XEM THÊM

1. NHÓM KHÁNG SINH

a. Nhóm Cephalosporin

  • Cefaloridin: Độc thận
  • Cefalotin: Viêm tĩnh mạch, viêm huyết khối tĩnh mạch
  • Điều chỉnh liều với suy thận (trừ cefoperazon)

b. Nhóm Macrolid (Azithromycin, Clarithromycin, Erythromycin, Roxithromycin, Spiramycin)

  • Muối estolat của Erythromycin: Viêm gan ứ mật
  • Rối loạn tiêu hóa
  • Chống chỉ định: Suy gan nặng

c. Nhóm Quinolon (Acid Naladixic, Ofloxacin, Norfloxacin, Ciprofloxacin, Levofloxacin, Moxifloxacin)

  • Nhạy cảm ánh sáng 
  • Tổn thương gân Achill
  • Sparfloxacin: Kéo dài khoảng QT
  • Chống chỉ định: Trẻ < 15 tuổi, người thiếu G6PD

d. Nhóm Cyclin (Tetracyclin, Doxycyclin, Minocyclin)

  • Nhạy cảm ánh sáng với da, gây sạm da
  • Vàng răng

e. Nhóm Lincosamid (Lincomycin, Clindamycin)

  • Viêm kết ruột màng giả 

f. Nhóm Aminoglycosid (Tobramycin, Neomycin, Gentamycin, Streptomycin)

  • Streptomycin, gentamicin: Độc tính trên tiền đình
  • Amikacin, kanamycin, neomycin: Độc tính trên ốc tai
  • Tobramycin: Độc tính trên tai và tiền đình
  • Độc tính trên thận, hoại tử ống thận
  • Gây nhược cơ
  • Độc tính do sử dụng kéo dài

g. Nhóm Phenicol

  • Cloramphenicol: thiếu máu bất sản do suy tủy, hội chứng xám (có thể gây tử vong ở trẻ sơ sinh)

h. Nhóm Sulfamid (Sulfaguanidin, Sulfasalazin, Sulfamethoxazol + Trimethoprim : Cotrim)

  • Tạo tinh thể khó hòa tan gây độc thận: Khuyên bệnh nhân uống đủ nước.

2. THUỐC GIẢM ĐAU – KHÁNG VIÊM

  • Paracetamol: Liều cao gây độc gan
  • Aspirin: Gây viêm, kích ứng dạ dày

A. NSAID

KHÔNG CHỌN LỌC TRÊN COX

(Ibuprofen, Diclofenac, Ketoprofen, Piroxicam, Indomethacin, Acelofenac)

  • Viêm loét dạ dày, ruột đặc biệt cần lưu ý

CHỌN LỌC TRÊN COX 2

(Meloxicam, Celecoxib, Nimesulid)

  • Viêm loét dạ dày, ruột nhưng yếu hơn 

B. CORTICOID (Prednisolon, Methylprednisolon, Triamcinolon, Betamethason, Dexamethason, Hydrocortisol, Budesonid, Fluticason)

  • Sử dụng không đúng cách (ngưng đột ngột, uống không đúng nhịp sinh lý): suy vỏ thượng thận
  • Ức chế miễn dịch: dễ nhiễm nấm, nhiễm khuẩn
  • Giảm mỡ ở các chi, tích tụ mỡ ở vùng mặt, xương đòn
  • Gây viêm loát dạ dày, tá tràng (tuyệt đối chống chỉ định cho người có tiền sử)

3. NHÓM THUỐC HÔ HẤP

A. GIẢM HO

  • Codein: Táo bón
  • Eucalyptol: Buồn nôn, nóng, kích động, đặc biệt ở trẻ em
  • Dextromethorphan: Buồn ngủ, ảo giác

B. LONG ĐÀM, TIÊU ĐÀM

  • Bromhexin, ambroxol: Buồn nôn, kích ứng dạ dày
  • Acetyl Cystein: Kích ứng dạ dày

4. KHÁNG HISTAMIN H1

A. Thế hệ 1

(Chlorpheniramin, Alimemazin, Hydroxyzine, Dimehydrinat, Diphenhydramin, Promethazin)

  • Buồn ngủ, ảo giác

B. Thế hệ 2

(Loratadin, Cetirizin, Loratadin)

  • Gây rối loạn nhịp tim, tương tác với nhiều thuốc (tránh phối hợp)

5. NHÓM DẠ DÀY

Antacid

(Phosphalugel, Maalox, Kremil, Trimafort)

  • Thuốc chứa aluminium hydroxid: táo bón, loãng xương
  • Thuốc chứa magie hudroxid: tiêu chảy

PPI

(Omeprazol, Esomeprazol, Pantoprazol, Rabeprazol, Lansoprazol)

  • Rối loạn hấp thu vitamin và khoáng chất: Ca, B12, Fe
  • Khó tiêu sau khi sử dụng thuốc kéo dài

KHÁNG H2

(Cimetidine, Famotidine, Nizatidine)

  • Tiêu chảy, chóng mặt, đau cơ, táo bón, to vú ở nam (Cimetidine)

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