Đặc điểm lâm sàng, cận lâm sàng và điều trị của ngộ độc phenylpropanolamin có trong thuốc cảm cúm

DIENDAN YHOC

Nghien CLPU khoa hpc

DAC DIEM LAM SANG, CAN LAM SANG VA DIEU TRI

CUA NGO DOC PHENYLPROPANOLAMIN

CO TRONG THUOC CHIJA CAM CUM • ; ' •••••' • •'-' .•• VU'Ml ' 1 U.v\'-

Pham Due*, Nguyin Trung Nguyen* j,

TOMTA T , ,.V\

Dat van de: nhieu thuoc cam cum cd phdi hgp phenylpropcmolamin (PPA) vd gdy nen can tdng HA

cho ngudi dimg thuoc. Nghien cim nay nhdm muc tieu mo td dgc diem lam sdng, can lam sdng vd dieu tri ciia

ngp dpc PPA CO Irong cdc thuoc ciru cum dim. Phuang phap nghiSn ciru: nghien cim tien cim md td, cdc benh

nhdn dugc xir ly cdp cim tdng HA. dugc theo doi vd ghi nhgn cdc trieu chimg lam sdng, cdc thay ddi can lam

sdng, cdc bien phdp dieu tri. KSt qua: 46 BN dugc chdn dodn la ngp dpc PPA, trong do 2 biet dugc chinh gdy

ngp dpc PPA Id Rhumenol vd Decolgen, (chiem 95.7%o). Ly do diing thuoc: 43 BN (93,5%) de dieu tri cdm

ciim. 37 BN (80.4%) bi ngp dpc ngay a lieu udng ddu tien: 33 BN (71,7%o) bi ngp dpc vdi lieu PPA < 60mg.

Benh canh lam .sang ndi bdt Id cue trieu chimg dau ddu a 43 BN (93,5%). budn ndn a 23 BN (50%). hoa mdt

chdng mat a 17 BN (3 7%>). timg HA tdm thu gap a 44/46 BN (95,7%)). nhip cham xoang a 18 BN (39,1%); hg

kali mdu gap a 11 BN (23,3%). Dieu tri chti yeu Id ngimg PPA. dimg thuoc hg huyet dp Adalat nhd dudi hrdi

3-IOmg. Huyet dp tra ve binh thuomg sau 7,6 ± 5,03 gia. Thdi gian ndm vien ngdn, 93,5% ra vien trong vdng

24 gid. Khdng cd tir vong. KSt luan: dgc diem lam sdng ciia ngp dpc PPA Id can tdng huyet dp, xdy ra ngay cd

khi BN udng lieu dieu tri theo khuyen cdo cua nhd san xudt; dieu tri chii yeu Id ngung thuoc co chira PPA vd

dimg thuoc hg dp; ket qua dieu tri toi: khdng cd tu vong. • • : ,-.',v\'.'••'

LDATVANDE

NhiSu thuoc cam ciim cd thanh phan la par￾acetamol phdi hpp vdi thude khang histamin va tbudc

chdng phii ne de lam tang hieu qua chua benh ciia tbudc

nhirng cung lam tang tac dung phu. dan dSn cle biSn

chirng. Trong so dd ed Phenylpropanolamin (PPA), la

chat gay co mach nham giam xung huySt nhung cd the

dan tdi tang huySt Ip nguy ca gay dot quy khiSn cho

BN lai phai di cap cuu. Ngoai ra, PPA ciin gay tang Ip

lire dpng mach phdi nang, khdi phat rdi loan tam than

d ngudi nghien amphetamin. gay hoang tirong. hinh

vi giSt ngudi. eo giat. tdn thuong ca tim.

CIc thude chua cam ciim vdn dugc ban ty do.

khdng can don thuoc dan dSn viec lam dung tbudc gay

ngd dpc thuoc (NDT. Tai My. nam 2004 cd 279.955

trudng hpp ngd dpc. qui liSu hoac gap cac tac dung cd

hai do cac thude giam dau trong do. hau het la do cae

biet dugc cd chira paracetamol [8].

*Trung tdm Chdng dpc - Benh vien Bgch Mai

d nudc ta, nam 2002 da cd bao cao ve 20 BN

ngd dpc cae thude cam ciim cd chu'a PPA ciia khoa

Chdng dpc, Benh vien Bach Mai tai Hdi nghj Chdng

dde toan qudc lan thir nhat nam 2002 va Hdi nghj Hdi

sire - cap cuu chdng dpc toan qudc nam 2003 [ I ]. Sau

do mdt dS tai cap bp la: "DiSu tra va nghiSn ciru ngd

dpc cac thude thudng gap d benh vien" da dugc tien

hinh va bli bio nly II mdt phan ket qua ciia de tai vdi

muc tieu: "Nghien cim cdc dgc diem lam sdng, can

liim sdng vd dieu tri ngp dpc cdp thuoc PPA ".

II. DOI TUrONG VA PHU^OTSG PHAP NGHIEN

ciru

1. Doi tuong nghien cihi: cle BN vao cap ciru vi

NDT cam ciim cd chua PPA trong thdi gian 2 nam

2004-2005.

- Tieu chudn chgn vdo nghien cim:

4 8 IY HOC LAM SANG S6 47 (Thang 12 / 2009)