{"id":32551,"date":"2022-05-09T18:11:59","date_gmt":"2022-05-09T11:11:59","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=32551"},"modified":"2022-05-09T18:15:22","modified_gmt":"2022-05-09T11:15:22","slug":"metformin-va-paracetamol-su-menh-an-danh","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/metformin-va-paracetamol-su-menh-an-danh\/","title":{"rendered":"Metformin v\u00e0 paracetamol: s\u1ee9 m\u1ec7nh \u1ea9n danh"},"content":{"rendered":"

Nh\u00e0 thu\u1ed1c L\u01b0u V\u0103n Ho\u00e0ng<\/a> \u2013 Ch\u1ee7 \u0111\u1ec1: Metformin v\u00e0 paracetamol: s\u1ee9 m\u1ec7nh \u1ea9n danh<\/a><\/strong><\/p>\n

Ngu\u1ed3n: Ngu\u1ed3n: Ngu\u1ed3n: B\u1ed9 m\u00f4n d\u01b0\u1ee3c li\u1ec7u \u2013 \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TP HCM<\/strong><\/p>\n

Kh\u1edfi ngu\u1ed3n m\u1edd nh\u1ea1t<\/h2>\n
C\u00f3 th\u1ec3 \u0111\u00e2u \u0111\u00f3 v\u00e0o n\u0103m 1852, nh\u00e0 h\u00f3a h\u1ecdc Ph\u00e1p Charles Gerhardt \u0111\u00e3 t\u1eebng t\u1ed5ng h\u1ee3p n\u00ean paracetamol, nh\u01b0ng m\u1ed9t c\u00e1ch r\u00f5 r\u00e0ng h\u01a1n th\u00ec Harmon Northrop Morse \u0111\u00e3 th\u1ef1c hi\u1ec7n ph\u1ea3n \u1ee9ng kh\u1eed p-nitrophenol b\u1eb1ng Thi\u1ebfc v\u1edbi acid acetic t\u1ea1i \u0110\u1ea1i h\u1ecdc John Hopkins cho ra s\u1ea3n ph\u1ea9m paracetamol v\u00e0o 1877. Trong d\u00f2ng \u0111\u1eddi l\u01b0u l\u1ea1c \u0111\u00f3, m\u1ed9t d\u01b0\u1ee3c ph\u1ea9m kh\u00e1c l\u00e0 aspirin c\u0169ng b\u1eaft \u0111\u1ea7u h\u00ecnh th\u00e0nh t\u1eeb ph\u1ea3n \u1ee9ng acetyl h\u00f3a h\u1ee3p ch\u1ea5t t\u1ef1 nhi\u00ean acid salicylic v\u00e0o n\u0103m 1853.<\/p>\n
\u1ede m\u1ed9t v\u01b0\u01a1ng qu\u1ed1c d\u01b0\u1ee3c l\u00fd kh\u00e1c, v\u00e0o n\u0103m 1922, khi m\u00e0 c\u00e1c nh\u00e0 khoa h\u1ecdc c\u00f2n \u0111ang m\u1ea3i m\u00ea t\u00ecm c\u00e1ch chi\u1ebft xu\u1ea5t v\u00e0 tinh ch\u1ebf insulin t\u1eeb h\u00f2n \u0111\u1ea3o Langerhan th\u00ec Emil Werner v\u00e0 James Bell trong l\u00fac t\u1ed5ng h\u1ee3p N,N-dimethylguanidin \u0111\u00e3 t\u00ecnh c\u1edd t\u1ea1o ra metformin, k\u1ebft qu\u1ea3 c\u1ee7a ph\u1ea3n \u1ee9ng gi\u1eefa dimethylamin hydrochlorid v\u1edbi 2-cyanoguanidin. Metformin thu\u1ed9c v\u00e0o nh\u00f3m t\u01b0\u01a1ng t\u1ef1 h\u1ee3p ch\u1ea5t t\u1ef1 nhi\u00ean guanidin v\u00e0 galegin ph\u00e2n l\u1eadp t\u1eeb lo\u00e0i goat\u2019s rue (Galega officinalis).<\/p>\n
Ch\u00ednh x\u00e1c th\u00ec goat\u2019s rue l\u00e0 g\u00ec<\/h2>\n
\u0110\u1ec3 hi\u1ec3u goat\u2019s rue<\/strong> l\u00e0 g\u00ec, tr\u01b0\u1edbc ti\u00ean ph\u1ea3i t\u00ecm hi\u1ec3u v\u1ec1 rue. Rue l\u00e0 m\u1ed9t t\u1eeb c\u1ed5 d\u00f9ng \u0111\u1ec3 ch\u1ec9 s\u1ef1 h\u1ed1i c\u1ea3i, do \u0111\u00f3 \u0111\u01b0\u1ee3c \u0111\u1eb7t t\u00ean cho lo\u00e0i c\u00e2y \u0111\u01b0\u1ee3c m\u1ec7nh danh \u201cth\u1ea3o m\u1ed9c tr\u1eddi ban\u201d herb-of-grace Ruta graveolens, thu\u1ed9c h\u1ecd Rutaceae, c\u00f2n g\u1ecdi l\u00e0 c\u1eefu l\u00fd h\u01b0\u01a1ng. B\u1ea3n th\u00e2n h\u00ecnh t\u01b0\u1ee3ng h\u1ed1i l\u1ed7i \u0111\u1ebfn t\u1eeb vi\u1ec7c s\u1eed d\u1ee5ng rue nh\u01b0 m\u1ed9t thu\u1ed1c gi\u1ea3i \u0111\u1ed9c. V\u00e0o th\u1eddi La M\u00e3 c\u1ed5 \u0111\u1ea1i, hai nh\u00e0 t\u1ef1 nhi\u00ean h\u1ecdc Pedanius Dioscorides v\u00e0 Pliny the Elder \u0111\u00e3 khuy\u00ean d\u00f9ng rue k\u1ebft h\u1ee3p v\u1edbi tr\u00fac \u0111\u00e0o \u0111\u1ec3 gi\u1ea3i \u0111\u1ed9c r\u1eafn c\u1eafn. M\u1ed9t t\u00ean g\u1ecdi kh\u00e1c \u1edf Trung Hoa l\u00e0 v\u00e2n h\u01b0\u01a1ng, v\u00e2n c\u00f3 ngh\u0129a l\u00e0 gieo, r\u1eafc, c\u00f3 l\u1ebd l\u1ea5y h\u00ecnh t\u01b0\u1ee3ng t\u1eeb vi\u1ec7c d\u00f9ng c\u00e0nh c\u00e2y n\u00e0y nh\u00fang v\u00e0o ch\u00e9n Th\u00e1nh trong nghi l\u1ec5 c\u1ee7a C\u00f4ng gi\u00e1o, n\u00ean c\u00f3 t\u00ean herb-of-grace \u1edf ph\u01b0\u01a1ng T\u00e2y. (graveolens: h\u01b0\u01a1ng n\u1ed3ng)<\/p>\n
Th\u1ebf nh\u01b0ng goat\u2019s rue l\u1ea1i l\u00e0 m\u1ed9t ng\u00e3 r\u1ebd kh\u00e1c. Rue l\u00e0 c\u1eefu l\u00fd h\u01b0\u01a1ng, n\u00ean goat\u2019s rue l\u00e0 d\u01b0\u01a1ng c\u1eefu l\u00fd, Galega officinalis. Thu\u1ed9c h\u1ecd Fabaceae, vi\u1ec7c mang \u201cgoat\u201d hay \u201cgalega\u201d v\u00e0o t\u00ean g\u1ecdi xu\u1ea5t ph\u00e1t t\u1eeb ni\u1ec1m tin d\u00e2n gian ph\u01b0\u01a1ng T\u00e2y r\u1eb1ng d\u01b0\u01a1ng c\u1eefu l\u00fd c\u00f3 kh\u1ea3 n\u0103ng t\u0103ng t\u1ea1o s\u1eefa \u1edf v\u1eadt nu\u00f4i. D\u01b0\u01a1ng c\u1eefu l\u00fd, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1eed \u0111inh h\u01b0\u01a1ng Ph\u00e1p, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t th\u1ea3o d\u01b0\u1ee3c trong y h\u1ecdc d\u00e2n gian ch\u00e2u u th\u1eddi Trung c\u1ed5 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh d\u1ecbch h\u1ea1ch, giun v\u00e0 r\u1eafn c\u1eafn. D\u01b0\u01a1ng c\u1eefu l\u00fd c\u0169ng t\u1eebng \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp trong v\u0103n b\u1ea3n gi\u1ea5y c\u00f3i Ebers tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng k\u1ebft h\u1ee3p v\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n.<\/p>\n
Th\u1eed nghi\u1ec7m ban \u0111\u1ea7u<\/h2>\n
M\u00e3i 10 n\u0103m sau ph\u1ea3n \u1ee9ng t\u1ed5ng h\u1ee3p t\u1ea1i \u0110\u1ea1i h\u1ecdc John Hopkins, paracetamol m\u1edbi \u0111\u01b0\u1ee3c mang \u0111i th\u1eed t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t v\u00e0o n\u0103m 1887, c\u00f9ng ng\u01b0\u1eddi anh em phenacetin. V\u00e0o n\u0103m 1893, nh\u00e0 d\u01b0\u1ee3c l\u00fd h\u1ecdc l\u00e2m s\u00e0ng Joseph von Mering c\u00f4ng b\u1ed1 k\u1ebft qu\u1ea3 th\u1eed nghi\u1ec7m v\u1edbi nh\u1eadn \u0111\u1ecbnh paracetamol c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y methemoglobin h\u01a1n phenacetin ch\u00fat \u0111\u1ec9nh. Do \u0111\u00f3, phenacetin \u0111\u01b0\u1ee3c mang \u0111i ph\u00e1t tri\u1ec3n. \u0110\u1ed3ng th\u1eddi, anh c\u1ea3 trong nh\u00f3m l\u00e0 acetanilid c\u0169ng b\u1ecb ng\u01b0ng s\u1eed d\u1ee5ng b\u1edfi t\u00e1c d\u1ee5ng ph\u1ee5 t\u00edm t\u00e1i do methemoglobin v\u00e0 \u0111\u1ed9c tr\u00ean gan, th\u1eadn.<\/p>\n
V\u1edbi s\u1ed1 ph\u1eadn kh\u00f4ng kh\u00e1c m\u1ea5y, sau khi th\u1eed nghi\u1ec7m t\u00e1c d\u1ee5ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft tr\u00ean th\u1ecf v\u00e0o n\u0103m 1929 b\u1edfi Slotta v\u00e0 Tschesche, metformin h\u1ea7u nh\u01b0 b\u1ecb l\u00e3ng qu\u00ean b\u1edfi c\u00e1c \u0111\u00e0n anh synthalin trong nh\u00f3m, v\u00e0 b\u1ea3n th\u00e2n nh\u1eefng anh ch\u00e0ng n\u00e0y c\u0169ng b\u1ecb c\u00e1i b\u00f3ng qu\u00e1 l\u1edbn c\u1ee7a insulin v\u00e0o th\u1eddi \u0111i\u1ec3m \u0111\u00f3 che l\u1ea5p; m\u1eb7c d\u00f9 k\u1ebft qu\u1ea3 cho th\u1ea5y metformin \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00e1c \u0111\u1ed9ng cao nh\u1ea5t trong nh\u00f3m h\u1ee3p ch\u1ea5t c\u00f3 c\u1ea5u tr\u00fac t\u01b0\u01a1ng t\u1ef1 guanidin.<\/p>\n
T\u00e1i xu\u1ea5t<\/h2>\n
Nhi\u1ec1u n\u0103m v\u1ec1 sau, \u0111\u1ed9 ch\u1eebng 1950, b\u00e1c s\u0129 ng\u01b0\u1eddi Philippine Eusebio Y. Garcia, kh\u00f4ng hi\u1ec3u do c\u01a1 duy\u00ean g\u00ec, mang metformin, d\u01b0\u1edbi c\u00e1i t\u00ean Fluamine, \u0111i ch\u1eefa\u2026c\u00fam, nh\u01b0ng l\u1ea1i k\u1ebft lu\u1eadn r\u1eb1ng “c\u00f3 kh\u1ea3 n\u0103ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft xu\u1ed1ng gi\u1edbi h\u1ea1n sinh l\u00fd t\u1ed1i thi\u1ec3u” v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 \u201ckh\u00f4ng \u0111\u1ed9c\u201d. Trong c\u00f9ng n\u0103m, m\u1ed9t s\u1ed1 c\u00f4ng tr\u00ecnh kh\u00e1c cho r\u1eb1ng metformin kh\u00f4ng g\u00e2y h\u1ea1 huy\u1ebft \u00e1p v\u00e0 nh\u1ecbp tim tr\u00ean \u0111\u1ed9ng v\u1eadt. \u1ede m\u1ed9t g\u00f3c ch\u00e2n tr\u1eddi kh\u00e1c, nh\u00e0 nghi\u00ean c\u1ee9u b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng ng\u01b0\u1eddi Ph\u00e1p Jean Sterne, t\u1eebng l\u00e0m vi\u1ec7c v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa metformin v\u1edbi galegin v\u00e0 sau \u0111\u00f3 tr\u00ean synthalin, \u0111\u01b0\u1ee3c th\u00fac \u0111\u1ea9y b\u1edfi k\u1ebft qu\u1ea3 c\u1ee7a Garcia, \u0111\u00e3 m\u1ed9t l\u1ea7n n\u1eefa t\u1eadp trung v\u00e0o metformin. Sterne l\u00e0 ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean th\u1eed nghi\u1ec7m t\u00e1c d\u1ee5ng tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng c\u1ee7a metformin tr\u00ean ng\u01b0\u1eddi, v\u00e0 \u0111\u1eb7t t\u00ean cho h\u1ee3p ch\u1ea5t n\u00e0y l\u00e0 K\u1ebb x\u01a1i glucose \u2013 Glucophage. \u0110\u00f3 l\u00e0 n\u0103m 1957.<\/p>\n
Th\u1ef1c ra, metformin c\u00f9ng v\u1edbi c\u00e1c anh em trong nh\u00e0 biguanid kh\u00e1 \u0111\u01b0\u1ee3c quan t\u00e2m trong kh\u1ea3 n\u0103ng di\u1ec7t khu\u1ea9n, kh\u00e1ng k\u00fd sinh tr\u00f9ng (s\u1ed1t r\u00e9t) v\u00e0 virus. D\u1eabn ch\u1ea5t clorhexidin c\u1ee7a nh\u00f3m hi\u1ec7n nay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m ch\u1ea5t s\u00e1t tr\u00f9ng.<\/p>\n
Paracetamol th\u1eadm ch\u00ed c\u00f2n ph\u1ea3i \u0111\u1ee3i l\u00e2u h\u01a1n, su\u1ed1t n\u1eeda th\u1ebf k\u1ef7 h\u1ea7u nh\u01b0 ch\u1eb3ng m\u1ea5y nh\u00e0 khoa h\u1ecdc th\u1eafc m\u1eafc v\u1ec1 k\u1ebft qu\u1ea3 c\u1ee7a von Mering, m\u1ed9t ph\u1ea7n c\u0169ng do \u1ea3nh h\u01b0\u1edfng qu\u00e1 l\u1edbn c\u1ee7a aspirin hay ng\u01b0\u1eddi anh em phenacetin. M\u00e3i cho \u0111\u1ebfn 1947, \u1edf b\u00e1n c\u1ea7u b\u00ean kia t\u1ea1i Hoa K\u1ef3, David Lester v\u00e0 Leon Greenberg t\u00ecm th\u1ea5y r\u1eb1ng paracetamol ch\u00ednh l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a acetanilid tr\u00ean ng\u01b0\u1eddi; v\u00e0 m\u1ed9t th\u00ed nghi\u1ec7m kh\u00e1c s\u1eed d\u1ee5ng li\u1ec1u cao paracetamol tr\u00ean chu\u1ed9t albino kh\u00f4ng g\u00e2y methomoglobin. N\u0103m sau, Bernard Brodie, Julius Axelrod v\u00e0 Frederick Flinn x\u00e1c nh\u1eadn k\u1ebft qu\u1ea3 n\u00f3i tr\u00ean, k\u00e8m nh\u1eadn \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 gi\u1ea3m \u0111au c\u1ee7a paracetamol t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nh\u01b0 ti\u1ec1n ch\u1ea5t acetanilid. N\u0103m sau, 1949, Brodie v\u00e0 Axelrod x\u00e1c \u0111\u1ecbnh phenacetin c\u0169ng chuy\u1ec3n h\u00f3a th\u00e0nh paracetamol trong c\u01a1 th\u1ec3.<\/p>\n
V\u00e0o n\u0103m 1950, Hoa K\u1ef3 cho ph\u00e9p s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p b\u1ed9 ba paracetamol, aspirin, cafein, mang t\u00ean Triagesic. M\u1ed9t s\u1ed1 b\u00e1o c\u00e1o n\u0103m 1951 ghi nh\u1eadn 3 ca gi\u1ea3m b\u1ea1ch c\u1ea7u h\u1ea1t khi s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y, v\u00e0 m\u1ea5t kh\u00e1 nhi\u1ec1u n\u0103m v\u1ec1 sau \u0111\u1ec3 ch\u1ee9ng minh kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean quan. Ban \u0111\u1ea7u, \u0111\u01a1n tr\u1ecb li\u1ec7u paracetamol ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn d\u01b0\u1edbi d\u1ea1ng thu\u1ed1c k\u00ea \u0111\u01a1n, nh\u01b0ng vi\u1ec7c phenacetin g\u00e2y \u0111\u1ed9c gan, th\u1eadn hay aspirin g\u00e2y lo\u00e9t ti\u00eau h\u00f3a \u0111\u00e3 \u0111\u01b0a paracetamol tr\u1edf th\u00e0nh thu\u1ed1c gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t ph\u1ed5 bi\u1ebfn h\u00e0ng \u0111\u1ea7u c\u1ee7a nh\u00e2n lo\u1ea1i.<\/p>\n
T\u01b0\u01a1ng t\u1ef1, metformin ch\u1ec9 th\u1eadt s\u1ef1 ph\u1ed5 bi\u1ebfn khi nh\u1eefng ng\u01b0\u1eddi anh em phenformin v\u00e0 buformin b\u1ecb r\u00fat kh\u1ecfi th\u1ecb tr\u01b0\u1eddng b\u1edfi t\u00e1c d\u1ee5ng ph\u1ee5 nhi\u1ec5m toan lactic. Metformin \u0111\u01b0\u1ee3c ph\u00e9p s\u1eed d\u1ee5ng \u1edf Canada v\u00e0o n\u0103m 1972 nh\u01b0ng m\u00e3i cho \u0111\u1ebfn 1994 m\u1edbi \u0111\u01b0\u1ee3c Hoa K\u1ef3 ch\u1ea5p thu\u1eadn.<\/p>\n
C\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng<\/h2>\n
Cho \u0111\u1ebfn nay, c\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng c\u1ee7a c\u1ea3 metformin v\u00e0 paracetamol v\u1eabn ch\u01b0a th\u1eadt s\u1ef1 \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5. Metformin thu\u1ed9c c\u00f9ng nh\u00f3m v\u1edbi phenformin v\u00e0 buformin nh\u01b0ng h\u1ea7u nh\u01b0 kh\u00f4ng g\u00e2y nhi\u1ec5m toan lactic \u0111\u00e1ng k\u1ec3 nh\u01b0 hai ng\u01b0\u1eddi anh em. Ng\u01b0\u1eddi ta c\u0169ng m\u1ea5t m\u1ed9t qu\u00e1 tr\u00ecnh d\u00e0i \u0111\u1ec3 bi\u1ebft paracetamol m\u1edbi ch\u00ednh l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a acetanilid v\u00e0 phenacetin, d\u00f9 tr\u01b0\u1edbc \u0111\u00f3 t\u1eebng ghi nh\u1eadn paracetamol trong n\u01b0\u1edbc ti\u1ec3u c\u1ee7a ng\u01b0\u1eddi d\u00f9ng phenacetin. Paracetamol ch\u00ednh l\u00e0 \u0111\u1ea1i di\u1ec7n c\u00f2n s\u00f3t l\u1ea1i duy nh\u1ea5t trong nh\u00f3m, \u0111\u1ee9ng t\u00e1ch kh\u1ecfi nh\u1eefng NSAID kh\u00e1c v\u00ec kh\u00f4ng c\u00f3 t\u00ednh kh\u00e1ng vi\u00eam.<\/p>\n
\u0110\u1ed9c t\u00ednh \u0111\u1ebfn t\u1eeb \u0111\u00e2u?<\/h2>\n
Gi\u1ed1ng nh\u01b0 c\u00e2u n\u00f3i c\u1ee7a D\u01b0\u1ee3c s\u01b0 Paracelsus \u201cAlle Dinge sind Gift, und nichts ist ohne Gift, allein die Dosis macht dass ein Ding kein Gift ist.\u201d
\n\u201cAll things are poison, and nothing is without poison, the dosage alone makes it so a thing is not a poison\u201d<\/p>\n
Li\u1ec1u l\u01b0\u1ee3ng t\u1ea1o ra \u0111\u1ed9c t\u00ednh<\/a>. U\u1ed1ng 4 l\u00edt n\u01b0\u1edbc l\u1ecdc m\u1ed9t ng\u00e0y c\u0169ng l\u00e0 qu\u00e1 s\u1ee9c v\u1edbi c\u01a1 th\u1ec3. Kh\u00f4ng c\u00f3 thu\u1ed1c n\u00e0o l\u00e0 ho\u00e0n to\u00e0n \u201cl\u00e0nh t\u00ednh\u201d, k\u1ec3 c\u1ea3 metformin hay paracetamol. Tuy nhi\u00ean, v\u00ec l\u00fd do mang b\u1ec7nh m\u00e0 ph\u1ea3i s\u1eed d\u1ee5ng, c\u00f3 khi c\u1ea5p t\u00ednh c\u00f3 khi l\u00e2u d\u00e0i, vi\u1ec7c l\u00e0m c\u1ee7a c\u00e1c nh\u00e0 khoa h\u1ecdc l\u00e0 h\u1ea1n ch\u1ebf h\u1ebft m\u1ee9c c\u00f3 th\u1ec3 \u0111\u1ed9c t\u00ednh cho ng\u01b0\u1eddi s\u1eed d\u1ee5ng \u1edf li\u1ec1u \u0111i\u1ec1u tr\u1ecb, hay n\u00f3i m\u1ed9t c\u00e1ch y h\u1ecdc l\u00e0 \u201cc\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1\u201d. Hai v\u1ecb th\u1ea7n gi\u1ea3i \u0111\u1ed9c gan, th\u1eadn th\u01b0\u1eddng s\u1ebd l\u00e0 n\u01a1i \u0111\u00f3n nh\u1eadn c\u00e1c h\u1eadu qu\u1ea3 (n\u1ebfu c\u00f3) n\u00e0y. Th\u00ed nghi\u1ec7m c\u1ee7a von Mering sau n\u00e0y \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch r\u1eb1ng paracetamol m\u00e0 \u00f4ng s\u1eed d\u1ee5ng c\u00f3 l\u1eabn t\u1ea1p ch\u1ea5t 4-aminophenol, s\u1ea3n ph\u1ea9m trung gian, \u201cbuilding block\u201d c\u1ee7a quy tr\u00ecnh t\u1ed5ng h\u1ee3p. C\u00f3 th\u1ec3 ch\u00ednh t\u1ea1p ch\u1ea5t n\u00e0y \u0111\u00e3 g\u00e2y hi\u1ec7n t\u01b0\u1ee3ng methemoglobin trong th\u1eed nghi\u1ec7m. \u0110\u1ed9c t\u00ednh c\u1ee7a acetanilid l\u1ea1i c\u00f3 th\u1ec3 do b\u1ecb th\u1ee7y ph\u00e2n th\u00e0nh anilin. Ri\u00eang v\u1edbi metformin, ch\u00ednh nh\u00e1nh b\u00ean dimethylamin g\u1ecdn g\u00e0ng h\u01a1n v\u1ec1 sau l\u1ea1i t\u00ecnh c\u1edd tr\u1edf th\u00e0nh m\u1ed9t nguy c\u01a1 kh\u00e1c.<\/p>\n
B\u1eb1ng m\u1ed9t suy ngh\u0129 k\u1ef3 l\u1ea1 n\u00e0o \u0111\u00f3, m\u1eb7c d\u00f9 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 thu\u1ed1c h\u00f3a d\u01b0\u1ee3c, phenformin \u0111\u00e3 s\u1ed1ng l\u1ea1i d\u01b0\u1edbi h\u00ecnh h\u00e0i m\u1edbi: ch\u1ebf ph\u1ea9m \u0111\u00f4ng d\u01b0\u1ee3c. M\u1ed9t s\u1ed1 s\u1ea3n ph\u1ea9m v\u1edbi th\u00e0nh ph\u1ea7n c\u00f4ng b\u1ed1 to\u00e0n d\u01b0\u1ee3c li\u1ec7u, kh\u00f4ng r\u00f5 xu\u1ea5t x\u1ee9 t\u1eeb \u0111\u00e2u, b\u1ecb ph\u00e1t hi\u1ec7n ch\u1ee9a phenformin. C\u00f3 th\u1ec3, c\u00e1c \u201cchuy\u00ean gia gian l\u1eadn\u201d \u0111ang mu\u1ed1n tr\u00e1nh kh\u1ecfi ph\u00e9p th\u1eed s\u1eafc k\u00fd c\u1ee7a c\u00e1c ph\u00f2ng ki\u1ec3m nghi\u1ec7m, v\u1edbi chi\u1ebfn l\u01b0\u1ee3c r\u1eb1ng phenformin s\u1ebd kh\u00f4ng c\u00f3 trong ph\u01b0\u01a1ng \u00e1n t\u00ecm ki\u1ebfm ch\u1ea5t ng\u1ee5y t\u1ea1o.<\/p>\n
T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/h2>\n
Jiben Roy (2011), \u201cThe top five most common or long-selling drugs\u201d, An Introduction to Pharmaceutical Sciences Production, Chemistry, Techniques and Technology, 231-296.<\/p>\n
Morse, H. N. (1878), “Ueber eine neue Darstellungsmethode der Acetylamidophenole” [On a new method of preparing acetylamidophenol], Berichte der deutschen chemischen Gesellschaft, 11(1), 232\u2013233.<\/p>\n
Campbell IW, (2007), “Metformin \u2013 life begins at 50: A symposium held on the occasion of the 43rd Annual Meeting of the European Association for the Study of Diabetes, Amsterdam, The Netherlands, September 2007”, The British Journal of Diabetes & Vascular Disease, 7(5), 247\u201352.<\/p>\n
Bailey, Cliff, (2017), \u201cMetformin: historical overview\u201d, Diabetologi, 60.
\nWerner E, Bell J (1922), “The preparation of methylguanidine, and of \u03b2\u03b2-dimethylguanidine by the interaction of dicyandiamide, and methylammonium and dimethylammonium chlorides respectively”, J. Chem. Soc., Trans., 121, 1790\u201395.<\/p>\n
Bailey, C. J., & Day, C. (1989), \u201cTraditional plant medicines as treatments for diabetes\u201d, Diabetes care, 12(, 553\u2013564.DR Hadden (2005), \u201cGoat’s rue \u2013 French lilac \u2013 Italian fitch \u2013 Spanish sainfoin: gallega officinalis and metformin: The Edinburgh connection\u201d, J R Coll Physicians Edinb, 35, 258\u2013260.<\/p>\n","protected":false},"excerpt":{"rendered":"
Nh\u00e0 thu\u1ed1c L\u01b0u V\u0103n Ho\u00e0ng \u2013 Ch\u1ee7 \u0111\u1ec1: Metformin v\u00e0 paracetamol: s\u1ee9 m\u1ec7nh \u1ea9n danh Ngu\u1ed3n: Ngu\u1ed3n: Ngu\u1ed3n: B\u1ed9 m\u00f4n d\u01b0\u1ee3c li\u1ec7u \u2013 \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TP HCM Kh\u1edfi ngu\u1ed3n m\u1edd nh\u1ea1t C\u00f3 th\u1ec3 \u0111\u00e2u \u0111\u00f3 v\u00e0o n\u0103m 1852, nh\u00e0 h\u00f3a h\u1ecdc Ph\u00e1p Charles Gerhardt \u0111\u00e3 t\u1eebng t\u1ed5ng h\u1ee3p n\u00ean paracetamol, nh\u01b0ng m\u1ed9t c\u00e1ch […]\n","protected":false},"author":1,"featured_media":32563,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-32551","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\/32551","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=32551"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/32551\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/32563"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=32551"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=32551"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=32551"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}