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8/10/2019 Phan Nhom Duoc Ly
1/14
Con ng xa em i, ngi ta qun dy ch, th l em ht i
ng sui ang ni zi b sui, nh trai bn gi ai ny cng u xui TH Dc l - Lp 12CDSL04 Trang 1
KHNG SINH
Nhm phn nhm nhn dng tn thuc C TDP CC
Lactam(nhm an ton choPNCT)
Phn nhmPenicillin
Penicillin M OxacillinNhim Gr (+), S.aureus (t cu vng)cn nhy vi methicillin (MSSA)Nhim trng cc loi
- Ri lon h tp khun rut(Ampicillin hp thu km,lng thuc cn trong d dy
nhiu nn gy lon khunng rut nhiu hn).- D ng, bin chng nng lhi chng Steven-Johnson.- Dng tim d gy sc phnv v gy vim tc tnh mchti ch nu tim nhanh.
- Mn cm- Suy thn
Penicillin A
Amoxicillin,Ampicillin,Amoxcicillin + Acidclavulanic (a.clavulanicc ch men -lactamase ph hykhng sinh nn tnghot tnh)
Dit Gr (+) mnh hn Peni MNhim trng cc loi
Phn nhmCephalosporin
TH1CefalexinCefadroxil
Nhim Gr (+) v vi Gr (-)
TH2Cefaclor,Cefuroxim
Mnh hn TH1
TH3
Ceftriaxone
Cefotaxim(nh test phn ng dng di da)
Nhim trng nng: bnh vin, mu,no, d phng phu thut
Macrolid(nhm an ton, lachn u tay choPNCTnhng ung
rt ng)
ui mycin &thromycin dng ung
Thin nhin:- Erythromycin- SpiramycinBn tng hp:- Azithromycin- Roxithromycin- Clarithromycin
KS kim khun ch yu Gr (+), phnb tt h hp.- Nhim trngTMH, xoang, phi, mmm, da, vn cn dng trong nhimtrng tit niu sinh dc.- Clarithromycin nhy vi H.pylori tr
lot DDTT do H.pylori.- Spiramycin + Metronidazol tr vikhun k kh (Rodogyl*)
- RLTH- D ng- Vim gan mt khi dngErythromycin dng mui
estolat.
- Mn cm- X gan, suy gan, vimgan
Cyclin(trnh dng chung vithuc c kim loi aha tr hay thc phmsa)
ui -cyclinTetracyclinDoxycyclin
KS kim khun ph rng, tr nhimtrng nhiu ni: da, m mm, h hp,TMH, tiu haD phng tr st rt
- Vng rng TE < 8 tui (dotetra to phc vi calci trongrng)- RLTH r rt- D ng
- Mn cm- TE < 8 tui- PNCT v cho con b- Suy thn nng (do khthi tr)
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8/10/2019 Phan Nhom Duoc Ly
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Con ng xa em i, ngi ta qun dy ch, th l em ht i
ng sui ang ni zi b sui, nh trai bn gi ai ny cng u xui TH Dc l - Lp 12CDSL04 Trang 3
2. Levofloxacin mu tn huyt- Mt s gy ri lon in tm, ko di sng QT lonnhp
hn c)
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HORMON
Nhm Thuc C TDP CC
Hormon gip bn tng hp Levothyroxin- Dng b sung hormon gip trong: suy gip,nhc gip- Bnh gip sau phu thut cng gip
Triu chng cng gip: mt ng, st cn,da nng, nhp tim nhanh, bt rt, tiu chy
- Cng gip- Tin s tim mch
Khng gipCarbimazolePropylthiouracil
- Cng gip (mt li, bu c)- Bnh gip trc phu thut
- D ng, ni m ay- Vim gan- Gim bch cu, tiu cu, rng tc
- Mn cm- Suy gan- Suy ty xng, ri lon to mu- PNCT (Carbimazole)
SulfonylureGliclazideGlypurid
Chlopropamide (c in)
Tiu ng type 2
- H ng huyt qu mc- Vim gan
- D ng ban
- Mn cm- Tiu ng type 1 v thai k
- Suy gan, suy thn
Biguanid Metformin- Bun nn, tiu chy- D ng ban - Nhim acid lactic mu
- Mn cm- Tiu ng type 1 v thai k- BN c nguy c nhim a.lactic:suy gan, suy thn, suy tim, suyh hp- Nghin ru: gy tng tcthuctry tim
Thiazolidinedion Pioglitazon- Bun nn, nhc u- Gy ph c gan
- Mn cm- Tiu ng type 1 v thai k- Suy gan- Suy tim xung huyt tin trin
c ch -glucosidase Acarbose- y hi, trung tin- Liu cao gy tng men gan
- Mn cm- Tiu ng type 1 v thai k- Suy gan, x gan- BN b km hp thu v tc nghnrut
GlucocorticoidsPrednisonDexamethasoneTriamcinolon
- Suy thng thn cp v mn (Triamcinolon,Hydrocortison)- Khng vim: bt k vim (khp, thp khp,mng no, hen suyn)- Chng d ng mnh: sc phn v, d ngthuc- c ch phn ng min dch: thp khp,lupus ban , thp tim, ghp c quan
- Tng ng huyt v teo c, ti phn bmhi chng Cushing- Tng Na+: gi mui, gi nc ph, tngcn, tng HA- Mt K+: nhc c- Mt Ca2+: long xng, xp xng- Liu rt cao: gy sng khoi, ri lon tmthn
- Lot DDTT- Suy gim min dch: lao, nm,chch vaccin- Tiu ng nng, long xngnng, tng HA, ri lon tm thn
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- Tng nhn p, c thy tinh th- Dng xt gy khn hng- Lot DDTT- Teo, suy thng thn
- Dng lu gy bt lc- Dng lu gy hy xng- Dng ngoi: nm da, teo da, mng da- Suy gim min dch
Androgen Testosterone- Suy gim chc nng sinh dc nam- V sinh nam- Bt lc
- Gi mui, gi nc ph- Ni mn trng c- Vng da, mt, tng lipid huyt- Qu liu: gy chng lon dm ngi gi,
v to, teo tinh hon, hi u (do b menchuyn ha thnh estrogen)
- Ung th v n ng- Ung th tin lit tuyn- PNCT v cho con b- Tr em cha dy th
- Thn trng tim mch
Estrogen + Progestin
Ethinyl estradiol +LevonogestrelEthinyl estradiol +Desogestrel
Nga thai ung hng ngy
- Bun nn- au na u- Cng tc ngc- Ph, tng cn, tng HA
- Mn cm- PNCT v cho con b- Migrain- Ung th v- Tim mch- Suy gan- Rong kinh
Progestin Levonogestrel (vin 750mg)- Nga thai khn cp 72h- Liu thp: an thai, iu kinh
- Bun nn- au na u- Cng tc ngc
- Ri lon kinh nguyt, rong kinh
Anti-progestin Mifepristone- Nga thai khn cp 120h- Ph thai ni khoa
Co tht t cung mnh: gy xut huyt
- Mn cm- Thai trn 7 tun hay thai ngoit cung- Suy thng thn, tim mch
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Con ng xa em i, ngi ta qun dy ch, th l em ht i
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VITAMIN
Vitamin C TDP CC
Vit A (retinol)- Qung g, kh mt- Mn trng c, vy nn
- Liu cao: kh mi, nim mc- Tng p lc ni s- Chn n- Qui thai
- Mn cm- Ri lon hp thu lipid- Dng chung vi du khong nhun trng
Vit D (calciferol)- Tr ci xng, long xng- H calci huyt
- Tng calci huyt, ri lon in gii, tng HA- Sn thn
Mn cm
Vit E (tocoferol)- Chng oxy ha, bo v t bo- Sy thai- Bnh mch vnh
Bun nn, tiu chy- Mn cm- Chm ng mu do thiu vit K
Vit K (K1: phylloquinon)- Cm mu: nga xut huyt trong phu thut, sinh n, chnthng, bng huyt- i khng vi warfarin, heparin
Sc phn v Mn cm
Vit C (acid ascorbic)- Tr bnh Scorbut- Tng cng h min dch
- Thiu men G6PD- Si oxalat thn- Dng ung: lot DDTT, RLTH- Dng tim: sc phn v
- Thiu men G6PD- Si thn- Mn cm
Vit B1 (thiamin)- Tr bnh t ph Beri-Beri- Vim dy thn kinh do ru
RLTH, d ng Mn cm
Vit B3 (PP, niacin)- Tr bnh Pellagra: vim da, vim li, trc vy- Liu cao: tr tng lipid huyt
- Lot DDTT- Gin mch: bng, h HA, tim nhanh
- Mn cm- Lot DDTT- HA thp- Suy gan nng
Vit B5 (acid pantothenic)- Ri lon dinh dng: lng, tc- Tng cng min dch
RLTH, d ng
Mn cmVit B6 (pyridoxin)
- Tr vim dy thn kinh- Ng c isoniazid
- RLTH, d ng (him)- Liu cao ko di gy ri lon thn kinh ngoi
bin
Vit B8 (biotin)- Tr vim da tit b nhn- H tr tr mn trng c- Vim li
RLTH, d ng
Vit B9 (acid folic)- Phi hp Fe: b mu- Thiu mu hng cu to- Phng nga d tt ch t sng thai nhi PNCT
D ng, RLTH, bun nn, to bn hay tiu chy- Mn cm- Tha Fe trong c th: gan nhim st, a hngcu
Vit B12 (cyanocobalamin) - Thiu mu hng cu to c tnh (ct b d dy hay ung th Dng tim: sc phn v - Mn cm
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d dy)- Vim dy thn kinh- Tng cng min dch BN suy nhc
- Thiu mu cha r nguyn nhn- Khi u c tnh
B1 + B6 + B12 Vim dy thn kinh RLTH
Mn cmSap multi Tng cng min dch RLTH, kch ng d dy, gin mchMagnesium B6 Co git do thiu Mg RLTH, ri lon in gii Mg
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TIM MCH HUYT P
Nhm Thuc C TDP CC
Chn knh Ca2+(CCB)
Thuc nhm DHP(dihydropyridin):
NifedipinAmlodipinFelodipin
- Tr tng HA- D phng TN- Hi chng Raynaud (thiu mu u chi)
- H HA mnh- Nhc u, chng mt, bun nn, bng mt, ph mt c chn, timnhanh
- HA thp- Sc tim suy tim- Thn trng cho PNCT
c ch men chuyn (ACEI)
Captopril
ElanaprilPerinopril
- Tng HA c km thm nhiu bnh: tiu
ng- L thuc u tay tr suy tim sung huyt- Dng sau NMCT phng bin chng suytim
- H HA liu u- Ho khan (tc dng ny s cdung np sau vi thng s dng)
- Ph mch do d ng- Tng ion K+huyt- Suy thn cp
- Mn cm- PNCT
- Hp ng mch thn 2 bn- Tin s ph mch d ng- Tng K+huyt- V niuChn receptor angiotensin 2
(ARB)LosartanTelmisartan
Ging ACEI nhng tho khan v phmch hn
Chn chn lc 1(1 tim, 2 kh ph qun, c ch:lm tim p chm, gin mch)
AtenololBisoprololMetoprolol
- Tng HA- D phng TN
- Chng lon nhp- Dng sau NMCT nga bin chng timnhanh
- Tim chm, tt HA, mt mi- Co tht ph qun, gy khi phthen suyn
- Hi chng Raynaud- Che lp du hiu h ng huyt- Lit dng
- Nhp tim chm- Block tim 2 & 3
- Hen suyn, COPD- PNCT- Suy tim 4
Chn c 1v 2 PropanololNadololTimolol
Chn 1 - ISA Acebutolol (liu thp ch vn)
Li tiu thiazid Indapamid- Tng HA- Ph do suy tim sung huyt, x gan
- Mt nc, mt mui, tng acid uirichuyt, tng ng huyt, tngcholesterol- D ng (do thuc c cu trcsulfamid)
- Thc y hn m gan- Tt HA t th
- Mn cm sulfamid
- BN b gim th tch mu- No gan, gout- PNCT v cho con b- V niu
Li tiu quai Furosemid- Ph do suy tim sung huyt, x gan- Tng HA
Ging thiazid, thm:- Gim thnh lc
Li tiu c ch carbonicanhydrase
Acetazolamid- Tng nhn p- Chng ng kinh- Tr ph
- Mt nc, mt mui mnh- D ng- Nhim acid chuyn ha- Thc y hn m gan
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Con ng xa em i, ngi ta qun dy ch, th l em ht i
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StatinSimvastatinLovastatinActorvastatin
Tng lipid huyt do tng LDL
- RLTH, bun nn, tiu chy- au c, tiu c vn- D ng- c gan
- Mn cm- Tr em nh- Suy gan- PNCT v cho con b
Fibrate Fenofibrate Tng lipid huyt do tng VLDL v triglyceridGing statin, thm:
- Si mt- Ri lon cng thc mu
Ging statin, thm:- BN b si mt
Glycosid tr tim Digoxin- Thuc cui tay tr suy tim- Lon nhp
- Bun nn- Tng K+huyt- Tn thng TK th gic: m mu,s nh sng
- Block tim 2 & 3- K+huyt thp- Lon nhp tht nng- Tim qu chm- Mn cm, PNCT
Hp ch t mi ch ng thi u mutim cc b Trimetazidin (Vastarel*) D phng TN RLTH v d ng Mn cm, PNCT
Nitrat hu c Nitroglycerin- Phng v iu tr TN- Tr tng HA kch pht
- Tng p lc ni s- Tt HA t th- Tim nhanh- Nhc u, bng, ph mt cchn
- BN b bnh v no- HA thp- Suy tim cp- Thiu mu nng
Lit giao cm TW(kch thch receptor 2 trn trung tmvn mch)
Methyldopa- Thuc u tay trong tng HA thai k- Tng HA trung bnh v nh cho nhiu itng
- Bun ng, trm cm- Kh ming, to bn
- Tt HA t th- Tim chm- Lit dng- Vim gan- C th gy thiu mu tiu huyt
- Trm cm- Suy gan- U ty thng thn- BN ang dng IMAO hay levodopa
Vitamin tan trong nc Vit B3 (PP, niacin)- Tr bnh Pellagra: vim da, vim li, trcvy- Liu cao: tr tng lipid huyt
- Lot DDTT- Gin mch: bng, h HA, timnhanh
- Mn cm- Lot DDTT- HA thp- Suy gan nng
NSAIDs Aspirin 81mgChng kt tp tiu cu trong: nga t qu,thiu mu tim cc b, t stent
- Lot DDTT- Khi pht hen suyn- D ng- D chy mu, kh ng mu- Dng cho tr em st siu vi gy hichng Reye
- Lot DDTT- Hen suyn- Mn cm- C a d chy mu- TE st siu vi
Chng kt tp tiu cu Clopidogrel- Gy chy mu- au DD
- Mn cm- Lot DD
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- D ng - BN c nguy c xut huyt
Cng giao cm Adrenalin Chng try tim mch khi sc phn vTim nhanhlon nhp, tng HA, hi
hp
- Lon nhp- Tng HA- Cng gip
- Glaucome gc hp- B tiu
Chn knh Na+ LidocainChng lon nhp tm tht (nu khng phaadrenalin)
- D ng, sc phn v- Tt HA- Nhc u, chut rt
- Mn cm- Block tim
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TIU HA
Nhm Thuc C TDP CC
Antacid
Al(OH)3+ MgCO3
- Lot DDTT- chua, nng rt d dy
- Mt phosphor huyt long xng- Gim s hp thu cc thuc khc- Al2(PO4)3: to bn
- Mn cm- Suy thn
Al2(PO4)3
Al(OH)3+ Mg (OH)2
AttapulgiteSimethicone Ph bt, chng y hi, h tr lot DDTT
Bo v nim mc
Bismuth subcitrate- Lot DDTT- Phi hp iu tr H.pylori
- To bn- Phn v li mu xm en
Sucrafat Lot DDTT- To bn- Mt phosphor huyt long xng- Gim s hp thu cc thuc khc
c ch bm proton
RabeprazolePantoprazoleEsomeprazoleOmeprazoleLansoprazole
- Lot DDTT
- Tro ngc d dy thc qun- Hi chng Zollinger-Ellison
- D ng : pht ban- y bng, kh tiu
- Mn cm- Thn trng PNCT 3 thng u
Khng histamin H2
Famotidin
RanitidinNizatidin
- y bng, kh tiu
- D ng - Mn cm- Thn trng PNCT- Thn trng cho TE trc tui dyth- Thn trng vi phi hp cc thucdng chung (do c ch men gan)
Cimetidin
- y bng, kh tiu- D ng- Tc dng khng androgen : gy v to,teo tinh hon, bt lc, n gii : ri lonkinh nguyt
H.pylori KITLansoprazole + Clarithromycin +Tinidazol (Flamokit *)
Lot DDTT do H.pylori RLTH, ming ng Mn cm
Prostaglandin BTH Misoprostol Lot DDTT do dng NSAIDs Co tht c trn: au bng, tiu chy PNCT
Anti dopamin Domperidon- Chng nn- Tr tiu ha, y bng, kh tiu
- Khng dopamin- Khng androgen- D ng
- Xut huyt tiu ha- Nn sau phu thut- PNCT v cho con b- Thn trng cho TE
BenzimidazoleMebendazole Tr giun: a, mc, tc, kim trong lng rut
- RLTH- D ng
- Mn cm- PNCT- Thn trong TE < 2 tuiAlbendazole Tr giun v sn: dy b, dy heo nm trong - RLTH
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lng rut - D ng- c ch ty xnggim BC
Sulfamid
Sulfaguanidin Tiu chy, l trc khun ng rut- Lon khun rut
- D ng
- Mn cm- PNCT
- Suy thn nng
Sulfamethoxazole + TrimethoprimKS kim khun ph rng: h hp, tiu ha,tit niu, sinh dc, m mm
- D ng, Steven Johnson, sm da- Lon khun rut- Thiu mu HC to- c ty xng mt BC- Si thn
- Mn cm- Thiu mu- Suy ty xng- Suy gan, suy thn- Thiu men G6PD- PNCT v cho con b
5-nitroimidazole
Metronidazole- L amip rut, m- Tr trng roi trichomonas hay giardia- Tr vi khun k kh: H.pylori, Clostridiumdifficile
- RLTH
- Liu cao: nhc u, chng mt
- Mn cm- Thn trng PNCT v cho con b- Ru bia (b hi chng antabuse)
Tinidazole- RLTH- Liu cao: nhc u, chng mt- Gim BC, ri lon qu trnh to mu
- Mn cm- Thn trng PNCT v cho con b- Ru bia (b hi chng antabuse)- Suy ty
Nhun trng thm thuLactuloseGlycerinSorbitol
- To bn- No gan
- au bng, tiu chy- Dng bm: gy kch ng ti ch
(glycerin)
- Mn cm- au bng cha r nguyn nhn- Tc rut
- Xut huyt tiu haNhun trng kch thch Natri picosulfatBisacodyl
- To bn- Chun b phu thut vng bng
Khng nhu ng LoperamidTiu chy cp v mn do khng nhimkhun
- To bn- Bun ng, kh ming
- Mn cm- Tr em- Ngi vim i trng, lit rut
Khng sinh thc vt Berberin- L trc khun, l amip- Tiu chy
Co tht c trn t cung- Mn cm- PNCT
Men vi sinh Lactobacilus acidophylusLp li cn bng h vi khun ng rut:tiu chy, to bn
Nn, d ng Mn cm
Dn xut Iodoquinon Tr chn gi amip trong rut- Ri lon tuyn gip- Bun nn, d ng
- Mn cm- Cng gip- Thn trng TE < 2 tui
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KHNG: NM VIRUS LAO VIM - HISTAMIN
Nhm Thuc C TDP CC
Khng nm dng ngoi
MiconazoleGrisefulvinKetoconazoleClotrimazole
Tr cc loi nm ngoi daKch ng
Mn cmNystatin Tr nm candida da v nim mc
Khng nm ung
Nystatin Tr nm candida rut Bun nn
Grisefulvin Tr nm da, nm mng, nm tc- Bun nn- Nhy cm AS
- Cm ng enzym ganFluconazoleKetoconazoleItraconazole
Tr nhim nm ni tng: candida, aspergillus- Nn, d ng- Dng lu khng androgen- c ch enzym gan
- Mn cm- Suy gan- PNCT
Khng nm dng t
Metronidazole +Cloramphenicol +Dexamethason +Nystatin
Nhim nm m o: candida, trichomonas Kch ng- Mn cm- PNCT
Khng virusAcyclovir
Ngoi da:- Da nhim virus herpes simplex- Thy u- Mn rp ming v sinh dc
Ung:- Nhim virus herpes simplex- Thy u
- Kch ng (dng bi da)- Nn, ni ban- Tng men gan
Lamivudine- Vim gan do virus- HIV
Nn, d ng, ni ban- Mn cm- Suy gan, suy thn
Khng lao
Ethambutol
iu tr cc th lao
- Vim gan- Vim dy thn kinh th gic
- Mn cm- Suy gan- PNCT
Isoniazid- Vim gan- Vim dy thn kinh ngoi bin (phi dng km vit B6)
Pyranizamid- Vim gan- Tng acid uric
Rifampicin iu tr cc th lao v phong- Vim gan- Nhum cc dch tit trong c th
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