Cac thuoc co the gay doc cho thai

Thứ ba, 29 Tháng ba 2011, 07:03 GMT+7


Cac thuoc co the gay doc cho thai Nhom aminoglycoside (gentamycin, streptomycin…) co the gay bat thuong cho thai Phoi thai thuong xuyen phai tiep xuc ngoai y muon voi cac thuoc duoc dung cho co the me o nhung muc do khac nhau, do khong co mot hang rao rau thai dac hieu ngan chan su xam nhap cua thuoc. Mot so loai thuoc co the vo hai hoac co tac dung chua benh doi voi co the me nhung lai co the gay hai hoac tham chi gay chet doi voi phoi hoac thai.

Mot loai thuoc duoc coi la co the gay doc cho thai neu viec su dung no o nhung phu nu dang mang thai co the truc tiep hoac gian tiep gay ra cac bat thuong ve cau truc hoac chuc nang o thai nhi hoac o tre sau khi ra doi, mot so bat thuong nay co the kin dao va khong duoc boc lo ro cho den cuoi doi. Phan lon cac loai thuoc hien nay deu duoc khuyen cao dung than trong hoac chong chi dinh o nhung cac phu nu dang mang thai. Tac dung doc cua thuoc doi voi thai co the xay ra o bat ky giai doan nao cua thai ky, nhung thuong gap nhat trong 3 thang dau, thuong phu thuoc lieu dung cua thuoc, tuoi cua thai va co su hiep dong giua cac loai thuoc. Nguy co gay doc thai voi moi loai thuoc cung khac nhau ro ret giua cac ca the.

Cac thuoc khang sinh: rat nhieu loai khang sinh duoc biet co the gay ra cac bat thuong cua thai, nhu nhom aminoglycoside (gentamycin, streptomycin…) co the xam nhap rat nhanh qua hang rao rau thai va pha huy than kinh thinh giac cua thai nhi, gay diec bam sinh. Tetracyclin khi su dung o phu nu mang thai sau 15 tuan co the gan manh vao xuong va rang lam rang bien mau vang nau va cham phat trien cac xuong dai. Trimethoprim cung co lien quan voi nguy co gay di dang thai khi su dung o nhung thai phu co thieu hut acid folic. Ngoai ra, nhom quinolon (ciprofloxacin, norfloxacin, pefloxacin…) cung bi chong chi dinh dung o phu nu mang thai do co nhung bang chung cho thay chung co the pha huy sun tiep cua thai o cac dong vat thi nghiem. Nhung nhom khang sinh ke tren nen duoc tranh su dung o phu nu mang thai, tru khi khong co khang sinh thich hop thay the.

Thuoc ha huyet ap: day la mot trong nhung nhom thuoc duoc dung pho bien nhat trong thoi ky mang thai. Cac thuoc loi tieu gay giam tuoi mau cho thai nen hau het bi chong chi dinh dung o phu nu mang thai. Nhom cac thuoc uc che men chuyen nhu captopril, lisinopril… va cac thuoc khang thu the angiotensin-II nhu losartan, valsartan khi dung o phu nu mang thai co the gay mot so bat thuong thai nhu thieu oi, loan san ong than, vo nieu so sinh, thieu san phoi, con ong dong mach, cham phat trien thai, chet thai hoac so sinh. Nhung nhom thuoc ha ap khac nhu methyldopa, chen beta giao cam va nhom chen kenh canxi deu tuong doi an toan doi voi thai nghen.

Cac thuoc khang giap: propylthiouracil la thuoc khang giap duoc lua chon dung o phu nu mang thai, dac biet trong 3 thang dau. Carbimazole va chat chuyen hoa cua no co the qua hang rao rau thai va gay suy giap o thai nhi hoac tre so sinh.

Cac thuoc chong co giat: barbiturate, carbamazepine, oxcarbazepine, oxazolidine, phenytoin, primidone, succinimide va valproic acid deu duoc ghi nhan trong mot so bao cao co lien quan voi cac bat thuong hinh thai o thai nhi nhu sut moi, ho ham ech, cam nho, sap song mui, bat thuong ong song va tim, lo tieu thap…Tuy nhien, cac bat thuong nay la hiem gap va viec dieu tri dong kinh o phu nu co thai la het suc can thiet, khong nen bi ngung lai.

Cac thuoc chong tram cam: nhom uc che men monoamine oxidase (IMAO) co the gay ra cac con tang huyet ap o phu nu mang thai dan den giam tuoi mau cho thai va lam cham su phat trien cua thai. Gan day, co mot so bao cao ghi nhan moi lien quan giua viec dung nhom thuoc nay voi mot so bat thuong hinh thai o thai nhi. Cac thuoc chong tram cam khac nhu amitriptyline, imipramine, fluoxetine deu tuong doi an toan voi thai nghen.

Cac thuoc khac: cac thuoc chong dong nhom coumarin co the gay ra bat thuong thai o khoang 5-10% cac truong hop dung thuoc trong 3 thang dau cua thai ky, thuong gap nhat la loan san sun, tang nguy co say thai, de non, suy ho hap luc sinh, giam san vung mat, mui. Neu dung trong nhung thang cuoi, cac thuoc nay co the gay ra xuat huyet trong so o thai nhi, dan den cac hau qua nhu nao nho, cham phat trien tri tue… Cac dan xuat cua vitamin A nhu isotretinoin neu duoc dung duong uong o phu nu mang thai co the lam tang 20-30% nguy co cac bat thuong bam sinh o tim, tuyen uc va so mat o nhung dua tre duoc sinh ra. Nguy co say thai tu phat cung tang 20%, 30% cac tre khong mang cac di tat lon co the co cham phat trien tri tue va 60% co cac bat thuong chuc nang tam than kinh. Do nhung nguy co nay, cac dan xuat vitamin A nen duoc ngung it nhat 1 thang truoc khi thu thai. Misoprostol la tac nhan gay say thai, thuong duoc dung phoi hop de pha thai. Neu dua tre van duoc sinh ra, no co the mang nhieu loai di tat nhu nao ung thuy, liet cac day than kinh so bam sinh…Methotrexate neu duoc dung trong 3 thang dau thai ky co nguy co ro ret gay say thai, mot so di dang cung co the gap trong mot so it truong hop nhu thop rong, lien khop so som, cham phat trien tri tue... Leflunomide cung bi chong chi dinh o phu nu co thai do cac nghien cuu o dong vat thi nghiem cho thay thuoc nay co the gay ton thuong nghiem trong phoi thai o lieu thap. Cac thuoc bisphosphonate nhu alendronate, risedronate… cung nen tranh su dung o phu nu mang thai do cac nghien cuu o dong vat thi nghiem cho thay, o lieu rat cao, cac thuoc nay co the gay ton thuong he thong xuong cua thai nhi.

Cac thuoc co the gay doc cho thai, Tin tuc trong ngay, suc khoe, ba bau, mang thai, thuoc, vo sinh

Chi dung nhung loai thuoc thuc su can thiet va co loi ich ro ret.

Voi nhung nguy co tiem tang cua cac loai thuoc doi voi thai, truoc khi dung thuoc o nhung phu nu mang thai, can can nhac ky luong giua nguy co gay doc cho thai cua thuoc va nguy co cua benh neu khong duoc dieu tri. Nguyen tac chung khi dung thuoc o phu nu mang thai la chi dung nhung loai thuoc thuc su can thiet va co loi ich ro ret, co gang tri hoan viec dieu tri qua 3 thang dau cua thai ky neu co the. Tot nhat nen tranh su dung cac loai thuoc moi vi con thieu nhung thong tin ve do an toan doi voi thai nghen. Cac loai thuoc ban khong can don va thuoc Dong duoc cung co the gay doc doi voi thai va do do cung nen duoc dung mot cach than trong o phu nu mang thai va phai tham khao y kien cua thay thuoc.

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