Ng\u01b0\u1eddi d\u1ecbch: \u0110\u1ed7 Th\u1ecb Anh \u0110\u00e0o, L\u01b0\u01a1ng Anh T\u00f9ng
\nTrong c\u1ed9ng \u0110\u1ed3ng, hi\u1ec7n c\u00f3 m\u1ed9t v\u1ea5n \u0110\u1ec1 \u0110\u00e1ng ch\u00fa \u00fd
\nli\u00ean quan \u0110\u1ebfn c\u00e1c b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c ng\u1ee7, opioid
\nv\u00e0 c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au kh\u00e1c trong th\u1eddi gian d\u00e0i m\u00e0
\nkh\u00f4ng c\u00f3 k\u1ebf ho\u1ea1ch ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c r\u00f5 r\u00e0ng.
\n\u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 kh\u0103n trong vi\u1ec7c ng\u1eebng d\u00f9ng
\nc\u00e1c thu\u1ed1c \u0110\u00e3 \u0110\u01b0\u1ee3c b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng trong nhi\u1ec1u
\nth\u00e1ng, th\u1eadm ch\u00ed nhi\u1ec1u n\u0103m, trong tr\u01b0\u1eddng h\u1ee3p vi\u1ec7c s\u1eed
\nd\u1ee5ng thu\u1ed1c g\u00e2y ra h\u1ec7 qu\u1ea3 kh\u00f4ng mong mu\u1ed1n. Tu\u00e2n
\nth\u1ee7 h\u01b0\u1edbng d\u1eabn k\u00ea \u0110\u01a1n c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 l\u1ea1m
\nd\u1ee5ng cao v\u00e0 \u0110\u00e1nh gi\u00e1 th\u01b0\u1eddng xuy\u00ean m\u1ee5c ti\u00eau \u0110i\u1ec1u tr\u1ecb
\nc\u00f3 th\u1ec3 gi\u00fap ng\u0103n ng\u1eeba t\u00ecnh tr\u1ea1ng n\u00e0y.<\/p>\n
S\u1eed d\u1ee5ng thu\u1ed1c an to\u00e0n, hi\u1ec7u qu\u1ea3
\nC\u00e1c \u0111i\u1ec3m ch\u00ednh trong th\u1ef1c h\u00e0nh:
\n\u2022 X\u00e2y d\u1ef1ng chi\u1ebfn l\u01b0\u1ee3c k\u00ea \u0111\u01a1n c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 l\u1ea1m d\u1ee5ng cao, nh\u01b0 c\u00e1c opioid, thu\u1ed1c an th\u1ea7n, thu\u1ed1c ng\u1ee7 v\u00e0 nh\u00f3m gabapentinoid.
\n\u2022 Tu\u00e2n th\u1ee7 c\u00e1c nguy\u00ean t\u1eafc k\u00ea \u0111\u01a1n \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 l\u1ea1m d\u1ee5ng thu\u1ed1c.
\n\u2022 H\u1ea1n ch\u1ebf c\u1ea5p ph\u00e1t l\u1ea7n \u0111\u1ea7u c\u00e1c thu\u1ed1c nh\u01b0 opioid (v\u00ed d\u1ee5 <5 ng\u00e0y), \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 s\u1eed d\u1ee5ng k\u00e9o d\u00e0i.
\n\u2022 \u0110\u1eb7t ra c\u00e1c m\u1ee5c ti\u00eau ch\u1ee9c n\u0103ng v\u00e0 c\u00e1 th\u1ec3 h\u00f3a trong \u0111i\u1ec1u tr\u1ecb, th\u01b0\u1eddng xuy\u00ean \u0111\u00e1nh gi\u00e1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh l\u00fd v\u00e0 c\u00e2n nh\u1eafc s\u1ef1 c\u1ea7n thi\u1ebft ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng
\nthu\u1ed1c khi b\u1ec7nh l\u00fd kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n ho\u1eb7c vi\u1ec7c \u0111i\u1ec1u tr\u1ecb kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3.
\n\u2022 D\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi b\u00e1c s\u0129 gi\u00fap x\u00e1c \u0111\u1ecbnh v\u00e0 ng\u0103n ng\u1eeba l\u1ea1m d\u1ee5ng thu\u1ed1c k\u00ea \u0111\u01a1n v\u00e0 t\u01b0 v\u1ea5n cho b\u1ec7nh nh\u00e2n khi mua thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n (OTC) c\u00f3
\nnguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng.
\nL\u1ea1m d\u1ee5ng thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 \u201cvi\u1ec7c s\u1eed d\u1ee5ng
\nthu\u1ed1c theo c\u00e1ch d\u00f9ng ho\u1eb7c li\u1ec1u d\u00f9ng kh\u00e1c v\u1edbi k\u00ea
\n\u0111\u01a1n\u201d. \u0110\u1ecbnh ngh\u0129a n\u00e0y bao g\u1ed3m nh\u1eefng ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c
\nv\u1edbi m\u1ee5c \u0111\u00edch duy nh\u1ea5t l\u00e0 \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u1ea3m gi\u00e1c h\u01b0ng ph\u1ea5n
\n(kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c h\u1ee3p ph\u00e1p) ho\u1eb7c \u0111\u1ec3
\nchuy\u1ec3n ti\u1ebfp (v\u00ed d\u1ee5 b\u00e1n l\u1ea1i cho ng\u01b0\u1eddi kh\u00e1c). Tuy nhi\u00ean,
\nt\u00ecnh hu\u1ed1ng x\u1ea3y ra ph\u1ed5 bi\u1ebfn h\u01a1n trong ch\u0103m s\u00f3c ban
\n\u0111\u1ea7u l\u00e0 b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng thu\u1ed1c theo m\u1ee5c \u0111\u00edch \u0111\u00e3
\n\u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n, nh\u01b0ng v\u1edbi li\u1ec1u cao h\u01a1n, t\u1ea7n su\u1ea5t nhi\u1ec1u
\nh\u01a1n ho\u1eb7c trong th\u1eddi gian d\u00e0i h\u01a1n so v\u1edbi ch\u1ec9 \u0111\u1ecbnh, v\u00ed d\u1ee5
\nthu\u1ed1c ng\u1ee7. Khi vi\u1ec7c l\u1ea1m d\u1ee5ng thu\u1ed1c g\u00e2y ra c\u00e1c h\u1ec7 qu\u1ea3
\nkh\u00f4ng mong mu\u1ed1n, n\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 r\u1ed1i
\nlo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n.
\nM\u1ea5t ki\u1ec3m so\u00e1t vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c
\nTrong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, b\u1ec7nh nh\u00e2n
\nkh\u00f4ng c\u1ed1 \u00fd l\u1ea1m d\u1ee5ng c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n
\ncho m\u00ecnh. Vi\u1ec7c l\u1ea1m d\u1ee5ng thu\u1ed1c c\u00f3 th\u1ec3 b\u1eaft
\n\u0111\u1ea7u khi b\u1ec7nh nh\u00e2n \u0111\u00f4i khi d\u00f9ng li\u1ec1u b\u1ed5 sung,
\nd\u00f9ng 2 vi\u00ean thay v\u00ec 1 vi\u00ean, ho\u1eb7c u\u1ed1ng thu\u1ed1c
\n\u201ckhi c\u1ea7n thi\u1ebft\u201d th\u01b0\u1eddng xuy\u00ean b\u1ea5t k\u1ec3 tri\u1ec7u
\nch\u1ee9ng c\u1ee7a b\u1ec7nh. Theo th\u1eddi gian, nh\u1eefng thay
\n\u0111\u1ed5i v\u1ec1 th\u1ea7n kinh b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n v\u00e0 b\u1ec7nh
\nnh\u00e2n t\u1eeb t\u1eeb kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c vi\u1ec7c s\u1eed
\nd\u1ee5ng thu\u1ed1c. Sau \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 hi\u1ec3u
\nl\u1ea7m r\u1eb1ng c\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 c\u00f3 th\u1ec3 sinh
\nho\u1ea1t b\u00ecnh th\u01b0\u1eddng h\u00e0ng ng\u00e0y v\u00e0 b\u1ecb m\u1eafc k\u1eb9t
\ntrong chu tr\u00ecnh l\u1ea1m d\u1ee5ng thu\u1ed1c.
\nNguy\u00ean nh\u00e2n l\u1ea1m d\u1ee5ng thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n
\ncho b\u1ec7nh nh\u00e2n bao g\u1ed3m nhi\u1ec1u y\u1ebfu t\u1ed1 v\u00e0
\nph\u1ee9c t\u1ea1p, nh\u01b0 c\u00e1c y\u1ebfu t\u1ed1 t\u00e2m l\u00fd v\u00e0 sinh l\u00fd,
\nc\u01a1 ch\u1ebf kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3 v\u1edbi \u0111au v\u00e0 c\u00e1c tri\u1ec7u
\nch\u1ee9ng kh\u00e1c, thi\u1ebfu s\u1ef1 h\u1ed7 tr\u1ee3 c\u1ee7a gia \u0111\u00ecnh v\u00e0
\nx\u00e3 h\u1ed9i, \u0111i\u1ec1u ki\u1ec7n s\u1ed1ng b\u1ea5t l\u1ee3i, g\u1eb7p ho\u00e0n c\u1ea3nh
\nkh\u00f3 kh\u0103n ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng. B\u00e1c s\u0129 c\u0169ng
\nc\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn t\u00ecnh tr\u1ea1ng l\u1ea1m
\nd\u1ee5ng thu\u1ed1c c\u1ee7a b\u1ec7nh nh\u00e2n theo c\u1ea3 h\u01b0\u1edbng
\nt\u00edch c\u1ef1c v\u00e0 ti\u00eau c\u1ef1c. V\u00ed d\u1ee5, b\u00e1c s\u0129 c\u00f3 th\u1ec3
\nkhi\u1ebfn b\u1ec7nh nh\u00e2n nh\u1eadn th\u1ee9c r\u1eb1ng m\u1ed9t thu\u1ed1c
\n(nh\u01b0 benzodiazepin) c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng su\u1ed1t
\n\u0111\u1eddi ho\u1eb7c ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng thu\u1ed1c m\u00e0 kh\u00f4ng
\nti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 l\u1ea1i l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 c\u1ee7a
\nthu\u1ed1c trong qu\u00e1 tr\u00ecnh s\u1eed d\u1ee5ng.
\nKhi ch\u1ec9 \u0111\u1ecbnh b\u1ea5t k\u1ef3 thu\u1ed1c n\u00e0o, \u0111\u1eb7c bi\u1ec7t l\u00e0
\nthu\u1ed1c c\u00f3 nguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng, b\u00e1c s\u0129 c\u1ea7n
\n\u0111\u1eb7t ra c\u00e1c gi\u1edbi h\u1ea1n s\u1eed d\u1ee5ng thu\u1ed1c, th\u00f4ng
\nqua vi\u1ec7c \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n hi\u1ec3u \u0111\u01b0\u1ee3c
\nl\u00fd do s\u1eed d\u1ee5ng, c\u00e1ch d\u00f9ng, th\u1eddi \u0111i\u1ec3m d\u00f9ng
\nthu\u1ed1c ph\u00f9 h\u1ee3p v\u00e0 n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c trong
\nbao l\u00e2u. Trong qu\u00e1 tr\u00ecnh c\u1ea5p ph\u00e1t thu\u1ed1c,
\nd\u01b0\u1ee3c s\u0129 n\u00ean nh\u1eafc l\u1ea1i th\u00f4ng tin n\u00e0y \u0111\u1ec3 b\u1ec7nh
\nnh\u00e2n hi\u1ec3u r\u00f5 th\u00eam.
\nR\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n
\n\u1ea4n b\u1ea3n l\u1ea7n th\u1ee9 5 c\u1ee7a H\u01b0\u1edbng d\u1eabn Ch\u1ea9n \u0111o\u00e1n v\u00e0 Th\u1ed1ng k\u00ea v\u1ec1 R\u1ed1i lo\u1ea1n T\u00e2m th\u1ea7n (DSM-5)
\n\u0111\u00e3 \u0111\u01b0a ra c\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n. T\u00ecnh tr\u1ea1ng nghi\u1ec7n
\nm\u1ed7i ch\u1ea5t \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a ri\u00eang (nh\u01b0 r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng r\u01b0\u1ee3u ho\u1eb7c opioid), nh\u01b0ng \u0111\u1eb7c
\n\u0111i\u1ec3m ch\u1ea9n \u0111o\u00e1n c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c t\u00ecnh tr\u1ea1ng l\u1ea1m d\u1ee5ng l\u00e0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau.
\nR\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 t\u1eeb nh\u1eb9 (2-3 ti\u00eau ch\u00ed) \u0111\u1ebfn n\u1eb7ng (6 ti\u00eau
\nch\u00ed tr\u1edf l\u00ean) d\u1ef1a tr\u00ean c\u00e1c ti\u00eau ch\u00ed sau:
\n\u2022 S\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n v\u1edbi l\u01b0\u1ee3ng l\u1edbn h\u01a1n v\u00e0 th\u1eddi gian d\u00e0i h\u01a1n d\u1ef1 ki\u1ebfn.
\n\u2022 Mu\u1ed1n gi\u1ea3m ho\u1eb7c ng\u1eebng s\u1eed d\u1ee5ng nh\u01b0ng kh\u00f4ng th\u1ec3.
\n\u2022 B\u1ecf ra nhi\u1ec1u th\u1eddi gian \u0111\u1ec3 t\u00ecm c\u00e1ch s\u1edf h\u1eefu ch\u1ea5t \u0111\u00f3.
\n\u2022 Th\u00e8m mu\u1ed1n ho\u1eb7c c\u00f3 mong mu\u1ed1n m\u1ea1nh m\u1ebd \u0111\u1ec3 s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n.
\n\u2022 L\u1eb7p \u0111i l\u1eb7p l\u1ea1i t\u00ecnh tr\u1ea1ng kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c nh\u1eefng c\u00f4ng vi\u1ec7c quan tr\u1ecdng \u1edf n\u01a1i l\u00e0m
\nvi\u1ec7c, tr\u01b0\u1eddng h\u1ecdc ho\u1eb7c t\u1ea1i nh\u00e0 do s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n.
\n\u2022 Ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n b\u1ea5t ch\u1ea5p s\u1ef1 xu\u1ea5t hi\u1ec7n c\u00e1c v\u1ea5n \u0111\u1ec1 x\u00e3 h\u1ed9i ho\u1eb7c gi\u1eefa c\u00e1c
\nc\u00e1 nh\u00e2n m\u1ed9t c\u00e1ch li\u00ean t\u1ee5c ho\u1eb7c l\u1eb7p \u0111i l\u1eb7p l\u1ea1i, ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 n\u00e0y tr\u1edf n\u00ean x\u1ea5u \u0111i do l\u1ea1m
\nd\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n.
\n\u2022 Ng\u1eebng ho\u1eb7c gi\u1ea3m tham gia c\u00e1c ho\u1ea1t \u0111\u1ed9ng quan tr\u1ecdng trong x\u00e3 h\u1ed9i, ngh\u1ec1 nghi\u1ec7p
\nho\u1eb7c gi\u1ea3i tr\u00ed.
\n\u2022 L\u1eb7p \u0111i l\u1eb7p l\u1ea1i vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n trong c\u00e1c t\u00ecnh hu\u1ed1ng nguy hi\u1ec3m v\u1ec1 th\u1ec3 ch\u1ea5t.
\n\u2022 Ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng m\u1eb7c d\u00f9 \u0111\u00e3 nh\u1eadn th\u1ee9c \u0111\u01b0\u1ee3c v\u1ec1 nh\u1eefng v\u1ea5n \u0111\u1ec1 th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m l\u00fd x\u1ea3y ra
\nli\u00ean t\u1ee5c ho\u1eb7c l\u1eb7p \u0111i l\u1eb7p l\u1ea1i do s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u00f3.<\/p>\n
C\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 l\u1ea1m d\u1ee5ng cao bao g\u1ed3m
\nopioid (nh\u01b0 oxycodon, morphin, tramadol,
\ncodein), thu\u1ed1c an th\u1ea7n v\u00e0 thu\u1ed1c ng\u1ee7 (nh\u01b0
\nbenzodiazepin, zopiclon), thu\u1ed1c nh\u00f3m gabapentinoid (nh\u01b0 gabapentin v\u00e0 pregabalin) v\u00e0
\nch\u1ea5t k\u00edch th\u00edch (v\u00ed d\u1ee5 methylphenidat). Tuy
\nnhi\u00ean, h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c k\u00ea \u0111\u01a1n \u0111\u1ec1u c\u00f3 nguy
\nc\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng. Thu\u1ed1c c\u00f3 th\u1ec3 b\u1ecb l\u1ea1m d\u1ee5ng v\u00ec
\nnhi\u1ec1u l\u00fd do, bao g\u1ed3m c\u1ed1 \u00fd l\u1ea1m d\u1ee5ng thu\u1ed1c.
\nV\u00ed d\u1ee5, thu\u1ed1c nhu\u1eadn tr\u00e0ng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 gi\u1ea3m
\nc\u00e2n, thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 t\u0103ng
\nc\u01b0\u1eddng kh\u1ea3 n\u0103ng ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t.
\nT\u1ea1i New Zealand, c\u00e1c b\u1eb1ng ch\u1ee9ng \u0111\u01b0\u1ee3c c\u00f4ng
\nb\u1ed1 c\u00f2n h\u1ea1n ch\u1ebf v\u1ec1 c\u01b0\u1eddng \u0111\u1ed9 v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u1ed5
\nbi\u1ebfn c\u1ee7a l\u1ea1m d\u1ee5ng thu\u1ed1c k\u00ea \u0111\u01a1n v\u00e0 ph\u1ea7n l\u1edbn
\nc\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng \u0111\u01b0\u1ee3c
\nb\u00e1o c\u00e1o. C\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn l\u1ea1m d\u1ee5ng
\nopioid v\u00e0 benzodiazepin \u0111\u01b0\u1ee3c ghi nh\u1eadn nhi\u1ec1u
\nnh\u1ea5t. G\u1ea7n \u0111\u00e2y, m\u1ed9t b\u00e1o c\u00e1o li\u00ean quan \u0111\u1ebfn c\u1ea5p
\nph\u00e1t thu\u1ed1c cho th\u1ea5y 20% b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea
\n\u0111\u01a1n zopiclon t\u1ea1i New Zealand t\u1eeb th\u00e1ng 7\/2017
\n\u0111\u1ebfn th\u00e1ng 6\/2018 \u0111\u01b0\u1ee3c c\u1ea5p h\u01a1n 180 vi\u00ean;
\ntrong \u0111\u00f3, nhi\u1ec1u ng\u01b0\u1eddi nh\u1eadn \u0111\u01b0\u1ee3c thu\u1ed1c v\u1edbi
\ns\u1ed1 l\u01b0\u1ee3ng \u0111\u1ee7 \u0111\u1ec3 s\u1eed d\u1ee5ng h\u00e0ng \u0111\u00eam. Vi\u1ec7c l\u1ea1m
\nd\u1ee5ng pregabalin, gabapentin v\u00e0 tramadol c\u0169ng
\n\u0111ang n\u1ed5i l\u00ean v\u00e0 \u0111\u01b0\u1ee3c quan t\u00e2m trong th\u1eddi gian
\ng\u1ea7n \u0111\u00e2y \u1edf New Zealand.
\nC\u00e1c bi\u1ec7n ph\u00e1p gi\u1ea3m thi\u1ec3u nguy c\u01a1 l\u1ea1m
\nd\u1ee5ng thu\u1ed1c k\u00ea \u0111\u01a1n
\nCon \u0111\u01b0\u1eddng ch\u00ednh d\u1eabn \u0111\u1ebfn m\u1ea5t ki\u1ec3m so\u00e1t s\u1eed
\nd\u1ee5ng thu\u1ed1c l\u00e0 thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n cho b\u1ec7nh l\u00fd
\nc\u1ea5p t\u00ednh nh\u01b0ng kh\u00f4ng c\u00f3 s\u1eb5n k\u1ebf ho\u1ea1ch v\u00e0 m\u1ee5c
\nti\u00eau r\u00f5 r\u00e0ng \u0111\u1ed1i v\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c
\n\u0111i\u1ec1u tr\u1ecb, s\u1eed d\u1ee5ng thu\u1ed1c trong bao l\u00e2u, t\u1ea7n su\u1ea5t
\ns\u1eed d\u1ee5ng thu\u1ed1c v\u00e0 c\u00e1ch ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c
\nnh\u01b0 th\u1ebf n\u00e0o.
\nH\u1ea7u h\u1ebft c\u00e1c t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 v\u1ec1 chi\u1ebfn
\nl\u01b0\u1ee3c gi\u1ea3m thi\u1ec3u t\u00ecnh tr\u1ea1ng l\u1ea1m d\u1ee5ng thu\u1ed1c \u0111\u1ec1u
\nli\u00ean quan \u0111\u1ebfn k\u00ea \u0111\u01a1n opioid. Tuy nhi\u00ean, c\u00e1c
\nnguy\u00ean t\u1eafc chung n\u00e0y c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c
\nv\u1edbi h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng.
\nChu\u1ea9n b\u1ecb tr\u01b0\u1edbc k\u1ebf ho\u1ea1ch th\u1ef1c h\u00e0nh
\nTh\u1ef1c h\u00e0nh ch\u0103m s\u00f3c ban \u0111\u1ea7u n\u00ean \u0111\u1ed3ng
\nthu\u1eadn v\u1ec1 m\u1ed9t ch\u00ednh s\u00e1ch k\u00ea \u0111\u01a1n v\u00e0 \u0111\u00e1nh gi\u00e1
\nnh\u1eefng b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng thu\u1ed1c c\u00f3 nguy c\u01a1
\nl\u1ea1m d\u1ee5ng cao. H\u1ed9i \u0111\u1ed3ng Y khoa New Zealand
\n(Medical Council of New Zealand) khuy\u1ebfn
\nc\u00e1o c\u00e2n nh\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 b\u00ean d\u01b0\u1edbi khi k\u00ea \u0111\u01a1n
\nthu\u1ed1c c\u00f3 nguy c\u01a1 cao:
\n\u2022 Kh\u00f4ng k\u00ea \u0111\u01a1n thu\u1ed1c qu\u00e1 3 ng\u00e0y cho
\nb\u1ec7nh nh\u00e2n m\u1edbi ho\u1eb7c ch\u01b0a n\u1eafm r\u00f5 vi\u1ec7c
\ns\u1eed d\u1ee5ng thu\u1ed1c m\u00e0 c\u00e1n b\u1ed9 y t\u1ebf kh\u00f4ng th\u1ec3
\n\u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n t\u00ednh h\u1ee3p l\u00fd v\u00e0 vi\u1ec7c tu\u00e2n
\nth\u1ee7 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n.
\n\u2022 X\u00e2y d\u1ef1ng m\u1ed1i li\u00ean h\u1ec7 v\u1edbi d\u01b0\u1ee3c s\u0129 c\u1ea5p
\nph\u00e1t thu\u1ed1c v\u00e0 chia s\u1ebb th\u00f4ng tin v\u1ec1 ph\u00e1c \u0111\u1ed3
\n\u0111i\u1ec1u tr\u1ecb c\u0169ng nh\u01b0 m\u1ecdi y\u00eau c\u1ea7u t\u00e1i c\u1ea5p ph\u00e1t
\nthu\u1ed1c s\u1edbm h\u01a1n d\u1ef1 ki\u1ebfn (th\u01b0\u1eddng ch\u1ec9 c\u1ea7n
\nthi\u1ebft khi nghi ng\u1edd ho\u1eb7c b\u1ec7nh nh\u00e2n c\u00f3 nguy
\nc\u01a1 l\u1ea1m d\u1ee5ng cao).
\n\u2022 Nh\u1eadn th\u1ee9c \u0111\u01b0\u1ee3c \u00e1p l\u1ef1c k\u00ea \u0111\u01a1n ho\u1eb7c k\u00ea
\n\u0111\u01a1n m\u1ed9t c\u00e1ch \u0111\u1ed9c l\u1eadp v\u1edbi c\u00e1c b\u00e1c s\u0129 kh\u00e1c.
\n\u2022 \u0110\u1ea3m b\u1ea3o r\u1eb1ng vi\u1ec7c ti\u1ebfp t\u1ee5c k\u00ea \u0111\u01a1n thu\u1ed1c
\nc\u00f3 nguy c\u01a1 l\u1ea1m d\u1ee5ng l\u00e0 c\u00f3 ch\u1ec9 \u0111\u1ecbnh l\u00e2m
\ns\u00e0ng v\u00e0 d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng.
\nK\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb n\u00ean \u0111\u01b0\u1ee3c ghi trong h\u1ed3 s\u01a1
\nb\u1ec7nh \u00e1n c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 c\u00e1c c\u00e1n b\u1ed9 y t\u1ebf
\nkh\u00e1c c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c th\u1ef1c hi\u1ec7n theo ph\u00e1c \u0111\u1ed3
\n\u0111i\u1ec1u tr\u1ecb.
\n\u0110\u1ed3ng thu\u1eadn m\u1ed9t ch\u00ednh s\u00e1ch th\u1ef1c h\u00e0nh v\u1ec1 y\u00eau
\nc\u1ea7u t\u00e1i c\u1ea5p ph\u00e1t thu\u1ed1c theo \u0111\u01a1n, v\u00ed d\u1ee5 kh\u00f4ng
\nt\u00e1i c\u1ea5p ph\u00e1t thu\u1ed1c s\u1edbm ho\u1eb7c b\u1ec7nh nh\u00e2n ph\u1ea3i
\n\u0111\u01b0\u1ee3c b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 tr\u1ef1c ti\u1ebfp \u00edt nh\u1ea5t m\u1ed7i 3
\nth\u00e1ng.
\nChu\u1ea9n b\u1ecb s\u1eb5n s\u00e0ng k\u1ebf ho\u1ea1ch th\u1ef1c h\u00e0nh\/\u0111\u1ed1i
\ntho\u1ea1i v\u1edbi b\u1ec7nh nh\u00e2n \u0111\u1ec3 gi\u1ea3i quy\u1ebft nh\u1eefng
\ny\u00eau c\u1ea7u c\u1ea5p ph\u00e1t thu\u1ed1c kh\u00f4ng h\u1ee3p l\u00fd \u0111\u1ed1i v\u1edbi
\nnh\u1eefng thu\u1ed1c c\u00f3 nguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng v\u00e0 l\u00e0m
\nquen v\u1edbi c\u00e1c quy tr\u00ecnh chuy\u1ec3n ti\u1ebfp b\u1ec7nh nh\u00e2n
\n\u0111\u1ebfn c\u00e1c t\u1ed5 ch\u1ee9c qu\u1ea3n l\u00fd v\u1ea5n \u0111\u1ec1 nghi\u1ec7n r\u01b0\u1ee3u\u00a0v\u00e0 ma tu\u00fd t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng.
\nC\u00e1c nguy\u00ean t\u1eafc k\u00ea \u0111\u01a1n an to\u00e0n thu\u1ed1c c\u00f3
\nnguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng
\n\u0110\u1ea7u ti\u00ean, n\u00ean c\u00e2n nh\u1eafc: C\u00f3 th\u1ec3 \u0111\u1ec1 xu\u1ea5t s\u1eed d\u1ee5ng
\nthu\u1ed1c kh\u00e1c \u0111\u1ec3 thay th\u1ebf kh\u00f4ng? N\u1ebfu thu\u1ed1c \u0111\u01b0\u1ee3c
\nk\u00ea \u0111\u01a1n \u0111\u1ec3 l\u00e0m gi\u1ea3m nh\u1eb9 tri\u1ec7u ch\u1ee9ng, c\u00e2n nh\u1eafc
\n\u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u1ea7u
\nti\u00ean v\u00e0 ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p n\u00e0y \u0111\u1ed3ng
\nth\u1eddi v\u1edbi c\u00e1c ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. V\u00ed d\u1ee5,
\nc\u00f3 nhi\u1ec1u bi\u1ec7n ph\u00e1p \u0111i\u1ec1u ch\u1ec9nh h\u00e0nh vi v\u00e0 m\u00f4i
\ntr\u01b0\u1eddng n\u00ean \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh
\nnh\u00e2n b\u1ecb m\u1ea5t ng\u1ee7 tr\u01b0\u1edbc khi xem x\u00e9t d\u00f9ng thu\u1ed1c
\nng\u1ee7. \u0110\u1ed3ng th\u1eddi, n\u00ean xem x\u00e9t s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a
\nthu\u1ed1c \u0111\u1ed1i v\u1edbi t\u1eebng t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng, nh\u01b0 s\u1eed
\nd\u1ee5ng paracetamol ho\u1eb7c NSAID cho b\u1ec7nh nh\u00e2n
\n\u0111au nh\u1eb9 \u0111\u1ebfn v\u1eeba thay v\u00ec d\u00f9ng opioid.
\nNh\u1eefng nguy\u00ean t\u1eafc k\u00ea \u0111\u01a1n
\nNh\u1eefng nguy\u00ean t\u1eafc sau li\u00ean quan \u0111\u1ebfn k\u00ea \u0111\u01a1n
\nopioid cho t\u00ecnh tr\u1ea1ng \u0111au m\u1ea1n t\u00ednh, nh\u01b0ng c\u0169ng
\nc\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho b\u1ea5t k\u1ef3 thu\u1ed1c n\u00e0o c\u00f3
\nnguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng:
\n1. T\u1eadp trung ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nguy\u00ean
\nnh\u00e2n c\u0103n b\u1ea3n c\u1ee7a tri\u1ec7u ch\u1ee9ng.
\n2. \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng t\u00e2m l\u00fd v\u00e0 nguy c\u01a1
\nnghi\u1ec7n, bao g\u1ed3m l\u1ea1m d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n
\ntrong qu\u00e1 kh\u1ee9 v\u00e0 hi\u1ec7n t\u1ea1i (g\u1ed3m c\u1ea3 r\u01b0\u1ee3u),
\nti\u1ec1n s\u1eed gia \u0111\u00ecnh l\u1ea1m d\u1ee5ng ch\u1ea5t g\u00e2y nghi\u1ec7n,
\nc\u00e1c b\u1ec7nh l\u00fd li\u00ean quan (nh\u01b0 b\u1ec7nh t\u00e2m th\u1ea7n),
\nmong \u0111\u1ee3i c\u1ee7a b\u1ec7nh nh\u00e2n v\u1ec1 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb, kh\u00ed
\ns\u1eafc, s\u1ef1 h\u1ed7 tr\u1ee3 c\u1ee7a gia \u0111\u00ecnh v\u00e0 x\u00e3 h\u1ed9i.
\n3. Trao \u0111\u1ed5i v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c l\u1ef1a
\nch\u1ecdn \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n, bao g\u1ed3m bi\u1ec7n
\nph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c v\u00e0 c\u00e1c chi\u1ebfn l\u01b0\u1ee3c
\n\u1ee9ng ph\u00f3.
\n4. L\u1ef1a ch\u1ecdn thu\u1ed1c d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng
\nv\u1ec1 hi\u1ec7u qu\u1ea3 v\u00e0 trao \u0111\u1ed5i v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1
\nnh\u1eefng l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 trong qu\u00e1 tr\u00ecnh
\n\u0111i\u1ec1u tr\u1ecb, bao g\u1ed3m s\u1ef1 th\u00edch nghi th\u1ea7n kinh
\n(s\u1ee9c ch\u1ecbu \u0111\u1ef1ng) v\u00e0 r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t
\ng\u00e2y nghi\u00ean (ph\u1ee5 thu\u1ed9c\/nghi\u1ec7n).
\n5. X\u00e2y d\u1ef1ng c\u00e1c m\u1ee5c ti\u00eau c\u00e1 nh\u00e2n h\u00f3a trong
\n\u0111i\u1ec1u tr\u1ecb, v\u00ed d\u1ee5 \u0111\u1ed3ng thu\u1eadn v\u1ec1 nh\u1eefng c\u1ea3i thi\u1ec7n
\nch\u1ee9c n\u0103ng \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi
\nch\u00ednh b\u1ec7nh nh\u00e2n h\u01a1n l\u00e0 \u0111\u00e1nh gi\u00e1 \u0111au d\u1ef1a
\ntr\u00ean thang \u0111i\u1ec3m; gi\u1ea3i th\u00edch r\u00f5 v\u1edbi b\u1ec7nh nh\u00e2n
\nr\u1eb1ng vi\u1ec7c \u0111i\u1ec1u tr\u1ecb s\u1ebd ng\u1eebng l\u1ea1i n\u1ebfu kh\u00f4ng
\n\u0111\u1ea1t \u0111\u01b0\u1ee3c c\u00e1c m\u1ee5c ti\u00eau ho\u1eb7c xu\u1ea5t hi\u1ec7n t\u00e1c
\nd\u1ee5ng kh\u00f4ng mong mu\u1ed1n.
\n6. B\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng thu\u1ed1c trong m\u1ed9t giai
\n\u0111o\u1ea1n th\u1eed nghi\u1ec7m tr\u01b0\u1edbc khi \u0111\u00e1nh gi\u00e1 t\u00e1c\u00a0d\u1ee5ng c\u1ee7a qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00e0 quy\u1ebft \u0111\u1ecbnh
\nc\u00f3 n\u00ean ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u00f3 hay
\nkh\u00f4ng.
\n7. Khi \u0111\u00e1nh gi\u00e1 l\u1ee3i \u00edch t\u1ed5ng th\u1ec3 c\u1ee7a m\u1ed9t
\nthu\u1ed1c, c\u00e2n nh\u1eafc hi\u1ec7u qu\u1ea3 c\u1ee7a vi\u1ec7c s\u1eed
\nd\u1ee5ng thu\u1ed1c \u0111\u1ed1i v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng, c\u1ea3i
\nthi\u1ec7n c\u00e1c m\u1ee5c ti\u00eau v\u1ec1 ho\u1ea1t \u0111\u1ed9ng v\u00e0 ch\u1ee9c
\nn\u0103ng, t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n, h\u00e0nh
\nvi b\u1ea5t th\u01b0\u1eddng (nh\u01b0 t\u0103ng li\u1ec1u, y\u00eau c\u1ea7u t\u00e1i
\nc\u1ea5p ph\u00e1t thu\u1ed1c s\u1edbm) v\u00e0 b\u1ea5t k\u1ef3 thay \u0111\u1ed5i
\nn\u00e0o v\u1ec1 kh\u00ed s\u1eafc v\u00e0 t\u00e2m l\u00fd c\u1ee7a b\u1ec7nh nh\u00e2n.
\n8. \u0110\u1ecbnh k\u1ef3 \u0111\u00e1nh gi\u00e1 c\u00e1c ch\u1ea9n \u0111o\u00e1n c\u0103n
\nb\u1ea3n v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c b\u1ec7nh m\u1eafc k\u00e8m
\n\u0111\u1ebfn th\u00e0nh c\u00f4ng c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb.
\n9. Cung c\u1ea5p k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1eb1ng v\u0103n
\nb\u1ea3n cho b\u1ec7nh nh\u00e2n, trong \u0111\u00f3 m\u00f4 t\u1ea3 r\u00f5
\nc\u00e1ch s\u1eed d\u1ee5ng thu\u1ed1c (li\u1ec1u, t\u1ea7n su\u1ea5t, th\u1eddi
\ngian), c\u00e1c m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb, sau bao l\u00e2u
\ns\u1ebd \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i, c\u00e1ch th\u1ee9c c\u0169ng
\nnh\u01b0 th\u1eddi \u0111i\u1ec3m ng\u1eebng thu\u1ed1c, v\u00e0 ph\u1ea3i l\u00e0m
\ng\u00ec n\u1ebfu kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u
\nch\u1ee9ng ho\u1eb7c kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau
\n\u0111i\u1ec1u tr\u1ecb.
\n10. Ghi l\u1ea1i k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb trong h\u1ed3 s\u01a1
\nb\u1ec7nh \u00e1n \u0111i\u1ec7n t\u1eed c\u1ee7a b\u1ec7nh nh\u00e2n, m\u1ee9c \u0111\u1ed9
\nho\u1eb7c m\u00f4 t\u1ea3 c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ee9c
\nn\u0103ng tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, v\u00e0 k\u1ebft qu\u1ea3 \u0111\u00e1nh gi\u00e1
\nl\u1ea1i sau khi \u0111i\u1ec1u tr\u1ecb.
\nC\u00e1c y\u1ebfu t\u1ed1 t\u00e2m l\u00fd c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng
\nnguy c\u01a1 l\u1ea1m d\u1ee5ng thu\u1ed1c, nh\u01b0 ti\u1ec1n s\u1eed c\u00e1 nh\u00e2n
\nho\u1eb7c gia \u0111\u00ecnh c\u00f3 h\u00e0nh vi nghi\u1ec7n, c\u00e1c v\u1ea5n \u0111\u1ec1
\nv\u1ec1 ph\u00e1p lu\u1eadt li\u00ean quan \u0111\u1ebfn r\u01b0\u1ee3u ho\u1eb7c ma
\nt\u00fay v\u00e0 nh\u1eefng thay \u0111\u1ed5i trong cu\u1ed9c s\u1ed1ng g\u1ea7n
\n\u0111\u00e2y (nh\u01b0 ng\u01b0\u1eddi th\u00e2n qua \u0111\u1eddi), b\u1ecb c\u00f4 l\u1eadp x\u00e3
\nh\u1ed9i, c\u0103ng th\u1eb3ng v\u00e0 \u00e1p l\u1ef1c t\u00e0i ch\u00ednh. M\u1ed9t s\u1ed1
\nt\u1ed5ng quan h\u1ec7 th\u1ed1ng cho th\u1ea5y c\u00e1c b\u1eb1ng ch\u1ee9ng
\nkh\u00f4ng th\u1ed1ng nh\u1ea5t v\u1ec1 t\u01b0\u01a1ng quan gi\u1eefa l\u1ea1m
\nd\u1ee5ng opioid v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nh\u00e2n kh\u1ea9u h\u1ecdc bao
\ng\u1ed3m gi\u1edbi t\u00ednh, t\u00ecnh tr\u1ea1ng vi\u1ec7c l\u00e0m, s\u1eafc t\u1ed9c,
\nt\u00ecnh tr\u1ea1ng h\u00f4n nh\u00e2n ho\u1eb7c tr\u00ecnh \u0111\u1ed9 h\u1ecdc v\u1ea5n
\nc\u1ee7a ng\u01b0\u1eddi s\u1eed d\u1ee5ng thu\u1ed1c.
\nLi\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n v\u00e0 s\u1ed1 ng\u00e0y s\u1eed
\nd\u1ee5ng \u0111\u01a1n thu\u1ed1c \u0111\u1ea7u ti\u00ean c\u0169ng t\u00e1c \u0111\u1ed9ng
\n\u0111\u1ebfn nguy c\u01a1 k\u00e9o d\u00e0i th\u1eddi gian d\u00f9ng thu\u1ed1c,
\nd\u1eabn \u0111\u1ebfn l\u1ea1m d\u1ee5ng thu\u1ed1c. V\u00ed d\u1ee5, m\u1ed9t ph\u00e2n
\nt\u00edch \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean g\u1ea7n 1,3 tri\u1ec7u h\u1ed3 s\u01a1
\nb\u1ec7nh \u00e1n t\u1ea1i M\u1ef9 cho th\u1ea5y trong s\u1ed1 c\u00e1c b\u1ec7nh
\nnh\u00e2n b\u1ecb \u0111au kh\u00f4ng do b\u1ec7nh l\u00fd \u00e1c t\u00ednh \u0111\u01b0\u1ee3c
\nk\u00ea \u0111\u01a1n opioid l\u1ea7n \u0111\u1ea7u (b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3
\n\u0111\u01a1n thu\u1ed1c opioid n\u00e0o trong v\u00f2ng \u22656 th\u00e1ng
\ntr\u01b0\u1edbc khi k\u00ea \u0111\u01a1n n\u00e0y), c\u00e1c y\u1ebfu t\u1ed1 quan tr\u1ecdng
\nl\u00e0m t\u0103ng kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng thu\u1ed1c k\u00e9o d\u00e0i
\nbao g\u1ed3m \u0111\u01a1n thu\u1ed1c \u0111\u1ea7u ti\u00ean v\u01b0\u1ee3t qu\u00e1 5, 10
\nho\u1eb7c 30 ng\u00e0y, sau \u0111\u00f3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n thu\u1ed1c th\u1ee9
\n2 v\u00e0 3, v\u00e0 khi t\u1ed5ng li\u1ec1u t\u00edch l\u0169y t\u01b0\u01a1ng \u0111\u01b0\u01a1ng
\n\u2265700 mg morphin. Trong s\u1ed1 nh\u1eefng b\u1ec7nh
\nnh\u00e2n \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n m\u1ed9t ho\u1eb7c nhi\u1ec1u ng\u00e0y \u0111i\u1ec1u
\ntr\u1ecb v\u1edbi opioid, 6% b\u1ec7nh nh\u00e2n v\u1eabn ti\u1ebfp t\u1ee5c s\u1eed
\nd\u1ee5ng opioid trong 1 n\u0103m sau. Tuy nhi\u00ean, c\u00f3
\nt\u1edbi 14% s\u1ed1 ng\u01b0\u1eddi c\u00f3 \u0111\u01a1n thu\u1ed1c l\u1ea7n \u0111\u1ea7u \u22658
\nng\u00e0y v\u00e0 30% s\u1ed1 ng\u01b0\u1eddi c\u00f3 \u0111\u01a1n thu\u1ed1c l\u1ea7n \u0111\u1ea7u
\n\u226531 ng\u00e0y ti\u1ebfp t\u1ee5c d\u00f9ng opioid 1 n\u0103m sau \u0111\u00f3.
\nKho\u1ea3ng 14% b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c t\u00e1i c\u1ea5p ph\u00e1t
\nopioid theo \u0111\u01a1n ho\u1eb7c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n opioid l\u1ea7n
\nth\u1ee9 2 v\u1eabn ti\u1ebfp t\u1ee5c d\u00f9ng opioid sau 1 n\u0103m.
\nB\u1ec7nh nh\u00e2n d\u00f9ng tramadol c\u00f3 kh\u1ea3 n\u0103ng s\u1eed
\nd\u1ee5ng opioid k\u00e9o d\u00e0i cao nh\u1ea5t, tuy nhi\u00ean \u0111i\u1ec1u
\nn\u00e0y c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh s\u1ef1 l\u1ef1a ch\u1ecdn thu\u1ed1c v\u1edbi
\nt\u00e1c d\u1ee5ng gi\u1ea3m \u0111au k\u00e9o d\u00e0i.
\nK\u00ea \u0111\u01a1n cho b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c y\u1ebfu t\u1ed1
\nnguy c\u01a1
\nT\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p, c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a
\nb\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn kh\u00f4ng s\u1eed d\u1ee5ng
\n\u0111\u01b0\u1ee3c thu\u1ed1c, ho\u1eb7c c\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c nh\u01b0ng
\nph\u1ea3i ti\u1ebfn h\u00e0nh k\u00e8m theo c\u00e1c bi\u1ec7n ph\u00e1p d\u1ef1
\nph\u00f2ng ho\u1eb7c gi\u00e1m s\u00e1t. V\u00ed d\u1ee5, gi\u1edbi h\u1ea1n c\u1ea5p
\nph\u00e1t thu\u1ed1c c\u00f2n 2 \u0111\u1ebfn 3 ng\u00e0y tr\u01b0\u1edbc khi \u0111\u00e1nh
\ngi\u00e1 l\u1ea1i.
\nN\u1ebfu hi\u1ec7n t\u1ea1i b\u1ec7nh nh\u00e2n b\u1ecb ph\u1ee5 thu\u1ed9c ch\u1ea5t
\ng\u00e2y nghi\u1ec7n (nh\u01b0 r\u01b0\u1ee3u, thu\u1ed1c k\u00ea \u0111\u01a1n ho\u1eb7c
\nch\u1ea5t c\u1ea5m), c\u00e1c thu\u1ed1c c\u00f3 nguy c\u01a1 l\u1ea1m d\u1ee5ng
\ncao (nh\u01b0 opioid v\u00e0 thu\u1ed1c ng\u1ee7) th\u01b0\u1eddng b\u1ecb
\nch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh; n\u00ean trao \u0111\u1ed5i v\u1ec1 c\u00e1c l\u1ef1a ch\u1ecdn
\n\u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa v\u1ec1 \u0111au v\u00e0
\nnghi\u1ec7n ch\u1ea5t.
\nXem x\u00e9t t\u00ednh h\u1ee3p l\u00fd \u0111\u1ec3 ti\u1ebfp t\u1ee5c k\u00ea \u0111\u01a1n
\n\u0110\u00e1nh gi\u00e1 l\u1ea1i c\u00e1c thu\u1ed1c c\u00f3 th\u1ec3 kh\u00f4ng c\u00f2n \u0111em
\nl\u1ea1i l\u1ee3i \u00edch ho\u1eb7c ph\u00f9 h\u1ee3p. V\u00ed d\u1ee5, v\u1edbi b\u1ec7nh nh\u00e2n
\nxu\u1ea5t vi\u1ec7n khi \u0111ang s\u1eed d\u1ee5ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c
\ngi\u1ea3m \u0111au, c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng ph\u00e1c \u0111\u1ed3 gi\u1ea3m li\u1ec1u
\nt\u1eeb t\u1eeb v\u00e0 c\u00e1c opioid t\u00e1c d\u1ee5ng m\u1ea1nh \u0111\u01b0\u1ee3c thay
\nth\u1ebf b\u1eb1ng c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au y\u1ebfu h\u01a1n khi
\nt\u00ecnh tr\u1ea1ng \u0111au \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n.
\nM\u1ed9t tr\u01b0\u1eddng h\u1ee3p ph\u1ee9c t\u1ea1p h\u01a1n l\u00e0 ti\u1ebfp t\u1ee5c
\nch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n \u0111\u00e3 s\u1eed d\u1ee5ng thu\u1ed1c
\ntrong th\u1eddi gian d\u00e0i, v\u00ed d\u1ee5 benzodiazepin
\nho\u1eb7c gabapentionid. Kh\u00f4ng bao gi\u1edd l\u00e0 qu\u00e1
\nmu\u1ed9n \u0111\u1ec3 \u00e1p d\u1ee5ng nh\u1eefng nguy\u00ean t\u1eafc k\u00ea \u0111\u01a1n
\nan to\u00e0n v\u00e0 thi\u1ebft l\u1eadp c\u00e1c m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb,
\nk\u1ebf ho\u1ea1ch gi\u1ea3m li\u1ec1u v\u00e0 ng\u1eebng thu\u1ed1c t\u1eeb t\u1eeb\u00a0\u00a0v\u00e0 th\u1eadn tr\u1ecdng trong tr\u01b0\u1eddng h\u1ee3p vi\u1ec7c s\u1eed d\u1ee5ng
\nthu\u1ed1c kh\u00f4ng c\u00f2n \u0111em l\u1ea1i l\u1ee3i \u00edch.
\nL\u1ea1m d\u1ee5ng thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n: Vai
\ntr\u00f2 c\u1ee7a d\u01b0\u1ee3c s\u0129 c\u1ed9ng \u0111\u1ed3ng
\nNhi\u1ec1u thu\u1ed1c OTC \u0111\u01b0\u1ee3c b\u00e1n t\u1ea1i c\u00e1c nh\u00e0 thu\u1ed1c
\nc\u00f3 nguy c\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 thu\u1ed1c k\u00ea
\n\u0111\u01a1n, v\u00ed d\u1ee5 thu\u1ed1c gi\u1ea3m \u0111au ch\u1ee9a codein, thu\u1ed1c
\nkh\u00e1ng histamin c\u00f3 t\u00e1c d\u1ee5ng an th\u1ea7n, thu\u1ed1c
\nnhu\u1eadn tr\u00e0ng, loperamid, thu\u1ed1c ch\u1ed1ng sung
\nhuy\u1ebft m\u0169i, ch\u1ebf ph\u1ea9m \u0111i\u1ec1u tr\u1ecb ho v\u00e0 c\u1ea3m l\u1ea1nh,
\nparacetamol v\u00e0 NSAID (c\u1ea7n l\u01b0u \u00fd, s\u1eed d\u1ee5ng
\nkh\u00f4ng h\u1ee3p l\u00fd paracetamol v\u00e0 c\u00e1c NSAID c\u00f3
\nth\u1ec3 d\u1eabn \u0111\u1ebfn \u0111au \u0111\u1ea7u do l\u1ea1m d\u1ee5ng thu\u1ed1c,
\nng\u1ed9 \u0111\u1ed9c gan v\u00e0 th\u1eadn). D\u01b0\u1ee3c s\u0129 c\u00f3 c\u01a1 h\u1ed9i t\u01b0
\nv\u1ea5n cho b\u1ec7nh nh\u00e2n v\u1ec1 nh\u1eefng bi\u1ec7n ph\u00e1p gi\u00fap
\nng\u0103n ng\u1eeba m\u1ea5t ki\u1ec3m so\u00e1t vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c.
\nT\u01b0\u01a1ng t\u00e1c gi\u1eefa b\u1ec7nh nh\u00e2n v\u00e0 d\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3
\nt\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn vi\u1ec7c \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh
\nv\u1ec1 c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e1t c\u0169ng nh\u01b0 c\u00e1ch s\u1eed
\nd\u1ee5ng c\u00e1c thu\u1ed1c n\u00e0y.
\nN\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u1ebfn mua thu\u1ed1c OTC c\u00f3 nguy
\nc\u01a1 b\u1ecb l\u1ea1m d\u1ee5ng, d\u01b0\u1ee3c s\u0129 n\u00ean c\u00e2n nh\u1eafc c\u00e1c
\ntr\u01b0\u1eddng h\u1ee3p:
\n\u2022 Ng\u01b0\u1eddi mua t\u1ef1 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh kh\u00f4ng
\nch\u00ednh x\u00e1c.
\n\u2022 Li\u1ec1u d\u00f9ng kh\u00f4ng ph\u00f9 h\u1ee3p.
\n\u2022 S\u1eed d\u1ee5ng k\u00e9o d\u00e0i.
\n\u2022 Ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i v\u00e0 t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c
\nthu\u1ed1c kh\u00e1c; \u0111\u1eb7c bi\u1ec7t l\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i c\u00f3
\nth\u1ec3 d\u00f9ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u0111\u1ed3ng th\u1eddi.
\n\u2022 Nh\u1eadn th\u1ee9c sai ho\u1eb7c thi\u1ebfu th\u00f4ng tin v\u1ec1
\nnguy c\u01a1 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n li\u00ean quan \u0111\u1ebfn vi\u1ec7c
\ns\u1eed d\u1ee5ng thu\u1ed1c.
\n\u2022 B\u1ecb l\u00f4i cu\u1ed1n b\u1edfi c\u00e1c qu\u1ea3ng c\u00e1o h\u01b0\u1edbng \u0111\u1ebfn
\n\u0111\u1ed1i t\u01b0\u1ee3ng kh\u00e1ch h\u00e0ng, d\u1eabn \u0111\u1ebfn l\u1ef1a ch\u1ecdn
\nthu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p.
\nM\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p sau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n
\n\u0111\u1ec3 gi\u1ea3m l\u1ea1m d\u1ee5ng thu\u1ed1c OTC:
\n\u2022 T\u1eadp hu\u1ea5n cho nh\u00e2n vi\u00ean kh\u1ea3 n\u0103ng nh\u1eadn
\nbi\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 l\u1ea1m d\u1ee5ng thu\u1ed1c
\nOTC v\u00e0 l\u00e0m theo c\u00e1c quy tr\u00ecnh \u0111\u00e3 \u0111\u01b0\u1ee3c
\nchu\u1ea9n b\u1ecb s\u1eb5n; bao g\u1ed3m c\u00e1c d\u01b0\u1ee3c s\u0129 thay th\u1ebf,
\nnh\u00e2n vi\u00ean l\u00e0m vi\u1ec7c v\u00e0o cu\u1ed1i tu\u1ea7n, c\u00f3 l\u1ecbch
\nl\u00e0m vi\u1ec7c kh\u00f4ng c\u1ed1 \u0111\u1ecbnh ho\u1eb7c kh\u00f4ng th\u01b0\u1eddng
\nxuy\u00ean tham gia v\u00e0o ho\u1ea1t \u0111\u1ed9ng b\u00e1n thu\u1ed1c.
\n\u2022 T\u00ecm hi\u1ec3u th\u00f4ng tin v\u1ec1 t\u00ecnh tr\u1ea1ng l\u1ea1m d\u1ee5ng
\nthu\u1ed1c t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng, x\u00e2y d\u1ef1ng m\u1ed1i li\u00ean h\u1ec7
\nv\u1edbi c\u00e1c nh\u00e0 thu\u1ed1c kh\u00e1c v\u00e0 b\u00e1c s\u0129 trong khu
\nv\u1ef1c.
\n\u2022 Chuy\u1ec3n t\u1ea5t c\u1ea3 c\u00e1c y\u00eau c\u1ea7u c\u1ea5p ph\u00e1t m\u1ed9t
\ns\u1ed1 thu\u1ed1c nh\u1ea5t \u0111\u1ecbnh \u0111\u1ebfn d\u01b0\u1ee3c s\u0129 ph\u1ee5 tr\u00e1ch
\nli\u00ean quan.<\/p>\n
D\u01b0\u1ee3c s\u0129 c\u00f3 c\u01a1
\nh\u1ed9i t\u01b0 v\u1ea5n cho
\nb\u1ec7nh nh\u00e2n v\u1ec1
\nnh\u1eefng bi\u1ec7n ph\u00e1p
\ngi\u00fap ng\u0103n ng\u1eeba
\nm\u1ea5t ki\u1ec3m so\u00e1t
\nvi\u1ec7c s\u1eed d\u1ee5ng
\nthu\u1ed1c. T\u01b0\u01a1ng
\nt\u00e1c gi\u1eefa b\u1ec7nh
\nnh\u00e2n v\u00e0 d\u01b0\u1ee3c s\u0129
\nc\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng
\n\u0111\u00e1ng k\u1ec3 \u0111\u1ebfn vi\u1ec7c
\n\u0111\u01b0a ra quy\u1ebft
\n\u0111\u1ecbnh v\u1ec1 c\u00e1c
\nthu\u1ed1c \u0111\u01b0\u1ee3c c\u1ea5p
\nph\u00e1t c\u0169ng nh\u01b0
\nc\u00e1ch s\u1eed d\u1ee5ng
\nc\u00e1c thu\u1ed1c n\u00e0y.<\/p>\n
C\u00e1c y\u1ebfu t\u1ed1 t\u00e2m
\nl\u00fd c\u0169ng c\u00f3 th\u1ec3
\nl\u00e0m t\u0103ng nguy
\nc\u01a1 l\u1ea1m d\u1ee5ng
\nthu\u1ed1c, nh\u01b0 ti\u1ec1n
\ns\u1eed c\u00e1 nh\u00e2n ho\u1eb7c
\ngia \u0111\u00ecnh c\u00f3 h\u00e0nh
\nvi nghi\u1ec7n, c\u00e1c
\nv\u1ea5n \u0111\u1ec1 v\u1ec1 ph\u00e1p
\nlu\u1eadt li\u00ean quan
\n\u0111\u1ebfn r\u01b0\u1ee3u ho\u1eb7c
\nma t\u00fay v\u00e0 nh\u1eefng
\nthay \u0111\u1ed5i trong
\ncu\u1ed9c s\u1ed1ng g\u1ea7n
\n\u0111\u00e2y (nh\u01b0 ng\u01b0\u1eddi
\nth\u00e2n qua \u0111\u1eddi),
\nb\u1ecb c\u00f4 l\u1eadp x\u00e3 h\u1ed9i,
\nc\u0103ng th\u1eb3ng v\u00e0
\n\u00e1p l\u1ef1c t\u00e0i ch\u00ednh<\/p>\n
<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Ng\u01b0\u1eddi d\u1ecbch: \u0110\u1ed7 Th\u1ecb Anh \u0110\u00e0o, L\u01b0\u01a1ng Anh T\u00f9ng Trong c\u1ed9ng \u0110\u1ed3ng, hi\u1ec7n c\u00f3 m\u1ed9t v\u1ea5n \u0110\u1ec1 \u0110\u00e1ng ch\u00fa \u00fd li\u00ean quan \u0110\u1ebfn c\u00e1c b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c ng\u1ee7, opioid v\u00e0 c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au kh\u00e1c trong th\u1eddi gian d\u00e0i m\u00e0 kh\u00f4ng c\u00f3 k\u1ebf ho\u1ea1ch ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c r\u00f5 r\u00e0ng. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 […]\n","protected":false},"author":1,"featured_media":3811,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5691","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\/5691","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=5691"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5691\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/3811"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}