{"id":10605,"date":"2016-03-13T08:24:54","date_gmt":"2016-03-13T01:24:54","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/natri-valproat-thuoc-chong-dong-kinh-chong-co-giat\/"},"modified":"2024-03-17T02:40:53","modified_gmt":"2024-03-16T19:40:53","slug":"natri-valproat-thuoc-chong-dong-kinh-chong-co-giat","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/natri-valproat-thuoc-chong-dong-kinh-chong-co-giat\/","title":{"rendered":"Natri Valproat – Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh, ch\u1ed1ng co gi\u1eadt"},"content":{"rendered":"

T\u00ean chung qu\u1ed1c t\u1ebf Natri Valproat<\/h2>\n

Sodium valproate<\/p>\n

D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng Natri Valproat<\/h2>\n

Nang m\u1ec1m 250 mg; Vi\u00ean bao tan trong ru\u1ed9t 150 mg, 200 mg, 300 mg, 500 mg; Siro 250 mg\/5 ml (l\u1ecd 50 ml).<\/p>\n

\"natri-valproat-thuoc-chong-dong-kinh-co-giat\" <\/a><\/p>\n

H\u00ecnh thu\u1ed1c <\/em><\/p>\n

Ch\u1ec9 \u0111\u1ecbnh Natri Valproat<\/h2>\n

C\u01a1n \u0111\u1ed9ng kinh co gi\u1eadt to\u00e0n b\u1ed9; \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9; c\u01a1n m\u1ea5t tr\u01b0\u01a1ng l\u1ef1c; \u0111\u1ed9ng kinh c\u01a1n v\u1eafng; c\u01a1n rung gi\u1eadt c\u01a1; h\u01b0ng c\u1ea3m c\u1ea5p (xem m\u1ee5c 24.2.2).<\/p>\n

Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh Natri Valproat<\/h2>\n

B\u1ec7nh gan \u0111ang ho\u1ea1t \u0111\u1ed9ng; ti\u1ec1n s\u1eed gia \u0111\u00ecnh b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan; vi\u00eam tu\u1ef5; r\u1ed1i lo\u1ea1n chuy\u1ec3n ho\u00e1 porphyrin.<\/p>\n

Th\u1eadn tr\u1ecdng Natri Valproat<\/h2>\n

Ph\u1ea3i ki\u1ec3m tra v\u00e0 theo d\u00f5i ch\u1ee9c n\u0103ng gan tr\u01b0\u1edbc v\u00e0 trong 6 th\u00e1ng \u0111\u1ea7u d\u00f9ng thu\u1ed1c (Ph\u1ee5 l\u1ee5c 5) \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nguy c\u01a1 cao (tr\u1ebb d\u01b0\u1edbi 3 tu\u1ed5i, ng\u01b0\u1eddi b\u1ecb r\u1ed1i lo\u1ea1n chuy\u1ec3n ho\u00e1, c\u00e1c b\u1ec7nh tho\u00e1i ho\u00e1, b\u1ec7nh n\u00e3o th\u1ef1c th\u1ec3, \u0111\u1ed9ng kinh n\u1eb7ng k\u1ebft h\u1ee3p v\u1edbi ch\u1eadm ph\u00e1t tri\u1ec3n tr\u00ed tu\u1ec7, ng\u01b0\u1eddi d\u00f9ng nhi\u1ec1u thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh); ph\u1ea3i ch\u1eafc ch\u1eafn ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng b\u1ecb ch\u1ea3y m\u00e1u tr\u01b0\u1edbc khi d\u00f9ng thu\u1ed1c ho\u1eb7c tr\u01b0\u1edbc ph\u1eabu thu\u1eadt ho\u1eb7c tr\u01b0\u1edbc khi d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng; suy th\u1eadn (Ph\u1ee5 l\u1ee5c 4); mang thai (xem Ph\u1ee5 l\u1ee5c 2); cho con b\u00fa (Ph\u1ee5 l\u1ee5c 3); lupus ban \u0111\u1ecf to\u00e0n th\u00e2n; x\u00e9t nghi\u1ec7m ceton ni\u1ec7u d\u01b0\u01a1ng t\u00ednh gi\u1ea3; tr\u00e1nh ng\u1eebng thu\u1ed1c \u0111\u1ed9t ng\u1ed9t.<\/p>\n

T\u01b0\u01a1ng t\u00e1c thu\u1ed1c Natri Valproat<\/h2>\n

(Ph\u1ee5 l\u1ee5c 1). C\u1ea7n h\u01b0\u1edbng d\u1eabn cho ng\u01b0\u1eddi b\u1ec7nh c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1ec1 r\u1ed1i lo\u1ea1n m\u00e1u v\u00e0 ch\u1ee9c n\u0103ng gan, c\u1ea7n \u0111i kh\u00e1m ngay n\u1ebfu c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a c\u01a1n \u0111\u1ed9ng kinh kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c, kh\u00f3 ch\u1ecbu, m\u1ecfi m\u1ec7t, ch\u00e1n \u0103n, ng\u1ee7 l\u1ecbm, ph\u00f9, n\u00f4n, \u0111au b\u1ee5ng; bu\u1ed3n ng\u1ee7; v\u00e0ng da; c\u00f3 v\u1ebft b\u1ea7m ch\u1ea3y m\u00e1u. Thu\u1ed1c l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng t\u1eadp trung ch\u00fa \u00fd, h\u1ea1n ch\u1ebf ng\u01b0\u1eddi b\u1ec7nh b\u1ecb \u0111\u1ed9ng kinh l\u00e1i xe.<\/p>\n

Li\u1ec1u l\u01b0\u1ee3ng v\u00e0 c\u00e1ch d\u00f9ng Natri Valproat<\/h2>\n

Kh\u00f4ng \u0111\u01b0\u1ee3c nhai vi\u00ean nang m\u00e0 ph\u1ea3i nu\u1ed1t. U\u1ed1ng thu\u1ed1c c\u00f9ng b\u1eefa \u0103n. N\u1ebfu d\u00f9ng li\u1ec1u tr\u00ean 250 mg\/ng\u00e0y th\u00ec ph\u1ea3i u\u1ed1ng l\u00e0m nhi\u1ec1u l\u1ea7n<\/p>\n

C\u01a1n v\u1eafng \u00fd th\u1ee9c \u0111\u01a1n gi\u1ea3n ho\u1eb7c ph\u1ee9c h\u1ee3p: <\/em> Li\u1ec1u ban \u0111\u1ea7u th\u01b0\u1eddng l\u00e0 10 – 15 mg\/kg\/ng\u00e0y. C\u00f3 th\u1ec3 t\u0103ng 5 – 10 mg\/kg\/ng\u00e0y c\u00e1ch nhau 1 tu\u1ea7n cho \u0111\u1ebfn khi ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u01a1n \u0111\u1ed9ng kinh. Li\u1ec1u t\u1ed1i \u0111a: 60 mg\/kg\/ng\u00e0y.<\/p>\n

\u0110\u1ed9ng kinh co gi\u1eadt to\u00e0n b\u1ed9, \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9, c\u01a1n m\u1ea5t tr\u01b0\u01a1ng l\u1ef1c: <\/em> D\u00f9ng theo \u0111\u01b0\u1eddng u\u1ed1ng, ng\u01b0\u1eddi l\u1edbn: li\u1ec1u ban \u0111\u1ea7u 600 mg\/ng\u00e0y, u\u1ed1ng sau b\u1eefa \u0103n; c\u1ee9 c\u00e1ch 3 ng\u00e0y l\u1ea1i t\u0103ng li\u1ec1u th\u00eam 200 mg cho t\u1edbi li\u1ec1u t\u1ed1i \u0111a l\u00e0 2,5 g m\u1ed7i ng\u00e0y, chia l\u00e0m nhi\u1ec1u l\u1ea7n u\u1ed1ng; li\u1ec1u duy tr\u00ec th\u01b0\u1eddng l\u00e0 1 – 2 g\/ng\u00e0y (20 – 30 mg\/kg\/ng\u00e0y). Tr\u1ebb em t\u1edbi 20 kg c\u00e2n n\u1eb7ng: li\u1ec1u ban \u0111\u1ea7u l\u00e0 20 mg\/kg\/ng\u00e0y chia l\u00e0m nhi\u1ec1u l\u1ea7n u\u1ed1ng; c\u00f3 th\u1ec3 t\u0103ng li\u1ec1u n\u1ebfu theo d\u00f5i \u0111\u01b0\u1ee3c n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng (c\u1ea7n theo d\u00f5i c\u00e1c th\u00f4ng s\u1ed1 huy\u1ebft h\u1ecdc v\u00e0 sinh ho\u00e1 n\u1ebfu d\u00f9ng li\u1ec1u tr\u00ean 40 mg\/kg\/ng\u00e0y). Tr\u1ebb tr\u00ean 20 kg c\u00e2n n\u1eb7ng: li\u1ec1u ban \u0111\u1ea7u l\u00e0 400 mg\/ng\u00e0y, chia l\u00e0m nhi\u1ec1u l\u1ea7n, t\u0103ng li\u1ec1u cho \u0111\u1ebfn khi c\u00f3 t\u00e1c d\u1ee5ng (th\u01b0\u1eddng t\u1eeb 20 \u0111\u1ebfn 30 mg\/kg\/ng\u00e0y); t\u1ed1i \u0111a l\u00e0 35 mg\/kg\/ng\u00e0y.<\/p>\n

Co gi\u1eadt \u1edf tr\u1ebb 1 – 12 tu\u1ed5i: <\/em> N\u1ebfu ch\u1ec9 d\u00f9ng natri valproat th\u00ec u\u1ed1ng li\u1ec1u ban \u0111\u1ea7u l\u00e0 15 – 45 mg\/kg\/ng\u00e0y, t\u0103ng d\u1ea7n c\u00e1ch nhau m\u1ed7i tu\u1ea7n 5 – 10 mg\/kg\/ng\u00e0y n\u1ebfu c\u1ea7n. N\u1ebfu d\u00f9ng k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1c: u\u1ed1ng 30 – 100 mg\/kg\/ng\u00e0y. \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u theo \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng. Nh\u01b0ng co gi\u1eadt do s\u1ed1t cao th\u01b0\u1eddng d\u00f9ng diazepam ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n

T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n Natri Valproat<\/h2>\n

K\u00edch \u1ee9ng \u0111\u01b0\u1eddng ti\u00eau ho\u00e1, t\u0103ng th\u00e8m \u0103n v\u00e0 t\u0103ng c\u00e2n; t\u0103ng amoniac huy\u1ebft; m\u1ea5t \u0111i\u1ec1u ho\u00e0 v\u1eadn \u0111\u1ed9ng; run \u0111\u1ea7u chi; r\u1ee5ng t\u00f3c (t\u00f3c m\u1ecdc l\u1ea1i c\u00f3 th\u1ec3 b\u1ecb qu\u0103n); ph\u00f9; gi\u1ea3m ti\u1ec3u c\u1ea7u, \u1ee9c ch\u1ebf ng\u01b0ng t\u1eadp ti\u1ec3u c\u1ea7u; gi\u1ea3m ch\u1ee9c n\u0103ng gan, c\u00f3 khi g\u00e2y suy gan n\u1eb7ng (xem ph\u1ea7n\u00a0Th\u1eadn tr\u1ecdng – ph\u1ea3i ng\u1eebng \u0111i\u1ec1u tr\u1ecb ngay n\u1ebfu th\u1ea5y kh\u00f3 ch\u1ecbu, m\u1ec7t m\u1ecfi, suy nh\u01b0\u1ee3c, ng\u1ee7 l\u1ecbm, ph\u00f9, \u0111au b\u1ee5ng, ch\u00e1n \u0103n, v\u00e0ng da, ng\u1ee7 g\u00e0 ho\u1eb7c b\u1ecb \u0111\u1ed9ng kinh kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c); t\u0103ng m\u1ee9c t\u1ec9nh t\u00e1o; r\u1ed1i lo\u1ea1n h\u00e0nh vi. Hi\u1ebfm g\u1eb7p: vi\u00eam tu\u1ef5 (ph\u1ea3i \u0111\u1ecbnh l\u01b0\u1ee3ng amylase huy\u1ebft n\u1ebfu b\u1ecb \u0111au b\u1ee5ng c\u1ea5p), gi\u1ea3m b\u1ea1ch c\u1ea7u, gi\u1ea3m c\u00e1c lo\u1ea1i t\u1ebf b\u00e0o m\u00e1u, thi\u1ec3u s\u1ea3n h\u1ed3ng c\u1ea7u, gi\u1ea3m fibrinogen; tri\u1ec7u ch\u1ee9ng ngo\u1ea1i th\u00e1p; r\u1ed1i lo\u1ea1n kinh nguy\u1ec7t; m\u1ea5t kinh; v\u00fa to; nghe k\u00e9m; h\u1ed9i ch\u1ee9ng Fanconi; sa s\u00fat tr\u00ed tu\u1ec7; vi\u00eam da ho\u1ea1i t\u1eed do ng\u1ed9 \u0111\u1ed9c; h\u1ed9i ch\u1ee9ng Stevens-Johnson v\u00e0 vi\u00eam m\u1ea1ch; tr\u1ee9ng c\u00e1; r\u1eadm l\u00f4ng.<\/p>\n

X\u1eed tr\u00ed ADR Natri Valproat<\/h2>\n

Theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm; x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan, ch\u1ee9c n\u0103ng \u0111\u00f4ng m\u00e1u tr\u01b0\u1edbc v\u00e0 trong \u0111i\u1ec1u tr\u1ecb; gi\u1ea3m li\u1ec1u ho\u1eb7c ng\u1eebng thu\u1ed1c.<\/p>\n

\u0110\u1ed9 \u1ed5n \u0111\u1ecbnh v\u00e0 b\u1ea3o qu\u1ea3n Natri Valproat<\/h2>\n

B\u1ea3o qu\u1ea3n n\u01a1i kh\u00f4 r\u00e1o, nhi\u1ec7t \u0111\u1ed9 15 \u2013 25 o <\/sup> C.<\/p>\n

 <\/p>\n

http:\/\/nidqc.org.vn\/duocthu\/242\/<\/p>\n","protected":false},"excerpt":{"rendered":"

Natri Valproatl\u00e0 Sodium valproate.Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh, ch\u1ed1ng co gi\u1eadt.<\/p>\n","protected":false},"author":143,"featured_media":9716,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5394,5316,5393,5317],"tags":[],"series":[],"coauthors":[],"acf":[],"yoast_head":"\nNatri Valproat - Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh, ch\u1ed1ng co gi\u1eadt - D\u1ef1 \u00e1n kh\u00e1c<\/title>\n<meta name=\"description\" content=\"Natri Valproat - Thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh, ch\u1ed1ng co gi\u1eadt - D\u1ef1 \u00e1n kh\u00e1c\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/du-an-khac\/natri-valproat-thuoc-chong-dong-kinh-chong-co-giat\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Natri Valproat - 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