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PARACETAMOL
2. Tc ng dc l.
2.1 C ch gy au, gy st
2.1.1 C ch gy au.
T bo Th cm th
Chn thng
b tn thng (Da, c, khp, rng, ty sng, ni tng)
Prostaglandins (H2)
No
Gim ngng
au
au
3
2.1.2 C ch gy st.
Cht gy st ngoi lai (vi khun , c t, nm...) xm nhp vo c th s kch thch
bch cu sn xut cc cht gy st ni ti (cc cytokin, interferon, TNF...). Cht
ny hot ha prostaglandin synthetase, lm tng tng hp Prostaglandin(PG, c
bit l PGE1,PGE2) t acid Arachidonic ca vng di i, lm tng qu trnh to
nhit (rung c, tng h hp, tng chuyn ha) v gim qu trnh mt nhit (co mch
da) t gy st.
* Prostaglandin (PG) l cc acid bo khng bo ha cc m, c vai tr nh mt cht
trung gian ha hc ca qu trnh vim v nhn cm au, ngoi ra cn c cc tc dng sinh
l cc m ring bit. PGE2 c gii phng do kch thch c hc, ha hc, nhit, vi
khun c tc dng lm gin mch, tng tnh thm thnh mch gy vim
* Cyclooxygenase (COX) hay Prostaglandin H2 synthetase(PGHS) l mt loi
enzyme hnh thnh prostanoids - prostaglandins, prostacyclins, v thromboxanes. Tt c
u chu trch nhim cho phn ng vim. COX tng hp PG (nht l PGE1 v PGE2 ), c
hai v tr tc ng l COX v POX( peroxidase). Trong COX chuyn acid arachidonic
thnh hydroperoxit trung gian khng n nh l PGG2, sau v tr POX chuyn PGG2
thnh PGH2 l dng hot tnh.
* COX-1 (PGH2 synthetase-1): tham gia trong qu trnh sn xut cc PG c tc dng
iu ha cc chc phn sinh l, n nh ni mi, bo v t bo. C mt hu ht cc m:
thn, d dy, ni mc mch mu, tiu cu
*- COX-2 (PGH2 synthetase-2): tham gia tng hp cc PG thc y qu trnh vim. C
mt hu ht cc m vi nng nh. Thng thy cc im vim vi nng ln.
Cht gy st ni sinh
Tng qu trnh to nhit Gim qu trnh thi nhit
(RungAcid
c, tng h Prostaglandin
hp, tng Prostaglandin (Co mch)
arachidonic
chuyn ha) synthetase St
(E1,E2)
4
Bch cu
Cht gy st ni sinh
Prostaglandin synthetase
c ch
Paracetamol
Prostaglandin
(E1,E2)
St
5
T bo
b tn thng
Chn thng
Acid
arachidonic
Prostaglandins (H2) No
Gim
ngng au
au
3. Dc ng hc.
- Hp thu: Paracetamol c hp thu nhanh chng v hon ton qua ng tiu
ha.
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4. Ch nh.
- Paracetamol c dng rng ri trong iu tr cc chng au v st t nh n va
- au:
+ Paracetamol c lm gim au tm thi trong cc chng au nh v va: au
u, au rang, au bng kinh Thuc c hiu qu nht l gim au cng thp
c ngun gc khng phi ni tng.
+ Paracetamol khng c tc dng tr thp khp
+ Paracetamol l thuc thay th salicylic (c a thch ngi bnh chng ch
nh hoc khng dung np salicylic) gim au nh hoc h st.
- St: Paracetamol thng c dng gim thn nhit ngi bnh st, khi st
c th c hi hoc khi h st ni chung khng c hiu, khng nh hng n tin
trnh ca bnh c bn v c th che lp tnh trng bnh ca ngi bnh.
7. Chng ch inh.
- Ngi bnh nhiu ln thiu mu hoc c bnh tim, phi, thn hoc gan.
- Ngi bnh qu mn vi paracetamol.
- Ngi bnh thiu ht glucose 6 phosphat dehydrogenase.
8. Tng tc thuc:
8.1. Tng tc thuc
- Ung paracetamol liu cao di ngy c th lm tng nh tc dng chng ng ca
coumarin v dn cht indandion.
- Dng ng thi isoniazid vi paracetamol cng c th dn n tng nguy c c tnh
vi gan.
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9. Bo qun
Bo qun thuc di 40C, tt nht l 15 30 C, trnh ng lnh dung dch,
dch treo ung.
- Tc ng 2 pha: Pha phng thch nhanh nhm gim nhanh triu chng
gim au, pha phng thch chm nhm duy tr lng thuc ti thiu gy hiu qu.
- Thi gian s dng thuc ko di, gim s ln s dng thuc
- Gim nguy c gy ng c cho gan.
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- Liu dng:
- Liu dng:
10.1.3.Vin si
- u im:
- D b lm dng, d gy qu liu.
- Kh bo qun.
- i tng s dng: Thch hp cho nhiu i tng.
- Liu dng v cch dng: Ha tan vin thuc trong lng nc tu thch n khi
ht si bt. Khong cch gia 2 ln ung phi hn 4 gi v khng ung qu 8 vin/
ngy.
- Ngi ln v tr em > 12 tui: ung 1 vin 500mg/ ln.
- au nhiu: ngi ln c th ung 2 vin/ ln.
- Trng hp bnh nhn suy thn nng ( thanh thi creatinin < 10 ml /pht),
khong cch gia cc liu ung phi t nht l 8 gi. Hoc theo ch dn ca Thy
thuc.
Lu : Liu ti a/ 24 gi: khng qu 4 g, khong cch gia 2 ln ung thuc phi
hn 4 gi.
- Ch phm trn th trng:
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10.1.4. Thuc bt si bt
- u im: Thch hp s dng cho tr em. C thm t dc to v ngt, thm d
ung.
- Nhc im:
- D b lm dng, gy qu liu.
- Kh bo qun.
- Nhc im:
- Kh bo qun.
- Liu dng:
15
- Ngi ln: 0,15g n 0,3g/ ngy tim 1 ln vo bui sng trong trng hp
au ngn ngy, au ko di khng qu 3 ngy.
- Tr em: liu 5mg/kg/ngy, tim 1 ln vo bui sng
- Liu dng:
PARACOL 1 g/100ml:
Ch dng cho ngi ln v tr em c th trng > 33 kg.
Ngi ln v tr em trn 13 tui c th trng > 50 kg: 1 g/ln (= 1 chai
100 ml), c th truyn 4 ln/ngy. Liu ti a 4 g/ngy.
Tr em c th trng > 33 kg v ngi ln c th trng < 50 kg: 15
mg/kg/ln (= 1,5 ml dung dch cho 1 kg th trng). Liu ti a 60
mg/kg/ngy.
PARACOL 0,5 g/50ml:
Dng cho tr s sinh (di 10 ngy tui) v tr em c th trng 33 kg.
Tr em c th trng 33 kg:15 mg/kg/ln (= 1,5 ml dung dch cho 1 kg
th trng), c th truyn 4 ln/ngy. Liu ti a 60 mg/kg/ngy.
Tr s sinh (di 10 ngy tui): 7,5 mg/kg/ln, khng qu 4 ln/ngy.
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Contents
1. Tng quan v paracetamol. .............................................................................................. 1
1.1. Gii thiu .................................................................................................................. 1
1.2. Cng thc ha hc, tnh cht l ha. ........................................................................ 1
1.2.1 Cng thc ha hc: ............................................................................................. 1
1.2.2 Tnh cht vt l: .................................................................................................. 1
1.2.3 Tnh cht ha hc: .............................................................................................. 1
1.2.4. Tng hp:........................................................................................................... 1
2. Tc ng dc l. ............................................................................................................ 2
2.1 C ch gy au, gy st ............................................................................................. 2
2.1.1 C ch gy au. .................................................................................................. 2
2.1.2 C ch gy st. ................................................................................................... 3
2.2 C ch gim au h st ca paracetamol. ................................................................. 3
3. Dc ng hc. ............................................................................................................... 5
4. Ch nh. .......................................................................................................................... 6
5. Cch dng Liu dng:................................................................................................... 6
5.1. Cch dng: ................................................................................................................ 6
5.2 Liu dng: .................................................................................................................. 7
6. Tc dng ph, c tnh. ................................................................................................... 7
6.1 Tc dng ph: ............................................................................................................ 7
6.2 c tnh: .................................................................................................................... 7
7. Chng ch inh................................................................................................................. 7
8. Tng tc thuc: .............................................................................................................. 7
8.1. Tng tc thuc ........................................................................................................ 7
8.2. Thn trng khi dng: ................................................................................................ 8
9. Bo qun .......................................................................................................................... 8
10. Cc dng bo ch v ch phm trn th trng. ............................................................ 8
10.1. Dng ung: Dng s dng ph bin nht. .............................................................. 8
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