Special_pop_QY09 - S DNG THUC CHO CC I TNG C BIT Ging vin Ths Phan Qunh Lan Bm Dc lm sng trng H Dc H ni 1 PH N PH N CHO CON B CHO CON B PH N PH N C

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1 S D NG THU C CHO CÁC ĐỐ I T ƯỢ NG ĐẶ C BI T Gi ng viên: Ths Phan Qu nh Lan Bm D ượ clâmsàng-tr ườ ng Đ H D ượ cHàn i
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2 PH N CÓ THAI PH N CÓ THAI PH N CHO CON BÚ PH N CHO CON BÚ NG ƯỜ I CAO TU I NG ƯỜ I CAO TU I TR EM TR EM ĐỐ I T ƯỢ NG ĐẶ C BI T ĐỐ I T ƯỢ NG ĐẶ C BI T
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3 Môc tiªu : 1. Ph©n tÝch ® îc ¶nh h ëng cña thuèc dïng cho PNCT ®èi víi thai nhi. 2. Nªu ® îc nh÷ng ®Æc ®iÓm kh¸c biÖt vÒ D§H cña thuèc ë PNCT, TE vμ NCT 3. Nªu ® îc nguyªn t¾c trong sö dông thuèc cho PNCT, PNCCB, TE vμ NCT
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4 Sö dông thuèc trong ®iÒu trÞ cho phô n÷ cã thai
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5 Nguyªn nh©n g©y dÞ tËt ë trÎ s¬ sinh ± Thuèc vμ ho¸ chÊt 1-5% ± MÑ bÞ nhiÔm trïng 3% ± T×nh tr¹ng bÖnh tËt cña mÑ 4% ± BÊt th êng di truyÒn 15- 20% ± Kh«ng râ nguyªn nh©n 60- 70%
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6 Mét sè thuèc g©y qu¸I thai ± Androgen ± Coumarin & d/c ± Cyclophosphamid ± Diethylstibestrol ± Etretinat ± Isotretionin ± Lithium ± Methimazol ± Misoprostol ± Penicillamin ± Phenytoin ± Tetracyclin ± Thalidomid ± CMC ± Acid valproic
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7 ¶nh h ëng cña thuèc ®èi víi thai nhi ± Cã lîi ± Cã h¹i ² Lîi tiÓu gi¶m t íi m¸u tö cung- rau thai thai thiÕu oxy ² Hydralazin gi¶m l ul îng tuÇn hoμn tö cung- rau thai, lo¹n nhÞp tim thai ² Thuèc g©y dÞ tËt (qu¸i thai)
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8 C¸c yÕu tè quyÕt ®Þnh kh¶ n¨ng g©y h¹i cña thuèc víi thai nhi 1. B¶n chÊt, c¬ chÕ g©y t¸c h¹i cña thuèc 2. §Æc ®iÓm di truyÒn cña thai nhi 3. LiÒu l îng, thêi gian dïng thuèc cña mÑ 4. Kh¶ n¨ng th¶i trõ thuèc cña mÑ vμ thai 5. Giai ®o¹n ph¸t triÓn cña thai khi mÑ dïng thuèc 6. Kh¶ n¨ng vËn chuyÓn thuèc tõ mÑ vμo thai
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9 thai kú v μ ¶nh h ëng cña thuèc 1. Ph©n ®o¹n : ngμy 0 – 14 (2 tuÇn sau khi thô thai) Qui luËt: tÊt c¶ hoÆc kh«ng cã g× 2. Ph«i : ngμy 18 – 60 (tuÇn 3 - tuÇn 9 sau thô thai) §Æc biÖt nguy hiÓm v× thai rÊt nh¹y c¶m víi t¸c dông bÊt lîi cña thuèc 3. Thai : tuÇn thø 10 - lóc sinh Thai Ýt nh¹y c¶m h¬n
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10 C¸c giai ®o¹n ph¸t triÓn cña thai nhi
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11 C¸c yÕu tè ¶nh h ëng tíi vËn chuyÓn thuèc qua Rau thai 1. TÝnh chÊt ho¸ lý cña thuèc 2. Chªnh lÖch nång ®é thuèc gi÷a m¸u mÑ vμ thai 3. §é dμy cña rau thai
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12 ¶Nh h ëng cña thuèc dïng cho PNCT ®èi víi trÎ s¬ sinh ± Thuèc dïng cho mÑ t¸c h¹i trùc tiÕp lªn trÎ sau khi sinh: ² Rifampicin ch¶y m¸u gi¶m tiÓu cÇu ² Fusidic acid vμng da nh©n n·o ² Chloramphenicol héi chøng x¸m (thiÕu UDP- glucuronyl transferase)
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13 ¶Nh h ëng cña thuèc dïng cho PNCT ®èi víi trÎ s¬ sinh ± Thuèc dïng cho PNCT gÇn ngμy sinh g©y héi chøng cai thuèc ë trÎ s¬ sinh ² Benzodiazepin ² Opioid (kÝch thÝch, run, t¨ng tr ¬ng lùc c¬…)
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14 §Æc ®iÓm D§H cña thuèc ë PNCT 1. HÊp thu thuèc
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This note was uploaded on 12/28/2011 for the course PHARMACEUT 101 taught by Professor Yentrang during the Spring '11 term at Albany College of Pharmacy and Health Sciences.

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Special_pop_QY09 - S DNG THUC CHO CC I TNG C BIT Ging vin Ths Phan Qunh Lan Bm Dc lm sng trng H Dc H ni 1 PH N PH N CHO CON B CHO CON B PH N PH N C

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