{"id":12048,"date":"2019-06-24T22:39:40","date_gmt":"2019-06-24T15:39:40","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=12048"},"modified":"2019-06-27T00:16:09","modified_gmt":"2019-06-26T17:16:09","slug":"van-de-dung-nhieu-thuoc-polypharmacy","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/van-de-dung-nhieu-thuoc-polypharmacy\/","title":{"rendered":"V\u1ea5n \u0111\u1ec1 d\u00f9ng nhi\u1ec1u thu\u1ed1c (Polypharmacy)"},"content":{"rendered":"

GI\u1edaI THI\u1ec6U<\/h2>\n
Hi\u1ec7n nay, nhi\u1ec1u b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng \u0111\u1ed3ng th\u1eddi nhi\u1ec1u lo\u1ea1i thu\u1ed1c v\u00e0 ch\u1ebf ph\u1ea9m b\u1ed5 sung<\/strong>. Kh\u1ea3o s\u00e1t k\u00ea \u0111\u01a1n v\u00e0 c\u1ea5p ph\u00e1t kh\u00e1ng sinh tr\u00ean b\u1ec7nh nh\u00e2n ngo\u1ea1i tr\u00fa t\u1ea1i B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tri Ph\u01b0\u01a1ng cho th\u1ea5y, s\u1ed1 thu\u1ed1c k\u00ea trung b\u00ecnh trong m\u1ed9t \u0111\u01a1n l\u00e0 7,1. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c cho th\u1ea5y, 25% ng\u01b0\u1eddi M\u1ef9 tr\u01b0\u1edfng th\u00e0nh d\u00f9ng 5 lo\u1ea1i thu\u1ed1c tr\u1edf l\u00ean. \u0110i\u1ec1u n\u00e0y g\u00e2y h\u1ea1i nhi\u1ec1u h\u01a1n l\u00e0 c\u00f3 l\u1ee3i.<\/p>\n
$\"Polypharmacy\"$ <\/p>\n
D\u00f9ng nhi\u1ec1u thu\u1ed1c, cho d\u00f9 l\u00e0 thu\u1ed1c k\u00ea \u0111\u01a1n, thu\u1ed1c OTC, th\u1ea3o d\u01b0\u1ee3c ho\u1eb7c ch\u1ebf ph\u1ea9m b\u1ed5 sung \u2013 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 polypharmacy \u2013 kh\u00f4ng ch\u1ec9 l\u00e0 g\u00e1nh n\u1eb7ng cho b\u1ec7nh nh\u00e2n m\u00e0 c\u00f2n r\u1ea5t nguy hi\u1ec3m. V\u00ed d\u1ee5 nh\u01b0 thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea khi kh\u00f4ng c\u1ea7n thi\u1ebft; thu\u1ed1c kh\u00f4ng \u0111\u01b0\u1ee3c k\u00ea khi c\u1ea7n thi\u1ebft; b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c kh\u00f4ng \u0111\u00fang c\u00e1ch; t\u01b0\u01a1ng t\u00e1c thu\u1ed1c hay s\u1ef1 gi\u1ea3m tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n
D\u01b0\u1ee3c s\u0129 v\u00e0 c\u00e1c chuy\u00ean gia ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe kh\u00e1c c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c gi\u1ea3m v\u1ea5n \u0111\u1ec1 d\u00f9ng nhi\u1ec1u thu\u1ed1c. [1]\n

\u0110\u1ecaNH NGH\u0128A<\/h2>\n
Kh\u00f4ng c\u00f3 \u0111\u1ecbnh ngh\u0129a duy nh\u1ea5t c\u1ee7a polypharmacy, m\u1eb7c d\u00f9 n\u00f3 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng n\u0103m lo\u1ea1i thu\u1ed1c tr\u1edf l\u00ean h\u00e0ng ng\u00e0y. Thu\u1ed1c \u1edf \u0111\u00e2y bao g\u1ed3m thu\u1ed1c k\u00ea \u0111\u01a1n, thu\u1ed1c OTC, ch\u1ebf ph\u1ea9m b\u1ed5 sung v\u00e0 th\u1ea3o d\u01b0\u1ee3c. [1]\n
$\"Polypharmacy\"$ <\/p>\n
NGUY\u00caN NH\u00c2N<\/h2>\n
Polypharmacy c\u00f3 th\u1ec3 x\u1ea3y ra khi c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n m\u1edbi d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a c\u00e1c lo\u1ea1i thu\u1ed1c c\u0169. \u0110\u00e2y g\u1ecdi l\u00e0 \u201ck\u00ea toa d\u00e2y chuy\u1ec1n\u201d. Khi \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh m\u00e3n t\u00ednh, nh\u01b0 cao huy\u1ebft \u00e1p v\u00e0 suy tim, vi\u1ec7c s\u1eed d\u1ee5ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng l\u00e0 c\u1ea7n thi\u1ebft v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng. Polypharmacy tr\u1edf n\u00ean c\u00f3 v\u1ea5n \u0111\u1ec1 khi l\u00fd do d\u00f9ng thu\u1ed1c kh\u00f4ng r\u00f5 r\u00e0ng, khi d\u00f9ng thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c, khi li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian d\u00f9ng thu\u1ed1c ph\u1ee9c t\u1ea1p, v\u00e0 khi thu\u1ed1c t\u01b0\u01a1ng t\u00e1c v\u1edbi nhau. [3]\n
Polypharmacy th\u01b0\u1eddng x\u1ea3y ra \u1edf ng\u01b0\u1eddi m\u1eafc nhi\u1ec1u b\u1ec7nh m\u00e3n t\u00ednh, ch\u1eb3ng h\u1ea1n nh\u01b0 ti\u1ec3u \u0111\u01b0\u1eddng, cao huy\u1ebft \u00e1p, suy tim, lo\u00e3ng x\u01b0\u01a1ng v\u00e0\/ho\u1eb7c c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au, m\u1ea5t ng\u1ee7, c\u1ea7n \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i b\u1eb1ng thu\u1ed1c. B\u1ec7nh m\u00e3n t\u00ednh v\u00e0 tri\u1ec7u ch\u1ee9ng t\u00edch l\u0169y theo tu\u1ed5i t\u00e1c. V\u00ec l\u00fd do n\u00e0y, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i c\u00f3 nguy c\u01a1 d\u00f9ng nhi\u1ec1u thu\u1ed1c cao h\u01a1n. [3]\n
H\u1eacU QU\u1ea2<\/h2>\n
Polypharmacy l\u00e0m t\u0103ng nguy c\u01a1 ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i v\u1edbi thu\u1ed1c. C\u00e0ng nhi\u1ec1u thu\u1ed1c, nguy c\u01a1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u00e0ng cao. Nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng 5-9 lo\u1ea1i thu\u1ed1c c\u00f3 50% kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c thu\u1ed1c b\u1ea5t l\u1ee3i, t\u0103ng l\u00ean 100% khi h\u1ecd d\u00f9ng 20 lo\u1ea1i thu\u1ed1c tr\u1edf l\u00ean. M\u1ed9t nghi\u00ean c\u1ee9u y t\u1ebf b\u00e1o c\u00e1o r\u1eb1ng polypharmacy chi\u1ebfm g\u1ea7n 30% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u00e0 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong \u0111\u1ee9ng th\u1ee9 5 \u1edf Hoa K\u1ef3. [2]\n
Polypharmacy c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c r\u1ee7i ro bao g\u1ed3m gi\u1ea3m nh\u1eadn th\u1ee9c, l\u00fa l\u1eabn, t\u00e9 ng\u00e3, ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i c\u1ee7a thu\u1ed1c, t\u0103ng th\u1eddi gian n\u1eb1m vi\u1ec7n, t\u00e1i nh\u1eadp vi\u1ec7n ngay sau khi xu\u1ea5t vi\u1ec7n v\u00e0 th\u1eadm ch\u00ed l\u00e0 t\u1eed vong. [4]\n
B\u1ec7nh nh\u00e2n c\u00e0ng d\u00f9ng nhi\u1ec1u thu\u1ed1c, c\u00e0ng kh\u00f3 c\u00f3 \u0111\u01b0\u1ee3c ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c ch\u00ednh x\u00e1c, \u0111i\u1ec1u n\u00e0y c\u1ea3n tr\u1edf vi\u1ec7c xem x\u00e9t v\u00e0 k\u00ea \u0111\u01a1n thu\u1ed1c. T\u1ef7 l\u1ec7 ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i c\u1ee7a thu\u1ed1c t\u0103ng theo s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c s\u1eed d\u1ee5ng. [4]\n
Vi\u1ec7c s\u1eed d\u1ee5ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00e1c nhau c\u00f9ng m\u1ed9t l\u00fac c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 nh\u1ea7m l\u1eabn trong vi\u1ec7c l\u01b0u tr\u1eef thu\u1ed1c ho\u1eb7c d\u00f9ng thu\u1ed1c kh\u00f4ng ch\u00ednh x\u00e1c. B\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 kh\u00f4ng bi\u1ebft nh\u1eefng lo\u1ea1i thu\u1ed1c m\u00e0 b\u1ec7nh nh\u00e2n c\u1ee7a h\u1ecd \u0111ang d\u00f9ng, d\u1eabn \u0111\u1ebfn sai s\u00f3t trong vi\u1ec7c k\u00ea \u0111\u01a1n. V\u00ed d\u1ee5, c\u00f9ng m\u1ed9t lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n 2 l\u1ea7n. [3]\n
M\u1ed9t lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 kh\u00f4ng ph\u00e1t huy t\u00e1c d\u1ee5ng ho\u1eb7c c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 khi s\u1eed d\u1ee5ng chung v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c. \u0110\u00e2y g\u1ecdi l\u00e0 m\u1ed9t t\u01b0\u01a1ng t\u00e1c thu\u1ed1c-thu\u1ed1c. B\u1ec7nh nh\u00e2n c\u00e0ng d\u00f9ng nhi\u1ec1u thu\u1ed1c v\u00e0 ch\u1ebf ph\u1ea9m b\u1ed5 sung th\u00ec nguy c\u01a1 m\u1eafc c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00e0ng cao. [3]\n
M\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t b\u1ec7nh ho\u1eb7c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 c\u00f3 t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c \u0111\u1ebfn m\u1ed9t b\u1ec7nh ho\u1eb7c tri\u1ec7u ch\u1ee9ng kh\u00e1c. \u0110\u00e2y g\u1ecdi l\u00e0 m\u1ed9t t\u01b0\u01a1ng t\u00e1c thu\u1ed1c-b\u1ec7nh. V\u00ed d\u1ee5, thu\u1ed1c ch\u1ed1ng vi\u00eam, th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m thu\u1ed1c gi\u1ea3m \u0111au, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng huy\u1ebft \u00e1p v\u00e0 l\u00e0m suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, do \u0111\u00f3 c\u1ea7n c\u00e2n nh\u1eafc khi k\u00ea \u0111\u01a1n thu\u1ed1c cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 huy\u1ebft \u00e1p cao ho\u1eb7c c\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 th\u1eadn. [3]\n
C\u00c1CH \u0110\u1ed0I PH\u00d3<\/h2>\n
Polypharmacy l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 c\u1ea7n s\u1ef1 \u0111\u1ed3ng t\u00e2m hi\u1ec7p l\u1ef1c c\u1ee7a c\u1ea3 \u0111\u1ed9i ng\u0169 nh\u00e2n vi\u00ean y t\u1ebf, b\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh. C\u1ea7n c\u00f3 nh\u1eefng ho\u1ea1t \u0111\u1ed9ng th\u00f4ng tin thu\u1ed1c, ch\u01b0\u01a1ng tr\u00ecnh khuy\u1ebfn kh\u00edch gi\u1ea3m thu\u1ed1c, t\u1ed5 ch\u1ee9c kh\u00e1m chuy\u00ean v\u1ec1 polypharmacy \u0111\u1ec3 g\u00f3p ph\u1ea7n ng\u0103n ng\u1eeba t\u00e1c h\u1ea1i.<\/p>\n
Nh\u1eefng c\u00f4ng c\u1ee5 h\u1eefu \u00edch c\u00f3 th\u1ec3 tham kh\u1ea3o: [5]\nBeers Criteria: h\u01b0\u1edbng d\u1eabn cho c\u00e1c chuy\u00ean gia ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe \u0111\u1ec3 c\u1ea3i thi\u1ec7n s\u1ef1 an to\u00e0n c\u1ee7a vi\u1ec7c k\u00ea \u0111\u01a1n thu\u1ed1c cho ng\u01b0\u1eddi cao tu\u1ed5i, gi\u00fap gi\u1ea3m c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 polypharmacy, t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u00e0 ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i c\u1ee7a thu\u1ed1c, t\u1eeb \u0111\u00f3 c\u1ea3i thi\u1ec7n ch\u1ebf \u0111\u1ed9 d\u00f9ng thu\u1ed1c \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1. www.americangeriatrics.org
\nSTOPP Criteria: Screening Tool of Older Persons\u2019 Potentially (C\u00f4ng c\u1ee5 s\u00e0ng l\u1ecdc c\u00e1c \u0111\u01a1n thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng ph\u00f9 h\u1ee3p c\u1ee7a ng\u01b0\u1eddi l\u1edbn tu\u1ed5i).
\nSTART Criteria: Screening Tool to Alert Doctors to Right Treatments (C\u00f4ng c\u1ee5 s\u00e0ng l\u1ecdc \u0111\u1ec3 c\u1ea3nh b\u00e1o c\u00e1c b\u00e1c s\u0129 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang)
\n7 b\u01b0\u1edbc \u0111\u1ec3 ng\u0103n ng\u1eeba polypharmacy: [6]\n
\n
B\u01b0\u1edbc 1: Hi\u1ec3u m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb<\/li>\n
B\u01b0\u1edbc 2: X\u00e1c \u0111\u1ecbnh thu\u1ed1c thi\u1ebft y\u1ebfu<\/li>\n
B\u01b0\u1edbc 3: X\u00e1c \u0111\u1ecbnh thu\u1ed1c \u201c kh\u00f4ng thi\u1ebft y\u1ebfu\u201d<\/li>\n
B\u01b0\u1edbc 4: \u0110\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb<\/li>\n
B\u01b0\u1edbc 5: \u0110\u00e1nh gi\u00e1 \u0111\u1ed9 an to\u00e0n<\/li>\n
B\u01b0\u1edbc 6: \u0110\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3-chi ph\u00ed<\/li>\n
B\u01b0\u1edbc 7: \u0110\u00e1nh gi\u00e1 \u0111\u1ed9 tu\u00e2n th\u1ee7 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n
CH\u1ebe PH\u1ea8M B\u1ed4 SUNG V\u00c0 THU\u1ed0C OTC<\/h2>\n
S\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa thu\u1ed1c k\u00ea \u0111\u01a1n, thu\u1ed1c OTC v\u00e0 ch\u1ebf ph\u1ea9m b\u1ed5 sung l\u00e0m t\u0103ng th\u00eam s\u1ef1 ph\u1ee9c t\u1ea1p trong \u0111i\u1ec1u tr\u1ecb. Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, c\u1ea3 c\u00e1c nh\u00e0 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u00e0 b\u1ec7nh nh\u00e2n \u0111\u1ec1u kh\u00f4ng coi c\u00e1c ch\u1ebf ph\u1ea9m b\u1ed5 sung l\u00e0 thu\u1ed1c v\u00e0 do \u0111\u00f3 th\u01b0\u1eddng b\u1ecb b\u1ecf qu\u00ean trong qu\u00e1 tr\u00ecnh ch\u0103m s\u00f3c l\u00e2m s\u00e0ng. Nhi\u1ec1u b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng c\u00e1c ch\u1ebf ph\u1ea9m b\u1ed5 sung k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c k\u00ea \u0111\u01a1n, c\u0169ng nh\u01b0 s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa thu\u1ed1c k\u00ea \u0111\u01a1n v\u1edbi thu\u1ed1c OTC c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng r\u1ee7i ro nghi\u00eam tr\u1ecdng. [1]\n
V\u00ed d\u1ee5, k\u1ebft h\u1ee3p thu\u1ed1c warfarin l\u00e0m lo\u00e3ng m\u00e1u v\u1edbi aspirin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ch\u1ea3y m\u00e1u, ch\u1eb3ng h\u1ea1n nh\u01b0 xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a. T\u01b0\u01a1ng t\u1ef1, s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin (ACE), th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cao huy\u1ebft \u00e1p v\u00e0 suy tim v\u1edbi c\u00e1c ch\u1ea5t b\u1ed5 sung kali OTC, c\u00f3 th\u1ec3 g\u00e2y ra t\u00ecnh tr\u1ea1ng t\u0103ng kali m\u00e1u \u0111e d\u1ecda t\u00ednh m\u1ea1ng. [1]\n
N\u00caN L\u00c0M G\u00cc N\u1ebeU \u0110ANG D\u00d9NG NHI\u1ec0U THU\u1ed0C<\/h2>\n
N\u00ean c\u00f3 m\u1ed9t danh s\u00e1ch thu\u1ed1c ch\u00ednh x\u00e1c v\u00e0 c\u1eadp nh\u1eadt c\u00e1c lo\u1ea1i thu\u1ed1c \u0111ang d\u00f9ng. Bao g\u1ed3m nh\u1eefng thu\u1ed1c k\u00ea \u0111\u01a1n, thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n, s\u1ea3n ph\u1ea9m th\u1ea3o d\u01b0\u1ee3c v\u00e0 ch\u1ebf ph\u1ea9m b\u1ed5 sung. Lu\u00f4n gi\u1eef danh s\u00e1ch n\u00e0y v\u00e0 c\u1eadp nh\u1eadt b\u1ea5t c\u1ee9 khi n\u00e0o c\u00f3 s\u1ef1 thay \u0111\u1ed5i \u0111\u01a1n thu\u1ed1c. [3]\n
H\u00e3y ch\u1eafc ch\u1eafn r\u1eb1ng b\u00e1c s\u0129 bi\u1ebft t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c v\u00e0 thu\u1ed1c b\u1ed5 sung kh\u00f4ng k\u00ea \u0111\u01a1n \u0111ang d\u00f9ng. [3]\n
Hi\u1ec3u l\u00fd do t\u1ea1i sao ph\u1ea3i d\u00f9ng c\u00e1c thu\u1ed1c n\u00e0y. Th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 v\u1ec1 nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ea7n ch\u00fa \u00fd. N\u1ebfu c\u1ea7n, h\u00e3y tham kh\u1ea3o c\u00e1c trang web v\u00e0 t\u00e0i li\u1ec7u tr\u1ef1c tuy\u1ebfn v\u1ec1 c\u00e1c th\u00f4ng tin thu\u1ed1c. [3]\n
\u0110\u1ecbnh k\u1ef3 th\u1ea3o lu\u1eadn v\u1ec1 ch\u1ebf \u0111\u1ed9 d\u00f9ng thu\u1ed1c v\u1edbi b\u00e1c s\u0129. H\u1ecfi b\u00e1c s\u0129 n\u1ebfu c\u00f3 thu\u1ed1c kh\u00f4ng c\u00f2n c\u1ea7n d\u00f9ng v\u00e0 thu\u1ed1c n\u00e0o c\u00f3 th\u1ec3 ng\u1eebng d\u00f9ng n\u1ebfu thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng (v\u00ed d\u1ee5, ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng, ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t v\u00e0 gi\u1ea3m c\u00e2n). [3]\n
Tr\u00e1nh \u0111\u1ed9t ng\u1ed9t d\u1eebng thu\u1ed1c theo quy \u0111\u1ecbnh. N\u1ebfu g\u1eb7p v\u1ea5n \u0111\u1ec1 v\u1edbi vi\u1ec7c d\u00f9ng thu\u1ed1c \u0111\u00fang c\u00e1ch, h\u00e3y th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 v\u1ec1 kh\u1ea3 n\u0103ng \u0111\u01a1n gi\u1ea3n h\u00f3a ch\u1ebf \u0111\u1ed9 d\u00f9ng thu\u1ed1c. N\u1ebfu c\u1ea7n, s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n ho\u1eb7c c\u00f4ng c\u1ee5 \u0111\u1ec3 \u0111\u01a1n gi\u1ea3n h\u00f3a vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c (v\u00ed d\u1ee5, h\u1ed9p thu\u1ed1c h\u00e0ng tu\u1ea7n ho\u1eb7c h\u00e0ng ng\u00e0y). [3]\n
D\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3 gi\u00fap \u0111\u1ee1! Tr\u01b0\u1edbc khi mua b\u1ea5t k\u1ef3 s\u1ea3n ph\u1ea9m ho\u1eb7c thu\u1ed1c b\u1ed5 sung n\u00e0o, h\u00e3y nh\u1edb h\u1ecfi d\u01b0\u1ee3c s\u0129 v\u1ec1 v\u1ea5n \u0111\u1ec1 an to\u00e0n khi d\u00f9ng chung v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c. D\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3 n\u00f3i chuy\u1ec7n tr\u1ef1c ti\u1ebfp v\u1edbi b\u00e1c s\u0129 \u0111\u1ec3 hi\u1ec3u r\u00f5 h\u01a1n l\u00fd do t\u1ea1i sao thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n v\u00e0 th\u1ea3o lu\u1eadn v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thay th\u1ebf c\u00f3 nguy c\u01a1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c th\u1ea5p h\u01a1n. [2]\n
TH\u00d4NG \u0110I\u1ec6P<\/h2>\n
Polypharmacy c\u00f3 ngh\u0129a l\u00e0 vi\u1ec7c d\u00f9ng nhi\u1ec1u thu\u1ed1c m\u1ed9t c\u00e1ch kh\u00f4ng h\u1ee3p l\u00fd.<\/p>\n
M\u1ed9t h\u1eadu qu\u1ea3 ph\u1ed5 bi\u1ebfn l\u00e0 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c, m\u1ed9t s\u1ed1 trong \u0111\u00f3 l\u00e0 do t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/p>\n
\u0110\u00e1nh gi\u00e1 th\u01b0\u1eddng xuy\u00ean \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c.<\/p>\n
T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h2>\n
\n
Kira Barrett, Eleanor Lucas, G. Caleb Alexander (9 Jun 2016). How polypharmacy has become a medical burden worldwide. Clinical Pharmacist.
\nhttps:\/\/www.pharmaceutical-journal.com\/opinion\/insight\/how-polypharmacy-has-become-a-medical-burden-worldwide<\/a><\/li>\n
Staff (June 16, 2017). Polypharmacy. US Pharm. https:\/\/www.uspharmacist.com\/article\/polypharmacy<\/a><\/li>\n
Graziano Onder; Alessandra Marengoni (November 7, 2017). Polypharmacy. JAMA. https:\/\/jamanetwork.com\/journals\/jama<\/a><\/li>\n
Sarah N Hilmer (1 February 2008). The dilemma of polypharmacy. NPS medicinewise. https:\/\/www.nps.org.au\/australian-prescriber\/articles\/the-dilemma-of-polypharmacy<\/a><\/li>\n
Harriet Pike (2 NOV 2018). Deprescribing: the fightback against polypharmacy has begun. The Pharmaceutical Journal. https:\/\/www.pharmaceutical-journal.com\/news-and-analysis\/features\/deprescribing-the-fightback-against-polypharmacy-has-begun<\/a><\/li>\n
Scottish Government Polypharmacy Model of Care Group. Polypharmacy Guidance, Realistic Prescribing 3 rd Edition, 2018. Scottish Government. https:\/\/www.therapeutics.scot.nhs.uk\/wp-content\/uploads\/2018\/09\/Polypharmacy-Guidance-2018.pdf<\/a><\/li>\n<\/ul>\n
T\u00e1c gi\u1ea3: Sinh vi\u00ean Nguy\u1ec5n Thanh Huy\u1ec1n \u2013 Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch – Nh\u1ecbp C\u1ea7u D\u01b0\u1ee3c L\u00e2m S\u00e0ng.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
GI\u1edaI THI\u1ec6U Hi\u1ec7n nay, nhi\u1ec1u b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng \u0111\u1ed3ng th\u1eddi nhi\u1ec1u lo\u1ea1i thu\u1ed1c v\u00e0 ch\u1ebf ph\u1ea9m b\u1ed5 sung. Kh\u1ea3o s\u00e1t k\u00ea \u0111\u01a1n v\u00e0 c\u1ea5p ph\u00e1t kh\u00e1ng sinh tr\u00ean b\u1ec7nh nh\u00e2n ngo\u1ea1i tr\u00fa t\u1ea1i B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tri Ph\u01b0\u01a1ng cho th\u1ea5y, s\u1ed1 thu\u1ed1c k\u00ea trung b\u00ecnh trong m\u1ed9t \u0111\u01a1n l\u00e0 7,1. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c […]\n","protected":false},"author":1,"featured_media":12092,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-12048","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\/12048","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=12048"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/12048\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/12092"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=12048"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=12048"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=12048"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}