T\u1ea1i sao \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n khi s\u1eed d\u1ee5ng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ho l\u00e0 Dextromethorphan l\u1ea1i g\u00e2y ho ?<\/strong><\/p>\n Dextromethorphan<\/strong> l\u00e0 d\u1eabn xu\u1ea5t thu\u1ed9c nh\u00f3m opioid c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ho, th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng tr\u1ecb ho do c\u1ea3m l\u1ea1nh th\u00f4ng th\u01b0\u1eddng, ho kh\u00f4ng c\u00f3 \u0111\u1eddm (ho khan). D\u00f9 n\u00f3 l\u00e0 d\u1eabn xu\u1ea5t opioid, nh\u01b0ng kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au hay g\u00e2y nghi\u1ec7n. T\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ho v\u00e0 \u1ee9c ch\u1ebf h\u00f4 h\u1ea5p t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi codein \u1edf ng\u01b0\u1eddi l\u1edbn [1].<\/p>\n Ho g\u00e2y ra do opioid:<\/strong> D\u00f9 c\u00e1c opiod \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 c\u00f3 ho\u1ea1t t\u00ednh \u1ee9c ch\u1ebf ho, nh\u01b0ng c\u00e1c opioid c\u0169ng \u0111\u01b0\u1ee3c Ho g\u00e2y ra do fentanyl:<\/strong> T\u1ea7n su\u1ea5t ghi nh\u1eadn ho g\u00e2y ra do ti\u00eam bolus IV fentanyl (2,5mcg\/kg) d\u00f9ng tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 r\u1ea5t cao, l\u00ean \u0111\u1ebfn 65%. Ho g\u00e2y ra do fentanyl g\u1ecdi l\u00e0 ho ph\u1ea3n x\u1ea1 (reflex cough) v\u00ec xu\u1ea5t hi\u1ec7n v\u00e0i gi\u00e2y sau khi ti\u00eam thu\u1ed1c v\u00e0 ch\u1ec9 k\u00e9o d\u00e0i m\u1ed9t th\u1eddi gian ng\u1eafn. \u0110a s\u1ed1 ho g\u00e2y ra b\u1edfi fentanyl l\u00e0 l\u00e0nh t\u00ednh, t\u1ef1 h\u1ebft, v\u1edbi t\u1ef7 l\u1ec7 hi\u1ebfm g\u1eb7p l\u00e0 ho co th\u1eaft v\u00e0 ho d\u1eef d\u1ed9i. \u0110\u1ec3 gi\u1ea3m t\u1ea7n su\u1ea5t ho ph\u1ea3n x\u1ea1 n\u00e0y, m\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng nh\u01b0 s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1c nhau nh\u01b0 terbutaline, clonidine, dexamethasone, lidocaine, pha lo\u00e3ng gentanyl xu\u1ed1ng 10mcg\/ml, k\u00e9o d\u00e0i th\u1eddi gian ti\u00eam. Tuy nhi\u00ean, nh\u1eefng bi\u1ec7n ph\u00e1p n\u00e0y kh\u00f4ng ph\u1ea3i lu\u00f4n hi\u1ec7u qu\u1ea3 [3,4].<\/p>\n C\u01a1 ch\u1ebf g\u00e2y ho do opioid:<\/strong> m\u1ed9t ph\u1ea3n x\u1ea1 h\u00f3a h\u1ecdc t\u1ea1i ph\u1ed5i, qua trung gian receptor s\u1ee3i C (c\u00f2n g\u1ecdi l\u00e0 receptor J) \u0111\u01b0\u1ee3c xem l\u00e0 \u0111\u00f3ng vai tr\u00f2 ch\u00ednh. C\u00e1c receptor opioid c\u00f3 m\u1eb7t \u1edf c\u01a1 tr\u01a1n kh\u00ed qu\u1ea3n, ph\u1ebf qu\u1ea3n, v\u00e0 c\u00e1c th\u00e0nh ph\u1ebf nang nh\u01b0ng kh\u00f4ng c\u00f3 t\u1ea1i c\u00e1c \u0111\u01b0\u1eddng d\u1eabn kh\u00ed nh\u1ecf. Opiod \u0111\u01b0\u1ee3c cho l\u00e0 k\u00edch th\u00edch c\u00e1c receptor n\u00e0y v\u00e0 g\u00e2y ho.<\/p>\n D\u00f9 c\u00e1c opiod \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 c\u00f3 ho\u1ea1t t\u00ednh \u1ee9c ch\u1ebf ho, nh\u01b0ng c\u00e1c opioid c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ho. 1. Use of Codeine- and Dextromethorphan-Containing Committee on Drugs. Cough Remedies in Children. Pediatrics. June 1997, VOLUME 99 \/ ISSUE 6. D\u01b0\u1ee3c s\u0129 Ph\u1ea1m Kim Ng\u00e2n, Ti\u1ebfn S\u0129 – D\u01b0\u1ee3c S\u0129 V\u00f5 Th\u1ecb H\u00e0<\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" C\u00c2U H\u1eceI: T\u1ea1i sao \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n khi s\u1eed d\u1ee5ng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ho l\u00e0 Dextromethorphan l\u1ea1i g\u00e2y ho ? TR\u1ea2 L\u1edcI: Dextromethorphan l\u00e0 d\u1eabn xu\u1ea5t thu\u1ed9c nh\u00f3m opioid c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ho, th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng tr\u1ecb ho do c\u1ea3m l\u1ea1nh th\u00f4ng th\u01b0\u1eddng, ho kh\u00f4ng c\u00f3 \u0111\u1eddm (ho khan). D\u00f9 n\u00f3 […]\n","protected":false},"author":1,"featured_media":3230,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3229","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\/3229","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=3229"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/3229\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/3230"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=3229"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=3229"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=3229"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}TR\u1ea2 L\u1edcI:<\/h2>\n
\nghi nh\u1eadn l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ho. Tr\u00ean trang www.vigiaccess.org<\/a> (c\u00f4ng c\u1ee5 tra c\u1ee9u d\u1eef li\u1ec7u b\u00e1o c\u00e1o ADR c\u1ee7a WHO)
\n[2], s\u1ed1 ca ghi nh\u1eadn c\u1ee7a c\u00e1c opioid nh\u01b0 sau:<\/p>\n\n\n
\n Ho\u1ea1t ch\u1ea5t opiod<\/td>\n S\u1ed1 ca ghi nh\u00e2n ho do thu\u1ed1c<\/td>\n<\/tr>\n \n Dextromethorphan<\/td>\n 138<\/td>\n<\/tr>\n \n Codein<\/td>\n 61<\/td>\n<\/tr>\n \n Morphine<\/td>\n 177<\/td>\n<\/tr>\n \n Fentanyl<\/td>\n 307<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n K\u1ebft lu\u1eadn:<\/h2>\n
\nTrong \u0111\u00f3, fentanyl v\u00e0 morphine th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng ph\u00f2ng gi\u1ea3m \u0111au tr\u01b0\u1edbc ph\u1eabu thu\u1eadt ghi nh\u1eadn g\u00e2y ho ph\u1ea3n x\u1ea1 ng\u1eafn, l\u00e0nh t\u00ednh \u1edf \u0111a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. Dextromethorphan v\u00e0 codein c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn ADR l\u00e0 g\u00e2y ho, d\u00f9 s\u1ed1 ca ghi nh\u1eadn trong y v\u0103n l\u00e0 th\u1ea5p h\u01a1n morphine v\u00e0 fentanyl. C\u01a1 ch\u1ebf g\u00e2y ho do opioid \u0111\u01b0\u1ee3c cho l\u00e0 do k\u00edch th\u00edch receptor \u1edf c\u01a1 tr\u01a1n h\u00f4 h\u1ea5p.
\nHo do opiod th\u01b0\u1eddng l\u00e0 ho ph\u1ea3n x\u1ea1, xu\u1ea5t hi\u1ec7n th\u1eddi gian ng\u1eafn sau khi d\u00f9ng thu\u1ed1c v\u00e0 t\u1ef1 h\u1ebft.<\/p>\nT\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h2>\n
\n2. Theo trang www.vigiaccess.org
\n3. Ambesh SP, Singh N, Srivastava K. Fentanyl induced coughing caused life threatening airway obstruction in a patient with arteriovenous malformation of tongue and hypopharynx. Int J Anesthesiol 2009;20:1.
\n4. Mukherjee Avik et al. Pre-emptive oral dexmethorphan reduces fentanyl-induced cough as well as immediate postoperative adrenocortico-tropic hormone and growth hormone level. Journal of Aneasthesiology Clinical 5. Pharmacology. Year : 2011 | Volume: 27 | Issue Number: 4 | Page: 489-494
\nPeter L. Bailey. Possible Mechanism(s) of Opioid-induced Coughing. Anesthesiology 1 1999, Vol.90, 335.<\/p>\n