Allopurinol dùng đúng cách mới hiệu quả an toàn

Allopurinol

dung diing each

mdi hieu qua an toan - Ddng du phdng phdt sinh can gout cdp mdi:

Sau dot gout cdp khdi nhuhg chua dUdc tren 3 thang,

niu ddng allopurinol se kdo ddi dot gout cap nen tai

thdi dilm ndy khdng duoc dung allopurinol. Nhimg

sau khi dot gout cdp dd khdi tren 3 thdng ma xet

nghiem uric ni$u hay uric mau eao thi dung allopurinol

dl dua chung vl mdc binh thUdng nhim trdnh phdt

sinh Cdn gout c^p mdi. Dung kfem vdi colchicin hoac

khdng vidm khdng steroid lieu thdp cho den khi uric

ni§u hay uric mdu trd lai mdc binh thudng. Sau dd

tilp tyc dung It nhdt 3 thang nda hodc cho de'n khi

tan sdi urat (ting c^ng 2- 3 thdng).

Dilu ki$n xdt dung: chi dung khi xdt nghiem tha'y

uric cao d mde bdo ddng (nhu da ndu d phan trdn) va

chi dung eho ngUdi cd 3 d ^ cd'p trd Idn trong m§t ndm.

Dung allopurinol trong vdng 24 - 48 gid uric mdu

sd gidm, dat mdc gidm t^i da trong vdng 2 tudn.

Ngdng ddng, uric mdu sd trd lai tri so' trudc dd trong

vdng 7-1 0 ngdy. Trong qud trinh dung thulc, bdc si

thudng kilm tra uric mdu hay uric ni^u de dieu ehinh

lilu thich hdp vd dl quylt dinh dung tiep hay ngimg

thud'c. NgUdi b^nh ngai khdm xdt nghiem, dung md

mSm khdng ddng thdi dilm, dilu ki$n ndn kdm hi$u

qud md lai cd hai. Cd ngUdi hieu nhdm allopurinol td't

hdn colchicin nen dung allopurinol (thay cho colchicin)

khi dang vidm vd dau, ldm cho trieu chdng ndng thdm,

kdo ddi dot gout cd'p.

Tophi d khu^iu tay ngudi bj gout

THu6c_&^SLfCKH6Eso500(15,.'5.20l4)

-»DS. BUIVANUY

Cac tn^dtng hcTp th^n trong

Khi dung lieu cao, ndng do allopurinol - mdu

tdng eao, cd the gay ra: Phan dng di dng gan (hoai

td gan, vidm mach hoai td, loan the tang mdu, bdm

mau, nbidm ddc da, phdt ban, rli loan da day ru^t).

Nhiem ddc gan ldm tang thdm nhiim ddc thdn. Gdy

phan dng qud man tram trong, bao gom ca h^i chdng

Stevens- Johnson (sd't cao, tang bach cau ai toan, hoai

td bieu bi, suy than dan den td vong). Ty le td vong

trong nhiem ddc 20%. Nhflng tac dyng khdng mong

mudn ndy rat hiem khi xay ra, neu dCing dung lieu,

nhung nd'u xay ra thi rat ndng.

Vdi ngUdi bi bdnh mdu de tinh (uric tdng cao do

bdnh ndy) phdi hidu chinh uric mdu hay uric ni?u trd

ve so' do binh thudng trudc lue tri ll?u.

Allopurinol cd thi ldm bung phdt con gout cd'p

khi dang xay ra qud trinh dilu chinh acid uric, do

dd can dung kit hop vdi colchicin de ngdn ngda cdn

bCing phdt ndy.

Khi dang dien ra tri^u chdng vidm dau nlu dung

allopurinol thi tri^u ehdng ndy se ndng hdn, ddt gout

cd'p bi kdo ddi ra, ndn khdng dUOc dung.

KS't htfp vdi che d^ dn, tranh diing m$t sd' thud'c

Bdnh gout chu yeu Id do tdng acid uric n^i sinh

(tdng ting hdp nucleoprotein ddn den tdng uric). An

uong khdng trUc tiep gdy ra bdnh gout nhung tao

thudn loi gay nen cdn gout cd'p (acid uric npi sinh dd

tang, chi do dn lam cho acid uric tang thdm, vUdt

ngiidng an toan). Cd ngUdi con gout cap xudt hidn ngay

sau bda dn no ne co nhieu chat dam, nhilu rUdu. Do

dd trong du phdng, dieu tri gout phdi: Kidng hoan

toan rUOu, cdc chd't cd rUdu, Kidng dn cdc thdc dn cd

cha^t purin (phu tang ddng vat, nam, ca trich, ca eao),

han ehe'dn thit cd torn cua (chi dung dUdi lOOg/ngdy),

ban che md (nlu cd beo beu, xo vda dpng mach), han

chd' muoi (ne'u co ton thuong th^n), uong nhieu nUdc

nhat la nude cd kiem.

Co mpt sd thuo'c gdy tdng uric mdu tao thuan

loi gay ra con gout cap hodc ldm cho b^nh

Kout ndng them, Chung gom cdc thud'c loi tieu

uhiazid, furosemid, etacrylic) cde thud'c chdng lao

tethambutol, pyrazinamid) cdc thude epinephrin,

angiotensin. Khi bi b?nh gout edn trdnh dung ede

thud'c ndy. :|c