{"id":22281,"date":"2019-10-02T14:44:22","date_gmt":"2019-10-02T07:44:22","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=22281"},"modified":"2020-10-31T12:18:14","modified_gmt":"2020-10-31T05:18:14","slug":"metronidazol","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/metronidazol\/","title":{"rendered":"Metronidazol – Kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb Amip, Giardia, L\u1eadu"},"content":{"rendered":"

Metronidazol<\/a> l\u00e0 m\u1ed9t kh\u00e1ng sinh quen thu\u1ed9c v\u1edbi t\u00ean bi\u1ec7t d\u01b0\u1ee3c n\u1ed5i ti\u1ebfng l\u00e0 Flagyl, d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n do vi khu\u1ea9n k\u1ef5 kh\u00ed c\u00f9ng c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m Amip, Giardia, l\u1eadu. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang t\u00f4i xin g\u1eedi \u0111\u1ebfn \u0111\u1ed9c gi\u1ea3 nh\u1eefng th\u00f4ng tin chi ti\u1ebft v\u00e0 quan tr\u1ecdng nh\u1ea5t v\u1ec1 ho\u1ea1t ch\u1ea5t Metronidazol<\/strong>: Metronidazol l\u00e0 thu\u1ed1c g\u00ec<\/strong>? T\u00e1c d\u1ee5ng v\u00e0 C\u00f4ng d\u1ee5ng c\u1ee7a Metronidazol<\/strong>? Li\u1ec1u d\u00f9ng v\u00e0 nh\u1eefng l\u01b0u \u00fd th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y.<\/p>\n

Metronidazol l\u00e0 thu\u1ed1c g\u00ec?<\/h2>\n

Metronidazol<\/strong> l\u00e0 d\u1eabn xu\u1ea5t th\u1ebf h\u1ec7 1 c\u1ee7a nh\u00f3m 5-nitroimidazol, \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng d\u01b0\u1edbi t\u00ean Flagyl c\u00f9ng v\u1edbi c\u00e1c t\u00ean kh\u00e1c, l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1ng khu\u1ea9n v\u00e0 thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng v\u1eadt nguy\u00ean sinh. Th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng m\u1ed9t m\u00ecnh ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c kh\u00e1ng sinh kh\u00e1c trong \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng nhi\u1ec5m khu\u1ea9n do vi khu\u1ea9n k\u1ef5 kh\u00ed, c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m Amip, Trichomonas vaginalis, Giardia, l\u1eadu. N\u00f3 c\u00f2n \u0111\u01b0\u1ee3c d\u00f9ng trong Vi\u00eam lo\u00e9t d\u00e0y t\u00e1 tr\u00e0ng c\u00f3 H.P(+) hay Vi\u00eam ru\u1ed9t k\u1ebft m\u00e0ng gi\u1ea3 do Clostridium difficile. Metronidazol \u0111\u01b0\u1ee3c d\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng, d\u1ea1ng kem v\u00e0 ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n

\"Thu\u1ed1c
Thu\u1ed1c Flagyl ch\u1ee9a ho\u1ea1t ch\u1ea5t Metronidazol<\/figcaption><\/figure>\n

T\u00e1c d\u1ee5ng c\u1ee7a Metronidazol<\/h2>\n

Metronidazol<\/strong>\u00a0c\u00f3 ho\u1ea1t ph\u1ed5 r\u1ed9ng tr\u00ean \u0111\u1ed9ng v\u1eadt nguy\u00ean sinh nh\u01b0 Amip, Giardia v\u00e0 Vi khu\u1ea9n k\u1ef5 kh\u00ed.<\/p>\n

C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: Hi\u1ec7n c\u00f2n ch\u01b0a bi\u1ebft r\u00f5, trong t\u1ebf b\u00e0o vi khu\u1ea9n ho\u1eb7c \u0111\u1ed9ng v\u1eadt nguy\u00ean sinh, nh\u00f3m 5-nitro b\u1ecb kh\u1eed b\u1edfi nitroreductase c\u1ee7a vi khu\u1ea9n th\u00e0nh c\u00e1c ch\u1ea5t trung gian \u0111\u1ed9c v\u1edbi t\u1ebf b\u00e0o, ph\u00e1 v\u1ee1 c\u1ea5u tr\u00fac xo\u1eafn c\u1ee7a ph\u00e2n t\u1eed ADN vi khu\u1ea9n l\u00e0m ng\u1eebng qu\u00e1 tr\u00ecnh sao ch\u00e9p d\u1eabn t\u1edbi t\u1ebf b\u00e0o b\u1ecb ti\u00eau di\u1ec7t.<\/p>\n

Ph\u1ed5 t\u00e1c d\u1ee5ng:<\/p>\n

V\u01a1\u0301i vi khu\u00e2\u0309n: In vitro, metronidazol c\u00f3 t\u00e1c du\u0323ng t\u1ed1t tr\u00ean nhi\u00ea\u0300u loa\u0323i vi khu\u00e2\u0309n gram \u00e2m ky\u0323 kh\u00ed nhu\u031b B. ovatus, Bacteroides fragilis, B. oreolyticus, B. distasonis, Prevotella bivia, P. disiens, B. thetaiotaomicron, B. vulgaris, P. gingivalis, P. intermedia, Porphyromonas asaccharolytic, Fusobacterium v\u00e0 Veillonella; M\u1ecd\u0302t s\u00f4\u0301 chu\u0309ng Mobiluncus; Thu\u00f4\u0301c cu\u0303ng c\u00f3 t\u00e1c du\u0323ng tr\u00ean m\u1ecd\u0302t s\u00f4\u0301 chu\u0309ng ky\u0323 kh\u00ed gram du\u031bo\u031bng nhu\u031b Clostridium, Peptococus, C. dif cile, Eubacterium, C. perfringens, v\u00e0 Peptostreptococus.<\/p>\n

V\u1edbi Helicobacter pylori khi d\u00f9ng n\u00ean ph\u1ed1i h\u1ee3p c\u00e1c kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 tr\u00e1nh t\u00ecnh tr\u1ea1ng kh\u00e1ng thu\u1ed1c<\/p>\n

V\u01a1\u0301i \u0111\u1ecd\u0302ng v\u1ea1\u0302t nguy\u00ean sinh: Metronidazol c\u00f3 t\u00e1c du\u0323ng v\u01a1\u0301i Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis v\u00e0 Balantidium coli.<\/p>\n

Metronidazol kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean n\u1ea5m, virus v\u00e0 h\u1ea7u h\u1ebft vi khu\u1ea9n hi\u1ebfu kh\u00ed b\u1eaft bu\u1ed9c<\/p>\n

\"Metronidazol
Metronidazol d\u00f9ng trong ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n HP<\/figcaption><\/figure>\n

Ch\u1ec9 \u0111\u1ecbnh v\u00e0 li\u1ec1u d\u00f9ng<\/h2>\n

– Nhi\u1ec5m amip: C\u00e1c th\u1ec3 nhi\u1ec5m amip c\u1ea5p \u1edf \u0111\u01b0\u1eddng ru\u1ed9t v\u00e0 \u00e1p xe gan do amip g\u00e2y ra b\u1edfi Entamoeba hystolistica. Tr\u01b0\u1eddng h\u1ee3p c\u00f3 k\u00e9n amip kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ec7nh kh\u00f4ng d\u00f9ng metronidazol m\u00e0 d\u00f9ng c\u00e1c thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng di\u1ec7t k\u00e9n<\/p>\n

Li\u00ea\u0300u \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng cho ngu\u031b\u01a1\u0300i tr\u01b0\u1edfng th\u00e0nh l\u00e0 m\u1ed7i ng\u00e0y 3 li\u1ec1u, m\u1ed7i li\u1ec1u d\u00f9ng 750 mg. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1eeb 5 – 10 ng\u00e0y (Tuy nhi\u00ean th\u01b0\u1eddng d\u00f9ng t\u1ed1i thi\u1ec3u 10 ng\u00e0y)<\/p>\n

\u0110i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng \u00e1p xe gan do amip: D\u00f9ng cho ngu\u031b\u01a1\u0300i l\u01a1\u0301n m\u1ed7i ng\u00e0y 3 li\u1ec1u, m\u1ed7i li\u1ec1u d\u00f9ng 500 – 750 mg. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1eeb 5 – 10 ng\u00e0y.<\/p>\n

\u0110\u00f4\u0301i v\u01a1\u0301i tre\u0309 em: li\u1ec1u \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng l\u00e0 d\u00f9ng m\u1ed7i ng\u00e0y t\u1eeb 35 – 40 mg\/kg th\u1ec3 tr\u1ecdng, d\u00f9ng 3 li\u1ec1u trong 1 ng\u00e0y; Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb trong kho\u1ea3ng 5 – 10 ng\u00e0y.<\/p>\n

– Nhi\u1ec5m vi khu\u1ea9n k\u1ef5 kh\u00ed v\u00e0 vi khu\u1ea9n hi\u1ebfu kh\u00ed, k\u1ef5 kh\u00ed h\u1ed7n h\u1ee3p:<\/p>\n

D\u00f9ng \u0111u\u031b\u01a1\u0300ng u\u00f4\u0301ng ho\u1ea1\u0306c ti\u00eam truy\u00ea\u0300n ti\u0303nh ma\u0323ch \u0111i\u00ea\u0300u tri\u0323 c\u00e1c nhi\u00ea\u0303m khu\u00e2\u0309n n\u1ea1\u0306ng nhu\u031b nhi\u00ea\u0303m khu\u00e2\u0309n trong \u00f4\u0309 bu\u0323ng (vi\u00eam m\u00e0ng bu\u0323ng, \u00e1p xe \u00f4\u0309 bu\u0323ng, vi\u00eam m\u00e0ng trong t\u01b0\u0309 cung, vi\u00eam v\u00f2i bu\u00f4\u0300ng tr\u01b0\u0301ng v\u00e0 nhi\u00ea\u0303m khu\u00e2\u0309n \u00e2m \u0111a\u0323o sau ph\u00e2\u0303u thu\u1ea1\u0302t), nhi\u00ea\u0303m khu\u00e2\u0309n da v\u00e0 c\u00e2\u0301u tr\u00fac da, nhi\u00ea\u0303m khu\u00e2\u0309n \u01a1\u0309 xu\u031bo\u031bng, kh\u01a1\u0301p, \u0111u\u031b\u01a1\u0300ng h\u00f4 h\u00e2\u0301p du\u031b\u01a1\u0301i (bao g\u00f4\u0300m vi\u00eam ph\u00f4\u0309i, vi\u00eam m\u00e0ng ph\u00f4\u0309i mu\u0309, \u00e1p xe ph\u00f4\u0309i); nhi\u00ea\u0303m khu\u00e2\u0309n h\u1eb9\u0302 n\u00e3o tu\u0309y (bao g\u00f4\u0300m vi\u00eam m\u00e0ng n\u00e3o v\u00e0 \u00e1p xe n\u00e3o), nhi\u00ea\u0303m khu\u00e2\u0309n huy\u00ea\u0301t, vi\u00eam m\u00e0ng trong tim g\u00e2y ra b\u01a1\u0309i c\u00e1c chu\u0309ng vi khu\u00e2\u0309n nha\u0323y ca\u0309m.<\/p>\n

Li\u00ea\u0300u kh\u01a1\u0309i \u0111\u00e2\u0300u 800 mg, sau \u0111\u00f3 l\u00e0 400 mg\/l\u00e2\u0300n, 8 gi\u01a1\u0300 m\u1ecd\u0302t l\u00e2\u0300n, d\u00f9ng trong khoa\u0309ng 7 ng\u00e0y; Ho\u1ea1\u0306c d\u00f9ng li\u00ea\u0300u 500 mg\/l\u00e2\u0300n, 8 gi\u01a1\u0300 m\u1ecd\u0302t l\u00e2\u0300n. Tru\u031b\u01a1\u0300ng h\u01a1\u0323p kh\u00f4ng th\u00ea\u0309 d\u00f9ng \u0111u\u031b\u01a1\u0300ng u\u00f4\u0301ng, ti\u00eam truy\u00ea\u0300n ti\u0303nh ma\u0323ch 500 mg (dung di\u0323ch 5 mg\/ml) v\u01a1\u0301i t\u00f4\u0301c \u0111\u1ecd\u0302 5 ml\/ph\u00fat, 8 gi\u01a1\u0300 m\u1ecd\u0302t l\u00e2\u0300n; Ho\u1ea1\u0306c \u0111\u1ea1\u0306t tr\u01b0\u0323c tr\u00e0ng 1 g da\u0323ng thu\u00f4\u0301c \u0111a\u0323n, 8 gi\u01a1\u0300 m\u1ecd\u0302t l\u00e2\u0300n trong \u00edt nh\u00e2\u0301t 3 ng\u00e0y, sau \u0111\u00f3 gia\u0309m 12 gi\u01a1\u0300 \u0111\u1ea1\u0306t m\u1ecd\u0302t l\u00e2\u0300n. Ho\u1ea1\u0306c d\u00f9ng li\u00ea\u0300u theo c\u00e2n n\u1ea1\u0306ng: U\u00f4\u0301ng 7,5 mg\/kg\/l\u00e2\u0300n, 6 – 8 gi\u01a1\u0300 m\u1ecd\u0302t l\u00e2\u0300n; Ho\u1ea1\u0306c ti\u00eam truy\u00ea\u0300n ti\u0303nh ma\u0323ch 15 mg\/kg sau \u0111\u00f3 7,5 mg\/kg\/l\u00e2\u0300n, 6 gi\u01a1\u0300 truy\u00ea\u0300n m\u1ecd\u0302t li\u00ea\u0300u.\u2028T\u00f4\u0309ng li\u00ea\u0300u t\u00f4\u0301i \u0111a theo b\u00e2\u0301t ky\u0300 \u0111u\u031b\u01a1\u0300ng d\u00f9ng n\u00e0o cu\u0303ng kh\u00f4ng n\u00ean vu\u031b\u01a1\u0323t qu\u00e1 4 g trong 24 gi\u01a1\u0300. \u0110\u01a1\u0323t \u0111i\u00ea\u0300u tri\u0323 7 – 10 ng\u00e0y.<\/p>\n

– B\u1eb9\u0302nh tr\u00f9ng roi do nhi\u00ea\u0303m Trichomonas vaginalis <\/em>cho ca\u0309 phu\u0323 n\u01b0\u0303 v\u00e0 nam gi\u01a1\u0301i. D\u00f9ng da\u0323ng thu\u00f4\u0301c u\u00f4\u0301ng, \u0111\u1ea1\u0306t ta\u0323i ch\u00f4\u0303 ho\u1ea1\u0306c k\u00ea\u0301t h\u01a1\u0323p ca\u0309 hai.<\/p>\n

S\u1eed d\u1ee5ng 1 li\u1ec1u 2g ho\u1eb7c d\u00f9ng li\u00ean t\u1ee5c trong 1 tu\u1ea7n, m\u1ed7i ng\u00e0y 3 li\u1ec1u, m\u1ed7i li\u1ec1u 250mg<\/p>\n

\u0110i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi cho b\u1ec7nh nh\u00e2n c\u00f3 quan h\u1ec7 t\u00ecnh d\u1ee5c cho k\u1ebft qu\u1ea3 t\u1ed1t<\/p>\n

N\u1ebfu ch\u01b0a kh\u1ecfi, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00eam 1 \u0111\u1ee3t 1 – 2 tu\u1ea7n, v\u1edbi li\u1ec1u 1g\/ng\u00e0y chia 2 l\u1ea7n<\/p>\n

\"\u0110i\u1ec1u
\u0110i\u1ec1u tr\u1ecb Trichomonas vaginalis<\/figcaption><\/figure>\n

– Vi\u00eam ru\u1ecd\u0302t, \u0111i ngo\u00e0i do Clostridium difficile<\/em>.<\/p>\n

– Nhi\u00ea\u0303m Giardia <\/em>\u01a1\u0309 ngu\u031b\u01a1\u0300i tr\u01b0\u1edfng th\u00e0nh v\u00e0 tre\u0309 em:<\/p>\n

+ Li\u1ec1u d\u00f9ng d\u00e0nh cho ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh: m\u1ed7i l\u1ea7n u\u1ed1ng 250 mg, ng\u00e0y u\u1ed1ng 3 l\u1ea7n; C\u1ea7n \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1eeb 5 -7 ng\u00e0y.<\/p>\n

+ Li\u1ec1u d\u00f9ng d\u00e0nh cho tr\u1ebb em: U\u1ed1ng m\u1ed7i ng\u00e0y m\u1ed9t l\u01b0\u1ee3ng 15 mg\/kg th\u1ec3 tr\u1ecdng c\u01a1 th\u1ec3, chia l\u00e0m 3 li\u1ec1u trong ng\u00e0y; C\u1ea7n \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1eeb 5 \u2013 10 ng\u00e0y<\/p>\n

– Vi\u00eam l\u01a1\u0323i hoa\u0323i t\u01b0\u0309 c\u00f3 lo\u00e9t c\u00e2\u0301p t\u00ednh, vi\u00eam l\u01a1\u0323i quanh ch\u00e2n ra\u0306ng c\u00f9ng v\u1edbi m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p nhi\u00ea\u0303m khu\u00e2\u0309n ra\u0306ng mi\u1ec7ng kh\u00e1c do vi khu\u00e2\u0309n ki\u0323 kh\u00ed g\u00e2y ra:<\/p>\n

Li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng: M\u1ed7i ng\u00e0y u\u1ed1ng t\u1eeb 7,5 mg \u2013 1g (base) tr\u00ean m\u1ed7i kg th\u1ec3 tr\u1ecdng, u\u1ed1ng ng\u00e0y 4 l\u1ea7n, \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1ed1i thi\u1ec3u 1 tu\u1ea7n<\/p>\n

– Vi\u00eam lo\u00e9t da\u0323 d\u00e0y – t\u00e1 tr\u00e0ng do vi khu\u1ea9n HP (c\u00f3 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p thu\u1ed1c ri\u00eang bi\u1ec7t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb HP).<\/p>\n

M\u1ed7i li\u1ec1u d\u00f9ng 500 mg Metronidazol, u\u1ed1ng 3 l\u1ea7n trong ng\u00e0y, k\u1ebft h\u1ee3p v\u1edbi kh\u00e1ng sinh bismuth subsalicylat ho\u1ea1\u0306c bismuth subcitrat keo c\u00f9ng m\u1ed9t s\u1ed1 kh\u00e1ng sinh kh\u00e1c nhu\u031b trong ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb HP nh\u01b0 amoxicilin ho\u1ea1\u0306c tetracyclin v\u00e0 1 thu\u00f4\u0301c thu\u1ed9c nh\u00f3m \u01b0\u0301c ch\u00ea\u0301 bo\u031bm proton. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i 1 – 2 tu\u00e2\u0300n.<\/p>\n

-Vi\u00eam ti\u00ea\u0301t ni\u1eb9\u0302u kh\u00f4ng do l\u1ea1\u0302u c\u1ea7u: Ph\u00f4\u0301i h\u01a1\u0323p v\u01a1\u0301i azithromycin \u0111i\u00ea\u0300u tri\u0323 khi b\u1eb9\u0302nh nh\u00e2n bi\u0323 vi\u00eam k\u00e9o d\u00e0i ho\u1ea1\u0306c t\u00e1i ph\u00e1t, ho\u1ea1\u0306c kh\u00f4ng \u0111u\u031b\u01a1\u0323c \u0111i\u00ea\u0300u tri\u0323 ngay t\u01b0\u0300 \u0111\u00e2\u0300u v\u01a1\u0301i azithromycin.<\/p>\n

– D\u1ef1 ph\u00f2ng nhi\u1ec5m khu\u1ea9n k\u1ef5 kh\u00ed sau ph\u1eabu thu\u1eadt<\/p>\n

D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/h2>\n

Metronidazole c\u00f3 kh\u1ea3 n\u0103ng h\u1ea5p thu ho\u00e0n to\u00e0n v\u00e0 nhanh ch\u00f3ng qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1. Sau khi u\u1ed1ng 500mg kho\u1ea3ng 1 ti\u1ebfng, thu\u1ed1c \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft t\u01b0\u01a1ng l\u00e0 10mcg\/mL. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc khi d\u00f9ng t\u1ea1i ch\u1ed7 (\u0111\u01b0\u1eddng \u0111\u1eb7t) kh\u00e1c nhi\u1ec1u so v\u1edbi khi d\u00f9ng to\u00e0n th\u00e2n (\u0111\u01b0\u1eddng ti\u00eam ho\u1eb7c u\u1ed1ng), v\u1edbi li\u1ec1u \u0111\u01a1n 5g gel \u0111\u1eb7t \u00e2m \u0111\u1ea1o, n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng \u0111\u1ea1t 237 ng\/mL sau 6-12h , b\u1eb1ng kho\u1ea3ng 2% so v\u1edbi khi d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng.<\/p>\n

Metronidazol x\u00e2m nh\u1eadp t\u1ed1t v\u00e0o c\u00e1c m\u00f4 v\u00e0 d\u1ecbch c\u01a1 th\u1ec3, k\u1ec3 c\u1ea3 n\u01b0\u1edbc b\u1ecdt, d\u1ecbch \u00e2m \u0111\u1ea1o, tinh d\u1ecbch, s\u1eefa m\u1eb9 v\u00e0 d\u1ecbch n\u00e3o tu\u1ef7. Li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng 10% – 20%.<\/p>\n

Metronidazol chuy\u1ec3n ho\u00e1 \u1edf gan b\u1eb1ng ph\u1ea3n \u1ee9ng oxy ho\u00e1 (kho\u1ea3ng 50%), c\u00e1c ch\u1ea5t chuy\u1ec3n ho\u00e1 d\u1ea1ng 2-hydroxy v\u00e0 glucuronid \u0111\u1ec1u c\u00f3 ho\u1ea1t t\u00ednh, th\u1ea3i tr\u1eeb ch\u1ee7 y\u1ebfu qua n\u01b0\u1edbc ti\u1ec3u. Th\u1eddi gian b\u00e1n th\u1ea3i kho\u1ea3ng 8 gi\u1edd, t\u0103ng l\u00ean khi b\u1ec7nh nh\u00e2n b\u1ecb suy gi\u1ea3m ch\u1ee9c n\u0103ng gan, ch\u1ee9c n\u0103ng th\u1eadn kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1eddi gian b\u00e1n th\u1ea3i.<\/p>\n

Th\u1eadn tr\u1ecdng<\/h2>\n

– C\u00e2\u0300n theo d\u00f5i v\u00e0 kh\u00f4ng d\u00f9ng ru\u031b\u01a1\u0323u v\u00e0 c\u00e1c ch\u00ea\u0301 ph\u00e2\u0309m c\u00f3 c\u00f4\u0300n khi u\u00f4\u0301ng thu\u00f4\u0301c.<\/p>\n

– D\u00f9ng li\u1ec1u cao c\u00f3 th\u00ea\u0309 g\u00e2y r\u00f4\u0301i loa\u0323n m\u00e1u v\u00e0 g\u00e2y ra c\u00e1c ch\u1ee9ng b\u1eb9\u0302nh th\u00e2\u0300n kinh th\u00ea\u0309 hoa\u0323t \u0111\u1ecd\u0302ng.<\/p>\n

– Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng thu\u1ed1c tr\u00ean tr\u1ebb em do t\u00ednh an to\u00e0n c\u00f2n ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh<\/p>\n

– Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng thu\u1ed1c cho ng\u01b0\u1eddi cao tu\u1ed5i do ch\u1ee9c n\u0103ng gan suy gi\u1ea3m<\/p>\n

– C\u1ea7n theo d\u00f5i \u0111\u1ec1 ph\u00f2ng nguy c\u01a1 b\u1ed9i nhi\u1ec5m Candida \u00e2m \u0111\u1ea1o, mi\u1ec7ng v\u00e0 ru\u1ed9t<\/p>\n

– Th\u1eddi k\u1ef3 mang thai: kh\u00f4ng n\u00ean d\u00f9ng cho th\u1eddi gian \u0111\u1ea7u do thu\u1ed1c qua nhau thai, tr\u1eeb khi b\u1eaft bu\u1ed9c d\u00f9ng ph\u1ea3i c\u00e2n nh\u1eafc nguy c\u01a1 \u2013 l\u1ee3i \u00edch<\/p>\n

– Th\u1eddi k\u1ef3 cho con b\u00fa: thu\u1ed1c b\u00e0i ti\u1ebft v\u00e0o s\u1eefa m\u1eb9 kh\u00e1 nhanh, n\u00ean ng\u1eebng cho tr\u1ebb b\u00fa s\u1eefa m\u1eb9 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u00e0 m\u1eb9 b\u1eb1ng kh\u00e1ng sinh metronidazole<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5<\/h2>\n

Thu\u031b\u01a1\u0300ng g\u1ea1\u0306p, ADR > 1\/100<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean h\u1ec7 ti\u00eau h\u00f3a: n\u00f4n nao, n\u00f4n m\u1eeda, ch\u00e1n a\u0306n, kh\u00f3 ti\u00eau, \u0111au bu\u0323ng, \u0111i ngo\u00e0i, c\u1ea3m th\u1ea5y m\u00f9i kim lo\u1ea1i trong mi\u1ec7ng.<\/p>\n

\u00cdt g\u1ea1\u0306p, 1\/1 000 < ADR < 1\/100<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean m\u00e1u: Gia\u0309m s\u1ed1 l\u01b0\u1ee3ng ba\u0323ch c\u00e2\u0300u.<\/p>\n

Hi\u00ea\u0301m g\u1ea1\u0306p, ADR < 1\/1 000<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean M\u00e1u: M\u00e2\u0301t ba\u0323ch c\u00e2\u0300u ha\u0323t.<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean TKTW: xu\u1ea5t hi\u1ec7n co\u031bn \u0111\u1ecd\u0302ng kinh b\u1ea5t ch\u1ee3t, b\u1eb9\u0302nh \u0111a d\u00e2y th\u00e2\u0300n kinh ngoa\u0323i vi, \u0111au nh\u1ee9c \u0111\u00e2\u0300u.<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean Da: n\u1ed5i ban \u0111\u1ecf, m\u1ea9n ng\u1ee9a, da ph\u1ed3ng r\u1ed9p, ch\u1ea5m n\u01b0\u1edbc.<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean Ti\u00ea\u0301t ni\u1eb9\u0302u: Nu\u031b\u01a1\u0301c ti\u00ea\u0309u chuy\u1ec3n m\u00e0u s\u00e2\u0303m.<\/p>\n

T\u01b0\u01a1ng t\u00e1c thu\u1ed1c<\/h2>\n

Metronidazol l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng coumarin, lithium, thu\u1ed1c gi\u00e3n c\u01a1 nh\u00f3m ch\u1ed1ng kh\u1eed c\u1ef1c. Do \u0111\u00f3 n\u00ean tr\u00e1nh d\u00f9ng \u0111\u1ed3ng th\u1eddi ho\u1eb7c khi d\u00f9ng n\u00ean hi\u1ec7u ch\u1ec9nh li\u1ec1u cho ph\u00f9 h\u1ee3p<\/p>\n

C\u00e1c thu\u1ed1c g\u00e2y c\u1ea3m \u1ee9ng enzyme nh\u01b0 phenobarbital, rifampicin\u2026 l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a Metronidazol, v\u00ec v\u1eady c\u1ea7n c\u00e2n nh\u1eafc khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi<\/p>\n

R\u01b0\u1ee3u v\u00e0 c\u00e1c ch\u1ea5t c\u00f3 ch\u1ee9a alcol: Thu\u1ed1c g\u00e2y h\u1ed9i ch\u1ee9ng gi\u1ed1ng disulfiram v\u00ec v\u1eady kh\u00f4ng n\u00ean u\u1ed1ng r\u01b0\u1ee3u trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb<\/p>\n

Gi\u00e1 b\u00e1n m\u1ed9t s\u1ed1 thu\u1ed1c c\u00f3 ch\u1ee9a Metronidazol<\/h2>\n