{"id":71753,"date":"2022-12-09T09:32:46","date_gmt":"2022-12-09T02:32:46","guid":{"rendered":"https:\/\/tcvn.gov.vn\/?p=71753"},"modified":"2022-12-09T09:32:49","modified_gmt":"2022-12-09T02:32:49","slug":"nhung-loai-thuoc-tim-mach-tuong-tac-voi-thuoc-khang-virus-tri-covid-19-nen-than-trong","status":"publish","type":"post","link":"https:\/\/tcvn.gov.vn\/nhung-loai-thuoc-tim-mach-tuong-tac-voi-thuoc-khang-virus-tri-covid-19-nen-than-trong\/09\/12\/2022\/","title":{"rendered":"Nh\u1eefng lo\u1ea1i thu\u1ed1c tim m\u1ea1ch t\u01b0\u01a1ng t\u00e1c v\u1edbi thu\u1ed1c kh\u00e1ng virus tr\u1ecb COVID-19 n\u00ean th\u1eadn tr\u1ecdng"},"content":{"rendered":"

M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n g\u1ea7n \u0111\u00e2y tr\u00ean T\u1ea1p ch\u00ed c\u1ee7a \u0110\u1ea1i h\u1ecdc Tim m\u1ea1ch Hoa K\u1ef3 n\u00eau: c\u00f3 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c tim m\u1ea1ch c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi thu\u1ed1c \u0111i\u1ec1u tr\u1ecb COVID-19.<\/span><\/p>\n

Tuy r\u1eb1ng\u00a0COVID-19\u00a0ch\u1ee7 y\u1ebfu l\u00e0 g\u00e2y b\u1ec7nh v\u1ec1 ph\u1ed5i nh\u01b0ng s\u1ed1 c\u00e1c c\u01a1 quan b\u1ecb \u1ea3nh h\u01b0\u1edfng c\u00f2n lan sang c\u1ea3 n\u00e3o, tim v\u00e0 th\u1eadn. Bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch h\u1eadu\u00a0COVID-19\u00a0c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh tr\u01b0\u1edbc \u0111\u00f3 v\u00e0 c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 s\u1eb5n b\u1ec7nh n\u1ec1n v\u1ec1 tim m\u1ea1ch, d\u1eabn \u0111\u1ebfn nguy c\u01a1 cao b\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i, \u0111\u1ed9t qu\u1ef5 v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim.\u00a0<\/span><\/p>\n

B\u1ec7nh nh\u00e2n tim m\u1ea1ch m\u1eafc COVID-19 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng nirmatrelvir-ritonavir (paxlovid) \u0111\u1ec3 tr\u00e1nh ti\u1ebfn tri\u1ec3n th\u00e0nh b\u1ec7nh n\u1eb7ng, tuy nhi\u00ean, thu\u1ed1c c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c tim m\u1ea1ch b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n tr\u01b0\u1edbc \u0111\u00f3.<\/span><\/p>\n

Paxlovid l\u00e0 thu\u1ed1c kh\u00e1ng virus d\u1ea1ng u\u1ed1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb COVID-19<\/strong><\/span><\/p>\n

Nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111i\u1ec1u tra c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c-thu\u1ed1c (DDI) c\u00f3 th\u1ec3 x\u1ea3y ra gi\u1eefa paxlovid v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c tim m\u1ea1ch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn, c\u0169ng nh\u01b0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ti\u1ec1m n\u0103ng \u0111\u1ec3 gi\u1ea3m r\u1ee7i ro li\u00ean quan.<\/span><\/p>\n

\"\"<\/span><\/p>\n
\u00a0Paxlovid l\u00e0 thu\u1ed1c kh\u00e1ng virus d\u1ea1ng u\u1ed1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb COVID-19 nh\u01b0ng c\u1ea7n th\u1eadn tr\u1ecdng khi \u0111ang d\u00f9ng m\u1ed9t s\u1ed1 thu\u1ed1c tim m\u1ea1ch. \u1ea2nh: SK&\u0110S<\/strong><\/span><\/div>\n<\/div>\n

Paxlovid \u0111\u00e3 \u0111\u01b0\u1ee3c C\u1ee5c Qu\u1ea3n l\u00fd D\u01b0\u1ee3c v\u00e0 Th\u1ef1c ph\u1ea9m Hoa K\u1ef3 ph\u00ea duy\u1ec7t \u0111\u1ec3 s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p kh\u1ea9n c\u1ea5p v\u00e0o th\u00e1ng 12 n\u0103m 2021, m\u1ed9t thu\u1ed1c kh\u00e1ng virus d\u1ea1ng u\u1ed1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m COVID-19 t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00f3 nguy c\u01a1 cao ti\u1ebfn tri\u1ec3n th\u00e0nh b\u1ec7nh n\u1eb7ng.<\/span><\/p>\n

B\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh tim v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c, bao g\u1ed3m b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng, huy\u1ebft \u00e1p cao, b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh v\u00e0 h\u00fat thu\u1ed1c, chi\u1ebfm m\u1ed9t t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 trong nh\u00f3m nguy c\u01a1 cao \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh paxlovid.<\/span><\/p>\n

Theo c\u00e1c t\u00e1c gi\u1ea3, paxlovid \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 l\u1ee3i \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh tim, nh\u01b0ng n\u00f3 c\u00f3 t\u01b0\u01a1ng t\u00e1c \u0111\u00e1ng k\u1ec3 v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c tim m\u1ea1ch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean.<\/span><\/p>\n

Do d\u1eef li\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 c\u00e1c bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i li\u00ean quan \u0111\u1ebfn t\u01b0\u01a1ng t\u00e1c c\u00f2n h\u1ea1n ch\u1ebf n\u00ean c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 s\u1eed d\u1ee5ng ki\u1ebfn th\u1ee9c v\u00e0 d\u1eef li\u1ec7u hi\u1ec7n c\u00f3 \u0111\u1ec3 \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn v\u1ec1 c\u00e1c t\u01b0\u01a1ng t\u00e1c ti\u1ec1m \u1ea9n v\u00e0 h\u1eadu qu\u1ea3 c\u00f3 th\u1ec3 x\u1ea3y ra d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng t\u00e1c. Theo \u0111\u00f3 5 trong s\u1ed1 c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c tim m\u1ea1ch quan tr\u1ecdng nh\u1ea5t v\u1edbi paxlovid c\u1ea7n l\u01b0u \u00fd bao g\u1ed3m:<\/span><\/p>\n

Thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp tim<\/em><\/span><\/p>\n

Thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng. Nhi\u1ec1u lo\u1ea1i thu\u1ed1c trong s\u1ed1 n\u00e0y \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a theo c\u00e1ch l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid.<\/span><\/p>\n

M\u1eb7c d\u00f9 c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u d\u00f9ng paxlovid sau khi ng\u1eebng t\u1ea1m th\u1eddi c\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp 2-2,5 ng\u00e0y, nh\u01b0ng \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 kh\u00f4ng kh\u1ea3 thi tr\u00ean th\u1ef1c t\u1ebf. C\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng n\u00ean xem x\u00e9t c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb COVID-19 thay th\u1ebf v\u00e0 tr\u00e1nh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c n\u00e0y v\u1edbi paxlovid.<\/span><\/p>\n

Thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u v\u00e0 ch\u1ed1ng \u0111\u00f4ng m\u00e1u<\/em><\/span><\/p>\n

Thu\u1ed1c kh\u00e1ng ti\u1ec3u c\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, \u0111\u1eb7c bi\u1ec7t n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1eb7t stent. Aspirin v\u00e0 prasugrel an to\u00e0n khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid. T\u0103ng nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng khi d\u00f9ng paxlovid c\u00f9ng v\u1edbi clopidogrel v\u00e0 t\u0103ng nguy c\u01a1 ch\u1ea3y m\u00e1u khi d\u00f9ng c\u00f9ng v\u1edbi ticagrelor. Khi c\u00f3 th\u1ec3, n\u00ean chuy\u1ec3n c\u00e1c thu\u1ed1c n\u00e0y sang prasugrel. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng prasugrel, th\u00ec n\u00ean tr\u00e1nh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi paxlovid v\u00e0 n\u00ean xem x\u00e9t c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb COVID-19 thay th\u1ebf.<\/span><\/p>\n

Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u ho\u1eb7c ch\u1ea5t l\u00e0m lo\u00e3ng m\u00e1u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ng\u0103n ng\u1eeba c\u1ee5c m\u00e1u \u0111\u00f4ng, nh\u01b0 warfarin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid nh\u01b0ng c\u1ea7n theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u trong x\u00e9t nghi\u1ec7m m\u00e1u.<\/span><\/p>\n

N\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng tr\u1ef1c ti\u1ebfp \u0111\u1ec1u t\u0103ng khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid, do \u0111\u00f3 c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u ho\u1eb7c ng\u1eebng t\u1ea1m th\u1eddi v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng thay th\u1ebf.<\/span><\/p>\n

M\u1ed9t s\u1ed1 statin<\/em><\/span><\/p>\n

S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi m\u1ed9t s\u1ed1 statin nh\u01b0 simvastatin ho\u1eb7c lovastatin v\u1edbi paxlovid c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y y\u1ebfu c\u01a1 v\u00e0 ti\u00eau c\u01a1 v\u00e2n (t\u00ecnh tr\u1ea1ng s\u1ef1 ph\u00e2n h\u1ee7y m\u00f4 c\u01a1 gi\u1ea3i ph\u00f3ng m\u1ed9t lo\u1ea1i protein g\u00e2y h\u1ea1i v\u00e0o m\u00e1u). N\u00ean ng\u1eebng c\u00e1c thu\u1ed1c n\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng paxlovid.<\/span><\/p>\n

Vi\u1ec7c gi\u1ea3m li\u1ec1u atorvastatin v\u00e0 rosuvastatin l\u00e0 h\u1ee3p l\u00fd khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid. C\u00e1c statin kh\u00e1c \u0111\u01b0\u1ee3c coi l\u00e0 an to\u00e0n khi d\u00f9ng c\u00f9ng v\u1edbi paxlovid.<\/span><\/p>\n

Thu\u1ed1c tr\u1ecb \u0111au th\u1eaft ng\u1ef1c ranolazin<\/em><\/span><\/p>\n

Khi s\u1eed d\u1ee5ng ranolazine \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111au th\u1eaft ng\u1ef1c c\u00f9ng paxlovid c\u00f3 th\u1ebb l\u00e0m t\u0103ng n\u1ed3ng thu\u1ed1c trong m\u00e1u, d\u1eabn \u0111\u1ebfn t\u0103ng nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT \u0111\u00e1ng k\u1ec3 tr\u00ean l\u00e2m s\u00e0ng v\u00e0 xo\u1eafn \u0111\u1ec9nh (m\u1ed9t lo\u1ea1i r\u1ed1i lo\u1ea1n nh\u1ecbp tim). Do \u0111\u00f3, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ranolazine c\u00f9ng v\u1edbi paxlovid. N\u00ean ng\u1eebng t\u1ea1m th\u1eddi ranolazine n\u1ebfu k\u00ea \u0111\u01a1n paxlovid.<\/span><\/p>\n

Thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch<\/em><\/span><\/p>\n

N\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n cho nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 tr\u1ea3i qua gh\u00e9p tim t\u0103ng theo c\u1ea5p s\u1ed1 nh\u00e2n \u0111\u1ebfn m\u1ee9c g\u00e2y \u0111\u1ed9c khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi paxlovid. Vi\u1ec7c gi\u1ea3m t\u1ea1m th\u1eddi li\u1ec1u l\u01b0\u1ee3ng c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch s\u1ebd c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i th\u01b0\u1eddng xuy\u00ean v\u00e0 kh\u00f3 kh\u0103n v\u1ec1 m\u1eb7t h\u1eadu c\u1ea7n. Do \u0111\u00f3, c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb COVID-19 thay th\u1ebf n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/span><\/p>\n

C\u00e1c t\u00e1c gi\u1ea3 k\u1ebft lu\u1eadn r\u1eb1ng nh\u1eadn th\u1ee9c v\u00e0 s\u1ef1 s\u1eb5n c\u00f3 c\u1ee7a c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb COVID-19 kh\u00e1c cho ph\u00e9p c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u01b0a ra c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb thay th\u1ebf cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 d\u00f9ng paxlovid do t\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/span><\/p>\n

Theo VietQ<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n g\u1ea7n \u0111\u00e2y tr\u00ean T\u1ea1p ch\u00ed c\u1ee7a \u0110\u1ea1i h\u1ecdc Tim m\u1ea1ch Hoa K\u1ef3 n\u00eau: c\u00f3 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c tim m\u1ea1ch c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c v\u1edbi thu\u1ed1c \u0111i\u1ec1u tr\u1ecb COVID-19. Tuy r\u1eb1ng\u00a0COVID-19\u00a0ch\u1ee7 y\u1ebfu l\u00e0 g\u00e2y b\u1ec7nh v\u1ec1 ph\u1ed5i nh\u01b0ng s\u1ed1 c\u00e1c c\u01a1 quan b\u1ecb \u1ea3nh h\u01b0\u1edfng c\u00f2n lan sang c\u1ea3 […]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22],"tags":[],"acf":{"linh-vuc":"C\u00e1c l\u0129nh v\u1ef1c kh\u00e1c"},"_links":{"self":[{"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/posts\/71753"}],"collection":[{"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/comments?post=71753"}],"version-history":[{"count":0,"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/posts\/71753\/revisions"}],"wp:attachment":[{"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/media?parent=71753"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/categories?post=71753"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tcvn.gov.vn\/wp-json\/wp\/v2\/tags?post=71753"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}