{"id":4762,"date":"2019-03-13T12:37:33","date_gmt":"2019-03-13T05:37:33","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=4762"},"modified":"2023-09-07T07:24:26","modified_gmt":"2023-09-07T00:24:26","slug":"than-trong-trong-tuong-tac-thuoc-khang-sinh-voi-cac-nhom-thuoc-khac","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/than-trong-trong-tuong-tac-thuoc-khang-sinh-voi-cac-nhom-thuoc-khac\/","title":{"rendered":"Th\u1eadn tr\u1ecdng trong t\u01b0\u01a1ng t\u00e1c thu\u1ed1c kh\u00e1ng sinh v\u1edbi c\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1c"},"content":{"rendered":"<h2>Kh\u00e1ng sinh l\u00e0 g\u00ec?<\/h2>\n<p><strong>Thu\u1ed1c kh\u00e1ng sinh<\/strong> l\u00e0 nh\u1eefng ch\u1ea5t \u0111\u01b0\u1ee3c chi\u1ebft t\u1eeb sinh v\u1eadt ho\u1eb7c t\u1ed5ng h\u1ee3p h\u00f3a h\u1ecdc, v\u1edbi li\u1ec1u r\u1ea5t nh\u1ecf v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ho\u1eb7c gi\u1ebft ch\u1ebft sinh v\u1eadt, kh\u00f4ng \u0111\u1ed9c ho\u1eb7c \u00edt \u0111\u1ed9c cho c\u01a1 th\u1ec3.[1]\n<p>Thu\u1ed1c <strong>kh\u00e1ng sinh<\/strong> \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t gi\u1ea3i ph\u00e1p hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh do nhi\u1ec5m vi khu\u1ea9n, nh\u1edd c\u00f3 thu\u1ed1c m\u00e0 ch\u00fang ta c\u00f3 th\u1ec3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c nhi\u1ec1u d\u1ecbch b\u1ec7nh. Tuy nhi\u00ean, hi\u1ec7n nay t\u1ea1i Vi\u1ec7t Nam thu\u1ed1c kh\u00e1ng sinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ch\u01b0a h\u1ee3p l\u00fd v\u00e0 c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng l\u1ea1m d\u1ee5ng thu\u1ed1c qu\u00e1 m\u1ee9c. T\u1ef7 l\u1ec7 s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng sinh ng\u00e0y c\u00e0ng t\u0103ng theo c\u1ea5p s\u1ed1 nh\u00e2n l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng b\u1ec7nh nh\u00e2n g\u1eb7p ph\u1ea3i c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u00f3 h\u1ea1i. \u0110\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 an to\u00e0n cho b\u1ec7nh nh\u00e2n khi \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng, c\u00e1c b\u00e1c s\u0129 v\u00e0 d\u01b0\u1ee3c s\u0129 c\u1ea7n l\u01b0u \u00fd v\u1ec1 c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng. B\u00e0i vi\u1ebft n\u00e0y nh\u1eb1m m\u1ee5c \u0111\u00edch li\u1ec7t k\u00ea c\u00e1c t\u01b0\u01a1ng t\u00e1c c\u00f3 th\u1ec3 x\u1ea3y ra gi\u1eefa nh\u00f3m thu\u1ed1c kh\u00e1ng sinh v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0 \u0111\u01b0\u1ee3c t\u00f3m t\u1eaft trong B\u1ea2NG T\u01af\u01a0NG T\u00c1C THU\u1ed0C KH\u00c1NG SINH.<\/p>\n<h2>C\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 t\u01b0\u01a1ng t\u00e1c cao v\u1edbi thu\u1ed1c kh\u00e1ng sinh c\u1ea7n l\u01b0u \u00fd:<\/h2>\n<h3>Warfarin<\/h3>\n<p>H\u1ea7u nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c kh\u00e1ng sinh \u0111\u1ec1u c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng c\u1ee7a Warfarin b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf c\u00e1c vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t c\u00f3 ch\u1ee9c n\u0103ng s\u1ea3n xu\u1ea5t vitamin K. Nh\u00f3m Fluoroquinolone, Macrolide v\u00e0 Sulfonamide c\u0169ng c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a warfarin, l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 g\u00e2y ch\u1ea3y m\u00e1u. C\u00e1c b\u00e1c s\u0129 c\u0169ng nh\u01b0 d\u01b0\u1ee3c s\u0129 l\u00e2m s\u00e0ng n\u00ean tr\u00e1nh ph\u1ed1i h\u1ee3p c\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1ng sinh n\u00e0y \u1edf b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng Warfarin b\u1eb1ng c\u00e1ch d\u00f9ng c\u00e1c thu\u1ed1c thay th\u1ebf kh\u00e1c. N\u1ebfu bu\u1ed9c ph\u1ea3i k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1ng sinh, b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u1ea7n ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd. [2]\n<h3>Ch\u1ebf ph\u1ea9m ch\u1ee9a ion d\u01b0\u01a1ng h\u00f3a tr\u1ecb hai v\u00e0 ba<\/h3>\n<p>Nh\u00f3m Fluoroquinolone (FQ) r\u1ea5t hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u lo\u1ea1i nhi\u1ec5m tr\u00f9ng. Tuy nhi\u00ean, s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi FQ v\u1edbi c\u00e1c ion d\u01b0\u01a1ng h\u00f3a tr\u1ecb hai (canxi v\u00e0 magi\u00ea) v\u00e0 ion d\u01b0\u01a1ng h\u00f3a tr\u1ecb ba (nh\u00f4m v\u00e0 s\u1eaft) s\u1ebd l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 s\u1ef1 h\u1ea5p thu c\u1ee7a FQ (gi\u1ea3m 60%-75%), do c\u00e1c ion d\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 t\u1ea1o th\u00e0nh c\u00e1c ph\u1ee9c ch\u1ea5t kh\u00f4ng h\u00f2a tan trong ru\u1ed9t, t\u1eeb \u0111\u00f3 g\u00e2y th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb. Nh\u1eefng ion d\u01b0\u01a1ng d\u1ea1ng n\u00e0y th\u01b0\u1eddng c\u00f3 trong th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng b\u1ed5 sung ho\u1eb7c thu\u1ed1c kh\u00e1ng acid. Sucralfate (Carafate), m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u1ed1ng lo\u00e9t, c\u0169ng c\u00f3 ch\u1ee9a nh\u00f4m.[2][4] C\u00e1c t\u01b0\u01a1ng t\u00e1c n\u00e0y c\u0169ng x\u1ea3y ra v\u1edbi nh\u00f3m Tetracycline, ngo\u00e0i ra c\u00f2n c\u00f3 t\u01b0\u01a1ng t\u00e1c gi\u1eefa nh\u00f3m Cephalosporin v\u00e0 k\u1ebdm.[3]\n<p>C\u1ea7n b\u00e1o c\u00e1o v\u1edbi b\u00e1c s\u0129 c\u00e1c lo\u1ea1i thu\u1ed1c s\u1eed d\u1ee5ng trong kho\u1ea3ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n n\u00ean ng\u1eebng d\u00f9ng c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a c\u00e1c ion d\u01b0\u01a1ng n\u00e0y cho \u0111\u1ebfn khi ho\u00e0n th\u00e0nh li\u1ec7u ph\u00e1p kh\u00e1ng sinh . N\u1ebfu bu\u1ed9c ph\u1ea3i ph\u1ed1i h\u1ee3p, c\u00e1c kh\u00e1ng sinh v\u00e0 ion \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp tr\u00ean n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng c\u00e1ch nhau t\u1eeb 2 \u0111\u1ebfn 3 gi\u1edd tr\u1edf l\u00ean. B\u00ean c\u1ea1nh \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u1ea7n tr\u00e1nh c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb s\u1eefa.[3]\n<h3>Thu\u1ed1c tr\u00e1nh thai \u0111\u01b0\u1eddng u\u1ed1ng (OCP \u2013 Oral Contraceptive Pill)<\/h3>\n<p>Rifampicin l\u00e0 lo\u1ea1i kh\u00e1ng sinh duy nh\u1ea5t cho \u0111\u1ebfn nay \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 estrogen trong huy\u1ebft t\u01b0\u01a1ng. C\u00f2n c\u00e1c nh\u00f3m kh\u00e1ng sinh kh\u00e1c hi\u1ec7n nay v\u1eabn ch\u01b0a c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng cho s\u1ef1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c n\u00e0y. Tuy nhi\u00ean, r\u1ea5t kh\u00f3 \u0111\u1ec3 t\u00e1ch ri\u00eang b\u1ea5t k\u1ef3 \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c kh\u00e1ng sinh n\u00e0o khi ch\u1ec9 d\u1ef1a tr\u00ean t\u1ec9 l\u1ec7 th\u1ea5t b\u1ea1i d\u1ef1 ki\u1ebfn c\u1ee7a thu\u1ed1c tr\u00e1nh thai \u0111\u01b0\u1eddng u\u1ed1ng (1 thai ph\u1ee5 tr\u00ean 100 ph\u1ee5 n\u1eef m\u1ed7i n\u0103m).[2]\n<p>C\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng n\u00ean khuy\u1ebfn kh\u00edch b\u1ec7nh nh\u00e2n c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00e1c trong khi \u0111ang d\u00f9ng Rifampicin c\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 tr\u00e1nh t\u0103ng nguy c\u01a1 th\u1ee5 thai. \u0110i\u1ec1u tr\u1ecb ng\u1eafn h\u1ea1n: Ph\u1ee5 n\u1eef \u0111ang s\u1eed d\u1ee5ng kh\u00e1ng sinh n\u00ean s\u1eed d\u1ee5ng bi\u1ec7n ph\u00e1p tr\u00e1nh thai kh\u00e1c ngo\u00e0i OCP nh\u01b0 bao cao su, \u0111\u1eb7t v\u00f2ng, ti\u00eam thu\u1ed1c,.. Ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng OCP t\u1eeb ng\u00e0y th\u1ee9 28 sau ng\u00e0y s\u1eed d\u1ee5ng li\u1ec1u kh\u00e1ng sinh cu\u1ed1i c\u00f9ng. \u0110i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i: \u1edf ph\u1ee5 n\u1eef \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i b\u1eb1ng c\u00e1c ho\u1ea1t ch\u1ea5t g\u00e2y men gan, c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai \u0111\u00e1ng tin c\u1eady, kh\u00f4ng c\u00f3 n\u1ed9i ti\u1ebft t\u1ed1 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.[2][3]\n<p>T\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u1edbi c\u00e1c nh\u00f3m kh\u00e1ng sinh th\u00f4ng d\u1ee5ng kh\u00e1c:<\/p>\n<table width=\"774\">\n<tbody>\n<tr>\n<td colspan=\"5\" width=\"774\">B\u1ea2NG T\u01af\u01a0NG T\u00c1C THU\u1ed0C KH\u00c1NG SINH<\/td>\n<\/tr>\n<tr>\n<td width=\"151\">Nh\u00f3m kh\u00e1ng sinh<\/td>\n<td width=\"132\">Thu\u1ed1c t\u01b0\u01a1ng t\u00e1c<\/td>\n<td width=\"157\">C\u01a1 ch\u1ebf<\/td>\n<td width=\"153\">H\u1eadu qu\u1ea3<\/td>\n<td width=\"181\">Gi\u1ea3i ph\u00e1p<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"151\">Nh\u00f3m PenicillinV\u00ed d\u1ee5:<\/p>\n<p>\u2013 Penicillin G, V<\/p>\n<p>\u2013 Aminopenicillin<\/p>\n<p>\u2013 Oxacillin<\/p>\n<p>\u2013 Carboxypenicillin<\/p>\n<p>&nbsp;<\/td>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u.<\/td>\n<td width=\"181\">C\u1ea7n ki\u1ec3m so\u00e1t INRch\u1eb7t ch\u1ebd.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Methotrexate<sup>[3]<\/sup><\/td>\n<td width=\"157\">Penicilline\u00a0g\u00e2y \u1ee9c ch\u1ebf s\u1ef1 b\u00e0i ti\u1ebft \u00a0Methotrexate\u1edf \u1ed1ng th\u1eadn theo c\u01a1 ch\u1ebf canh tranh.<\/td>\n<td width=\"153\">L\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a\u00a0Methotrexatev\u00e0 t\u0103ng nguy c\u01a1 ng\u1ed9 \u0111\u1ed9c thu\u1ed1c.<\/td>\n<td width=\"181\">Theo d\u00f5i c\u1ea9n th\u1eadn c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng ng\u1ed9 \u0111\u1ed9c \u00a0Methotrexate(\u0111\u1ed9c t\u00ednh v\u1ec1 huy\u1ebft h\u1ecdc v\u00e0 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a), \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn v\u00e0 ng\u01b0\u1eddi gi\u00e0.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\" width=\"151\">Nh\u00f3mTetracyclineV\u00ed d\u1ee5:<\/p>\n<p>\u2013 Doxycycline<\/p>\n<p>\u2013 Lymecycline<\/p>\n<p>\u2013 Minocycline<\/td>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u.<\/td>\n<td width=\"181\">C\u1ea7n ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Ch\u1ebf\u00a0ph\u1ea9m\u00a0ch\u1ee9a ion d\u01b0\u01a1ng h\u00f3a tr\u1ecb hai v\u00e0 ba<\/td>\n<td width=\"157\">T\u1ea1o th\u00e0nh c\u00e1c ph\u1ee9c ch\u1ea5t kh\u00f4ng h\u00f2a tan trong ru\u1ed9t.<\/td>\n<td width=\"153\">C\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m sinh kh\u1ea3 d\u1ee5ng v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c.<\/td>\n<td width=\"181\">B\u1ec7nh nh\u00e2n n\u00ean ng\u1eebng d\u00f9ng c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a c\u00e1c cation n\u00e0y cho \u0111\u1ebfn khi ho\u00e0n th\u00e0nh li\u1ec7u ph\u00e1p kh\u00e1ng sinh.\u00a0N\u1ebfu bu\u1ed9c ph\u1ea3i ph\u1ed1i h\u1ee3p, s\u1eed d\u1ee5ng c\u00e1ch nhau t\u1eeb 2 \u0111\u1ebfn 3 gi\u1edd tr\u1edf l\u00ean<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Methotrexate<sup>[<\/sup><sup>5<\/sup><sup>]<\/sup><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/td>\n<td width=\"157\">G\u00e2y \u1ee9c ch\u1ebf h\u1ec7 vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t gi\u00fap chuy\u1ec3n h\u00f3a\u00a0Methotrexate.<\/td>\n<td width=\"153\">Tetracylin\u00a0c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i n\u1ed3ng \u0111\u1ed9 \u00a0Methotrexatetrong huy\u1ebft thanh, gi\u1ea3m s\u1ef1 h\u1ea5p thu c\u1ee7a \u00a0Methotrexate<em>.\u00a0<\/em>D\u1eabn \u0111\u1ebfn c\u00e1c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng nh\u01b0 c\u00fam, c\u00e1c d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng, da nh\u1ee3t nh\u1ea1t, d\u1ec5 b\u1ecb b\u1ea7m t\u00edm ho\u1eb7c ch\u1ea3y m\u00e1u, ti\u00eau ch\u1ea3y ho\u1eb7c l\u1edf mi\u1ec7ng.<\/td>\n<td width=\"181\">N\u1ebfu bu\u1ed9c ph\u1ea3i k\u1ebft h\u1ee3p c\u00e1c lo\u1ea1i thu\u1ed1c tr\u00ean, c\u1ea7n theo d\u00f5i ch\u1eb7t ch\u1ebd v\u1ec1 \u0111\u1ed9c t\u00ednh nghi\u00eam tr\u1ecdng c\u1ee7a\u00a0Methotrexate. N\u00ean s\u1eed d\u1ee5ng kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 thay th\u1ebf.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Nh\u00f3mRetinoid<sup>[6]<\/sup><\/td>\n<td width=\"157\">Tetracyclinec\u00f3 th\u1ec3 can thi\u1ec7p tr\u1ef1c ti\u1ebfp v\u00e0o c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4i RA c\u00f3 li\u00ean quan \u0111\u1ebfn con \u0111\u01b0\u1eddng chuy\u1ec3n h\u00f3a\u00a0Retinoid.<\/td>\n<td width=\"153\">L\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc m\u1ed9t b\u1ec7nh hi\u1ebfm g\u1eb7p g\u1ecdi l\u00e0 t\u0103ng huy\u1ebft \u00e1p n\u1ed9i s\u1ecd, t\u0103ng \u00e1p l\u1ef1c c\u1ee7a d\u1ecbch n\u00e3o.<\/td>\n<td width=\"181\">Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh. C\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c nh\u01b0\u00a0Erythromycin,\u00a0Cephalosporinv\u00e0\u00a0Penicillin\u00a0c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thay th\u1ebf cho\u00a0Tetracycline\u00a0\u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea7n \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\" width=\"151\">Nh\u00f3m CephalosporinV\u00ed d\u1ee5:<\/p>\n<p>\u2013 Cefaclor<\/p>\n<p>\u2013\u00a0 Cefixime<\/p>\n<p>\u2013\u00a0 Cephalexin<\/p>\n<p>\u2013\u00a0 Cefuroxime<\/td>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u<\/td>\n<td width=\"181\">Ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">K\u1ebdm<sup>[3]<\/sup><\/td>\n<td width=\"157\">T\u1ea1o th\u00e0nh ph\u1ee9c ch\u1ea5t kh\u00f4ng h\u00f2a tan trong \u0111\u01b0\u1eddng ru\u1ed9t.<\/td>\n<td width=\"153\">L\u00e0m gi\u1ea3m sinh kh\u1ea3 d\u1ee5ng v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c.<\/td>\n<td width=\"181\">S\u1eed d\u1ee5ng c\u00e1ch li\u1ec1u t\u1eeb 2 \u0111\u1ebfn 3 gi\u1edd tr\u1edf l\u00ean.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Probenecid\u00a0<sup>[<\/sup><sup>2]<\/sup><\/td>\n<td width=\"157\">T\u01b0\u01a1ng t\u00e1c theo c\u01a1 ch\u1ebf d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc g\u00e2y gi\u1ea3m b\u00e0i ti\u1ebft\u00a0Cephalosporinqua \u1ed1ng th\u1eadn<\/td>\n<td width=\"153\">T\u0103ng h\u00e0m l\u01b0\u1ee3ng\u00a0Cephalosporintrong huy\u1ebft thanh v\u00e0 t\u0103ng chu k\u00ec th\u1ea3i c\u1ee7a kh\u00e1ng sinh.<\/td>\n<td width=\"181\">X\u00e1c \u0111\u1ecbnh m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb v\u00e0 l\u01b0u \u00fd \u0111\u1ebfn t\u01b0\u01a1ng t\u00e1c n\u00e0y, \u0111\u1ed3ng th\u1eddi n\u00ean tr\u00e1nh ph\u1ed1i h\u1ee3p. \u1ede li\u1ec1u b\u00ecnh th\u01b0\u1eddng, v\u1edbi m\u1ed9t v\u00e0i\u00a0Cephalosporin, c\u00f3 nguy c\u01a1 g\u00e2y \u0111\u1ed9c v\u1edbi th\u1eadn.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"5\" width=\"151\">Nh\u00f3m Fluoroquinolone (FQ)V\u00ed d\u1ee5 :<\/p>\n<p>\u2013\u00a0 Ciprofloxacin<\/p>\n<p>\u2013\u00a0 Levofloxacin<\/p>\n<p>\u2013\u00a0 Moxifloxacin<\/p>\n<p>\u2013 \u00a0Ofloxacin<\/td>\n<td width=\"132\">Ch\u1ebf ph\u1ea9m ch\u1ee9a ion d\u01b0\u01a1ng h\u00f3a tr\u1ecb hai v\u00e0 ba<\/td>\n<td width=\"157\">T\u1ea1o th\u00e0nh c\u00e1c ph\u1ee9c ch\u1ea5t kh\u00f4ng h\u00f2a tan trong ru\u1ed9t n\u1ebfu\u00a0 d\u00f9ng \u0111\u1ed3ng th\u1eddi c\u00e1c ion d\u01b0\u01a1ng n\u00e0y v\u1edbi\u00a0FQ.<\/td>\n<td width=\"153\">C\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 s\u1ef1 h\u1ea5p thu c\u1ee7a\u00a0FQ, do \u0111\u00f3 g\u00e2y ra th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb.<\/td>\n<td width=\"181\">B\u1ec7nh nh\u00e2n n\u00ean ng\u1eebng d\u00f9ng c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a c\u00e1c ion d\u01b0\u01a1ng n\u00e0y n\u00e0y cho \u0111\u1ebfn khi ho\u00e0n th\u00e0nh li\u1ec7u ph\u00e1p kh\u00e1ng sinh.\u00a0N\u1ebfu bu\u1ed9c ph\u1ea3i ph\u1ed1i h\u1ee3p, s\u1eed d\u1ee5ng c\u00e1ch nhau t\u1eeb 2 \u0111\u1ebfn 3 gi\u1edd tr\u1edf l\u00ean.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u<\/td>\n<td width=\"181\">Ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Nh\u00f3mMacrolide<sup>[2]<\/sup><\/td>\n<td width=\"157\">G\u00e2y t\u01b0\u01a1ng t\u00e1c theo c\u01a1 ch\u1ebf hi\u1ec7p \u0111\u1ed3ng.<\/td>\n<td width=\"153\">H\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng c\u1ee7a t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u00f3 th\u1ec3 x\u1ea3y ra l\u00e0 k\u00e9o d\u00e0i kho\u1ea3ng QT v\u00e0 t\u0103ng nguy c\u01a1 r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t bao g\u1ed3m c\u1ea3 xo\u1eafn \u0111\u1ec9nh v\u00e0 t\u1eed vong \u0111\u1ed9t ng\u1ed9t.<\/td>\n<td width=\"181\">N\u00ean l\u1ef1a ch\u1ecdn thay th\u1ebf c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c kh\u00f4ng t\u01b0\u01a1ng t\u00e1c.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Tizanidine<sup>[3]<\/sup><\/td>\n<td width=\"157\">Ciprofloxacing\u00e2y t\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Tizanidinetrong huy\u1ebft thanh<\/td>\n<td width=\"153\">Li\u00ean quan \u0111\u1ebfn h\u1ea1 huy\u1ebft \u00e1p v\u00e0 an th\u1ea7n.<\/td>\n<td width=\"181\">Kh\u00f4ng khuy\u1ebfn kh\u00edch ph\u1ed1i h\u1ee3p hai lo\u1ea1i thu\u1ed1c n\u00e0y. B\u00e1c s\u0129 c\u00f3 th\u1ec3 quy\u1ebft \u0111\u1ecbnh kh\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng\u00a0Tizanidineho\u1eb7c thay th\u1ebf b\u1eb1ng lo\u1ea1i thu\u1ed1c kh\u00e1ng sinh kh\u00e1c.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Theophyllin<sup>[3]<\/sup><\/td>\n<td width=\"157\">Ciprofloxacing\u00e2y \u1ee9c ch\u1ebf enzym chuy\u1ec3n h\u00f3a\u00a0Theophyllin, do \u0111\u00f3 g\u00e2y t\u0103ng n\u1ed3ng \u0111\u1ed9 ch\u1ea5t n\u00e0y trong huy\u1ebft thanh \u0111\u1ebfn h\u01a1n 100%.<em>\u00a0<\/em><\/td>\n<td width=\"153\">D\u1eabn \u0111\u1ebfn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 hi\u1ebfm g\u1eb7p c\u1ee7a\u00a0Theophylline, g\u00e2y \u0111e d\u1ecda t\u00ednh m\u1ea1ng v\u00e0 th\u1eadm ch\u00ed t\u1eed vong.<\/td>\n<td width=\"181\">C\u1ea7n tr\u00e1nh k\u1ebft h\u1ee3p ho\u1eb7c n\u1ebfu c\u1ea7n thi\u1ebft s\u1eed d\u1ee5ng c\u1ea3 hai thu\u1ed1c, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea9n th\u1eadn v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u th\u00edch h\u1ee3p.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"7\" width=\"151\">Nh\u00f3m\u00a0MacrolideV\u00ed d\u1ee5:<\/p>\n<p>\u2013\u00a0 Azithromycin<\/p>\n<p>\u2013\u00a0 Clarithromycin<\/p>\n<p>\u2013\u00a0 Erythromycin<\/td>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u<\/td>\n<td width=\"181\">Ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Nh\u00f3mFluoroquinolone<\/td>\n<td width=\"157\">T\u01b0\u01a1ng t\u00e1c theo c\u01a1 ch\u1ebf hi\u1ec7p \u0111\u1ed3ng.<\/td>\n<td width=\"153\">G\u00e2y k\u00e9o d\u00e0i kho\u1ea3ng QT v\u00e0 t\u0103ng nguy c\u01a1 r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t bao g\u1ed3m c\u1ea3 xo\u1eafn \u0111\u1ec9nh v\u00e0 t\u1eed vong \u0111\u1ed9t ng\u1ed9t.<\/td>\n<td width=\"181\">N\u00ean l\u1ef1a ch\u1ecdn thay th\u1ebf c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c kh\u00f4ng t\u01b0\u01a1ng t\u00e1c.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Amiodarone<sup>[<\/sup><sup>5<\/sup><sup>]<\/sup><\/td>\n<td width=\"157\">L\u00e0m\u00a0 \u1ee9c ch\u1ebf \u0111\u00e1ng k\u1ec3 s\u1ef1 trao \u0111\u1ed5i ch\u1ea5t c\u1ee7a\u00a0Amiodarone.<\/td>\n<td width=\"153\">L\u00e0m k\u00e9o d\u00e0i kho\u1ea3ng QT g\u00e2y t\u0103ng nguy c\u01a1 lo\u1ea1n nh\u1ecbp th\u1ea5t bao g\u1ed3m xo\u1eafn \u0111\u1ec9nh v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1eed vong.<\/td>\n<td width=\"181\">Th\u1eadn tr\u1ecdng khi ph\u1ed1i h\u1ee3p. B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a \u0111\u1ebfn trung t\u00e2m y t\u1ebf n\u1ebfu h\u1ecd g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a xo\u1eafn \u0111\u1ec9nh nh\u01b0 ch\u00f3ng m\u1eb7t, ch\u00f3ng m\u1eb7t, ng\u1ea5t, nh\u1ecbp tim kh\u00f4ng \u0111\u1ec1u, kh\u00f3 th\u1edf ho\u1eb7c ng\u1ea5t.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Nh\u00f3m\u00a0Statin<sup>[3][5]<\/sup>(Simvastatinv\u00e0Atorvastatin)<\/td>\n<td width=\"157\">L\u00e0m t\u0103ng \u0111\u00e1ng k\u1ec3 n\u1ed3ng \u0111\u1ed9 nh\u00f3m\u00a0Statintrong m\u00e1u.<\/td>\n<td width=\"153\">G\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng hi\u1ebfm g\u1eb7p nh\u01b0ng nghi\u00eam tr\u1ecdng g\u1ecdi l\u00e0 ti\u00eau c\u01a1 v\u00e2n li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1 v\u1ee1 c\u00e1c m\u00f4 c\u01a1 x\u01b0\u01a1ng c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn v\u00e0 th\u1eadm ch\u00ed t\u1eed vong.<\/td>\n<td width=\"181\">C\u00e2n nh\u1eafc thay th\u1ebf b\u1eb1ng kh\u00e1ng sinh\u00a0Macrolidkh\u00e1c kh\u00f4ng g\u00e2y \u1ee9c ch\u1ebf enzym gan nh\u01b0\u00a0Azithromycin. N\u1ebfu bu\u1ed9c ph\u1ea3i k\u1ebft h\u1ee3p th\u00ec tr\u00e1nh d\u00f9ng thu\u1ed1c c\u00f9ng m\u1ed9t th\u1eddi \u0111i\u1ec3m thu\u1ed1c c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u r\u1ee7i ro x\u1ea3y ra c\u00e1c t\u01b0\u01a1ng t\u00e1c, \u0111\u01b0a ra nh\u1eefng li\u1ec1u thu\u1ed1c c\u00e1ch nhau 12h s\u1ebd ng\u0103n ng\u1eeba n\u1ed3ng \u0111\u1ed9 thu\u1ed1c \u0111\u1ea1t \u0111\u1ec9nh c\u00f9ng l\u00fac.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Colchicine<sup>[3][<\/sup><sup>7<\/sup><sup>]<\/sup><\/td>\n<td width=\"157\">G\u00e2y \u1ee9c ch\u1ebf chuy\u1ec3n h\u00f3a\u00a0Colchicine\u00a0t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng \u0111\u1ed9c t\u1ed1 c\u1ee7a\u00a0Colchicinetrong c\u01a1 th\u1ec3.<\/td>\n<td width=\"153\">R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a th\u01b0\u1eddng l\u00e0 d\u1ea5u hi\u1ec7u ng\u1ed9 \u0111\u1ed9c \u0111\u1ea7u ti\u00ean c\u1ee7a ng\u1ed9 \u0111\u1ed9c\u00a0Colchicin. C\u00e1c bi\u1ec3u hi\u1ec7n ti\u1ebfp theo c\u1ee7a ng\u1ed9 \u0111\u1ed9c bao g\u1ed3m th\u1edf nhanh, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n, r\u1ed1i lo\u1ea1n huy\u1ebft h\u1ecdc, lo\u1ea1n nh\u1ecbp, suy th\u1eadn v\u00e0 t\u1ed5n th\u01b0\u01a1ng gan. T\u1eed vong th\u01b0\u1eddng do suy \u0111a t\u1ea1ng ti\u1ebfn tri\u1ec3n v\u00e0 nhi\u1ec5m tr\u00f9ng.<\/td>\n<td width=\"181\">Nh\u00f3mMacrolide\u00a0\u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o kh\u00f4ng n\u00ean ph\u1ed1i h\u1ee3p v\u1edbi\u00a0Colchicine\u00a0\u0111\u1ec3 tr\u00e1nh ng\u1ed9 \u0111\u1ed9c.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Digoxin<sup>[3][8]<\/sup><\/td>\n<td width=\"157\">T\u0103ng c\u01b0\u1eddng sinh kh\u1ea3 d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng c\u1ee7a\u00a0Digoxinb\u1eb1ng c\u00e1ch thay th\u1ebf h\u1ec7 th\u1ef1c v\u1eadt \u0111\u01b0\u1eddng ti\u00eau h\u00f3a chuy\u1ec3n h\u00f3a\u00a0Digoxin\u00a0b\u1eb1ng c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a dihydro k\u00e9m ho\u1ea1t \u0111\u1ed9ng h\u01a1n.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Digoxin\u00a0trong huy\u1ebft thanh v\u00e0 g\u00e2y ng\u00f4 \u0111\u1ed9c\u00a0Digoxin\u00a0\u1edf c\u00e1c b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb \u1ed5n \u0111\u1ecbnh b\u1eb1ng thu\u1ed1c n\u00e0y.<\/td>\n<td width=\"181\">Theo d\u00f5i n\u1ed3ng \u0111\u1ed9\u00a0Digoxin\u00a0v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u ng\u1ed9 \u0111\u1ed9c\u00a0Digoxin\u00a0(nh\u01b0 ch\u1eadm nh\u1ecbp tim) trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Theophyllin<sup>[13]<\/sup><\/td>\n<td width=\"157\">Erythromycing\u00e2y \u1ee9c ch\u1ebf enzym gan l\u00e0m cho\u00a0Theophyllinkh\u00f3 chuy\u1ec3n h\u00f3a qua gan.<\/td>\n<td width=\"153\">G\u00e2y k\u00e9o d\u00e0i t\u00e1c d\u1ee5ng, t\u0103ng n\u1ed3ng \u0111\u1ed9 v\u00e0 \u0111\u1ed9c t\u00ednh c\u1ee7a\u00a0 Theophyllin (bi\u1ec3u hi\u1ec7n: n\u00f4n, bu\u1ed3n n\u00f4n, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, co gi\u1eadt)<\/td>\n<td width=\"181\">N\u00ean gi\u1ea3m li\u1ec1u\u00a0Theophyllin\u00a0v\u00e0 theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00e1c bi\u1ec3u hi\u1ec7n ng\u1ed9 \u0111\u1ed9c. Tr\u01b0\u1eddng h\u1ee3p ph\u1ea3i d\u00f9ng\u00a0Macrolid\u00a0c\u00f9ng m\u1ed9t s\u1ed1 thu\u1ed1c chuy\u1ec3n h\u00f3a qua gan nhi\u1ec1u v\u00e0 c\u00f3 \u0111\u1ed9c t\u00ednh cao n\u00ean d\u00f9ng\u00a0Azithromycin.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\" width=\"151\">Rifampicin<\/td>\n<td width=\"132\">Warfarin<\/td>\n<td width=\"157\">Lo\u1ea1i b\u1ecf vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t s\u1ea3n xu\u1ea5t vitamin K.<\/td>\n<td width=\"153\">T\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0warfarin\u00a0trong huy\u1ebft t\u01b0\u01a1ng, t\u0103ng ch\u1ea5t ch\u1ed1ng \u0111\u00f4ng m\u00e1u, c\u00f3 nguy c\u01a1 g\u00e2y ch\u1ea3y m\u00e1u.<\/td>\n<td width=\"181\">Ki\u1ec3m so\u00e1t INR ch\u1eb7t ch\u1ebd.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Thu\u1ed1c tr\u00e1nh thai \u0111\u01b0\u1eddng u\u1ed1ng<\/td>\n<td width=\"157\">Gi\u00e0m sinh kh\u1ea3 d\u1ee5ng v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c.<\/td>\n<td width=\"153\">L\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 estrogen trong huy\u1ebft t\u01b0\u01a1ng, g\u00e2y th\u1ea5t ba\u1ecb \u0111i\u1ec1u tr\u1ecb.<\/td>\n<td width=\"181\">N\u00ean khuy\u1ebfn kh\u00edch b\u1ec7nh nh\u00e2n c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00e1c trong khi \u0111ang d\u00f9ng\u00a0Rifampicinc\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 tr\u00e1nh t\u0103ng nguy c\u01a1 th\u1ee5 thai.<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Nh\u00f3m\u00a0Sulfonylurea<sup>[9] [10]<\/sup><\/td>\n<td width=\"157\">Rifampicin\u00a0s\u1ebd t\u00e1c \u0111\u1ed9ng m\u1ea1nh \u0111\u1ebfn c\u00e1c enzim chuy\u1ec3n h\u00f3a thu\u1ed1c d\u1eabn \u0111\u1ebfn l\u00e0m t\u0103ng t\u1ed1c \u0111\u1ed9 chuy\u1ec3n h\u00f3a thu\u1ed1c s\u1eed d\u1ee5ng chung.<\/td>\n<td width=\"153\">L\u00e0m gi\u1ea3m \u0111i\u1ec1u tr\u1ecb thu\u1ed1c \u0111\u00f3. N\u1ed3ng \u0111\u1ed9 glucose trong m\u00e1u c\u00f3 th\u1ec3 t\u0103ng.<\/td>\n<td width=\"181\">Theo d\u00f5i n\u1ed3ng \u0111\u1ed9 glucose trong m\u00e1u. C\u00f3 th\u1ec3 y\u00eau c\u1ea7u t\u0103ng li\u1ec1u\u00a0\u00a0Sulfonylureas.<\/td>\n<\/tr>\n<tr>\n<td width=\"151\">Linezolid\u00a0(u\u1ed1ng)<\/td>\n<td width=\"132\">Rifampin-isoniazid (u\u1ed1ng)\u00a0<sup>[11]<\/sup><\/td>\n<td width=\"157\">L\u00e0m t\u0103ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ee9c serotonin trong m\u00e1u.<\/td>\n<td width=\"153\">Qu\u00e1 nhi\u1ec1u serotonin\u00a0 c\u00f3 kh\u1ea3 n\u0103ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng.\u00a0C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng bao g\u1ed3m huy\u1ebft \u00e1p cao v\u00e0 nh\u1ecbp tim t\u0103ng d\u1eabn \u0111\u1ebfn s\u1ed1c.<\/td>\n<td width=\"181\">C\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u d\u00f9ng l\u1ea1i thu\u1ed1c kh\u00e1c sau 24 gi\u1edd sau li\u1ec1u\u00a0Linezolid\u00a0cu\u1ed1i c\u00f9ng ho\u1eb7c ph\u1ea3i ng\u1eebng m\u1ed9t trong hai thu\u1ed1c v\u00e0 theo d\u00f5i v\u1ec1 \u0111\u1ed9c t\u00ednh c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (CNS)<\/td>\n<\/tr>\n<tr>\n<td width=\"151\">Gentamicin<\/td>\n<td width=\"132\">Furosemid<sup>[12]<\/sup><\/td>\n<td width=\"157\">L\u00e0m cho \u0111\u1ed9 thanh th\u1ea3i trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a\u00a0Gentamicingi\u1ea3m.<\/td>\n<td width=\"153\">C\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c t\u00ednh cho tai.<\/td>\n<td width=\"181\">Thay th\u1ebf c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 ch\u1ee9c n\u0103ng nh\u01b0\u00a0Gentamicin. N\u1ebfu c\u1ea3 hai lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng nhau, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u ho\u1eb7c theo d\u00f5i \u0111\u1ed9c t\u00ednh th\u1eadn v\u00e0 \u0111\u1ed9c tai.C\u1ea7n ch\u00fa \u00a0tr\u1ecdng \u0111\u1ebfn ng\u01b0\u1eddi l\u1edbn tu\u1ed5i ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 th\u1eadn t\u1eeb tr\u01b0\u1edbc v\u00e0 m\u1ea5t n\u01b0\u1edbc.<\/td>\n<\/tr>\n<tr>\n<td width=\"151\">Itraconazol\/\u00a0Ketonazol<\/td>\n<td width=\"132\">Colchicin<sup>[13]<\/sup><\/td>\n<td width=\"157\">l\u00e0m gi\u1ea3m chuy\u1ec3n h\u00f3a\u00a0Colchicin\u00a0\u1edf gan.<\/td>\n<td width=\"153\">L\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0Colchicintrong m\u00e1u v\u00e0 t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a\u00a0Colchicin\u00a0t\u1eed vong c\u1ee7a\u00a0Colchicin\u00a0c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn\u00a0 ho\u1eb7c suy gan).<\/td>\n<td width=\"181\">Thay th\u1ebf\u00a0Itraconazol<em>\/\u00a0<\/em>Ketonazol\u00a0b\u1eb1ng\u00a0Microzanolho\u1eb7c d\u1eebng\u00a0Itraconazol\/\u00a0Ketonazol\u00a0\u00edt nh\u1ea5t 2 tu\u1ea7n tr\u01b0\u1edbc khi s\u01b0r d\u1ee5ng\u00a0Colchicin.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>T\u1ed4NG K\u1ebeT<\/h2>\n<p>Thu\u1ed1c kh\u00e1ng sinh c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00e1c, bao g\u1ed3m thu\u1ed1c k\u00ea \u0111\u01a1n, OTC v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m t\u1ef1 nhi\u00ean. T\u1ed1t nh\u1ea5t, n\u00ean c\u00f3 danh s\u00e1ch \u0111\u1ea7y \u0111\u1ee7 c\u00e1c thu\u1ed1c hi\u1ec7n t\u1ea1i b\u1ec7nh nh\u00e2n d\u00f9ng tr\u01b0\u1edbc khi k\u00ea toa thu\u1ed1c kh\u00e1ng sinh m\u1edbi. Ng\u01b0\u1eddi k\u00ea \u0111\u01a1n n\u00ean l\u01b0u \u00fd v\u1ec1 c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c nghi\u00eam tr\u1ecdng ch\u00ednh \u0111\u1ed1i v\u1edbi c\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1ng sinh th\u00f4ng d\u1ee5ng.<sup>[2]<\/sup><\/p>\n<h2>T\u00c0I LI\u1ec6U THAM KH\u1ea2O:<\/h2>\n<ol>\n<li>B\u1ed9 m\u00f4n Vi Sinh (2018-1019). S\u00e1ch \u0110\u1ea1i c\u01b0\u01a1ng vi sinh. \u0110\u1ea1i h\u1ecdc Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch<\/li>\n<li>Meghan Gagnon, PharmD (2017). Identifying Important Antibiotic Drug Interactions. Contemporary Clinic. Link:<\/li>\n<\/ol>\n<p><a href=\"http:\/\/contemporaryclinic.pharmacytimes.com\/journals\/issue\/2017\/December2017\/Identifying-Important-Antibiotic-Drug-Interactions\" rel=\"noopener\">http:\/\/contemporaryclinic.pharmacytimes.com\/journals\/issue\/2017\/December2017\/Identifying-Important-Antibiotic-Drug-Interactions<\/a><\/p>\n<ol start=\"3\">\n<li>Drug Interactions Table (2018). Antimicrobial Drug Interactions. HSE Antibiotic prescribing. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.hse.ie\/eng\/services\/list\/2\/gp\/antibiotic-prescribing\/drug-interactions\/\" rel=\"noopener\">https:\/\/www.hse.ie\/eng\/services\/list\/2\/gp\/antibiotic-prescribing\/drug-interactions\/<\/a><\/p>\n<ol start=\"4\">\n<li>Paul W. Ament, Pharm.D., John G. Bertolino, M.D., M.S.P.H., and James L. Liszewski, M.D. (2000). Clinically Significant Drug Interactions. American Family Physician. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.aafp.org\/afp\/2000\/0315\/p1745.html#ref-list-1\" rel=\"noopener\">https:\/\/www.aafp.org\/afp\/2000\/0315\/p1745.html#ref-list-1<\/a><\/p>\n<ol>\n<li>Drugs.com. Link:<a href=\"https:\/\/www.drugs.com\/\" rel=\"noopener\">https:\/\/www.drugs.com\/<\/a><\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Regen%20F%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=25810318\" rel=\"noopener\">Regen F<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Hildebrand%20M%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=25810318\" rel=\"noopener\">Hildebrand M<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Le%20Bret%20N%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=25810318\" rel=\"noopener\">Le Bret N<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Herzog%20I%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=25810318\" rel=\"noopener\">Herzog I<\/a>,\u00a0Heuser I,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Hellmann-Regen%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=25810318\" rel=\"noopener\">Hellmann-Regen J<\/a>. (2015). Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?. PubMed.gov. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25810318\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25810318<\/a><\/p>\n<ol start=\"7\">\n<li>\u0110o\u00e0n Th\u1ecb Ph\u01b0\u01a1ng Th\u1ea3o, L\u01b0\u01a1ng Anh T\u00f9ng (2010). K\u00ea \u0111\u01a1n an to\u00e0n: Colchicin \u2013 \u0110\u1ed9c t\u00ednh nghi\u00eam tr\u1ecdng khi qu\u00e1 li\u1ec1u. Trung t\u00e2m DI v\u00e0 ADR Qu\u1ed1c gia. Link:<\/li>\n<\/ol>\n<p>http:\/\/magazine.canhgiacduoc.org.vn\/Magazine\/Details\/137<\/p>\n<ol start=\"8\">\n<li>Bizjak ED, Mauro VF (1997). Digoxin-Macrolide drug interaction. NCBI. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9296249\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9296249<\/a><\/p>\n<ol start=\"9\">\n<li>Jeannette Y.Wick, RPh, MBA, FASCP. Pharmacy Times. Ng\u01b0\u1eddi d\u1ecbch: DS Phan Th\u1ecb Xu\u00e2n H\u01b0\u01a1ng (2016). T\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u1ea7n tr\u00e1nh trong \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Link:<\/li>\n<\/ol>\n<p>http:\/\/hcpa.vn\/tuong-tac-thuoc-can-tranh-trong-dieu-tri-dai-thao-duong-ds-phan-thi-xuan-huong-159.html<\/p>\n<ol start=\"10\">\n<li>CLB D\u01af\u1ee2C L\u00c2M S\u00c0NG-Tr\u01b0\u1eddng \u0111\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c Hu\u1ebf. Thu\u1ed1c t\u0103ng ti\u1ebft ISULIN. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.slideshare.net\/ssusere03103\/thuc-tng-tit-insulin\" rel=\"noopener\">https:\/\/www.slideshare.net\/ssusere03103\/thuc-tng-tit-insulin<\/a><\/p>\n<ol start=\"11\">\n<li>RxList, Inc. (2019). Drug interactions with linezolid oral and rifampin-isoniazid oral. RxList. Link:<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.rxlist.com\/drug-interactions\/linezolid-oral-and-rifampin-isoniazid-oral-interaction.htm\" rel=\"noopener\">https:\/\/www.rxlist.com\/drug-interactions\/linezolid-oral-and-rifampin-isoniazid-oral-interaction.htm<\/a><\/p>\n<ol>\n<li>Drug Information Center.(2014).FUROSEMIDE \u00b1 GENTAMICIN?. link:<\/li>\n<\/ol>\n<p>https:\/\/druginfoaau.wordpress.com\/2014\/07\/23\/furosemide-\u00b1-<u>gentamicin\/<\/u><\/p>\n<ol start=\"13\">\n<li>DS. Ninh Mai H\u01b0\u1eddng (2017). T\u01b0\u01a1ng t\u00e1c thu\u1ed1c. B\u1ec7nh vi\u1ec7n Trung \u01af\u01a1ng Th\u00e1i Nguy\u00ean \u2013 Khoa D\u01b0\u1ee3c. Link:<\/li>\n<\/ol>\n<p>http:\/\/www.bvdktuthainguyen.gov.vn\/uploads\/media\/duoc\/T%C6%B0%C6%A1ng%20t%C3%A1c%20thu%E1%BB%91c%20trong%20th%E1%BB%B1c%<\/p>\n<p>Sinh vi\u00ean d\u01b0\u1ee3c L\u00e2m H\u1ed3ng Ch\u00e2u, Phan Th\u1ecb Ng\u1ecdc \u00c1nh, Tr\u1ecbnh Ng\u1ecdc Nh\u01b0 \u00dd, Nguy\u1ec5n Duy Khang Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch &#8211; Nh\u1ecbp C\u1ea7u D\u01b0\u1ee3c L\u00e2m S\u00e0ng.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Kh\u00e1ng sinh l\u00e0 g\u00ec? Thu\u1ed1c kh\u00e1ng sinh l\u00e0 nh\u1eefng ch\u1ea5t \u0111\u01b0\u1ee3c chi\u1ebft t\u1eeb sinh v\u1eadt ho\u1eb7c t\u1ed5ng h\u1ee3p h\u00f3a h\u1ecdc, v\u1edbi li\u1ec1u r\u1ea5t nh\u1ecf v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ho\u1eb7c gi\u1ebft ch\u1ebft sinh v\u1eadt, kh\u00f4ng \u0111\u1ed9c ho\u1eb7c \u00edt \u0111\u1ed9c cho c\u01a1 th\u1ec3.[1] Thu\u1ed1c kh\u00e1ng sinh \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t gi\u1ea3i ph\u00e1p hi\u1ec7u qu\u1ea3 trong [&#8230;]\n","protected":false},"author":1,"featured_media":3371,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4762","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\/4762","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=4762"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/4762\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/3371"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=4762"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=4762"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=4762"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}