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8/10/2019 bao cao bao che

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Khoa Dci hc Y-Dc TP.HCM.

BO CO THC TP

Nhm thc tp: Nhm 3

Ngy thc tp: chiu th t

Bn thc tp s 4


2/14


THUC NHMT CN T NHNG TIU CHUN C BITNO?

Thuc nh mt phi t 3 tiu chun sau:

V khun:Tt c cc ch phm dng trong nhn khoa uphi t tiu chun v khun. bo m tiu chun ny, thuc nhmt phi c iu ch trong iu kin mi trng v khun, thngc thm cht st khun thch hp v sau khi pha ch phi c titkhun.Nc dng pha ch thuc nh mt phi l nc ct t ccyu cu tiu chun ghi trong dc in.V vy, khng th ly bt cdng thuc no khc dng cho mt.

pH:pH l i lng cho bit tnh acid, tnh kim ca mtdung dch. Nc mt c pH trung tnh, ngha l khng c tnh acidhay tnh kim (pH ca nc mt trong khong 7,4-7,6), do tt nhtthuc nh mt nn c pH bng vi pHca nc mt. Khi pha chthuc nh mt, nh bo ch phi cn nhc, tnh ton, la chn pHsao cho va c tc dng n nh hot cht ca thuc, va gip mtkhng b kch ng v p ng tt trong iu tr.

ng trng: Khi nh thuc vo mt, ta cm thy d chu,mt phn l do dung dch thuc nh mt ng trng vi dch ncmt, ni cch khc thuc nh mt phi c tnh cht ging nh ncmt. Nu dung dch thuc nh mt khng ng trng s d gy kh

chu, gy au mt, lm nc mt tit ra nhiu v y thuc ra ngoi.

Hiu bit v tnh ng trng ca thuc nh mt, chng ta c th rt ra kinh nghim, nu nh mtthuc no vo mt m thy xt, kh chu, au nhc th c th l do thuc nh mt khng t ng trng, phi ngng dng ngay v hi kin bc s chuyn khoa.

Ngoi 3 tiu chun k trn, ty theo dng thuc nh mt, cn c mt s tiu chun khc nh: Dung dchthuc nh mt phi t trong, khng c cha cc tiu phn l lm tn thngbiu m gic mc

Thuc dng cho mt hay gil thuc nhn khoa bao

gm nhiu dng nh: thucm, thuc hn dch (tc

thuc c cha cc ht nhrt mn), thuc t vo mt,thuc nc

Thuc nhn khoa ni chung

l nhng ch phm v

khun (ngha l khng

cha cc vi khun gy

bnh), khng cha cc cht

l gy hi, c pha ch vng gi thch hp nh

mt, tra vo b m mt hoc

ci t vo mt, vi mc

ch iu tr hoc chn on

cc bnh v mt.

NHNG LU KHI SDNG THUC NHMT

Khi s dng thuc nh mt, ta cn lu mt s vn sau:

- Khi m l thuc ra, ch nn dng trong vng 15-20 ngy k t khi m. V qu thi gian ny, c th thuckhng cn t vkhun.

- i vi mt s dc cht c trong thuc nh mt, c bit l chloramphenicol, cn phi c bo qun trongt lnh.

- Hin nay, trn thtrng c rt nhiu loi thuc nhmt khc nhau. V vy, m bo iu trng bnh,ngi bnh cn n khm bc s chuyn khoa c hng dn mua dng loi thuc thch hp.


3/14


-nh ngha thuc: l dng thuc rn, chnh dng nht nh, c iu chbng

cch nn mt hay nhiu loi dc cht vinhng lng chnh xc , mi vin l mt

n vliu lng.

-u i m:

+dchia liu sdng

+thtch gn nh, dvn chuyn,mang theo ngi

+dche giu mi vkh chu ca dccht

+dc cht n nh, tui thdi hnthuc lng

+du t sn xut ln nn gi thnhgim

+din sdng rng

+trn vin nn thng c chgip

ngi bnh dnhn bit tn thuc

-Nhc im:

+khng phi mi dc cht u bochc thnh vin nn

+sau khi dp vin, din tch bmttip xc ca vin nn vi mi trngha tan gim nhiu do vi dccht t tan thi bo chdng vin nnkhng tt , SKD thuc c thbgimkh nhiu

+SKD vin nn thay i tht thngdo bo ch, c rt nhiu yu ttcng dn n nh ca dc cht vkhnng gii phng dc cht cavin nn nh: m, t dc, lcnn,


4/14


Nhc im:

-Dht m v chy ra do cha lng mui kim kh ln nn phi trnh mnhgi ht m sillicagen

-Khng dng cho ngi king mui,c thgy kim ha mu nh hng nkhnng hp thu mt scht.

nh ngha:Lnhng dngvin nn pha

vo dung dch

hay hn dchdng unghay dng ngoi

u im:

-Vin nn thcht rn c n nh v tui thcao hn,dng gi,bo qun; khilng v thtch nhnn dvn chuyn,tn tr, mang theo ngi.

-Dng thch hp cho nhng ngi kh nut vin nn, che du c mi vkhchu,gim kch ng nim mc.

-Thuc ha tan trong dung dch hay hn dch nhanh, chosinh khdng cao.


5/14


nh ngha:

Vin nang l dng thuc rn hay mm

c phn liu chnh xc v c bo

ch di dng thch hp (dung dch,

bt, ht) ng trng vnang lm bng

gelatin hay tinh bt.

Vi cc dng bo chny, thuc c th

che du c mi vkh chu, lm cho

thuc dung, trnh c cc tc dng

bn ngoi bo v thuc khng b dch

ph hy, v vy khng nn nhai trnh

lm hng vnang, khng tch phn v

nang ly phn dc cht bn trng

ung.

Ring i vi ngi ln tui, phn x

nut c thgim v c hin tng gim

tit nn khi ung nn ngm vin thuc

trong ming lm mm v nang ri

nut vi nc nhm trnh hin tng

thuc dnh thc qun.

Thng thng c 2 dng chnh:

-Vin nang cng c bit n bng tn vin

con nhng. N c sn xut t gelatin tinh

khit c m t10-15%. Vi khnng hp thunc v tan nhanh chng trong c th, vin

nang cng gip ngi ung thuc cm thy d

dng hn so vi vic ung trc tip. ng thi

cc nh sn xut thuc cng cm thy thun

tin trong vic lm t dc cho vin thuc. Vin

nang cng c sdng cha cc loi thuc

dng ht hay dng bt nghin nh.

-Vin nang mm c v thuc do cha thnh

phn gelatin. mm do v n hi ca v

thuc ty thuc vo loi v hm lng ca

gelatin c sdng, m v dy ca v.

V vin nang mm thng dy hn so vi v

vin nang cng. Mt cng nghmi trong lnh

vc bo ch dc phm l thuc bc gelatin

hay caplet. y l qu trnh ngm vin thuc vi

dung dich gelatin ri lm kh. Cng ngh ny

gip tit kim chi ph qu trnh sn xut thuc

v thn thin vi ngi s dng.


6/14


nh ngha:Siro l dng thuc lng,snh v c cha t l ng cao(64%); do dng thuc ny thng

c vngt dung.

Liu dng:Dng thuc ny c phn liu theo mung c ph hay mung canh.

u im:Dng thuc ny gip che giu c mi vkh chu ca thuc nn tin dngcho trem. Tlng cao nn thuc c thbo qun c lu v cng c gi trdinhdng.

Nhc im:Hp thu chm do nht cao, do cn pha long hay ung km vinc nu mun tn tc h th.


7/14


Thuc bt dng ngoi

Thuc bt dng ngoi thng ng ginhiu liu, c thdng p, rc trc tip lnda, vt thng hoc c ho tan, phn tntrong dung mi thch hp nhmt, ra hoctht. Thuc bt dng ngoi phi p ng ccyu cu chung ca thuc bt, ngoi ra phi tcc chtiu ring vv khun Thuc bt p, dng cho vt thng

rng hoc trn da btn thng nng, thuc btdng cho mt phi v khun. Thuc bt dngp hoc rc phi l bt mn hoc rt mn.

Thuc bt pha tim phi p ngyu cu cht lng i vi thuc tim, timtruyn dng bt.

nh nghaThuc bt l dng thuc rn, gm cc ht nh, kh ti, c mn xcnh, c cha mt hay nhiu loi dc cht. Ngoi dc cht, thuc btcn c th thm cc t dc nh t dc n, t dc ht, t dcmu, t dc iu hng, v ... Thuc bt c th dng ung, phatim hay dng ngoi.

Tnh cht

Quan st mu sc bng mt thng,

di nh sng t nhin, vi mt lngbt va , c phn tn u trnmt t giy trng mn.

Bt phi kh ti, khng b m, vn,mu sc ng nht.

Bo qun

Thuc bt phi c bo qun trong ng kn.

ni kh mt.

Thuc bt ung

Thuc bt ung c th dng nut trc tip hocc s dng sau khi ha tan hay phn tn trongnc hoc cht lng thch hp.

Thuc bt ung phi p ng cc yu cu chtlng chung ca thuc bt. Ngoi ra thuc bt si bt

phi t yu cu vtan:Cho mt lng bt tngng vi mt liu vo mt cc thutinh cha 200 mlnc 15 - 25oC, xut hin nhiu bt kh bay ra. Khiht bt kh, thuc phi tan hon ton. Thnh vy vi6 liu n. Mu tht yu cu nu mi liu thutan trong vng 5 pht, trkhi c chdn ring.


8/14


I. NH NGHA- Thuc m l hnhpgm dcchttrnu vi tdc dng bi ngoi dahay nim mc.- Thuc mc c im:+ Thcht: mm.+ ng dng: da, nim

mc.+ Mc ch tr liu: bo v

da; a thuc thm qua da:gy tc dng ti ch hocton thn,- Mt sloi thuc m:+ Bt nho bi da: dc

cht rn khng tan trong tdc (>40%).+ Kem bi da: c cu trc

kiu nh tng.

II. U IM

- Thuc hp thu qua da hay nim mc nn trnh c nhng yu tnh hng nh: pH ca dch tiu ha, thc n trong ddy,- Dc cht c hp thu thng vo h mch, trnh c nhngyu tchuyn ha qua gan ln u c thbphn hy hoc gimhiu lc iu tr.- Do thuc c gii phng v d tr theo mc v tc xcnh, cho nn nhng dc cht c thi gian bn hy t1/2ngn khngcn ng lo ngi do nng trong mu khng m bo ngngiu tr. Nng thuc lun lun c duy tr trong vng c tcdng iu tr. Cng v vy, rt thch hp cho nhng bnh nhn cndng thuc thng xuyn.- Bnh nhn khng phi dng thuc nhiu ln trong ngy v thigian ban m khng cn phi lo ngi.

III. NHC IM- Mt sloi thuc mc khnng gy kch ng da, nim mc.- Mt sloi thuc mdbra tri nh hng n hiu qutrliu, hoc kh ra sch, gy cn trhot ng sinh l bnh thngca da, nim mc.
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9/14


nh ngha:Thuccm l dng thucc ht nh xphoc si ngn xp,thng dng bngcch ung vi mtt nc hoc chtlng thch hphoc pha thnhdung dch, hn dchhay siro. Thuccm c th chamt hay nhiuhot cht km theo

cc t dc.... Cth ng thnhmt liu hay nhiuliu.

Cng dng:Tr si mt, si thn, tt cho ng tiu ha, h tr iu tr

vim lot d dy.

Yu cu cht lng:thuc cm phi kh, ng u v kch thc ht, khng chin tng ht m, b mm, bin mu.

Bo qun:trong ng kn, ni thong mt, trnh nh sng trc tip.


10/14


u im:

C thchc cc dc cht rn khng ha tan hoc

rt t ha tan trong cc cht dn thng thng di dngthuc lng c tha thuc vo c thbng nhiung hn thuc rn, sdng thuc ddng hn.

Hn chnhc im mt sdc cht khi ha tan skobn vng, hoc mi vkh ung hoc gy kch ngnim mc tiu ha.

Lm cho dc cht tc dng chm hn nhng bn hnhoc hn chtc dng ca thuc ti ch.

Nhc im:kh iu chv khng n nh.

Ch :lc trc khi sdng.

nh ngha:

Hn dch thuc l cc thuclng, dng ung, tim, dngngoi, cha cc cht rn khng

tan dng cc ht nh(ngknh >0,1 m) phn tn u trongcht lng l mi trng phn tn(cht dn).

Dc cht chnh ca hn dch thucl cc cht rn thc tkhng tan hocrt t tan trong cht dn. Ngoi ratrong cht dn (l nc ct,glycerin,du lng,...ko c tc dngdc l) c cc dc cht khc hatan, c tc dng hp ng vi dc

cht chnh.


11/14


c im:

Thuc tim l ccdung dch, hn dchhoc nh tng vkhun, tim voc th theo nhiung tim khcnhau: tim di da,tim bp, tim tnhmch...

Dng bo ch:

Dung dch (Injectablesolution): mt haynhiu dc cht hotan trong mt hocmt hn hp dungmi to thnh hnhp ng nht

Hn dch (Injectablesuspention): dc

cht rn khng ha tan dng ht tht nhc phn tnng nht trong mt dn cht thch hp.

Nh tng (Injectable emulsion): cc tiu phn lng phntc ng nht trong mt cht lng khc khng ng tan.

u im:

Thuc c hp thu trc tip v trn vn vo m, vo munn c tc dng nhanh v hiu qu cao, cho tc dng tichmong mun

Trnh c cc tc dng phca thuc trn htiu ha. Thch hp cho nhng dc cht bphn hy bi dch tiu

ha hoc gan Kim sot c liu lng chnh xc hn ng ung.

Hn ch:

Bnh nhn kh c thtsdng. C thgy nhng phn ng ti chhay ton thn. Do c tc dng nhanh v hp thu trn vn nn c tha

n nhng hu qunghim trng, nht l i vi cc dccht c v mnh.

Thuc tim phi l nhng chphm v khun, tinh khit,n nh; quy trnh tim phi tuyt i v khun.

Vn chuyn gp nhiu kh khn do thuc c ng gicng knh, dv.


12/14


Dng thuc l ming bng dn(c khi c gi l ming cao

dn) dng dn ln da nhm tr hoc phng bnh.

im c bit l dng thuc dnc th cho tc dng ph ging

nh dng thuc ung hay thuctim. V vy, trc khi dng cnxem hng dn hoc hi bc s

trc!

C 2 loi cho 2 tc dng:

Mt l loi dn ln da cho tcdng ti ch kiu nh dnming cao dn Salonpas ch ctc dng gim au ch vngdn.

Cn loi th hai mc d dn lnda nhng cho tc dng tonthn, kiu nh dn thuc ln da ngc nhng tr c au thtngc, phng nhi mu c tim.


13/14


+ nh ngha:

Cao thuc l ch phm c ch bng cchc hoc sy n th cht quy nh cc dch

chit thu c t dc liu thc vt hayng vt vi cc dung mi thch hp.

Cn thucl nhng ch phm lng, ciu ch bng cch chit dc liu thc vt,

ng vt hoc ha tan cao thuc, dc chttheo t l quy nh vi ethanol cc nng

khc nhau.

+ Bo qun:

Cao thuc c ng trong bao b kn, ni kh, mt, trnh nh sng, nhit t thayi.

Lu :khng dng cho trdi 5 tui v chdng xoa hoc bp ngoi da,khng bi ln cc vngda, c bllot, mng m.


14/14


Thi Th Minh Ha

Phan Th Thu Hin

Nguyn Thanh Hi

Nguyn Thanh H

Giang Ngc Hiu

Ninh Ngc Xun Hin

Hong Lnh Thu Giang

V Trng Giang

Nay H'sra

ng Ngc H

L Th Tr Giang

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