{"id":57397,"date":"2023-11-16T23:31:20","date_gmt":"2023-11-16T16:31:20","guid":{"rendered":"https:\/\/vnras.com\/drug\/?post_type=product&#038;p=57397"},"modified":"2025-07-24T13:59:34","modified_gmt":"2025-07-24T06:59:34","slug":"thuoc-depo-medrol-40mg","status":"publish","type":"product","link":"https:\/\/vnras.com\/drug\/thuoc-depo-medrol-40mg\/","title":{"rendered":"Depo-Medrol 40mg"},"content":{"rendered":"<p><b>Trong b\u00e0i vi\u1ebft n\u00e0y, d\u01b0\u1ee3c s\u0129 L\u01b0u V\u0103n Ho\u00e0ng gi\u1edbi thi\u1ec7u \u0111\u1ebfn c\u00e1c b\u1ea1n s\u1ea3n ph\u1ea9m thu\u1ed1c Depo-Medrol 40mg ch\u1ee9a th\u00e0nh ph\u1ea7n methylprednisolon h\u00e0m l\u01b0\u1ee3ng 40mg\/1ml; thu\u1ed9c nh\u00f3m Glucocorticoid t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i, do h\u00e3ng d\u01b0\u1ee3c ph\u1ea9m Pfizer, Th\u00e1i Lan s\u1ea3n xu\u1ea5t v\u00e0 ph\u00e2n ph\u1ed1i t\u1ea1i Vi\u1ec7t Nam v\u1edbi s\u1ed1 \u0111\u0103ng k\u00fd l\u00e0 VN-11978-11.<\/b><\/p>\n<h2><span style=\"font-weight: 400\">Depo-Medrol 40mg l\u00e0 thu\u1ed1c g\u00ec?<\/span><\/h2>\n<h3><span style=\"font-weight: 400\">Th\u00e0nh ph\u1ea7n<\/span><\/h3>\n<p><span style=\"font-weight: 400\">Thu\u1ed1c <strong>Depo-Medrol 40mg<\/strong> c\u00f3 ch\u1ee9a th\u00e0nh ph\u1ea7n:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\">Methylprednisolon:&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..40mg.<\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">T\u00e1 d\u01b0\u1ee3c v\u1eeba \u0111\u1ee7 1ml.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">D\u1ea1ng b\u00e0o ch\u1ebf: H\u1ed7n d\u1ecbch ti\u00eam.<\/span><\/p>\n<h3><span style=\"font-weight: 400\">Tr\u00ecnh b\u00e0y<\/span><\/h3>\n<p><span style=\"font-weight: 400\">S\u0110K: VN-11978-11.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Quy c\u00e1ch \u0111\u00f3ng g\u00f3i: H\u1ed9p 1 l\u1ecd 1ml.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Xu\u1ea5t x\u1ee9: Pfizer &#8211; Th\u00e1i Lan<\/span><\/p>\n<h2><span style=\"font-weight: 400\">T\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c Depo-Medrol 40mg<\/span><\/h2>\n<h3><span style=\"font-weight: 400\">C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng\u00a0<\/span><\/h3>\n<p>Methylprednisolon l\u00e0 m\u1ed9t steroid ch\u1ed1ng vi\u00eam m\u1ea1nh. N\u00f3 c\u00f3 hi\u1ec7u l\u1ef1c ch\u1ed1ng vi\u00eam l\u1edbn h\u01a1n prednisolon v\u00e0 c\u0169ng \u00edt c\u00f3 xu h\u01b0\u1edbng g\u00e2y gi\u1eef mu\u1ed1i v\u00e0 n\u01b0\u1edbc h\u01a1n prednisolon.<\/p>\n<p>Glucocorticoid c\u00f3 \u1ea3nh h\u01b0\u1edfng m\u1ea1nh \u0111\u1ebfn qu\u00e1 tr\u00ecnh mi\u1ec5n d\u1ecbch v\u00e0 g\u00e2y vi\u00eam, t\u00ednh ch\u1ea5t n\u00e0y li\u00ean quan \u0111\u1ebfn nhi\u1ec1u ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb c\u1ee7a methylprednisolon, bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb d\u1ecb \u1ee9ng. T\u00e1c d\u1ee5ng ch\u1ed1ng d\u1ecb \u1ee9ng bao g\u1ed3m s\u1ef1 \u1ee9c ch\u1ebf c\u1ee7a nhi\u1ec1u cytokin nh\u01b0 interleukin, GM-CSF, TNF- \u03b1 v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c th\u00fac \u0111\u1ea9y s\u1ef1 di chuy\u1ec3n c\u1ee7a b\u1ea1ch c\u1ea7u v\u00e0 s\u1ef1 h\u00ecnh th\u00e0nh c\u1ee7a ph\u1ea3n \u1ee9ng vi\u00eam do d\u1ecb \u1ee9ng v\u00e0 kh\u00f4ng d\u1ecb \u1ee9ng.<\/p>\n<p>Nh\u1eefng t\u00ednh ch\u1ea5t ch\u1ed1ng vi\u00eam, \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch n\u00e0y bao g\u1ed3m:<\/p>\n<p>Ng\u0103n ch\u1eb7n c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch bao g\u1ed3m: Gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o lympho v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng.<\/p>\n<p>Ng\u0103n ch\u1eb7n v\u00e0 \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh vi\u00eam bao g\u1ed3m: \u1ee8c ch\u1ebf s\u1ea3n xu\u1ea5t v\u00e0 gi\u1ea3i ph\u00f3ng c\u00e1c cytokin v\u00e0 ch\u1ea5t trung gian g\u00e2y vi\u00eam kh\u00e1c, \u1ee9c ch\u1ebf s\u1ef1 gi\u00e3n m\u1ea1ch, huy \u0111\u1ed9ng b\u1ea1ch c\u1ea7u \u0111\u1ebfn v\u1ecb tr\u00ed vi\u00eam v\u00e0 c\u00e1c qu\u00e1 tr\u00ecnh quan tr\u1ecdng kh\u00e1c \u0111\u1ed1i v\u1edbi ph\u1ea3n \u1ee9ng vi\u00eam.<\/p>\n<h3><span style=\"font-weight: 400\">\u0110\u1eb7c \u0111i\u1ec3m d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc\u00a0<\/span><\/h3>\n<p><em>H\u1ea5p thu<\/em><\/p>\n<p>M\u1ed9t nghi\u00ean c\u1ee9u n\u1ed9i b\u1ed9 tr\u00ean 8 t\u00ecnh nguy\u1ec7n vi\u00ean \u0111\u00e3 x\u00e1c \u0111\u1ecbnh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a li\u1ec1u \u0111\u01a1n 40 mg Depo Medrol ti\u00eam b\u1eafp. M\u1ee9c n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trung b\u00ecnh trong huy\u1ebft t\u01b0\u01a1ng t\u1eebng b\u1ec7nh nh\u00e2n l\u00e0 14,8 \u00b1 8,6 ng\/mL, th\u1eddi gian \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trung b\u00ecnh c\u1ee7a t\u1eebng b\u1ec7nh nh\u00e2n l\u00e0 7,25 \u00b1 1,04 gi\u1edd, v\u00e0 di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong trung b\u00ecnh (AUC) l\u00e0 1354,2 \u00b1424,1 ng\/mL x gi\u1edd (Ng\u00e0y 1 \u2013 2 L).<\/p>\n<p><em>Ph\u00e2n b\u1ed1<\/em><\/p>\n<p>Methylprednisolon \u0111\u01b0\u1ee3c ph\u00e2n b\u1ed1 r\u1ed9ng v\u00e0o c\u00e1c m\u00f4, qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o, v\u00e0 \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua s\u1eefa m\u1eb9. Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 bi\u1ec3u ki\u1ebfn c\u1ee7a thu\u1ed1c l\u00e0 kho\u1ea3ng 1,4 L\/kg. T\u1ef7 l\u1ec7 li\u00ean k\u1ebft protein huy\u1ebft t\u01b0\u01a1ng c\u1ee7a methylprednisolon \u1edf ng\u01b0\u1eddi l\u00e0 kho\u1ea3ng 77%.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>\u1ede ng\u01b0\u1eddi, methylprednisolon \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a \u1edf gan th\u00e0nh c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a kh\u00f4ng ho\u1ea1t t\u00ednh, nh\u1eefng ch\u1ea5t ch\u1ee7 y\u1ebfu l\u00e0 20\u03b1 &#8211; hydroxymethylprednisolon v\u00e0 20\u03b2 &#8211; hydroxymethylprednisolon. Qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a trong gan x\u1ea3y ra ch\u1ee7 y\u1ebfu th\u00f4ng qua CYP3A4.<\/p>\n<p>Gi\u1ed1ng nh\u01b0 nhi\u1ec1u lo\u1ea1i c\u01a1 ch\u1ea5t c\u1ee7a CYP3A4, methylprednisolon c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t c\u01a1 ch\u1ea5t c\u1ee7a protein v\u1eadn chuy\u1ec3n p-glycoprotein g\u1eafn ATP (ATP &#8211; binding cassette, ABC), \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ph\u00e2n b\u1ed1 v\u00e0o m\u00f4 v\u00e0 t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>Th\u1eddi gian b\u00e1n th\u1ea3i trung b\u00ecnh c\u1ee7a methylprednisolon l\u00e0 t\u1eeb 1,8 \u0111\u1ebfn 5,2 gi\u1edd. \u0110\u1ed9 thanh th\u1ea3i to\u00e0n ph\u1ea7n x\u1ea5p x\u1ec9 5 &#8211; 6 mL\/ph\u00fat\/kg.<\/p>\n<h2><span style=\"font-weight: 400\">Thu\u1ed1c Depo-Medrol 40mg \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong b\u1ec7nh g\u00ec?<\/span><\/h2>\n<p>Thu\u1ed1c Depo-Medrol 40mg \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb vi\u00eam x\u01b0\u01a1ng kh\u1edbp, vi\u00eam th\u1ea5p kh\u1edbp m\u1ea1n t\u00ednh.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n n\u1ed9t ti\u1ebft t\u1ed1, \u0111i\u1ec1u tr\u1ecb vi\u00eam kh\u1edbp do v\u1ea9y n\u1ebfn, vi\u00eam \u0111\u1ed1t s\u1ed1ng, vi\u00eam kh\u1edbp sau c\u00e1c ch\u1ea5n th\u01b0\u01a1ng, b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng, c\u00e1c b\u1ec7nh v\u1ec1 da nh\u01b0 vi\u00eam da t\u1ea5y\u2026; \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a; gi\u1ea3m t\u00ecnh tr\u1ea1ng ph\u00f9, \u0111i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p, \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb suy v\u1ecf th\u01b0\u1ee3ng th\u1eadn, t\u0103ng b\u1ea9m sinh s\u1ea3n l\u01b0\u1ee3ng th\u1eadn\u2026<\/p>\n<h2><span style=\"font-weight: 400\">Li\u1ec1u d\u00f9ng c\u1ee7a thu\u1ed1c Depo-Medrol 40mg<\/span><\/h2>\n<h3>C\u00e1ch d\u00f9ng thu\u1ed1c Depo-Medrol 40mg<\/h3>\n<p>Thu\u1ed1c Depo-Medrol 40mg l\u00e0 thu\u1ed1c kh\u00e1ng vi\u00eam methylprednisolon t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n, \u0111\u01b0\u1ee3c d\u00f9ng theo \u0111\u01b0\u1eddng ti\u00eam b\u1eafp, ti\u00eam trong kh\u1edbp ho\u1eb7c m\u00f4 m\u1ec1m.<\/p>\n<h3>Li\u1ec1u d\u00f9ng c\u1ee7a thu\u1ed1c Depo-Medrol 40mg<\/h3>\n<p>Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 vi\u00eam x\u01b0\u01a1ng kh\u1edbp:<\/p>\n<p>Kh\u1edbp l\u1edbn: Ti\u00eam 0.5 l\u1ecd \u2013 2 l\u1ecd\/ l\u1ea7n.<\/p>\n<p>Kh\u1edbp trung b\u00ecnh: Ti\u00eam 0.25 l\u1ecd \u2013 1 l\u1ecd\/ l\u1ea7n.<\/p>\n<p>Kh\u1edbp nh\u1ecf, vi\u00eam g\u00e2n, vi\u00eam bao g\u00e2n: Ti\u00eam 4 \u2013 10 mg\/ l\u1ea7n.<\/p>\n<p>H\u1ea1ch, vi\u00eam g\u00e2n, vi\u00eam m\u1ecfm l\u1ed3i c\u1ea7u x\u01b0\u01a1ng: li\u1ec1u thay \u0111\u1ed5i t\u1eeb 4 mg \u0111\u1ebfn 30 mg\/ l\u1ea7n. Trong c\u00e1c b\u1ec7nh t\u00e1i ph\u00e1t ho\u1eb7c m\u1ea1n t\u00ednh, c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i \u00e1p d\u1ee5ng c\u00e1c li\u1ec1u ti\u00eam l\u1eb7p l\u1ea1i.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh v\u1ec1 da v\u00e0 m\u00f4 m\u1ec1m: Ti\u00eam 0.5 &#8211; 1.5 l\u1ecd\/l\u1ea7n, th\u01b0\u1eddng ti\u00eam 1-4 m\u0169i v\u00e0 kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c l\u1ea7n ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 b\u1ec7nh.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb hen: ti\u00eam 2 \u2013 3 l\u1ecd\/ tu\u1ea7n.<\/p>\n<h2><span style=\"font-weight: 400\">Kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c Depo-Medrol 40mg trong tr\u01b0\u1eddng h\u1ee3p n\u00e0o?<\/span><\/h2>\n<p>Kh\u00f4ng d\u00f9ng Depo-Medrol trong tr\u01b0\u1eddng h\u1ee3p b\u00eanh nh\u00e2n nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n.<\/p>\n<p>Qu\u00e1 m\u1eabn v\u1edbi methylprednisolon ho\u1eb7c b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o trong c\u00f4ng th\u1ee9c thu\u1ed1c.<\/p>\n<p>Methylprednisolon kh\u00f4ng \u0111\u01b0\u1ee3c ti\u00eam n\u1ed9i t\u1ee7y; kh\u00f4ng ti\u00eam ngo\u00e0i m\u00e0ng c\u1ee9ng kh\u1edbp.<\/p>\n<p>Kh\u00f4ng d\u00f9ng thu\u1ed1c theo \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng v\u1eafc-xin s\u1ed1ng ho\u1eb7c v\u1eafc-xin s\u1ed1ng gi\u1ea3m \u0111\u1ed9c l\u1ef1c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng c\u00e1c li\u1ec1u corticosteroid \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch.<\/p>\n<h2><span style=\"font-weight: 400\">L\u01b0u \u00fd \u0111\u1eb7c bi\u1ec7t khi s\u1eed d\u1ee5ng thu\u1ed1c Depo-Medrol 40mg<\/span><\/h2>\n<h3><span style=\"font-weight: 400\">Th\u1eadn tr\u1ecdng<\/span><\/h3>\n<p>Ti\u00eam corticosteroid v\u00e0o bao ho\u1ea1t d\u1ecbch c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng to\u00e0n th\u00e2n c\u0169ng nh\u01b0 t\u1ea1i ch\u1ed7.<\/p>\n<p>C\u1ea7n ki\u1ec3m tra c\u1ea9n th\u1eadn khi xu\u1ea5t hi\u1ec7n d\u1ecbch \u1edf b\u1ea5t k\u1ef3 kh\u1edbp n\u00e0o \u0111\u1ec3 lo\u1ea1i tr\u1eeb qu\u00e1 tr\u00ecnh nhi\u1ec5m khu\u1ea9n.<\/p>\n<p>M\u1ee9c \u0111\u1ed9 \u0111au t\u0103ng r\u00f5 r\u1ec7t k\u00e8m theo s\u01b0ng t\u1ea1i ch\u1ed7, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp, s\u1ed1t v\u00e0 kh\u00f3 ch\u1ecbu l\u00e0 d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd vi\u00eam kh\u1edbp do nhi\u1ec5m tr\u00f9ng. N\u1ebfu bi\u1ebfn ch\u1ee9ng n\u00e0y xu\u1ea5t hi\u1ec7n v\u00e0 ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh ph\u00f9 h\u1ee3p.<\/p>\n<p>C\u1ea7n tr\u00e1nh ti\u00eam steroid t\u1ea1i ch\u1ed7 v\u00e0o kh\u1edbp b\u1ecb nhi\u1ec5m tr\u00f9ng tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<p>Kh\u00f4ng n\u00ean ti\u00eam corticosteroid v\u00e0o c\u00e1c kh\u1edbp kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/p>\n<p>C\u1ea7n th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt v\u00f4 khu\u1ea9n \u0111\u1ec3 ng\u0103n ng\u1eeba nhi\u1ec5m tr\u00f9ng ho\u1eb7c nhi\u1ec5m b\u1ea9n.<\/p>\n<p>T\u1ed1c \u0111\u1ed9 h\u1ea5p thu qua \u0111\u01b0\u1eddng ti\u00eam b\u1eafp s\u1ebd ch\u1eadm h\u01a1n.<\/p>\n<p>T\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch\/t\u0103ng nguy c\u01a1 nhi\u1ec5m khu\u1ea9n<\/p>\n<p>Corticosteroid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m khu\u1ea9n, che l\u1ea5p m\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u nhi\u1ec5m khu\u1ea9n v\u00e0 m\u1ed9t s\u1ed1 nhi\u1ec5m khu\u1ea9n m\u1edbi c\u00f3 th\u1ec3 x\u1ea3y ra khi \u0111ang d\u00f9ng corticosteroid.<\/p>\n<p>T\u00e1c d\u1ee5ng tr\u00ean h\u1ec7 mi\u1ec5n d\u1ecbch<\/p>\n<p>C\u00f3 th\u1ec3 x\u1ea3y ra c\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng. V\u00ec m\u1ed9t s\u1ed1 hi\u1ebfm c\u00e1c tr\u01b0\u1eddng h\u1ee3p d\u1ecb \u1ee9ng tr\u00ean da v\u00e0 ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 \u0111\u00e3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n d\u00f9ng corticosteroid, c\u1ea7n c\u00f3 nh\u1eefng bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba th\u00edch h\u1ee3p tr\u01b0\u1edbc khi d\u00f9ng corticosteroid, \u0111\u1eb7c bi\u1ec7t khi b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng v\u1edbi b\u1ea5t k\u1ef3 lo\u1ea1i thu\u1ed1c n\u00e0o.<\/p>\n<p>T\u00e1c d\u1ee5ng tr\u00ean chuy\u1ec3n ho\u00e1 v\u00e0 dinh d\u01b0\u1ee1ng<\/p>\n<p>C\u00e1c corticosteroid, bao g\u1ed3m methylprednisolon, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, l\u00e0m n\u1eb7ng h\u01a1n t\u00ecnh tr\u1ea1ng ti\u1ec3u \u0111\u01b0\u1eddng s\u1eb5n c\u00f3, v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ti\u1ec3u \u0111\u01b0\u1eddng tr\u00ean nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng s\u1eed d\u1ee5ng corticosteroid k\u00e9o d\u00e0i.<\/p>\n<p>T\u00e1c d\u1ee5ng tr\u00ean t\u00e2m th\u1ea7n<\/p>\n<p>C\u00e1c x\u00e1o tr\u1ed9n v\u1ec1 t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n khi s\u1eed d\u1ee5ng corticosteroid, t\u1eeb s\u1ea3ng kho\u00e1i, m\u1ea5t ng\u1ee7, thay \u0111\u1ed5i t\u00e2m tr\u1ea1ng, t\u00ednh kh\u00ed th\u1ea5t th\u01b0\u1eddng v\u00e0 tr\u1ea7m c\u1ea3m n\u1eb7ng cho \u0111\u1ebfn nh\u1eefng bi\u1ec3u hi\u1ec7n t\u00e2m th\u1ea7n th\u1ef1c s\u1ef1. Ngo\u00e0i ra, s\u1ef1 b\u1ea5t \u1ed5n c\u1ea3m x\u00fac ho\u1eb7c khuynh h\u01b0\u1edbng t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 n\u1eb7ng h\u01a1n do corticosteroid.<\/p>\n<p>T\u00e1c d\u1ee5ng tr\u00ean h\u1ec7 c\u01a1 x\u01b0\u01a1ng<\/p>\n<p>M\u1eb7c d\u00f9 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00f3 \u0111\u1ed1i ch\u1ee9ng \u0111\u00e3 cho th\u1ea5y corticosteroid c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m nhanh m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ea5p t\u00ednh trong \u0111\u1ee3t c\u1ea5p c\u1ee7a b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng, nh\u01b0ng nh\u1eefng th\u1eed nghi\u1ec7m \u0111\u00f3 kh\u00f4ng ch\u1ee9ng t\u1ecf \u0111\u01b0\u1ee3c r\u1eb1ng corticosteroid c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb cu\u1ed1i c\u00f9ng ho\u1eb7c di\u1ec5n bi\u1ebfn t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y r\u1eb1ng c\u1ea7n d\u00f9ng li\u1ec1u corticosteroid t\u01b0\u01a1ng \u0111\u1ed1i cao m\u1edbi c\u00f3 t\u00e1c d\u1ee5ng \u0111\u00e1ng k\u1ec3. \u0110\u00e3 c\u00f3 c\u00e1c b\u00e1o c\u00e1o v\u1ec1 hi\u1ec7n t\u01b0\u1ee3ng t\u00edch m\u1ee1 ngo\u00e0i m\u00e0ng c\u1ee9ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng corticosteroid, \u0111i\u1ec3n h\u00ecnh l\u00e0 khi s\u1eed d\u1ee5ng li\u1ec1u cao k\u00e9o d\u00e0i.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean m\u1eaft\u00a0 \u00a0<\/em><\/p>\n<p>D\u00f9ng corticosteroid k\u00e9o d\u00e0i c\u00f3 th\u1ec3 l\u00e0m \u0111\u1ee5c th\u1ee7y tinh th\u1ec3 d\u01b0\u1edbi bao sau v\u00e0 \u0111\u1ee5c th\u1ee7y tinh th\u1ec3 2 \u1edf trung t\u00e2m (\u0111\u1eb7c bi\u1ec7t \u1edf tr\u1ebb em), l\u1ed3i m\u1eaft ho\u1eb7c t\u0103ng \u00e1p l\u1ef1c n\u1ed9i nh\u00e3n, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn b\u1ec7nh t\u0103ng nh\u00e3n \u00e1p \u0111i k\u00e8m t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh th\u1ecb gi\u00e1c. C\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 nhi\u1ec5m n\u1ea5m v\u00e0 virus th\u1ee9 ph\u00e1t tr\u00ean m\u1eaft \u1edf b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng glucocorticoid.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean tim<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a glucocorticoid tr\u00ean h\u1ec7 tim m\u1ea1ch nh\u01b0 r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 t\u0103ng huy\u1ebft \u00e1p, c\u00f3 th\u1ec3 khi\u1ebfn c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 s\u1eb5n c\u00e1c nguy c\u01a1 v\u1ec1 tim m\u1ea1ch ph\u1ea3i ch\u1ecbu th\u00eam c\u00e1c \u1ea3nh h\u01b0\u1edfng tim m\u1ea1ch kh\u00e1c n\u1ebfu d\u00f9ng li\u1ec1u cao v\u00e0 k\u00e9o d\u00e0i.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean m\u1ea1ch<\/em><\/p>\n<p>Huy\u1ebft kh\u1ed1i, bao g\u1ed3m thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch, \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o x\u1ea3y ra khi d\u00f9ng corticosteroid. Do \u0111\u00f3, corticosteroid c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n \u0111ang b\u1ecb ho\u1eb7c c\u00f3 th\u1ec3 c\u00f3 nguy c\u01a1 b\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n v\u1ec1 huy\u1ebft kh\u1ed1i.<\/p>\n<p><em>T\u00e1c d\u1ee5ng l\u00ean \u1ed1ng ti\u00eau h\u00f3a<\/em><\/p>\n<p>Li\u1ec1u cao c\u1ee7a corticosteroid c\u00f3 th\u1ec3 g\u00e2y vi\u00eam t\u1ee5y c\u1ea5p.<\/p>\n<p><em>T\u00e1c d\u1ee5ng l\u00ean gan m\u1eadt<\/em><\/p>\n<p>R\u1ed1i lo\u1ea1n gan m\u1eadt \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o c\u00f3 th\u1ec3 t\u00e1i ph\u00e1t sau khi ng\u01b0ng \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3 vi\u1ec7c gi\u00e1m s\u00e1t th\u00edch h\u1ee3p l\u00e0 c\u1ea7n thi\u1ebft.<\/p>\n<p><em>T\u00e1c d\u1ee5ng tr\u00ean h\u1ec7 c\u01a1 x\u01b0\u01a1ng<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 b\u1ec7nh c\u01a1 c\u1ea5p t\u00ednh khi s\u1eed d\u1ee5ng corticosteroid li\u1ec1u cao, th\u01b0\u1eddng x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n b\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n d\u1eabn truy\u1ec1n th\u1ea7n kinh c\u01a1 (v\u00ed d\u1ee5 nh\u01b0\u1ee3c c\u01a1 n\u1eb7ng), hay tr\u00ean b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng c\u00e1c thu\u1ed1c kh\u00e1ng cholinergic nh\u01b0 thu\u1ed1c \u1ee9c ch\u1ebf th\u1ea7n kinh c\u01a1 (v\u00ed d\u1ee5 nh\u01b0 pancuronium). B\u1ec7nh c\u01a1 c\u1ea5p t\u00ednh n\u00e0y lan r\u1ed9ng, c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn c\u00e1c c\u01a1 m\u1eaft, c\u01a1 h\u00f4 h\u1ea5p v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn li\u1ec7t chi. T\u00ecnh tr\u1ea1ng t\u0103ng creatinin kinase c\u00f3 th\u1ec3 x\u1ea3y ra. \u0110\u1ec3 c\u00f3 ti\u1ebfn tri\u1ec3n v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng hay h\u1ed3i ph\u1ee5c, c\u1ea7n d\u1eebng thu\u1ed1c trong v\u00f2ng v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i n\u0103m.<\/p>\n<p>Lo\u00e3ng x\u01b0\u01a1ng l\u00e0 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n ph\u1ed5 bi\u1ebfn nh\u01b0ng \u00edt \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n khi d\u00f9ng glucocorticoid li\u1ec1u cao v\u00e0 k\u00e9o d\u00e0i.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n th\u1eadn v\u00e0 ti\u1ebft ni\u1ec7u<\/em><\/p>\n<p>N\u00ean th\u1eadn tr\u1ecdng khi d\u00f9ng corticosteroid tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n suy th\u1eadn.<\/p>\n<p>Nghi\u00ean c\u1ee9u: Li\u1ec1u trung b\u00ecnh ho\u1eb7c cao c\u1ee7a hydrocortison ho\u1eb7c cortison c\u00f3 th\u1ec3 g\u00e2y t\u0103ng huy\u1ebft \u00e1p, gi\u1eef mu\u1ed1i v\u00e0 n\u01b0\u1edbc v\u00e0 t\u0103ng th\u1ea3i tr\u1eeb kali. Nh\u1eefng t\u00e1c d\u1ee5ng n\u00e0y \u00edt g\u1eb7p h\u01a1n v\u1edbi c\u00e1c d\u1eabn xu\u1ea5t t\u1ed5ng h\u1ee3p tr\u1eeb khi d\u00f9ng li\u1ec1u cao. Ch\u1ebf \u0111\u1ed9 \u0103n h\u1ea1n ch\u1ebf mu\u1ed1i v\u00e0 b\u1ed5 sung kali c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft. T\u1ea5t c\u1ea3 c\u00e1c corticosteroid \u0111\u1ec1u l\u00e0m t\u0103ng th\u1ea3i tr\u1eeb calci.<\/p>\n<p><em>Ch\u1ea5n th\u01b0\u01a1ng, ng\u1ed9 \u0111\u1ed9c v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng do ph\u1eabu thu\u1eadt<\/em><\/p>\n<p>Corticosteroid d\u00f9ng to\u00e0n th\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh v\u00e0 do \u0111\u00f3 kh\u00f4ng n\u00ean d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o.<\/p>\n<p><em>C\u1ea3nh b\u00e1o kh\u00e1c<\/em><\/p>\n<p>Do c\u00e1c bi\u1ebfn ch\u1ee9ng khi d\u00f9ng glucocorticoid ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb, c\u1ea7n c\u00e2n nh\u1eafc l\u1ee3i \u00edch\/nguy c\u01a1 tr\u00ean t\u1eebng b\u1ec7nh nh\u00e2n v\u1ec1 li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb theo li\u1ec1u h\u00e0ng ng\u00e0y hay d\u00f9ng c\u00e1ch nh\u1eadt.<\/p>\n<p>C\u1ea7n th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng aspirin v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid ph\u1ed1i h\u1ee3p v\u1edbi corticosteroid.<\/p>\n<p>B\u1ec7nh u t\u1ebf b\u00e0o \u01b0a cr\u00f4m c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o sau khi s\u1eed d\u1ee5ng corticosteroid to\u00e0n th\u00e2n. V\u1edbi b\u1ec7nh nh\u00e2n nghi ng\u1edd ho\u1eb7c \u0111\u00e3 x\u00e1c \u0111\u1ecbnh l\u00e0 m\u1eafc b\u1ec7nh u t\u1ebf b\u00e0o \u01b0a cr\u00f4m, ch\u1ec9 n\u00ean s\u1eed d\u1ee5ng corticosteroid sau khi \u0111\u00e3 ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 l\u1ee3i \u00edch\/nguy c\u01a1 ph\u00f9 h\u1ee3p.<\/p>\n<p>Ch\u1ebf ph\u1ea9m n\u00e0y c\u00f3 ch\u1ee9a natri. N\u1ed3ng \u0111\u1ed9 natri \u00edt h\u01a1n 1 mmol\/1 ml h\u1ed7n d\u1ecbch ti\u00eam, n\u00ean c\u00f3 th\u1ec3 coi nh\u01b0 &#8220;kh\u00f4ng c\u00f3 natri&#8221;<\/p>\n<p><em>D\u00f9ng \u1edf tr\u1ebb em<\/em><\/p>\n<p>C\u1ea7n theo d\u00f5i ch\u1eb7t ch\u1ebd s\u1ef1 t\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb em khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng corticosteroid k\u00e9o d\u00e0i. Ch\u1eadm t\u0103ng tr\u01b0\u1edfng c\u00f3 th\u1ec3 g\u1eb7p tr\u00ean tr\u1ebb em s\u1eed d\u1ee5ng glucocorticoid k\u00e9o d\u00e0i, h\u00e0ng ng\u00e0y, v\u1edbi li\u1ec1u chia nh\u1ecf v\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p n\u00e0y n\u00ean h\u1ea1n ch\u1ebf, ch\u1ec9 n\u00ean d\u00f9ng v\u1edbi c\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u1ea9n c\u1ea5p nh\u1ea5t.<\/p>\n<p>Tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb em s\u1eed d\u1ee5ng corticosteroid k\u00e9o d\u00e0i c\u00f3 nguy c\u01a1 \u0111\u1eb7c bi\u1ec7t v\u1ec1 t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/p>\n<p>Li\u1ec1u cao corticosteroid c\u00f3 th\u1ec3 g\u00e2y vi\u00eam t\u1ee5y \u1edf tr\u1ebb em.<\/p>\n<h3><span style=\"font-weight: 400\">T\u00e1c d\u1ee5ng ph\u1ee5<\/span><\/h3>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 x\u1ea3y ra khi s\u1eed d\u1ee5ng Methylprednisolone th\u01b0\u1eddng do d\u00f9ng li\u1ec1u cao v\u00e0 s\u1eed d\u1ee5ng d\u00e0i ng\u00e0y. T\u00e1c d\u1ee5ng ph\u1ee5 r\u00f5 r\u1ec7t nh\u1ea5t c\u00f3 th\u1ec3 th\u1ea5y tr\u00ean d\u1ea1 d\u00e0y, do n\u00f3 \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p prostaglandin \u1edf d\u1ea1 d\u00e0y v\u00e0 \u1ee9c ch\u1ebf ti\u1ebft l\u1edbp acid b\u1ea3o v\u1ec7 d\u1ea1 d\u00e0y, d\u1eabn t\u1edbi c\u00e1c b\u1ec7nh nh\u01b0 vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng.<\/p>\n<p>Ngo\u00e0i ra, c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c th\u01b0\u1eddng g\u1eb7p nh\u01b0: k\u00edch \u0111\u1ed9ng th\u1ea7n kinh, m\u1ea5t ng\u1ee7, \u0103n nhi\u1ec1u, kh\u00f3 ti\u00eau, r\u1eadm l\u00f4ng, \u0111au kh\u1edbp, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, glocom, \u0111\u1ee5c th\u1ee7y tinh th\u1ec3, ch\u1ea3y m\u00e1u cam.<\/p>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 \u00edt g\u1eb7p h\u01a1n: ch\u00f3ng m\u1eb7t, lo\u1ea1n th\u1ea7n, co gi\u1eadt, nh\u1ee9c \u0111\u1ea7u, m\u00ea s\u1ea3ng, \u1ea3o gi\u00e1c, t\u0103ng huy\u1ebft \u00e1p, ph\u00f9 m\u1ea1ch, t\u0103ng s\u1eafc t\u1ed1 m\u00f4, da th\u00e2m t\u00edm t\u00e1i, teo da, m\u1ee5n tr\u1ee9ng c\u00e1, lo\u00e9t d\u1ea1 d\u00e0y, ch\u01b0\u1edbng b\u1ee5ng, lo\u00e9t th\u1ef1c qu\u1ea3n, y\u1ebfu c\u01a1, g\u00e3y x\u01b0\u01a1ng, qu\u00e1 m\u1eabn\u2026<\/p>\n<h3><span style=\"font-weight: 400\">T\u01b0\u01a1ng t\u00e1c<\/span><\/h3>\n<p>Methylprednisolon l\u00e0 c\u01a1 ch\u1ea5t c\u1ee7a enzym cytochrom P450 (CYP) v\u00e0 ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1edfi enzym CYP3A4. CYP3A4 l\u00e0 enzym ch\u00ednh c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c ph\u00e2n h\u1ecd CYP trong gan c\u1ee7a ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh. N\u00f3 x\u00fac t\u00e1c cho qu\u00e1 tr\u00ecnh 6\u03b2 &#8211; hydroxyl h\u00f3a steroid, giai \u0111o\u1ea1n 1 thi\u1ebft y\u1ebfu trong qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a cho c\u1ea3 corticosteroid n\u1ed9i sinh v\u00e0 t\u1ed5ng h\u1ee3p.<\/p>\n<p>C\u0169ng c\u00f3 r\u1ea5t nhi\u1ec1u ch\u1ea5t kh\u00e1c c\u0169ng l\u00e0 c\u01a1 ch\u1ea5t c\u1ee7a CYP3A4, m\u1ed9t s\u1ed1 ch\u1ea5t n\u00e0y (c\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c kh\u00e1c) l\u00e0m thay \u0111\u1ed5i s\u1ef1 chuy\u1ec3n h\u00f3a glucocorticoid b\u1eb1ng c\u00e1ch g\u00e2y c\u1ea3m \u1ee9ng (\u0111i\u1ec1u h\u00f2a t\u0103ng) ho\u1eb7c \u1ee9c ch\u1ebf enzym CYP3A4.<\/p>\n<p><em>C\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf CYP3A4<\/em>: Isoniazid, aprepitant, fosaprepitant, diltiazem, ethinylestradiol, norethindron, n\u01b0\u1edbc \u00e9p b\u01b0\u1edfi, thu\u1ed1c \u1ee9c ch\u1ebf HIV \u2013 Protease, cyclosporin, clarithromycin, erythromycin, troleandomycin.<\/p>\n<p>Nh\u1eefng thu\u1ed1c \u1ee9c ch\u1ebf ho\u1ea1t t\u00ednh CYP3A4 nh\u00ecn chung l\u00e0m gi\u1ea3m \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a gan v\u00e0 t\u0103ng n\u1ed3ng \u0111\u1ed9 c\u1ee7a c\u00e1c thu\u1ed1c l\u00e0 c\u01a1 ch\u1ea5t c\u1ee7a CYP3A4 nh\u01b0 methylprednisolon trong huy\u1ebft t\u01b0\u01a1ng. N\u1ebfu c\u00f3 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf CYP3A4, n\u00ean chu\u1ea9n li\u1ec1u methylprednisolon \u0111\u1ec3 tr\u00e1nh b\u1ecb ng\u1ed9 \u0111\u1ed9c steroid.<\/p>\n<p><em>C\u00e1c ch\u1ea5t c\u1ea3m \u1ee9ng CYP3A4<\/em>: Carbamazepin, phenobarbital, phenytoin.<\/p>\n<p>Nh\u1eefng thu\u1ed1c g\u00e2y c\u1ea3m \u1ee9ng CYP3A4 nh\u00ecn chung l\u00e0m t\u0103ng \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a gan, d\u1eabn t\u1edbi l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 c\u00e1c thu\u1ed1c l\u00e0 c\u01a1 ch\u1ea5t c\u1ee7a CYP3A4. C\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i t\u0103ng li\u1ec1u methylprednisolon khi d\u00f9ng c\u00f9ng c\u00e1c thu\u1ed1c n\u00e0y \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb nh\u01b0 mong mu\u1ed1n.<\/p>\n<p><em>C\u00e1c ch\u1ea5t l\u00e0 c\u01a1 ch\u1ea5t c\u1ee7a CYP3A4<\/em>: Carbamazepin, aprepitant, fosaprepitant, thu\u1ed1c \u1ee9c ch\u1ebf HIV \u2013 Protease, diltiazem, ethinylestradiol, norethindron, cyclosporin, clarithromycin, erythromycin, cyclophosphamid, tacrolimus.<\/p>\n<p>Khi c\u00f3 m\u1eb7t m\u1ed9t c\u01a1 ch\u1ea5t kh\u00e1c c\u1ee7a CYP3A4, qu\u00e1 tr\u00ecnh thanh th\u1ea3i qua gan c\u1ee7a methylprednisolon c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng, do \u0111\u00f3 c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh t\u01b0\u01a1ng \u1ee9ng li\u1ec1u d\u00f9ng c\u1ee7a methylprednisolon. C\u00f3 th\u1ec3 c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n khi d\u00f9ng ri\u00eang m\u1ed7i thu\u1ed1c s\u1ebd d\u1ec5 x\u1ea3y ra h\u01a1n khi d\u00f9ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c v\u1edbi nhau.<\/p>\n<p><em>Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng (d\u1ea1ng u\u1ed1ng)<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng c\u1ee7a methylprednisolon tr\u00ean thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng c\u00f3 th\u1ec3 thay \u0111\u1ed5i t\u00f9y tr\u01b0\u1eddng h\u1ee3p. \u0110\u00e3 c\u00f3 nhi\u1ec1u b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c t\u0103ng c\u0169ng nh\u01b0 gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng khi d\u00f9ng chung v\u1edbi corticosteroid. Ch\u00ednh v\u00ec v\u1eady, ph\u1ea3i ki\u1ec3m tra c\u00e1c ch\u1ec9 s\u1ed1 \u0111\u00f4ng m\u00e1u \u0111\u1ec3 duy tr\u00ec t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng mong mu\u1ed1n.<\/p>\n<p><em>Thu\u1ed1c kh\u00e1ng cholinergic \u2013 Ch\u1eb9n th\u1ea7n kinh c\u01a1<\/em><\/p>\n<p>C\u00e1c corticosteroid c\u00f3 th\u1ec3 l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1ng cholinergic.<\/p>\n<p><em>Thu\u1ed1c kh\u00e1ng cholinesterase<\/em><\/p>\n<p>C\u00e1c steroid c\u00f3 th\u1ebf l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1ng cholinesterase d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u01b0\u1ee3c c\u01a1.<\/p>\n<p><em>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng<\/em><\/p>\n<p>V\u00ec corticosteroid c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 glucose m\u00e1u n\u00ean c\u00f3 th\u1ec3 ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u d\u00f9ng c\u1ee7a thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng.<\/p>\n<p><em>Thu\u1ed1c \u1ee9c ch\u1ebf aromatase (aminoglutethimid)<\/em><\/p>\n<p>G\u00e2y \u1ee9c ch\u1ebf tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn, c\u00f3 th\u1ebf l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam c\u00e1c thay \u0111\u1ed5i v\u1ec1 n\u1ed9i ti\u1ebft do d\u00f9ng glucocorticoid k\u00e9o d\u00e0i.<\/p>\n<p><em>NSAID (aspirin) li\u1ec1u cao<\/em><\/p>\n<p>T\u1ef7 l\u1ec7 xu\u1ea5t huy\u1ebft v\u00e0 lo\u00e9t \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u00f3 th\u1ec3 t\u0103ng khi d\u00f9ng methylprednisolon c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c NSAID. Methylprednisolon c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a aspirin li\u1ec1u cao, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn gi\u1ea3m n\u1ed3ng \u0111\u1ed9 salicylat trong huy\u1ebft thanh.<\/p>\n<p>D\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng methylprednisolon c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng l\u01b0\u1ee3ng salicylat trong huy\u1ebft thanh, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng nguy c\u01a1 ng\u1ed9 \u0111\u1ed9c salicylat.<\/p>\n<p><em>C\u00e1c thu\u1ed1c l\u00e0m t\u0103ng th\u1ea3i kali<\/em><\/p>\n<p>Khi d\u00f9ng corticosteroid c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c l\u00e0m t\u0103ng th\u1ea3i kali (v\u00ed d\u1ee5 thu\u1ed1c l\u1ee3i ti\u1ec3u), n\u00ean theo d\u00f5i ch\u1eb7t ch\u1ebd hi\u1ec7n t\u01b0\u1ee3ng h\u1ea1 kali m\u00e1u \u1edf b\u1ec7nh nh\u00e2n.<\/p>\n<p>Vi\u1ec7c d\u00f9ng chung corticosteroid v\u1edbi amphotericin B, c\u00e1c xanthin hay thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 c\u0169ng l\u00e0m t\u0103ng nguy c\u01a1 h\u1ea1 kali m\u00e1u.<\/p>\n<h3><span style=\"font-weight: 400\">L\u01b0u \u00fd khi s\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u00e0 m\u1eb9 cho con b\u00fa<\/span><\/h3>\n<p>Kinh nghi\u1ec7m l\u00e2m s\u00e0ng v\u1ec1 pantoprazol khi d\u00f9ng trong thai k\u1ef3 c\u00f2n h\u1ea1n ch\u1ebf. Trong c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 sinh s\u1ea3n \u1edf \u0111\u1ed9ng v\u1eadt, c\u00e1c d\u1ea5u hi\u1ec7u v\u1ec1 \u0111\u1ed9c t\u00ednh tr\u00ean b\u00e0o thai d\u1ea1ng nh\u1eb9 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf li\u00eau tr\u00ean 5 mg\/kg.<\/p>\n<p>Hi\u1ec7n ch\u01b0a c\u00f3 th\u00f4ng tin v\u1ec1 b\u00e0i ti\u1ebft pantoprazol qua s\u1eefa m\u1eb9. Do \u0111\u00f3, ch\u1ec9 d\u00f9ng pantoprazol khi l\u1ee3i \u00edch c\u1ee7a ng\u01b0\u1eddi m\u1eb9 \u0111\u01b0\u1ee3c xem l\u00e0 l\u1edbn h\u01a1n nguy c\u01a1 g\u00e2y ra \u0111\u1ed1i v\u1edbi thai nhi v\u00e0 em b\u00e9.<\/p>\n<h3><span style=\"font-weight: 400\">\u1ea2nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c<\/span><\/h3>\n<p>C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n, nh\u01b0 hoa m\u1eaft, ch\u00f3ng m\u1eb7t, r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c v\u00e0 m\u1ec7t m\u1ecfi c\u00f3 th\u1ec3 g\u1eb7p sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng corticosteroid. N\u1ebfu b\u1ecb \u1ea3nh h\u01b0\u1edfng, b\u1ec7nh nh\u00e2n n\u00ean d\u1eebng l\u00e1i xe ho\u1eb7c v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/p>\n<h3><span style=\"font-weight: 400\">Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed<\/span><\/h3>\n<p>Ng\u1ed9 \u0111\u1ed9c t\u00ednh c\u1ea5p v\u00e0 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a Glucocorticoid r\u1ea5t hi\u1ebfm x\u1ea3y ra. Qu\u00e1 li\u1ec1u c\u1ea5p t\u00ednh c\u00f3 th\u1ec3 l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam tri\u1ec7u ch\u1ee9ng b\u1ec7nh \u0111\u00e3 c\u00f3 t\u1eeb tr\u01b0\u1edbc nh\u01b0: lo\u00e9t \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, nhi\u1ec5m tr\u00f9ng, ti\u1ec3u \u0111\u01b0\u1eddng v\u00e0 ph\u00f9 n\u1ec1.<\/p>\n<p>S\u1eed d\u1ee5ng Glucocorticoid th\u01b0\u1eddng xuy\u00ean trong m\u1ed9t th\u1eddi gian d\u00e0i c\u00f3 th\u1ec3 m\u1eafc h\u1ed9i ch\u1ee9ng Cushing, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf tr\u1ebb em.<\/p>\n<p>Methylprednisolon khi d\u00f9ng li\u1ec1u cao trong th\u1eddi gian d\u00e0i c\u00f3 th\u1ec3 g\u00e2y ho\u1ea1i t\u1eed gan v\u00e0 t\u0103ng amylase.<\/p>\n<p>N\u1ebfu ti\u00eam t\u0129nh m\u1ea1ch Methylprednisolon li\u1ec1u cao c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n lo\u1ea1n nh\u1ecbp tim, lo\u1ea1n nh\u1ecbp th\u1ea5t v\u00e0 ng\u1eebng tim.<\/p>\n<p>Kh\u00f4ng c\u00f3 thu\u1ed1c gi\u1ea3i \u0111\u1ed9c c\u1ee5 th\u1ec3 trong tr\u01b0\u1eddng h\u1ee3p qu\u00e1 li\u1ec1u Methylprednisolon. D\u00f9ng c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ed7 tr\u1ee3. Trong nhi\u1ec5m \u0111\u1ed9c m\u00e3n t\u00ednh c\u1ea7n b\u1ed5 sung k\u1ecbp th\u1eddi n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i.<\/p>\n<h3><span style=\"font-weight: 400\">B\u1ea3o qu\u1ea3n<\/span><\/h3>\n<p>B\u1ea3o qu\u1ea3n trong bao b\u00ec k\u00edn, \u1edf nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30oC.<\/p>\n<h2><span style=\"font-weight: 400\">Thu\u1ed1c Depo-Medrol 40mg gi\u00e1 bao nhi\u00eau? b\u00e1n \u1edf \u0111\u00e2u?<\/span><\/h2>\n<p><span style=\"font-weight: 400\">Thu\u1ed1c Depo-Medrol 40mg hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c b\u00e1n t\u1ea1i Nh\u00e0 thu\u1ed1c D\u01b0\u1ee3c s\u0129 L\u01b0u V\u0103n Ho\u00e0ng, <strong>gi\u00e1 thu\u1ed1c Depo-Medrol 40mg<\/strong> c\u00f3 th\u1ec3 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadp t\u1ea1i \u0111\u1ea7u trang. Hi\u1ec7n nay, nh\u00e0 thu\u1ed1c ch\u00fang t\u00f4i h\u1ed7 tr\u1ee3 giao h\u00e0ng to\u00e0n qu\u1ed1c. Qu\u00fd kh\u00e1ch h\u00e0ng c\u00f3 th\u1ec3 li\u00ean h\u1ec7 qua s\u1ed1 hotline 0868 552 633 \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n k\u1ecbp th\u1eddi.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Tr\u01b0\u1eddng h\u1ee3p thu\u1ed1c Depo-Medrol 40mg t\u1ea1m th\u1eddi h\u1ebft h\u00e0ng, qu\u00fd kh\u00e1ch c\u00f3 th\u1ec3 tham kh\u1ea3o c\u00e1c thu\u1ed1c (s\u1ea3n ph\u1ea9m) kh\u00e1c c\u1ee7a nh\u00e0 thu\u1ed1c c\u00f3 c\u00f9ng t\u00e1c d\u1ee5ng v\u1edbi thu\u1ed1c Depo-Medrol 40mg nh\u01b0:\u00a0<\/span><\/p>\n<ol>\n<li><\/li>\n<\/ol>\n<h2><span style=\"font-weight: 400\">T\u1ea1i sao n\u00ean l\u1ef1a ch\u1ecdn thu\u1ed1c Depo-Medrol 40mg?<\/span><\/h2>\n<table style=\"border-collapse: collapse;width: 100%\">\n<tbody>\n<tr>\n<td style=\"width: 54.2394%;text-align: center\">\u01afu \u0111i\u1ec3m<\/td>\n<td style=\"width: 45.7606%;text-align: center\">Nh\u01b0\u1ee3c \u0111i\u1ec3m<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 54.2394%\">\u0110i\u1ec1u tr\u1ecb methylprednisolone ti\u00eam t\u0129nh m\u1ea1ch li\u1ec1u cao c\u00f3 hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n trong \u0111i\u1ec1u tr\u1ecb t\u00e1i ph\u00e1t b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng, nh\u01b0ng t\u00e1c d\u1ee5ng l\u00e2u d\u00e0i kh\u00f4ng r\u00f5 r\u00e0ng.<\/p>\n<p>Ti\u00eam corticosteroid n\u1ed9i kh\u1edbp l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn trong vi\u1ec7c ki\u1ec3m so\u00e1t vi\u00eam x\u01b0\u01a1ng kh\u1edbp c\u1ee7a \u0111\u1ea7u g\u1ed1i.<\/p>\n<p>Methylprednisolone axetat c\u00f3 l\u1ecbch s\u1eed s\u1eed d\u1ee5ng l\u00e2u d\u00e0i trong \u0111i\u1ec1u tr\u1ecb \u0111au th\u1ea7n kinh t\u1ecda v\u00e0 c\u00e1c h\u1ed9i ch\u1ee9ng \u0111au th\u1ea7n kinh kh\u00e1c.<\/p>\n<p>Ti\u00eam t\u0129nh m\u1ea1ch li\u1ec1u cao methylprednisolone c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c gi\u1ea3m m\u1ee9c \u0111\u1ed9 h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p c\u1ea7n thi\u1ebft \u1edf tr\u1ebb s\u01a1 sinh m\u1eafc ch\u1ee9ng lo\u1ea1n s\u1ea3n ph\u1ebf qu\u1ea3n ph\u1ed5i r\u1ea5t n\u1eb7ng, v\u1edbi t\u00e1c d\u1ee5ng l\u1edbn h\u01a1n \u1edf nh\u1eefng tr\u1ebb th\u1edf m\u00e1y ho\u1eb7c th\u1edf m\u00e1y kh\u00f4ng x\u00e2m l\u1ea5n<\/p>\n<p>D\u1ea1ng thu\u1ed1c ti\u00eam cho t\u00e1c d\u1ee5ng nhanh, th\u00edch h\u1ee3p trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1ea5p c\u1ee9u.<\/p>\n<p>Methylprednisolone axetat hai l\u1ea7n m\u1ed7i tu\u1ea7n c\u1ed9ng v\u1edbi ch\u1ea5t l\u00e0m m\u1ec1m da cung c\u1ea5p ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb duy tr\u00ec hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ki\u1ec3m so\u00e1t vi\u00eam da d\u1ecb \u1ee9ng. Sau khi \u1ed5n \u0111\u1ecbnh, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Methylprednisolone l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 nguy c\u01a1 t\u00e1i ph\u00e1t v\u00e0 c\u01b0\u1eddng \u0111\u1ed9 ng\u1ee9a, \u0111\u1ed3ng th\u1eddi c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng chung c\u1ee7a b\u1ec7nh nh\u00e2n<\/td>\n<td style=\"width: 45.7606%\">C\u00f3 th\u1ec3 g\u00e2y c\u00e1c tri\u1ec7u ch\u1ee9ng t\u1ea1i ch\u1ed7 \u1edf v\u1ecb tr\u00ed ti\u00eam thu\u1ed1c.<\/p>\n<p>S\u1eed d\u1ee5ng Methylprednisolone th\u01b0\u1eddng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1ea5p t\u00ednh c\u1ea7n gi\u1ea3m \u0111au nhanh ch\u00f3ng, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ng\u1eafn. Vi\u1ec7c s\u1eed d\u1ee5ng k\u00e9o d\u00e0i Glucocorticoid c\u00f3 th\u1ec3 g\u00e2y c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><span style=\"font-weight: 400\">T\u00e0i li\u1ec7u tham kh\u1ea3o<\/span><\/h2>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">T\u00e1c gi\u1ea3 Elodie Billion v\u00e0 c\u1ed9ng s\u1ef1 (Ng\u00e0y \u0111\u0103ng: Th\u00e1ng 1 n\u0103m 2021). <em>Intravenous pulses of methylprednisolone for infants with severe bronchopulmonary dysplasia and respiratory support after 3 months of age.<\/em> Truy c\u1eadp ng\u00e0y 16 th\u00e1ng 11 n\u0103m 2023, t\u1eeb <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33034950\/\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/33034950\/<\/a><\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">T\u00e1c gi\u00e1 A Peserico\u00a0 v\u00e0 c\u1ed9ng s\u1ef1 (Ng\u00e0y \u0111\u0103ng: th\u00e1ng 4 n\u0103m 2008). <em>Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study<\/em>. Truy c\u1eadp ng\u00e0y 16 th\u00e1ng 11 n\u0103m 2023, t\u1eeb <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18284403\/\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/18284403\/<\/a><\/span><\/li>\n<li>H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng thu\u1ed1c Depo-Medrol 40mg do nh\u00e0 s\u1ea3n xu\u1ea5t cung c\u1ea5p, t\u1ea3i b\u1ea3n PDF t\u1ea1i \u0111\u00e2y.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Thu\u1ed1c Depo-Medrol 40mg l\u00e0 thu\u1ed1c ch\u1ed1ng vi\u00eam, \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam b\u1eafp, h\u1ed9p 1 l\u1ecd 1ml do Pfizer (Thailand) s\u1ea3n xu\u1ea5t<\/p>\n","protected":false},"author":490,"featured_media":57421,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false},"product_cat":[89],"product_tag":[],"class_list":{"0":"post-57397","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-thuoc","8":"first","9":"instock","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/product\/57397","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/product"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/490"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=57397"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/57421"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=57397"}],"wp:term":[{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/product_cat?post=57397"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/product_tag?post=57397"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}