giam dau 09 - nguyn tc s dng thuc gim au ThS Phan Qunh Lan...

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1 nguyªn t¾c sö dông thuèc gi¶m ®au ThS. Phan Quúnh Lan Bé m«n D îc l©m s μ ng Tr êng §H D îc H μ néi
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2 1. Ph©n tÝch bèn nguyªn t¾c sö dông thuèc gi¶m ®au trung ¬ng 2. Ph©n tÝch bèn nguyªn t¾c sö dông thuèc gi¶m ®au ngo¹i vi Môc tiªu:
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3 1. Bé m«n DLS - tr êng §H D îc HN (2006), D îc l©m s μ ng , NXB Y häc, tr. 229- 236. 2. Bé m«n D îc lùc - tr êng §H D îc HN (2005), D îc lý häc , Th viÖn tr êng §H D îc Hμ néi, tr.100-111(tËp 1), 231-244(tËp 2). 3. Edwards C., Walker R.(1999), Clinical Pharmacy and Therapeutics , Churchill Livingstone, 2 nd ed, pp. 465-478. T μ i liÖu tham kh¶o
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4 Héi chèng ®au quèc tÕ (International Association for the Study of Pain- IASP) §au lμ mét c¶m gi¸c khã chÞu , cã tÝnh chÊt c¶m tÝnh , ®i kÌm víi nh÷ng tæn th ¬ng cã thËt/ tiÒm t μ ng cña c¸c tæ chøc, hoÆc ® îc t¶ l μ nh÷ng tæn th ¬ng ®ã.
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5 ¾ §¸nh gi¸ møc ®é ®au ¾ Ph©n lo¹i ®au ¾ Sinh lý ®au §Au !!!
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6 Thô thÓ nhËn c¶m ®au Viêm c ch ế cyclo-oxygenase
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7 Da Néi t¹ng Tuû sèng
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8 è ng tuû- ®åi thÞ Tæn th ¬ng §åi thÞ Tuû sèng N o gi÷a è ng sèng
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9 Ph©n lo¹i ®au (1) §au cÊp §au m·n (2) NhËn c¶m ThÇn kinh (3) Sinh lý BÖnh lý (4) BÒ ngoμi Néi t¹ng ¾ Møc ®é ®au
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10 ) Lμm gi¶m/mÊt c¶m gi¸c ®au do mäi nguyªn nh©n ) Kh«ng ¶nh h ëng ®Õn c¸c c¶m gi¸c kh¸c thuèc gi¶m ®au
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11 ) Thuèc gi¶m ®au trung ¬ng ) Thuèc gi¶m ®au ngo¹i vi ) C¸c nhãm thuèc kh¸c ®iÒu trÞ ®au thuèc gi¶m ®au
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12 NSAID OPIAT Th th nh n c m đ au
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13 Tªn quèc tÕ Đ êng dïng LiÒu t ¬ng ® ¬ng (mg) T 1/2 (h) T/g t¸c dông (h) Morphin Uèng Tiªm 30 10 2 3 - 5 Fentanyl Tiªm D¸n qua da 0.1 – 0.15 25 mcg/h 3 - 4 1 - 2 72 (SR) Hydromorphon Uèng Tiªm 7.5 1.5 2 - 3 3 - 5 Methadon Uèng Tiªm 20 10 4 - 6 Oxycodon Uèng 20- 30 3 - 4 Pethidin Uèng Tiªm 300 75 – 100 3 - 4 3 - 5 Sufentanil Tiªm 0,015 Thuèc gi¶m ®au trung ¬ng ¾ Lo¹i t¸c dông m¹nh
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14 Tªn quèc tÕ Đ êng dïng LiÒu t ¬ng ® ¬ng (mg) T 1/2 (h) T/g t¸c dông (h) Codein Uèng Tiªm 200 130 3 4 - 6 Dextropropoxyphen Uèng 130 6 -12 4 - 6 Tramadol Uèng Tiªm 100 50 6 - 7 4 - 6 ¾ T¸c dông võa Thuèc gi¶m ®au trung ¬ng
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15 Opioid: Liên quan li u – đ áp ng Hi u qu gi m đ au Li u (mg)
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16 DÉn xuÊt C¸c thuèc T¸c dông 1 Acid salicylic Acid acetyl salicylic Methyl salicylat Diflunisal Osalazin Salsalat Phenylbutazon Noramidopyrin Metamizol Meloxicam Piroxicam Tenoxicam Inoxicam Indometacin Tolmetin Etodolac Sulindac Ketorolac 2 Pyrazolon (d/c acid enolic) 3 Oxicam (d/c acid enolic) 4 Indol (d/c acid acetic) 5 Acid phenyl acetic Diclofenac Gi¶m ®au H¹ sèt Chèng viªm thuèc gi¶m ®au ngo¹i vi
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