{"id":4084,"date":"2018-09-02T23:41:03","date_gmt":"2018-09-02T16:41:03","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khoa-nhi\/2018\/09\/02\/huong-dan-su-dung-thuoc-dieu-tri-ho-o-tre-em\/"},"modified":"2024-03-04T13:50:43","modified_gmt":"2024-03-04T06:50:43","slug":"huong-dan-su-dung-thuoc-dieu-tri-ho-o-tre-em","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/nhi-khoa\/huong-dan-su-dung-thuoc-dieu-tri-ho-o-tre-em\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ho \u1edf tr\u1ebb em"},"content":{"rendered":"<h2 style=\"text-align: justify\">Ho l\u00e0 ph\u1ea3n x\u1ea1 c\u00f3 l\u1ee3i cho c\u01a1 th\u1ec3<\/h2>\n<ol style=\"text-align: justify\">\n<li>B\u1ea3o v\u1ec7 khi c\u00f3 s\u1ef1 t\u1ea5n c\u00f4ng do h\u00edt c\u00e1c ph\u00e2n t\u1eed t\u1eeb b\u00ean ngo\u00e0i<\/li>\n<li>Gi\u1edbi h\u1ea1n vi\u1ec7c x\u00e2m nh\u1eadp \u0111\u1ed9t ng\u1ed9t c\u1ee7a c\u00e1c d\u1ecb v\u1eadt<\/li>\n<li>Tham gia v\u00e0o vi\u1ec7c di chuy\u1ec3n v\u00e0 t\u1ed1ng xu\u1ea5t c\u00e1c d\u1ecbch ti\u1ebft b\u1ea5t th\u01b0\u1eddng b\u00ean trong \u0111\u01b0\u1eddng th\u1edf<\/li>\n<\/ol>\n<p style=\"text-align: justify\">Ho c\u00f3 th\u1ec3 l\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a nhi\u1ec1u nguy\u00ean nh\u00e2n: h\u00f4 h\u1ea5p, tim m\u1ea1ch (suy tim tr\u00e1i), ti\u00eau h\u00f3a (GERD) t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c (captopril), t\u00e2m l\u00fd.<\/p>\n<h2 style=\"text-align: justify\">Ph\u00e2n lo\u1ea1i ho<\/h2>\n<ul style=\"text-align: justify\">\n<li>Ho c\u1ea5p (&lt; 3 tu\u1ea7n), ho k\u00e9o d\u00e0i (&gt; 8 tu\u1ea7n) (1 s\u1ed1 t\u00e0i li\u1ec7u l\u1ea5y ng\u01b0\u1ee1ng 4 tu\u1ea7n)<\/li>\n<li>Ho c\u00f3 \u0111\u00e0m, ho khan<\/li>\n<li>Ho c\u00f3 nguy\u00ean nh\u00e2n, ho kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">\u0110i\u1ec1u tr\u1ecb ho<\/h2>\n<p style=\"text-align: justify\"><strong>Ho do nguy\u00ean nh\u00e2n t\u1ea1i \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean<\/strong>: c\u1ea3m l\u1ea1nh, vi\u00eam m\u0169i, vi\u00eam h\u1ecdng, vi\u00eam xoang. vi\u00eam amidan th\u01b0\u1eddng ho khan, \u0111\u00f4i khi ho \u0111\u00e0m do m\u0169i ch\u1ea3y t\u1eeb xoang ho\u1eb7c m\u0169i sau<\/p>\n<p style=\"text-align: justify\"><strong>Ho do nguy\u00ean nh\u00e2n t\u1ea1i \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi:<\/strong> vi\u00eam thanh qu\u1ea3n th\u01b0\u1eddng ho khan, ho vang d\u1ed9i \u00f4ng \u1ed5ng, vi\u00eam ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ed5i, vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n, hen th\u01b0\u1eddng ho \u0111\u00e0m<\/p>\n<p style=\"text-align: justify\"><strong>\u0110i\u1ec1u tr\u1ecb ho bao g\u1ed3m:<\/strong><\/p>\n<ul style=\"text-align: justify\">\n<li>\u0110i\u1ec1u tr\u1ecb <strong>nguy\u00ean nh\u00e2n<\/strong> g\u00e2y ho: r\u1ea5t quan tr\u1ecdng, n\u00ean h\u1ecfi v\u00e0 kh\u00e1m th\u1eadt c\u1ea9n th\u1eadn \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb<strong> tri\u1ec7u ch\u1ee9ng<\/strong>: thu\u1ed1c \u1ee9c ch\u1ebf ho (antitussive), thu\u1ed1c k\u00edch th\u00edch ho hay thu\u1ed1c tan \u0111\u00e0m(protussive)<\/li>\n<\/ul>\n<h3 style=\"text-align: justify\">Thu\u1ed1c \u1ee9c ch\u1ebf ho<\/h3>\n<p style=\"text-align: justify\">Ch\u1ec9 \u0111\u1ecbnh khi ho khan g\u00e2y n\u00f4n \u00f3i kh\u00f4ng \u0103n kh\u00f4ng ng\u1ee7 \u0111\u01b0\u1ee3c, ho nhi\u1ec1u g\u00e2y xu\u1ea5t huy\u1ebft k\u1ebft m\u1ea1c, n\u1ebfu s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c n\u00e0y sau 5 ng\u00e0y c\u00f2n ho, n\u00ean d\u1eebng l\u1ea1i v\u00e0 t\u00ecm l\u1ea1i nguy\u00ean nh\u00e2n g\u00e2y ho.<\/p>\n<p style=\"text-align: justify\">C\u00f3 3 nh\u00f3m thu\u1ed1c ho g\u00e2y \u1ee9c ch\u1ebf trung t\u00e2m ho \u1edf n\u00e3o: t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c n\u00e0y \u0111\u1ec1u c\u00f3 t\u00e1c d\u1ee5ng g\u00e2y bu\u1ed3n ng\u1ee7.<\/p>\n<ul style=\"text-align: justify\">\n<li>Thu\u1ed1c ho <strong>g\u00e2y nghi\u1ec7n<\/strong>: c\u00e1c thu\u1ed1c ho c\u00f3 ch\u1ee9a codein kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho tr\u1ebb d\u01b0\u1edbi 6 tu\u1ed5i<\/li>\n<li>Thu\u1ed1c ho <strong>kh\u00f4ng g\u00e2y nghi\u1ec7n<\/strong>: c\u00f3 ch\u1ee9a dextromethorphan (atussin, antituss\u2026) kh\u00f4ng d\u00f9ng cho tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i.<\/li>\n<li>Thu\u1ed1c <strong>kh\u00e1ng histamine th\u1ebf h\u1ec7 1<\/strong>: \u0111\u00e2y l\u00e0 nh\u1eefng thu\u1ed1c ch\u1ed1ng d\u1ecb \u1ee9ng c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p <strong>ho khan do d\u1ecb \u1ee9ng, k\u00edch \u1ee9ng kh\u00f3i, b\u1ee5i<\/strong> \u2026. Nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng cho tr\u1ebb ho do hen, c\u00e1c thu\u1ed1c n\u00e0y <strong>kh\u00f4ng d\u00f9ng cho tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i<\/strong> v\u00e0 <strong>kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng nh\u01b0 thu\u1ed1c tr\u1ecb ho<\/strong> v\u00ec c\u00f3 th\u1ec3 l\u00e0m kh\u00f4 c\u00e1c ch\u1ea5t ti\u1ebft ph\u1ebf qu\u1ea3n.\n<ul>\n<li>Alimemazin (themaxtene, theralen\u2026..)<\/li>\n<li>Oxomemazine (toplexil)<\/li>\n<li>Chlopheniramine (pheramin\u2026.)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 style=\"text-align: justify\">Thu\u1ed1c tan \u0111\u00e0m<\/h3>\n<p style=\"text-align: justify\">D\u00f9ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ho c\u00f3 \u0111\u00e0m do c\u00e1c nguy\u00ean nh\u00e2n vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean v\u00e0 d\u01b0\u1edbi, c\u00e1c thu\u1ed1c n\u00e0y sau khi u\u1ed1ng c\u00f3 th\u1ec3 g\u00e2y ho t\u0103ng gi\u00fap h\u1ed7 tr\u1ee3 t\u1ed1ng xu\u1ea5t \u0111\u1eddm nh\u1edbt, kh\u00f4ng n\u00ean d\u00f9ng ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf ho.<\/p>\n<p style=\"text-align: justify\"><strong>C\u00f3 c\u00e1c nh\u00f3m thu\u1ed1c d\u01b0\u1edbi \u0111\u00e2y:<\/strong><\/p>\n<ul style=\"text-align: justify\">\n<li>Ch\u1ed1ng d\u00ednh ch\u1ea5t nh\u1ea7y v\u00e0o \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p (detergent): Natri benzoate(passed) c\u1ea9n th\u1eadn \u1edf b\u1ec7nh nh\u00e2n c\u00f3 lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng.<\/li>\n<li>C\u1eaft v\u1ee1 \u0111\u00e0m l\u00e0m d\u1ec5 ho kh\u1ea1c \u0111\u00e0m (mucolytic):\n<ul>\n<li>Acetylcystein (acemuc, exomuc, acehasan,..) thu\u1ed1c n\u00e0y c\u00f3 2 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ea7n l\u01b0u \u00fd kh\u00f4ng d\u00f9ng cho tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i, tr\u1ebb c\u00f3 ti\u1ec1n s\u1eed hen (nguy c\u01a1 g\u00e2y co th\u1eaft ph\u1ebf qu\u1ea3n)<\/li>\n<li>Bromhexin (bisolvon kids, Bromhexin \u2026) ambroxol (ambroco\u2026)<\/li>\n<\/ul>\n<\/li>\n<li>K\u00edch th\u00edch ti\u1ebft nh\u00e0y do t\u0103ng ho\u1ea1t \u0111\u1ed9ng nhung mao c\u1ee7a bi\u1ec3u m\u00f4 \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p (cilliary stimulant)\n<ul>\n<li>Ambroxol, bromhexin (c\u00f3 th\u1ec3 d\u00f9ng cho tr\u1ebb d\u01b0\u1edbi 6 th\u00e1ng)<\/li>\n<\/ul>\n<\/li>\n<li>Salbutamol \u0111\u01a1n thu\u1ea7n hay d\u01b0\u1edbi d\u1ea1ng ph\u1ed1i h\u1ee3p salbutamol + Guaiphenesin (ventolinte expectorant), salbutamol + carbocystein (solmux Broncho: thu\u1ed1c n\u00e0y ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i do th\u00e0nh ph\u1ea7n carbocystein) li\u1ec1u thu\u1ed1c t\u00ednh theo li\u1ec1u salbutamol.<\/li>\n<li>K\u00edch th\u00edch ti\u1ebft nh\u1ea7y qua th\u1ea7n kinh ph\u1ebf v\u1ecb: ipeca, terpin hydrate, guaifenesine.<\/li>\n<\/ul>\n<h3 style=\"text-align: justify\"><strong>C\u00e1c thu\u1ed1c ho th\u1ea3o d\u01b0\u1ee3c<\/strong><\/h3>\n<p style=\"text-align: justify\">C\u00f3 th\u1ec3 d\u00f9ng trong ho khan l\u1eabn ho \u0111\u00e0m<\/p>\n<ul style=\"text-align: justify\">\n<li>Thu\u1ed1c ch\u1ee9a tr\u1ea7n b\u00ec, cao n\u00fac n\u00e1c, vi\u1ec5n ch\u00ed, h\u00fang chanh (t\u1ea7n d\u00e0y l\u00e1) \u2026 v\u00ed d\u1ee5 nh\u01b0 siro ho pectol E (d\u00f9ng cho tr\u1ebb tr\u00ean 30 th\u00e1ng)<\/li>\n<li>C\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 ch\u1ee9a h\u01b0\u01a1ng nhu, cam th\u1ea3o b\u1eafc, ngh\u1ec7, g\u1eebng \u2026.<\/li>\n<li>C\u1ea7n ch\u00fa \u00fd th\u00e0nh ph\u1ea7n c\u1ee7a thu\u1ed1c ho th\u1ea3o d\u01b0\u1ee3c c\u00f3 ch\u1ee9a b\u1ea1c h\u00e0 (menthol) v\u00ed d\u1ee5 nh\u01b0 Zecuf kh\u00f4ng n\u00ean d\u00f9ng cho tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i v\u00ec c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf h\u00f4 h\u1ea5p \u1edf l\u1ee9a tu\u1ed5i n\u00e0y.<\/li>\n<li>Ho astex ch\u1ee9a h\u00fang chanh (t\u1ea7n d\u00e0y l\u00e1 an to\u00e0n cho tr\u1ebb t\u1eeb tu\u1ed5i s\u01a1 sinh \u0111\u1ebfn tr\u1ebb l\u1edbn).<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">C\u00e1c tr\u01b0\u1eddng h\u1ee3p ho k\u00e8m c\u00e1c tri\u1ec7u ch\u1ee9ng sau \u0111\u00e2y c\u1ea7n \u0111\u1eb7c bi\u1ec7t l\u01b0u \u00fd ch\u1ec9 \u0111\u1ecbnh nh\u1eadp vi\u1ec7n<\/h2>\n<ul style=\"text-align: justify\">\n<li>X\u1ea3y ra t\u1eeb l\u00fac s\u01a1 sinh<\/li>\n<li>Ho ra m\u00e1u, ho ra \u0111\u00e0m m\u1ee7<\/li>\n<li>Ho b\u1eaft \u0111\u1ea7u v\u00e0 dai d\u1eb3ng sau h\u1ed9i ch\u1ee9ng x\u00e2m nh\u1eadp<\/li>\n<li>Ho trong v\u00e0 sau \u0103n<\/li>\n<li>B\u1ecf \u0103n<\/li>\n<li>Bi\u1ebfn d\u1ea1ng l\u1ed3ng ng\u1ef1c<\/li>\n<li>C\u00f3 b\u1ec7nh l\u00ed tim<\/li>\n<li>Suy dinh d\u01b0\u1ee1ng<\/li>\n<li>Ng\u00f3n tay d\u00f9i tr\u1ed1ng<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>L\u01b0u \u00fd:<\/strong> B\u00e0i vi\u1ebft c\u00f3 t\u00ednh ch\u1ea5t tham kh\u1ea3o, n\u00ean h\u1ecfi \u00fd ki\u1ebfn b\u00e1c s\u0129 nhi c\u1ee7a b\u1ea1n tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m ho. B\u00e0i vi\u1ebft kh\u00f4ng th\u1ec3 hi\u1ec7n quan \u0111i\u1ec3m c\u00e1 nh\u00e2n c\u1ee7a admin NhikhoaMDTran. Kh\u00f4ng c\u00f3 m\u1ee5c ti\u00eau l\u1ee3i nhu\u1eadn hay qu\u1ea3ng c\u00e1o thu\u1ed1c.<\/p>\n<h2 style=\"text-align: justify\">T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ol>\n<li style=\"text-align: justify\"><a href=\"https:\/\/www.facebook.com\/diendannhikhoa\/posts\/711265672404289?__tn__=K-R\" target=\"_blank\" rel=\"noopener\">https:\/\/www.facebook.com\/diendannhikhoa\/posts\/711265672404289?__tn__=K-R<\/a><\/li>\n<li style=\"text-align: justify\">&#8220;<em>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa b\u1ec7nh vi\u1ec7n nhi \u0111\u1ed3ng 1<\/em>&#8221; (2017)- PGS.TS.Bs Phan H\u1eefu Nguy\u1ec7t Di\u1ec5m<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>\u0110i\u1ec1u tr\u1ecb ho g\u1ed3m \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n (r\u1ea5t quan tr\u1ecdng)v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng (c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf ho, thu\u1ed1c k\u00edch th\u00edch ho hay thu\u1ed1c tan \u0111\u00e0m)<\/p>\n","protected":false},"author":14,"featured_media":4085,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6104],"tags":[4805,5674,5673],"series":[3454],"coauthors":[2652],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ho \u1edf tr\u1ebb em - D\u1ef1 \u00e1n Nhi Khoa<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb ho g\u1ed3m \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n (r\u1ea5t quan tr\u1ecdng)v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng (c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf ho, thu\u1ed1c k\u00edch th\u00edch ho hay thu\u1ed1c tan \u0111\u00e0m)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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