{"id":10247,"date":"2019-05-29T22:24:36","date_gmt":"2019-05-29T15:24:36","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=10247"},"modified":"2019-05-31T22:30:31","modified_gmt":"2019-05-31T15:30:31","slug":"hoi-chung-nguoi-do-do-vancomycin","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/hoi-chung-nguoi-do-do-vancomycin\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng ng\u01b0\u1eddi \u0111\u1ecf do Vancomycin"},"content":{"rendered":"

Bi\u00ean so\u1ea1n: Nh\u1ecbp c\u1ea7u D\u01b0\u1ee3c l\u00e2m s\u00e0ng<\/p>\n

$\"Vancomycin\"$ <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
V1.5\/2019<\/td>\n H\u1ed9i ch\u1ee9ng ng\u01b0\u1eddi \u0111\u1ecf (red man syndrome) do vancomycin<\/td>\n<\/tr>\n
Th\u1eddi gian xu\u1ea5t hi\u1ec7n<\/td>\n \u00a7\u00a0 Ph\u1ea3n \u1ee9ng nhanh: Xu\u1ea5t hi\u1ec7n\u00a04-10 ph\u00fat\u00a0sau khi b\u1eaft \u0111\u1ea7u truy\u1ec1n li\u1ec1u \u0111\u1ea7u ti\u00ean.\u00a7\u00a0 Ph\u1ea3n \u1ee9ng mu\u1ed9n: Xu\u1ea5t hi\u1ec7n sau khi truy\u1ec1n k\u1ebft th\u00fac ho\u1eb7c sau h\u01a1n 7 ng\u00e0y d\u00f9ng vancomycin b\u00ecnh th\u01b0\u1eddng.<\/td>\n<\/tr>\n
Tri\u1ec7u ch\u1ee9ng<\/td>\n Nh\u1eb9 \u2013 trung b\u00ecnh<\/td>\n N\u1eb7ng<\/td>\n<\/tr>\n
\u00a7\u00a0\u00a0M\u1ea9n \u0111\u1ecf\u00a0\u1edf m\u1eb7t, c\u1ed5, v\u00e0 th\u00e2n tr\u00ean. Da c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u0111\u1ecf \u1eedng v\u00e0 tr\u1edf n\u00ean\u00a0ng\u1ee9a\u00a0v\u00e0\u00a0r\u00e1t.\u00a7\u00a0 C\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh\u00a0s\u1ed1t\u00a0v\u00e0\u00a0\u1edbn l\u1ea1nh, \u0111au \u0111\u1ea7u v\u00e0 ch\u00f3ng m\u1eb7t ho\u1eb7c k\u00edch \u0111\u1ed9ng.<\/p>\n
\u00a7\u00a0 Khu\u00f4n m\u1eb7t, m\u1eaft v\u00e0 m\u00f4i c\u00f3 th\u1ec3 s\u01b0ng l\u00ean.<\/p>\n
\u00a7\u00a0 Sau kho\u1ea3ng 6 ng\u00e0y, da c\u0169ng c\u00f3 th\u1ec3 d\u00e0y l\u00ean v\u00e0 b\u1eaft \u0111\u1ea7u bong tr\u00f3c, \u1edf d\u1ea1ng t\u1ea5m l\u1edbn ho\u1eb7c m\u1ea3nh nh\u1ecf, \u0111\u1eb7c bi\u1ec7t l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n.<\/p>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c bao g\u1ed3m:<\/p>\n
\u00a7\u00a0\u00a0n\u00f4n\/bu\u1ed3n n\u00f4n<\/p>\n
\u00a7\u00a0 \u0111au<\/td>\n
\u00a7\u00a0 huy\u1ebft \u00e1p th\u1ea5p\u00a7\u00a0 \u0111au ng\u1ef1c v\u00e0 kh\u00f3 th\u1edf.
\nt\u1ed5n th\u01b0\u01a1ng th\u1eadn v\u00e0 th\u00ednh gi\u00e1c\u00a7\u00a0 ng\u1ea5t x\u1ec9u<\/p>\n
\u00a7\u00a0 co th\u1eaft c\u01a1 v\u00e0 m\u1ec7t m\u1ecfi<\/p>\n
\u00a7\u00a0 ph\u00f9 m\u1ea1ch<\/td>\n<\/tr>\n
D\u1ecbch t\u1ec5<\/td>\n \u00a7\u00a0 Ph\u1ed5 bi\u1ebfn,\u00a05-50%\u00a0BN d\u00f9ng vancomycin<\/td>\n<\/tr>\n
C\u01a1 ch\u1ebf<\/td>\n \u00a7\u00a0 Kh\u00f4ng ph\u1ea3i ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng (v\u00ec kh\u00f4ng qua c\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch) nh\u01b0ng c\u00f3 tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 m\u1ed9t ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng\u00a7\u00a0 Vancomycin l\u00e0m thay \u0111\u1ed5i c\u00e1c t\u1ebf b\u00e0o m\u00e1u (gi\u1ea3m ti\u1ec3u c\u1ea7u, thay \u0111\u1ed5i b\u1ea1ch c\u1ea7u)<\/p>\n
\u00a7\u00a0 Ph\u00e1 v\u1ee1 t\u1ebf b\u00e0o mast g\u00e2y gi\u1ea3i ph\u00f3ng histamin l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 histamin \u0111\u1ed9t ng\u1ed9t<\/td>\n<\/tr>\n
Y\u1ebfu t\u1ed1 nguy c\u01a1<\/td>\n \u00a7\u00a0 T\u1ed1c \u0111\u1ed9 truy\u1ec1n nhanh\u00a7\u00a0 BN ti\u1ec1n s\u1eed h\u1ed9i ch\u1ee9ng ng\u01b0\u1eddi \u0111\u1ecf tr\u01b0\u1edbc \u0111\u00e2y<\/p>\n
\u00a7\u00a0 BN ung th\u01b0, HIV, gh\u00e9p t\u1ea1ng (gh\u00e9p t\u1ee7y)<\/p>\n
\u00a7\u00a0 Ph\u1ea3n \u1ee9ng n\u1eb7ng h\u01a1n ch\u1ee7 y\u1ebfu \u1edf BN d\u01b0\u1edbi 40 tu\u1ed5i v\u00e0 \u0111\u1eb7c bi\u1ec7t tr\u1ebb em<\/p>\n
\u00a7\u00a0 Rifampicin, teicoplantin, ciprofloxacin v\u00e0 amphotericin B, thu\u1ed1c gi\u00e3n c\u01a1, thu\u1ed1c c\u1ea3n quang, opioid.<\/td>\n<\/tr>\n
Nguy\u00ean t\u1eafc x\u1eed l\u00fd<\/td>\n \u00a7\u00a0 D\u1eebng truy\u1ec1n vancomycin ngay. Ch\u1ec9 khi c\u00e1c tri\u1ec7u ch\u1ee9ng bi\u1ebfn m\u1ea5t c\u00f3 th\u1ec3 truy\u1ec1n l\u1ea1i v\u1edbi t\u1ed1c \u0111\u1ed9 truy\u1ec1n ch\u1eadm h\u01a1n.\u00a7\u00a0 D\u1eebng c\u00e1c thu\u1ed1c kh\u00f4ng c\u1ea7n thi\u1ebft<\/p>\n
\u00a7\u00a0 D\u00f9ng kh\u00e1ng histamin H1, c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi kh\u00e1ng histamin H2<\/p>\n
\u00a7\u00a0 D\u00f9ng corticoid b\u00f4i da tr\u1ef1c ti\u1ebfp l\u00ean v\u00f9ng da<\/p>\n
\u00a7\u00a0 C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 thuy\u00ean gi\u1ea3m v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch gi\u1eef \u1ea9m cho v\u00f9ng da b\u1ecb \u1ea3nh h\u01b0\u1edfng. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng b\u0103ng \u01b0\u1edbt, ho\u1eb7c d\u00f9ng ch\u1ea5t l\u00e0m m\u1ec1m\/gi\u1eef \u1ea9m.<\/p>\n
<\/p>\n
<\/td>\n<\/tr>\n
Nguy\u00ean t\u1eafc d\u1ef1 ph\u00f2ng<\/td>\n \u00a7\u00a0 D\u00f9ng kh\u00e1ng histamin tr\u01b0\u1edbc khi d\u00f9ng vancomycin cho b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 nguy c\u01a1 da b\u1ecb \u0111\u1ecf v\u00e0 ng\u1ee9a.\u00a7\u00a0\u00a0D\u00f9ng li\u1ec1u th\u1ea5p h\u01a1n v\u00e0 t\u0103ng t\u1ea7n su\u1ea5t d\u00f9ng\u00a0vancomycin dung n\u1ea1p t\u1ed1t h\u01a1n l\u00e0 d\u00f9ng li\u1ec1u cao v\u00e0 gi\u1ea3m t\u1ea7n su\u1ea5t d\u00f9ng.<\/p>\n
\u00a7\u00a0 T\u1ed1c \u0111\u1ed9 truy\u1ec1n vancomycin kh\u00f4ng nhanh qu\u00e1 (xem b\u1ea3ng d\u01b0\u1edbi)<\/td>\n<\/tr>\n
Th\u1eddi gian truy\u1ec1n vancomycin khuy\u1ebfn c\u00e1o<\/td>\n \u00a7\u00a0 T\u1ed1c \u0111\u1ed9 truy\u1ec1n: \u2264\u00a010mg\/ph\u00fat.\u00a0N\u1ed3ng \u0111\u1ed9: \u2264\u00a05mg\/ml. Dung m\u00f4i:\u00a0NaCl 0.9%ho\u1eb7c\u00a0Glucose 5%.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Li\u1ec1u<\/td>\n Th\u1eddi gian truy\u1ec1n<\/td>\n Th\u1ec3 t\u00edch DM pha lo\u00e3ng<\/td>\n T\u1ed1c \u0111\u1ed9 truy\u1ec1n<\/td>\n<\/tr>\n
\u00a0\u00a0 500mg<\/td>\n 1 \u00a0\u00a0\u00a0gi\u1edd<\/td>\n 250ml<\/td>\n 60 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n
\u00a0\u00a0 750mg<\/td>\n 1.5 gi\u1edd<\/td>\n 250ml<\/td>\n 50 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n
1.000mg<\/td>\n 2 \u00a0\u00a0\u00a0gi\u1edd<\/td>\n 250ml<\/td>\n 40 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n
1250mg<\/td>\n 2.5 gi\u1edd<\/td>\n 250ml<\/td>\n 30 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n
1.500mg<\/td>\n 3 \u00a0\u00a0\u00a0gi\u1edd<\/td>\n 500ml<\/td>\n 50 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n
2.000mg<\/td>\n 4 \u00a0\u00a0\u00a0gi\u1edd<\/td>\n 500ml<\/td>\n 40 gi\u1ecdt\/ph\u00fat<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n
X\u1eed l\u00fd c\u1ee5 th\u1ec3<\/td>\n Ph\u1ea3n \u1ee9ng nh\u1eb9-trung b\u00ecnh:\u00a7\u00a0 D\u1eebng truy\u1ec1n + diphenhydramine (50mg u\u1ed1ng ho\u1eb7c IV) + ranitidne (50mg IV).<\/p>\n
\u00a7\u00a0 Tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng gi\u1ea3m ngay l\u1eadp t\u1ee9c.<\/p>\n
\u00a7\u00a0 Truy\u1ec1n vancomycin c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u l\u1ea1i v\u1edbi\u00a0t\u1ed1c \u0111\u1ed9 truy\u1ec1n gi\u1ea3m m\u1ed9t n\u1eefa.<\/td>\n<\/tr>\n
Ph\u1ea3n \u1ee9ng n\u1eb7ng\u00a7\u00a0 D\u1eebng truy\u1ec1n + diphenhydramine (50mg IV) + ranitidine (50mg IV) + truy\u1ec1n d\u1ecbch IV (n\u1ebfu h\u1ea1 huy\u1ebft \u00e1p).<\/p>\n
\u00a7\u00a0 Khi tri\u1ec7u ch\u1ee9ng bi\u1ebfn m\u1ea5t, c\u00f3 th\u1ec3 truy\u1ec1n l\u1ea1i vancomyicn (th\u1eddi gian truy\u1ec1n \u22654h).<\/p>\n
\u00a7\u00a0 V\u1edbi c\u00e1c l\u1ea7n truy\u1ec1n ti\u1ebfp theo tr\u00ean BN n\u00e0y: d\u00f9ng thu\u1ed1c kh\u00e1ng histamin (hydroxyzine ho\u1eb7c diphenhydramine) d\u1ef1 ph\u00f2ng 1h tr\u01b0\u1edbc khi truy\u1ec1n vancomyicn (th\u1eddi gian truy\u1ec1n \u22654h).<\/td>\n<\/tr>\n
Ti\u00ean l\u01b0\u1ee3ng<\/td>\n \u00a7\u00a0 Th\u01b0\u1eddng kh\u00f4ng nghi\u00eam tr\u1ecdng, nh\u01b0ng ch\u00fang c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 ch\u1ecbu v\u00e0 ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nhanh ch\u00f3ng.\u00a7\u00a0 C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t v\u00e0 gi\u1ea3m b\u1edbt b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng histamine, m\u00e0 kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 l\u00e2u d\u00e0i.<\/td>\n<\/tr>\n
TLTK<\/td>\n 1.\u00a0\u00a0\u00a0\u00a0 Seymour, T. (2018, February 6). \u201cWhat is red man syndrome?.\u201d\u00a0Medical News Today<\/em>. Retrieved from
\nhttps:\/\/www.medicalnewstoday.com\/articles\/320833.php<\/a>.2.\u00a0\u00a0\u00a0\u00a0 Drisyamol KA et al. Vancomycin induced Red man syndrome. International Journal of Pharmacological Research. 2016:6(4).3.\u00a0\u00a0\u00a0\u00a0 NHS Grampian Staff Guidance for the Administrayion of IV Vancomycin in Adults via Intermittent (pulsed) Infusion. 2017. Link:\u00a0 https:\/\/foi.nhsgrampian.org\/globalassets\/foidocument\/foi-public-documents1\u2014all-documents\/nhsgvanc.pdf<\/a><\/p>\n
4.\u00a0\u00a0\u00a0\u00a0 Betty LG et al. 2014 IV medications.<\/p>\n
5.\u00a0\u00a0\u00a0\u00a0 Hayder S et al. The surgical antimicrobial prophylaxis; an Irish experience. Iraqi New Medical Journal. 2017;3(2).<\/p>\n
6.\u00a0\u00a0\u00a0\u00a0 T\u1ed1c \u0111\u1ed9 truy\u1ec1n:\u00a0 https:\/\/www.thecalculator.co\/health\/IV-Flow-Rate-Calculator-677.html<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Bi\u00ean so\u1ea1n: Nh\u1ecbp c\u1ea7u D\u01b0\u1ee3c l\u00e2m s\u00e0ng V1.5\/2019 H\u1ed9i ch\u1ee9ng ng\u01b0\u1eddi \u0111\u1ecf (red man syndrome) do vancomycin Th\u1eddi gian xu\u1ea5t hi\u1ec7n \u00a7\u00a0 Ph\u1ea3n \u1ee9ng nhanh: Xu\u1ea5t hi\u1ec7n\u00a04-10 ph\u00fat\u00a0sau khi b\u1eaft \u0111\u1ea7u truy\u1ec1n li\u1ec1u \u0111\u1ea7u ti\u00ean.\u00a7\u00a0 Ph\u1ea3n \u1ee9ng mu\u1ed9n: Xu\u1ea5t hi\u1ec7n sau khi truy\u1ec1n k\u1ebft th\u00fac ho\u1eb7c sau h\u01a1n 7 ng\u00e0y d\u00f9ng vancomycin b\u00ecnh th\u01b0\u1eddng. Tri\u1ec7u […]\n","protected":false},"author":1,"featured_media":10248,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-10247","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/10247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=10247"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/10247\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/10248"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=10247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=10247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=10247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}