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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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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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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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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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