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logo1.  Khuy?n co khng s? d?ng lidocain 2% ?? ?i?u tr? ?au do m?c r?ng

Ngy 26/6/2014, FDA ? ??a ra c?nh bo thu?c lidocain 2 % khng nn s? d?ng ?? ?i?u tr? cho tr? s? sinh v tr? em b? ?au r?ng. FDA ?ang yu c?u m?t c?nh bo m?nh nh?t ???c thm vo cc nhn thu?c ?? lm n?i b?t thng tin ny. S? d?ng lidocain 2% bi t?i ch? khng ???c ch?p thu?n ?? ?i?u tr? ?au r?ng, v s? d?ng ? tr? s? sinh v tr? nh? do thu?c c th? gy ra tc h?i nghim tr?ng, k? c? t? vong.

Thu?c gi?m ?au t?i ch? v thu?c ???c bi trn n??u r?ng l khng c?n thi?t v chng r?a ra kh?i mi?ng ??a b trong vng vi pht. Khi c qu nhi?u lidocain ???c bi cho tr? s? sinh v tr? nh? ho?c tr? nh? v tnh nu?t qu nhi?u c th? d?n ??n tr?ng thi co gi?t, t?n th??ng no nghim tr?ng, v cc c th? gy ra cc nguy c? v?i tim. Cc tr??ng h?p qu li?u do sai li?u l??ng ho?c tnh c? nu?t ph?i ? d?n ??n tr? s? sinh v tr? em ???c nh?p vi?n ho?c t? vong.

Trong n?m 2014, FDA ? xem xt 22 tr??ng h?p bo co ph?n ?ng ph? nghim tr?ng, bao g?m c? tr??ng h?p t? vong, tr? s? sinh v tr? em t? 5 thng ??n 3,5 n?m tu?i ???c cho u?ng dung d?ch lidocain 2% ?? ?i?u tr? ?au mi?ng, k? c? khi m?c r?ng v vim mi?ng, ho?c tr? em v tnh nu?t ph?i. FDA c?ng khuy?n khch cc b?c cha m? v ng??i ch?m sc khng s? d?ng thu?c bi t?i ch? cho ?au r?ng.

2.  C?nh bo v? tc h?i khi s? d?ng qu li?u s?n ph?m Sodium phosphat ?? ?i?u tr? to bn

Ngy 8/1/2014, FDA ??a ra c?nh bo v? vi?c s? d?ng qu 1 li?u duy nh?t trong vng 24 gi? Sodium phosphat ?? ?i?u tr? to bn c th? gy ra nh?ng tc h?i nghim tr?ng ??n th?n v tim, th?m ch gy t? vong. FDA ? nh?n ???c cc bo co v? tnh tr?ng m?t n??c nghim tr?ng khi s? d?ng qu li?u Sodium phosphat d?n ??n thay ??i n?ng ?? cc ch?t ?i?n gi?i trong huy?t thanh bao g?m canxi, natri v phosphat.

Nn s? d?ng th?n tr?ng khi dng m?t li?u u?ng duy nh?t / ngy cc s?n ph?m ny cho tr? em t? 5 tu?i tr? xu?ng. Khng nn s? d?ng ???ng tr?c trng cho tr? em d??i 2 tu?i.

M?t s? b?nh nhn c nguy c? cao b? cc tc d?ng ph? c?a thu?c khi s? d?ng Natri phosphat v??t qu li?u ???c khuy?n co nh? : tr? em, ng??i l?n h?n 55 tu?i, b?nh nhn m?t n??c, b?nh nhn c b?nh th?n, t?c ru?t, vim ru?t v b?nh nhn ?ang s? d?ng thu?c ?nh h??ng t?i ch?c n?ng th?n. Khng s? d?ng ??ng th?i natri phosphat v?i cc ch?t ?c ch? men chuy?n angiotensin (ACEIs) v thu?c ch?n th? th? angiotensin (ARB) ???c s? d?ng ?? ?i?u tr? huy?t p cao; v cc thu?c khng vim khng steroid (NSAIDs) nh? aspirin, ibuprofen v naproxen.

3. Khng sinh doripenem khng cn ???c s? d?ng trong ?i?u tr? vim ph?i

Ngy 6/3/2014 FDA ??a ra c?nh bo doripenem khng cn ???c s? d?ng ?i?u tr? vim ph?i. FDA ghi nh?n nhi?u b?ng ch?ng ch?ng minh doripenem lm t?ng nguy c? t? vong v hi?u qu? ?i?u tr? th?p h?n imipenem/cilastatin. FDA yu c?u thay ??i thng tin k toa, doripenem khng ???c ch?p thu?n ?? ?i?u tr? b?t k? lo?i vim ph?i no.

Doripenem v?n ???c coi l an ton v hi?u qu? trong ?i?u tr? nhi?m trng ? b?ng ph?c t?p v nhi?m trng ???ng ti?t ni?u ph?c t?p ? ng??i l?n, bao g?m c? nhi?m trng th?n (vim th?n b? th?n).

4. S? d?ng ceftriaxon c th? gy suy th?n c?p ? tr? em

M?t nghin c?u cng b? ngy 24/3/2014 ??ng trn t?p ch Pediatrics, vi?c s? d?ng ceftriaxon ?i?u tr? cc b?nh nhi?m trng ? tr? nh? c th? gy ra suy th?n c?p (suy th?n c?p c lin quan t?i ceftriaxon - PARF).

Nghin c?u h?i c? bo co 31 tr? em b? suy th?n c?p sau khi ?i?u tr? ceftriaxon trong th?i gian 2003 2012, khng c ti?n s? s?i ni?u ho?c b?nh th?n tr??c ?. Ceftriaxon ? ???c ch?ng minh l thnh ph?n chnh c?a s?i trong 4 tr? em d?a vo phn tch ph? kh?i. C 21 tr? khng ?p ?ng v?i ?i?u tr? b?ng thu?c.

5. S? d?ng thu?c azithromycin c th? t? vong do lo?n nh?p tim

Ngy 12/3/2013 FDA c?nh bo r?ng azithromycin c th? gy ra nh?ng thay ??i b?t th??ng trong ho?t ??ng ?i?n c?a tim c th? d?n ??n nh?p tim b?t th??ng c kh? n?ng gy t? vong. ??c bi?t trn nh?ng b?nh nhn c y?u t? nguy c? nh?: ko di kho?ng QT, n?ng ?? kali ho?c magie trong mu th?p, nh?p tim ch?m ho?c s? d?ng m?t s? lo?i thu?c dng ?? ?i?u tr? lo?n nh?p tim.

Cc chuyn gia ch?m sc s?c kh?e nn xem xt cc nguy c? lo?n nh?p tim gy t? vong v?i azithromycin khi xem xt l?a ch?n ?i?u tr? cho nh?ng b?nh nhn ? c nguy c? tai bi?n tim m?ch.

Ti li?u tham kh?o

1. FDA Drug Safety Communication: FDA recommends not using lidocaine to treat teething pain and requires new Boxed Warning.

2. FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphate products to treat constipation

3. FDA Drug Safety Communication: Doribax (doripenem) - Risk When Used to Treat Pneumonia on Ventilated Patients.

4. Antibiotic Could Cause Pediatric Renal Failure, Pediatrics. Published online March 24, 2014. 

5. FDA Drug Safety Communication: Azithromycin (Zithromax or Zmax) and the risk of potentially fatal heart rhythms.

6. Thng tin thu?c thng 6/2014: DS Thn M? Linh Khoa D??c B?nh vi?n T? D?.