{"id":6514,"date":"2019-04-02T10:32:52","date_gmt":"2019-04-02T03:32:52","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=6514"},"modified":"2025-01-08T23:02:48","modified_gmt":"2025-01-08T16:02:48","slug":"betamethasone-celestone","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/betamethasone-celestone\/","title":{"rendered":"Betamethasone &#8211; Celestone"},"content":{"rendered":"<p><strong>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: <\/strong><\/p>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <a href=\"https:\/\/pharmog.com\/wp\/betamethasone\/\">Betamethasone<\/a><\/strong><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c Corticosteroids.<\/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): H02AB01.<\/p>\n<p><strong><em>Brand name:<\/em><\/strong> CELESTONE, .<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: PT Schering Plough.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng: <\/strong><\/p>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Vi\u00ean n\u00e9n 0,5 mg . H\u1ed9p 15 v\u1ec9 x 10 vi\u00ean n\u00e9n<\/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>CELESTONE<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i vi\u00ean n\u00e9n c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Betamethasone<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>0,5 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\" width=\"393\" height=\"219\" class=\"wp-image-6515\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/word-image-61.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/word-image-61.png 393w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/word-image-61-300x167.png 300w\" sizes=\"auto, (max-width: 393px) 100vw, 393px\" \/><\/p>\n<p><strong>3. Video by Pharmog:<\/strong><\/p>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<p><strong>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng: <\/strong><\/p>\n<p><strong>4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>\u0110\u01b0\u1ee3c s\u1eed d\u1ee5ng trong b\u1ec7nh n\u1ed9i ti\u1ebft, c\u01a1 &#8211; x\u01b0\u01a1ng, r\u1ed1i lo\u1ea1n ch\u1ea5t t\u1ea1o keo, da, d\u1ecb \u1ee9ng, m\u1eaft, h\u00f4 h\u1ea5p, m\u00e1u, ung th\u01b0 v\u00e0 nh\u1eefng b\u1ec7nh kh\u00e1c c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb corticoide.<\/p>\n<p>R\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft t\u1ed1 : thi\u1ec3u n\u0103ng v\u1ecf th\u01b0\u1ee3ng th\u1eadn s\u01a1 c\u1ea5p ho\u1eb7c th\u1ee9 c\u1ea5p (d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi min\u00e9ralocorticoide, n\u1ebfu c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c) ; t\u0103ng s\u1ea3n tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn b\u1ea9m sinh ; vi\u00eam tuy\u1ebfn gi\u00e1p kh\u00f4ng m\u01b0ng m\u1ee7 v\u00e0 t\u0103ng calci huy\u1ebft c\u00f3 li\u00ean quan \u0111\u1ebfn ung th\u01b0.<\/p>\n<p>R\u1ed1i lo\u1ea1n v\u1ec1 c\u01a1 &#8211; x\u01b0\u01a1ng : \u0111\u01b0\u1ee3c d\u00f9ng nh\u01b0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung trong th\u1eddi gian ng\u1eafn (gi\u00fap cho b\u1ec7nh nh\u00e2n kh\u1eafc ph\u1ee5c qua giai \u0111o\u1ea1n c\u1ea5p t\u00ednh v\u00e0 lan tr\u00e0n) trong ch\u1ee9ng th\u1ea5p kh\u1edbp do b\u1ec7nh v\u1ea9y n\u1ebfn ; vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p (trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 d\u00f9ng li\u1ec1u duy tr\u00ec th\u1ea5p) ; vi\u00eam d\u00ednh kh\u1edbp s\u1ed1ng ; vi\u00eam bao ho\u1ea1t d\u1ecbch c\u1ea5p v\u00e0 b\u00e1n c\u1ea5p ; vi\u00eam g\u00e2n m\u00e0ng ho\u1ea1t d\u1ecbch c\u1ea5p t\u00ednh kh\u00f4ng \u0111\u1eb7c hi\u1ec7u ; b\u1ec7nh th\u1ed1ng phong ; b\u1ec7nh th\u1ea5p c\u1ea5p t\u00ednh v\u00e0 vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch.<\/p>\n<p>B\u1ec7nh c\u1ee7a ch\u1ea5t t\u1ea1o keo : trong th\u1eddi k\u1ef3 lan tr\u00e0n ho\u1eb7c trong \u0111i\u1ec1u tr\u1ecb duy tr\u00ec m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p lupus ban \u0111\u1ecf to\u00e0n th\u00e2n, vi\u00eam c\u01a1 tim c\u1ea5p t\u00ednh do th\u1ea5p kh\u1edbp, x\u01a1 c\u1ee9ng b\u00ec v\u00e0 vi\u00eam da-c\u01a1.<\/p>\n<p>Khoa da : b\u1ec7nh Pemphigus ; vi\u00eam da m\u1ee5n n\u01b0\u1edbc d\u1ea1ng herpes ; h\u1ed3ng ban \u0111a d\u1ea1ng nghi\u00eam tr\u1ecdng (h\u1ed9i ch\u1ee9ng Stevens-Johnson) ; vi\u00eam da tr\u00f3c v\u1ea9y ; u s\u00f9i d\u1ea1ng n\u1ea5m ; b\u1ec7nh v\u1ea9y n\u1ebfn n\u1eb7ng ; ecz\u00e9ma d\u1ecb \u1ee9ng (vi\u00eam da m\u00e3n t\u00ednh) v\u00e0 n\u1ed5i m\u1ec1 \u0111ay.<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p d\u1ecb \u1ee9ng : \u0111\u01b0\u1ee3c d\u00f9ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ecb d\u1ecb \u1ee9ng n\u1eb7ng ho\u1eb7c th\u1ea5t b\u1ea1i sau c\u00e1c \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng, nh\u01b0 l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p vi\u00eam m\u0169i d\u1ecb \u1ee9ng theo m\u00f9a ho\u1eb7c dai d\u1eb3ng, polyp m\u0169i, hen ph\u1ebf qu\u1ea3n (bao g\u1ed3m suy\u1ec5n), vi\u00eam da ti\u1ebfp x\u00fac, vi\u00eam da d\u1ecb \u1ee9ng (vi\u00eam da th\u1ea7n kinh), c\u00e1c ph\u1ea3n \u1ee9ng thu\u1ed1c v\u00e0 huy\u1ebft thanh.<\/p>\n<p>M\u1eaft : nh\u1eefng ti\u1ebfn tr\u00ecnh vi\u00eam v\u00e0 d\u1ecb \u1ee9ng c\u1ea5p v\u00e0 m\u00e3n, tr\u1ea7m tr\u1ecdng li\u00ean quan \u0111\u1ebfn m\u1eaft v\u00e0 c\u00e1c c\u1ea5u tr\u00fac c\u1ee7a m\u1eaft nh\u01b0 vi\u00eam k\u1ebft m\u1ea1c d\u1ecb \u1ee9ng, vi\u00eam gi\u00e1c m\u1ea1c, lo\u00e9t m\u00e9p gi\u00e1c m\u1ea1c d\u1ecb \u1ee9ng, herp\u00e8s zona \u1edf m\u1eaft, vi\u00eam m\u1ed1ng m\u1eaft, vi\u00eam m\u1ed1ng m\u1eaft th\u1ec3 mi, vi\u00eam h\u1eafc v\u00f5ng m\u1ea1c, vi\u00eam ph\u1ea7n tr\u01b0\u1edbc, vi\u00eam m\u00e0ng m\u1ea1ch nho v\u00e0 vi\u00eam m\u1ea1ch m\u1ea1c tr\u01b0\u1edbc lan t\u1ecfa ra sau, vi\u00eam d\u00e2y th\u1ea7n kinh m\u1eaft, vi\u00eam m\u1eaft giao c\u1ea3m ; vi\u00eam v\u00f5ng m\u1ea1c trung t\u00e2m ; vi\u00eam th\u1ea7n kinh sau nh\u00e3n c\u1ea7u.<\/p>\n<p>H\u00f4 h\u1ea5p : b\u1ec7nh sarcoidose c\u00f3 tri\u1ec7u ch\u1ee9ng ; h\u1ed9i ch\u1ee9ng Loeffler kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c ; ng\u1ed9 \u0111\u1ed9c berylium ; ph\u1ed1i h\u1ee3p v\u1edbi h\u00f3a tr\u1ecb li\u1ec7u trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh lao ph\u1ed5i c\u1ea5p v\u00e0 lan t\u1ecfa ; tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i ; x\u01a1 h\u00f3a ph\u1ed5i.<\/p>\n<p>M\u00e1u : gi\u1ea3m ti\u1ec3u c\u1ea7u t\u1ef1 ph\u00e1t v\u00e0 th\u1ee9 ph\u00e1t \u1edf ng\u01b0\u1eddi l\u1edbn ; thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft t\u1ef1 mi\u1ec5n d\u1ecbch ; gi\u1ea3m nguy\u00ean h\u1ed3ng c\u1ea7u v\u00e0 thi\u1ebfu m\u00e1u do gi\u1ea3m s\u1ea3n do di truy\u1ec1n ; ph\u1ea3n \u1ee9ng v\u1edbi \u0111\u01b0\u1eddng ti\u00eam truy\u1ec1n.<\/p>\n<p>Ung th\u01b0 : \u0111i\u1ec1u tr\u1ecb t\u1ea1m th\u1eddi ung th\u01b0 m\u00e1u v\u00e0 u b\u1ea1ch huy\u1ebft b\u00e0o \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 ung th\u01b0 m\u00e1u c\u1ea5p t\u00ednh \u1edf tr\u1ebb em.<\/p>\n<p>Tr\u1ea1ng th\u00e1i ph\u00f9 : l\u1ee3i ti\u1ec3u ho\u1eb7c l\u00e0m gi\u1ea3m prot\u00e9ine ni\u1ec7u kh\u00f4ng g\u00e2y t\u0103ng ur\u00ea huy\u1ebft trong h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 nguy\u00ean ph\u00e1t ho\u1eb7c do lupus ban \u0111\u1ecf ; ph\u00f9 m\u1ea1ch.<\/p>\n<p>C\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c : lao m\u00e0ng n\u00e3o c\u00f3 t\u1eafc ngh\u1ebdn ho\u1eb7c nguy c\u01a1 t\u1eafc ngh\u1ebdn d\u01b0\u1edbi m\u00e0ng nh\u1ec7n, sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng h\u00f3a li\u1ec7u ph\u00e1p kh\u00e1ng lao t\u01b0\u01a1ng \u1ee9ng ; vi\u00eam \u0111\u1ea1i tr\u00e0ng lo\u00e9t ; li\u1ec7t Bell&#8217;s.<\/p>\n<p><strong>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/strong><\/p>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> : D\u00f9ng u\u1ed1ng sau \u0103n ho\u1eb7c trong \u0103n.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>Li\u1ec1u d\u00f9ng thay \u0111\u1ed5i t\u00f9y theo t\u1eebng lo\u1ea1i b\u1ec7nh, m\u1ee9c \u0111\u1ed9 n\u1eb7ng nh\u1eb9 v\u00e0 \u0111\u00e1p \u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>Li\u1ec1u kh\u1edfi \u0111\u1ea7u c\u1ee7a b\u00e9tam\u00e9thasone c\u00f3 th\u1ec3 thay \u0111\u1ed5i t\u1eeb 0,25 \u0111\u1ebfn 8 mg\/ng\u00e0y, t\u00f9y theo ch\u1ee9ng b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 d\u00f9ng li\u1ec1u kh\u1edfi \u0111\u1ea7u th\u1ea5p l\u00e0 \u0111\u1ee7, ngo\u1ea1i tr\u1eeb \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n ph\u1ea3i d\u00f9ng li\u1ec1u cao.<\/p>\n<p>Li\u1ec1u kh\u1edfi \u0111\u1ea7u n\u00ean \u0111\u01b0\u1ee3c duy tr\u00ec ho\u1eb7c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 mong mu\u1ed1n.<\/p>\n<p>N\u1ebfu sau m\u1ed9t th\u1eddi gian m\u00e0 v\u1eabn ch\u01b0a \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng th\u1ecfa \u0111\u00e1ng, ph\u1ea3i ng\u01b0ng Celestone v\u00e0 chuy\u1ec3n sang \u0111i\u1ec1u tr\u1ecb kh\u00e1c.<\/p>\n<p>\u1ede tr\u1ebb em, li\u1ec1u u\u1ed1ng kh\u1edfi \u0111\u1ea7u th\u01b0\u1eddng thay \u0111\u1ed5i t\u1eeb 17,5 \u0111\u1ebfn 200 mg (0,0017-0,25 mg)\/kg c\u00e2n n\u1eb7ng\/ng\u00e0y ho\u1eb7c 0,5 \u0111\u1ebfn 7,5 mg\/m2 c\u01a1 th\u1ec3\/ng\u00e0y. Li\u1ec1u d\u00f9ng cho tr\u1ebb em ph\u1ea3i \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t ch\u1eb7t ch\u1ebd theo nh\u1eefng \u0111i\u1ec1u ki\u1ec7n c\u00e2n nh\u1eafc nh\u01b0 \u1edf ng\u01b0\u1eddi l\u1edbn h\u01a1n l\u00e0 b\u00e1m s\u00e1t v\u00e0o t\u1ef7 l\u1ec7 tu\u1ed5i t\u00e1c ho\u1eb7c c\u00e2n n\u1eb7ng.<\/p>\n<p>Khi \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng th\u00edch h\u1ee3p th\u00ec c\u1ea7n x\u00e1c \u0111\u1ecbnh li\u1ec1u duy tr\u00ec b\u1eb1ng c\u00e1ch gi\u1ea3m li\u1ec1u d\u1ea7n d\u1ea7n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c li\u1ec1u t\u1ed1i thi\u1ec3u c\u00f3 hi\u1ec7u l\u1ef1c l\u00e2m s\u00e0ng.<\/p>\n<p>Trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh m\u00e3n t\u00ednh, n\u1ebfu b\u1ec7nh t\u1ef1 thuy\u00ean gi\u1ea3m, n\u00ean ng\u01b0ng \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Li\u1ec1u Celestone c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u0103ng l\u00ean trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n ph\u1ea3i ti\u1ebfp x\u00fac v\u1edbi c\u00e1c stress kh\u00e1c kh\u00f4ng li\u00ean quan \u0111\u1ebfn b\u1ec7nh \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. Trong tr\u01b0\u1eddng h\u1ee3p sau khi \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i, n\u1ebfu mu\u1ed1n ng\u01b0ng thu\u1ed1c ph\u1ea3i gi\u1ea3m li\u1ec1u t\u1eeb t\u1eeb.<\/p>\n<p>Li\u1ec1u khuy\u1ebfn c\u00e1o cho c\u00e1c ch\u1ee9ng b\u1ec7nh nh\u01b0 sau :<\/p>\n<p><em>Vi\u00eam th\u1ea5p kh\u1edbp v\u00e0 c\u00e1c th\u01b0\u01a1ng t\u1ed5n kh\u1edbp kh\u00e1c<\/em> : li\u1ec1u kh\u1edfi \u0111\u1ea7u h\u00e0ng ng\u00e0y t\u1eeb 1 \u0111\u1ebfn 2,5 mg, \u0111\u1ebfn khi nh\u1eadn \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng t\u1ed1t, th\u01b0\u1eddng sau 3 ho\u1eb7c 4 ng\u00e0y, ho\u1eb7c 7 ng\u00e0y. M\u1eb7c d\u00f9 n\u00f3i chung kh\u00f4ng c\u1ea7n s\u1eed d\u1ee5ng li\u1ec1u cao nh\u01b0ng c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3 t\u1ea1o ra \u0111\u00e1p \u1ee9ng mong mu\u1ed1n ban \u0111\u1ea7u. N\u1ebfu sau 7 ng\u00e0y m\u00e0 kh\u00f4ng c\u00f3 \u0111\u00e1p \u1ee9ng, n\u00ean ch\u1ea9n \u0111o\u00e1n l\u1ea1i. Khi \u0111\u00e3 c\u00f3 s\u1ef1 \u0111\u00e1p \u1ee9ng th\u1ecfa \u0111\u00e1ng, n\u00ean gi\u1ea3m li\u1ec1u xu\u1ed1ng 0,25 mg m\u1ed7i 2 ho\u1eb7c 3 ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1t li\u1ec1u duy tr\u00ec th\u00edch h\u1ee3p, th\u01b0\u1eddng t\u1eeb 0,5 \u0111\u1ebfn 1,5 mg\/ng\u00e0y. Trong b\u1ec7nh th\u1ed1ng phong c\u1ea5p t\u00ednh, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ph\u1ea3i \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c trong v\u00e0i ng\u00e0y m\u1eb7c d\u00f9 c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u00e3 thuy\u00ean gi\u1ea3m. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng corticoide \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p kh\u00f4ng ng\u0103n ng\u1eeba vi\u1ec7c ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 kh\u00e1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh.<\/p>\n<p><em>Th\u1ea5p kh\u1edbp c\u1ea5p t\u00ednh<\/em> : li\u1ec1u kh\u1edfi \u0111\u1ea7u h\u00e0ng ng\u00e0y t\u1eeb 6 \u0111\u1ebfn 8 mg. Khi \u0111\u00e3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c \u0111\u1ea7y \u0111\u1ee7 ch\u1ee9ng b\u1ec7nh, li\u1ec1u t\u1ed5ng c\u1ed9ng h\u00e0ng ng\u00e0y gi\u1ea3m xu\u1ed1ng 0,25 \u0111\u1ebfn 0,5 mg\/ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1t li\u1ec1u duy tr\u00ec th\u1ecfa \u0111\u00e1ng v\u00e0 ti\u1ebfp t\u1ee5c v\u1edbi li\u1ec1u n\u00e0y trong 4 \u0111\u1ebfn 8 tu\u1ea7n l\u1ec5 ho\u1eb7c l\u00e2u h\u01a1n n\u1eefa. Khi ng\u01b0ng tr\u1ecb li\u1ec7u, n\u00ean d\u00f9ng l\u1ea1i thu\u1ed1c n\u1ebfu xu\u1ea5t hi\u1ec7n l\u1ea1i s\u1ef1 t\u00e1i k\u00edch ho\u1ea1t l\u1ea1i c\u0103n b\u1ec7nh.<\/p>\n<p><em>Vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch :<\/em> li\u1ec1u kh\u1edfi \u0111\u1ea7u t\u1eeb 1 \u0111\u1ebfn 2,5 mg\/ng\u00e0y, n\u00ean chia ra nhi\u1ec1u l\u1ea7n. Th\u01b0\u1eddng sau 2 \u0111\u1ebfn 3 ng\u00e0y s\u1ebd nh\u1eadn \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng, gi\u1ea3m li\u1ec1u t\u1eeb t\u1eeb trong v\u00e0i ng\u00e0y ti\u1ebfp theo v\u00e0 sau \u0111\u00f3 ng\u01b0ng thu\u1ed1c. Th\u01b0\u1eddng ch\u1ec9 c\u1ea7n m\u1ed9t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb ng\u1eafn ; n\u1ebfu c\u00f3 t\u00e1i ph\u00e1t, ti\u1ebfn h\u00e0nh \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb th\u1ee9 hai.<\/p>\n<p><em>T\u00ecnh tr\u1ea1ng hen suy\u1ec5n<\/em> : 3,5 \u0111\u1ebfn 4,5 mg\/ng\u00e0y, trong 1 ho\u1eb7c 2 ng\u00e0y \u0111\u1ec3 gi\u1ea3m c\u01a1n ; sau \u0111\u00f3 gi\u1ea3m li\u1ec1u xu\u1ed1ng 0,25 \u0111\u1ebfn 0,5 mg\/c\u00e1ch ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1t li\u1ec1u duy tr\u00ec ho\u1eb7c l\u00e0 ng\u01b0ng \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><em>Suy\u1ec5n m\u00e3n t\u00ednh kh\u00f3 tr\u1ecb<\/em> : b\u1eaft \u0111\u1ea7u \u1edf li\u1ec1u 3,5 mg (ho\u1eb7c h\u01a1n)\/ng\u00e0y \u0111\u1ebfn khi c\u00f3 \u0111\u00e1p \u1ee9ng ho\u1eb7c d\u00f9ng su\u1ed1t trong 7 ng\u00e0y ; sau \u0111\u00f3 gi\u1ea3m 0,25 \u0111\u1ebfn 0,5 mg\/ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c li\u1ec1u duy tr\u00ec.<\/p>\n<p><em>Kh\u00ed ph\u1ebf th\u1ee7ng ho\u1eb7c x\u01a1 h\u00f3a ph\u1ed5i :<\/em> th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u t\u1eeb 2 \u0111\u1ebfn 3,5 mg\/ng\u00e0y (chia nhi\u1ec1u l\u1ea7n) trong v\u00e0i ng\u00e0y cho \u0111\u1ebfn khi c\u00f3 \u0111\u00e1p \u1ee9ng ; sau \u0111\u00f3 gi\u1ea3m 0,5 mg trong m\u1ed7i 2 ho\u1eb7c 3 ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1t li\u1ec1u duy tr\u00ec, th\u01b0\u1eddng l\u00e0 1 \u0111\u1ebfn 2,5 mg.<\/p>\n<p><em>B\u1ec7nh d\u1ecb \u1ee9ng b\u1ee5i hay ph\u1ea5n hoa kh\u00f3 tr\u1ecb<\/em> : n\u00ean \u0111\u1ecbnh h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng b\u1ec7nh trong giai \u0111o\u1ea1n cao \u0111i\u1ec3m. Ng\u00e0y th\u1ee9 nh\u1ea5t : d\u00f9ng li\u1ec1u 1,5 \u0111\u1ebfn 2,5 mg\/ng\u00e0y, chia l\u00e0m nhi\u1ec1u l\u1ea7n ; sau \u0111\u00f3 gi\u1ea3m d\u1ea7n 0,5 mg m\u1ed7i ng\u00e0y \u0111\u1ebfn khi tri\u1ec7u ch\u1ee9ng ph\u00e1t l\u1ea1i. Li\u1ec1u \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh v\u00e0 sau \u0111\u00f3 duy tr\u00ec \u1edf li\u1ec1u n\u00e0y trong su\u1ed1t \u0111\u1ee3t b\u1ec7nh (th\u01b0\u1eddng kh\u00f4ng qu\u00e1 10 \u0111\u1ebfn 14 ng\u00e0y) v\u00e0 sau \u0111\u00f3 ng\u01b0ng thu\u1ed1c. Ch\u1ec9 d\u00f9ng Celestone \u0111\u1ec3 h\u1ed7 tr\u1ee3 c\u00e1c tr\u1ecb li\u1ec7u kh\u00e1ng d\u1ecb \u1ee9ng th\u00edch h\u1ee3p kh\u00e1c khi c\u00f3 y\u00eau c\u1ea7u.<\/p>\n<p><em>Trong b\u1ec7nh lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng<\/em> : nh\u00ecn chung, li\u1ec1u kh\u1edfi \u0111\u1ea7u t\u1eeb 1 \u0111\u1ebfn 1,5 mg x 3 l\u1ea7n\/ng\u00e0y trong v\u00e0i ng\u00e0y l\u00e0 th\u00edch h\u1ee3p ; m\u1eb7c d\u00f9 \u0111\u00f4i khi c\u00f3 th\u1ec3 c\u1ea7n li\u1ec1u cao h\u01a1n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng th\u1ecfa \u0111\u00e1ng. Sau \u0111\u00f3 gi\u1ea3m li\u1ec1u t\u1eeb t\u1eeb \u0111\u1ebfn li\u1ec1u duy tr\u00ec v\u1eeba \u0111\u1ee7 (th\u01b0\u1eddng t\u1eeb 1,5 \u0111\u1ebfn 3 mg\/ng\u00e0y).<\/p>\n<p><em>B\u1ec7nh da<\/em> : li\u1ec1u kh\u1edfi \u0111\u1ea7u t\u1eeb 2,5 \u0111\u1ebfn 4 mg\/ng\u00e0y, \u0111\u1ebfn khi \u0111\u1ea1t hi\u1ec7u qu\u1ea3 mong mu\u1ed1n. Sau \u0111\u00f3 gi\u1ea3m 0,25 \u0111\u1ebfn 0,5 mg m\u1ed7i 2 ho\u1eb7c 3 ng\u00e0y cho \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u1ebfn li\u1ec1u duy tr\u00ec.<\/p>\n<p><em>Trong c\u00e1c r\u1ed1i lo\u1ea1n ng\u1eafn h\u1ea1n v\u00e0 t\u1ef1 h\u1ea1n ch\u1ebf<\/em> : th\u01b0\u1eddng c\u00f3 th\u1ec3 ng\u01b0ng thu\u1ed1c m\u00e0 kh\u00f4ng g\u00e2y t\u00e1i ph\u00e1t sau khi ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u0103n b\u1ec7nh trong v\u00f2ng v\u00e0i ng\u00e0y. Li\u1ec1u l\u01b0\u1ee3ng r\u1ea5t thay \u0111\u1ed5i trong c\u00e1c \u0111i\u1ec1u tr\u1ecb d\u00e0i h\u1ea1n.<\/p>\n<p>Trong nh\u1eefng r\u1ed1i lo\u1ea1n tr\u00ean, th\u1ea7y thu\u1ed1c n\u00ean tham kh\u1ea3o th\u00eam t\u00e0i li\u1ec7u \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><em>Vi\u00eam m\u1eaft (h\u1eadu ph\u00f2ng)<\/em> : li\u1ec1u kh\u1edfi \u0111\u1ea7u t\u1eeb 2,5 \u0111\u1ebfn 4,5 mg\/ng\u00e0y, chia l\u00e0m nhi\u1ec1u l\u1ea7n, \u0111\u1ebfn khi \u0111\u1ea1t s\u1ef1 ki\u1ec3m so\u00e1t mong mu\u1ed1n, ho\u1eb7c \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 7 ng\u00e0y. Sau \u0111\u00f3 gi\u1ea3m 0,5 mg m\u1ed7i ng\u00e0y \u0111\u1ebfn li\u1ec1u duy tr\u00ec \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n m\u00e3n t\u00ednh. Th\u00f4ng th\u01b0\u1eddng \u1edf nh\u1eefng b\u1ec7nh c\u1ea5p t\u00ednh hay t\u1ef1 h\u1ea1n ch\u1ebf, ng\u01b0\u1eddi ta ng\u01b0ng thu\u1ed1c sau m\u1ed9t kho\u1ea3ng th\u1eddi gian th\u00edch h\u1ee3p.<\/p>\n<p><em>H\u1ed9i ch\u1ee9ng sinh d\u1ee5c-th\u01b0\u1ee3ng th\u1eadn :<\/em> li\u1ec1u d\u00f9ng thay \u0111\u1ed5i t\u00f9y theo c\u01a1 \u0111\u1ecba v\u00e0 \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 duy tr\u00ec n\u1ed3ng \u0111\u1ed9 17-k\u00e9tost\u00e9roide ni\u1ec7u n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, v\u00e0 th\u01b0\u1eddng c\u00f3 hi\u1ec7u qu\u1ea3 \u1edf li\u1ec1u 1 \u0111\u1ebfn 1,5 mg\/ng\u00e0y, chia nhi\u1ec1u l\u1ea7n.<\/p>\n<p><em>Li\u1ec1u m\u1ed9t l\u1ea7n trong ng\u00e0y<\/em> : \u0111\u1ec3 t\u1ea1o thu\u1eadn l\u1ee3i cho b\u1ec7nh nh\u00e2n \u0111\u1ed3ng th\u1eddi v\u1eabn \u0111\u1ea3m b\u1ea3o nguy\u00ean t\u1eafc c\u1ea3i thi\u1ec7n li\u1ec1u, li\u1ec1u duy tr\u00ec h\u00e0ng ng\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t l\u1ea7n v\u00e0o m\u1ed7i s\u00e1ng s\u1edbm.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb c\u00e1ch ng\u00e0y :<\/em> kh\u00f4ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho li\u1ec7u ph\u00e1p corticoide v\u00ec b\u00e9tam\u00e9thasone c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y d\u00e0i (t\u1eeb 36 \u0111\u1ebfn 54 gi\u1edd), v\u1edbi t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf tr\u1ee5c h\u1ea1 \u0111\u1ed3i-tuy\u1ebfn y\u00ean-th\u01b0\u1ee3ng th\u1eadn. N\u1ebfu \u0111i\u1ec1u tr\u1ecb trong th\u1eddi gian d\u00e0i, n\u00ean xem x\u00e9t d\u00f9ng ch\u1ebf \u0111\u1ed9 li\u1ec1u xen k\u1ebd b\u00e9tam\u00e9thasone v\u1edbi m\u1ed9t t\u00e1c \u0111\u1ed9ng adr\u00e9nocorticoide t\u1ee9c th\u1eddi (nh\u01b0 prednisone, prednisolone ho\u1eb7c m\u00e9thylprednisolone).<\/p>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Nh\u1eefng b\u1ec7nh nh\u00e2n nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n, ph\u1ea3n \u1ee9ng nh\u1ea1y c\u1ea3m v\u1edbi b\u00e9tam\u00e9thasone ho\u1eb7c v\u1edbi c\u00e1c corticoide kh\u00e1c ho\u1eb7c v\u1edbi b\u1ea5t c\u1ee9 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a Celestone.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p>\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u t\u00f9y theo m\u1ee9c \u0111\u1ed9 gi\u1ea3m ho\u1eb7c t\u0103ng b\u1ec7nh, \u0111\u00e1p \u1ee9ng c\u1ee7a t\u1eebng c\u01a1 \u0111\u1ecba, trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ecb nhi\u1ec5m khu\u1ea9n nghi\u00eam tr\u1ecdng, b\u1ecb th\u01b0\u01a1ng ho\u1eb7c tr\u1ea3i qua ph\u1eabu thu\u1eadt. C\u1ea7n ph\u1ea3i gi\u00e1m s\u00e1t \u0111\u1ebfn 1 n\u0103m trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0ng li\u1ec7u ph\u00e1p corticoide d\u00e0i h\u1ea1n hay \u1edf li\u1ec1u cao.<\/p>\n<p>Corticoide c\u00f3 th\u1ec3 che khu\u1ea5t m\u1ed9t v\u00e0i d\u1ea5u hi\u1ec7u c\u1ee7a s\u1ef1 nhi\u1ec5m tr\u00f9ng. Khi s\u1eed d\u1ee5ng corticoide, kh\u1ea3 n\u0103ng \u0111\u1ec1 kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3 gi\u1ea3m v\u00e0 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng khu tr\u00fa nhi\u1ec5m tr\u00f9ng.<\/p>\n<p>S\u1eed d\u1ee5ng l\u00e2u d\u00e0i corticoide c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ee5c th\u1ee7y tinh th\u1ec3 d\u01b0\u1edbi bao (\u0111\u1eb7c bi\u1ec7t \u1edf tr\u1ebb em), b\u1ec7nh t\u0103ng nh\u00e3n \u00e1p c\u00f3 th\u1ec3 g\u00e2y nguy h\u1ea1i \u0111\u1ebfn th\u1ea7n kinh m\u1eaft v\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng c\u00e1c nhi\u1ec5m tr\u00f9ng n\u1ea5m ho\u1eb7c virus th\u1ee9 ph\u00e1t \u1edf m\u1eaft.<\/p>\n<p>\u1ede li\u1ec1u trung b\u00ecnh v\u00e0 li\u1ec1u cao, corticoide c\u00f3 th\u1ec3 l\u00e0m t\u0103ng huy\u1ebft \u00e1p v\u00e0 t\u0103ng gi\u1eef mu\u1ed1i n\u01b0\u1edbc, v\u00e0 t\u0103ng b\u00e0i ti\u1ebft kali. Nh\u1eefng t\u00e1c \u0111\u1ed9ng n\u00e0y h\u1ea7u nh\u01b0 \u00edt x\u1ea3y ra \u0111\u1ed1i v\u1edbi c\u00e1c d\u1eabn xu\u1ea5t t\u1ed5ng h\u1ee3p ngo\u1ea1i tr\u1eeb d\u00f9ng \u1edf li\u1ec1u cao. N\u00ean \u00e1p d\u1ee5ng ch\u1ebf \u0111\u1ed9 \u0103n h\u1ea1n ch\u1ebf mu\u1ed1i v\u00e0 gi\u00e0u kali. T\u1ea5t c\u1ea3 corticoide \u0111\u1ec1u l\u00e0m t\u0103ng b\u00e0i ti\u1ebft calci.<\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ee7ng ng\u1eeba \u0111\u1eadu m\u00f9a trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1eb1ng corticoide. C\u0169ng kh\u00f4ng n\u00ean d\u00f9ng c\u00e1c li\u1ec7u ph\u00e1p g\u00e2y gi\u1ea3m mi\u1ec5n d\u1ecbch trong li\u1ec7u ph\u00e1p corticoide, \u0111\u1eb7c bi\u1ec7t \u1edf li\u1ec1u cao, v\u00ec c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y c\u00e1c r\u1ed1i lo\u1ea1n th\u1ea7n kinh v\u00e0 l\u00e0m m\u1ea5t t\u00ednh \u0111\u00e1p \u1ee9ng c\u1ee7a kh\u00e1ng th\u1ec3. Tuy nhi\u00ean, \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng corticoide nh\u01b0 m\u1ed9t li\u1ec7u ph\u00e1p thay th\u1ebf (ch\u1eb3ng h\u1ea1n trong b\u1ec7nh Addison) v\u1eabn c\u00f3 th\u1ec3 d\u00f9ng li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch.<\/p>\n<p>B\u1ec7nh nh\u00e2n d\u00f9ng nh\u1eefng li\u1ec1u corticoide g\u00e2y gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ea7n l\u01b0u \u00fd tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi ngu\u1ed3n l\u00e2y b\u1ec7nh th\u1ee7y \u0111\u1eadu v\u00e0 s\u1edfi ; n\u1ebfu ph\u1ea3i ti\u1ebfp x\u00fac v\u1edbi nh\u1eefng m\u00f4i tr\u01b0\u1eddng n\u00e0y, c\u1ea7n c\u00f3 \u00fd ki\u1ebfn c\u1ee7a B\u00e1c s\u0129. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng \u1edf tr\u1ebb em.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng corticoide trong b\u1ec7nh lao th\u1ec3 ho\u1ea1t \u0111\u1ed9ng, n\u00ean gi\u1edbi h\u1ea1n \u1edf th\u1ec3 lao c\u1ea5p v\u00e0 lan t\u1ecfa trong \u0111\u00f3 corticoide \u0111\u01b0\u1ee3c d\u00f9ng ph\u1ed1i h\u1ee3p v\u1edbi m\u1ed9t ch\u1ebf \u0111\u1ed9 kh\u00e1ng lao th\u00edch h\u1ee3p.<\/p>\n<p>\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng corticoide \u0111i\u1ec1u tr\u1ecb lao ti\u1ec1m t\u00e0ng ho\u1eb7c ph\u1ea3n \u1ee9ng v\u1edbi lao t\u1ed1, c\u1ea7n ph\u1ea3i quan s\u00e1t k\u1ef9 v\u00ec c\u00f3 th\u1ec3 x\u1ea3y ra ph\u1ea3n \u1ee9ng. Trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb d\u00e0i h\u1ea1n b\u1eb1ng corticoide, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng h\u00f3a d\u1ef1 ph\u00f2ng. N\u1ebfu d\u00f9ng rifampine \u0111\u1ec3 d\u1ef1 ph\u00f2ng, th\u00ec ch\u00fa \u00fd \u0111\u1ebfn t\u00e1c d\u1ee5ng c\u1ee7a n\u00f3 l\u00e0m t\u0103ng chuy\u1ec3n h\u00f3a thanh th\u1ea3i corticoide \u1edf gan, c\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u corticoide.<\/p>\n<p>Trong tr\u1ecb li\u1ec7u, n\u00ean d\u00f9ng li\u1ec1u corticoide th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3 ; khi c\u00f3 th\u1ec3 gi\u1ea3m li\u1ec1u, n\u00ean gi\u1ea3m t\u1eeb t\u1eeb.<\/p>\n<p>N\u1ebfu gi\u1ea3m nhanh li\u1ec1u coriticoide, c\u00f3 th\u1ec3 g\u00e2y suy th\u01b0\u1ee3ng th\u1eadn th\u1ee9 ph\u00e1t do thu\u1ed1c v\u00e0 nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u b\u1eb1ng c\u00e1ch ng\u01b0ng thu\u1ed1c t\u1eeb t\u1eeb. Suy th\u01b0\u1ee3ng th\u1eadn c\u00f3 th\u1ec3 k\u00e9o d\u00e0i nhi\u1ec1u th\u00e1ng sau khi ng\u01b0ng tr\u1ecb li\u1ec7u ; do \u0111\u00f3, n\u1ebfu c\u00f3 stress trong th\u1eddi gian n\u00e0y, n\u00ean d\u00f9ng l\u1ea1i li\u1ec7u ph\u00e1p corticoide. N\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 d\u00f9ng li\u1ec7u ph\u00e1p corticoide tr\u01b0\u1edbc \u0111\u00f3, li\u1ec1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u0103ng l\u00ean. N\u00ean d\u00f9ng \u0111\u1ed3ng th\u1eddi mu\u1ed1i v\u00e0\/ho\u1eb7c li\u1ec7u ph\u00e1p min\u00e9ralocorticoide b\u1edfi v\u00ec s\u1ef1 ti\u1ebft min\u00e9ralocorticoide c\u00f3 th\u1ec3 b\u1ecb suy gi\u1ea3m.<\/p>\n<p>Hi\u1ec7u qu\u1ea3 corticoide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u0103ng l\u00ean \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n thi\u1ec3u n\u0103ng tuy\u1ebfn gi\u00e1p ho\u1eb7c b\u1ecb x\u01a1 gan.<\/p>\n<p>S\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng corticoide \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb herpes simplex v\u00ec c\u00f3 th\u1ec3 g\u00e2y th\u1ee7ng gi\u00e1c m\u1ea1c.<\/p>\n<p>C\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 x\u1ea3y ra trong li\u1ec7u ph\u00e1p corticoide, \u0111\u1ed3ng th\u1eddi c\u00f3 th\u1ec3 l\u00e0m n\u1eb7ng th\u00eam c\u00e1c b\u1ea5t \u1ed5n t\u00e2m l\u00fd v\u00e0 khuynh h\u01b0\u1edbng b\u1ecb b\u1ec7nh t\u00e2m th\u1ea7n.<\/p>\n<p>Corticoide n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng trong vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, n\u1ebfu c\u00f3 nguy c\u01a1 b\u1ecb th\u1ee7ng, \u00e1p-xe ho\u1eb7c nhi\u1ec5m tr\u00f9ng m\u01b0ng m\u1ee7, vi\u00eam t\u00fai th\u1eeba, v\u1eeba qua ph\u1eabu thu\u1eadt n\u1ed1i ru\u1ed9t ; lo\u00e9t d\u1ea1 d\u00e0y \u0111\u00e3 th\u1ec3 hi\u1ec7n ho\u1eb7c ti\u1ec1m t\u00e0ng ; suy th\u1eadn ; cao huy\u1ebft \u00e1p ; lo\u00e3ng x\u01b0\u01a1ng v\u00e0 nh\u01b0\u1ee3c c\u01a1 n\u1eb7ng.<\/p>\n<p>Do bi\u1ebfn ch\u1ee9ng c\u1ee7a li\u1ec7u ph\u00e1p glucocorticoide t\u00f9y thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb, cho n\u00ean vi\u1ec7c quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i ho\u1eb7c h\u1ea1i kh\u00e1c nhau \u1edf t\u1eebng b\u1ec7nh nh\u00e2n.<\/p>\n<p>V\u00ec vi\u1ec7c s\u1eed d\u1ee5ng corticoide c\u00f3 th\u1ec3 g\u00e2y r\u1ed1i lo\u1ea1n m\u1ee9c \u0111\u1ed9 t\u0103ng tr\u01b0\u1edfng v\u00e0 \u1ee9c ch\u1ebf s\u1ef1 s\u1ea3n xu\u1ea5t corticoide n\u1ed9i sinh \u1edf tr\u1ebb em. Do \u0111\u00f3 c\u1ea7n th\u1eadn tr\u1ecdng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb d\u00e0i h\u1ea1n.<\/p>\n<p>Corticoide c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i t\u00ednh di \u0111\u1ed9ng v\u00e0 s\u1ed1 l\u01b0\u1ee3ng tinh tr\u00f9ng \u1edf m\u1ed9t v\u00e0i b\u1ec7nh nh\u00e2n.<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>C\u1ea7n th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/p>\n<p><strong>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/strong><\/p>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: Betamethasone Dipropionate\/Valerate \u2013 B1\/B3<\/p>\n<p>US FDA pregnancy category: C<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Do ch\u01b0a c\u00f3 c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u, vi\u1ec7c s\u1eed d\u1ee5ng Celestone trong th\u1eddi k\u1ef3 c\u00f3 thai v\u00e0 th\u1eddi k\u1ef3 nu\u00f4i con b\u00fa n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch tr\u1ecb li\u1ec7u v\u00e0 nh\u1eefng nguy c\u01a1 khi s\u1eed d\u1ee5ng thu\u1ed1c \u1edf ng\u01b0\u1eddi m\u1eb9, b\u00e0o thai ho\u1eb7c \u0111\u1ee9a b\u00e9. \u0110\u1ee9a b\u00e9 c\u00f3 m\u1eb9 d\u00f9ng nhi\u1ec1u li\u1ec1u corticoide ph\u1ea3i \u0111\u01b0\u1ee3c quan s\u00e1t c\u1ea9n th\u1eadn v\u1ec1 nh\u1eefng d\u1ea5u hi\u1ec7u suy th\u01b0\u1ee3ng th\u1eadn.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Do ch\u01b0a c\u00f3 c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u, vi\u1ec7c s\u1eed d\u1ee5ng Celestone trong th\u1eddi k\u1ef3 c\u00f3 thai v\u00e0 th\u1eddi k\u1ef3 nu\u00f4i con b\u00fa n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch tr\u1ecb li\u1ec7u v\u00e0 nh\u1eefng nguy c\u01a1 khi s\u1eed d\u1ee5ng thu\u1ed1c \u1edf ng\u01b0\u1eddi m\u1eb9, b\u00e0o thai ho\u1eb7c \u0111\u1ee9a b\u00e9. \u0110\u1ee9a b\u00e9 c\u00f3 m\u1eb9 d\u00f9ng nhi\u1ec1u li\u1ec1u corticoide ph\u1ea3i \u0111\u01b0\u1ee3c quan s\u00e1t c\u1ea9n th\u1eadn v\u1ec1 nh\u1eefng d\u1ea5u hi\u1ec7u suy th\u01b0\u1ee3ng th\u1eadn.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>Nh\u1eefng t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i c\u1ee7a Celestone c\u0169ng gi\u1ed1ng nh\u01b0 \u0111\u1ed1i v\u1edbi c\u00e1c lo\u1ea1i corticoide kh\u00e1c, c\u00f3 li\u00ean quan \u0111\u1ebfn li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. Th\u00f4ng th\u01b0\u1eddng nh\u1eefng t\u00e1c d\u1ee5ng n\u00e0y l\u00e0 c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c ho\u1eb7c gi\u1ea3m b\u1edbt b\u1eb1ng c\u00e1ch gi\u1ea3m li\u1ec1u ; n\u00f3i chung, t\u1ed1t h\u01a1n n\u00ean ng\u01b0ng thu\u1ed1c trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i :<\/em> gi\u1eef mu\u1ed1i v\u00e0 n\u01b0\u1edbc, suy tim sung huy\u1ebft, m\u1ea5t kali, cao huy\u1ebft \u00e1p, ki\u1ec1m huy\u1ebft gi\u1ea3m kali.<\/p>\n<p><em>Tr\u00ean h\u1ec7 c\u01a1 x\u01b0\u01a1ng<\/em> : suy y\u1ebfu c\u01a1, b\u1ec7nh l\u00fd c\u01a1 do corticoide, gi\u1ea3m kh\u1ed1i l\u01b0\u1ee3ng c\u01a1, l\u00e0m n\u1eb7ng th\u00eam tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1, lo\u00e3ng x\u01b0\u01a1ng, g\u00e3y l\u00fan c\u1ed9t s\u1ed1ng, ho\u1ea1i t\u1eed v\u00f4 tr\u00f9ng \u0111\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 \u0111\u1ea7u x\u01b0\u01a1ng c\u00e1nh tay, g\u00e3y x\u01b0\u01a1ng d\u00e0i b\u1ec7nh l\u00fd, \u0111\u1ee9t d\u00e2y ch\u1eb1ng.<\/p>\n<p><em>Tr\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a<\/em> : lo\u00e9t d\u1ea1 d\u00e0y v\u1edbi th\u1ee7ng ho\u1eb7c xu\u1ea5t huy\u1ebft, vi\u00eam t\u1ee5y, tr\u01b0\u1edbng b\u1ee5ng, vi\u00eam lo\u00e9t th\u1ef1c qu\u1ea3n.<\/p>\n<p><em>B\u1ec7nh v\u1ec1 da :<\/em> l\u00e0m ch\u1eadm s\u1ef1 l\u00e0nh v\u1ebft th\u01b0\u01a1ng, l\u00ean da non, da m\u1ecfng gi\u00f2n ; c\u00f3 \u0111\u1ed1m xu\u1ea5t huy\u1ebft v\u00e0 m\u1ea3ng b\u1ea7m m\u00e1u ; h\u1ed3ng ban \u1edf m\u1eb7t ; t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i ; thay \u0111\u1ed5i c\u00e1c k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m da ; d\u1ecb \u1ee9ng nh\u01b0 vi\u00eam da d\u1ecb \u1ee9ng, n\u1ed5i m\u1ec1 \u0111ay ; ph\u00f9 m\u1ea1ch th\u1ea7n kinh.<\/p>\n<p><em>Th\u1ea7n kinh :<\/em> co gi\u1eadt ; t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd v\u1edbi ph\u00f9 gai th\u1ecb (g\u00e2y b\u01b0\u1edbu gi\u1ea3 \u1edf n\u00e3o) th\u01b0\u1eddng sau khi \u0111i\u1ec1u tr\u1ecb ; ch\u00f3ng m\u1eb7t ; nh\u1ee9c \u0111\u1ea7u.<\/p>\n<p><em>N\u1ed9i ti\u1ebft<\/em> : r\u1ed1i lo\u1ea1n kinh nguy\u1ec7t ; h\u1ed9i ch\u1ee9ng gi\u1ed1ng Cushing ; l\u00e0m gi\u1ea3m t\u0103ng tr\u01b0\u1edfng c\u1ee7a ph\u00f4i trong t\u1eed cung ho\u1eb7c s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a \u0111\u1ee9a b\u00e9 ; m\u1ea5t \u0111\u00e1p \u1ee9ng tuy\u1ebfn y\u00ean v\u00e0 th\u01b0\u1ee3ng th\u1eadn th\u1ee9 ph\u00e1t, \u0111\u1eb7c bi\u1ec7t trong th\u1eddi gian b\u1ecb stress, v\u00ed d\u1ee5 nh\u01b0 ch\u1ea5n th\u01b0\u01a1ng, gi\u1ea3i ph\u1eabu ho\u1eb7c b\u1ecb b\u1ec7nh ; l\u00e0m gi\u1ea3m dung n\u1ea1p carbohydrate ; c\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ti\u1ec1m \u1ea9n, g\u00e2y t\u0103ng nhu c\u1ea7u v\u1ec1 insuline ho\u1eb7c c\u00e1c t\u00e1c nh\u00e2n h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p><em>M\u1eaft :<\/em> g\u00e2y \u0111\u1ee5c th\u1ee7y tinh th\u1ec3 d\u01b0\u1edbi bao, t\u0103ng nh\u00e3n \u00e1p, glaucome, ch\u1ee9ng l\u1ed3i m\u1eaft.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em> : C\u00e2n b\u1eb1ng nitrog\u00e8ne \u00e2m t\u00ednh do d\u1ecb h\u00f3a prot\u00e9ine.<\/p>\n<p><em>T\u00e2m th\u1ea7n<\/em> : g\u00e2y s\u1ea3ng kho\u00e1i, c\u1ea3m gi\u00e1c l\u00e2ng l\u00e2ng ; c\u00e1c bi\u1ec3u hi\u1ec7n suy gi\u1ea3m t\u00e2m l\u00fd tr\u1ea7m tr\u1ecdng ; thay \u0111\u1ed5i nh\u00e2n c\u00e1ch ; m\u1ea5t ng\u1ee7.<\/p>\n<p><em>C\u00e1c t\u00e1c d\u1ee5ng kh\u00e1c<\/em> : s\u1ed1c ph\u1ea3n v\u1ec7 ho\u1eb7c ph\u1ea3n \u1ee9ng t\u0103ng m\u1eabn c\u1ea3m.<\/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<p><strong>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/strong><\/p>\n<p>\u0110a s\u1ed1 c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n th\u01b0\u1eddng c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i ho\u1eb7c gi\u1ea3m thi\u1ec3u b\u1eb1ng c\u00e1ch gi\u1ea3m li\u1ec1u; c\u00e1ch n\u00e0y th\u01b0\u1eddng \u01b0a d\u00f9ng h\u01a1n l\u00e0 ng\u1eebng thu\u1ed1c. D\u00f9ng corticosteroid d\u1ea1ng u\u1ed1ng k\u00e8m v\u1edbi th\u1ee9c \u0103n h\u1ea1n ch\u1ebf \u0111\u01b0\u1ee3c ch\u1ee9ng kh\u00f3 ti\u00eau ho\u1eb7c k\u00edch \u1ee9ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u00f3 th\u1ec3 x\u1ea3y ra. Ng\u01b0\u1eddi b\u1ec7nh \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i v\u1edbi corticosteroid \u1edf li\u1ec1u \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 ph\u1ea3i h\u1ea1n ch\u1ebf d\u00f9ng natri v\u00e0 b\u1ed5 sung kali trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. V\u00ec corticosteroid l\u00e0m t\u0103ng d\u1ecb h\u00f3a protein, n\u00ean c\u1ea7n thi\u1ebft ph\u1ea3i t\u0103ng kh\u1ea5u ph\u1ea7n protein trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i. D\u00f9ng calci v\u00e0 vitamin D c\u00f3 th\u1ec3 gi\u1ea3m nguy c\u01a1 lo\u00e3ng x\u01b0\u01a1ng do corticosteroid g\u00e2y n\u00ean trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed ho\u1eb7c c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 lo\u00e9t d\u1ea1 d\u00e0y ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c ch\u1ed1ng lo\u00e9t (thu\u1ed1c kh\u00e1ng acid, ho\u1eb7c \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 H<sub>2<\/sub> ho\u1eb7c \u1ee9c ch\u1ebf b\u01a1m proton). Ng\u01b0\u1eddi b\u1ec7nh \u0111ang d\u00f9ng corticoid m\u00e0 b\u1ecb thi\u1ebfu m\u00e1u th\u00ec c\u1ea7n ngh\u0129 \u0111\u1ebfn nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 do ch\u1ea3y m\u00e1u d\u1ea1 d\u00e0y.<\/p>\n<p><strong>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi ph\u00e9nobarbital, ph\u00e9nytoine, rifampicine ho\u1eb7c \u00e9ph\u00e9drine c\u00f3 th\u1ec3 l\u00e0m t\u0103ng chuy\u1ec3n h\u00f3a corticoide, l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>B\u1ec7nh nh\u00e2n d\u00f9ng \u0111\u1ed3ng th\u1eddi corticoide v\u00e0 estrog\u00e8ne n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i v\u1ec1 kh\u1ea3 n\u0103ng t\u0103ng hi\u1ec7u qu\u1ea3 c\u1ee7a corticoide.<\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi corticoide v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ea3m kali c\u00f3 th\u1ec3 g\u00e2y h\u1ea1 kali huy\u1ebft. S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi corticoide v\u1edbi c\u00e1c glucoside tr\u1ee3 tim c\u00f3 th\u1ec3 l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng g\u00e2y lo\u1ea1n nh\u1ecbp ho\u1eb7c \u0111\u1ed9c t\u00ednh c\u1ee7a digitalis c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c h\u1ea1 kali huy\u1ebft. Corticoide c\u00f3 th\u1ec3 l\u00e0m t\u0103ng vi\u1ec7c h\u1ea1 kali huy\u1ebft g\u00e2y b\u1edfi amphot\u00e9ricine B. Trong t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n d\u00f9ng ph\u1ed1i h\u1ee3p c\u00e1c lo\u1ea1i thu\u1ed1c tr\u00ean, c\u1ea7n ph\u1ea3i theo d\u00f5i ch\u1eb7t ch\u1ebd n\u1ed3ng \u0111\u1ed9 c\u00e1c ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i trong huy\u1ebft thanh, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ed3ng \u0111\u1ed9 kali.<\/p>\n<p>D\u00f9ng \u0111\u1ed3ng th\u1eddi corticoide v\u1edbi thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u lo\u1ea1i coumarine c\u00f3 th\u1ec3 l\u00e0m t\u0103ng hay gi\u1ea3m hi\u1ec7u qu\u1ea3 ch\u1ed1ng \u0111\u00f4ng. Tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u1ea7n ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng.<\/p>\n<p>Ph\u1ed1i h\u1ee3p c\u1ee7a thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng st\u00e9roide ho\u1eb7c r\u01b0\u1ee3u v\u1edbi glucocorticoide c\u00f3 th\u1ec3 g\u00e2y t\u0103ng lo\u00e9t d\u1ea1 d\u00e0y ru\u1ed9t.<\/p>\n<p>Corticoide c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng salicylate trong m\u00e1u.<\/p>\n<p>Trong b\u1ec7nh gi\u1ea3m prothrombine trong m\u00e1u, n\u00ean th\u1eadn tr\u1ecdng khi ph\u1ed1i h\u1ee3p acide ac\u00e9tyl salicylique v\u1edbi corticoide.<\/p>\n<p>C\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c ch\u1ed1ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng khi c\u00f3 ph\u1ed1i h\u1ee3p v\u1edbi corticoide. D\u00f9ng \u0111\u1ed3ng th\u1eddi li\u1ec7u ph\u00e1p glucocorticoide c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf hi\u1ec7u qu\u1ea3 c\u1ee7a somatotropine.<\/p>\n<p>C\u00e1c t\u01b0\u01a1ng t\u00e1c trong c\u00e1c x\u00e9t nghi\u1ec7m \u1edf ph\u00f2ng th\u00ed nghi\u1ec7m : corticoide c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng tr\u00ean th\u1eed nghi\u1ec7m nitro-blue t\u00e9trazolium \u0111\u1ed1i v\u1edbi nhi\u1ec5m khu\u1ea9n v\u00e0 t\u1ea1o ra k\u1ebft qu\u1ea3 \u00e2m t\u00ednh gi\u1ea3 t\u1ea1o.<\/p>\n<p><strong>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p><em>Tri\u1ec7u ch\u1ee9ng :<\/em> Qu\u00e1 li\u1ec1u c\u1ea5p t\u00ednh glucocorticoide (bao g\u1ed3m b\u00e9tam\u00e9thasone) kh\u00f4ng d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng nguy k\u1ecbch. Ngo\u1ea1i tr\u1eeb \u1edf li\u1ec1u c\u1ef1c cao, m\u1ed9t v\u00e0i ng\u00e0y d\u00f9ng glucocorticoide qu\u00e1 li\u1ec1u h\u1ea7u nh\u01b0 kh\u00f4ng g\u00e2y ra c\u00e1c h\u1eadu qu\u1ea3 nguy h\u1ea1i tr\u1eeb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p thu\u1ed9c v\u1ec1 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1eb7c hi\u1ec7u, nh\u01b0 \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, glaucome ho\u1eb7c vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y, ho\u1eb7c nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng digitaline, ch\u1ed1ng \u0111\u00f4ng m\u00e1u lo\u1ea1i coumarine ho\u1eb7c thu\u1ed1c l\u1ee3i ti\u1ec3u m\u1ea5t kali.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb :<\/em> tr\u01b0\u1eddng h\u1ee3p b\u1ecb qu\u00e1 li\u1ec1u c\u1ea5p t\u00ednh, n\u00ean \u0111i\u1ec1u tr\u1ecb t\u1ee9c kh\u1eafc b\u1eb1ng c\u00e1ch g\u00e2y n\u00f4n ho\u1eb7c th\u1ee5t r\u1eeda d\u1ea1 d\u00e0y. M\u1eb7c kh\u00e1c, n\u00ean c\u00f3 c\u00e1c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p \u0111\u1ed1i v\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng do t\u00e1c d\u1ee5ng chuy\u1ec3n h\u00f3a c\u1ee7a corticoide, ho\u1eb7c do t\u00e1c d\u1ee5ng g\u00e2y \u0111\u1ed9c c\u1ee7a b\u1ec7nh g\u1ed1c ho\u1eb7c nh\u1eefng b\u1ec7nh c\u00f9ng m\u1eafc \u0111\u1ed3ng th\u1eddi, ho\u1eb7c nh\u1eefng h\u1eadu qu\u1ea3 do t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><\/p>\n<p><strong>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/strong><\/p>\n<p>B\u00e9tam\u00e9thasone l\u00e0 m\u1ed9t d\u1eabn xu\u1ea5t t\u1ed5ng h\u1ee3p c\u1ee7a prednisolone.<\/p>\n<p>B\u00e9tam\u00e9thasone l\u00e0 m\u1ed9t corticoide th\u01b0\u1ee3ng th\u1eadn c\u00f3 t\u00ednh kh\u00e1ng vi\u00eam. B\u00e9tam\u00e9thasone c\u00f3 kh\u1ea3 n\u0103ng kh\u00e1ng vi\u00eam m\u1ea1nh, ch\u1ed1ng vi\u00eam kh\u1edbp v\u00e0 kh\u00e1ng d\u1ecb \u1ee9ng, \u0111\u01b0\u1ee3c d\u00f9ng \u0111i\u1ec1u tr\u1ecb nh\u1eefng r\u1ed1i lo\u1ea1n c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi corticoide.<\/p>\n<p>L\u00e0 m\u1ed9t glucocorticoide, b\u00e9tam\u00e9thasone g\u00e2y hi\u1ec7u qu\u1ea3 chuy\u1ec3n h\u00f3a s\u00e2u r\u1ed9ng v\u00e0 kh\u00e1c nhau, \u0111\u1ed3ng th\u1eddi l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng \u0111\u1ec1 kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ed1i v\u1edbi nh\u1eefng t\u00e1c nh\u00e2n k\u00edch th\u00edch. B\u00e9tam\u00e9thasone c\u00f3 ho\u1ea1t t\u00ednh glucocorticoide cao v\u00e0 ho\u1ea1t t\u00ednh min\u00e9ralocorticoide th\u1ea5p.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Corticosteroid t\u1ea1i ch\u1ed7 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 t\u00e1c nh\u00e2n kh\u00e1ng vi\u00eam th\u00f4ng qua nhi\u1ec1u c\u01a1 ch\u1ebf \u0111\u1ec3 \u1ee9c ch\u1ebf ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng giai \u0111o\u1ea1n mu\u1ed9n bao g\u1ed3m gi\u1ea3m m\u1eadt \u0111\u1ed9 t\u1ebf b\u00e0o mast, gi\u1ea3m chemotaxis v\u00e0 k\u00edch ho\u1ea1t b\u1ea1ch c\u1ea7u \u01b0a eosin, gi\u1ea3m s\u1ea3n xu\u1ea5t cytokine c\u1ee7a t\u1ebf b\u00e0o lympho, b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n, t\u1ebf b\u00e0o mast v\u00e0 b\u1ea1ch c\u1ea7u \u01b0a eosin, v\u00e0 \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a axit arachidonic.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<p><strong>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/strong><\/p>\n<p>Betamethason d\u1ec5 \u0111\u01b0\u1ee3c h\u1ea5p thu qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Thu\u1ed1c c\u0169ng d\u1ec5 \u0111\u01b0\u1ee3c h\u1ea5p thu khi d\u00f9ng t\u1ea1i ch\u1ed7. Khi b\u00f4i, \u0111\u1eb7c bi\u1ec7t n\u1ebfu b\u0103ng k\u00edn ho\u1eb7c khi da b\u1ecb r\u00e1ch ho\u1eb7c khi th\u1ee5t tr\u1ef1c tr\u00e0ng, c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t l\u01b0\u1ee3ng betamethason \u0111\u01b0\u1ee3c h\u1ea5p thu \u0111\u1ee7 cho t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n. C\u00e1c d\u1ea1ng betamethason tan trong n\u01b0\u1edbc \u0111\u01b0\u1ee3c d\u00f9ng ti\u00eam t\u0129nh m\u1ea1ch \u0111\u1ec3 cho \u0111\u00e1p \u1ee9ng nhanh, c\u00e1c d\u1ea1ng tan trong lipid ti\u00eam b\u1eafp s\u1ebd cho t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i h\u01a1n.<\/p>\n<p>Betamethason ph\u00e2n b\u1ed1 nhanh ch\u00f3ng v\u00e0o t\u1ea5t c\u1ea3 c\u00e1c m\u00f4 trong c\u01a1 th\u1ec3. Thu\u1ed1c qua nhau thai v\u00e0 c\u00f3 th\u1ec3 b\u00e0i xu\u1ea5t v\u00e0o s\u1eefa m\u1eb9 v\u1edbi l\u01b0\u1ee3ng nh\u1ecf. Trong tu\u1ea7n ho\u00e0n, betamethason li\u00ean k\u1ebft ch\u1ee7 y\u1ebfu v\u1edbi globulin, \u00edt v\u1edbi albumin. T\u1ef7 l\u1ec7 betamethason li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft kho\u1ea3ng 60%, th\u1ea5p h\u01a1n so v\u1edbi hydrocortison. Betamethason l\u00e0 m\u1ed9t glucocorticoid t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i v\u1edbi n\u1eeda \u0111\u1eddi kho\u1ea3ng 36 &#8211; 54 gi\u1edd. Thu\u1ed1c \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ch\u1ee7 y\u1ebfu \u1edf gan v\u00e0 th\u1ea3i tr\u1eeb ch\u1ee7 y\u1ebfu qua th\u1eadn v\u1edbi t\u1ef7 l\u1ec7 chuy\u1ec3n h\u00f3a d\u01b0\u1edbi 5%. Do betamethason c\u00f3 t\u1ed1c \u0111\u1ed9 chuy\u1ec3n h\u00f3a ch\u1eadm, t\u1ef7 l\u1ec7 li\u00ean k\u1ebft v\u1edbi protein th\u1ea5p v\u00e0 n\u1eeda \u0111\u1eddi d\u00e0i n\u00ean hi\u1ec7u l\u1ef1c m\u1ea1nh h\u01a1n v\u00e0 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i h\u01a1n so v\u1edbi c\u00e1c corticosteroid t\u1ef1 nhi\u00ean.<\/p>\n<p><strong>5.3 Gi\u1ea3i th\u00edch: <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong>5.4 Thay th\u1ebf thu\u1ed1c : <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><\/p>\n<p><strong>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/strong><\/p>\n<p>T\u00e1 d\u01b0\u1ee3c: Tinh b\u1ed9t ng\u00f4, lactose, P.V.P, b\u1ed9t talc, magnesi stearat, aerosil, m\u00e0u Ponceau 4R.<\/p>\n<p><strong>6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<p><strong>6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n<p>B\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30 \u00b0C trong bao b\u00ec k\u00edn. Tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n<p><strong>6.4. Th\u00f4ng tin kh\u00e1c :<\/strong><\/p>\n<p>Kh\u00f4ng c\u00f3.<\/p>\n<p><strong>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Betamethasone Ph\u00e2n lo\u1ea1i: Thu\u1ed1c Corticosteroids. Nh\u00f3m ph\u00e1p l\u00fd: Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine) M\u00e3 ATC (Anatomical Therapeutic Chemical): H02AB01. Brand name: CELESTONE, . H\u00e3ng s\u1ea3n xu\u1ea5t : PT Schering Plough. 2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng: D\u1ea1ng [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":6515,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[370],"tags":[519],"class_list":["post-6514","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc-goc","tag-betamethasone"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/6514","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=6514"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/6514\/revisions"}],"predecessor-version":[{"id":52343,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/6514\/revisions\/52343"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/6515"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=6514"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=6514"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=6514"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}