{"id":2294,"date":"2018-11-19T14:18:21","date_gmt":"2018-11-19T14:18:21","guid":{"rendered":"https:\/\/robot.yeupet.vn\/thuoc-khang-nam-cach-su-dung-tren-cho-meo\/"},"modified":"2018-11-19T14:18:21","modified_gmt":"2018-11-19T14:18:21","slug":"thuoc-khang-nam-cach-su-dung-tren-cho-meo","status":"publish","type":"post","link":"https:\/\/robot.yeupet.vn\/index.php\/2018\/11\/19\/thuoc-khang-nam-cach-su-dung-tren-cho-meo\/","title":{"rendered":"Thu\u1ed1c Kh\u00e1ng N\u1ea5m, C\u00e1ch S\u1eed D\u1ee5ng Tr\u00ean Ch\u00f3 M\u00e8o"},"content":{"rendered":"

L\u1ef1a ch\u1ecdn thu\u1ed1c kh\u00e1ng n\u1ea5m th\u00edch h\u1ee3p c\u0169ng nh\u01b0 li\u1ec1u d\u00f9ng cho \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n c\u00f3 th\u1ec3 g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n. Ch\u1ecdn m\u1ed9t thu\u1ed1c kh\u00e1ng n\u1ea5m d\u1ef1a v\u00e0o d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 nh\u1ea1y c\u1ea3m v\u1edbi m\u1ed9t v\u00e0i nguy\u00ean nh\u00e2n. X\u00e1c \u0111\u1ecbnh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc v\u1ec1 n\u1ed3ng \u0111\u1ed9 thu\u1ed1c kh\u00e1ng n\u1ea5m trong c\u00e1c m\u00f4 kh\u00e1c nhau ho\u1eb7c trong ch\u1ea5t l\u1ecfng c\u1ee7a ch\u00f3 v\u00e0 m\u00e8o l\u00e0 t\u1ed1i thi\u1ec3u.<\/span><\/p>\n

1. Griseofulvin (thu\u1ed1c kh\u00e1ng sinh \u0111\u1eb7c tr\u1ecb c\u00e1c b\u1ec7nh ngo\u00e0i da do n\u1ea5m)<\/strong>
\nGriseofulvin l\u00e0 thu\u1ed1c kh\u00e1ng n\u1ea5m \u0111u\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi Peniclillium griseofulvum. H\u1ea5p thu qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng l\u1ea1i s\u1ef1 l\u00e2y nhi\u1ec5m b\u1edfi n\u1ea5m ngo\u00e0i da nh\u01b0ng kh\u00f4ng ph\u1ea3i l\u00e0 n\u1ea5m men. Griseofulvin \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o b\u00ean trong l\u1edbp bi\u1ec3u b\u00ec c\u1ee7a da v\u00e0 nh\u1eefng ph\u1ea7n li\u00ean quan \u0111\u1ebfn da. V\u00e0i tu\u1ea7n \u0111i\u1ec1u tr\u1ecb l\u00e0 c\u1ea7n thi\u1ebft cho s\u1ef1 ph\u00e2n ph\u1ed1i ho\u00e0n to\u00e0n thu\u1ed1c v\u00e0o trong t\u1ebf b\u00e0o v\u00e0 \u1ee9c ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a n\u1ea5m. S\u1ef1 \u0111\u1ec1 kh\u00e1ng hi\u1ebfm khi x\u1ea3y ra trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. M\u1eb7c d\u00f9 c\u00f3 th\u1ec3 g\u00e2y qu\u00e1i thai tr\u00ean ch\u00f3 nh\u01b0ng griseofulvin kh\u00f4ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng tinh d\u1ecbch \u1edf ch\u00f3.<\/p>\n

\"thuoc-khang-nam-cho-meo\"<\/p>\n

2. Iodides<\/strong>
\nDung d\u1ecbch ch\u1ee9a 20% sodium iodide (NaI) ho\u1eb7c 100% potassium iodide (KI) d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nhi\u1ec5m n\u1ea5m ngo\u00e0i da, \u00edt \u0111\u1ed9c h\u01a1n so v\u1edbi amphotericin B (AMB), d\u1ec5 d\u00e0ng t\u00ecm th\u1ea5y t\u1ea1i c\u00e1c ph\u00f2ng m\u1ea1ch \u0111\u1ec3 tr\u1ecb ph\u00e1t ban tr\u00ean da c\u00f9ng v\u1edbi ch\u1ee9ng r\u1ee5ng l\u00f4ng.<\/p>\n

\"thuoc-khang-nam-cho-meo-1\"<\/p>\n

3. Amphotericin B v\u00e0 Polyenes kh\u00e1c<\/strong>
\nAMB l\u00e0 m\u1ed9t lypophilic polyene chi\u1ebft xu\u1ea5t t\u1eeb Streptomyces nodosus. Do n\u00f3 k\u00e9m h\u1ea5p thu qua ni\u00eam m\u1ea1c t\u1ebf b\u00e0o d\u1ea1 d\u00e0y ho\u1eb7c qua da n\u00ean AMB ph\u1ea3i \u0111\u01b0\u1ee3c ti\u00eam ( th\u01b0\u1eddng d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch) trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ea5m to\u00e0n th\u00e2n. Thu\u1ed1c n\u01b0\u1edbc v\u00e0 thu\u1ed1c d\u00f9ng t\u1ea1i ch\u1ed7 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nhi\u1ec5m tr\u00f9ng ni\u00eam m\u1ea1c ho\u1eb7c nhi\u1ec5m tr\u00f9ng ngo\u00e0i da. K\u1ebft qu\u1ea3 t\u1eeb nghi\u00ean c\u1ee9u ph\u00f2ng th\u00ed nghi\u1ec7m ch\u1ed1ng l\u1ea1i nhi\u1ec5m tr\u00f9ng n\u1ea5m ch\u1ec9 ra khi d\u00f9ng thu\u1ed1c c\u1ee9 3 ng\u00e0y<\/p>\n

1 l\u1ea7n th\u00ec hi\u1ec7u qu\u1ea3 cao so v\u1edbi li\u1ec1u d\u00f9ng m\u1ed7i ng\u00e0y.
\nH\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ngay t\u1ea1i t\u1ebf b\u00e0o, m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf s\u1ebd \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua n\u01b0\u1edbc ti\u1ec3u. Ti\u00eam t\u0129nh m\u1ea1ch (IV) chu\u1ea9n c\u1ea7n chu\u1ea9n b\u1ecb AMB \u0111\u00f4ng kh\u00f4 k\u1ebft h\u1ee3p v\u1edbi deoxycholate mu\u1ed1i m\u1eadt v\u00e0 ch\u1ea5t \u0111\u1ec7m \u1edf tr\u1ea1ng th\u00e1i keo (ADB). V\u00ec n\u1ed3ng \u0111\u1ed9 \u1edf m\u00f4 n\u00e3o l\u00e0 6-10 l\u1ea7n cao h\u01a1n so v\u1edbi c\u00e1c ch\u1ebf ph\u1ea9m kh\u00e1c AMB v\u00e0 l\u00e0 y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh quan tr\u1ecdng x\u00e1c \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 trong nhi\u1ec5m tr\u00f9ng \u1edf h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n

AMB l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u ti\u00ean trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng n\u1ea5m \u0111\u1ed1i v\u1edbi c\u00e1c lo\u1ea1i n\u1ea5m \u0103n s\u00e2u v\u00e0o trong c\u01a1 th\u1ec3 v\u00e0 c\u00f3 ti\u1ebfn tri\u1ec3n nhanh ch\u00f3ng, ph\u1ed5 bi\u1ebfn. S\u1ef1 kh\u00e1ng thu\u1ed1c r\u1ea5t hi\u1ebfm khi x\u1ea3y ra trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng t\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t c\u00f3 th\u1ec3 x\u1ea3y ra khi thu\u1ed1c \u0111\u01b0\u1ee3c ng\u01b0ng.<\/p>\n

Hamycin l\u00e0 m\u1ed9t polyene kh\u00e1c n\u00f3 c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng l\u1ea1i Candida Cryptococcus, Histoplasma, Blastomyces, v\u00e0 c\u00e1c lo\u00e0i Aspergillus. N\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o \u0111\u01b0\u1eddng mi\u1ec7ng (PO), t\u1ea1i ch\u1ed7, v\u00e0 m\u00e0ng b\u1ee5ng (IP) \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ea5m kh\u00e1c nhau.<\/p>\n

\"thuoc-khang-nam-cho-meo-3\"<\/p>\n

4. Flucytosine<\/strong>
\nL\u00e0 m\u1ed9t pyrimidin fluorinated ban \u0111\u1ea7u \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p nh\u01b0 m\u1ed9t t\u00e1c nh\u00e2n ch\u1ed1ng ung th\u01b0. Tr\u00e1i ng\u01b0\u1ee3c v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 AMB hi\u1ec7u qu\u1ea3 c\u1ee7a FCY \u0111\u01b0\u1ee3c t\u0103ng l\u00ean khi m\u1ee9c \u0111\u1ed9 li\u1ec1u l\u01b0\u1ee3ng nh\u1ecf \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o t\u1ea7n s\u1ed1 v\u1edbi n\u1ed3ng \u0111\u1ed9 th\u1ea5p h\u01a1n \u0111\u1ed9c t\u00ednh c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m b\u1edbt. Tuy nhi\u00ean, s\u1ef1 th\u00e2m nh\u1eadp kh\u00f3 ti\u1ebfp c\u1eadn v\u1edbi v\u00f9ng nh\u01b0 h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng v\u00ec c\u00f3 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

FCY c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng l\u1ea1i Cryptococcus, Candida, v\u00e0 c\u00e1c lo\u1ea1i n\u1ea5m men kh\u00e1c. S\u1ef1 \u0111\u1ec1 kh\u00e1ng v\u1edbi FCY th\u01b0\u1eddng xuy\u00ean ph\u00e1t tri\u1ec3n trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. V\u00ec l\u00fd do n\u00e0y, thu\u1ed1c n\u00e0y lu\u00f4n \u0111\u01b0\u1ee3c d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi AMB. Ph\u00e1t ban tr\u00ean da t\u01b0\u01a1ng t\u1ef1 nh\u01b0 g\u00e2y ra do azoles \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t trong \u0111i\u1ec1u tr\u1ecb tr\u00ean ch\u00f3. \u1ea2nh h\u01b0\u1edfng tr\u00ean GI v\u00e0 \u1ee9c ch\u1ebf t\u1ee7y s\u01a1 c\u1ea5p l\u00e0 nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 quan s\u00e1t \u0111\u01b0\u1ee3c \u1edf ng\u01b0\u1eddi (xem c\u00f4ng th\u1ee9c thu\u1ed1c trong ph\u1ea7n ph\u1ee5 l\u1ee5c).<\/p>\n

\"thuoc-khang-nam-cho-meo-2\"<\/p>\n

5. D\u1eabn xu\u1ea5t c\u1ee7a Azole<\/strong>
\nC\u00e1c d\u1eabn xu\u1ea5t t\u1ed5ng h\u1ee3p c\u1ee7a nh\u00f3m azole ban \u0111\u1ea7u \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 s\u1ea3n xu\u1ea5t Anthelmintics ph\u1ed5 r\u1ed9ng v\u1edbi c\u00e1c ho\u1ea1t \u0111\u1ed9ng ch\u1ed1ng l\u1ea1i m\u1ed9t s\u1ed1 vi khu\u1ea9n gram+ v\u00e0 \u0111\u1ed9ng v\u1eadt nguy\u00ean sinh. Azoles c\u00f3 m\u1ee9c \u0111\u1ed9 \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p sterol t\u01b0\u01a1ng \u0111\u1ed1i th\u1ea5p tr\u00ean \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa. Do \u0111\u00f3, n\u00f3 c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 l\u00e0 gi\u1ea3m testosterone, cortisol, androgen, ho\u1eb7c cholesterol. \u1ede n\u1ed3ng \u0111\u1ed9 th\u1ea5p ch\u00fang c\u00f3 t\u00e1c d\u1ee5ng k\u00ecm n\u1ea5m.<\/p>\n

Hi\u1ec7u qu\u1ea3 c\u1ee7a azoles d\u01b0\u1eddng nh\u01b0 ph\u1ee5 thu\u1ed9c v\u00e0o t\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o trong 24 gi\u1edd ch\u1ee9 kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u01b0\u1eddng u\u1ed1ng. T\u1ea5t c\u1ea3 azoles tr\u1ea3i qua chuy\u1ec3n h\u00f3a \u1edf gan b\u1edfi c\u00e1c enzym cytochrome P450. N\u1ed3ng \u0111\u1ed9 azole gi\u1ea3m khi d\u00f9ng thu\u1ed1c k\u1ebft h\u1ee3p. Khi d\u00f9ng thu\u1ed1c k\u1ebft h\u1ee3p \u0111\u1ed9c t\u00ednh kh\u00f4ng mong \u0111\u1ee3i c\u00f3 th\u1ec3 x\u1ea3y ra v\u00ec azoles tr\u00ec ho\u00e3n s\u1ef1 trao \u0111\u1ed5i ch\u1ea5t.<\/p>\n

Nh\u00f3m imidazole, thiabendazole ban \u0111\u1ea7u \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh n\u1ea5m da tr\u00ean ng\u01b0\u1eddi. Miconazole, clotrimazole v\u00e0 enilconazole c\u00f3 s\u1eb5n trong c\u00e1c lo\u1ea1i kem v\u00e0 m\u1ef9 ph\u1ea9m d\u00f9ng cho da, n\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng trong c\u00e1c gi\u1ea3i ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7 c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng do n\u1ea5m \u1edf da ch\u1eb3ng h\u1ea1n nh\u01b0 Dermatophytosis v\u00e0 candida Imidazoles d\u00f9ng t\u1ea1i ch\u1ed7 bao g\u1ed3m enilconazole ho\u1eb7c clotrimazole \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng m\u0169i v\u00e0 vi\u00eam xoang v\u1edbi aspergillosis.<\/p>\n

6. Ketoconazole<\/strong>
\nKTZ \u00edt ho\u1ea1t \u0111\u1ed9ng h\u01a1n so v\u1edbi miconazole nh\u01b0ng \u0111\u01b0\u1ee3c h\u1ea5p thu t\u1ed1t h\u01a1n t\u1eeb \u0111\u01b0\u1eddng ru\u1ed9t l\u00e0m cho n\u00f3 thu\u1eadn l\u1ee3i trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u00e1c n\u1ea5m to\u00e0n th\u00e2n v\u00e0 nhi\u1ec5m n\u1ea5m cadidiasis m\u00e3n t\u00ednh tr\u00ean ni\u00eam m\u1ea1c. T\u00e1c d\u1ee5ng ph\u1ee5 bu\u1ed3n n\u00f4n, ch\u00e1n \u0103n, n\u00f4n \u1edf ch\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1eafc ph\u1ee5c b\u1eb1ng c\u00e1ch cho thu\u1ed1c v\u00e0o trong b\u1eeda \u0103n v\u00e0 chia nh\u1ecf li\u1ec1u d\u00f9ng h\u1eb1ng ng\u00e0y th\u00e0nh 3-4 l\u1ea7n. KTZ \u0111\u01a1n tr\u00ean ch\u00f3 v\u00e0 m\u00e8o l\u1ea1i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u1edbi c\u00e1c b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, b\u1ec7nh ph\u1ed5i do n\u1ea5m histoplasma, b\u1ec7nh truy\u1ec1n nhi\u1ec5m do n\u1ea5m crytococcus g\u00e2y t\u1ed5n th\u01b0\u01a1ng h\u1ec7 th\u1ea7n kinh.<\/p>\n

7. Itraconazole<\/strong>
\nThu\u1ed9c nh\u00f3m azole.
\nKh\u00f4ng x\u00e2m nh\u1eadp \u0111\u01b0\u1ee3c v\u00e0o th\u1ea7n kinh trung \u01b0\u01a1ng, c\u0169ng kh\u00f4ng \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf trong n\u01b0\u1edbc ti\u1ec3u.
\n\u0110\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c \u0111\u01b0\u1eddng ti\u00eam v\u00e0 \u0111\u01b0\u1ee3c ph\u00e2n b\u1ed1 r\u1ed9ng r\u00e3i trong c\u00e1c m\u00f4 c\u1ee7a c\u01a1 th\u1ec3.
\nTh\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00e0nh cho nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng v\u1edbi Blastomyces, Histoplasma, Coccidioides, v\u00e0 Aspergillus do ph\u1ed5 r\u1ed9ng h\u01a1n v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 \u00edt h\u01a1n so v\u1edbi thu\u1ed1c KTZ.<\/p>\n

8. Fluconazole<\/strong>
\nD\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb n\u1ea5m to\u00e0n th\u00e2n bao g\u1ed3m: vi\u00eam m\u00e0ng n\u00e3o, blastomycosis v\u00e0 histoplasmosis v\u00e0 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng b\u1ec1 m\u1eb7t bao g\u1ed3m c\u1ea3 n\u1ea5m candida v\u00e0 Dermatophytosis (n\u1ea5m da).
\n\u01afu \u0111i\u1ec3m: h\u1ea5p thu t\u1ed1t qua \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 c\u00f3 th\u1eddi gian b\u00e1n th\u1ea3i t\u01b0\u01a1ng \u0111\u1ed1i d\u00e0i.
\nFCZ \u0111i qua m\u00e1u n\u00e3o, h\u00e0ng r\u00e0o d\u1ecbch th\u1ec3 t\u1ed1t h\u01a1n so v\u1edbi c\u00e1c d\u1eabn xu\u1ea5t azole c\u0169.
\nkhuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn s\u1eed d\u1ee5ng \u0111\u1ea7u ti\u00ean FCZ s\u1ebd \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng do Candida ho\u1eb7c Cryptococcus \u1edf th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n

9. Voriconazole<\/strong>
\nL\u00e0 m\u1ed9t d\u1eabn xu\u1ea5t t\u1ed5ng h\u1ee3p c\u1ee7a FCZ.
\n\u0110\u01b0\u1ee3c c\u1ea5p ph\u00e9p \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng thu\u1ed1c do nhi\u1ec5m tr\u00f9ng Candida v\u00e0 Aspergillus \u1edf ng\u01b0\u1eddi.
\nC\u00f3 hi\u1ec7u qu\u1ea3 m\u1ea1nh trong \u0111i\u1ec1u tr\u1ecb aspergillosis (n\u1ea5m ph\u1ed5i) v\u00e0 v\u00e0 candida n\u1ea5m h\u1ea7u h\u1ecdng \u1edf \u0111\u1ed9ng v\u1eadt th\u1ef1c nghi\u1ec7m.
\nKhi s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c th\u1ea7n kinh, hay gan.<\/p>\n

10. Posaconazole<\/strong>
\nM\u1ed9t ch\u1ea5t t\u01b0\u01a1ng t\u1ef1 hydroxy h\u00f3a c\u1ee7a itz.
\nSinh kh\u1ea3 d\u1ee5ng khi d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng c\u00f3 ph\u1ea7n c\u00f3 gi\u00e1 tr\u1ecb h\u01a1n.
\nPh\u00e2n b\u1ed1 r\u1ed9ng r\u00e3i trong c\u00e1c m\u00f4 v\u00e0 d\u1ecbch th\u1ec3 k\u1ec3 c\u1ea3 t\u1ebf b\u00e0o ph\u1ebf nang ph\u1ed5i, nh\u01b0ng kh\u00f4ng x\u00e2m nh\u1eadp \u0111\u01b0\u1ee3c v\u00e0o th\u1ea7n kinh trung \u01b0\u01a1ng.
\nTh\u1eed nghi\u1ec7m s\u01a1 b\u1ed9 \u1edf lo\u00e0i g\u1eb7m nh\u1ea5m v\u1edbi s\u1ef1 x\u00e2m h\u1ea1i c\u1ee7a n\u1ea5m ph\u1ed5i aspergillosis cho th\u1ea5y PCZ t\u1ed1t h\u01a1n AMB ho\u1eb7c triazoles kh\u00e1c trong vi\u1ec7c gi\u1ea3m g\u00e1nh n\u1eb7ng v\u1ec1 n\u1ea5m.<\/p>\n

11. Terbinafine<\/strong>
\nThu\u1ed1c d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng c\u00f3 ho\u1ea1t t\u00ednh t\u1ed1t trong ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u1ed1i v\u1edbi Aspergillus spp, Fusarium spp v\u00e0 n\u1ea5m s\u1ee3i kh\u00e1c nh\u01b0ng ho\u1ea1t t\u00ednh bi\u1ebfn thi\u00ean trong vi\u1ec7c ch\u1ed1ng l\u1ea1i n\u1ea5m men.
\nC\u00f3 hi\u1ec7u qu\u1ea3 c\u1ef1c t\u1ed1t trong vi\u00eac ch\u1ed1ng l\u1ea1i n\u1ea5m ngo\u00e0i da m\u00e3n t\u00ednh \u1edf ng\u01b0\u1eddi, n\u1ea5m m\u00f3ng tay, sporotrichosis v\u00e0 nhi\u1ec5m tr\u00f9ng n\u1ea5m b\u1ec1 m\u1eb7t.<\/p>\n

12. Ch\u1ea5t \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p Chitin v\u00e0 t\u1ed5ng h\u1ee3p t\u1ebf b\u00e0o v\u00e1ch<\/strong>
\nTh\u00e0nh t\u1ebf b\u00e0o n\u1ea5m bao g\u1ed3m c\u00e1c polysaccharides ch\u1ee7 y\u1ebfu l\u00e0 chitin, chitosan , glucan v\u00e0 Mannan.
\nC\u00e1c h\u1ee3p ch\u1ea5t m\u1edbi \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u nh\u01b0 thu\u1ed1c kh\u00e1ng n\u1ea5m to\u00e0n th\u00e2n l\u00e0 polyoxins v\u00e0 nikkomycins Lufenuron, ur\u00ea benzoylphenyl \u0111\u1ec1u l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p chitin trong v\u00e1ch t\u1ebf b\u00e0o n\u1ea5m.
\nKhi k\u1ebft h\u1ee3p v\u1edbi FCZ ho\u1eb7c itz c\u00f3 th\u1ec3 c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n.<\/p>\n

13. Echinocandins<\/strong>
\nAculeacins, echinocandins, v\u00e0 papulacandins l\u00e0 lipopeptides \u1ee9c ch\u1ebf s\u1ef1 t\u1ed5ng h\u1ee3p c\u1ee7a 1,3- \u03b2-glucan , m\u1ed9t polysaccharide trong th\u00e0nh t\u1ebf b\u00e0o c\u1ee7a nhi\u1ec1u lo\u1ea1i n\u1ea5m g\u00e2y b\u1ec7nh.
\nC\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng h\u1ec7 th\u1ed1ng n\u1ea5m candidiasis v\u00e0 c\u00e1c lo\u1ea1i Aspergillus.<\/p>\n

14. Caspofungin<\/strong>
\nD\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb s\u1ef1 x\u00e2m l\u1ea5n c\u1ee7a n\u1ea5m candidiasis v\u00e0 aspergillus cho nhi\u1ec5m tr\u00f9ng ni\u00eam m\u1ea1c.
\nThu\u1ed1c tan trong n\u01b0\u1edbc v\u00e0 \u0111\u01b0\u1eddng d\u00f9ng l\u00e0 \u0111\u01b0\u1eddng ti\u00eam
\n\u0110\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n AMB trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m n\u1ea5m candidiasis
\nM\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1c: C\u00e1c thu\u1ed1c nh\u01b0: Anidulafungin, Micafungin, Miltefosine \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c ch\u1ed1ng l\u1ea1i c\u00e1c lo\u1ea1i n\u1ea5m men, n\u1ea5m ngo\u00e0i da v\u00e0 m\u1ed9t s\u1ed1 n\u1ea5m s\u1ee3i<\/p>\n

15. Li\u1ec7u ph\u00e1p k\u1ebft h\u1ee3p<\/strong>
\nD\u00f9ng \u0111\u1ed3ng th\u1eddi hai hay nhi\u1ec1u thu\u1ed1c kh\u00e1ng n\u1ea5m \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u1ea5t \u0111\u1ecbnh.
\nK\u1ebft h\u1ee3p AMB v\u00e0 FYC c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7p l\u1ef1c trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng Cryptococcus.
\nTr\u01b0\u1eddng h\u1ee3p aspergillosis x\u00e2m nhi\u1ec5m, \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p s\u1eed d\u1ee5ng AMB v\u00e0 FYC ho\u1eb7c AMB v\u00e0 rifampin l\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n c\u1ea3 thu\u1ed1c d\u00f9ng m\u1ed9t m\u00ecnh v\u00e0 v\u01b0\u1ee3t tr\u1ed9i so v\u1edbi AMB v\u00e0 ITZ.<\/p>\n

16. S\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng n\u1ea5m trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3<\/strong>
\nV\u1eadt ch\u1ee7 b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch:
\nThu\u1ed1c ch\u1ed1ng n\u1ea5m k\u1ebft h\u1ee3p v\u1edbi interferon \u2013 \u03b3 ho\u1eb7c interleukin- 12 c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7p l\u1ef1c trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ed1ng \u1edf th\u00fa g\u1eb7m nh\u1eafm (\u1edf ph\u00f2ng th\u00ed nghi\u1ec7m), \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng n\u1ea5m v\u00e0 mi\u1ec5n d\u1ecbch c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7u qu\u1ea3.
\nTrong tr\u01b0\u1eddng h\u1ee3p tr\u1ecb li\u1ec7u b\u1eb1ng kh\u00e1ng ch\u1ea5t x\u01a1:
\nX\u01a1 h\u00f3a l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh nhi\u1ec5m tr\u00f9ng n\u1ea5m, \u0111\u1eb7c bi\u1ec7t l\u00e0 tr\u00ean nh\u1eefng m\u00f4 c\u01a1 th\u1ec3.
\n\u0110i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p pentoxifylline v\u00e0 itz l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng \u0111i\u1ec1u tr\u1ecb cidioidomycosis so v\u1edbi nh\u1eefng ng\u01b0\u1eddi ch\u1ec9 d\u00f9ng ITZ.
\nThu\u1ed1c Kh\u00e1ng n\u1ea5m s\u1eed d\u1ee5ng trong thai k\u1ef3:
\nGriseofulvin, FCZ v\u00e0 KTZ \u0111\u1ec1u g\u00e2y qu\u00e1i thai ho\u1eb7c g\u00e2y \u0111\u1ed9c cho ph\u00f4i \u1edf \u0111\u1ed9ng v\u1eadt v\u00e0 n\u00ean tr\u00e1nh s\u1eed d\u1ee5ng.
\nKTZ c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i t\u00ednh d\u1ee5c.
\nIot c\u00f3 th\u1ec3 g\u00e2y b\u01b0\u1edbu c\u1ed5 b\u1ea9m sinh \u1edf thai nhi, g\u00e2y sinh non.
\nAMB v\u00e0 c\u00e1c ch\u1ebf ph\u1ea9m lipid c\u1ee7a n\u00f3 kh\u00f4ng g\u00e2y qu\u00e1i thai v\u00e0 c\u00f3 th\u1ec3 l\u00e0 thu\u1ed1c \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb n\u1ea5m h\u1ec7 th\u1ed1ng c\u1ee7a \u0111\u1ed9ng v\u1eadt mang thai. FCZ l\u00e0 an to\u00e0n \u1edf li\u1ec1u l\u01b0\u1ee3ng th\u1ea5p trong thai k\u1ef3
\nS\u1ef1 \u0111\u1ec1 kh\u00e1ng v\u1edbi thu\u1ed1c kh\u00e1ng n\u1ea5m:
\nV\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch v\u00e0 tr\u01b0\u1edbc \u0111\u00f3 c\u00f3 s\u1eed d\u1ee5ng FCZ \u0111\u01b0\u1ee3c ghi nh\u1eadn r\u1eb1ng c\u00f3 s\u1ef1 gia t\u0103ng nhi\u1ec5m n\u1ea5m v\u1edbi aspergillus khi d\u00f9ng AMB \u0111i\u1ec1u tr\u1ecb.
\nX\u1eed l\u00fd tr\u01b0\u1edbc v\u1edbi FCZ \u0111\u00e3 l\u00e0m lo\u00e0i Aspergillus \u0111\u1ec1 kh\u00e1ng hi\u1ec7u qu\u1ea3 h\u01a1n AMB.
\nT\u1ed5ng li\u1ec1u t\u00edch l\u0169y c\u1ee7a FCZ v\u00e0 s\u1eed d\u1ee5ng l\u1ecbch tr\u00ecnh li\u1ec1u li\u00ean t\u1ee5c v\u1edbi li\u1ec1u l\u01b0\u1ee3ng th\u1ea5p h\u01a1n m\u1ee9c c\u1ea7n thi\u1ebft l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng g\u00f3p ph\u1ea7n cho s\u1ef1 xu\u1ea5t hi\u1ec7n vi\u1ec7c \u0111\u1ec1 kh\u00e1ng n\u1ea5m.
\n\u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 ph\u1eabu thu\u1eadt:
\nPh\u1eabu thu\u1eadt th\u01b0\u1eddng c\u1ea7n thi\u1ebft \u0111\u1ec3 lo\u1ea1i b\u1ecf nh\u1eefng t\u1ea1p ch\u1ea5t t\u1eeb v\u1ebft th\u01b0\u01a1ng nhi\u1ec5m n\u1ea5m trong c\u00e1c khu v\u1ef1c n\u00e0y g\u00e2y kh\u00f3 kh\u0103n cho c\u00e1c thu\u1ed1c kh\u00e1ng n\u1ea5m x\u00e2m nh\u1eadp.
\nNhi\u1ec5m n\u1ea5m trong c\u00e1c m\u1ea1ch v\u00f5ng m\u1ea1c v\u00e0 m\u00e0ng m\u1ea1ch, v\u1edbi t\u1ed5n th\u01b0\u01a1ng r\u1ec9 d\u1ecbch ph\u00e1t tri\u1ec3n d\u1ecdc theo c\u00e1c m\u1ea1ch m\u00e1u sau \u0111\u00f3 c\u00e1c nhi\u1ec5m tr\u00f9ng l\u00e2y lan \u0111\u1ebfn th\u1ee7y tinh th\u1ec3, mao m\u1ea1ch c\u1ee7a th\u1ea7n kinh trung \u01b0\u01a1ng v\u00e0 k\u1ebft qu\u1ea3 l\u00e0 nhi\u1ec1u kh\u1ea3 n\u0103ng ch\u1ed1ng s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1ng n\u1ea5m.
\nFCZ c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft cho nhi\u1ec5m tr\u00f9ng n\u1ed9i nh\u00e3n.
\nThu\u1ed1c kh\u00e1ng n\u1ea5m d\u00f9ng ngo\u00e0i:
\nM\u1ed9t s\u1ed1 thu\u1ed1c d\u00f9ng ngo\u00e0i da: Axit Undecylenic, Cuprimyxin Dung d\u1ecbch chlorhexidine (0,5%), Nystatin, Thiabendazole (13%), d\u1ea7u g\u1ed9i \u0111\u1ea7u c\u00f3 ch\u1ee9a miconazole chlorhexidin.
\nNystatin d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng (nh\u01b0ng h\u1ea5p thu k\u00e9m) ho\u1eb7c d\u00f9ng b\u00f4i l\u00ean da ho\u1eb7c ni\u00eam m\u1ea1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m n\u1ea5m tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c.
\nThiabendazole (13%) \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t thu\u1ed1c nh\u00fang ( ba l\u1ea7n m\u1ed9t tu\u1ea7n) \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u00e8o v\u1edbi Dermatophytosis.
\nD\u1ea7u g\u1ed9i \u0111\u1ea7u c\u00f3 ch\u1ee9a miconazole chlorhexidine v\u00e0 c\u00f3 s\u1eb5n cho \u0111i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7 nhi\u1ec5m n\u1ea5m da. Miconazole th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u1ea1i ch\u1ed7 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb n\u1ea5m ngo\u00e0i da \u0111\u1ed3ng th\u1eddi k\u1ebft h\u1ee3p \u0111i\u1ec1u tr\u1ecb to\u00e0n th\u00e2n v\u1edbi griseofulvin.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"

L\u1ef1a ch\u1ecdn thu\u1ed1c kh\u00e1ng n\u1ea5m th\u00edch h\u1ee3p c\u0169ng nh\u01b0 li\u1ec1u d\u00f9ng cho \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n c\u00f3 th\u1ec3 g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n. Ch\u1ecdn m\u1ed9t thu\u1ed1c kh\u00e1ng n\u1ea5m d\u1ef1a v\u00e0o d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 nh\u1ea1y c\u1ea3m v\u1edbi m\u1ed9t v\u00e0i nguy\u00ean nh\u00e2n. X\u00e1c \u0111\u1ecbnh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc v\u1ec1 n\u1ed3ng \u0111\u1ed9 thu\u1ed1c kh\u00e1ng n\u1ea5m trong c\u00e1c […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2294","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/comments?post=2294"}],"version-history":[{"count":0,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2294\/revisions"}],"wp:attachment":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/media?parent=2294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/categories?post=2294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/tags?post=2294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}