Khi nim Nng lng

- Nng lng l sc mnh (kh nng) bin i s vt.

- Nng lng l kh nng thc hin cng
Nng lng c phn loi thnh hai loi:
- ng nng: nng lng ca vt th c c do chuyn ng ca n
- Th nng : nng lng tim n ca vt th, c c do v tr ca n hay s sp xp cc
phn ca n, ni cch khc nh v tr tng i ca vt vi mi trng v cu trc bn
trong ca vt th. Th nng ca vt cht do cu trc v s sp xp theo trt t ca cc phn
t c hiu rt t v cm tnh. Th d nng lng ca nam chm,ca cc loi qu, ca
bng,
- Nng lng sinh hc: hon ton cha hiu c

S bin i nng lng trong c th

Trong cc c th sng cc loi cng khc nhau c thc hin, cc dng cng c bn l
cng ha hc , cng c hc , cng vn chuyn
Cng ha hc: c thc hin trong vic tng hp cc hp cht cao phn t nh protein,
AND t cc hp cht thp phn t, tng hp ATP t ADP, trong thc hin cc phn ng
ha hc nht nh, tit cc hormone, dch v,cc qu trnh ny i hi tiu ph nng
lng nn cng c th c nh gi l thc hin cng
Cng c hc: Cng ny thc hin bi cc c khi c co.
Cng vn chuyn: cng thc hin khi vn chuyn cc cht khc nhau qua cc cu trc
mng theo cc c ch vn chuyn ch ng t ni nng thp n cao chng li xu th
khuch tn v i hi s tiu ph nng lng ca t bo.

c th trc tin chuyn nng lng tim n ca thc n tng hp ATP v sau
nh ATP thc hin cc loi cng trong hot ng sng . ATP l energy
money
Nhng hiu qu vic s dng nng lng ca thc n tng hp ATP t ADP
ph thuc trng thi sinh l ca c th v nhng c tnh khng nhn thy ca
thc n.
Sau mi loi cng trong c th c thc hin phi dng nng lng gii phng
ra khi ATP thy phn thnh ADP trong t bo.

To ATP t ADP
ADP + HPO42 ATP + H2O
ADP ATP cn nng lng, ch yu ly t qu trnh
C6H12O6 + 6 O2 6 CO2 + 6 H2O

Qu trnh rt phc tp oxi ha glucose c gi l s h hp ca t bo. Mt phn

t glucose b oxi ha nh trn c th to ra n 36 phn t ATP t ADP (y l th
nghim, khng phi qu trnh thc din ra trong t bo )
Nhit lng tht thot l tt yu
Hiu sut tng hp ATP (bao nhiu ATP t mt phn t glucose) l rt khc nhau
trong cc c th sng khc nhau
Ngoi ra cn c cc qu trnh khc cung cp nng lng cho s tng hp ATP
S h hp ym kh khng cn oxi
C6H12O6 2CH3CH(OH)COOH (acid lactic) + 2 ATP
ADP + creatin phosphate ATP + creatin
(sn xut ATP tc thi ~ 20 s u tin hot ng th cht t ngt, mnh)
Lu : Cc cht m, bo cng c chuyn ha thnh glucose tng hp ATP
Phn ng thy phn ATP gii phng nng lng
1

ATP + H2O ADP + HPO42

Nng lng gii phng ra khi ATP thy phn thnh ADP c s dng cho mi
hot ng ca t bo pht trin, vn chuyn ch ng, chuyn ha, sa cha,
tng hp, co c.
Hiu sut qu trnh ny:
nng lng c th gii phng t s thy phn ATP rt khc nhau ph thuc
mi trng phn ng v trng thi sinh l.
Nhit lng tht thot l tt yu
hiu qu s dng nng lng gii phng ra thc hin cng cc c th
khc nhau cng vn cha c hiu nhiu
c thm: 1. nh hng ca pH: cc nghin cu in vitro cho thy pH cng cao
(mi trng cng kim) s thy phn ATP ADP cng gii phng nhiu nhit lng. C
th l l do mi trng c th cng kim cng tt.
2. nh hng ca t l nng ATP/ADP trong t bo: in vitro t l ny cng cao nhit
lng ta ra cng nhiu, l thuyt cng khng nh nh th. Rt c th nhng c th
khe mnh t l ny c duy tr mc cao
Mi qu trnh sinh cng trong c th do cn cc qu trnh tng hp ATP v qu trnh
thy phn ATP.
V cc phn ng ha sinh c hiu sut hu ch nh hn 100%, nn lun c km tht that
nhit v ch gi l nhit lng s cp. Nhit lng ny trn s c k hiu l Q1
Nng lng, trc tip c dng thc hin cc loi cng C HC hu ch bn trong
c th, cui cng ri cng bin thnh nhit. Th d: nng lng c tim s dng trong
vic vn chuyn mu trong h mch (thc hin cng c hc) c tiu hao vo vic thng
sc cn do ma st cui cng s bin thnh nhit ta ra. Nhit c bn cht nh th gi l
nhit lng th cp k hiu trn s l Q2
Nu nh c th thc hin thc hin cng trong cc hot ng nh nng, di chuyn vt,
th mt phn cng hu ch thc hin trong c th, mt phn l cng c hc thc hin ln
mi trng ngoi l A
Tm li nhit lng s cp l s tht thot trc tip nng lng t cc phn ng ha
sinh trong c th
nhit lng th cp l kt qu s bin i thnh nhit ca phn nng lng m
ban u tiu hao thc hin cng c hc hu ch bn trong c th (chim
phn ln tiu hao nng lng cho cc hot ng sng)

Sinh vin phi hiu thu o cc qu trnh v ngha 2 loi nhit lng (qua cch cc
nhit lng ny c din t trn s ):
Q1 xut pht t cc QU TRNH ha sinh, Q2 xut pht t chnh CNG HU CH
A1 trong c th

c thm
S xoay vng ATP
Tng s lng ATP + ADP trong c th ngi ~ 0.1 mole. Ti mi thi im tng
s ATP + ADP tng i n nh. Nhn chung ATP khng c tng hp mi,
m c ti to t ADP.
Nng lng m cc t bo trong c th dng i hi thy phn 100 150 mole
ATP hng ngy ( 50 75 kg).
iu ny c ngha l mi phn t ATP c ti to 1000 1500 ln mi ngy.
ATP khng th d tr c, do s tiu hao n gn lin vi s tng hp li t
ADP s h hp t bo din ra lin tc.
Glycogen
Glycogen c trong nhiu loi t bo, ng vai tr quan trng trong vng quay
glucose.
glucose glycogen glucose
Glycogen to mt dng d tr nng lng (trong gan, trong c) c th nhanh
chng c huy ng tha mn nhu cu glucose tng t ngt.
S vn chuyn glucose t ngoi vo trong t bo v s tng hp glycogen u cn
hormone l insulin. Thiu insulin th glucose tha ngoi m thiu trong, t bo
th i m ng mu cao v khng tiu hao c v khng chuyn ha c
thnh dng d tr
Dng d tr glycogen rt linh hot, d dng nhanh chng gii phng thnh
glucose.
nh lut Hess
Nhit ta ra hay thu vo trong mt qu trnh ha hc khng ph thuc vo cc
bc din ra (tc l ch ph thuc sn phm u v sn phm cui ca phn ng)
Nng lng ca thc n = ?
Trong c th : thc n glucose glucose b oxi ha thnh CO2 + H2O v gii
phng ra nng lng tng hp ATP
da trn s kin glucose + O2 CO2 + H2O + nng lng E, p dng nh lut
Hess, u th k 20 ngi ta a ra kt lun thiu thuyt phc rng: thc n
mang li cho c th nng lng ng bng nhit lng ta ra khi t chy thc
n trong oxy ???

T c s ngi ta ch to ra bung t thc n xc nh nng lng thc

n gi l calori k (calorimeter). Thc n hoc ung c sy kh (?), c
t trong hp tr kim loi kn ng oxi bng tia la in (?), sau khi chy ht s
3

ta nhit lm nng nc m hp kn c ngm trong . Nhit

lng o

c l nng lng thc n???

Rt nhiu iu khng thuyt phc trong l thuyt ny:

- nh lut Hess ni v nhit lng ch khng phi nng lng. Nng lng c th
dng l rt tru tng, kh hnh dung,khng th nh lng th d nh co c, vn
chuyn ch ng,to cc hp cht,nng lng cn to ATP hay gii phng ra
khi thy phn ATP cng vy
- cc cht m khng th dng cch t gng p p dng nh lut Hess
c. Qu trnh tiu ha cht m trong c th v qu trnh chuyn ha acid amin
thnh glucose to ra cc sn phm cui nh urea,... hon ton khng ging cc
sn phm cui nu em t cht m trong O2
- Theo l thuyt ny, hai lng thc phm khc loi nhau nhng c cng lng
calories s em li NNG LNG ging nhau cho con ngi (v c ng vt),
c v l cy em li rt nhu nng lng cho ng vt n c nhng v ngha vi
cc loi n tht v con ngi. Ru em t sinh ra nhiu nhit lng nhng ch
lm hao nng lng o thi
- khng tnh n qu trnh tiu ha thc n v o thi cc cht tha hoc c
hi. Cc qu trnh tiu hao rt nhiu nng lng, tc ATP
- Cn nhiu, cn nhiu iu phi l khc m khng th lit k ra y
Ngy nay trong khoa hc dinh dng ngi ta quan tm khng phi l lng
calories trong thc n m quan tm ch yu n kh nng to ATP ca thc n
. Lu rng trc khi thnh glucose th thc n phi tri qua qu trnh tiu ha
phc tp tiu tn nng lng tc l tiu th ATP, nhiu cht v ch hoc c hi
trong thc n phi c thi tr cng tiu tn ATP (xem s bin i nng
lng trong c th pha trn).
Do xt kh nng to ATP ca thc n phi tnh n s lng ATP thng d
tng cng thu c (s lng NET ) tc l hiu ca lng ATP to ra tr i lng
ATP tiu th
Nh vy nhiu th m c gi l thc phm thc cht khng c gi tri dinh
dng v khng sinh ATP hoc rt t m tiu tn nhiu ATP ca c th tiu ha,
thi tr cc cht ra khi c th. Th d r rt nht l ru, th d khc l ngi b
bnh Gt (Gout) c n tht c vo th li b sng au khp nng v thc n sinh
ra nhiu acid uric c hi m c th khng thi ra ht c v chc nng thn
yu.
Thc n qu nhiu cht nhng c th KHNG DNG N th cng thnh cht c
hi phi tng ra. Lm tiu tn nng lng v bt cc c quan thanh thi nh gan ,
thn lm vic nhiu.
C nhiu ci gi l thc phm, vitamin,... nhng c con ngi tng hp, c
th KHNG DNG C
Cc trng phi dinh dng t nhin th khng quan tm n s calories v ngha
nhng rt quan tm n nng lng sinh hc, dng nng lng tru tng khng
o m c ca thc phm, c bit l thc phm thin nhin.
Rt nhiu bng chng cho thy ngha quan trng ca nng lng ny i vi
SC KHE th d nh cng dng tng sinh lc c th ca rt nhiu loi tho
dc, rau, hoa, qu,
Ngy nay ch n king gim cn theo trng phi bc s M Atkin ( cht,
tui th va phi, lc sng sc khe khim tn)c ng o ngi hm m v
gim cn nhanh m vn c n thoi mi. L do: ch n king ny cu thnh
ch yu t m ng vt m hu nh khng c cht ng bt (cn gi l low
carb hay no carb). Gim cn nhanh v thc cht ch n ny tiu hao ATP nhiu
hn sinh ra ATP, c th thiu dinh dng v phi ly t d tr m tha ra nui
4

c th. Tt c nhng ngi dng ch ny u cm thy mt mi, sinh kh

thp.Ch n nh th sinh nhiu cht c, ng thi lm acid ha c th v sinh
nhiu gc t do, h qu gan thn phi lm vic qu mt thi tr

One-quarter of what you eat keeps you alive. The other threequarters keeps your doctor alive.
Mt phn t nhng g bn n duy tr bn sng. Ba phn t cn
li duy tr bc s ca bn sng

Ni dung mt dng ch tng hnh tm thy trn mt lng

m Ai cp c

Let food be thy medicine, and let thy medicine be food.

Hy lm sao thc n l thuc ca bn v lm sao
thuc ca bn l thc n
Hippocrates
Suy ngm: ngy nay, thc n l cht c v thuc cn l cht c hn
na, vy chng ta suy tn Hippocrates lm g nu ta ch lm ngc li
li ng?

S IU HA THN NHIT CA C TH

3 c ch trao i nhit trong t nhin

1. Dn nhit

S din tch tip xc hai vt th nhit khc nhau

2.TRUYN NHIT = I LU
i lu chnh l s DN NHIT nhng mnh hn nh s chuyn ng ca cht
lu (ni chung l cht lng v cht kh).

3. TRUYN NHIT = BC X
Cc vt u c th pht x sng in t. Nu nhit khng qu cao ch pht bc x
hng ngoi. Nhit rt cao s pht sng.
C th pht x ra mi trng v ngc li Mi trng pht x vo c th (c c th
hp th)
Lng nhit trao i tng cng dQ = k S (T4 TA4).dt
TA nhit mi trng, T nhit b mt c th (da), S din tch b mt c th tip
xc mi trng
5

T cc cng thc ca 3 c ch trn rt ra c mt kt lun quan trng l:

Tc ca qu trnh trao i nhit gia mi trng v c th t l thun vi 2
i lng:
1 chnh lch nhit b mt c th tip xc mi trng (tc l da) > <
nhit mi trng tip xc da
2 din tch b mt tip xc ca c th (da) vi mi trng

S TRAO I NHIT GIA C TH SNG V MI TRNG

S sinh nhit trong c th
Cc phn ng ha sinh l ngun gc to nng lng duy nht cho c th: tiu ha
thc n; c 2 qu trnh ATP < > ADP lun km nhit lng tht thot v ch
(nhit lng s cp Q1)
Hot ng ca c sn sinh ra nhit lng th cp Q2 l kt qu ca cng hu ch
bin thnh
Tiu hao nng lng bi c th trong thi gian dt l dE = dQ1 + dQ2 + dA
Cng sut sinh nhit bi c th = d(Q1 + Q2)/dt
S ta nhit (s mt nhit) ca c th
Cc c ch trao i nhit c th - mi trng
1. C th pht ra bc x nhit hng ngoi.
2. Trao i nhit bng cch dn nhit qua b mt tip xc ca c th vi mi trng
xung quanh
3. Trao i nhit bng i lu nh cc dng khng kh chuyn ng trn b mt c
th v nh s h hp
4. S bc hi ca m hi . M hi bc hi lm c th mt mt nhit lng theo t l
0.58 kcal/ml. Tc bc hi khng ph thuc chnh lch nhit c th > < mi
trng m ph thuc m ca khng kh v nhit . m khng kh cng ln,
s bc hi ca m hi cng chm. Tri nng nhng m khng kh bo ha
(100%) th s bay hi m hi khng th xy ra.
5. Hi nc trong khng kh th ra cng lm mt mt nhit lng ca c th do nc
trong c th bc hi thu nhit

Vi 3 c ch 1, 2, 3 tc trao i nhit t l thun din tch b mt v ln ca

chnh lch nhit gia b mt c th (tc nhit da) v mi trng, cn chiu
trao i nhit (tc l c th thu nhit hay mt nhit) ph thuc vo du ca chnh
lch nhit .
Cn cc c ch 4, 5 ch c th lm c th mt nhit

S IU HA THN NHIT CA C TH
Con ngi, cng nh cc ng vt c v khc c h thng iu ha thn nhit
duy tr nhit n nh cn thit cho hot ng ca cc c quan quan trng bn
trong c th
Nhit cao qu hay thp qu mc gii hn u nh hng khng tt n hot
ng sng, mc cao nht l t vong.
Tuy nhin c khi c th t to ra trng thi c nhit cao hn mc bnh thng
bo v chnh n cn st
CN BNG SINH NHIT > < TA NHIT
C th iu ha thn nhit bi trung tm iu ha nhit trong hypotalamus (vng
i th ca h thn kinh thc vt)
Trung tm ny trng thi bnh thng ngm mc nh mt mc nhit bnh
thng cho cc c quan bn trong. Nhit ny khc nhau cc loi mu nng
khc nhau
Xt trng thi nhit c th ang mc bnh thng
6

Khi cng sut sinh nhit dQsinh nhit /dt cao hn (hoc thp hn) cng sut ta
nhit dQta nhit /dt, chnh c th s hp th (hay mt) nhit lng chnh lch ny
v c th s nng ln (hoc lnh i)
Nhit c cm nhn bi cc th cm th nhit phn b khp ni trong c
th . Cc thng tin nhit t cc th cm th ny truyn v vng i th
(hypotalamus), c so snh vi mc mc nh Nu nhit ti cc c
quan thit yu trong c th tng hoc gim qu mc nhit mc nh ny th
hypotalamus gi n cc c quan, cc tuyn hormones,nhng tn hiu thch
ng cc hot ng sinh l lm tng, gim sinh nhit v ta nhit thch hp.

Cc c ch cn bng sinh nhit v ta nhit v thc (khng ch ng)

Cc hot ng c iu khin bi hypotalamus l cc hot ng bn nng, v
thc
2 c ch quan trng l m hi, gin mch ngoi bin khi b nng qu v c ch
run, co mch ngoi bin khi b lnh qu l cc v d tiu biu v cch c th cn
bng sinh nhit - ta nhit mt cch v thc.
C ch co hoc dn cc mch ngoi bin nh cc hormones:
Khi lnh mch ngoi vi co gim dng i lu t trong c th ra b mt T da
gim gim ta nhit.
Khi nng mch ngoi vi gin tng dng i lu t trong c th ra b mt T
da tng tng ta nhit
Mt s hormones lm tng trao i cht, nhng vi hiu qu to ATP thp sinh
nhit lng s cp tng
C ch t nguyn (ch ng)
thch ng con ngi cn ch ng (c thc) tng hay gim ta nhit, tng
sinh nhit . (sv t suy ngm)

c thm:
Cn st l g?
Cn st thng l du hiu bo rng c th ang chin u chng li cc virus vi
khun c hi hoc tnh trng mt cn bng ni mi nghim trng (do tch t nhiu
c t,). Cng c th st khi c th chu nhng thng tn, cn sa cha, hn
gn
Khi c s bng pht hot ng ca cc virus, vi khun c hi trong c th, cc
bch cu tit ra hormone tn l interleukin-1 theo dng mu
hypothalamus mt loi neuron trong tit ra cht prostagladin c tc dng
nng mc nhit mc nh ln cao hn mc bnh thng.
Theo c ch iu ha nhit nu trn, sinh nhit ca c th s tng ln (run,
tng trao i cht) nhit c th tng ln n mc mc nh mi.
7

 cn ST c kch hot h tr c th t v, l tnh trng khn cp. C nhit

cao v interleukin-1 u lm tng hiu qu ca h min dch chng virus, vi
khun c hi, lm tng sn xut khng th ln 20 ln. Nhit cao cng gip tiu
dit v v hiu ha virus, vi khun ngoi nhp.
Nhit cao tng trao i cht cc m b tn thng hi phc nhanh hn,
cc qu trnh thanh thi c t mnh ln
H st bng thuc c phi l tt?
Cc thuc h st tc ng ln hypothalamus
Lu c bit PARACETAMOL: thnh phn chnh ca v s cc loi thuc
gim au, chng vim, h st. Trong cn st, mt loi protein l pyrogen c sn
sinh, protein ny kch thch s tng sinh cht prostagladin ni trn trong
hypothalamus v lm tng mc nhit mc nh. Paracetamol c ch
pyrogen v do c ch tit prostagladin. Paracetamol cn lm h nhanh nhit
bng tc dng gy tot m hi v dn mch ( ta nhit nhanh). Nh vy
Paracetamol tc ng ln thn kinh
aspirin c ch s tng hp cht prostagladin
Tm li cc loi thuc h st khng chng li cc tc nhn gy bnh m ngc
li chn ng c ch t bo v, t cha lnh ca c th, cn tr c th chin u
chng bnh v thi c.
Ngoi ra paracetamol hi gan, hi thn kinh, cn aspirin th rt hi cho d dy,
d gy chy mu trong.
Tuy nhin st cao n hn 390C v ko di th khng tt cho h thn kinh, lc
c th h nhit vng u , khng nht thit = thuc m = chm lnh u v
bng nhiu loi cy c c kim chng bi kinh nghim dn gian trong qu
trnh rt lu di nh sc c nh ni hay c mc, p cc lt chanh ln trn , ln
ngi.
Th phn tch nguyn nhn c th gy ra ci cht sau y trong bi
http://doisong.vnexpress.net/tin-tuc/suc-khoe/be-tu-vong-cha-me-kien-benh-vienkhong-som-tim-ra-benh-2277373.html

"Give me fever, and I can cure your patient." Hippocrates

Hy cho ti cn st v ti c th cha cho bnh nhn ca bn
Hippocrates
"If your child contracts an infection, the fever that accompanies it
is a blessing, not a curse ... A rising body temperature simply
indicates that the process of healing is sped up. It is something to
rejoice over, not to fear."
The "people's doctor," Dr. Robert Mendelsohn, in his book How to
Raise a Healthy Child in Spite of Your Doctor
Nu a tr ca bn ang chng mt bnh truyn nhim, cn
st km theo l mt hng n ch khng phi l iu than
trchNhit c th tng cao n thun l du hiu cho ta thy
qu trnh t cha lnh ang c tng cng. l iu m ta
phi vui mng ch khng phi l s hi
Bc s nhn dn Robert Mendelsohn, trch sch Lm th no pht
trin mt a tr khe mnh bt chp bc s ca bn
8

DNG PARACETAMOL BA BI
DS. Xun Ngc
(Ngun Suckhoedoisong)
iu khng ghi trong t hng dn dng thuc:
c hi ca paracetamol: Paracetamol b N-hydroxyl ho do cytochrom P450 to ra. Nacetylbenzoquinonimin l cht c gy hoi t gan khng hi phc. Nh c glutathion ca
gan chuyn ha N-acetylbenzoquinonimin thnh cht khng c o thi ra ngoi. Do ,
mi ln ung paracetamol (d liu thng thng) c th s mt mt lng glutathion
bng 4% trong lng paracetamol dng. Khi ung qu liu paracetamol (ngi ln 610g/24 gi) gan khng lng glutathion gii c. -N-acetylbenzoquinonimin tch li
s phn hy t bo gan, dn n hoi t khng hi phc, Nhim toan chuyn ha (axit ha
mi trng ni mi), hn m ri t vong (nh vy paracetamol dng ng ung nguy hi
hn tim v t hu mn).
Qu nhiu tn bit dc cha paracetamol
Cc nh bo ch phi hp paracetamol vi nhiu dc cht khc to ra hng trm bit
dc. Nu khng c xem nhn hp thuc th nhiu khi n c bc s, dc s cng
khng on c. - Bit dc ch cha paracetamol c tn t A - Z: acephen, babifever,
B nng, camol, dafalgan, decolgen ace, efferalgan, larylin, mexcol, panadol, servigesic,
temol, vadol, zumol,.
- Bit dc phi hp vi cc dc cht khc t 2 - 7 thnh phn c hng trm tn khc
nhau. ng lu l: nhng bit dc c thnh phn phenobarbital (cht tng tc xu lm
tng c tnh ca paracetamol vi gan) nh thn kinh D3, thn kinh s II, setal, frebital.
Nhng bit dc cha phenylpropanolamin, pseudoephedrin, phenylephrin (khng nn
dng cho ngi c bnh cng gip, tng huyt p, au tht ngc, huyt khi, mch vnh,
i tho ng, tin s tai bin mch mu no).
Qu nhiu dng bo ch
Theo ng dng thuc: thuc tim, thuc ung, ta dc (thuc n) vi nhiu hm
lng khc nhau.
Gia nh hoc ngi bnh t dng thuc
Cc bit dc cha paracetamol c khong 90% l thuc mua khng cn n bc s
(OTC). V vy, vic s dng qu liu paracetamol do trng lp cc dng thuc khc nhau,
tn bit dc khc nhau, cho mt ngi bnh c au nhc hoc st lu l iu d xy ra,
nht l vi nhng bnh nhi. http://doisong.vnexpress.net/tin-tuc/suc-khoe/be-tu-vong-chame-kien-benh-vien-khong-som-tim-ra-benh-2277373.html
Tai nn ph bin hn c l vic t dng cc bit dc cha paracetamol cha cm,
cm, ho. Vi ngi bnh ch c ht hi s mi, nc mi chy rng rng (c th do cm
9

lnh, do vim mi d ng), ngi ta li ung decolgen forte vi liu 1-2 vin/ln x 3 hoc
4 ln/ngy. Nh vy, ngi dng thuc phi chu tc hi ca mt cht khng cn thit l
1.500 - 4.000mg paracetamol/ngy, rt hi gan v c th mt oan mt lng t 60 - 160mg
glutathion qu gi (cht to sc khng v chng xy ha trong c th).
Thy thuc ch nh v ti v v khng hng dn y
Vi ngi bnh st cao hay au nhc dai dng, thy thuc thng cho liu cao hoc dng
paracetamol nhiu ngy, nhng thng khng quan tm trc bnh nhn dng thuc
c cha paracetamol hoc cc loi thuc tng tc c hi vi paracetamol (nh
phenobarbital...) cng dn n ng c. Ti n thm bnh nhn iu tr nhiu bnh
vin thy bnh nhn ht st cao 2 ngy (xem bng theo di u ging bnh nhn
ghi: 37,5oC v 38oC), khng au nhc m bnh nhn vn c pht efferangan codein.
C l cng l mt nguyn nhn gp phn lm gia tng s bnh nhn suy gan, bnh nhn
t vong do st xut huyt mi ngy mt tng (c trng hp men gan cao, tiu cu gim
m vn c pht thuc ung c cha paracetamol). Thiu st ph bin l bc s cp n
cho ngi c th bo him y t thng km theo 10-20 vin paracetamol 500mg vi cc
thuc cha bnh khc trong khi ngi bnh khng au nhc, khng st cao, n thuc vn
ghi: ngy ung 2-3 ln x 1-2 vin. Do , phn ln ngi bnh c theo n m ung n
ht thuc c cp, d khng st, khng au. Hu qu l va lng ph thuc, va gy suy
gim sc khe ngi bnh.

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