V sao nhm quinolon k dng cho tr em? Gii thch?

Khng sinh nhm quinolon: ng kinh c th xy ra khi iu tr bng cc khng

sinh nhm quinolon. Do vy, nhm khng sinh ny nn c s dng mt cch
thn trng trn nhng bnh nhn c hay ang nghi ng c cc bnh l h thn
kinh trung ng. Khi s dng trn nhm bnh nhn ny, cc quinolon c th lm
khi pht ng kinh hay h thp ngng ng kinh. Phn ng h thn kinh trung
ng cng c th xy ra ngay khi dng quinolon liu u tin. iu tr bng
quinolon cng i khi gy trm cm hoc ri lon tm thn c th tin trin n
gy hnh vi nguy him cho bn thn v x hi. Vim gn v t gn (thng l gn
Achille) c th xy ra khi iu tr bng quinolon, c bit trn bnh nhn ln tui
v nhng bnh nhn ang iu tr hoc trc iu tr bng glucocorticoid.
Khi c nhng du hiu u tin ca au hay vim, phi ngng thuc ngay v bt
ng chi b nh hng. Quinolon c th gy cc phn ng nhy cm vi nh sng.
Do , bnh nhn ang iu tr bng quinolon nn trnh tip xc trc tip vi nh
sng mt tri hoc tia cc tm. Nn ngng iu tr nu c xut hin ban hay
phng rp trn da. Ngay c khi s dng thuc theo n, quinolon vn c th nh
hng n tc phn x n mc lm gim kh nng li xe hoc vn hnh my
mc, c bit l khi c ung ru km theo. Tc dng ph thng thy trn tiu
ha do quinolon l: nn, bun nn, au thng v, cm gic nng d dy. Vi
t chc sn, quinolon nh hng n s pht trin ca sn ti cc khp chu lc do
chng ch nh cho ph n c thai v tr em trong tui pht trin (di16
tui). Vi h hp, quinolon c th gy ngng th khi tim hoc truyn tnh mch.
Vi cc sulfamid: nhm thuc ny ch c dng hn ch vi cc ch nh iu tr
mi. Tc dng khng mong mun ch yu bao gm:
- Biu hin nhy cm: xy ra sau 5-7 ngy (pht ban, nga, my ay, vim qung,
bng nc, bong biu b, au khp, kh th dng hen, vim cu thn, vim k
thn).
- V mu, gim bch cu, thiu mu tan mu cp tnh.
- V gan, vng da (do sulfamid y bilirubin khi lin kt vi protein), c th gy
bin chng thn kinh do cm dng sulfamid cho tr s sinh. Vi tiu ha, gy
chn n, bun nn, nn, tiu chy.
Vi thn kinh, lm mt ng, mt mi, nhc u. Sulfamid cng c th gy c ch
min dch v d dng thai nhi.

Theo thc nghim trn sc vt cn non thy m sn b hu hoi cho nn khng

dng cho tr em di 18 tui, ph n c mang v ang nui con b. Khng dng
cho ngi thiu G6PD. Ni lun cho n vung l G6PD l glucose-6-phosphate.
DY HC DC Online chia s vi cc bn cch s dng thuc an ton
hp l khi kt hp thuc vi nhm khng vim corticosteroid.Chnh vic
lm dng thuc khng vim iu tr cc bnh l trn th trng ang
mc bo ng , trnh c cc tng tc do kt hp thuc nhm ny xin
c v d hot cht PREDNSOLON :
KHI S DNG HOT CHT THUC PREDNISOLON CN LU
TNG TC THUC S XY RA KHI KT HP VI CC HOT
CHT SAU;
1.Actazolamid; tng nguy c gim kali huyt i khng vi tc dng li tiu.
2.Acid acetylsalicylic ; Tng nguy c chy mu d dy ru t ,prednisolon
lm gim nng salicylat trong huyt tng.
3. Amilorid ; i khng vi li tiu .
4.-Amphotericin ; Tng nguy c gim kali huyt
5.Atenolol , Captopril: i khng vi tc dng gim huyt p
6. Carbamazepin; Tng nhanh chuyn ha prednisolone ( gim tc dng)
7.Digoxin:Tng nguy c gim kali huyt -8.Erythromycin: Tng nguy c chuyn c ch ha prednisolon
9.Ipuprofen ;Tng nguy c chy mu d dy -rut
10.Levonorgestrel lm tng nng prednisolon trong huyt tng
11.Metformin ;i khng vi tc dng gim glucose huyt
12.Salbutamol ;tng nguy c gim kali huyt nu dng Prednisolon13.Theophylin ;tng nguy c gim kali huyt
14.Glycery trinitrat: i khng voi tc dng gim huyt p
15.Hydroclorothiazid: i khng vi tc dng li tiu
16.Methotrexat; Tng nguy c c tnh huyt hc
17.Nifedipin ;i khng vi tc dng gim huyt p
18. Phenobarbital; Chuyn ha prednisolon tng nhanh ( gim tc dng )
19, Phenytoin; Chuyn ha prednisolon tng nhanh ( gim tc dng )
20, Thuc trnh thai dng ung ;Lm tng nng prednisolon trong huyt
tng
21 .Rifampicin;Chuyn ha prednisolon tng nhanh (gim tc dng )

22. Warfarin ;Tc dng chng ng mu c th b thay i

NGHA CA VIC TNG TC THUC
Thy thuc dng thuc phi hp vi mc ch
-Lm tng tc dng ca thuc
-Lm gim tc dng khng mong mun ca thuc iu tr
-Gii c (thuc i khng ,thuc thi tr ,gim hp thu .trung ha)
TUY NHIN NU KHNG HIU R TC DNG PHI HP ,THY
THUC C TH LM GIM TC DNG IU TR HOC TNG TC
DNG C CA THUC

Theo cc bn thun tin cho vic bn hng v ph hp vi tiu chun GPP th nn

thit k t thuc, quy thuc (chiu cao, chiu rng, chiu su v khong cch gia cc t)
v b tr mt bng nh thuc nh th no cho hp l?

1.Vic thit k t quy phi theo ch s nhn trc hc chiu cao, tm vi ca ngi bn hng.
2.KT quy cao 100-105 cm, su 38cm, di ty theo mt bng nhng khng nn di hn 200cm.
3.KT t thuc cao 195-210cm, su 30cm, di 110-120cm cc bn khng nn ng t di qu kh di chuyn,
khong cch chia t 28-30cm gia mi t c th b tri thm 1 t lng.
4. Khong cch t quy n t 100-120 cm
5.Nn b tr t quy theo hnh mng nga tn dung ti a khng gian tip xc vi khch, hoc b tr
bn phi theo chiu t ca vo s thun theo chiu nhn ca khch.

- Hiu v chnh bn thn mnh (ma trn SWOT rt hu hiu).

- Hiu bit v cng ty (nhng thng s v phn cng, p mm: thnh lp, gi tr ct li, sn phm, i th
cnh tranh.....).
- Cc k nng mm phi c.
- Vn na l hu nh NTD ca cty chuyn nghip u hi:
+ A (C) c xut hay c tng g cty lun pht trin khng?
+ A (C) thy mc lng nh vy c hp l ko hay Theo a (c) vi mc cng vic nh th, lng bao nhiu
l hp l.
Tm li phng vn xin vic l bc u tin trong vic BN CHNH MNH CHO CNG TY(ni chnh xc hn
l BN SC LAO NG) nn b phi nu bt c th mnh ca b trn nn hiu bit.
i xin vic ging y nh i mua vy, phi p ng c nhu cu hoc mong mun ca mnh m phi hp ti
tin th m mi b tin ra mua, NTD cng nh th y.

1. Hiu bit v cng ty: mt s bit dc m cng ty ang c bn ti VN. Cn phn bit gia mt s cng ty
bn hng brandname (nh Sanofi, Pfizer) v hng generic (nh United Pharma). Cc mng thuc m cng
ty ang kinh doanh: thuc tr tiu ng, huyt p, khng sinh, ...
2. Hiu bit v cng vic trnh dc: bit c th no l trnh OTC v trnh ETC. Nu bn xin vo cc cng
ty a quc gia th hu ht l trnh ETC c. C th cn hiu cht t v trnh dc, hoc hnh dung ra c
nhng g mnh s lm. V iu ny th ch c th hc hi t cc anh (ch) i lm thi.
3. C d nh pht trin bn thn trong tng lai, s theo hng Sales hay Marketting hay CRA (Clinical
Research Assistant).
4. Cn chun b k nng giao tip, k nng PR (qung co sn phm), k nng thuyt phc ngi khc, k

nng sp xp qun l, k nng lm vic nhm. C th khi phng vn, NTD s a cho bn 1 s tnh hung
yu cn bn a ra cch x l hoc c th a ra tnh hung thc t xem k nng ca bn (nh bn th
thuyt phc NTD mua 1 cy vit no hoc cho bn ng vai TDV th gii thiu v sn phm ca mnh vi
bc s).