Dung thuoc giam dau • 7
irung uong cho ngudi bi ung thu
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ien nay, cd khd nhieu ngudi nha benh nhan ung thu thUcfng tim Adn cdc nhd thuoc de hdi mua thudc giam dau. Dd'i vdi benh nhdn ung thU khi b^nh da trd ndn tram trong, vi$c dung thudc giam dau Id rat can thiet d i gidm nhOfng ctfn dau manh, lidn tuc anh hudng rat ldn den cugc sdng cua hg. Ngudi bi ung thu giai doan cudi cam nhan dUpc quy ludt dau ciia minh vd thudng chd dpi cPn dau vdi noi am anh so hdi. Tdm ly dd thudng ldm trdm trong hpn cdc cpn dau khien cho vi^c dung thud'c giam dau rcfi vao thd bi dgng.Thud'c giam dau gom nhieu loai, ke dpn vd khdng can ke ddn. Mdt sd' thudc giam dau thdng dung nhu aspirin, paracetamol, ibuprofen, meloxicam, indomethacin... thudng duuc nhiiu gia dinh du tr0 trong nhd. Tuy nhien, dd'i vdi benh nhdn ung thu, cdc thud'c giam dau ndy rd't it tdc dung bdi dau do ung thU Id mgt dang dau ndng, rdt trdm trgng, phai dimg den nhdm thud'c gidm dau trung uong.
-» ThS. LE QUOC THINH
E)au la m6t cd c h ^ b&o v&
cua cd thi, do cac ngon d&y t h i n kinh cam giac bi kich thich qua d6 bcfi tac n h a n v&t ly hay hoa h o c Co nhieu benh lidn quan dg^n cam giac dau, trong do dau do ung thu thudng diidc nhi^u ngifdi
quan tSm do nhQng bdnh nhdn nay buoc phai diing n h i l u thucfc giam dau m a n h d^ n&ng cao
cha't liidng sd'ng cho hg.
Cdc thudc giam dau trung Ucfng cd tdc dung gidm dau manh do lie che trung tdm dau d nao vd ngan cdn dudng dan truyen cam giac dau tif tuy sdng ldn nao. Do tdc dung giam dau thudng k6m theo tdc dung gdy ngii nen cdn gpi Id nhdm thud'c giam dau gay ngii. Day cung la nhdm thudc gdy nghien, dupc quan ly rdt chdt che theo quy che rieng de trdnh bi lam dung vdo cdc muc dich khdc khdng trong pham vi dieu tri benh. Trong nhdm thudc ndy lai chia ra iam 2 loai theo miic dg giam dau:
Dd gikm dau do ung thu cdn dung thudc gikm dau trung ddng THUOC .>c St^C KHOE sd .S03 ( L7,:()I4)
- Logi gidm dau mgnh: morphin, pethidin (dolargan, dolosan..) methadon, fentanyl
- Logi gidm dau trung binh:
codein, tramadol, propoxyphen..
Trong cdc chd't ke tren, morphin la cha't chudn de so sdnh vdi cdc thudc giam dau khdc. Morphin Id thud'c giam dau manh do ldm tdng ngUdng nhan cam giac dau, thudc cdn lam giam cac dap dng phdn xa vdi dau, Morphin la chat tong hpp cd ngudn gd'c tif cay thud'c phi$n.
Nhua khd ciia qua cay thudc phidn cd chda khodng 25 alcaloid, trong dd morphin chiem 10%, codein gan 0,5%, papaverin 0,8%... Tac dung giam dau cua morphin la do thudc kich thich tren receptor muy (/() va kappa (K) dc che td't cd cdc diem chdt tren dUdng dan truyen cam gidc dau cua hd thdn kinh trung uong nhu tiiy sd'ng, hanh tiiy, ddi thi vd vd nao. NhU vdy, vi tri tdc dung cua morphin vd cac dan xud't cua opioid (nhifa qua cdy thud'c phien) chu yeu ndm trong h§
than kinh trung uang. Khi dimg morphin, cdc trung tam d vd ndo van hoat dgng binh thudng, nhifng cdm gidc dau da mat. chdng lo tdc tv
DEN NAM 2020
THI TRLfdNG THUOC VIET NAM SE DAT 8 TI USD
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heo du bdo cua cdng ty NghiSn cdu - phan tich Global Data, trong vdng 6 nam tdi doanh so' thudc d thi trudng Vidt Nam se tang tdi 5 ti USD, cdn den nam 2020 se len ddn 8 ti USD vdi mdc dd tang trudng binh qudn 15,5%/nam.Cdc yeu td anh hudng tdi tieu thu la gid cao vi mdc do sd dung thudc generic cdn tha'p do bac si qua tin vao nhiing bi§t duac ngoai khien cdc thudc nUdc ngoai thd'ng tri thi trudng, con thudc do cac cdng ty trong nudc san xudt cham dupc tieu thu. Cdc cdng ty nUdc ngoai kiem dUgc khoan lgi nhuan kech xu qua kinh doanh thudc d Vidt Nam. Nam 2005, gia thudc biet dugc mdi d thi trUdng Viet Nam cao ban 8,3% so vdi gid thud'c thd gidi.
Theo cac nha phan tich, kha nang tdng sd dung thud'c generic cdn bi han che, mac dau Nhd nUdc Viet Nam da qui dinh ap dung GMP va nhieu bien phdp khac,
Kinh td Vidt Nam la mgt trong nhflng nen kinh te phat trien deu dan d Ddng Nam A. Tdng thu nhdp qud'c ddn (GDP) ndm 2008 Id 101,6 ti USD, ddn nam 2013 da tang len 170,6 ti USD.
Viec quan ly kiim sodt thudc dd duac cai tidn,
Thdi gian dang ky thud'c qui dinh chi cdn 180 ngay ke td khi nop ho sa. Nhu vdy la nhanh ban ca Anh qud'c vd Hoa Ky, nhUng cung tUPng dupng vdi cac nudc trong khu vUc.
Vigc dUa thudc vao thi trUdng gap nhieu trd ngai. Thi du: qud trinh nop ho sP ra't phdc tap, ddi hdi rat nhieu chdng td bo sung, md nhieu chdng td Iai phai bdng tidng Viet.
- » NXH theo Pharmveslnik, 29.5 2014
Coch
f dung giam dau cua morphin la chgn loc. Khac vdi thudc ngu, khi ta't ca cac trung tam d vd nao bi dc chd, benh nhdn mdi hdt dau. Tdc dung giam dau cua morphin dugc tang cUdng khi dung cung thudc an than kinh. Morphin lam tdng tac dung cua thudc te.
Cdc tdc dung phu cua cdc chd't giam dau trung UOng la gay tao bdn, buon ndn vd ndn. Nhifng phan dng ndy cd the gap khi sd dung khdng phu thudc vdo lieu dung. Neu dung lieu cao, keo dai can chu y den tac dung dc chd hd ha'p va gay le thugc thud'c, Morphin dugc dung trong nhdng con dau dd dgi cap tinh hoac dau khdng dap ifng vdi cac thud'c giam dau khac nhu dau sau chdn thuang, dau sau phdu thudt, dau d thdi ky cudi cua benh, dau do ung thu... De giam dau d nhiing benh khdng chda khdi dugc (nhu ung thU thdi ky cudi), cd the dung morphin qud 7 ngay. Do thudc dugc quan ly theo quy che thudc gdy nghien vd
hudng tam than nen dd'i vdi bdnh nhdn ung thu, ngUdi nha nen lien he vdi cac benh vien de diiu tri theo chd do ngoai tru. Viec quan ly loai thud'c ndy can het sdc chat che d i trdnh that thodt thudc ra ngodi, bi Iam dung vao cac muc dich phi y te, cdc td nan xd hdi.
Cdc thudc giam dau trung UPng noi chung diu cd hai dang bdo che de tiem va udng. Cdng cd mdt sd' thudc tac dung keo ddi, dang ddn tren da nhu fentanyl. Khi sd dung thud'c giam dau trung UPng cho ngUdi hi ung thU, can cdn cd vdo tinh trang dau cua ngUdi benh de chpn thudc thich hpp. Da sd cac trUdng hpp dau nang phai dung thudc d dang tiem. Can chu y dung thudc theo lieu hpp ly, dua thud'c vao cP the vao thdi diem da dinh de duy tri nong do thudc trong mdu dn dinh. Trdnh trUdng hgp benh nhdn dau ddn yeu cau mdi cho dung thudc se ddn den cdng ngay cdng phai tang lieu. 3$E
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idn nay, cd mdt sd'chi em giam cdn bdng cdch udng cdc che ph^m chda cac loai duoc thao dUpc cho Id cd tdc dung giam can. Thdm chi, cd mcit sd thudc Ddng y hodc ehd phim thuc pham chdc nang thuc chjft chi chda dUUc thao cd tac dui^nhudn xd vd lcfi tieu ddng giam cdn chd'ng beo phi, khien nhilu ngUdi Iam tudng rang thifc sd c6 loai duoc thao cd the giup giam can. Dieu rat rd rdng Id khi dung thudc hay che pham cd tdc dung Id tieu (lam thoat ra lUpng ldn nifdc cd trong co thi) vd ddc biSt, co tdc dung Iam cho xd (gay tieu chdy trong thdi gian ddn md^y ngay);
trong thdi gian nay ngddi dur^ da dn khdng duac Iai th&m ti§u ton sflc luc vao nhd ve sinh lien tuc thi se giam can Id ddOng nhien, Tuy nhien, each ldm dep nhu th^
chdc chdn anh hudng tram trong den sdc khoe.
TrUdc h e t , can xde dinh IS khdng cd dupc thao ndo than ky md chi dung mdt minh nd, khflng tac ddng ddn yeu to' dinh dU9ng, ydu to van ddng t h i luc md difa den gidm can.
Xin ndi ve dflpc thdo Id thuflc xd tfle thud'c tri tdo bdn vd bi
THUOC & sCC KHOE sd503 (1.7,2014)