{"id":4589,"date":"2019-03-13T12:58:12","date_gmt":"2019-03-13T05:58:12","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=4589"},"modified":"2019-03-15T12:58:48","modified_gmt":"2019-03-15T05:58:48","slug":"canh-bao-nguy-co-phinh-va-boc-tach-dong-mach-chu-khi-su-dung-khang-sinh-nhom-flouroquinolon","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/canh-bao-nguy-co-phinh-va-boc-tach-dong-mach-chu-khi-su-dung-khang-sinh-nhom-flouroquinolon\/","title":{"rendered":"C\u1ea3nh b\u00e1o nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 khi s\u1eed d\u1ee5ng kh\u00e1ng sinh nh\u00f3m Flouroquinolon."},"content":{"rendered":"<h2>HSA c\u1ea3nh b\u00e1o c\u00e1c c\u00e1n b\u1ed9 y t\u1ebf v\u1ec1<a href=\"https:\/\/www.vnras.com\/drug\/2019\/03\/canh-bao-nguy-co-phinh-va-boc-tach-dong-mach-chu-khi-su-dung-khang-sinh-nhom-flouroquinolon.html\"> nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 khi s\u1eed d\u1ee5ng fluoroquinolon<\/a> t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n.<\/h2>\n<p>Nguy c\u01a1 hi\u1ebfm g\u1eb7p n\u00e0y \u0111\u01b0\u1ee3c C\u01a1 quan D\u01b0\u1ee3c ph\u1ea9m Ch\u00e2u \u00c2u (EMA) v\u00e0 C\u01a1 quan Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 (FDA) khuy\u1ebfn c\u00e1o sau khi xem x\u00e9t c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u1edf b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng<strong> fluoroquinolones<\/strong> v\u00e0 d\u1eef li\u1ec7u t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 phi l\u00e2m s\u00e0ng trong \u0111\u00f3 \u0111\u00e3 cho th\u1ea5y<strong> t\u0103ng nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng fluoroquinolones t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n<\/strong>. Nguy c\u01a1 n\u00e0y t\u0103ng cao h\u01a1n \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch, x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch, t\u0103ng huy\u1ebft \u00e1p v\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n<p>Fluoroquinolones l\u00e0 m\u1ed9t nh\u00f3m kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng g\u00e2y c\u1ea3n tr\u1edf qu\u00e1 tr\u00ecnh sao ch\u00e9p DNA c\u1ee7a vi khu\u1ea9n v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea9n b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a DNA gyrase v\u00e0 topoisomerase. C\u00f3 b\u1ea3y fluoroquinolone \u0111\u01b0\u1eddng d\u00f9ng to\u00e0n th\u00e2n \u0111\u01b0\u1ee3c \u0111\u0103ng k\u00fd l\u01b0u h\u00e0nh t\u1ea1i n\u01b0\u1edbc n\u00e0y, \u0111\u00f3 l\u00e0 ciprofloxacin, ofloxacin, norfloxacin, lomefloxacin, levofloxacin, moxifloxacin v\u00e0 pefloxacin.<\/p>\n<h2>Th\u00f4ng tin v\u1ec1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h2>\n<p>Ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ef1 gi\u00e3n n\u1edf c\u1ee5c b\u1ed9 ho\u1eb7c khu\u1ebfch t\u00e1n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, trong khi b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 x\u1ea3y ra khi c\u00f3 s\u1ef1 ph\u00e2n t\u00e1ch c\u1ee7a c\u00e1c l\u1edbp trong th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. C\u00e1c b\u1ec7nh n\u00e0y c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 thay \u0111\u1ed5i v\u1ec1 h\u00e0m l\u01b0\u1ee3ng, n\u1ed3ng \u0111\u1ed9 v\u00e0 c\u1ea5u tr\u00fac collagen. Do g\u00e2n Achilles v\u00e0 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ph\u1ea7n l\u1edbn \u0111\u1ec1u c\u1ea5u t\u1ea1o t\u1eeb c\u00e1c lo\u1ea1i collagen gi\u1ed1ng nhau, n\u00ean c\u00e1c lo\u1ea1i thu\u1ed1c g\u00e2y \u0111\u1ee9t g\u00e2n c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra ho\u1eb7c l\u00e0m n\u1eb7ng th\u00eam t\u00ecnh tr\u1ea1ng ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 th\u00f4ng qua m\u1ed9t c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u1ef1. Fluoroquinolones c\u00f3 th\u1ec3 ph\u00e1 h\u1ee7y collagen v\u00e0 m\u00f4 li\u00ean k\u1ebft d\u1ecdc theo th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1eb1ng c\u00e1ch \u0111i\u1ec1u h\u00f2a nhi\u1ec1u lo\u1ea1i metallicoproteinase v\u00e0 g\u00e2y ra s\u1ef1 tho\u00e1i h\u00f3a trong c\u00e1c t\u1ebf b\u00e0o tenocyte, d\u1eabn \u0111\u1ebfn gi\u1ea3m \u0111\u01b0\u1eddng k\u00ednh v\u00e0 s\u1ed1 l\u01b0\u1ee3ng m\u1ed9t s\u1ed1 lo\u1ea1i fibrils. Nh\u01b0 v\u1eady, ch\u00fang c\u00f3 th\u1ec3 \u0111\u00f3ng g\u00f3p s\u00e2u s\u1eafc v\u00e0o s\u1ef1 ti\u1ebfn tri\u1ec3n v\u00e0 v\u1ee1 ph\u00ecnh m\u1ea1ch m\u1eb7c d\u00f9 c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c v\u1eabn c\u00f2n \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn.<\/p>\n<p>Nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 th\u1ec3 kh\u00e1c nhau ph\u1ee5 thu\u1ed9c b\u1ec7nh nh\u00e2n, t\u1eeb 9 tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 tr\u00ean 100.000 ng\u01b0\u1eddi m\u1ed7i n\u0103m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n th\u00f4ng th\u01b0\u1eddng \u0111\u1ebfn 300 tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 tr\u00ean 100.000 ng\u01b0\u1eddi m\u1ed7i n\u0103m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 (v\u00ed d\u1ee5 : 85 tu\u1ed5i). C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y bao g\u1ed3m ti\u1ec1n s\u1eed gia \u0111\u00ecnh ho\u1eb7c b\u1ea3n th\u00e2n t\u1eebng m\u1eafc b\u1ec7nh ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch,c\u00e1c b\u1ec7nh di truy\u1ec1n (e. G. H\u1ed9i ch\u1ee9ng Marfan, h\u1ed9i ch\u1ee9ng Ehlers-Danlos m\u1ea1ch m\u00e1u), x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch, ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n<h2>K\u1ebft qu\u1ea3 t\u1eeb nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc<\/h2>\n<p>Tr\u00ean nhi\u1ec1u nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 t\u1eeb n\u0103m 2015 \u0111\u1ebfn 2018, \u0111\u00e3 c\u00f3 b\u1eb1ng ch\u1ee9ng nh\u1ea5t qu\u00e1n cho th\u1ea5y nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 t\u0103ng g\u1ea5p hai l\u1ea7n khi s\u1eed d\u1ee5ng fluoroquinolone. Tuy nhi\u00ean, c\u00e1c h\u1ea1n ch\u1ebf nghi\u00ean c\u1ee9u nh\u01b0 c\u1ee1 m\u1eabu nh\u1ecf ng\u0103n c\u1ea3n vi\u1ec7c x\u00e1c \u0111\u1ecbnh m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa nguy c\u01a1 n\u00e0y v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>\n<p>Trong m\u1ed9t nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 h\u1ed3i c\u1ee9u c\u1ee7a Pasternak \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 khi s\u1eed d\u1ee5ng fluoroquinolone \u0111\u01b0\u1eddng u\u1ed1ng so v\u1edbi s\u1eed d\u1ee5ng amoxicillin \u1edf c\u00e1c b\u1ec7nh nh\u00e2n t\u1eeb 50 tu\u1ed5i tr\u1edf l\u00ean, nh\u00f3m fluoroquinolone c\u00f3 nguy c\u01a1 t\u0103ng g\u1ea5p 1.66 l\u1ea7n ( 95%CI= 1.12-2.46) trong v\u00f2ng 60 ng\u00e0y, v\u1edbi nguy c\u01a1 gia t\u0103ng x\u1ea3y ra ch\u1ee7 y\u1ebfu trong 10 ng\u00e0y \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. M\u1ed9t nghi\u00ean c\u1ee9u t\u1ef1 ki\u1ec3m so\u00e1t kh\u00e1c c\u1ee7a Lee \u1edf b\u1ec7nh nh\u00e2n cao tu\u1ed5i (c\u00f3 \u0111\u1ed9 tu\u1ed5i trung b\u00ecnh 71 tu\u1ed5i) cho th\u1ea5y t\u0103ng nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do ph\u01a1i nhi\u1ec5m v\u1edbi fluoroquinolones (t\u1ef7 l\u1ec7 ch\u00eanh l\u1ec7ch [OR] = 2. 71; 95% CI = 1.14-6.46).<\/p>\n<h2>C\u00e1c \u0111\u1ed9ng th\u00e1i ph\u00e1p l\u00fd qu\u1ed1c t\u1ebf<\/h2>\n<h3>EMA<\/h3>\n<p>V\u00e0o th\u00e1ng 9 n\u0103m 2018, PRAC \u0111\u00e3 k\u1ebft lu\u1eadn r\u1eb1ng c\u00f3 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do s\u1eed d\u1ee5ng fluoroquinolone \u0111\u01b0\u1eddng to\u00e0n th\u00e2n v\u00e0 d\u1ea1ng h\u00edt. \u0110\u00e1nh gi\u00e1 an to\u00e0n c\u1ee7a h\u1ecd \u0111\u00e3 xem x\u00e9t b\u1eb1ng ch\u1ee9ng t\u1eeb d\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 c\u00e1c nghi\u00ean c\u1ee9u phi l\u00e2m s\u00e0ng, b\u00e1o c\u00e1o t\u1ef1 ph\u00e1t v\u00e0 ph\u1ea3n h\u1ed3i t\u1eeb c\u00e1c c\u00f4ng ty d\u01b0\u1ee3c ph\u1ea9m. PRAC sau \u0111\u00f3 \u0111\u00e3 khuy\u1ebfn ngh\u1ecb r\u1eb1ng tr\u00ean bao b\u00ec v\u00e0 t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c flouroquinolon \u0111\u01b0\u1eddng to\u00e0n th\u00e2n v\u00e0 d\u1ea1ng h\u00edt ph\u1ea3i c\u1eadp nh\u1eadt th\u00eam th\u00f4ng tin v\u1ec1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7,v\u00e0 ph\u1ea3i c\u00f3 th\u01b0 th\u00f4ng b\u00e1o t\u1edbi c\u00e1c c\u00e1n b\u1ed9 y t\u1ebf v\u1ec1 nguy c\u01a1 n\u00e0y.<\/p>\n<h3>FDA Hoa K\u1ef3<\/h3>\n<p>V\u00e0o th\u00e1ng 12 n\u0103m 2018, FDA \u0111\u00e3 ban h\u00e0nh th\u00f4ng tin an to\u00e0n thu\u1ed1c \u0111\u1ec3 c\u1ea3nh b\u00e1o v\u1ec1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do fluoroquinolones. Ngo\u00e0i c\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1, b\u00e0i \u0111\u00e1nh gi\u00e1 t\u1ed5ng quan c\u0169ng bao g\u1ed3m 56 tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o v\u1edbi FDA Hoa K\u1ef3 trong ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng fluoroquinolones t\u1eeb 2015 \u0111\u1ebfn 2018. Tuy nhi\u00ean, FDA l\u01b0u \u00fd r\u1eb1ng t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u1ec1u c\u00f3 \u00edt nh\u1ea5t m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 kh\u00f4ng th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n c\u1ee7a bi\u1ebfn c\u1ed1 n\u00e0y. D\u1ef1a tr\u00ean \u0111\u00e1nh gi\u00e1 c\u1ee7a h\u1ecd, FDA Hoa K\u1ef3 r\u1eb1ng tr\u00ean bao b\u00ec v\u00e0 t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c flouroquinolon \u0111\u01b0\u1eddng to\u00e0n th\u00e2n ph\u1ea3i c\u1eadp nh\u1eadt th\u00eam th\u00f4ng tin v\u1ec1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n<h2>T\u00ecnh h\u00ecnh t\u1ea1i Singapore v\u00e0 khuy\u1ebfn c\u00e1o c\u1ee7a HSA<\/h2>\n<p>Cho \u0111\u1ebfn nay, HSA ch\u01b0a nh\u1eadn \u0111\u01b0\u1ee3c b\u1ea5t k\u1ef3 b\u00e1o c\u00e1o n\u00e0o v\u1ec1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do fluoroquinolon. T\u1ea1i Singapore, h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng fluoroquinolone \u0111\u01b0\u1eddng to\u00e0n th\u00e2n \u0111ang \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadt th\u00eam nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n<p>C\u00e1c c\u00e1n b\u1ed9 y t\u1ebf n\u00ean xem x\u00e9t c\u00e1c th\u00f4ng tin an to\u00e0n \u1edf tr\u00ean khi k\u00ea \u0111\u01a1n fluoroquinolon,\u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, bao g\u1ed3m nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed m\u1ea1ch m\u00e1u x\u01a1 v\u1eefa ngo\u1ea1i bi\u00ean, t\u0103ng huy\u1ebft \u00e1p, m\u1ed9t s\u1ed1 r\u1ed1i lo\u1ea1n di truy\u1ec1n li\u00ean quan \u0111\u1ebfn thay \u0111\u1ed5i m\u1ea1ch m\u00e1u (nh\u01b0 h\u1ed9i ch\u1ee9ng Marfan v\u00e0 h\u1ed9i ch\u1ee9ng Ehlers-Danlos) v\u00e0 ng\u01b0\u1eddi gi\u00e0.<\/p>\n<p>C\u00e1c c\u00e1n b\u1ed9 y t\u1ebf c\u0169ng \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch t\u01b0 v\u1ea5n cho b\u1ec7nh nh\u00e2n c\u1ee7a h\u1ecd v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c li\u00ean quan \u0111\u1ebfn fluoroquinolones, ch\u1eb3ng h\u1ea1n nh\u01b0 nh\u1eefng v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn g\u00e2n, c\u01a1 v\u00e0 kh\u1edbp v\u00e0 h\u1ec7 th\u1ea7n kinh.<\/p>\n<p>Ngu\u1ed3n:\u00a0<a href=\"https:\/\/www.hsa.gov.sg\/content\/hsa\/en\/Health_Products_Regulation\/Safety_Information_and_Product_Recalls\/Product_Safety_Alerts\/2019\/fluoroquinolonesandriskofaorticaneurysmanddissection.html\" rel=\"noopener\">https:\/\/www.hsa.gov.sg\/content\/hsa\/en\/Health_Products_Regulation\/Safety_Information_and_Product_Recalls\/Product_Safety_Alerts\/2019\/fluoroquinolonesandriskofaorticaneurysmanddissection.html<\/a><\/p>\n<p>Ng\u01b0\u1eddi t\u1ed5ng h\u1ee3p: \u0110\u1ed7 Thu Thanh \u2013 Nguy\u1ec5n Ph\u01b0\u01a1ng Th\u00fay &#8211; Trung t\u00e2m C\u1ea3nh Gi\u00e1c D\u01b0\u1ee3c Qu\u1ed1c Gia.<\/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<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>HSA c\u1ea3nh b\u00e1o c\u00e1c c\u00e1n b\u1ed9 y t\u1ebf v\u1ec1 nguy c\u01a1 ph\u00ecnh v\u00e0 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 khi s\u1eed d\u1ee5ng fluoroquinolon t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n. Nguy c\u01a1 hi\u1ebfm g\u1eb7p n\u00e0y \u0111\u01b0\u1ee3c C\u01a1 quan D\u01b0\u1ee3c ph\u1ea9m Ch\u00e2u \u00c2u (EMA) v\u00e0 C\u01a1 quan Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 (FDA) khuy\u1ebfn c\u00e1o sau [&#8230;]\n","protected":false},"author":1,"featured_media":4590,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4589","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\/4589","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=4589"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/4589\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/4590"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=4589"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=4589"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=4589"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}