\n| T\u00e1 d\u01b0\u1ee3c (Sucrose, tragacanth, glycerin, polysorbate 80, methyl paraben, propyl paraben, saccharin natri, erythrosin, strawberry essence, n\u01b0\u1edbc tinh khi\u1ebft)<\/span><\/td>\n | V\u1eeba \u0111\u1ee7 5ml<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n D\u1ea1ng b\u00e0o ch\u1ebf: H\u1ed7n d\u1ecbch u\u1ed1ng.<\/span><\/p>\nTr\u00ecnh b\u00e0y<\/span><\/h3>\nS\u0110K: VN-22089-19.<\/span><\/p>\nQuy c\u00e1ch \u0111\u00f3ng g\u00f3i: H\u1ed9p 1 l\u1ecd 60ml.<\/span><\/p>\nXu\u1ea5t x\u1ee9: Th\u00e1i Lan.<\/span><\/p>\nThu\u1ed1c Tolsus c\u00f3 t\u00e1c d\u1ee5ng g\u00ec?<\/span>\u00a0<\/span><\/h2>\nD\u01b0\u1ee3c l\u1ef1c h\u1ecdc<\/span><\/h3>\nThu\u1ed1c Tolsus v\u1edbi s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a 2 th\u00e0nh ph\u1ea7n l\u00e0 Sulfamethoxazole v\u00e0 Trimethoprim.<\/span><\/p>\n\n- Sulfamethoxazole l\u00e0 m\u1ed9t lo\u1ea1i kh\u00e1ng sinh sulfamid k\u00ecm khu\u1ea9n, c\u1ea3n tr\u1edf qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p axit folic \u1edf vi khu\u1ea9n nh\u1ea1y c\u1ea3m.<\/span><\/li>\n
- Trimethoprim \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn l\u00e0 m\u1ed9t ch\u1ea5t kh\u00e1ng khu\u1ea9n antifolate c\u00f3 t\u00e1c d\u1ee5ng g\u00e2y \u1ee9c ch\u1ebf \u0111\u1eb7c hi\u1ec7u enzyme dihydrofolate reductase c\u1ee7a vi khu\u1ea9n.<\/span><\/li>\n<\/ul>\n
Khi Sulfamethoxazole v\u00e0 Trimethoprim k\u1ebft h\u1ee3p l\u1ea1i v\u1edbi nhau s\u1ebd t\u1ea1o ra m\u1ed9t lo\u1ea1i kh\u00e1ng sinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng bao g\u1ed3m nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, nhi\u1ec5m tr\u00f9ng tai gi\u1eefa (vi\u00eam tai gi\u1eefa), vi\u00eam ph\u1ebf qu\u1ea3n,…\u00a0 Ngo\u00e0i ra kh\u00e1ng sinh k\u1ebft h\u1ee3p c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ng\u1eeba ho\u1eb7c \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i do Pneumocystis jiroveci ho\u1eb7c vi\u00eam ph\u1ed5i do Pneumocystis carinii (PCP). N\u00f3 ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf vi khu\u1ea9n g\u00e2y ra nhi\u1ec1u lo\u1ea1i nhi\u1ec5m tr\u00f9ng.<\/span><\/p>\nD\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/span><\/h3>\nH\u1ea5p thu:\u00a0<\/span><\/p>\n\n- Sau khi u\u1ed1ng, Sulfamethoxazole v\u00e0 Trimethoprim s\u1ebd \u0111\u01b0\u1ee3c c\u01a1 th\u1ec3 h\u1ea5p thu r\u1ea5t nhanh ch\u00f3ng v\u00e0 g\u1ea7n nh\u01b0 l\u00e0 h\u1ea5p th\u1ee5 ho\u00e0n to\u00e0n. Th\u1ee9c \u0103n s\u1ebd kh\u00f4ng l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 h\u1ea5p thu thu\u1ed1c.\u00a0<\/span><\/li>\n
- N\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh \u0111\u1ea1t \u1edf trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a Sulfamethoxazole l\u00e0 kho\u1ea3ng t\u1eeb 40 – 60 mg\/ml v\u00e0 Trimethoprim l\u00e0 kho\u1ea3ng t\u1eeb 1 – 2 mg\/ml, sau khi u\u1ed1ng \u0111\u01b0\u1ee3c t\u1eeb 1 – 4 ti\u1ebfng.<\/span><\/li>\n<\/ul>\n
Ph\u00e2n b\u1ed1:<\/span><\/p>\n\n- Sulfamethoxazole c\u00f3 kh\u1ea3 n\u0103ng li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng l\u00e0 kho\u1ea3ng 66%.<\/span><\/li>\n
- Trimethoprim c\u00f3 kh\u1ea3 n\u0103ng li\u00ean k\u1ebft v\u1edbi protein huy\u1ebft t\u01b0\u01a1ng l\u00e0 kho\u1ea3ng 50 %.\u00a0<\/span><\/li>\n<\/ul>\n
Chuy\u1ec3n h\u00f3a:<\/span><\/p>\n\n- Sulfamethoxazole s\u1ebd ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c N-acetyl h\u00f3a v\u00e0 c\u00f3 k\u1ebft h\u1ee3p v\u1edbi c\u1ea3 acid glucuronic.<\/span><\/li>\n
- Trimethoprim s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1edfi qu\u00e1 tr\u00ecnh hydroxyl h\u00f3a vfa oxyd.<\/span><\/li>\n<\/ul>\n
Th\u1ea3i tr\u1eeb:<\/span><\/p>\n\n- Sulfamethoxazole s\u1ebd \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua th\u1eadn, c\u00f3 kho\u1ea3ng t\u1eeb 15 \u0111\u1ebfn 30% li\u1ec1u s\u1eed d\u1ee5ng s\u1ebd \u0111\u01b0\u1ee3c thu h\u1ed3i trong n\u01b0\u1edbc ti\u1ec3u \u1edf d\u1ea1ng ho\u1ea1t \u0111\u1ed9ng.<\/span><\/li>\n
- Trimethoprim th\u1ea3i tr\u1eeb ch\u1ee7 y\u1ebfu qua th\u1eadn v\u00e0 c\u00f3 kho\u1ea3ng 50% li\u1ec1u s\u1eed d\u1ee5ng s\u1ebd \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft v\u00e0o trong n\u01b0\u1edbc ti\u1ec3u \u1edf d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng \u0111\u1ed5i.<\/span><\/li>\n<\/ul>\n
\u0110\u1ed1i t\u01b0\u1ee3ng n\u00ean s\u1eed d\u1ee5ng Tolsus<\/span><\/h2>\nThu\u1ed1c Tolsus \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y:<\/span><\/p>\n\n- Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean v\u00e0 d\u01b0\u1edbi nh\u01b0 vi\u00eam ph\u1ebf qu\u1ea3n c\u1ea5p v\u00e0 m\u1ea1n t\u00ednh, vi\u00eam ph\u1ed5i, vi\u00eam h\u1ecdng,…<\/span><\/li>\n
- Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a nh\u01b0 vi\u00eam ru\u1ed9t, th\u01b0\u01a1ng h\u00e0n v\u00e0 ph\u00f3 th\u01b0\u01a1ng h\u00e0n.<\/span><\/li>\n
- Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u v\u00e0 th\u1eadn nh\u01b0 vi\u00eam b\u00e0ng quang c\u1ea5p v\u00e0 m\u1ea1n t\u00ednh, vi\u00eam \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u,…<\/span><\/li>\n
- Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m da nh\u01b0 vi\u00eam m\u1ee7 da, \u00e1p xe, \u0111inh nh\u1ecdt hay nhi\u1ec5m khu\u1ea9n \u1edf v\u1ebft th\u01b0\u01a1ng.<\/span><\/li>\n
- Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n m\u00e1u hay nhi\u1ec5m khu\u1ea9n kh\u00e1c.<\/span><\/li>\n<\/ul>\n
Li\u1ec1u d\u00f9ng – C\u00e1ch s\u1eed d\u1ee5ng Tolsus<\/span><\/h2>\nC\u00e1ch d\u00f9ng\u00a0<\/span><\/h3>\nThu\u1ed1c Tolsus \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1eb1ng \u0111\u01b0\u1eddng u\u1ed1ng.<\/span><\/p>\nLi\u1ec1u d\u00f9ng<\/span><\/h3>\nLi\u1ec1u s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n c\u1ea5p t\u00ednh:<\/span><\/i><\/p>\n\n\n\n| \u0110\u1ed9 tu\u1ed5i<\/span><\/td>\n | Li\u1ec1u s\u1eed d\u1ee5ng<\/span><\/td>\n<\/tr>\n\n| Tr\u1ebb em c\u00f3 \u0111\u1ed9 tu\u1ed5i d\u01b0\u1edbi 2<\/span><\/td>\n | \u00bd th\u00eca c\u00e0 ph\u00ea, u\u1ed1ng 2 l\u1ea7n\/ng\u00e0y<\/span><\/td>\n<\/tr>\n\n| Tr\u1ebb em c\u00f3 \u0111\u1ed9 tu\u1ed5i t\u1eeb 2 \u0111\u1ebfn 5<\/span><\/td>\n | 1 th\u00eca c\u00e0 ph\u00ea, u\u1ed1ng 2 l\u1ea7n\/ng\u00e0y<\/span><\/td>\n<\/tr>\n\n| Tr\u1ebb em c\u00f3 \u0111\u1ed9 tu\u1ed5i t\u1eeb 6 \u0111\u1ebfn 12<\/span><\/td>\n | 1 – 2 th\u00eca c\u00e0 ph\u00ea, u\u1ed1ng 2 l\u1ea7n\/ng\u00e0y<\/span><\/td>\n<\/tr>\n\n| Tr\u1ebb em c\u00f3 \u0111\u1ed9 tu\u1ed5i t\u1eeb 12 tr\u1edf l\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn<\/span><\/td>\n | 2 – 4 th\u00eca c\u00e0 ph\u00ea, u\u1ed1ng 2 l\u1ea7n\/ng\u00e0y<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \u0110i\u1ec1u tr\u1ecb b\u1ec7nh cho \u0111\u1ebfn khi b\u1ec7nh nh\u00e2n h\u1ebft ho\u00e0n to\u00e0n c\u00e1c tri\u1ec7u ch\u1ee9ng trong v\u00f2ng 2 ng\u00e0y v\u00e0 \u0111a s\u1ed1 s\u1ebd ph\u1ea3i \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u00edt nh\u1ea5t trong v\u00f2ng 5 ng\u00e0y. N\u1ebfu d\u1ea5u hi\u1ec7u b\u1ec7nh kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n r\u00f5 sau khi s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb 7 ng\u00e0y th\u00ec b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i t\u1eeb b\u00e1c s\u0129.<\/span><\/p>\nLi\u1ec1u s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p:<\/span><\/i><\/p>\n\n- \u1ede \u0111\u1ee3t c\u1ea5p vi\u00eam ph\u1ebf qu\u1ea3n m\u1ea1n: Ng\u01b0\u1eddi l\u1edbn, s\u1eed d\u1ee5ng 4 th\u00eca c\u00e0 ph\u00ea, ng\u00e0y u\u1ed1ng 2 l\u1ea7n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i trong v\u00f2ng 14 ng\u00e0y.<\/span><\/li>\n
- Vi\u00eam ph\u1ed5i do P.carinii: \u0110\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng li\u1ec1u cao 20mg Trimethoprim v\u00e0 100mg Sulfamethoxazole m\u1ed7i kg c\u00e2n n\u1eb7ng c\u01a1 th\u1ec3 v\u00e0 chia l\u00e0m 2 l\u1ea7n s\u1eed d\u1ee5ng ho\u1eb7c nhi\u1ec1u l\u1ea7n trong v\u00f2ng 2 tu\u1ea7n.<\/span><\/li>\n<\/ul>\n
Li\u1ec1u s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng\u00a0 ti\u1ebft ni\u1ec7u:<\/span><\/i><\/p>\n\n- T\u00ecnh tr\u1ea1ng kh\u00f4ng bi\u1ebfn ch\u1ee9ng: Ng\u01b0\u1eddi l\u1edbn, U\u1ed1ng 4 th\u00eca c\u00e0 ph\u00ea, s\u1eed d\u1ee5ng 2 l\u1ea7n\/ng\u00e0y v\u1edbi th\u1eddi gian \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 l\u00e0 3 – 7 – 10 ng\u00e0y. \u0110\u1ed1i v\u1edbi tr\u1ebb em s\u1eed d\u1ee5ng li\u1ec1u 8 mg Trimethoprim\/kg c\u00e2n n\u1eb7ng\/ng\u00e0y v\u00e0 \u0111\u01b0\u1ee3c chia l\u00e0m 2 l\u1ea7n u\u1ed1ng, m\u1ed7i l\u1ea7n u\u1ed1ng c\u00e1ch nhau 12 ti\u1ebfng.<\/span><\/li>\n
- Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u m\u1ea1n t\u00ednh ho\u1eb7c t\u00e1i ph\u00e1t (\u0111\u1ed1i v\u1edbi n\u1eef tr\u01b0\u1edfng th\u00e0nh) ho\u1eb7c b\u1ecb vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t: U\u1ed1ng 4 th\u00eca c\u00e0 ph\u00ea\/l\u1ea7n, c\u00e1ch 12 ti\u1ebfng u\u1ed1ng 1 l\u1ea7n v\u00e0 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i t\u1eeb 10 – 14 ng\u00e0y \u0111\u1ed1i v\u1edbi nhi\u1ec5m khu\u1ea9n ni\u1ec7u v\u00e0 3 – 6 th\u00e1ng \u0111\u1ed1i v\u1edbi vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t.<\/span><\/li>\n<\/ul>\n
Li\u1ec1u s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a:<\/span><\/i><\/p>\n\n- \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh t\u1ea3: Ng\u01b0\u1eddi l\u1edbn s\u1ebd s\u1eed d\u1ee5ng li\u1ec1u 160 mg Trimethoprim, ng\u00e0y u\u1ed1ng 2 l\u1ea7n v\u00e0 m\u1ed7i l\u1ea7n s\u1ebd c\u00e1ch nhau 12 ti\u1ebfng, \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 3 ng\u00e0y. \u0110\u1ed1i v\u1edbi tr\u1ebb nh\u1ecf: s\u1ebd s\u1eed d\u1ee5ng li\u1ec1u 4 – 5 mg\/kg Trimethoprim, ng\u00e0y u\u1ed1ng 2 l\u1ea7n v\u00e0 m\u1ed7i l\u1ea7n s\u1ebd c\u00e1ch nhau 12 ti\u1ebfng, \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 3 ng\u00e0y.<\/span><\/li>\n
- B\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh Brucella: s\u1ebd s\u1eed d\u1ee5ng li\u1ec1u 10 mg\/kg Trimethoprim, ng\u00e0y u\u1ed1ng 2 l\u1ea7n v\u00e0 m\u1ed7i l\u1ea7n s\u1ebd c\u00e1ch nhau 12 ti\u1ebfng, \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 4 – 6 tu\u1ea7n..<\/span><\/li>\n<\/ul>\n
Kh\u00f4ng s\u1eed d\u1ee5ng Tolsus trong tr\u01b0\u1eddng h\u1ee3p n\u00e0o?<\/span><\/h2>\nCh\u1ed1ng ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c Tolsus cho \u0111\u1ed1i t\u01b0\u1ee3ng:\u00a0<\/span><\/p>\n\n- B\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o trong thu\u1ed1c.<\/span><\/li>\n
- Ph\u1ee5 n\u1eef \u0111ang c\u00f3 thai v\u00e0 \u0111ang cho con b\u00fa.<\/span><\/li>\n
- B\u1ec7nh nh\u00e2n \u0111ang m\u1eafc b\u1ec7nh thi\u1ebfu m\u00e1u h\u1ed3ng c\u1ea7u kh\u1ed5ng l\u1ed3.<\/span><\/li>\n
- B\u1ec7nh nh\u00e2n \u0111ang b\u1ecb t\u1ed5n th\u01b0\u01a1ng gan nghi\u00eam tr\u1ecdng hay \u0111ang b\u1ecb suy th\u1eadn n\u1eb7ng.<\/span><\/li>\n
- \u0110\u1ed1i t\u01b0\u1ee3ng l\u00e0 tr\u1ebb em c\u00f3 \u0111\u1ed9 tu\u1ed5i d\u01b0\u1edbi 2 v\u00e0 tr\u1ebb b\u1ecb \u0111\u1ebb non.<\/span><\/li>\n<\/ul>\n
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