{"id":4095,"date":"2019-03-09T09:33:21","date_gmt":"2019-03-09T02:33:21","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=4095"},"modified":"2019-03-09T09:33:21","modified_gmt":"2019-03-09T02:33:21","slug":"case-lam-sang-lua-chon-thuoc-dieu-tri-tang-huyet-ap","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/case-lam-sang-lua-chon-thuoc-dieu-tri-tang-huyet-ap\/","title":{"rendered":"[Case l\u00e2m s\u00e0ng] L\u1ef1a ch\u1ecdn thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p"},"content":{"rendered":"<h2>Ca l\u00e2m s\u00e0ng<\/h2>\n<p>B\u1ec7nh nh\u00e2n nam, 62 tu\u1ed5i, c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh m\u1ea1ch v\u00e0nh v\u00e0 t\u0103ng huy\u1ebft \u00e1p, \u0111\u1ebfn ki\u1ec3m tra l\u1ea1i huy\u1ebft \u00e1p. Huy\u1ebft \u00e1p hi\u1ec7n \u0111o \u0111\u01b0\u1ee3c l\u00e0 156\/82 mmHg. C\u00e1ch \u0111\u00f3 v\u00e0i tu\u1ea7n b\u1ec7nh nh\u00e2n b\u1eaft \u0111\u1ea7u d\u00f9ng hydrochlorothiazide li\u1ec1u 25 mg\/ng\u00e0y. C\u00e1c thu\u1ed1c ph\u1ed1i h\u1ee3p bao g\u1ed3m aspirin 81 mg\/ng\u00e0y, carvedilol 25 mg 2 l\u1ea7n\/ng\u00e0y v\u00e0 simvastatin 40 mg\/ng\u00e0y. Ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 n\u1ed3ng \u0111\u1ed9 kali m\u00e1u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n<h3>Thu\u1ed1c n\u00e0o sau \u0111\u00e2y c\u00f3 th\u1ec3 th\u00eam v\u00e0o ph\u00e1c \u0111\u1ed3 hi\u1ec7n t\u1ea1i c\u1ee7a b\u1ec7nh nh\u00e2n?<\/h3>\n<p>A. Verapamil<br \/>\nB. Ramipril<br \/>\nC. Doxazosin<br \/>\nD. Amlodipine<br \/>\nE. Diltiazem<\/p>\n<h2>\u0110\u00e1p \u00e1n: B.<\/h2>\n<p>\u0110i\u1ec3m m\u1ea5u ch\u1ed1t: Gi\u1edbi h\u1ea1n li\u1ec1u d\u00f9ng t\u1ed1i \u0111a h\u00e0ng ng\u00e0y c\u1ee7a simvastatin khi d\u00f9ng c\u00f9ng c\u00e1c thu\u1ed1c nh\u01b0 verapamil hay diltiazem l\u00e0 10 mg.<\/p>\n<h3>Gi\u1ea3i th\u00edch chi ti\u1ebft:<\/h3>\n<p>Simvastatin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 b\u1ec7nh l\u00ed c\u01a1, v\u00e0 m\u1ed9t s\u1ed1 thu\u1ed1c d\u00f9ng ph\u1ed1i h\u1ee3p c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a simvastatin. C\u00e1c thu\u1ed1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n d\u00f9ng simvastatin bao g\u1ed3m ketoconazole, erythromycin, c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf protease, gemfibrozil, cyclosporine v\u00e0 danazol. Verapamil, diltiazem, amiodarone v\u00e0 dronedarone ch\u1ec9 c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng khi li\u1ec1u d\u00f9ng simvastatin kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 10 mg. Amlodipine c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p khi li\u1ec1u simvastatin kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 20 mg. Ramipril c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p khi li\u1ec1u simvastatin \u0111\u1ea1t \u0111\u1ebfn 40 mg.<\/p>\n<p>Kh\u00f4ng khuy\u1ebfn c\u00e1o c\u00e1c thu\u1ed1c ch\u1eb9n alpha giao c\u1ea3m nh\u01b0 doxazosin \u0111\u1ec3 s\u1eed d\u1ee5ng l\u00e0m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p h\u00e0ng th\u1ee9 2 do c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 gia t\u0103ng t\u1ec9 l\u1ec7 bi\u1ebfn c\u1ed1 tim m\u1ea1ch.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p>1. David WS et al. Case records of the Massachusetts General Hospital. Case 7-2012. A 79-year-old man with pain and weakness in the legs. N Engl J Med 2012 Mar 9; 366:944.<\/p>\n<p>2. Rowan C et al. Rhabdomyolysis reports show interaction between simvastatin and CYP3A4 inhibitors. Pharmacoepidemiol Drug Saf 2009 Feb 12; 18:301.<\/p>\n<p>3. Merck Sharp &amp; Dohme LTD. Highlights of prescribing information: Zocor (simvastatin) Tablets. Revised: 2\/2018\u00a0<a href=\"https:\/\/www.merck.com\/product\/usa\/pi_circulars\/z\/zocor\/zocor_pi.pdf?fbclid=IwAR0PYLl0jBmkEkZwxP6dFMfe0yd71M4iDpb5yV7VSmcSI-lMnjfDB154Vv4\" rel=\"noopener\">https:\/\/www.merck.com\/product\/usa\/pi_circulars\/z\/zocor\/zocor_pi.pdf?fbclid=IwAR0PYLl0jBmkEkZwxP6dFMfe0yd71M4iDpb5yV7VSmcSI-lMnjfDB154Vv4<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ca l\u00e2m s\u00e0ng B\u1ec7nh nh\u00e2n nam, 62 tu\u1ed5i, c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh m\u1ea1ch v\u00e0nh v\u00e0 t\u0103ng huy\u1ebft \u00e1p, \u0111\u1ebfn ki\u1ec3m tra l\u1ea1i huy\u1ebft \u00e1p. Huy\u1ebft \u00e1p hi\u1ec7n \u0111o \u0111\u01b0\u1ee3c l\u00e0 156\/82 mmHg. C\u00e1ch \u0111\u00f3 v\u00e0i tu\u1ea7n b\u1ec7nh nh\u00e2n b\u1eaft \u0111\u1ea7u d\u00f9ng hydrochlorothiazide li\u1ec1u 25 mg\/ng\u00e0y. C\u00e1c thu\u1ed1c ph\u1ed1i h\u1ee3p bao g\u1ed3m aspirin 81 mg\/ng\u00e0y, carvedilol [&#8230;]\n","protected":false},"author":1,"featured_media":4096,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4095","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\/4095","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=4095"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/4095\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/4096"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=4095"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=4095"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=4095"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}