{"id":7654,"date":"2019-04-03T14:19:36","date_gmt":"2019-04-03T07:19:36","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=7654"},"modified":"2025-01-08T23:01:54","modified_gmt":"2025-01-08T16:01:54","slug":"meropenem-meronem","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/meropenem-meronem\/","title":{"rendered":"Meropenem &#8211; Meronem"},"content":{"rendered":"<p><em>Thu\u1ed1c MERONEM l\u00e0 thu\u1ed1c g\u00ec ? D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c MERONEM (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\/meropenem-meronem\/#1-ten-hoat-chat-va-biet-duoc\" >1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#2-dang-bao-che-%e2%80%93-ham-luong\" >2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#3-video-by-pharmog\" >3. Video by Pharmog:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#4-ung-dung-lam-sang\" >4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#41-chi-dinh\" >4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#42-lieu-dung-%e2%80%93-cach-dung\" >4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#43-chong-chi-dinh\" >4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#44-than-trong\" >4.4 Th\u1eadn tr\u1ecdng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\" >4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#46-tac-dung-khong-mong-muon-adr\" >4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#47-huong-dan-cach-xu-tri-adr\" >4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#48-tuong-tac-voi-cac-thuoc-khac\" >4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#49-qua-lieu-va-xu-tri\" >4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#5-co-che-tac-dung-cua-thuoc\" >5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#51-duoc-luc-hoc\" >5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#52-duoc-dong-hoc\" >5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#53-giai-thich\" >5.3 Gi\u1ea3i th\u00edch:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#54-thay-the-thuoc\" >5.4 Thay th\u1ebf thu\u1ed1c :<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#6-phan-thong-tin-kem-theo-cua-thuoc\" >6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#61-danh-muc-ta-duoc\" >6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#62-tuong-ky\" >6.2. T\u01b0\u01a1ng k\u1ef5 :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#63-bao-quan\" >6.3. B\u1ea3o qu\u1ea3n:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#64-thong-tin-khac\" >6.4. Th\u00f4ng tin kh\u00e1c :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#65-tai-lieu-tham-khao\" >6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/pharmog.com\/wp\/meropenem-meronem\/#7-nguoi-dang-tai-tac-gia\" >7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/a><\/li><\/ul><\/nav><\/div>\n\n<h1><span class=\"ez-toc-section\" id=\"1-ten-hoat-chat-va-biet-duoc\"><\/span>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <\/strong><a href=\"https:\/\/pharmog.com\/wp\/meropenem\/\"><strong>Meropenem<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c Kh\u00e1ng sinh nh\u00f3m beta-lactam , ph\u00e2n nh\u00f3m carbapenem.<\/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): J01DH02.<\/p>\n<p><strong><em>Brand name:<\/em><\/strong> MERONEM.<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: ACS Dobfar S.P.A \/ AstraZeneca<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h1><span class=\"ez-toc-section\" id=\"2-dang-bao-che-%e2%80%93-ham-luong\"><\/span>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Meropenem trihydrat 1140 mg t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi Meropenem khan 1000 mg<\/p>\n<p>B\u1ed9t pha ti\u00eam 500 mg : h\u1ed9p 10 l\u1ecd 20 mL, h\u1ed9p 1 l\u1ecd 20 mL,<\/p>\n<p>B\u1ed9t pha ti\u00eam 1 g : h\u1ed9p 10 l\u1ecd 30 mL, h\u1ed9p 1 l\u1ecd 30 mL<\/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>MERONEM IV<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i l\u1ecd b\u1ed9t pha ti\u00eam c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Meropenem<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>1000 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 size-full wp-image-33113\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/MEronem.png\" alt=\"\" width=\"615\" height=\"334\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/MEronem.png 615w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/04\/MEronem-300x163.png 300w\" sizes=\"auto, (max-width: 615px) 100vw, 615px\" \/><\/p>\n<h1><span class=\"ez-toc-section\" id=\"3-video-by-pharmog\"><\/span>3. Video by Pharmog:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=0TIIfoiJFwA&amp;feature=youtu.be\"><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/a><\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog SS1 - T\u1eadp 08] - D\u01b0\u1ee3c l\u00fd c\u00e1c thu\u1ed1c kh\u00e1ng sinh\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/0TIIfoiJFwA?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<h1><span class=\"ez-toc-section\" id=\"4-ung-dung-lam-sang\"><\/span>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"41-chi-dinh\"><\/span>4.1. Ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Meronem d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (IV) \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m khu\u1ea9n \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em g\u00e2y ra b\u1edfi m\u1ed9t hay nhi\u1ec1u vi khu\u1ea9n nh\u1ea1y c\u1ea3m v\u1edbi meropenem nh\u01b0 sau:<\/p>\n<p>Vi\u00eam ph\u1ed5i v\u00e0 vi\u00eam ph\u1ed5i b\u1ec7nh vi\u1ec7n.<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ni\u1ec7u.<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n trong \u1ed5 b\u1ee5ng.<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n ph\u1ee5 khoa, nh\u01b0 vi\u00eam n\u1ed9i m\u1ea1c t\u1eed cung v\u00e0 c\u00e1c b\u1ec7nh l\u00fd vi\u00eam v\u00f9ng ch\u1eadu.<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n da v\u00e0 c\u1ea5u tr\u00fac da.<\/p>\n<p>Vi\u00eam m\u00e0ng n\u00e3o.<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n huy\u1ebft.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb theo kinh nghi\u1ec7m c\u00e1c nghi ng\u1edd nhi\u1ec5m khu\u1ea9n \u1edf ng\u01b0\u1eddi l\u1edbn b\u1ecb s\u1ed1t gi\u1ea3m b\u1ea1ch c\u1ea7u theo \u0111\u01a1n tr\u1ecb li\u1ec7u hay ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng virus ho\u1eb7c thu\u1ed1c kh\u00e1ng n\u1ea5m.<\/p>\n<p>Meronem \u0111\u01a1n tr\u1ecb li\u1ec7u hay ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng khu\u1ea9n kh\u00e1c \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n h\u1ed7n h\u1ee3p.<\/p>\n<p>Meropenem d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u0111\u00e3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 tr\u00ean b\u1ec7nh nh\u00e2n x\u01a1 h\u00f3a nang v\u00e0 nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi m\u1ea1n t\u00ednh khi s\u1eed d\u1ee5ng nh\u01b0 \u0111\u01a1n tr\u1ecb li\u1ec7u ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng khu\u1ea9n kh\u00e1c. Vi khu\u1ea9n kh\u00f4ng ph\u1ea3i lu\u00f4n lu\u00f4n \u0111\u01b0\u1ee3c ti\u1ec7t tr\u1eeb ho\u00e0n to\u00e0n.<\/p>\n<p>Ch\u01b0a c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng thu\u1ed1c \u1edf tr\u1ebb em gi\u1ea3m b\u1ea1ch c\u1ea7u hay suy gi\u1ea3m mi\u1ec5n d\u1ecbch nguy\u00ean ph\u00e1t ho\u1eb7c th\u1ee9 ph\u00e1t.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"42-lieu-dung-%e2%80%93-cach-dung\"><\/span>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>&#8216;Meronem&#8217; IV v\u1edbi c\u00e1c d\u1ea1ng tr\u00ecnh b\u00e0y c\u00f3 s\u1eb5n c\u00f3 th\u1ec3 d\u00f9ng ti\u00eam t\u0129nh m\u1ea1ch trong kho\u1ea3ng 5 ph\u00fat hay truy\u1ec1n t\u0129nh m\u1ea1ch trong kho\u1ea3ng 15-30 ph\u00fat.<\/p>\n<p>&#8216;Meronem&#8217; IV d\u00f9ng ti\u00eam t\u0129nh m\u1ea1ch n\u00ean \u0111\u01b0\u1ee3c pha v\u1edbi n\u01b0\u1edbc v\u00f4 khu\u1ea9n \u0111\u1ec3 ti\u00eam (5 ml cho m\u1ed7i 250 mg meropenem) cho dung d\u1ecbch c\u00f3 n\u1ed3ng \u0111\u1ed9 kho\u1ea3ng 50 mg\/ml. Dung d\u1ecbch sau khi pha trong su\u1ed1t, kh\u00f4ng m\u00e0u ho\u1eb7c m\u00e0u v\u00e0ng nh\u1ea1t.<\/p>\n<p>&#8216;Meronem&#8217; IV d\u00f9ng truy\u1ec1n t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 pha v\u1edbi c\u00e1c d\u1ecbch truy\u1ec1n t\u01b0\u01a1ng th\u00edch (50 \u0111\u1ebfn 200 ml) (Xem T\u01b0\u01a1ng k\u1ef5 &amp; B\u1ea3o qu\u1ea3n&#8221;).<\/p>\n<p>Khuy\u1ebfn c\u00e1o n\u00ean s\u1eed d\u1ee5ng dung d\u1ecbch &#8216;Meronem&#8217; d\u00f9ng ti\u00eam ho\u1eb7c ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch ngay sau khi pha. Dung d\u1ecbch thu\u1ed1c sau khi pha theo h\u01b0\u1edbng d\u1eabn \u1edf ph\u1ea7n tr\u00ean duy tr\u00ec ho\u1ea1t t\u00ednh \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (\u2264 25oC) ho\u1eb7c khi b\u1ea3o qu\u1ea3n l\u1ea1nh (4oC) nh\u01b0 m\u00f4 t\u1ea3 trong b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<table>\n<tbody>\n<tr>\n<td rowspan=\"2\"><strong>Ch\u1ea5t pha lo\u00e3ng<\/strong><\/td>\n<td colspan=\"2\"><strong>Th\u1eddi gian (gi\u1edd) \u1ed5n \u0111\u1ecbnh \u1edf<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>15-25<sup>o<\/sup>C<\/strong><\/td>\n<td><strong>4<sup>o<\/sup>C<\/strong><\/td>\n<\/tr>\n<tr>\n<td>L\u1ecd thu\u1ed1c pha v\u1edbi n\u01b0\u1edbc pha ti\u00eam d\u00f9ng ti\u00eam t\u0129nh m\u1ea1ch<\/td>\n<td>8<\/td>\n<td>48<\/td>\n<\/tr>\n<tr>\n<td>Dung d\u1ecbch thu\u1ed1c (1-20 mg\/ml) sau khi pha v\u1edbi:<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Natri clorid 0,9%<\/td>\n<td>8<\/td>\n<td>48<\/td>\n<\/tr>\n<tr>\n<td>Glucose 5%<\/td>\n<td>3<\/td>\n<td>14<\/td>\n<\/tr>\n<tr>\n<td>Glucose 5% v\u00e0 natri clorid 0,225%<\/td>\n<td>3<\/td>\n<td>14<\/td>\n<\/tr>\n<tr>\n<td>Glucose 5% v\u00e0 natri clorid 0,9%<\/td>\n<td>3<\/td>\n<td>14<\/td>\n<\/tr>\n<tr>\n<td>Glucose 5% v\u00e0 kali clorid 0,15%<\/td>\n<td>3<\/td>\n<td>14<\/td>\n<\/tr>\n<tr>\n<td>Dung d\u1ecbch mannitol truy\u1ec1n t\u0129nh m\u1ea1ch 2,5% ho\u1eb7c 10%<\/td>\n<td>3<\/td>\n<td>14<\/td>\n<\/tr>\n<tr>\n<td>Glucose 10%<\/td>\n<td>2<\/td>\n<td>8<\/td>\n<\/tr>\n<tr>\n<td>Glucose 5% v\u00e0 natri bicarbonate 0,02% truy\u1ec1n t\u0129nh m\u1ea1ch<\/td>\n<td>2<\/td>\n<td>8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>L\u1eafc k\u1ef9 dung d\u1ecbch thu\u1ed1c \u0111\u00e3 pha tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng.<\/p>\n<p>T\u1ea5t c\u1ea3 c\u00e1c l\u1ecd thu\u1ed1c ch\u1ec9 s\u1eed d\u1ee5ng 1 l\u1ea7n.<\/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 l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb t\u00f9y thu\u1ed9c m\u1ee9c \u0111\u1ed9 v\u00e0 lo\u1ea1i nhi\u1ec5m khu\u1ea9n c\u0169ng nh\u01b0 t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n.<\/p>\n<p><em>Li\u1ec1u khuy\u1ebfn c\u00e1o m\u1ed7i ng\u00e0y nh\u01b0 sau:<\/em><\/p>\n<p>500 mg Meronem d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (IV) m\u1ed7i 8 gi\u1edd trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i, nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ni\u1ec7u, c\u00e1c nhi\u1ec5m khu\u1ea9n ph\u1ee5 khoa nh\u01b0 vi\u00eam n\u1ed9i m\u1ea1c t\u1eed cung, nhi\u1ec5m khu\u1ea9n da v\u00e0 c\u1ea5u tr\u00fac da.<\/p>\n<p>1 g Meronem d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (IV) m\u1ed7i 8 gi\u1edd trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i b\u1ec7nh vi\u1ec7n, vi\u00eam ph\u00fac m\u1ea1c, c\u00e1c nghi ng\u1edd nhi\u1ec5m khu\u1ea9n \u1edf b\u1ec7nh nh\u00e2n gi\u1ea3m b\u1ea1ch c\u1ea7u, nhi\u1ec5m khu\u1ea9n huy\u1ebft.<\/p>\n<p>Trong b\u1ec7nh x\u01a1 h\u00f3a nang, li\u1ec1u l\u00ean \u0111\u1ebfn 2 g m\u1ed7i 8 gi\u1edd \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng; \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi li\u1ec1u 2 g m\u1ed7i 8 gi\u1edd.<\/p>\n<p>Trong vi\u00eam m\u00e0ng n\u00e3o, li\u1ec1u khuy\u1ebfn c\u00e1o l\u00e0 2 g m\u1ed7i 8 gi\u1edd.<\/p>\n<p>C\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c, c\u1ea7n \u0111\u1eb7c bi\u1ec7t th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng meropenem \u0111\u01a1n tr\u1ecb li\u1ec7u trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n hay nghi ng\u1edd nhi\u1ec5m khu\u1ea9n Pseudomonas aeruginosa \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi tr\u1ea7m tr\u1ecdng.<\/p>\n<p>Khuy\u1ebfn c\u00e1o n\u00ean th\u01b0\u1eddng xuy\u00ean th\u1eed nghi\u1ec7m \u0111\u1ed9 nh\u1ea1y c\u1ea3m c\u1ee7a thu\u1ed1c khi \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n do Pseudomonas aeruginosa.<\/p>\n<p><em>Li\u1ec1u d\u00f9ng cho b\u1ec7nh nh\u00e2n ng\u01b0\u1eddi l\u1edbn suy ch\u1ee9c n\u0103ng th\u1eadn:<\/em><\/p>\n<p>N\u00ean gi\u1ea3m li\u1ec1u cho b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 thanh th\u1ea3i creatinine &lt; 51 ml\/ph\u00fat theo h\u01b0\u1edbng d\u1eabn d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>ClCr (ml\/ph\u00fat)<\/strong><\/td>\n<td><strong>26-50<\/strong><\/td>\n<td><strong>10-25<\/strong><\/td>\n<td><strong>&lt; 10<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Li\u1ec1u d\u00f9ng (t\u00ednh theo \u0111\u01a1n v\u1ecb li\u1ec1u 500 mg, 1 g, 2 g)<\/td>\n<td>m\u1ed9t \u0111\u01a1n v\u1ecb li\u1ec1u, m\u1ed7i 12 gi\u1edd<\/td>\n<td>n\u1eeda \u0111\u01a1n v\u1ecb li\u1ec1u m\u1ed7i 12 gi\u1edd<\/td>\n<td>n\u1eeda \u0111\u01a1n v\u1ecb li\u1ec1u m\u1ed7i 24 gi\u1edd<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Meropenem th\u1ea3i tr\u1eeb qua th\u1ea9m ph\u00e2n m\u00e1u; n\u1ebfu c\u1ea7n ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb v\u1edbi Meronem, sau khi ho\u00e0n t\u1ea5t th\u1ea9m ph\u00e2n m\u00e1u, khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng m\u1ed9t \u0111\u01a1n v\u1ecb li\u1ec1u (t\u00f9y theo lo\u1ea1i v\u00e0 m\u1ee9c \u0111\u1ed9 nhi\u1ec5m khu\u1ea9n) \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 trong huy\u1ebft t\u01b0\u01a1ng.<\/p>\n<p>Ch\u01b0a c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng &#8216;Meronem&#8217; cho b\u1ec7nh nh\u00e2n \u0111ang th\u1ea9m ph\u00e2n ph\u00fac m\u1ea1c.<\/p>\n<p><em>Li\u1ec1u d\u00f9ng cho b\u1ec7nh nh\u00e2n suy gan:<\/em><\/p>\n<p>Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u (xem &#8220;Ch\u00fa \u00fd \u0111\u1ec1 ph\u00f2ng v\u00e0 th\u1eadn tr\u1ecdng l\u00fac d\u00f9ng&#8221;).<\/p>\n<p><em>B\u1ec7nh nh\u00e2n cao tu\u1ed5i:<\/em><\/p>\n<p>Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho b\u1ec7nh nh\u00e2n cao tu\u1ed5i c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng hay \u0111\u1ed9 thanh th\u1ea3i creatinine &gt; 50 ml\/ph\u00fat.<\/p>\n<p><em>Tr\u1ebb em:<\/em><\/p>\n<p>Tr\u1ebb em t\u1eeb 3 th\u00e1ng \u0111\u1ebfn 12 tu\u1ed5i: li\u1ec1u khuy\u1ebfn c\u00e1o l\u00e0 10-20 mg\/kg m\u1ed7i 8 gi\u1edd t\u00f9y thu\u1ed9c m\u1ee9c \u0111\u1ed9 v\u00e0 lo\u1ea1i nhi\u1ec5m khu\u1ea9n, \u0111\u1ed9 nh\u1ea1y c\u1ea3m c\u1ee7a t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n.<\/p>\n<p>Tr\u1ebb em c\u00e2n n\u1eb7ng tr\u00ean 50 kg: khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng li\u1ec1u nh\u01b0 \u1edf ng\u01b0\u1eddi l\u1edbn.<\/p>\n<p>Li\u1ec1u khuy\u1ebfn c\u00e1o cho vi\u00eam m\u00e0ng n\u00e3o l\u00e0 40 mg\/kg m\u1ed7i 8 gi\u1edd.<\/p>\n<p>Ch\u01b0a c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng thu\u1ed1c cho tr\u1ebb em suy th\u1eadn.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"43-chong-chi-dinh\"><\/span>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Meronem ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n qu\u00e1 m\u1eabn v\u1edbi 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<h2><span class=\"ez-toc-section\" id=\"44-than-trong\"><\/span>4.4 Th\u1eadn tr\u1ecdng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>C\u00f3 m\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng v\u1ec1 d\u1ecb \u1ee9ng ch\u00e9o m\u1ed9t ph\u1ea7n gi\u1eefa c\u00e1c kh\u00e1ng sinh carbapenem kh\u00e1c v\u1edbi c\u00e1c kh\u00e1ng sinh h\u1ecd beta-lactam, penicillin v\u00e0 cephalosporin. C\u0169ng nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c kh\u00e1ng sinh h\u1ecd beta-lactam, c\u00e1c ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn hi\u1ebfm x\u1ea3y ra (xem &#8220;T\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd&#8221;). Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb v\u1edbi meropenem, n\u00ean h\u1ecfi k\u1ef9 b\u1ec7nh nh\u00e2n v\u1ec1 ti\u1ec1n s\u1eed c\u00e1c ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn v\u1edbi c\u00e1c kh\u00e1ng sinh h\u1ecd beta-lactam. N\u00ean s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng Meronem cho b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed qu\u00e1 m\u1eabn n\u00e0y. N\u1ebfu ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng v\u1edbi meropenem x\u1ea3y ra, n\u00ean ng\u01b0ng thu\u1ed1c v\u00e0 c\u00f3 bi\u1ec7n ph\u00e1p x\u1eed l\u00fd th\u00edch h\u1ee3p.<\/p>\n<p>Khi s\u1eed d\u1ee5ng Meronem cho b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh gan c\u1ea7n theo d\u00f5i k\u1ef9 n\u1ed3ng \u0111\u1ed9 transaminase v\u00e0 bilirubin.<\/p>\n<p>C\u0169ng nh\u01b0 c\u00e1c kh\u00e1ng sinh kh\u00e1c, t\u0103ng sinh c\u00e1c vi khu\u1ea9n kh\u00f4ng nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c c\u00f3 th\u1ec3 x\u1ea3y ra v\u00e0 do \u0111\u00f3, c\u1ea7n ph\u1ea3i theo d\u00f5i b\u1ec7nh nh\u00e2n li\u00ean t\u1ee5c.<\/p>\n<p>Kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1ed1c trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng do c\u00e1c Staphylococcus \u0111\u1ec1 kh\u00e1ng v\u1edbi methicillin.<\/p>\n<p>Tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng, c\u0169ng nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c kh\u00e1ng sinh kh\u00e1c, vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c hi\u1ebfm khi x\u1ea3y ra khi s\u1eed d\u1ee5ng Meronem v\u00e0 c\u00f3 th\u1ec3 \u1edf m\u1ee9c \u0111\u1ed9 t\u1eeb nh\u1eb9 \u0111\u1ebfn \u0111e d\u1ecda t\u00ednh m\u1ea1ng. V\u00ec v\u1eady, c\u1ea7n th\u1eadn tr\u1ecdng khi k\u00ea toa c\u00e1c thu\u1ed1c kh\u00e1ng sinh cho b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, \u0111\u1eb7c bi\u1ec7t vi\u00eam \u0111\u1ea1i tr\u00e0ng. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 c\u1ea7n xem x\u00e9t ch\u1ea9n \u0111o\u00e1n vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c khi b\u1ec7nh nh\u00e2n b\u1ecb ti\u00eau ch\u1ea3y li\u00ean quan \u0111\u1ebfn s\u1eed d\u1ee5ng thu\u1ed1c Meronem. M\u1eb7c d\u00f9 c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y \u0111\u1ed9c t\u1ed1 do Clostridium difficile sinh ra l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y vi\u00eam \u0111\u1ea1i tr\u00e0ng li\u00ean quan \u0111\u1ebfn s\u1eed d\u1ee5ng c\u00e1c kh\u00e1ng sinh, c\u0169ng c\u1ea7n xem x\u00e9t \u0111\u1ebfn c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.<\/p>\n<p>N\u00ean th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi Meronem v\u1edbi c\u00e1c thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y \u0111\u1ed9c tr\u00ean th\u1eadn (Xem &#8220;Li\u1ec1u l\u01b0\u1ee3ng v\u00e0 C\u00e1ch d\u00f9ng&#8221; \u0111\u1ec3 bi\u1ebft li\u1ec1u d\u00f9ng).<\/p>\n<p>Meronem c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 ax\u00edt valproic huy\u1ebft thanh. \u1ede m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, n\u1ed3ng \u0111\u1ed9 ax\u00edt valproic huy\u1ebft thanh c\u00f3 th\u1ec3 th\u1ea5p h\u01a1n n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><em>S\u1eed d\u1ee5ng cho tr\u1ebb em:<\/em><\/p>\n<p>Hi\u1ec7u qu\u1ea3 v\u00e0 s\u1ef1 dung n\u1ea1p \u0111\u1ed1i v\u1edbi tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c l\u1eadp; do \u0111\u00f3, kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng Meronem cho tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i. Ch\u01b0a c\u00f3 kinh nghi\u1ec7m s\u1eed d\u1ee5ng thu\u1ed1c cho tr\u1ebb em b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan hay th\u1eadn.<\/p>\n<p>\u0110\u1ec3 thu\u1ed1c ngo\u00e0i 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>Kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u th\u00edch h\u1ee3p, nh\u01b0ng ng\u01b0\u1eddi ta kh\u00f4ng cho r\u1eb1ng Meronem s\u1ebd \u1ea3nh h\u01b0\u1edfng l\u00ean kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\"><\/span>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: B2<\/p>\n<p>US FDA pregnancy category: B<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>T\u00ednh an to\u00e0n c\u1ee7a Meronem \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef mang thai ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt kh\u00f4ng ghi nh\u1eadn t\u00e1c \u0111\u1ed9ng ngo\u1ea1i \u00fd n\u00e0o tr\u00ean s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u00e0o thai. T\u00e1c \u0111\u1ed9ng ngo\u1ea1i \u00fd duy nh\u1ea5t quan s\u00e1t \u0111\u01b0\u1ee3c qua c\u00e1c th\u1eed nghi\u1ec7m v\u1ec1 kh\u1ea3 n\u0103ng sinh s\u1ea3n \u1edf \u0111\u1ed9ng v\u1eadt l\u00e0 t\u0103ng t\u1ea7n su\u1ea5t s\u1ea9y thai \u1edf kh\u1ec9 \u1edf n\u1ed3ng \u0111\u1ed9 ti\u1ebfp x\u00fac cao g\u1ea5p 13 l\u1ea7n n\u1ed3ng \u0111\u1ed9 ti\u1ebfp x\u00fac \u1edf ng\u01b0\u1eddi. Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng Meronem cho ph\u1ee5 n\u1eef mang thai tr\u1eeb phi l\u1ee3i \u00edch v\u01b0\u1ee3t tr\u1ed9i c\u00e1c r\u1ee7i ro c\u00f3 th\u1ec3 x\u1ea3y ra cho b\u00e0o thai. N\u00ean c\u00f3 b\u00e1c s\u0129 gi\u00e1m s\u00e1t tr\u1ef1c ti\u1ebfp cho m\u1ecdi tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng thu\u1ed1c cho ph\u1ee5 n\u1eef mang thai.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Meropenem \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong s\u1eefa \u0111\u1ed9ng v\u1eadt \u1edf n\u1ed3ng \u0111\u1ed9 r\u1ea5t th\u1ea5p. Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng Meronem \u1edf ph\u1ee5 n\u1eef cho con b\u00fa tr\u1eeb phi l\u1ee3i \u00edch v\u01b0\u1ee3t tr\u1ed9i c\u00e1c r\u1ee7i ro c\u00f3 th\u1ec3 x\u1ea3y ra cho tr\u1ebb.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"46-tac-dung-khong-mong-muon-adr\"><\/span>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hi\u1ebfm khi c\u00f3 c\u00e1c bi\u1ebfn c\u1ed1 ngo\u1ea1i \u00fd nghi\u00eam tr\u1ecdng. C\u00e1c bi\u1ebfn c\u1ed1 ngo\u1ea1i \u00fd sau ghi nh\u1eadn qua c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o:<\/p>\n<p>* C\u00e1c ph\u1ea3n \u1ee9ng t\u1ea1i n\u01a1i ti\u00eam: vi\u00eam, vi\u00eam t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i, \u0111au t\u1ea1i n\u01a1i ti\u00eam.<\/p>\n<p>* C\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng to\u00e0n th\u00e2n: c\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng to\u00e0n th\u00e2n (qu\u00e1 m\u1eabn) hi\u1ebfm x\u1ea3y ra khi s\u1eed d\u1ee5ng meropenem. C\u00e1c ph\u1ea3n \u1ee9ng n\u00e0y bao g\u1ed3m ph\u00f9 m\u1ea1ch v\u00e0 c\u00e1c bi\u1ec3u hi\u1ec7n ph\u1ea3n v\u1ec7.<\/p>\n<p>* C\u00e1c ph\u1ea3n \u1ee9ng da: ph\u00e1t ban, ng\u1ee9a, m\u1ec1 \u0111ay. C\u00e1c ph\u1ea3n \u1ee9ng da nghi\u00eam tr\u1ecdng nh\u01b0 h\u1ed3ng ban \u0111a d\u1ea1ng, h\u1ed9i ch\u1ee9ng Stevens-Johnson v\u00e0 ho\u1ea1i t\u1eed da nhi\u1ec5m \u0111\u1ed9c hi\u1ebfm khi ghi nh\u1eadn.<\/p>\n<p>* Ti\u00eau h\u00f3a: \u0111au b\u1ee5ng, bu\u1ed3n n\u00f4n, n\u00f4n, ti\u00eau ch\u1ea3y. Vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o.<\/p>\n<p>* Huy\u1ebft h\u1ecdc: t\u0103ng ti\u1ec3u c\u1ea7u, t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan, gi\u1ea3m ti\u1ec3u c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u v\u00e0 b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh (k\u1ec3 c\u1ea3 m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t r\u1ea5t hi\u1ebfm x\u1ea3y ra) c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c. Thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft hi\u1ebfm khi x\u1ea3y ra. Ph\u1ea3n \u1ee9ng Coombs d\u01b0\u01a1ng t\u00ednh tr\u1ef1c ti\u1ebfp hay gi\u00e1n ti\u1ebfp c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n; \u0111\u00e3 c\u00f3 ghi nh\u1eadn v\u1ec1 gi\u1ea3m th\u1eddi gian thromboplastin m\u1ed9t ph\u1ea7n.<\/p>\n<p>* Ch\u1ee9c n\u0103ng gan: t\u0103ng n\u1ed3ng \u0111\u1ed9 bilirubin, transaminase, phosphatase ki\u1ec1m v\u00e0 lactic dehydrogenase huy\u1ebft thanh \u0111\u01a1n thu\u1ea7n hay ph\u1ed1i h\u1ee3p \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o.<\/p>\n<p>* H\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: nh\u1ee9c \u0111\u1ea7u, d\u1ecb c\u1ea3m. Co gi\u1eadt \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o m\u1eb7c d\u00f9 m\u1ed1i li\u00ean h\u1ec7 nh\u00e2n qu\u1ea3 v\u1edbi &#8216;Meronem&#8217; ch\u01b0a \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp.<\/p>\n<p>* T\u00e1c \u0111\u1ed9ng kh\u00f4ng mong mu\u1ed1n kh\u00e1c: nhi\u1ec5m Candida mi\u1ec7ng v\u00e0 \u00e2m \u0111\u1ea1o.<\/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><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=\"47-huong-dan-cach-xu-tri-adr\"><\/span>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>N\u1ebfu x\u1ea3y ra c\u00e1c ADR nghi\u00eam tr\u1ecdng, c\u1ea7n ng\u1eebng d\u00f9ng meropenem v\u00e0 \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p.<\/p>\n<p>Khi b\u1ec7nh nh\u00e2n b\u1ecb co gi\u1eadt ho\u1eb7c g\u1eb7p c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i tr\u00ean th\u1ea7n kinh trung \u01b0\u01a1ng, c\u1ea7n gi\u1ea3m li\u1ec1u ho\u1eb7c ng\u1eebng d\u00f9ng meropenem.<\/p>\n<p>N\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb ti\u00eau ch\u1ea3y trong ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng meropenem, c\u1ea7n theo d\u00f5i v\u00e0 c\u00f3 ch\u1ea5n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"48-tuong-tac-voi-cac-thuoc-khac\"><\/span>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Probenecid c\u1ea1nh tranh v\u1edbi meropenem trong b\u00e0i ti\u1ebft ch\u1ee7 \u0111\u1ed9ng qua \u1ed1ng th\u1eadn v\u00e0 v\u00ec v\u1eady \u1ee9c ch\u1ebf s\u1ef1 b\u00e0i ti\u1ebft meropenem qua th\u1eadn, g\u00e2y t\u0103ng th\u1eddi gian b\u00e1n th\u1ea3i v\u00e0 n\u1ed3ng \u0111\u1ed9 meropenem trong huy\u1ebft t\u01b0\u01a1ng. Khi kh\u00f4ng d\u00f9ng chung v\u1edbi probenecid, &#8216;Meronem&#8217; \u0111\u00e3 c\u00f3 ho\u1ea1t t\u00ednh th\u00edch h\u1ee3p v\u00e0 th\u1eddi gian t\u00e1c \u0111\u1ed9ng \u0111\u00e3 \u0111\u1ee7 d\u00e0i n\u00ean kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi probenecid v\u00e0 &#8216;Meronem&#8217;.<\/p>\n<p>Ti\u1ec1m n\u0103ng t\u00e1c \u0111\u1ed9ng c\u1ee7a &#8216;Meronem&#8217; tr\u00ean s\u1ef1 g\u1eafn k\u1ebft v\u1edbi protein ho\u1eb7c chuy\u1ec3n h\u00f3a c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. &#8216;Meronem&#8217; g\u1eafn k\u1ebft v\u1edbi protein th\u1ea5p (kho\u1ea3ng 2%), do \u0111\u00f3 t\u01b0\u01a1ng t\u00e1c v\u1edbi nh\u1eefng h\u1ee3p ch\u1ea5t kh\u00e1c do s\u1ef1 ph\u00e2n t\u00e1ch kh\u1ecfi protein trong huy\u1ebft t\u01b0\u01a1ng kh\u00f4ng d\u1ef1 ki\u1ebfn x\u1ea3y ra.<\/p>\n<p>&#8216;Meronem&#8217; c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 ax\u00edt valproic huy\u1ebft thanh. \u1ede m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, n\u1ed3ng \u0111\u1ed9 ax\u00edt valproic huy\u1ebft thanh c\u00f3 th\u1ec3 th\u1ea5p h\u01a1n n\u1ed3ng \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>&#8216;Meronem&#8217; \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c m\u00e0 kh\u00f4ng c\u00f3 c\u00e1c t\u01b0\u01a1ng t\u00e1c b\u1ea5t l\u1ee3i v\u1ec1 d\u01b0\u1ee3c l\u00fd. Tuy nhi\u00ean, kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u \u0111\u1eb7c tr\u01b0ng n\u00e0o v\u1ec1 c\u00e1c kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c (ngo\u1ea1i tr\u1eeb probenecid nh\u01b0 n\u00eau \u1edf tr\u00ean).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"49-qua-lieu-va-xu-tri\"><\/span>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Qu\u00e1 li\u1ec1u kh\u00f4ng ch\u1ee7 \u00fd c\u00f3 th\u1ec3 x\u1ea3y ra trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb, \u0111\u1eb7c bi\u1ec7t tr\u00ean b\u1ec7nh nh\u00e2n suy th\u1eadn. \u0110i\u1ec1u tr\u1ecb qu\u00e1 li\u1ec1u n\u00ean l\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng. \u1ede ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng, thu\u1ed1c s\u1ebd \u0111\u01b0\u1ee3c nhanh ch\u00f3ng th\u1ea3i tr\u1eeb qua th\u1eadn; \u1edf c\u00e1c b\u1ec7nh nh\u00e2n suy th\u1eadn, th\u1ea9m ph\u00e2n m\u00e1u s\u1ebd lo\u1ea1i tr\u1eeb meropenem v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a.<\/p>\n<h1><span class=\"ez-toc-section\" id=\"5-co-che-tac-dung-cua-thuoc\"><\/span>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"51-duoc-luc-hoc\"><\/span>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Meropenem l\u00e0 kh\u00e1ng sinh nh\u00f3m carbapenem d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, t\u01b0\u01a1ng \u0111\u1ed1i \u1ed5n \u0111\u1ecbnh v\u1edbi dehydropeptidase-1 (DHP-1) \u1edf ng\u01b0\u1eddi, do \u0111\u00f3 kh\u00f4ng c\u1ea7n th\u00eam ch\u1ea5t \u1ee9c ch\u1ebf DHP-1.<\/p>\n<p>Meropenem di\u1ec7t khu\u1ea9n b\u1eb1ng c\u00e1ch c\u1ea3n tr\u1edf qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p th\u00e0nh t\u1ebf b\u00e0o vi khu\u1ea9n s\u1ed1ng. S\u1ef1 th\u00e2m nh\u1eadp d\u1ec5 d\u00e0ng qua th\u00e0nh t\u1ebf b\u00e0o vi khu\u1ea9n c\u1ee7a thu\u1ed1c, \u0111\u1ed9 b\u1ec1n cao \u0111\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c \u00e2 lactamases trong huy\u1ebft thanh v\u00e0 \u00e1i l\u1ef1c \u0111\u00e1ng k\u1ec3 v\u1edbi c\u00e1c protein g\u1eafn k\u1ebft v\u1edbi penicillin (PBP) gi\u1ea3i th\u00edch t\u00e1c \u0111\u1ed9ng di\u1ec7t khu\u1ea9n m\u1ea1nh c\u1ee7a meropenem \u0111\u1ed1i v\u1edbi nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n k\u1ef5 kh\u00ed v\u00e0 hi\u1ebfu kh\u00ed. C\u00e1c n\u1ed3ng \u0111\u1ed9 di\u1ec7t khu\u1ea9n t\u1ed1i thi\u1ec3u (MBC) th\u01b0\u1eddng t\u01b0\u01a1ng t\u1ef1 v\u1edbi n\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf t\u1ed1i thi\u1ec3u (MIC). \u0110\u1ed1i v\u1edbi 76% vi khu\u1ea9n \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m, t\u1ef7 s\u1ed1 gi\u1eefa MBC:MIC nh\u1ecf h\u01a1n ho\u1eb7c b\u1eb1ng 2.<\/p>\n<p>Meropenem \u1ed5n \u0111\u1ecbnh trong c\u00e1c th\u1eed nghi\u1ec7m v\u1ec1 \u0111\u1ed9 nh\u1ea1y c\u1ea3m v\u00e0 c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh c\u00e1c th\u1eed nghi\u1ec7m n\u00e0y b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u01b0\u1eddng quy. C\u00e1c th\u1eed nghi\u1ec7m in vitro cho th\u1ea5y meropenem c\u00f3 t\u00e1c \u0111\u1ed9ng hi\u1ec7p l\u1ef1c v\u1edbi nhi\u1ec1u thu\u1ed1c kh\u00e1ng sinh kh\u00e1c. Meropenem \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 t\u00e1c \u0111\u1ed9ng h\u1eadu kh\u00e1ng sinh c\u1ea3 in vitro v\u00e0 in vivo.<\/p>\n<p>C\u00e1c ti\u00eau ch\u00ed v\u1ec1 s\u1ef1 nh\u1ea1y c\u1ea3m v\u1edbi meropenem \u0111\u00e3 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o d\u1ef1a tr\u00ean d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, m\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng v\u00e0 vi sinh h\u1ecdc \u0111\u1ed1i v\u1edbi \u0111\u01b0\u1eddng k\u00ednh kh\u00e1ng khu\u1ea9n v\u00e0 n\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf t\u1ed1i thi\u1ec3u (MIC) tr\u00ean c\u00e1c vi khu\u1ea9n g\u00e2y b\u1ec7nh.<\/p>\n<table>\n<tbody>\n<tr>\n<td rowspan=\"2\"><strong>Ph\u00e2n lo\u1ea1i<\/strong><\/td>\n<td colspan=\"2\"><strong>Ph\u01b0\u01a1ng ph\u00e1p \u0111\u00e1nh gi\u00e1<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>\u0110\u01b0\u1eddng k\u00ednh v\u00f2ng kh\u00e1ng khu\u1ea9n (mm)<\/strong><\/td>\n<td><strong>MIC (mg\/l)<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Nh\u1ea1y c\u1ea3m<\/td>\n<td>\u2265 14<\/td>\n<td>\u2264 4<\/td>\n<\/tr>\n<tr>\n<td>Nh\u1ea1y c\u1ea3m trung gian<\/td>\n<td>12 13<\/td>\n<td>8<\/td>\n<\/tr>\n<tr>\n<td>\u0110\u1ec1 kh\u00e1ng<\/td>\n<td>\u2264 11<\/td>\n<td>\u2265 16<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Ph\u1ed5 kh\u00e1ng khu\u1ea9n in vitro c\u1ee7a meropenem bao g\u1ed3m ph\u1ea7n l\u1edbn c\u00e1c ch\u1ee7ng vi khu\u1ea9n Gram \u00e2m v\u00e0 Gram d\u01b0\u01a1ng, hi\u1ebfu kh\u00ed v\u00e0 k\u1ef5 kh\u00ed quan tr\u1ecdng tr\u00ean l\u00e2m s\u00e0ng d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<p>Vi khu\u1ea9n hi\u1ebfu kh\u00ed Gram d\u01b0\u01a1ng:<\/p>\n<p>Bacillus spp., Corynebacterium diphtheriae, Enterococcus faecalis, Enterococcus liquifaciens, Enterococcus avium, Listeria monocytogenes, Lactobacillus spp., Nocardia asteroides, Staphylococcus aureus (penicillinase d\u01b0\u01a1ng t\u00ednh v\u00e0 \u00e2m t\u00ednh), c\u00e1c Staphylococcus coagulase \u00e2m t\u00ednh; bao g\u1ed3m, Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus capitis, Staphylococcus cohnii, Staphylococcus xylosus, Staphylococcus warneri, Staphylococcus hominis, Staphylococcus simulans, Staphylococcus intermedius, Staphylococcus sciuri, Staphylococcus lugdunensis, Streptococcus pneumoniae (nh\u1ea1y c\u1ea3m v\u00e0 \u0111\u1ec1 kh\u00e1ng v\u1edbi penicillin), Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus equi, Streptococcus bovis, Streptococcus mitis, Streptococcus mitior, Streptococcus milleri, Streptococcus sanguis, Streptococcus viridans, Streptococcus salivarius, Streptococcus morbillorum, Streptococcus nh\u00f3m G, Streptococcus nh\u00f3m F, Rhodococcus equi.<\/p>\n<p>Vi khu\u1ea9n hi\u1ebfu kh\u00ed Gram \u00e2m:<\/p>\n<p>Achromobacter xylosoxidans, Acinetobacter anitratus, Acinetobacter lwoffii, Acinetobacter baumannii, Aeromonas hydrophila, Aeromonas sorbria, Aeromonas caviae, Alcaligenes faecalis, Bordetella bronchiseptica, Brucella melitensis, Campylobacter coli, Campylobacter jejuni, Citrobacter freundii, Citrobacter diversus, Citrobacter koseri, Citrobacter amalonaticus, Enterobacter aerogenes, Enterobacter (Pantoea) agglomerans, Enterobacter cloacae, Enterobacter sakazakii, Escherichia coli, Escherichia hermannii, Gardnerella vaginalis, Haemophilus influenzae (k\u1ec3 c\u1ea3 c\u00e1c ch\u1ee7ng ti\u1ebft \u00e2 lactamase v\u00e0 \u0111\u1ec1 kh\u00e1ng v\u1edbi ampicillin), Haemophilus parainfluenzae, Haemophilus ducreyi, Helicobacter pylori, Neisseria meningitidis, Neisseria gonorrhoeae (k\u1ec3 c\u1ea3 c\u00e1c ch\u1ee7ng ti\u1ebft \u00e2 lactamase, \u0111\u1ec1 kh\u00e1ng v\u1edbi penicillin v\u00e0 \u0111\u1ec1 kh\u00e1ng v\u1edbi spectinomycin), Hafnia alvei, Klebsiella pneumoniae, Klebsiella aerogenes, Klebsiella ozaenae, Klebsiella oxytoca, Moraxella (Branhamella) catarrhalis, Morganella morganii, Proteus mirabilis, Proteus vulgaris, Proteus penneri, Providencia rettgeri, Providencia stuartii, Providencia alcalifaciens, Pasteurella multocida, Plesiomonas shigelloides, Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas alcaligenes, Burkholderia (Pseudomonas) cepacia, Pseudomonas fluorescens, Pseudomonas stutzeri, Pseudomonas pseudomallei, Pseudomonas acidovorans, Salmonella spp. k\u1ec3 c\u1ea3 Salmonella enteritidis\/typhi, Serratia marcescens, Serratia liquefaciens, Serratia rubidaea, Shigella sonnei, Shigella flexneri, Shigella boydii, Shigella dysenteriae, Vibrio cholerae, Vibrio parahaemolyticus,Vibrio vulnificus, Yersinia enterocolitica.<\/p>\n<p>Vi khu\u1ea9n k\u1ef5 kh\u00ed:<\/p>\n<p>Actinomyces odontolyticus, Actinomyces meyeri, Bacteroides Prevotella Porphyromonas spp., Bacteroides fragilis, Bacteroides vulgatus, Bacteroides variabilis, Bacteroides pneumosintes, Bacteroides coagulans, Bacteroides uniformis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides eggerthii, Bacteroides capsillosis, Prevotella buccalis, Prevotella corporis, Bacteroides gracilis, Prevotella melaninogenica, Prevotella intermedia, Prevotella bivia, Prevotella splanchnicus, Prevotella oralis, Prevotella disiens, Prevotella rumenicola, Bacteroides ureolyticus, Prevotella oris, Prevotella buccae, Prevotella denticola, Bacteroides levii, Porphyromonas asaccharolytica, Bifidobacterium spp., Bilophila wadsworthia, Clostridium perfringens, Clostridium bifermentans, Clostridium ramosum, Clostridium sporogenes, Clostridium cadaveris, Clostridium sordellii, Clostridium butyricum, Clostridium clostridiiformis, Clostridium innocuum, Clostridium subterminale, Clostridium tertium, Eubacterium lentum, Eubacterium aerofaciens, Fusobacterium mortiferum, Fusobacterium necrophorum, Fusobacterium nucleatum, Fusobacterium varium, Mobiluncus curtisii, Mobiluncus mulieris, Peptostreptococcus anaerobius, Peptostreptococcus micros, Peptostreptococcus saccharolyticus, Peptococcus saccharolyticus, Peptostreptococcus asaccharolyticus, Peptostreptococcus magnus, Peptostreptococcus prevotii, Propionibacterium acnes, Propionibacterium avidum, Propionibacterium granulosum. Stenotrophomonas maltophilia, Enterococcus faecium v\u00e0 c\u00e1c Staphylococcus \u0111\u1ec1 kh\u00e1ng v\u1edbi methicillin \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u0111\u1ec1 kh\u00e1ng v\u1edbi meropenem.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Meropenem l\u00e0 m\u1ed9t kh\u00e1ng sinh t\u1ed5ng h\u1ee3p nh\u00f3m carbapenem, c\u00f3 c\u1ea5u tr\u00fac v\u00e0 t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd t\u01b0\u01a1ng t\u1ef1 c\u00e1c thu\u1ed1c trong nh\u00f3m l\u00e0 imipenem v\u00e0 ertapenem. Kh\u00e1c v\u1edbi imipenem, meropenem b\u1ec1n v\u1eefng v\u1edbi t\u00e1c d\u1ee5ng th\u1ee7y ph\u00e2n c\u1ee7a dehydropeptidase 1 (DHP-1) c\u00f3 \u1edf vi nhung mao c\u1ee7a t\u1ebf b\u00e0o \u1ed1ng l\u01b0\u1ee3n g\u1ea7n c\u1ee7a th\u1eadn, v\u00ec v\u1eady kh\u00f4ng c\u1ea7n d\u00f9ng c\u00f9ng v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf DHP-1 nh\u01b0 cilastatin.<\/p>\n<p>Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea5n th\u00f4ng qua \u1ee9c ch\u1ebf s\u1ef1 t\u1ed5ng h\u1ee3p v\u00e1ch t\u1ebf b\u00e0o b\u1eb1ng c\u00e1ch th\u1ea5m qua th\u00e0nh t\u1ebf b\u00e0o c\u1ee7a h\u1ea7u h\u1ebft vi khu\u1ea5n Gram \u00e2m v\u00e0 Gram d\u01b0\u01a1ng, g\u1eafn v\u00e0o c\u00e1c protein li\u00ean k\u1ebft penicillin (PBP) v\u00e0 l\u00e0m b\u1ea5t ho\u1ea1t c\u00e1c protein n\u00e0y.<\/p>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=0TIIfoiJFwA&amp;feature=youtu.be\"><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/a><\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog E SS1 - Ep. 01] - Pharmacology of all Antibiotics\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/9bo1ZCykDso?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<h2><span class=\"ez-toc-section\" id=\"52-duoc-dong-hoc\"><\/span>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Khi truy\u1ec1n t\u0129nh m\u1ea1ch m\u1ed9t li\u1ec1u \u0111\u01a1n Meronem trong v\u00f2ng 30 ph\u00fat \u1edf ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng v\u00e0o kho\u1ea3ng 11 mcg\/ml \u0111\u1ed1i v\u1edbi li\u1ec1u 250 mg, 23 mcg\/ml \u0111\u1ed1i v\u1edbi li\u1ec1u 500 mg v\u00e0 49 mcg\/ml \u0111\u1ed1i v\u1edbi li\u1ec1u 1 g.<\/p>\n<p>Tuy nhi\u00ean, kh\u00f4ng c\u00f3 m\u1ed1i t\u01b0\u01a1ng quan tuy\u1ec7t \u0111\u1ed1i v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc gi\u1eefa Cmax v\u00e0 AUC v\u1edbi li\u1ec1u d\u00f9ng. H\u01a1n n\u1eefa, s\u1ef1 gi\u1ea3m \u0111\u1ed9 thanh th\u1ea3i trong huy\u1ebft t\u01b0\u01a1ng t\u1eeb 287 xu\u1ed1ng 205 ml\/ph\u00fat khi s\u1eed d\u1ee5ng li\u1ec1u t\u1eeb 250 mg \u0111\u1ebfn 2 g \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn.<\/p>\n<p>Khi ti\u00eam t\u0129nh m\u1ea1ch m\u1ed9t l\u01b0\u1ee3ng l\u1edbn Meronem trong 5 ph\u00fat \u1edf ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh, n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng v\u00e0o kho\u1ea3ng 52 mcg\/ml khi s\u1eed d\u1ee5ng li\u1ec1u 500 mg v\u00e0 112 mcg\/ml khi s\u1eed d\u1ee5ng li\u1ec1u 1 g.<\/p>\n<p>Truy\u1ec1n t\u0129nh m\u1ea1ch 1 g trong v\u00f2ng 2 ph\u00fat, 3 ph\u00fat v\u00e0 5 ph\u00fat \u0111\u01b0\u1ee3c so s\u00e1nh trong m\u1ed9t th\u1eed nghi\u1ec7m b\u1eaft ch\u00e9o ba chi\u1ec1u (Three-way crossover study). N\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1ng \u1ee9ng l\u1ea7n l\u01b0\u1ee3t v\u1edbi th\u1eddi gian truy\u1ec1n n\u00e0y l\u00e0 110, 91 v\u00e0 94 microgram\/ml.<\/p>\n<p>6 gi\u1edd sau khi ti\u00eam t\u0129nh m\u1ea1ch li\u1ec1u 500 mg, n\u1ed3ng \u0111\u1ed9 meropenem trong huy\u1ebft t\u01b0\u01a1ng gi\u1ea3m c\u00f2n \u2264 1 mcg\/ml.<\/p>\n<p>Khi s\u1eed d\u1ee5ng nhi\u1ec1u li\u1ec1u c\u00e1ch kho\u1ea3ng m\u1ed7i 8 gi\u1edd cho ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng c\u00f3 s\u1ef1 t\u00edch l\u0169y meropenem.<\/p>\n<p>\u1ede ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng, th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a meropenem kho\u1ea3ng 1 gi\u1edd.<\/p>\n<p>T\u1ef7 l\u1ec7 g\u1eafn k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng c\u1ee7a meropenem kho\u1ea3ng 2%.<\/p>\n<p>Kho\u1ea3ng 70% li\u1ec1u meropenem s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong n\u01b0\u1edbc ti\u1ec3u d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i trong 12 gi\u1edd, sau \u0111\u00f3 ch\u1ec9 c\u00f3 m\u1ed9t l\u01b0\u1ee3ng r\u1ea5t nh\u1ecf \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft th\u00eam v\u00e0o n\u01b0\u1edbc ti\u1ec3u. N\u1ed3ng \u0111\u1ed9 meropenem trong n\u01b0\u1edbc ti\u1ec3u &gt; 10 mcg\/ml duy tr\u00ec \u0111\u1ebfn 5 gi\u1edd sau khi s\u1eed d\u1ee5ng li\u1ec1u 500 mg. Kh\u00f4ng c\u00f3 s\u1ef1 t\u00edch t\u1ee5 meropenem trong n\u01b0\u1edbc ti\u1ec3u hay huy\u1ebft t\u01b0\u01a1ng \u0111\u01b0\u1ee3c ghi nh\u1eadn v\u1edbi ph\u00e1c \u0111\u1ed3 li\u1ec1u 500 mg m\u1ed7i 8 gi\u1edd hay 1 g m\u1ed7i 6 gi\u1edd \u1edf ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Ch\u1ea5t chuy\u1ec3n h\u00f3a duy nh\u1ea5t c\u1ee7a meropenem kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh kh\u00e1ng khu\u1ea9n.<\/p>\n<p>Meropenem x\u00e2m nh\u1eadp t\u1ed1t v\u00e0o h\u1ea7u h\u1ebft c\u00e1c m\u00f4 v\u00e0 d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 k\u1ec3 c\u1ea3 d\u1ecbch n\u00e3o t\u1ee7y \u1edf b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o nhi\u1ec5m khu\u1ea9n, \u0111\u1ea1t \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 cao h\u01a1n n\u1ed3ng \u0111\u1ed9 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u1ee9c ch\u1ebf h\u1ea7u h\u1ebft vi khu\u1ea9n.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean tr\u1ebb em ch\u1ee9ng t\u1ecf d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a Meronem \u1edf tr\u1ebb em t\u01b0\u01a1ng t\u1ef1 \u1edf ng\u01b0\u1eddi l\u1edbn. Th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a meropenem v\u00e0o kho\u1ea3ng 1,5-2,3 gi\u1edd \u1edf tr\u1ebb em d\u01b0\u1edbi 2 tu\u1ed5i v\u00e0 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc tuy\u1ebfn t\u00ednh v\u1edbi li\u1ec1u d\u00f9ng trong kho\u1ea3ng 10-40 mg\/kg.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn cho th\u1ea5y \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a meropenem trong huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1ng quan v\u1edbi \u0111\u1ed9 thanh th\u1ea3i creatinine. C\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho b\u1ec7nh nh\u00e2n suy th\u1eadn.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc \u1edf ng\u01b0\u1eddi cao tu\u1ed5i cho th\u1ea5y \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a meropenem trong huy\u1ebft t\u01b0\u01a1ng gi\u1ea3m t\u01b0\u01a1ng \u1ee9ng v\u1edbi s\u1ef1 gi\u1ea3m \u0111\u1ed9 thanh th\u1ea3i creatinine theo tu\u1ed5i.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc \u1edf b\u1ec7nh nh\u00e2n suy gan cho th\u1ea5y b\u1ec7nh gan kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a meropenem.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"53-giai-thich\"><\/span>5.3 Gi\u1ea3i th\u00edch:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"54-thay-the-thuoc\"><\/span>5.4 Thay th\u1ebf thu\u1ed1c :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h1><span class=\"ez-toc-section\" id=\"6-phan-thong-tin-kem-theo-cua-thuoc\"><\/span>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<h2><span class=\"ez-toc-section\" id=\"61-danh-muc-ta-duoc\"><\/span>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>45.1 mg Natri \u1edf d\u1ea1ng Na2CO3.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"62-tuong-ky\"><\/span>6.2. T\u01b0\u01a1ng k\u1ef5 :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Kh\u00f4ng n\u00ean tr\u1ed9n &#8216;Meronem&#8217; v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c. &#8216;Meronem&#8217; t\u01b0\u01a1ng th\u00edch v\u1edbi c\u00e1c dung d\u1ecbch ti\u00eam truy\u1ec1n sau:<\/p>\n<p>Dung d\u1ecbch natri clorid 0,9%.<\/p>\n<p>Dung d\u1ecbch glucose 5% ho\u1eb7c 10%.<\/p>\n<p>Dung d\u1ecbch glucose 5% v\u1edbi dung d\u1ecbch bicarbonat 0,02%.<\/p>\n<p>Dung d\u1ecbch natri clorid 0,9% v\u00e0 dung d\u1ecbch glucose 5%.<\/p>\n<p>Dung d\u1ecbch glucose 5% v\u1edbi dung d\u1ecbch natri clorid 0,225%.<\/p>\n<p>Dung d\u1ecbch glucose 5% v\u1edbi dung d\u1ecbch kali clorid 0,15%.<\/p>\n<p>Dung d\u1ecbch mannitol 2,5% ho\u1eb7c 10%.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"63-bao-quan\"><\/span>6.3. B\u1ea3o qu\u1ea3n:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Kh\u00f4ng b\u1ea3o qu\u1ea3n tr\u00ean 30<sup>o<\/sup>C. Kh\u00f4ng \u0111\u00f4ng l\u1ea1nh.<\/p>\n<p>Dung d\u1ecbch thu\u1ed1c sau khi ho\u00e0n nguy\u00ean c\u00f3 n\u1ed3ng \u0111\u1ed9 50 mg\/ml (h\u00f2a tan b\u1eb1ng n\u01b0\u1edbc c\u1ea5t) c\u00f3 th\u1ec3 \u1ed5n \u0111\u1ecbnh trong kho\u1ea3ng 2 gi\u1edd \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng (15 25 <sup>o<\/sup>C) ho\u1eb7c kho\u1ea3ng 12 gi\u1edd khi b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh (4 <sup>o<\/sup>C). Dung d\u1ecbch thu\u1ed1c \u0111\u01b0\u1ee3c pha lo\u00e3ng \u0111\u1ec3 truy\u1ec1n t\u0129nh m\u1ea1ch, n\u1ed3ng \u0111\u1ed9 1 20 mg\/ml: N\u1ebfu pha trong dung d\u1ecbch natri clorid 0,9% s\u1ebd \u1ed5n \u0111\u1ecbnh trong 4 gi\u1edd \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng ho\u1eb7c trong 24 gi\u1edd khi b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh; n\u1ebfu pha trong glucose 5% s\u1ebd \u1ed5n \u0111\u1ecbnh trong 1 gi\u1edd \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng ho\u1eb7c trong 4 gi\u1edd khi b\u1ea3o qu\u1ea3n trong t\u1ee7 l\u1ea1nh.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"64-thong-tin-khac\"><\/span>6.4. Th\u00f4ng tin kh\u00e1c :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>An to\u00e0n ti\u1ec1n l\u00e2m s\u00e0ng<\/em><\/strong><\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y meropenem dung n\u1ea1p t\u1ed1t qua th\u1eadn. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y meropenem ch\u1ec9 g\u00e2y \u0111\u1ed9c th\u1eadn \u1edf li\u1ec1u cao (500 mg\/kg).<\/p>\n<p>C\u00e1c t\u00e1c \u0111\u1ed9ng tr\u00ean h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, co gi\u1eadt \u1edf chu\u1ed9t v\u00e0 n\u00f4n \u1edf ch\u00f3 ch\u1ec9 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf li\u1ec1u cao (&gt; 2000 mg\/kg).<\/p>\n<p>Li\u1ec1u g\u00e2y ch\u1ebft 50% (LD50) \u0111\u1ed1i v\u1edbi m\u1ed9t li\u1ec1u \u0111\u01a1n d\u00f9ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u1edf lo\u00e0i g\u1eadm nh\u1ea5m l\u00e0 &gt; 2000 mg\/kg. Trong c\u00e1c nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng li\u1ec1u l\u1eb7p l\u1ea1i (th\u1eddi gian l\u00ean \u0111\u1ebfn 6 th\u00e1ng) ch\u1ec9 ghi nh\u1eadn c\u00e1c t\u00e1c \u0111\u1ed9ng nh\u1eb9 nh\u01b0 gi\u1ea3m nh\u1eb9 s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u v\u00e0 t\u0103ng tr\u1ecdng l\u01b0\u1ee3ng gan \u1edf ch\u00f3 \u0111ang d\u00f9ng li\u1ec1u 500 mg\/kg.<\/p>\n<p>Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 kh\u1ea3 n\u0103ng g\u00e2y \u0111\u1ed9t bi\u1ebfn qua 5 th\u1eed nghi\u1ec7m v\u00e0 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 \u0111\u1ed9c t\u00ednh l\u00ean s\u1ef1 sinh s\u1ea3n v\u00e0 g\u00e2y qu\u00e1i thai qua c\u00e1c nghi\u00ean c\u1ee9u \u1edf chu\u1ed9t v\u00e0 kh\u1ec9 s\u1eed d\u1ee5ng li\u1ec1u cao nh\u1ea5t c\u00f3 th\u1ec3, li\u1ec1u kh\u00f4ng g\u00e2y t\u00e1c \u0111\u1ed9ng l\u00e0m gi\u1ea3m tr\u1ecdng l\u01b0\u1ee3ng (nh\u1eb9) \u1edf chu\u1ed9t th\u1ebf h\u1ec7 F1 l\u00e0 120 mg\/kg. C\u00f3 s\u1ef1 gia t\u0103ng t\u1ea7n su\u1ea5t s\u1ea9y thai qua m\u1ed9t nghi\u00ean c\u1ee9u s\u01a1 b\u1ed9 tr\u00ean kh\u1ec9 s\u1eed d\u1ee5ng li\u1ec1u 500 mg\/kg.<\/p>\n<p>Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 s\u1ef1 gia t\u0103ng t\u00ednh nh\u1ea1y c\u1ea3m v\u1edbi meropenem \u1edf \u0111\u1ed9ng v\u1eadt c\u00f2n non so v\u1edbi \u0111\u1ed9ng v\u1eadt tr\u01b0\u1edfng th\u00e0nh.<\/p>\n<p>Thu\u1ed1c s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch dung n\u1ea1p t\u1ed1t qua c\u00e1c nghi\u00ean c\u1ee9u \u1edf \u0111\u1ed9ng v\u1eadt.<\/p>\n<p>Ch\u1ea5t chuy\u1ec3n h\u00f3a duy nh\u1ea5t c\u1ee7a meropenem c\u00f3 \u0111\u1ed9c t\u00ednh t\u01b0\u01a1ng t\u1ef1 trong c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"65-tai-lieu-tham-khao\"><\/span>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>Ho\u1eb7c HDSD Thu\u1ed1c.<\/p>\n<h1><span class=\"ez-toc-section\" id=\"7-nguoi-dang-tai-tac-gia\"><\/span>7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p>B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c s\u01b0u t\u1ea7m ho\u1eb7c vi\u1ebft b\u1edfi: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-tac-gia-bac-sy-do-my-linh\/\">B\u00e1c s\u0129 nhi khoa &#8211; \u0110\u1ed7 M\u1ef9 Linh.<\/a><\/p>\n<p>Ki\u1ec3m duy\u1ec7t , hi\u1ec7u \u0111\u00ednh v\u00e0 \u0111\u0103ng t\u1ea3i: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-ve-pharmog-team\/\">PHARMOG TEAM<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thu\u1ed1c MERONEM l\u00e0 thu\u1ed1c g\u00ec ? D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c MERONEM (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 : Meropenem Ph\u00e2n lo\u1ea1i: Thu\u1ed1c Kh\u00e1ng sinh nh\u00f3m beta-lactam [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":33113,"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":[1303],"class_list":["post-7654","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc-goc","tag-meropenem"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/7654","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=7654"}],"version-history":[{"count":5,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/7654\/revisions"}],"predecessor-version":[{"id":52045,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/7654\/revisions\/52045"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/33113"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=7654"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=7654"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=7654"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}