em>T\u0103ng huy\u1ebft \u00e1p do th\u1eadn<\/em><\/p>\n<p>T\u0103ng nguy c\u01a1 b\u1ecb h\u1ea1 huy\u1ebft \u00e1p n\u1eb7ng v\u00e0 suy th\u1eadn khi b\u1ec7nh nh\u00e2n b\u1ecb h\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn hai b\u00ean ho\u1eb7c h\u1eb9p \u0111\u1ed9ng m\u1ea1ch \u1edf th\u1eadn c\u00f2n ho\u1ea1t \u0111\u1ed9ng s\u1eed d\u1ee5ng thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 renin-angiotensin-aldosteron.<\/p>\n<p><em>Suy th\u1eadn v\u00e0 gh\u00e9p th\u1eadn<\/em><\/p>\n<p>Li\u1ec1u t\u1ed1i \u0111a c\u1ee7a olmesartan medoxomil \u1edf b\u1ec7nh nh\u00e2n b\u1ecb suy th\u1eadn nh\u1eb9 v\u00e0 v\u1eeba l\u00e0 20 mg x 1 l\u1ea7n\/ ng\u00e0y. Tuy nhi\u00ean \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y, ZOKORA-HCTZ 20\/12,5 n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng v\u00e0 \u0111\u1ecbnh k\u1ef3 theo d\u00f5i n\u1ed3ng \u0111\u1ed9 kali, creatinin, uric huy\u1ebft thanh. T\u0103ng nit\u01a1 m\u00e1u do thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u1ecb t\u1ed5n th\u01b0\u01a1ng. N\u1ebfu c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y suy th\u1eadn \u0111ang ti\u1ebfn tri\u1ec3n, \u0111\u00e1nh gi\u00e1 l\u1ea1i c\u1ea9n th\u1eadn s\u1ef1 c\u1ea7n thi\u1ebft c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u00e2n nh\u1eafc ng\u1eebng thu\u1ed1c l\u1ee3i ti\u1ec3u.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ZOKORA-HCTZ 20\/12,5 \u1edf b\u1ec7nh nh\u00e2n b\u1ecb suy th\u1eadn n\u1eb7ng (Clcr &lt; 30 mL\/ ph\u00fat).<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n suy th\u1eadn \u1edf t\u1ea5t c\u1ea3 giai \u0111o\u1ea1n.<\/p>\n<p>Kh\u00f4ng c\u00f3 kinh nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n v\u1eeba \u0111\u01b0\u1ee3c gh\u00e9p th\u1eadn.<\/p>\n<p><em>Phong b\u1ebf k\u00e9p h\u1ec7 renin-angiotensin-aldosteron<\/em><\/p>\n<p>Phong b\u1ebf k\u00e9p h\u1ec7 renin-angiotensin-aldosteron do s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ch\u1ea5t \u1ee9c ch\u1ebf enzym chuy\u1ec3n angiotensin, ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II ho\u1eb7c aliskiren l\u00e0m t\u0103ng nguy c\u01a1 h\u1ea1 huy\u1ebft \u00e1p, t\u0103ng kali m\u00e1u v\u00e0 gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn (bao g\u1ed3m suy th\u1eadn c\u1ea5p). Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi.<\/p>\n<p>N\u1ebfu c\u1ea7n ph\u1ea3i s\u1eed d\u1ee5ng chung, ch\u1ec9 n\u00ean d\u00f9ng d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a chuy\u00ean gia, theo d\u00f5i ch\u1ee9c n\u0103ng th\u1eadn, ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i v\u00e0 huy\u1ebft \u00e1p th\u01b0\u1eddng xuy\u00ean. Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ch\u1ea5t \u1ee9c ch\u1ebf enzym chuy\u1ec3n angiotensin v\u00e0 ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p><em>Suy gan<\/em><\/p>\n<p>Suy gan nh\u1eb9: Th\u1eadn tr\u1ecdng khi d\u00f9ng ZOKORA 20\/12,5.<\/p>\n<p>Suy gan v\u1eeba v\u00e0 n\u1eb7ng: Kh\u00f4ng c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng olmesartan medoxomil \u1edf b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng. \u1ede b\u1ec7nh nh\u00e2n suy gan v\u1eeba, li\u1ec1u t\u1ed1i \u0111a c\u1ee7a olmesartan medoxomil l\u00e0 20 mg. Ngo\u00e0i ra, s\u1ef1 thay \u0111\u1ed5i nh\u1ecf c\u1ee7a c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i trong khi \u0111i\u1ec1u tr\u1ecb thiazid c\u00f3 th\u1ec3 g\u00e2y h\u00f4n m\u00ea gan \u1edf b\u1ec7nh nh\u00e2n suy gan ho\u1eb7c b\u1ec7nh gan ti\u1ebfn tri\u1ec3n.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng vi\u00ean k\u1ebft h\u1ee3p \u1edf b\u1ec7nh nh\u00e2n suy gan v\u1eeba v\u00e0 n\u1eb7ng, \u1ee9 m\u1eadt v\u00e0 r\u1ed1i lo\u1ea1n t\u1eafc m\u1eadt.<\/p>\n<p><em>H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 van hai l\u00e1, c\u01a1 tim ph\u00ec \u0111\u1ea1i t\u1eafc ngh\u1ebdn<\/em><\/p>\n<p>Gi\u1ed1ng nh\u01b0 c\u00e1c thu\u1ed1c gi\u00e3n m\u1ea1ch kh\u00e1c, th\u1eadn tr\u1ecdng khi ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n b\u1ecb h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ho\u1eb7c van hai l\u00e1, ho\u1eb7c b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i t\u1eafc ngh\u1ebdn.<\/p>\n<p><em>C\u01b0\u1eddng aldosteron ti\u00ean ph\u00e1t<\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n c\u01b0\u1eddng aldosteron ti\u00ean ph\u00e1t n\u00f3i chung s\u1ebd kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p t\u00e1c \u0111\u1ed9ng th\u00f4ng qua s\u1ef1 \u1ee9c ch\u1ebf c\u1ee7a h\u1ec7 th\u1ed1ng renin-angiotensin. Do \u0111\u00f3, kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p><em>T\u00e1c \u0111\u1ed9ng l\u00ean chuy\u1ec3n h\u00f3a v\u00e0 n\u1ed9i ti\u1ebft<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb v\u1edbi thiazid c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m dung n\u1ea1p glucose. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, c\u00f3 th\u1ec3 ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin v\u00e0 thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft \u0111\u01b0\u1eddng u\u1ed1ng. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng ti\u1ec1m \u1ea9n c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n trong khi \u0111i\u1ec1u tr\u1ecb v\u1edbi thiazid.<\/p>\n<p>T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n kh\u00e1c c\u00f3 li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb v\u1edbi thiazid l\u00e0 t\u0103ng n\u1ed3ng \u0111\u1ed9 cholesterol v\u00e0 triglycerid.<\/p>\n<p>T\u0103ng uric m\u00e1u ho\u1eb7c c\u01a1n gout c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c \u1edf b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi thiazid.<\/p>\n<p><em>C\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i<\/em><\/p>\n<p>\u0110\u1ed1i v\u1edbi b\u1ea5t k\u1ef3 b\u1ec7nh nh\u00e2n n\u00e0o \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u, n\u00ean \u0111\u1ecbnh k\u1ef3 theo d\u00f5i n\u1ed3ng \u0111\u1ed9 ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i.<\/p>\n<p>Thiazid, bao g\u1ed3m hydroclorothiazid, c\u00f3 th\u1ec3 g\u00e2y m\u1ea5t c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i (bao g\u1ed3m h\u1ea1 kali m\u00e1u, h\u1ea1 natri m\u00e1u v\u00e0 nhi\u1ec5m ki\u1ec1m do gi\u1ea3m clorid). D\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o c\u1ee7a m\u1ea5t c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i l\u00e0 kh\u00f4 mi\u1ec7ng, kh\u00e1t n\u01b0\u1edbc, y\u1ebfu, ng\u1ee7 l\u1ecbm, bu\u1ed3n ng\u1ee7, b\u1ed3n ch\u1ed3n, \u0111au ho\u1eb7c chu\u1ed9t r\u00fat, m\u1ecfi c\u01a1, h\u1ea1 huy\u1ebft \u00e1p, thi\u1ec3u ni\u1ec7u, tim \u0111\u1eadp nhanh, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a nh\u01b0 bu\u1ed3n n\u00f4n ho\u1eb7c n\u00f4n m\u1eeda.<\/p>\n<p>Nguy c\u01a1 h\u1ea1 kali m\u00e1u cao nh\u1ea5t l\u00e0 \u1edf b\u1ec7nh nh\u00e2n x\u01a1 gan, \u1edf c\u00e1c b\u1ec7nh nh\u00e2n ti\u1ec3u nhi\u1ec1u, b\u1ec7nh nh\u00e2n \u0111ang u\u1ed1ng c\u00e1c ch\u1ea5t b\u1ed5 sung ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i \u0111\u01b0\u1eddng u\u1ed1ng kh\u00f4ng h\u1ee3p l\u00fd v\u00e0 b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi v\u1edbi corticosteroid ho\u1eb7c ACTH.<\/p>\n<p>Ng\u01b0\u1ee3c l\u1ea1i, do t\u00e1c d\u1ee5ng \u0111\u1ed1i kh\u00e1ng t\u1ea1i th\u1ee5 th\u1ec3 angiotensin II c\u1ee7a olmesartan medoxomil, t\u0103ng kali m\u00e1u c\u00f3 th\u1ec3 x\u1ea3y ra, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi c\u00f3 suy th\u1eadn v\u00e0\/ ho\u1eb7c suy tim, v\u00e0 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Theo d\u00f5i ch\u1eb7t ch\u1ebd n\u1ed3ng \u0111\u1ed9 kali trong huy\u1ebft thanh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1. Thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1eef kali, ch\u1ea5t b\u1ed5 sung kali ho\u1eb7c ch\u1ea5t thay th\u1ebf mu\u1ed1i c\u00f3 ch\u1ee9a kali v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh (v\u00ed d\u1ee5 heparin) n\u00ean th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng chung v\u1edbi vi\u00ean k\u1ebft h\u1ee3p.<\/p>\n<p>Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng n\u00e0o cho th\u1ea5y olmesartan medoxomil l\u00e0m gi\u1ea3m ho\u1eb7c ng\u0103n ng\u1eeba h\u1ea1 natri m\u00e1u do thu\u1ed1c l\u1ee3i ti\u1ec3u. Gi\u1ea3m clorid th\u00f4ng th\u01b0\u1eddng nh\u1eb9 v\u00e0 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Thiazid c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ti\u1ebft calci trong n\u01b0\u1edbc ti\u1ec3u v\u00e0 d\u1eabn \u0111\u1ebfn t\u0103ng nh\u1eb9 v\u00e0 kh\u00f4ng li\u00ean t\u1ee5c n\u1ed3ng \u0111\u1ed9 calci huy\u1ebft thanh trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 c\u00e1c r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a calci k\u00e8m theo. T\u0103ng calci m\u00e1u c\u00f3 th\u1ec3 l\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a c\u01b0\u1eddng c\u1eadn gi\u00e1p. N\u00ean ng\u1eebng thiazid tr\u01b0\u1edbc khi l\u00e0m x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng tuy\u1ebfn c\u1eadn gi\u00e1p.<\/p>\n<p>Thiazid \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 l\u00e0m t\u0103ng th\u1ea3i magnesi trong n\u01b0\u1edbc ti\u1ec3u, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ea1 magnesi huy\u1ebft.<\/p>\n<p>H\u1ea1 natri m\u00e1u do t\u0103ng th\u1ec3 t\u00edch c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n ph\u00f9 n\u1ec1 khi th\u1eddi ti\u1ebft n\u00f3ng.<\/p>\n<p><em>Lithi<\/em><\/p>\n<p>Gi\u1ed1ng nh\u01b0 v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II kh\u00e1c, kh\u00f4ng khuy\u1ebfn c\u00e1o vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi vi\u00ean k\u1ebft h\u1ee3p v\u1edbi lithi.<\/p>\n<p><em>Ti\u00eau ch\u1ea3y m\u1ea1n t\u00ednh t\u01b0\u01a1ng t\u1ef1 Sprue<\/em><\/p>\n<p>Trong c\u00e1c ca hi\u1ebfm g\u1eb7p nghi\u00eam tr\u1ecdng, ti\u00eau ch\u1ea3y m\u1ea1n t\u00ednh k\u00e8m v\u1edbi s\u1ee5t c\u00e2n nhi\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng olmesartan v\u00e0i th\u00e1ng cho \u0111\u1ebfn v\u00e0i n\u0103m, c\u00f3 th\u1ec3 do ph\u1ea3n x\u1ea1 qu\u00e1 m\u1eabn ch\u1eadm t\u1ea1i ch\u1ed7.<\/p>\n<p>Sinh thi\u1ebft ru\u1ed9t b\u1ec7nh nh\u00e2n th\u01b0\u1eddng cho th\u1ea5y teo l\u00f4ng ru\u1ed9t. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u1edbi olmesartan, lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh kh\u00e1c. Xem x\u00e9t ng\u1eebng olmesartan medoxomil trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh n\u00e0o kh\u00e1c.<\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p tri\u1ec7u ch\u1ee9ng bi\u1ebfn m\u1ea5t v\u00e0 b\u1ec7nh \u0111\u01b0\u1eddng ru\u1ed9t t\u01b0\u01a1ng t\u1ef1 Sprue \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng sinh thi\u1ebft, kh\u00f4ng n\u00ean \u0111i\u1ec1u tr\u1ecb l\u1ea1i v\u1edbi olmesartan medoxomil.<\/p>\n<p><em>Kh\u00e1c bi\u1ec7t ch\u1ee7ng t\u1ed9c<\/em><\/p>\n<p>Gi\u1ed1ng nh\u01b0 c\u00e1c ch\u1ebf ph\u1ea9m c\u00f3 ch\u1ee9a ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II kh\u00e1c, t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p c\u1ee7a vi\u00ean k\u1ebft h\u1ee3p \u00edt h\u01a1n \u1edf b\u1ec7nh nh\u00e2n da \u0111en so v\u1edbi b\u1ec7nh nh\u00e2n m\u00e0u da kh\u00e1c, c\u00f3 th\u1ec3 v\u00ec t\u1ec9 l\u1ec7 cao b\u1ec7nh nh\u00e2n da \u0111en b\u1ecb t\u0103ng huy\u1ebft \u00e1p c\u00f3 renin th\u1ea5p.<\/p>\n<p><em>X\u00e9t nghi\u1ec7m kh\u00e1ng doping<\/em><\/p>\n<p>Hydroclorothiazid trong ch\u1ebf ph\u1ea9m c\u00f3 th\u1ec3 cho k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh trong x\u00e9t nghi\u1ec7m kh\u00e1ng doping.<\/p>\n<p><em>Kh\u00e1c<\/em><\/p>\n<p>Gi\u1ed1ng nh\u01b0 c\u00e1c t\u00e1c nh\u00e2n ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p kh\u00e1c, h\u1ea1 huy\u1ebft \u00e1p qu\u00e1 m\u1ee9c \u1edf b\u1ec7nh nh\u00e2n thi\u1ebfu m\u00e1u tim c\u1ee5c b\u1ed9 ho\u1eb7c thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1ed3i m\u00e1u c\u01a1 tim ho\u1eb7c s\u1ed1c tim.<\/p>\n<p>Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn v\u1edbi hydroclorothiazid c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed b\u1ecb hen suy\u1ec5n, nh\u01b0ng th\u01b0\u1eddng x\u1ea3y ra h\u01a1n \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed.<\/p>\n<p>Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n ho\u1eb7c tr\u1ea7m tr\u1ecdng h\u01a1n \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid.<\/p>\n<p><em>C\u1ea3nh b\u00e1o v\u00e0 th\u1eadn tr\u1ecdng li\u00ean quan t\u00e1 d\u01b0\u1ee3c<\/em><\/p>\n<p>Ch\u1ebf ph\u1ea9m c\u00f3 ch\u1ee9a lactose. B\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh di truy\u1ec1n hi\u1ebfm g\u1eb7p k\u00e9m dung n\u1ea1p galactose, thi\u1ebfu h\u1ee5t Lapp lactase ho\u1eb7c r\u1ed1i lo\u1ea1n h\u1ea5p thu glucose-galactose kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng.<\/p>\n<p>Ch\u1ebf ph\u1ea9m c\u00f3 ch\u1ee9a polysorbat 80 c\u00f3 th\u1ec3 g\u00e2y d\u1ecb \u1ee9ng, d\u1ea7u th\u1ea7u d\u1ea7u c\u00f3 th\u1ec3 g\u00e2y \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y.<\/p>\n<p>\u0110\u1ec3 xa t\u1ea7m tay tr\u1ebb em.<\/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>Vi\u00ean k\u1ebft h\u1ee3p c\u00f3 t\u00e1c \u0111\u1ed9ng \u00edt v\u00e0 trung b\u00ecnh l\u00ean kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c. Ch\u00f3ng m\u1eb7t v\u00e0 m\u1ec7t m\u1ecfi \u0111\u00f4i khi c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng ch\u1ea5t ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p, c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng ph\u1ea3n x\u1ea1.<\/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<h3><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><\/h3>\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>Do t\u00e1c \u0111\u1ed9ng c\u1ee7a olmesartan medoxomil v\u00e0 hydroclorothiazid l\u00ean thai k\u00ec, kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p trong su\u1ed1t 3 th\u00e1ng \u0111\u1ea7u thai k\u00ec. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh vi\u00ean k\u1ebft h\u1ee3p trong ba th\u00e1ng gi\u1eefa v\u00e0 ba th\u00e1ng cu\u1ed1i c\u1ee7a thai k\u00ec.<\/p>\n<p>Olmesartan medoxomil<\/p>\n<p>S\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II kh\u00f4ng khuy\u1ebfn c\u00e1o trong ba th\u00e1ng \u0111\u1ea7u thai k\u00ec v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong ba th\u00e1ng gi\u1eefa v\u00e0 ba th\u00e1ng cu\u1ed1i thai k\u00ec.<\/p>\n<p>B\u1eb1ng ch\u1ee9ng d\u1ecbch t\u1ec5 h\u1ecdc li\u00ean quan \u0111\u1ebfn nguy c\u01a1 g\u00e2y qu\u00e1i thai khi s\u1eed d\u1ee5ng ACEI trong ba th\u00e1ng \u0111\u1ea7u thai k\u00ec v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c k\u1ebft lu\u1eadn, tuy nhi\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng l\u00e0m t\u0103ng nh\u1eb9 nguy c\u01a1. Trong khi kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u v\u1ec1 d\u1ecbch t\u1ec5 h\u1ecdc c\u00f3 ki\u1ec3m so\u00e1t v\u1ec1 nguy c\u01a1 c\u1ee7a ch\u1ea5t \u0111\u1ed1i kh\u00e1ng angiotensin II, nguy c\u01a1 t\u01b0\u01a1ng t\u1ef1 c\u00f3 th\u1ec3 x\u1ea3y ra trong nh\u00f3m thu\u1ed1c n\u00e0y. Tr\u1eeb khi c\u1ea7n thi\u1ebft ph\u1ea3i ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng ch\u1ea5t \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin, b\u1ec7nh nh\u00e2n d\u1ef1 \u0111\u1ecbnh c\u00f3 thai n\u00ean chuy\u1ec3n qua \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 s\u1eed d\u1ee5ng an to\u00e0n khi mang thai. Khi ph\u00e1t hi\u1ec7n c\u00f3 thai, ng\u1eebng \u0111i\u1ec1u tr\u1ecb v\u1edbi ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II v\u00e0 n\u1ebfu c\u00f3 th\u1ec3 n\u00ean b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c kh\u00e1c.<\/p>\n<p>S\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II trong ba th\u00e1ng gi\u1eefa v\u00e0 ba th\u00e1ng cu\u1ed1i thai k\u00ec \u0111\u00e3 x\u00e1c \u0111\u1ecbnh g\u00e2y h\u1ea1i cho thai nhi (suy th\u1eadn, h\u1ea1 huy\u1ebft \u00e1p, t\u0103ng kali m\u00e1u). N\u1ebfu s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II trong ba th\u00e1ng gi\u1eefa c\u1ee7a thai k\u00ec, khuy\u1ebfn c\u00e1o si\u00eau \u00e2m ki\u1ec3m tra ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 h\u1ed9p s\u1ecd thai nhi.<\/p>\n<p>Tr\u1ebb sinh ra c\u00f3 m\u1eb9 s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i kh\u1ea3 n\u0103ng h\u1ea1 huy\u1ebft \u00e1p.<\/p>\n<p>Hydroclorothiazid<\/p>\n<p>D\u1eef li\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a hydroclorothiazid \u0111\u1ed1i v\u1edbi thai k\u00ec r\u1ea5t h\u1ea1n ch\u1ebf, \u0111\u1eb7c bi\u1ec7t trong ba th\u00e1ng \u0111\u1ea7u thai k\u00ec. D\u1eef li\u1ec7u nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt ch\u01b0a \u0111\u1ea7y \u0111\u1ee7.<\/p>\n<p>Hydroclorothiazid qua \u0111\u01b0\u1ee3c nhau thai. D\u1ef1a tr\u00ean c\u01a1 ch\u1ebf d\u01b0\u1ee3c l\u1ef1c c\u1ee7a hydroclorothiazid, s\u1eed d\u1ee5ng hydroclorothiazid trong ba th\u00e1ng gi\u1eefa v\u00e0 ba th\u00e1ng cu\u1ed1i thai k\u00ec c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u01b0\u1edbi m\u00e1u nhau thai v\u00e0 g\u00e2y ra v\u00e0ng da, r\u1ed1i lo\u1ea1n c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i v\u00e0 thi\u1ebfu ti\u1ec3u c\u1ea7u \u1edf thai nhi v\u00e0 tr\u1ebb s\u01a1 sinh.<\/p>\n<p>Hydroclorothiazid kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb ph\u00f9 khi mang thai, t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 ho\u1eb7c ti\u1ec1n s\u1ea3n gi\u1eadt do nguy c\u01a1 gi\u1ea3m th\u1ec3 t\u00edch huy\u1ebft t\u01b0\u01a1ng v\u00e0 gi\u1ea3m truy\u1ec1n dinh d\u01b0\u1ee1ng qua nhau thai, kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i cho b\u1ec7nh hi\u1ec7n m\u1eafc.<\/p>\n<p>Hydroclorothiazid kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p nguy\u00ean ph\u00e1t \u1edf ph\u1ee5 n\u1eef mang thai tr\u1eeb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm kh\u00f4ng c\u00f3 c\u00e1ch \u0111i\u1ec1u tr\u1ecb n\u00e0o kh\u00e1c.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Olmesartan medoxomil<\/p>\n<p>V\u00ec kh\u00f4ng c\u00f3 th\u00f4ng tin li\u00ean quan \u0111\u1ebfn khi s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p \u1edf ph\u1ee5 n\u1eef cho con b\u00fa, kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef cho con b\u00fa v\u00e0 n\u00ean s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh an to\u00e0n khi cho con b\u00fa, \u0111\u1eb7c bi\u1ec7t trong th\u1eddi gian tr\u1ebb m\u1edbi sinh.<\/p>\n<p>Hydroclorothiazid<\/p>\n<p>Hydroclorothiazid b\u00e0i ti\u1ebft m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf trong s\u1eefa m\u1eb9. Thiazid li\u1ec1u cao g\u00e2y ti\u1ec3u nhi\u1ec1u v\u00e0 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ti\u1ebft s\u1eefa. Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p trong th\u1eddi gian cho con b\u00fa. N\u1ebfu s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p trong th\u1eddi gian cho con b\u00fa, s\u1eed d\u1ee5ng li\u1ec1u th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3.<\/p>\n<h3><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><\/h3>\n<p>T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n th\u01b0\u1eddng g\u1eb7p khi s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p l\u00e0 nh\u1ee9c \u0111\u1ea7u (2,9%), ch\u00f3ng m\u1eb7t (1,9%) v\u00e0 m\u1ec7t m\u1ecfi (1,0%).<\/p>\n<p>Hydroclorothiazid c\u00f3 th\u1ec3 l\u00e0m n\u1eb7ng th\u00eam t\u00ecnh tr\u1ea1ng gi\u1ea3m th\u1ec3 t\u00edch v\u00e0 d\u1eabn \u0111\u1ebfn r\u1ed1i lo\u1ea1n c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i.<\/p>\n<p><em>*OLMESARTAN<\/em><\/p>\n<p><em>Th\u01b0\u1eddng g\u1eb7p, 1\/100 \u2264 ADR &lt; 1\/10<\/em><\/p>\n<p>Chuy\u1ec3n h\u00f3a: T\u0103ng triglycerid m\u00e1u, t\u0103ng uric m\u00e1u, t\u0103ng creatin phosphokinase m\u00e1u, t\u0103ng ur\u00ea m\u00e1u, t\u0103ng enzym gan.<\/p>\n<p>Th\u1ea7n kinh: Ch\u00f3ng m\u1eb7t, nh\u1ee9c \u0111\u1ea7u.<\/p>\n<p>H\u00f4 h\u1ea5p: Ho, vi\u00eam ph\u1ebf qu\u1ea3n, vi\u00eam h\u1ecdng, vi\u00eam m\u0169i.<\/p>\n<p>Ti\u00eau h\u00f3a: \u0110au b\u1ee5ng, ti\u00eau ch\u1ea3y, kh\u00f3 ti\u00eau, ti\u00eau ch\u1ea3y nhi\u1ec5m khu\u1ea9n, bu\u1ed3n n\u00f4n.<\/p>\n<p>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: Vi\u00eam kh\u1edbp, \u0111au l\u01b0ng, \u0111au c\u01a1.<\/p>\n<p>Ti\u1ebft ni\u1ec7u: Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ec3u, ti\u1ec3u ra m\u00e1u.<\/p>\n<p>To\u00e0n th\u00e2n: \u0110au ng\u1ef1c, m\u1ec7t m\u1ecfi, tri\u1ec7u ch\u1ee9ng gi\u1ed1ng c\u00fam, \u0111au, ph\u00f9 ngo\u1ea1i bi\u00ean.<\/p>\n<p><em>\u00cdt g\u1eb7p, 1\/1.000 \u2264 ADR &lt; 1\/100<\/em><\/p>\n<p>Huy\u1ebft h\u1ecdc: Gi\u1ea3m ti\u1ec3u c\u1ea7u.<\/p>\n<p>Mi\u1ec5n d\u1ecbch: Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n<p>Ti\u1ec1n \u0111\u00ecnh: Ch\u00f3ng m\u1eb7t.<\/p>\n<p>Tim m\u1ea1ch: \u0110au th\u1eaft ng\u1ef1c<\/p>\n<p>Ti\u00eau h\u00f3a: N\u00f4n \u00f3i.<\/p>\n<p>Da: Ban \u0111\u1ecf, ban \u0111\u1ecf lan r\u1ed9ng, ng\u1ee9a, m\u00e0y \u0111ay.<\/p>\n<p>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0110au g\u00e2n.<\/p>\n<p>To\u00e0n th\u00e2n: Suy nh\u01b0\u1ee3c, ph\u00f9 m\u1eb7t, kh\u00f3 ch\u1ecbu.<\/p>\n<p><em>Hi\u1ebfm g\u1eb7p, 1\/10.000 \u2264 ADR &lt; 1\/1.000<\/em><\/p>\n<p>Chuy\u1ec3n h\u00f3a: T\u0103ng kali m\u00e1u.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: H\u1ea1 huy\u1ebft \u00e1p.<\/p>\n<p>Da: Ph\u00f9 m\u1ea1ch.<\/p>\n<p>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: Co c\u01a1.<\/p>\n<p>Ti\u1ebft ni\u1ec7u: Suy th\u1eadn, suy th\u1eadn c\u1ea5p.<\/p>\n<p>To\u00e0n th\u00e2n: H\u00f4n m\u00ea<\/p>\n<p><em>R\u1ea5t hi\u1ebfm g\u1eb7p, ADR \u2264 1\/10.000<\/em><\/p>\n<p>Ti\u00eau h\u00f3a: Ti\u00eau ch\u1ea3y m\u1ea1n t\u00ednh tri\u1ec7u ch\u1ee9ng nh\u01b0 Sprue.<\/p>\n<p><em>*HYDROCLOROTHIAZID<\/em><\/p>\n<p><em>R\u1ea5t th\u01b0\u1eddng g\u1eb7p, ADR \u2264 1\/10<\/em><\/p>\n<p>Chuy\u1ec3n h\u00f3a: T\u0103ng cholesterol m\u00e1u, t\u0103ng triglycerid m\u00e1u, t\u0103ng uric m\u00e1u.<\/p>\n<p><em>Th\u01b0\u1eddng g\u1eb7p, 1\/100 \u2264 ADR &lt; 1\/10<\/em><\/p>\n<p>Chuy\u1ec3n h\u00f3a: \u0110\u01b0\u1eddng trong n\u01b0\u1edbc ti\u1ec3u, t\u0103ng calci m\u00e1u, gi\u1ea3m clorid m\u00e1u, h\u1ea1 kali m\u00e1u, h\u1ea1 magnesi m\u00e1u, h\u1ea1 natri m\u00e1u, t\u0103ng amylase m\u00e1u, t\u0103ng creatinin m\u00e1u, t\u0103ng ur\u00ea m\u00e1u.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: H\u1ea1 huy\u1ebft \u00e1p th\u1ebf \u0111\u1ee9ng.<\/p>\n<p>Ti\u00eau h\u00f3a: \u0110au b\u1ee5ng, t\u00e1o b\u00f3n, ti\u00eau ch\u1ea3y, k\u00edch th\u00edch d\u1ea1 d\u00e0y, tr\u01b0\u1edbng b\u1ee5ng, bu\u1ed3n n\u00f4n, n\u00f4n \u00f3i.<\/p>\n<p><em>\u00cdt g\u1eb7p, 1\/1.000 \u2264 ADR &lt; 1\/100<\/em><\/p>\n<p>Mi\u1ec5n d\u1ecbch: Ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n<p>Dinh d\u01b0\u1ee1ng: Bi\u1ebfng \u0103n.<\/p>\n<p>Th\u1ea7n kinh: Ch\u00e1n \u0103n.<\/p>\n<p>M\u1eaft: L\u00e0m m\u1eaft b\u1ecb c\u1eadn th\u1ecb n\u1eb7ng h\u01a1n.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: H\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/p>\n<p>H\u00f4 h\u1ea5p: G\u1eafng s\u1ee9c khi th\u1edf.<\/p>\n<p>Da: \u0110\u1ecf da, nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng, ng\u1ee9a, ban xu\u1ea5t huy\u1ebft, ban \u0111\u1ecf, m\u00e0y \u0111ay.<\/p>\n<p>Sinh d\u1ee5c: R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/p>\n<p><em>Hi\u1ebfm g\u1eb7p, 10.000 \u2264 ADR &lt; 1\/1.000<\/em><\/p>\n<p>Nhi\u1ec5m tr\u00f9ng: Nhi\u1ec5m tr\u00f9ng r\u0103ng mi\u1ec7ng.<\/p>\n<p>Huy\u1ebft h\u1ecdc: Thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o, suy t\u1ee7y, thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft, gi\u1ea3m b\u1ea1ch c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u h\u1ea1t, gi\u1ea3m ti\u1ec3u c\u1ea7u.<\/p>\n<p>Th\u1ea7n kinh: Nh\u1ee9c \u0111\u1ea7u.<\/p>\n<p>M\u1eaft: Gi\u1ea3m ch\u1ea3y n\u01b0\u1edbc m\u1eaft, nh\u00ecn m\u1edd, gi\u1ea3m kh\u1ea3 n\u0103ng nh\u00ecn m\u00e0u s\u1eafc.<\/p>\n<p>Tim m\u1ea1ch: Lo\u1ea1n nh\u1ecbp tim.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: T\u1eafc m\u1ea1ch, huy\u1ebft kh\u1ed1i, vi\u00eam m\u1ea1ch m\u00e1u ho\u1ea1i t\u1eed.<\/p>\n<p>H\u00f4 h\u1ea5p: Kh\u00f3 th\u1edf, vi\u00eam ph\u1ed5i m\u00f4 k\u1ebd, ph\u00f9 ph\u1ed5i.<\/p>\n<p>Ti\u00eau h\u00f3a: Vi\u00eam t\u1ee5y.<\/p>\n<p>Gan m\u1eadt: V\u00e0ng da, vi\u00eam t\u00fai m\u1eadt.<\/p>\n<p>Da: Ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 tr\u00ean da, ph\u1ea3n \u1ee9ng gi\u1ed1ng lupus ban \u0111\u1ecf, ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec nhi\u1ec5m \u0111\u1ed9c (TEN).<\/p>\n<p>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: Y\u1ebfu c\u01a1, nh\u01b0\u1ee3c c\u01a1.<\/p>\n<p>Ti\u1ebft ni\u1ec7u: Suy th\u1eadn, vi\u00eam k\u1ebd th\u1eadn.<\/p>\n<p>To\u00e0n th\u00e2n: S\u1ed1t.<\/p>\n<p><em>*OLMESARTAN\/ HYDROCLOROTHIAZID<\/em><\/p>\n<p><em>Th\u01b0\u1eddng g\u1eb7p, 1\/100 \u2264 ADR &lt; 1\/10<\/em><\/p>\n<p>Th\u1ea7n kinh: Hoa m\u1eaft, ch\u00f3ng m\u1eb7t, nh\u1ee9c \u0111\u1ea7u.<\/p>\n<p>To\u00e0n th\u00e2n: Suy nh\u01b0\u1ee3c, \u0111au ng\u1ef1c, m\u1ec7t m\u1ecfi, ph\u00f9 ngo\u1ea1i bi\u00ean.<\/p>\n<p><em>\u00cdt g\u1eb7p, 1\/1.000 \u2264 ADR &lt; 1\/100<\/em><\/p>\n<p>Huy\u1ebft h\u1ecdc: T\u0103ng AST, ALT, t\u0103ng calci m\u00e1u, t\u0103ng creatinin m\u00e1u, t\u0103ng creatin phosphokinase m\u00e1u, t\u0103ng glucose m\u00e1u, t\u0103ng lipid m\u00e1u, t\u0103ng\/ h\u1ea1 kali m\u00e1u, t\u0103ng ur\u00ea m\u00e1u, t\u0103ng Gamma-GTP.<\/p>\n<p>Chuy\u1ec3n h\u00f3a: T\u0103ng cholesterol m\u00e1u, t\u0103ng triglycerid m\u00e1u, t\u0103ng uric m\u00e1u.<\/p>\n<p>Th\u1ea7n kinh: Ch\u00f3ng m\u1eb7t t\u01b0 th\u1ebf, m\u01a1 m\u00e0ng, b\u1ea5t t\u1ec9nh.<\/p>\n<p>Ti\u1ec1n \u0111\u00ecnh: Ch\u00f3ng m\u1eb7t<\/p>\n<p>Tim m\u1ea1ch: H\u1ed3i h\u1ed9p.<\/p>\n<p>Tu\u1ea7n ho\u00e0n: H\u1ea1 huy\u1ebft \u00e1p, h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/p>\n<p>H\u00f4 h\u1ea5p: Ho.<\/p>\n<p>Ti\u00eau h\u00f3a: \u0110au b\u1ee5ng, bu\u1ed3n n\u00f4n, n\u00f4n, kh\u00f3 ti\u00eau, ti\u00eau ch\u1ea3y.<\/p>\n<p>Da: Ban \u0111\u1ecf, eczema.<\/p>\n<p>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0110au kh\u1edbp, \u0111au l\u01b0ng, co c\u01a1, \u0111au c\u01a1, \u0111au nghi\u00eam tr\u1ecdng<\/p>\n<p>Ti\u1ebft ni\u1ec7u: Ti\u1ec3u ra m\u00e1u.<\/p>\n<p>Sinh d\u1ee5c: R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/p>\n<p>To\u00e0n th\u00e2n: Y\u1ebfu.<\/p>\n<p><em>Hi\u1ebfm g\u1eb7p, 10.000 \u2264 ADR &lt; 1\/1.000<\/em><\/p>\n<p>Huy\u1ebft h\u1ecdc: Gi\u1ea3m hematocrit, gi\u1ea3m hemoglobin, t\u0103ng ur\u00ea nit\u01a1 m\u00e1u, t\u0103ng acid uric m\u00e1u.<\/p>\n<p>Th\u1ea7n kinh: Kh\u00f4ng t\u1ec9nh t\u00e1o.<\/p>\n<p>Da: Ph\u00f9 do ph\u00f9 m\u1ea1ch, m\u00e0y \u0111ay.<\/p>\n<p>Ti\u1ebft ni\u1ec7u: Suy th\u1eadn c\u1ea5p.<\/p>\n<p>To\u00e0n th\u00e2n: Kh\u00f3 ch\u1ecbu.<\/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<h3><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><\/h3>\n<p>Ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. V\u1edbi c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 c\u1ea7n ng\u1eebng thu\u1ed1c. Tr\u01b0\u1eddng h\u1ee3p m\u1eabn c\u1ea3m n\u1eb7ng ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (gi\u1eef tho\u00e1ng kh\u00ed v\u00e0 d\u00f9ng epinephrin, th\u1edf oxygen, d\u00f9ng kh\u00e1ng histamin, corticoid&#8230;).<\/p>\n<h3><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><\/h3>\n<p><em>(1) Kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c li\u00ean quan \u0111\u1ebfn ph\u1ed1i h\u1ee3p ZOKORA-HCTZ 20\/12,5<\/em><\/p>\n<p><em>*Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p><em>Lithi<\/em><\/p>\n<p>T\u0103ng thu\u1eadn ngh\u1ecbch n\u1ed3ng \u0111\u1ed9 lithi huy\u1ebft thanh v\u00e0 \u0111\u1ed9c t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi lithi v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf enzym chuy\u1ec3n angiotensin, hi\u1ebfm khi x\u1ea3y ra v\u1edbi ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II. Ngo\u00e0i ra, thiazid l\u00e0m gi\u1ea3m \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a lithi v\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a lithi. Do \u0111\u00f3 kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng chung lithi v\u00e0 vi\u00ean k\u1ebft h\u1ee3p. N\u1ebfu c\u1ea7n thi\u1ebft ph\u1ea3i s\u1eed d\u1ee5ng chung th\u00ec ph\u1ea3i theo d\u00f5i n\u1ed3ng \u0111\u1ed9 lithi.<\/p>\n<p><em>*Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p><em>Baclofen<\/em><\/p>\n<p>C\u00f3 th\u1ec3 x\u1ea3y ra ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n<p><em>Thu\u1ed1c gi\u1ea3m \u0111au &#8211; kh\u00e1ng vi\u00eam kh\u00f4ng steroid (NSAIDs)<\/em><\/p>\n<p><em>NSAIDs<\/em> (v\u00ed d\u1ee5 acid acetylsalicylic &gt; 3 g\/ ng\u00e0y, ch\u1ea5t \u1ee9c ch\u1ebf COX-2 v\u00e0 NSAIDs kh\u00f4ng ch\u1ecdn l\u1ecdc) c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p c\u1ee7a thiazid v\u00e0 ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II.<\/p>\n<p>\u1ede m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn (v\u00ed d\u1ee5 b\u1ec7nh nh\u00e2n b\u1ecb m\u1ea5t n\u01b0\u1edbc ho\u1eb7c ng\u01b0\u1eddi cao tu\u1ed5i b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn) vi\u1ec7c k\u1ebft h\u1ee3p ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf cyclooxygenase c\u00f3 th\u1ec3 l\u00e0m t\u1ed5n th\u01b0\u01a1ng th\u1eadn nhi\u1ec1u h\u01a1n, bao g\u1ed3m suy th\u1eadn c\u1ea5p, v\u00e0 th\u01b0\u1eddng c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c. Do \u0111\u00f3, n\u00ean th\u1eadn tr\u1ecdng khi ph\u1ed1i h\u1ee3p, \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi cao tu\u1ed5i. B\u1ec7nh nh\u00e2n n\u00ean u\u1ed1ng n\u01b0\u1edbc \u0111\u00fang m\u1ef1c v\u00e0 theo d\u00f5i ch\u1ee9c n\u0103ng th\u1eadn sau khi b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c v\u00e0 ki\u1ec3m tra \u0111\u1ecbnh k\u1ef3 sau \u0111\u00f3.<\/p>\n<p><em>*Vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn<\/em><\/p>\n<p><em>Amifostin<\/em><\/p>\n<p>C\u00f3 th\u1ec3 x\u1ea3y ra ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n<p><em>C\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p c\u00f3 th\u1ec3 t\u0103ng l\u00ean khi s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p chung v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c.<\/p>\n<p><em>Alcohol, barbiturat, ch\u1ea5t g\u00e2y nghi\u1ec7n ho\u1eb7c ch\u1ed1ng tr\u1ea7m c\u1ea3m<\/em><\/p>\n<p>C\u00f3 th\u1ec3 x\u1ea3y ra h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/p>\n<p><em>(2) Kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c li\u00ean quan \u0111\u1ebfn olmesartan medoxomil<\/em><\/p>\n<p><em>*Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng chung<\/em><\/p>\n<p><em>Ch\u1ea5t \u1ee9c ch\u1ebf enzym chuy\u1ec3n angiotensin (ACEI), ch\u1ea5t \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin II ho\u1eb7c aliskiren<\/em><\/p>\n<p>D\u1eef li\u1ec7u l\u00e2m s\u00e0ng cho th\u1ea5y phong t\u1ecfa k\u00e9p h\u1ec7 th\u1ed1ng renin-angiotensin-aldosteron (RAAS) khi s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p ACEI, ch\u1ea5t \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin II ho\u1eb7c aliskiren l\u00e0m t\u0103ng t\u1ea7n su\u1ea5t t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n l\u00e0 h\u1ea1 huy\u1ebft \u00e1p, t\u0103ng kali m\u00e1u v\u00e0 gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn (bao g\u1ed3m suy th\u1eadn c\u1ea5p) so v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng ri\u00eang l\u1ebb c\u00e1c thu\u1ed1c t\u00e1c \u0111\u1ed9ng l\u00ean RAAS.<\/p>\n<p><em>Thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 kali<\/em><\/p>\n<p>D\u1ef1a tr\u00ean kinh nghi\u1ec7m s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c t\u00e1c \u0111\u1ed9ng l\u00ean h\u1ec7 th\u1ed1ng renin-angiotensin-aldosteron, s\u1eed d\u1ee5ng chung v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1eef kali, ch\u1ea5t b\u1ed5 sung kali, mu\u1ed1i thay th\u1ebf ch\u1ee9a kali ho\u1eb7c c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 kali m\u00e1u (v\u00ed d\u1ee5 heparin, ACEI) c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh. N\u1ebfu thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 kali \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng chung v\u1edbi vi\u00ean k\u1ebft h\u1ee3p, theo d\u00f5i n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft t\u01b0\u01a1ng.<\/p>\n<p><em>Ch\u1ea5t c\u00f4 l\u1eadp acid m\u1eadt colesevelam<\/em><\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ch\u1ea5t c\u00f4 l\u1eadp acid m\u1eadt colesevelam hydroclorid l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong m\u00e1u v\u00e0 n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a olmesartan, gi\u1ea3m Tin. S\u1eed d\u1ee5ng olmesartan medoxomil \u00edt nh\u1ea5t 4 gi\u1edd tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng colesevelam hydroclorid \u0111\u1ec3 gi\u1ea3m t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/p>\n<p><em>* Th\u00f4ng tin kh\u00e1c<\/em><\/p>\n<p>Sau khi \u0111i\u1ec1u tr\u1ecb v\u1edbi antacid (nh\u00f4m\/ magnesi hydroxyd), c\u00f3 s\u1ef1 gi\u1ea3m \u0111\u00e1ng k\u1ec3 sinh kh\u1ea3 d\u1ee5ng c\u1ee7a olmesartan.<\/p>\n<p>Olmesartan medoxomil kh\u00f4ng \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc v\u00e0 d\u01b0\u1ee3c l\u1ef1c h\u1ecdc c\u1ee7a warfarin v\u00e0 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a digoxin.<\/p>\n<p>S\u1eed d\u1ee5ng chung olmesartan v\u00e0 pravastatin tr\u00ean l\u00e2m s\u00e0ng kh\u00f4ng g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a c\u1ea3 hai thu\u1ed1c \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh.<\/p>\n<p>Tr\u00ean l\u00e2m s\u00e0ng, olmesartan kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf l\u00ean h\u1ec7 enzym cytochrom P450 1A1\/2, 2A6, 2C8\/9, 2C19, 2D6, 2E1 v\u00e0 3A4 in vitro, v\u00e0 kh\u00f4ng c\u00f3 ho\u1eb7c t\u00e1c d\u1ee5ng c\u1ea3m \u1ee9ng th\u1ea5p nh\u1ea5t tr\u00ean h\u1ec7 cytochrom P450 \u1edf chu\u1ed9t. Kh\u00f4ng c\u00f3 t\u01b0\u01a1ng t\u00e1c tr\u00ean l\u00e2m s\u00e0ng gi\u1eefa olmesartan v\u00e0 c\u00e1c thu\u1ed1c chuy\u1ec3n h\u00f3a b\u1edfi h\u1ec7 th\u1ed1ng cytochrom P450.<\/p>\n<p><em>(3) Kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c li\u00ean quan \u0111\u1ebfn hydroclorothiazid<\/em><\/p>\n<p><em>* Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p><em>Thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 kali<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng gi\u1ea3m kali c\u1ee7a hydroclorothiazid c\u00f3 th\u1ec3 x\u1ea3y ra khi s\u1eed d\u1ee5ng chung v\u1edbi c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m kali ho\u1eb7c h\u1ea1 kali m\u00e1u (v\u00ed d\u1ee5: Thu\u1ed1c l\u1ee3i ti\u1ec3u th\u1ea3i kali kh\u00e1c, ch\u1ea5t nhu\u1eadn tr\u00e0ng, corticosteroid, ACTH, amphotericin, carbenoxolon, penicillin G natri ho\u1eb7c d\u1eabn ch\u1ea5t acid salicylic).<\/p>\n<p><em>* Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p><em>Mu\u1ed1i calci<\/em><\/p>\n<p>Thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 calci huy\u1ebft thanh do gi\u1ea3m \u0111\u00e0o th\u1ea3i. N\u1ebfu ph\u1ea3i k\u00ea \u0111\u01a1n ch\u1ea5t b\u1ed5 sung calci, theo d\u00f5i n\u1ed3ng \u0111\u1ed9 calci huy\u1ebft t\u01b0\u01a1ng v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u calci t\u01b0\u01a1ng \u1ee9ng.<\/p>\n<p><em>Cholestyramin v\u00e0 colestipol resin<\/em><\/p>\n<p>Khi c\u00f3 m\u1eb7t resin trao \u0111\u1ed5i anion, s\u1ef1 h\u1ea5p thu c\u1ee7a hydroclorothiazid gi\u1ea3m.<\/p>\n<p><em>Digitalis glycosid<\/em><\/p>\n<p>H\u1ea1 kali m\u00e1u ho\u1eb7c h\u1ea1 magnesi m\u00e1u do thiazid c\u00f3 th\u1ec3 g\u00e2y r\u1ed1i lo\u1ea1n nh\u1ecbp tim c\u1ea3m \u1ee9ng digitalis.<\/p>\n<p><em>Thu\u1ed1c \u1ea3nh h\u01b0\u1edfng b\u1edfi n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh<\/em><\/p>\n<p>Theo d\u00f5i n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh v\u00e0 ECG th\u01b0\u1eddng xuy\u00ean \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi s\u1eed d\u1ee5ng vi\u00ean k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi n\u1ed3ng \u0111\u1ed9 kali huy\u1ebft thanh (v\u00ed d\u1ee5 digitalis glycosid v\u00e0 ch\u1ea5t ch\u1ed1ng lo\u1ea1n nh\u1ecbp) v\u00e0 v\u1edbi c\u00e1c thu\u1ed1c g\u00e2y xo\u1eafn \u0111\u1ec9nh (bao g\u1ed3m m\u1ed9t v\u00e0i thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp), h\u1ea1 kali m\u00e1u l\u00e0 m\u1ed9t trong nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 g\u00e2y xo\u1eafn \u0111\u1ec9nh.<\/p>\n<p>Ch\u1ea5t ch\u1ed1ng lo\u1ea1n nh\u1ecbp nh\u00f3m Ia (quinidin, hydroquinidin, disopyramid).<\/p>\n<p>Ch\u1ea5t ch\u1ed1ng lo\u1ea1n nh\u1ecbp nh\u00f3m III (amiodaron, sotalol, dofetilid, ibutilid).<\/p>\n<p>M\u1ed9t s\u1ed1 thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n (thioridazin, clopromazin, levopromazin, trifloperazin, cyanmemazin, sulpirid, amisulprid, tiaprid, pimozid, haloperidol, mizolastin, droperidol).<\/p>\n<p>Kh\u00e1c (bepridil, cisaprid, diphemanil, erythromycin IV, halofantrin, mizolastin, pentamidin, sparfloxacin, terfenadin, vincamin IV).<\/p>\n<p><em>Ch\u1ea5t gi\u00e3n c\u01a1 kh\u00f4ng ph\u00e2n c\u1ef1c (v\u00ed d\u1ee5 tubocurarin)<\/em><\/p>\n<p>Hydroclorothiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng c\u1ee7a ch\u1ea5t gi\u00e3n c\u01a1 kh\u00f4ng ph\u00e2n c\u1ef1c.<\/p>\n<p><em>Ch\u1ea5t \u0111\u1ed1i giao c\u1ea3m (v\u00ed d\u1ee5: Atropin, biperiden)<\/em><\/p>\n<p>L\u00e0m t\u0103ng sinh kh\u1ea3 d\u1ee5ng c\u1ee7a thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid do l\u00e0m gi\u1ea3m nhu \u0111\u1ed9ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 gi\u1ea3m t\u1ed1c \u0111\u1ed9 l\u00e0m r\u1ed7ng d\u1ea1 d\u00e0y.<\/p>\n<p><em>Thu\u1ed1c ch\u1ed1ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng (thu\u1ed1c s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c insulin)<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb v\u1edbi thiazid \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng dung n\u1ea1p glucose. C\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u c\u1ee7a thu\u1ed1c ch\u1ed1ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p><em>Metformin<\/em><\/p>\n<p>Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng metformin do nguy c\u01a1 l\u00e0m t\u0103ng acid lactic do suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn c\u00f3 th\u1ec3 x\u1ea3y ra li\u00ean quan \u0111\u1ebfn hydroclorothiazid.<\/p>\n<p><em>Ch\u1ea5t ch\u1eb9n beta v\u00e0 diazoxid<\/em><\/p>\n<p>Thiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft c\u1ee7a ch\u1ea5t ch\u1eb9n beta v\u00e0 diazoxid.<\/p>\n<p><em>Amin \u1ea3nh h\u01b0\u1edfng huy\u1ebft \u00e1p (v\u00ed d\u1ee5: Adrenalin)<\/em><\/p>\n<p>C\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c amin \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn huy\u1ebft \u00e1p.<\/p>\n<p><em>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb gout (v\u00ed d\u1ee5: Probenecid, sulfinpyrazol v\u00e0 allopurinol)<\/em><\/p>\n<p>C\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u c\u1ee7a c\u00e1c thu\u1ed1c g\u00e2y b\u00e0i ti\u1ebft uric trong n\u01b0\u1edbc ti\u1ec3u v\u00ec hydroclorothiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 acid uric huy\u1ebft thanh. C\u00f3 th\u1ec3 c\u1ea7n t\u0103ng li\u1ec1u c\u1ee7a probenecid ho\u1eb7c sulfinpyrazol.<\/p>\n<p>S\u1eed d\u1ee5ng chung v\u1edbi m\u1ed9t thiazid c\u00f3 th\u1ec3 t\u0103ng t\u1ea7n su\u1ea5t ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn v\u1edbi allopurinol.<\/p>\n<p><em>Amantadin<\/em><\/p>\n<p>Thiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n do amantadin.<\/p>\n<p><em>Ch\u1ea5t g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o (v\u00ed d\u1ee5 cyclophosphamid, methotrexat)<\/em><\/p>\n<p>Thiazid c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u00e0o th\u1ea3i t\u1ea1i th\u1eadn c\u1ee7a c\u00e1c thu\u1ed1c g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y \u1ee9c ch\u1ebf t\u1ee7y.<\/p>\n<p><em>Salicylat<\/em><\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng li\u1ec1u cao salicylat, hydroclorothiazid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a salicylat l\u00ean h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n<p><em>Methyldopa<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft x\u1ea3y ra khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi hydroclorothiazid v\u00e0 methyldopa.<\/p>\n<p><em>Cyclosporin<\/em><\/p>\n<p>S\u1eed d\u1ee5ng chung v\u1edbi cyclosporin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u0103ng uric m\u00e1u v\u00e0 b\u1ec7nh gout bi\u1ebfn ch\u1ee9ng.<\/p>\n<p><em>Tetracyclin<\/em><\/p>\n<p>S\u1eed d\u1ee5ng chung tetracyclin v\u00e0 hydroclorothiazid l\u00e0m t\u0103ng nguy c\u01a1 t\u0103ng ur\u00ea do tetracyclin. T\u01b0\u01a1ng t\u00e1c n\u00e0y c\u00f3 th\u1ec3 kh\u00f4ng x\u1ea3y ra \u0111\u1ed1i v\u1edbi doxycyclin.<\/p>\n<h3><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><\/h3>\n<p>Kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u v\u1ec1 qu\u00e1 li\u1ec1u olmesartan\/ hydroclorothiazid. Theo d\u00f5i b\u1ec7nh nh\u00e2n, \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ed7 tr\u1ee3. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o th\u1eddi gian t\u1eeb khi u\u1ed1ng v\u00e0 t\u00ednh nghi\u00eam tr\u1ecdng c\u1ee7a tri\u1ec7u ch\u1ee9ng. C\u00e1c bi\u1ec7n ph\u00e1p c\u00f3 th\u1ec3 l\u00e0m l\u00e0 g\u00e2y n\u00f4n v\u00e0\/ ho\u1eb7c r\u1eeda d\u1ea1 d\u00e0y. Than ho\u1ea1t c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i khi \u0111i\u1ec1u tr\u1ecb qu\u00e1 li\u1ec1u. Theo d\u00f5i th\u01b0\u1eddng xuy\u00ean n\u1ed3ng \u0111\u1ed9 ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i v\u00e0 creatinin. N\u1ebfu x\u1ea3y ra h\u1ea1 huy\u1ebft \u00e1p, n\u00ean \u0111\u1ec3 b\u1ec7nh nh\u00e2n n\u1eb1m y\u00ean, truy\u1ec1n mu\u1ed1i v\u00e0 d\u1ecbch.<\/p>\n<p>Tri\u1ec7u ch\u1ee9ng qu\u00e1 li\u1ec1u hay g\u1eb7p c\u1ee7a olmesartan medoxomil l\u00e0 h\u1ea1 huy\u1ebft \u00e1p v\u00e0 tim nhanh; ch\u1eadm nh\u1ecbp tim c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra. Qu\u00e1 li\u1ec1u hydroclorothiazid th\u01b0\u1eddng l\u00e0 gi\u1ea3m ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i (h\u1ea1 kali m\u00e1u, h\u1ea1 clorid m\u00e1u) v\u00e0 m\u1ea5t n\u01b0\u1edbc do l\u1ee3i ti\u1ec3u qu\u00e1 m\u1ee9c. D\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p c\u1ee7a qu\u00e1 li\u1ec1u l\u00e0 bu\u1ed3n n\u00f4n v\u00e0 b\u1ea5t t\u1ec9nh.<\/p>\n<p>H\u1ea1 kali m\u00e1u c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn co c\u01a1 v\u00e0\/ ho\u1eb7c lo\u1ea1n nh\u1ecbp tim khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi digitalis glycosid ho\u1eb7c c\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp kh\u00e1c.<\/p>\n<p>Kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u li\u00ean quan \u0111\u1ebfn vi\u1ec7c th\u1ea9m ph\u00e2n olmesartan hay hydroclorothiazid.<\/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=\"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><\/h2>\n<h3><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><\/h3>\n<p>Olmesartan medoxomil: Nh\u00f3m d\u01b0\u1ee3c l\u00fd: Thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p. M\u00e3 ATC: C09CA08.<\/p>\n<p>Hydrochlorothiazid: Nh\u00f3m d\u01b0\u1ee3c l\u00fd: Thu\u1ed1c l\u1ee3i ti\u1ec3u nh\u00f3m thizazid. M\u00e3 ATC: C03AA03.<\/p>\n<p>ZOKORA-HCTZ 20\/12,5 l\u00e0 d\u1ea1ng k\u1ebft h\u1ee3p li\u1ec1u c\u1ed1 \u0111\u1ecbnh c\u1ee7a olmesartan medoxomil, ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II v\u00e0 hydroclorothiazid, thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid. K\u1ebft h\u1ee3p n\u00e0y l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p, huy\u1ebft \u00e1p h\u1ea1 nhi\u1ec1u h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng hai thu\u1ed1c ri\u00eang l\u1ebb.<\/p>\n<p>Li\u1ec1u 1 l\u1ea7n\/ ng\u00e0y c\u1ee7a vi\u00ean k\u1ebft h\u1ee3p cho hi\u1ec7u qu\u1ea3 trong v\u00f2ng 24 gi\u1edd.<\/p>\n<p>Olmesartan medoxomil l\u00e0 thu\u1ed1c s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng, \u0111\u1ed1i kh\u00e1ng ch\u1ecdn l\u1ecdc th\u1ee5 th\u1ec3 angiotensin II (AT1). Angiotensin II l\u00e0 hormon v\u1eadn m\u1ea1ch c\u1ee7a h\u1ec7 renin-angiotensin-aldosteron v\u00e0 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong sinh l\u00fd b\u1ec7nh c\u1ee7a t\u0103ng huy\u1ebft \u00e1p. T\u00e1c \u0111\u1ed9ng c\u1ee7a angiotensin II bao g\u1ed3m co m\u1ea1ch, k\u00edch th\u00edch t\u1ed5ng h\u1ee3p v\u00e0 ph\u00f3ng th\u00edch aldosteron, k\u00edch th\u00edch tim v\u00e0 t\u00e1i h\u1ea5p thu natri t\u1ea1i th\u1eadn.<\/p>\n<p>Olmesartan \u1ee9c ch\u1ebf t\u00e1c d\u1ee5ng co m\u1ea1ch v\u00e0 ti\u1ebft aldosteron c\u1ee7a angiotensin II b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf n\u00f3 g\u1eafn v\u1edbi th\u1ee5 th\u1ec3 AT1 \u1edf m\u00f4 bao g\u1ed3m c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u v\u00e0 tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn. T\u00e1c d\u1ee5ng c\u1ee7a olmesartan kh\u00f4ng li\u00ean quan \u0111\u1ebfn ngu\u1ed3n hay qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p angiotensin II. T\u00e1c d\u1ee5ng \u0111\u1ed1i kh\u00e1ng ch\u1ecdn l\u1ecdc th\u1ee5 th\u1ec3 angiotensin II (AT1) b\u1edfi olmesartan l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 renin huy\u1ebft t\u01b0\u01a1ng v\u00e0 n\u1ed3ng \u0111\u1ed9 angiotensin I v\u00e0 angiotensin II, v\u00e0 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 aldosteron huy\u1ebft t\u01b0\u01a1ng.<\/p>\n<p>Trong t\u0103ng huy\u1ebft \u00e1p, olmesartan medoxomil g\u00e2y h\u1ea1 huy\u1ebft \u00e1p \u0111\u1ed9ng m\u1ea1ch k\u00e9o d\u00e0i ph\u1ee5 thu\u1ed9c li\u1ec1u.<\/p>\n<p>Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng g\u00e2y h\u1ea1 huy\u1ebft \u00e1p li\u1ec1u \u0111\u1ea7u, ph\u1ea3n x\u1ea1 tim nhanh khi \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i, ho\u1eb7c t\u0103ng huy\u1ebft \u00e1p d\u1ed9i ng\u01b0\u1ee3c sau khi ng\u01b0ng \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Li\u1ec1u olmesartan medoxomil 1 l\u1ea7n\/ ng\u00e0y c\u00f3 t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p trong v\u00f2ng 24 gi\u1edd. Li\u1ec1u 1 l\u1ea7n\/ ng\u00e0y cho hi\u1ec7u qu\u1ea3 h\u1ea1 huy\u1ebft \u00e1p t\u01b0\u01a1ng t\u1ef1 nh\u01b0 li\u1ec1u hai l\u1ea7n m\u1ed9t ng\u00e0y v\u1edbi t\u1ed5ng li\u1ec1u h\u00e0ng ng\u00e0y t\u01b0\u01a1ng \u0111\u01b0\u01a1ng.<\/p>\n<p>Khi \u0111i\u1ec1u tr\u1ecb li\u00ean t\u1ee5c, t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p \u0111\u1ea1t t\u1ed1i \u0111a sau 8 tu\u1ea7n sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, m\u1eb7c d\u00f9 ph\u1ea7n l\u1edbn t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p \u0111\u1ea1t \u0111\u01b0\u1ee3c sau 2 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Hydroclorothiazid l\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid. C\u01a1 ch\u1ebf ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p c\u1ee7a thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid v\u1eabn c\u00f2n ch\u01b0a r\u00f5. Thiazid t\u00e1c \u0111\u1ed9ng l\u00ean c\u01a1 ch\u1ebf t\u00e1i h\u1ea5p th\u1ee5 ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i \u1edf \u1ed1ng th\u1eadn, t\u0103ng \u0111\u00e0o th\u1ea3i tr\u1ef1c ti\u1ebfp natri v\u00e0 clorid v\u1edbi l\u01b0\u1ee3ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng. T\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u c\u1ee7a hydroclorothiazid l\u00e0m gi\u1ea3m th\u1ec3 t\u00edch huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ho\u1ea1t \u0111\u1ed9ng renin huy\u1ebft t\u01b0\u01a1ng v\u00e0 t\u0103ng b\u00e0i ti\u1ebft aldosteron, t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng m\u1ea5t kali v\u00e0 bicarbonat trong n\u01b0\u1edbc ti\u1ec3u, v\u00e0 gi\u1ea3m kali huy\u1ebft thanh. Renin-angiotensin li\u00ean quan v\u1edbi nhau b\u1edfi angiotensin II v\u00e0 do \u0111\u00f3 vi\u1ec7c s\u1eed d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II b\u00f9 tr\u1eeb s\u1ef1 m\u1ea5t kali do thu\u1ed1c l\u1ee3i ti\u1ec3u thiazid. V\u1edbi hydroclorothiazid, t\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u xu\u1ea5t hi\u1ec7n sau 2 gi\u1edd d\u00f9ng thu\u1ed1c v\u00e0 t\u00e1c d\u1ee5ng t\u1ed1i \u0111a sau 4 gi\u1edd, trong khi t\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u k\u00e9o d\u00e0i kho\u1ea3ng 6 \u2013 12 gi\u1edd.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Olmesartan l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 angiotensin II lo\u1ea1i 1 (AT1) c\u1ee5 th\u1ec3, ng\u1eafn ch\u1eb7n t\u00e1c d\u1ee5ng l\u00e0m t\u0103ng huy\u1ebft \u00e1p c\u1ee7a angiotensin II th\u00f4ng qua h\u1ec7 th\u1ed1ng renin-angiotensin-aldosterone (RAAS). Trong qu\u00e1 tr\u00ecnh k\u00edch th\u00edch giao c\u1ea3m ho\u1eb7c khi huy\u1ebft \u00e1p th\u1eadn ho\u1eb7c l\u01b0u l\u01b0\u1ee3ng m\u00e1u gi\u1ea3m, renin \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng t\u1eeb c\u00e1c t\u1ebf b\u00e0o h\u1ea1t c\u1ee7a b\u1ed9 m\u00e1y juxtaglomeular trong th\u1eadn. Renin ph\u00e2n c\u1eaft angiotensinogen l\u01b0u h\u00e0nh th\u00e0nh angiotensin I, \u0111\u01b0\u1ee3c ph\u00e2n c\u1eaft b\u1edfi enzyme chuy\u1ec3n \u0111\u1ed5i angiotensin (ACE) th\u00e0nh angiotensin II. Angiotensin II l\u00e0m t\u0103ng huy\u1ebft \u00e1p b\u1eb1ng c\u00e1ch t\u0103ng t\u1ed5ng s\u1ee9c \u0111\u1ec1 kh\u00e1ng ngo\u1ea1i bi\u00ean, t\u0103ng t\u00e1i h\u1ea5p thu natri v\u00e0 n\u01b0\u1edbc \u1edf th\u1eadn th\u00f4ng qua b\u00e0i ti\u1ebft aldosterone v\u00e0 thay \u0111\u1ed5i c\u1ea5u tr\u00fac tim m\u1ea1ch. Angiotensin II li\u00ean k\u1ebft v\u1edbi hai th\u1ee5 th\u1ec3: AT1 v\u00e0 AT2. AT1 l\u00e0 m\u1ed9t th\u1ee5 th\u1ec3 k\u1ebft h\u1ee3p G-protein (GPCR) l\u00e0m trung gian t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf v\u1eadn m\u1ea1ch v\u00e0 aldosterone c\u1ee7a angiotensin II. Thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin (ARB) l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf c\u1ea1nh tranh kh\u00f4ng peptide c\u1ee7a AT1. ARB ng\u1eafn ch\u1eb7n kh\u1ea3 n\u0103ng c\u1ee7a angiotensin II \u0111\u1ec3 k\u00edch th\u00edch t\u00e1c d\u1ee5ng t\u0103ng sinh t\u1ebf b\u00e0o v\u00e0 t\u1ebf b\u00e0o. Kh\u00f4ng gi\u1ed1ng nh\u01b0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, ARB kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 gi\u00e3n m\u1ea1ch do bradykinin g\u00e2y ra. T\u00e1c d\u1ee5ng chung c\u1ee7a ARB l\u00e0 gi\u1ea3m huy\u1ebft \u00e1p.<\/p>\n<p>Hydrochlorothiazide l\u00e0 m\u1ed9t thu\u1ed1c l\u1ee3i ni\u1ec7u v\u00e0 h\u1ea1 huy\u1ebft \u00e1p. C\u00f3 t\u00e1c d\u1ee5ng tr\u00ean c\u01a1 ch\u1ebf t\u00e1i h\u1ea5p thu \u0111i\u1ec7n gi\u1ea3i \u1edf \u1ed1ng l\u01b0\u1ee3n xa. Hydrochlorothiazide l\u00e0m t\u0103ng b\u00e0i ti\u1ebft natri v\u00e0 chloride \u1edf m\u1ee9c x\u1ea5p x\u1ec9 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau. Natri-ni\u1ec7u, c\u00f3 th\u1ec3 k\u00e8m theo hi\u1ec7n t\u01b0\u1ee3ng m\u1ea5t kali v\u00e0 bicarbonate.<\/p>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=F1Pl4DO5flA\"><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/a><\/p>\n<h3><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><\/h3>\n<p><em>*H\u1ea5p thu v\u00e0 ph\u00e2n b\u1ed1<\/em><\/p>\n<p><em>Olmesartan medoxomil<\/em><\/p>\n<p>Olmesartan medoxomil l\u00e0 m\u1ed9t ti\u1ec1n d\u01b0\u1ee3c. N\u00f3 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a nhanh ch\u00f3ng th\u00e0nh ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh l\u00e0 olmesartan b\u1edfi enzym esterase \u1edf ru\u1ed9t v\u00e0 m\u00e1u t\u0129nh m\u1ea1ch c\u1eeda trong khi h\u1ea5p thu qua ru\u1ed9t. Kh\u00f4ng t\u00ecm th\u1ea5y olmesartan medoxomil ho\u1eb7c medoxomil d\u1ea1ng nguy\u00ean v\u1eb9n trong huy\u1ebft t\u01b0\u01a1ng ho\u1eb7c ch\u1ea5t b\u00e0i ti\u1ebft. Sinh kh\u1ea3 d\u1ee5ng tuy\u1ec7t \u0111\u1ed1i c\u1ee7a olmesartan khi s\u1eed d\u1ee5ng d\u1ea1ng vi\u00ean n\u00e9n l\u00e0 25,6%.<\/p>\n<p>N\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a olmesartan \u0111\u1ea1t \u0111\u01b0\u1ee3c trong v\u00f2ng 2 gi\u1edd sau khi u\u1ed1ng m\u1ed9t li\u1ec1u olmesartan medoxomil v\u00e0 n\u1ed3ng \u0111\u1ed9 olmesartan huy\u1ebft t\u01b0\u01a1ng t\u0103ng g\u1ea7n nh\u01b0 tuy\u1ebfn t\u00ednh \u0111\u1ebfn li\u1ec1u t\u1ed1i \u0111a 80 mg.<\/p>\n<p>Th\u1ee9c \u0103n c\u00f3 t\u00e1c \u0111\u1ed9ng r\u1ea5t \u00edt \u0111\u1ebfn sinh kh\u1ea3 d\u1ee5ng c\u1ee7a olmesartan, do \u0111\u00f3 c\u00f3 th\u1ec3 u\u1ed1ng olmesartan medoxomil c\u00f9ng ho\u1eb7c kh\u00f4ng c\u00f9ng v\u1edbi th\u1ee9c \u0103n.<\/p>\n<p>Olmesartan g\u1eafn k\u1ebft nhi\u1ec1u v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng (99,7%), nh\u01b0ng kh\u1ea3 n\u0103ng x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c c\u1ea1nh tranh g\u1eafn k\u1ebft protein huy\u1ebft t\u01b0\u01a1ng gi\u1eefa olmesartan v\u00e0 c\u00e1c thu\u1ed1c g\u1eafn k\u1ebft nhi\u1ec1u protein huy\u1ebft t\u01b0\u01a1ng kh\u00e1c th\u1ea5p tr\u00ean l\u00e2m s\u00e0ng. Kh\u1ea3 n\u0103ng g\u1eafn k\u1ebft c\u1ee7a olmesartan v\u1edbi t\u1ebf b\u00e0o m\u00e1u kh\u00f4ng \u0111\u00e1ng k\u1ec3. Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 sau khi d\u00f9ng li\u1ec1u ti\u00eam t\u0129nh m\u1ea1ch th\u1ea5p (16 &#8211; 29 L).<\/p>\n<p><em>Hydroclorothiazid<\/em><\/p>\n<p>Sau khi u\u1ed1ng ph\u1ed1i h\u1ee3p olmesartan medoxomil v\u00e0 hydroclorothiazid, th\u1eddi gian trung b\u00ecnh \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh huy\u1ebft t\u01b0\u01a1ng c\u1ee7a hydroclorothiazid l\u00e0 1,5 &#8211; 2 gi\u1edd.<\/p>\n<p>Hydroclorothiazid g\u1eafn k\u1ebft 68% protein huy\u1ebft t\u01b0\u01a1ng v\u00e0 th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 l\u00e0 0,83 &#8211; 1,14 L\/ kg.<\/p>\n<p><em>*Chuy\u1ec3n h\u00f3a v\u00e0 th\u1ea3i tr\u1eeb:<\/em><\/p>\n<p><em>Olmesartan medoxomil<\/em><\/p>\n<p>\u0110\u1ed9 thanh th\u1ea3i huy\u1ebft t\u01b0\u01a1ng to\u00e0n ph\u1ea7n c\u1ee7a olmesartan l\u00e0 1,3 L\/ gi\u1edd v\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i ch\u1eadm h\u01a1n so v\u1edbi t\u1ed1c \u0111\u1ed9 m\u00e1u \u1edf gan (90 L\/ gi\u1edd). Sau khi u\u1ed1ng m\u1ed9t li\u1ec1u olmesartan medoxomil \u0111\u00e1nh d\u1ea5u \u0111\u1ed3ng v\u1ecb 14C, 10 &#8211; 16% thu\u1ed1c \u0111\u00e1nh d\u1ea5u \u0111\u1ed3ng v\u1ecb th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u (ph\u1ea7n l\u1edbn trong 24 gi\u1edd \u0111\u1ea7u) v\u00e0 ph\u1ea7n c\u00f2n l\u1ea1i \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua ph\u00e2n. D\u1ef1a tr\u00ean sinh kh\u1ea3 d\u1ee5ng to\u00e0n th\u00e2n l\u00e0 25,6%, c\u00f3 th\u1ec3 t\u00ednh \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng olmesartan h\u1ea5p thu \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua th\u1eadn l\u00e0 40% v\u00e0 gan l\u00e0 60%. T\u1ea5t c\u1ea3 c\u00e1c \u0111\u1ed3ng v\u1ecb \u0111\u00e1nh d\u1ea5u \u0111\u1ec1u l\u00e0 c\u1ee7a olmesartan. Kh\u00f4ng c\u00f3 ch\u1ea5t chuy\u1ec3n h\u00f3a kh\u00e1c \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y. Chu tr\u00ecnh gan ru\u1ed9t c\u1ee7a olmesartan th\u1ea5p. Do ph\u1ea7n l\u1edbn olmesartan \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua \u0111\u01b0\u1eddng m\u1eadt, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh olmesartan cho b\u1ec7nh nh\u00e2n b\u1ecb t\u1eafc m\u1eadt.<\/p>\n<p>T\u1ed5ng th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a olmesartan bi\u1ebfn thi\u00ean t\u1eeb 10 \u0111\u1ebfn 15 gi\u1edd sau khi s\u1eed d\u1ee5ng li\u1ec1u u\u1ed1ng l\u1eb7p l\u1ea1i. Tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh \u0111\u1ea1t \u0111\u01b0\u1ee3c sau v\u00e0i li\u1ec1u \u0111\u1ea7u ti\u00ean v\u00e0 kh\u00f4ng c\u00f3 t\u00edch l\u0169y trong 14 ng\u00e0y sau khi d\u00f9ng li\u1ec1u l\u1eb7p l\u1ea1i. \u0110\u1ed9 thanh th\u1ea3i \u1edf th\u1eadn kho\u1ea3ng 0,5 &#8211; 0,7 L\/ gi\u1edd v\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c li\u1ec1u.<\/p>\n<p><em>Hydroclorothiazid<\/em><\/p>\n<p>Hydroclorothiazid kh\u00f4ng \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a \u1edf ng\u01b0\u1eddi v\u00e0 th\u1ea3i tr\u1eeb g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i c\u00f3 ho\u1ea1t t\u00ednh trong n\u01b0\u1edbc ti\u1ec3u. Kho\u1ea3ng 60% li\u1ec1u u\u1ed1ng \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i c\u00f3 ho\u1ea1t t\u00ednh trong v\u00f2ng 48 gi\u1edd. \u0110\u1ed9 thanh th\u1ea3i \u1edf th\u1eadn kho\u1ea3ng 250 &#8211; 300 mL\/ ph\u00fat. T\u1ed5ng th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a hydroclorothiazid l\u00e0 10 &#8211; 15 gi\u1edd.<\/p>\n<p>Sinh kh\u1ea3 d\u1ee5ng to\u00e0n th\u00e2n c\u1ee7a hydroclorothiazid gi\u1ea3m kho\u1ea3ng 20% khi s\u1eed d\u1ee5ng chung v\u1edbi olmesartan medoxomil, nh\u01b0ng m\u1ee9c gi\u1ea3m n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a tr\u00ean l\u00e2m s\u00e0ng. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a olmesartan kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng khi s\u1eed d\u1ee5ng chung v\u1edbi hydroclorothiazid.<\/p>\n<p><em>*D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc \u1edf \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u1eb7c bi\u1ec7t<\/em><\/p>\n<p><em>Ng\u01b0\u1eddi cao tu\u1ed5i (\u2265 65 tu\u1ed5i)<\/em><\/p>\n<p>\u1ede b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng huy\u1ebft \u00e1p, AUC c\u1ee7a olmesartan \u1edf tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh t\u0103ng kho\u1ea3ng 35% \u1edf ng\u01b0\u1eddi cao tu\u1ed5i (65 &#8211; 75 tu\u1ed5i) v\u00e0 kho\u1ea3ng 44% \u1edf ng\u01b0\u1eddi \u2265 75 tu\u1ed5i so v\u1edbi nh\u00f3m tu\u1ed5i tr\u1ebb h\u01a1n.<\/p>\n<p>D\u1eef li\u1ec7u l\u00e2m s\u00e0ng c\u00f2n h\u1ea1n ch\u1ebf cho th\u1ea5y \u0111\u1ed9 thanh th\u1ea3i to\u00e0n th\u00e2n c\u1ee7a hydroclorothiazid gi\u1ea3m \u1edf nh\u00f3m ng\u01b0\u1eddi gi\u00e0 kh\u1ecfe m\u1ea1nh ho\u1eb7c b\u1ecb t\u0103ng huy\u1ebft \u00e1p so v\u1edbi ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n tr\u1ebb kh\u1ecfe m\u1ea1nh.<\/p>\n<p><em>Suy th\u1eadn<\/em><\/p>\n<p>\u1ede b\u1ec7nh nh\u00e2n suy th\u1eadn, AUC c\u1ee7a olmesartan \u1edf tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh t\u0103ng kho\u1ea3ng 62%, 82% v\u00e0 179% l\u1ea7n l\u01b0\u1ee3t \u1edf b\u1ec7nh nh\u00e2n b\u1ecb suy th\u1eadn nh\u1eb9, trung b\u00ecnh v\u00e0 n\u1eb7ng so v\u1edbi nh\u00f3m ch\u1ee9ng kh\u1ecfe m\u1ea1nh. Th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a hydroclorothiazid k\u00e9o d\u00e0i h\u01a1n \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn.<\/p>\n<p><em>Suy gan<\/em><\/p>\n<p>Sau khi u\u1ed1ng li\u1ec1u duy nh\u1ea5t, gi\u00e1 tr\u1ecb AUC c\u1ee7a olmesartan cao h\u01a1n 6% \u1edf ng\u01b0\u1eddi suy gan nh\u1eb9 v\u00e0 65% \u1edf ng\u01b0\u1eddi suy gan v\u1eeba so v\u1edbi nh\u00f3m ch\u1ee9ng kh\u1ecfe m\u1ea1nh. Sau khi s\u1eed d\u1ee5ng li\u1ec1u l\u1eb7p l\u1ea1i \u1edf b\u1ec7nh nh\u00e2n suy gan v\u1eeba, AUC olmesartan cao h\u01a1n kho\u1ea3ng 65% so v\u1edbi nh\u00f3m ch\u1ee9ng kh\u1ecfe m\u1ea1nh. Gi\u00e1 tr\u1ecb Cmax c\u1ee7a olmesartan gi\u1ed1ng nhau gi\u1eefa nh\u00f3m ch\u1ee9ng kh\u1ecfe m\u1ea1nh v\u00e0 b\u1ec7nh nh\u00e2n suy gan. Olmesartan medoxomil ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u1edf b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng. Suy gan kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng c\u1ee7a hydroclorothiazid.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"53-hieu-qua-lam-sang\"><\/span>5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"54-du-lieu-tien-lam-sang\"><\/span>5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\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\u1ee9ng 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<h2><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><\/h2>\n<h3><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><\/h3>\n<p>Cellulose vi tinh th\u1ec3 M101, povidon, polysorbat 80, glycerol, natri starch glycolat, magnesi stearat, HPMC E6, titan dioxyd, talc, PEG 4000, d\u1ea7u th\u1ea7u d\u1ea7u (virgin castor oil).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"62-tuong-ky\"><\/span>6.2. T\u01b0\u01a1ng k\u1ef5 :<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"63-bao-quan\"><\/span>6.3. B\u1ea3o qu\u1ea3n:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>N\u01a1i kh\u00f4, tr\u00e1nh \u00e1nh s\u00e1ng, nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30\u00b0C.<\/p>\n<h3><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><\/h3>\n<p>Kh\u00f4ng c\u00f3.<\/p>\n<h3><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><\/h3>\n<p>HDSD Thu\u1ed1c Zokora-HCTZ do C\u00f4ng ty C\u1ed5 ph\u1ea7n D\u01b0\u1ee3c ph\u1ea9m \u0110\u1ea1t Vi Ph\u00fa s\u1ea3n xu\u1ea5t (2018).<\/p>\n<h2><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><\/h2>\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<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Th\u00f4ng tin t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c Zokora-HCTZ, Andirel-HCTZ D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a Thu\u1ed1c Zokora-HCTZ, Andirel-HCTZ (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 : Hydrochlorothiazide + Olmesartan [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":58496,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","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":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[419],"tags":[827,2444,1086],"class_list":["post-58494","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-hydrochlorothiazide","tag-hydrochlorothiazide-olmesartan","tag-olmesartan"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/58494","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=58494"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/58494\/revisions"}],"predecessor-version":[{"id":59992,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/58494\/revisions\/59992"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/58496"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=58494"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=58494"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=58494"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}