nhng lu khi dng thuc

Vim tai l mt loi bnh l hay gp, chim t l 12% dn s. Bnh c th gp c ngi ln v tr em. Vim tai cng c th nh hng ti

nhin phn ln nhng bnh nhn vim tai nh hng ti chc nng nghe v nh hng ca ngi bnh.

Vim tai gia (VTG) c chia lm hai loi: VTG nguy him v VTG khng nguy him. VTG nguy him l loi vim tai c ch nh phu thut

khng nguy him bn cnh vic phu thut phc hi chc nng nghe th vic iu tr ni khoa phi hp khng th thiu c.

Thuc iu tr ton thn

S dng khng sinh ng ung hoc tim. Nhm b-lac tam (ampicillin, cepholosporin th h I, II, III), nhm macrolid, nhm quinolon l la c

ca bc s tai mi hng. Tuy nhin, hn ch s dng nhm khng sinh aminoglucosid (gentamycin, ankamycin...) v tr b VTG thng di

ang tp ni trong khi nhm khng sinh ny c kh nng gy c c tai cho tr. Nu dng tr c th s b cm ic do thuc. Do t l khn

cng cao nn cc bc s thng phi phi hp khng sinh cc nhm khc nhau trong nhng trng hp c tnh vi khun cao, tr suy dinh

gim sc khng hoc iu tr ba ngy m triu chng ca bnh khng thuyn gim.

Thuc chng vim corticoid ngn ngy (7-10 ngy) hoc thuc khng vim non-steroid, thuc chng vim dng men nh chymotrypsine, serr

l nhng enzym thu phn protein nhm ngn chn cc triu chng khc nhau do vim, phc hi cu trc ca m b tn thng cng nha

ngn chn tin trin vim, ng thi h tr cng vi khng sinh tiu dit cc loi vi khun gy vim.

Thuc h st, gim au dng tu theo cn nng ca tr. Thuc thng dng v an ton nht l paracetamol.

C th s dng thm khng histamin H1 (siro phenergan 1%, siro clarytine...) gim hin tng xut tit ca nim mc vim, nht l trn nh

thc c tin s d ng.

Thuc iu tr ti ch

Ti mi: Dng thuc chng xung huyt, co mch, gim ph n, chng vim theo ng la tui (thuc hay s dng l otrivin 0,05%, sunfarin, c

naphtazoline, xylomethazoline, adrnaline...). Thuc nh mi c s dng vi mc ch l lm sch hc mi v tr li s thng thong tai g

iu ny gip cho vic phc hi nim mc vim trong tai gia d dng hn v dn lu dch m t tai gia ra ngoi qua ng vi tai.

Ti tai: Dng thuc gim au v khng vim ti ch. y l loi thuc khng c s dng khi tai thng mng nh.

Khi dng thuc nh tai cn lu :

Thuc nh tai c chia lm hai loi tu theo thnh phn c bn ca thuc l thuc nh cho nhng trng hp vim tai khng thng mng n

thuc dng cho vim tai c km theo thng mng nh. Tai gia v tai trong c ngn cch vi nhau bi lp mng ca s trn rt d hp t

v l mt trong nhng c ch ng c tai trong gy ic nng khng hi phc.

Nhm thuc dng cho bnh l vim tai khng thng mng nh : Giai on xung huyt: Thuc c phi hp gia khng sinh v khng vim, c

mt tr liu ti ch v a nng do tnh khng vim ca thuc dng phi hp dexamethasone. Do c s phi hp ca hai thuc khng sinh l n

polymycine cho php m rng ph khng khun trn cc mm bnh Gr+ v Gr- l cc tc nhn gy bnh ca VTG. Nomycine tiu dit lin c

coli, Klebsiella Pneumonia, Hemophilus Influenza trong khi polymycine tc ng trn cc mm bnh Gr-...; otipax l loi thuc cha phena

HCL c tc dng chng vim v gim au ti ch c dng trong nhng trng hp VTG cp giai on xung huyt. Phi kim tra tht k m

bnh nhn trc khi cho thuc. Trng hp mng nh b rch, thuc tip xc vi cc cu trc tai gia v tai trong gy cc tai bin nng n nh

thng bng... Nu c biu hin ngoi da khi qu mn cm vi thnh phn khng sinh c trong thuc nh tai rt cn thn khi dng khng sinh

theo con ng ton thn phi hp.

Nhm thuc dng cho trng hp mng nh b thng: L nhng thuc c bo ch bng nhng khng sinh c tnh an ton cao cho c tai n

rifamycin, ciplox, efexin...

Otofa c bo ch vi thnh phn chnh l rifamycine sodium. Thuc c tc dng tiu dit vi khun Gr+ v Gr- trong cc bnh nhim trng t

Rifamycine gy tc ng trn cc chui xon k trong nhn t bo bng cch hnh thnh mt phc hp n nh gy c ch s tng trng c

Ciplox, efexin l mt loi thuc nh tai cha khng sinh ciprofloxacine - nhm quinolone tc ng ch yu ln cc vi khun Gr- v mt s vi kh

Vic dng thuc iu tr VTG cn ht sc thn trng v phi c thc hin ti cc c s c chuyn khoa tai mi hng.

ThS. BS. Phm o

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