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Ging vin bin son :

TS. NGUYN NH PHO
ThS. V TH TR AN
2003
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NI DUNG
Trang
CHNG 1. M U 3
V Th Tr An
CHNG 2. THUC TC NG LN H THN KINH 9
Nguyn Nh Pho
CHNG 3. THUC KHNG KHUN 20
V Th Tr An
CHNG 4. THUC ST TRNG, KH TRNG 38
V Th Tr An
CHNG 5. THUC TR K SINH TRNG 42
V Th Tr An
CHNG 6. THUC KHNG VIM V KHNG HISTAMIN 50
V Th Tr An
CHNG 7. THUC TC NG LN H MU 54
V Th Tr An
CHNG 8. THUC TC NG LN H H HP, TIU HA 60
V Th Tr An
CHNG 9. THUC TC NG LN H SINH DC TIT NIU 64
V Th Tr An
TI LIU THAM KHO 67
CHNG 1: I CNG
I. Gii thiu mn hc:

Cc khi nim
- Dc l hc (Pharmacology) l mn hc nghin cu v nguyn l v nhng qui lut tc
dng ln nhau gia thuc v c th sinh vt trong chia thnh hai phn:
- Dc ng hc (Pharmacokinetics) nghin cu v tc ng ca c th i vi thuc hay

nghin cu v s phn ca thuc trong c th qua cc qu trnh hp thu, phn b chuyn ha
v o thi.
- Dc lc hc (Pharmacodynamics) nghin cu v tc ng ca thuc i vi c th v mt

tnh cht cng v thi gian.
- Thuc l nhng cht (c ngun gc t nhin, tng hp hay bn tng hp) khi c a vo
c th sinh vt s c tc ng lm thay i chc nng ca c th. S thay i ny c th l
hu ch nh trong iu tr hoc c th gy tc hi nh trong trng hp ng c. Do ranh
gii gia thc n, thuc v cht c thng khng r rt, ph thuc nhiu yu t trong liu
lng l quan trng
II. Dc ng hc
2.1. S hp thu: l qu trnh dc phm thm nhp vo ni mi trng
2.1.1. Cc phng cch vn chuyn
2.1.1.1.Vn chuyn th ng (khuych tn)
- Ch ph thuc tnh cht ha l ca mng v thuc
- Thun chiu gradien nng
- Khng tn nng lng
C 3 cch:
* Qua lp lipid ca mng: thung cc cht tan trong li pid, khng ion ha (khng phn cc)
d qua hn
* Qua l ca mng: ty thuc ng knh ca l v trng lng phn t ca thuc. ng
knh ny cng thay i ty tng m.
V d: d mao mch =40 A0
d ni khc = 4 A0
* Qua khe cc t bo: khong cch gia cc khe cng thay i ty m
V d: mch mu > rut > m thn kinh
2.1.1.2. Vn chuyn ch ng (tch cc)

- Cn c cht chuyn ch (cht mang)
- Vn chuyn ngc chiu gradien nng
- Cn cung cp nng lng
2.1.2. Cc ng cp thuc thng dng trong th y

2.1.2.1. ng ung (ng tiu ha, oral, per os, P.O)
Thuc c hp thu qua nim mc d dy, rut non
u im ca ng cp thuc ny l tin li, d thc hin v an ton nht.
Nhc im l s hp thu ph thuc nhiu yu t nh tnh trng ca d dy rut, thnh phn
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thc n. ng cp ny thuc c th b mt tc dng do pH thp ca dch v v cc
enzym tiu ha c th ph hy thuc. i vi gia sc, vic cung cp thuc bng ng ung
cn phi ch v liu lng v c th s khng cung cp c bit l trng hp trn vo
thc n, nc ung. Thm vo , ng cp ny khng nn s dng i vi cc thuc c
mi v kh chu, gy kch ng, cc thuc c tnh ion ha.
2.1.2.2. ng tim chch (ng ngoi tiu ha, parenteral)

Thuc khuch tn th ng do chnh lch nng , d mao mch ln nn nhiu phn t thuc
qua c.
u im ca ng cp ny l thuc c hp thu nhanh v nhanh c tc ng. Cp thuc
bng ng tim chch s gii quyt c nhng hn ch ca ng ung.
Hn ch ca ng tim chch l i hi iu kin v trng, ngi cp thuc phi c k thut.

Thuc dng cho ng tim chch thng t tin, km an ton v gy au.
* Tim di da (subcutaneous injection, S.C)

Thuc s c tc dng sau 30-60 pht, liu dng thng ch bng 1/3 liu ung
Nnb trnh dng ng ny cho ccthuc c tnh kch ng, gy xt.
* Tim bp (intramuscular, I.M)

Thuc c tc dng nhanh hn khong 10-30 pht, liu dng bng 1/2 liu ung
C th tim cc thuc m ng tim di da gy au xt.
* Tim tnh mch (intravenous, I.V)

y thuc khng phi c hp thu na m l thu nhp nhanh chng v ton vn
vo h tun hon chung, c tc dng sau 30 giy n 5 pht, liu cp bng 1/2-1/4 liu ung.
ng tim ny thng p dng cho cc trng hp cp cu hoc cn thuc c tc dng tc
thi.
Cn ht sc thn trng khi dng ng cp ny, lu s ng trng, tc cp thuc v

tuyt i khng s dng cc dung mi l cc cht du, cht khng tan.
* Tim phc m (intraperitoneal, I.P)

Vi b mt hp thu ln cng mng li mao mch pht trin ca phc m, thuc c
hp thu nhanh chng gn bng ng tim tnh mch. S dng ng cp ny cn ch trnh
gy vim nhim, thng rut, bng quang.
ng cp ny thng dng khi cn cp mt lng ln thuc trong thi gian ngn m ng

tim tnh mch kh thc hin.
* Tim trong da (intradermic I.D) thng gp trong cc th nghim lao t (tuberculin test)
hoc th d ng vi khng sinh
2.1.2.3. Cc ng cp thuc khc:

* ng thm qua mng nhy kh qun, cung phi, b m ph nang
Thng p dng cho cc thuc bay hi hoc d bay hi, kh dung. Thuc s c hp thu qua
din tch rng ln ca b my h hp v mng mao qun v h tun hon chung.
* ng trc trng (rectum mucosa)

Thuc s trnh c tc ng chuyn ha ti gan. C th dng cho cc thuc c mi v kh
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chu. Tuy nhin, ng cp ny ch p dng cho cc thuc khng b hy bi men penicillinase.
* ng bi ngoi da, t vo m o, t cung...
2.2. Phn b
Thuc vo h tun hon chung s c phn b ch yu n ni tc ng, t sinh
ra tc ng dc l. Mt phn b chuyn ha hay cn gi l bin i sinh hc, mt phn nh
n ni d tr v mt phn khc b thi ra ngoi. D c phn b u, thuc cng c th
nm dng t do hoc kt hp vi cc thnh phn khc ca m.
Vic phn b thuc mu ph thuc vo s v tr gn v i lc ca thuc vi protein. m,

s phn b ph thuc l ha tnh ca thuc, mc tun hon ti m v i lc ca thuc vi
m.
2.3. Chuyn ha (bin i sinh hc)

Ch yu do h microsomes ca gan m nhn, ngoi ra, cn c ti phi, thn, lch...
thng qua cc phn ng oxyha, kh, thy phn, tng hp c bit l phn ng lin hp vi
acid glucuronic to thnh nhng phn t ester c cc cao, tan trong nc, kh thm qua
mng t bo, khng cn hot tnh dc lc v d o thi ra ngoi.
2.4. Bi thi
Thuc c bi thi qua rut (theo phn), qua thn (theo nc tiu), qua phi (theo
hi th), qua cc tuyn tit (m hi, nc bt), qua sa...Trong quan trng nht l thn.
S bi thi thuc qua thn ph thuc 3 c ch:

- Lc qua cu thn, ph thuc lng thuc gn vo protein huyt thanh v tc lc ca cu
thn.
- Bi tit ch ng qua biu m ng thn.
- S ti hp thu t lng ng thn vo mu theo s khuch tn th ng. Do pH nc tiu
nh hng n ti hp thu. iu ny c ng dng trong vic gii c trn nguyn tc l
tng cc dng ion ha ca thuc, lm thuc d tan trong nc t d thi ra ngoi.
V d: + Ng c cc cht kim yu (Amphetamin, quinidin...) dng NH4Cl acid ha nc

tiu.
+ Ng c cc cht acid yu (Streptomycin...) dng NaHCO3 kim ha nc tiu.
Tm li:
- Cc cht tan trong nc c bi thi ch yu qua ng tiu
- Cc cht khng tan trong nc c bi thi ch yu qua phn.
- Cc cht kh, d bay hi c bi thi ch yu qua ng h hp.
- Cc kim loi nng (As, Hg...) c bi thi ch yu qua da, m hi.
III. Dc lc hc
3.1. Receptor (ni tip nhn, im ch)
L bt c thnh phn no ca t bo, kt hp vi thuc v khi u mt chui cc hin
tng sinh ha dn n cc tc ng dc lc.
V bn cht ha hc, receptor l cc i phn t sinh hc nh acid nucleic, lipid mng t bo

nhng hu ht chng c bn cht protein.
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Lin kt gia receptor vi thuc l cc lin kt ion, hydro, k nc, vanderwal v lin kt
cng ha tr.
3.2. Cc cch tc dng ca thuc

- Tc dng ti ch: l tc dng xut hin ngay ni ta cung cp thuc
V d: st trng da: dit vi khun ti ch
- Tc dng phn x: tc dng dc l c c thng qua s dn truyn kch thch t ni cung
cp thuc n c quan khc qua h thn kinh trung ng
V d: ngi amoniac: kch thch tun hon, h hp
- Tc dng chn lc: l tc dng ring, c hiu i vi 1 hoc 1 s c quan
V d: digitalin (Coramin) c tc dng u tin trn tim
- Tc dng trc tip v gin tip: tc dng gin tip l hu qu ca tc dng trc tip
V d: Tc dng trc tip ca cafein l tng cng tun hon, tc dng gin tip l gy li tiu
- Tc dng chnh v tc dng ph: tc dng chnh l mc ch cn t ca iu tr, tc dng
ph l tc dng khng mong mun, c khi cn gy c cho c th. Do , cc nh iu ch
dc phm lc no cng c gng hn ch hoc loi b hon ton tc dng ph ca thuc
V d: tc dng chnh ca chloramphenicol l tiu dit vi khun gy bnh, tc dng ph l gy
suy ty, thiu mu v to.
3.3. Tng tc gia hai dc phm (thuc)

3.3.1. Hip lc:
Dc phm A gi l hip lc vi dc phm B khi A lm tng hot tnh ca B v 3 phng
din: thu ngn tim thi, tng cng tc ng, tng thi gian tc ng.
ngha trong iu tr:
- Phi hp thuc lm tng hot tnh m khng lm tng c tnh.
- Trnh hin tng khng thuc.
3.3.2. i khng
Hai dc phm i khng nhau khi hot tnh ca mt trong hai dc phm lm gim hay tiu
hy hot tnh dc phm kia.
ngha trong iu tr:
- Trnh phi hp hai dc phm i khng dn n lm gim hiu lc thuc.
- Gii c trong trng hp ng c.
IV. Nhng yu t nh hng n tc dng ca dc phm

4.1. Cc yu t bn trong c th
- Tui tc
gia sc non, h thng chuyn ha v bi thi thuc cha hon chnh, trong khi gia sc gi
chc nng ca cc c quan trn b gim nn khi dng thuc cho cc i tng trn cn phi
thn trng.
- Trng lng: cn c vo trng lng hoc din tch b mt c th tnh liu lng thuc
cn cp.
-Phi tnh: mc nhy cm vi thuc ca th c v th ci c th khc nhau
V d: con ci nhy cm vi thuc ng, strychnin hn con c
- Cch dng thuc: lin quan n hin tng quen thuc, l thuc thuc, khng thuc
- iu kin dinh dng: trong thc n, protein c bit lin quan n hin tng gn kt thuc
cng nh cc enzym chuyn ha thuc
- Tnh trng bnh l: c bit l cc bnh v gan thn
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4.2. Yu t ngoi c th (lin quan n thuc)
- Cu trc ha hc: 1 thay i (d rt nh) v cu to ha hc ca dc phm cng nh hng
n tc dng ca dc phm . iu ny m ra cc kh nng rng ln cho cc nh khoa hc
ch to ra cc thuc mi.
V d: PABA yu t sinh trng ca vi khun
Sulfonamid: thuc chng vi khun
- Tnh cht vt l: c lin quan n

. ha tan trong nc v trong lipid thuc c hp thu vo trong c th
. bc hi: i vi cc loi thuc m bay hi
. Dng bo ch: bt, nc, dung dch treo...
- Liu dng v nng

. Liu ti thiu c tc dng (liu ngng): lng thuc cho vo c th bt u c tc dng
. Liu iu tr (thng cao hn liu ngng): c s dng lm sng nhm mc ch khi
phc chc nng bnh thng ca c th v gy ri lon bnh l
. Liu gy c (cao hn liu iu tr): liu bt u c nhng bnh l c hi
. Liu gy cht (LD50) gy cht 50% ng vt th nghim.
- Nhp cung cp thuc: ph thuc vo thi gian bn hy (T1/2) ca thuc

T1/2 l thi gian cn thit nng thuc trong huyt tng gim i mt na
Nhp cung cp thuc (khong cch gia cc ln s dng)
.3-4 ln / ngy nu T1/2 t vi pht - 4 gi
.2 ln /ngy nu T1/2 t 4 gi - 10 gi
1 ln/ ngy nu T1/2 t trn 12 gi
V. Thng tin v mt loi thuc

Mt s vn cn c ch nh sau:
5.1. Tn thuc
Mt bit dc thng c 3 tn ch yu sau
- Tn khoa hc (chemical name): c gi theo cu to ha hc ca bit dc . Tn ny c
khi khng c ghi trn nhn thuc.
- Tn hot cht (generic name): cn gi l tn chung, c gi theo qui nh chung ca quc

t. Tn ny cho ta bit hot tnh dc lc cho nn cn phi nm vng. C th tm thy tn
hot cht mc thnh phn (composition).
- Tn thng mi (brand name): cn gi l bit dc. Tn ny thay i ty theo cch t ca

tng hng sn xut dc phm. Tn ny c s dng trn th trng.
V d 1: Tn khoa hc: ortho- acetobenzoic acid
Tn hot cht: Aspirin (U.S.P) hay Acetylsalicylic acid (B.P)
Tn thng mi: Aspan pH 8 (SANOFI)
V d 2: Tn khoa hc: naphthacenecarboxamide
Tn hot cht: oxytetracyclin
Tn thng mi: Terramycin (PFIZER)
5.2. Ch nh v chng ch nh (indications v contraindications).

- Ch nh: s dng thuc trong trng hp no?, bnh g ?
- Chng ch nh: khng c php s dng thuc trong nhng trng hp c th nhm
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phng c tnh v cc tai bin khi dng thuc
Ngoi ra c th c phn thn trng khi dng thuc (precaution)
5.3. Liu lng v ng cung cp (Dosage v Administration)

Liu lng s thay i ty theo ng cp thuc, loi gia sc v mc ch s dng
5.4. Dng trnh by (Presention)

Lin quan n ng cp thuc:
- Bt trn vo thc n (Feed additive), nc ung (drinking water)
- Vin ung (tablet)
- Siro ung (syrup)
- Kem n (cream)
- Bt pha tim (powder for injection)
- Dung dch tim (solution for injection)
- Dung dch xt (spray)...
5.5. Bo qun (storage)

Qui nh phng cch bo qun nhm trnh lm h hng cc hot cht trong bit dc
5.6. Hn dng (expiration date)

Cho bit thi hn ti a c th dng thuc
5.7. Thi gian ngng thuc (Withholding periods)

Trong th y, ngi s dng thuc cn cn ch n thi gian ngng thuc trc khi git m
(i vi heo tht, b tht, g tht...), trc khi s dng cc sc sn (sa, mt ong, trng g...)
m bo vn an ton thc phm.
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CHNG 2
THUC TC DNG TRN H THN KINH
1. THUC C CH H THN KINH TRUNG NG
1.1. THUC M: (GENERAL ANESTHETICS)

nh ngha:
Thuc m l cht khi cp vo c th s tc ng ln h thn kinh trung ng sinh ra trng thi
ng, u tin l s mt thc v cm gic, k n l s gin ngh hon ton ca c vn,
nhng khng lm xo trn cc hot ng ca h tun hon v h hp.
ngha ca vic dng thuc m :

Dng trong phu thut
Dng chng shock, co git
Dng trong gy ng, gim au
S la chn thuc m cho cc loi gia sc :

Tru b: Ketamine
Ch mo: Zoletil, Ketamine, Barbital sodium
Heo: Pentobarbital, Thiopental sodium
Nga: Ketamine
Cc giai on xy ra trong lc gy m
Giai on 1: Hng phn ty .
Co git
Nhp tim nhanh, mnh
H hp nhanh, su
Mng mt dn
Tit nhiu nc bt
C th tiu, tiu tin
Giai on 2: Hng phn khng ty

Bt u vi s suy yu ca trung tm v no, th mt dn thc vi cc biu hin sau :
Pht ting ku trong hng
Bn chn c ng kiu nga phi
H hp su v chm
M mt m rng, ng t dn
C th i ma ( ch) nu khng cho nhn n 6 gi trc khi gy m
Cn phn x chn (chn co rt khi kch thch au)
Giai on 3: M gii phu

Giai on ny tc dng ca thuc m lan rng t v no, trung no, n ty sng; thc, cm
gic au v phn x ty sng bin mt. Cc c dn v khng cn chuyn ng.
Phn x chn
Phn x gic mc cn, ng t co rt li
H hp tr nn chm v u n
Nhp tim v huyt p bnh thng
M su
t c dng trong th y. S dng qu liu thuc m s dn ti m su.
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H hp u nhng chm
C hon ton dn, th mm nhn
Phn v nc tiu bi thi ra ngoi
Mt phn x m mt
Nhit c th gim, th run v co mch
Giai on 4: T lit hnh ty

Cc trung tm iu ho s sng ca hnh tub t lit. H hp ngng. Tim p rt yu, ri
ngng c vng hu mn v bng quang dn hon ton.
Nhng tai bin lc gy m v cch phng

Chy nc bt, nn ma:
Cho th nhn i ti thiu 12 gi trc phu thut
Tim Atropin lm gim tit nc bt
Shock: vi c im tt huyt p, th dy da do tu sng b c ch.
Can thip: Tng huyt p bng cch truyn mu, truyn dch, dng cc loi thuc kch thch
thn kinh nh: Nikethamide, Amphetamin, Cafein, Camphorate
H thn nhit. Cn gi m th lc gy m (Dng n hng ngoi si m.
Cc loi thuc m dng trong th y:
BARBITURATES
L cht chuyn ho ca acid barbituric, bao gm nhiu loi thuc c tc dng gy m di hoc
ngn.
Phenobarbital sodium di
Barbital sodium di
Amobarbital sodium trung bnh
Pentobarbital sodium ngn
Secobarbital sodium ngn
Thiopental sodium rt ngn
Thiamalyl sodium rt ngn
Thialbarbitone sodium rt ngn
c tnh ca barbiturates:
Tim qu nhanh, hoc qu liu
Try h hp, phi cp cu bng th oxy
huyt no, mng no.
Suy gan trn cc th b bnh gan khi dng nhm barbiturates tc ng ngn
Khng dng cho th s sanh do khong an ton hp, v thi gian tc ng ko di
Liu lng v cch s dng:
Pentobarbital sodium:
Chng co git, lm m du trn i gia sc:
0,6 1,2 g / con, tim tnh mch
Lm m du trn heo: 20 mg / kg th trng
Tiu gii phu trn heo: 2 4 mg / kg th trng, tim tnh mch, sau gy t vng gii phu
Thiopental sodium:
Liu gy m cho tiu gia sc: 20 35 mg / kg, tim tnh mch
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Liu gy m cho i gia sc: 10 15 mg / kg, tim tnh mch
Thiabarbitone sodium:
Liu gy m cho , mo : 72 88 mg / kg, tim tnh mch
Liu gy m cho nga : 22 33 mg / kg, tim tnh mch. Nu cha m su c th tng n 44
mg / kg, nhng phi tim tht chm.
CHLORAL HYDRATE
p dng lm sng
Lm thuc ng cho th ln
Lm thuc tin m
Gy m cho gia sc
Liu dng :
Ung: vi mc ch an thn
Nga, b: 25 45 g
Heo: 2 4 g
Ch: 0,3 1 g
Mo: 120 600 mg
Tim tnh mch vi mc ch gy m: 6 9 g / i gia sc
Tim tnh mch vi mc ch gy ng: t n 2/3 liu gy m
KETAMIN
Tc dng: gy m ngn, gim au,
Tc dng ph: Tng tit nc bt do cn dng Atropin lm cht tin m (1 mg/10 kg th
trng).
Ri lon tm thn (phng nga bng Diazepam)
Tng nh nhp tim v tng huyt p
Liu dng : tim tnh mch 2 5 mg / kg th trng liu u
Liu duy tr bng liu u, cch nhau 8 10 pht. Thuc dng cho cc loi gia sc.
ZOLETIL
Thuc m dng cho tiu gia sc (Ch mo)
Tin m bng Atropin liu 1 mg / 10 kg th trng
Sau 10 pht chch Zoletil
Liu dng : Ch : 725 mg/kg th trng (tim bp), 510 mg/kg th trng (tim tnh mch)
Mo : 1015 mg/kg th trng (tim bp), 7,5 mg/kg th trng (tim tnh mch)
1.2. THUC AN THN THUC NG V CHNG CO GIT
Dng liu cao s gy ng, cao hn na chng co git
Barbiturates: c tc dng trn an thn kinh v gy ng nu dng liu thp. Thuc thng dng
l Phenobarbitone : ch ln 90 mg / ln, ngy 3 ln ; ch nh : 30 mg / ln, ngy 3 ln
Bromides:
Dng cho ch vi mc ch trn an thn kinh, chng co git ch, liu dng : 0,3 1 g / ln
(ung)
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Chlorbutol:
Dng cho ch : 0,13 0,6 g / con / ln. Cho ung.
Chlorpromazine:
Liu ung : 1 2 mg / kg th trng , 2 4 ln / ngy
Tim bp : 0,5 1 mg / kg th trng , 2 4 ln / ngy
Tim tnh mch : 0,5 mg / kg th trng , 2 4 ln / ngy
Bnh Colic nga : 1,5 mg / kg th trng tim bp
Diazepam:
Thuc tim : 2 ml = 10 mg
Liu dng tim bp : 0,2 mg / kg th trng
Acepromazine:
Dng ung : dng cho ch, mo
Liu dng : 1 3 mg / kg th trng
Dng chch : Komisirastress
Liu dng : 0,05 0,1 mg / kg th trng
1.3. THUC GIM AU - H ST - CHNG VIM:
C tc dng lm gim nhit c th, thng qua s tng thi nhit, c ch sinh nhit, v c
tc dng gim au trung bnh.
Tc dng tng thi nhit bao gm :
Dn mch mu ngoi bin
Gia tng bi tit m hi
Gia tng tc h hp
Gim sinh nhit do tc ng c ch hot ng trung khu sinh nhit h tng th gic, hoc
gim tc oxy ho cc m
1.3.1. Salicylates: gm Sodium Salicylic v Aspirin

Sodium Salicylic:
Nga, b: 15 - 120 g / con / ln
Cu, heo: 1 - 4 g / con / ln
Ch: 0,3 - 1 g / con / ln
Mo: 3 - 30 mg / con / ln
Aspirin:
Tc dng : c ch men Cyclo-oxygenase, lm gim tng hp Prostaglandin, do c tc dng
h st, gim au v chng vim.
Liu dng
Ch: 0,3 - 1 g / con / ln
Mo: 0,1 - 0,3 / con / ln
Ngy ung 3 ln
1.3.2. Paracetamol:
L cht chuyn ho ca Phenacetine
C tc dng gim au, h st rt tt, tuy nhin khng c tc dng chng vim
Trn gia sc hiu qu ca paracetamol khc nhau
Tc dng tt trn gia cm, t tc dng trn heo, i gia sc
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c trung bnh trn ch, rt c trn mo
Liu dng: Ung : 10 mg / kg th trng, ngy 3 ln.
Chch bp: 7 - 8 mg / kg th trng, ngy 2 ln
Chng ch nh: Mo, ch
1.3.3. Phenylbutazone:
Tc dng h st , gim au, v chng vim. Tuy nhin tc dng h st chm, tc dng chng
vim yu hn Aspirin
Tc dng ph: bun nn, au bng, to bn, chong nh.
Liu dng: (ng chch bp)
15 mg / kg th trng, ngy 2 - 3 ln
1.3.4. Codein phosphate:

Tc dng gim au yu hn Morphin, nhng mnh hn cc thuc gim au h st khc
Codein cn c dng lm gim ho
Tc dng ph: Gy to bn, c ch h hp.
Dng lu c th gy nghin.
Khng dng cho trng hp ho c nhiu m v gy tch m ph qun.
Liu dng: (cho ung) 0.3 -0.6 mg /kg th trng. Ngy 3 ln.
2. THUC KCH THCH H THN KINH TRUNG NG
2.1. NIKETHAMIDE. (CORAMIN)

Tc dng:
Trn h thn kinh:
- Kch thch trung khu h hp.
- Kch thch trung khu vn mch
T c tc dng tng huyt p, ci thin huyt p khi tt huyt p. Thuc c dng trong
nhng ca suy h hp. Do thn kinh trung ng b c ch qa .
Liu dng:
Nga , tru ,b: 2.5-6 g / con
Ch: 0.25-0.75 g / con.
Mo: 0.25-0.5 g / con.
ng cp thuc: ung hoc tim di da.
2.2. AMPHETAMINE SUPHATE

Tc dng: Tng huyt p.
Kch thch trung khu h hp lm th nhanh, su.
p dng lm sng : tru h hp, tt huyt p.
Liu dng: (tim di da)
Nga , b: 1000-300 mg /con.
Tiu gia sc: 1.1-4.4 mg /kg th trng.
2.3. CAFEIN
L cht kch thch h thn kinh trung ng, tc dng mnh trn trung khu vn ng lm gia
tng trng lc c, v cc vng nhn cm ti v no, trung khu h hp, trung khu vn mch
v thn kinh vagus.
p dng lm sng.
13
Kch thch tng cng v tn s tim, c th phi hp vi digitalis, hoc strychnin.
Kch thch c trong trng hp c yu.
Lm hi tnh hot ng no.
Li tiu trong bnh ph thn, gan do suy tim.
Liu dng : ung hoc chch di da 1-2 ln/ngy.
Tru ,b: 1-4 g/con /ln
Heo: 0.3-1.5 g /con /ln.
Ch: 50-250 mg con /ln.
Nga: 0.5 g /con /ln.
Chng ch nh:
- Trong trng hp cao huyt p
- Bnh vim thn cp trong cao huyt p.
- Cn thn khi dng trn nga c mang.
2.4. STRYCHNINE
Tc dng: c ch men acetylcholinesterase , ngn phn gii acetylcholine - gy nn s tch t
acetylcholine trn b mt neuron lm tng trng lc c trn ,c vn.
V ng ca strychnine: gia tng bi tit dch tiu ha, tng trng lc d dy, kch thch nhu
ng rut.
p dng lm sng:
- Tr thn kinh, nh ci thin cc phn x v gia tng nhng phn ng thn kinh.
- Tr sc , kch thch tiu ha, ngon ming trong cc trng hp bnh ang trong giai n
phc hi.
Liu dng:
Gia sc Ung / con / ln Tim di da/ngy.

B
Heo, d cu
Ch
Mo
Nga 150 mg
5 mg
1 mg
0,5 mg
100 mg 150 mg
5 mg
1 mg
0,5 mg
100 mg
Ng c strychnine:
Co git do phn x , c thi k yn ngh, s ng chm , ting ng, s gy co git tr li.
Th cht do ngt th v co c ph qun.
iu tr ng c:
- Tim tnh mch Barbiturate i vi th nh
- Cho ung hoc tim tnh mch Chloralhydrate
14
2.5. CAMPHORE
Tc dng :
- Kch thch h thn kinh trung ng
- Tng hot ng tim, tng huyt p
- Tng hot ng h hp
S tng hot ng tim, tng huyt p xy ra nh tc dng lm tng tm thu, phc hi nhp tim,
do Camphor c dng lm thuc phc hi hot ng tim lc tim b nhim c cp, ng
c thc n
ng dng lm sng:
Kch thch ton thn trong trng hp h thn kinh trung ng b c ch lm gim h hp, ri
lon tun hon do trng c hoc nhim trng
Tng cng hot ng tim khi tim b suy yu lc m, phng h huyt p t ngt
Lu : khng dng cho gia sc sp m tht, v lm tht c mi long no
Liu dng : (chch di da)
Gia sc Du long no
20% Dung dch long no 10%
Nga, tru b
Heo, d cu
Ch 40 ml
6 ml
2 ml 100 ml
20 ml
6 ml
3. THUC TC NG TRN DY THN KINH NGOI BIN

(THUC T - LOCAL ANESTHETICS)
3.1. nh ngha :
Thuc t l nhng dc phm c th tm thi lm gim hoc mt cm gic ni tip xc.
c bit l cm gic au do hy b tnh cm ng v tnh dn truyn ca thn kinh hay cc dy
tn cng ca thn kinh.
3.2. Cc phng php gy t:

T b mt : lm mt cm gic do chm tn cng ca dy thn kinh cm gic b t lit.
Phng php ny c p dng rng ri khi gy t mng nhy mt, mi, ming, da b try
st. Khng tc dng trn da nguyn vn v biu b sng ha, thuc t khng th thm vo
T thm : tim nhiu ln,cc th tch nh vo m. Thuc khuych tn chung quanh ni chch
lm t chm tn cng ca dy thn kinh.
Gy t mng cng hoc ngoi mng cng ty sng
(Epidural Etraduran anesthesia)
Bm thuc vo trong khong trng mng cng ca pha sau ty sng (gia cc xng ct).
Thuc tc dng ln dy thn kinh ty sng pha sau, trc khi dy ny ra khi ct ty sng v
phn chia khp c th.
3.3. C ch tc ng:
S truyn xung ng thn kinh l do s gia tng t ngt kh nng thm thu ca mng t bo
thn kinh vi nhng ion K trong t bo vi ion Na ngoi t bo. S khuych tn ny gy nn
15
s thay i in th gia bn trong v bn ngoi mng t bo, lm in th m lan rng nhanh
chng dc theo dy thn kinh khi xung ng lan truyn
Thuc t khi vo m c tnh kim nh, s b thy gii chm, phng thch base alkaloid, tc
dng gim kh nng thm thu ca mng t bo thn kinh, s thay i in th mng b ngn
chn.
3.4. Cc loi thuc t:

Cocain hydrochloride:
Nh mt nga, ch chun b khm mt hoc gii phu. Dng dung dch 3 5 % nh
thng vo mt, 2 5 git.
Gy t mng nhy mi, thanh qun, khoang ming th ln hoc th nh bng cch nh
mi, bm vo ming
Khng dng gy t thm hoc mng cng ty sng
Procain hydrochloride:
c s dng rng ri do c tnh thp, hiu qu tc th
Tuy nhin thi gian gy t ngn do cn kt hp vi cc thuc co mch, hoc thuc tr hon
hp thu ko di thi gian gy t nh Adrenaline.
Chuyn ha: xy ra gan, procain b thy gii thnh PABA v diethylamino etanol.
c tnh: xy ra khi tim tnh mch tc nhanh.
Liu 44 mg / kg th trng gy cht mo nu tim nhanh (trng hp tim chm liu gy cht
ln n 440 mg / kg) do lm h huyt p.
p dng lm sng:
Gy t thm gii phu ngoi bin, thin th c
Nng 2% dng trn th nh
Nng 4% dng trn th ln
t dng gy t b mt do hiu qu km hn cocaine, butacaine.
Dng gy t mng cng ty sng, dung dch 2%.
Lindocaine:
Vi cng nng thuc c tc dng nhanh v mnh hn 2 ln so vi Procaine.
Gy t ti ch: dung dch 0,5% th nh; 1% th ln.
Gy t mng cng ty sng: 1 2% th nh
2 3% th ln
(Nn dng chung vi dung dch Adrenaline 1/100.000 ko di thi gian gy t)
c tnh: tim qu nhiu m khng kt hp vi Adrenaline thuc hp thu qu nhanh lm suy
yu h thn kinh trung ng gy bun ng, c th gy co rt c, h huyt p, i ma.
Tetracaine:
Tc dng gy t mnh hn Procaine
Cch dng :
Gy t mt : 0,5% th nh, 1% th ln.
Gy t b mt mng nhy : 2%
Gy t thm : 1% cho th nh, 2% th ln.
Butacaine:
Ch dng gy t b mt do c tnh cao.
Cch dng : gy t b mt nim mc mt, mi, ming, cung hng : dung dch 2% cho th
nh, 4 5% cho th ln.
16
4. THUC TC DNG LN H THN KINH T TR
4.1. Tng quan v h thn kinh t tr:

Phn loi : h thn kinh t tr c chia lm 2 nhm :
Nhm ph giao cm
Nhm giao cm
Thn kinh ph giao cm : xut pht t trung no, hnh ty, xng cng ct sng. Dy thn
kinh Vagus l dy ph giao cm chnh ca c th.
Thn kinh giao cm : xut pht t min ngc, thc lng ca ct sng
Nhm ph giao cm v giao cm sau khi xut pht u phn chia v i n tn cc c quan,
nhm iu khin s hot ng ca tt c cc c quan trong c th. Hai nhm ny thng c
tc dng i nghch nhau nhm gi cho cc c quan hot ng trng thi cn bng.
Th d: kch thch h giao cm : tim p nhanh
kch thch h ph giao cm : tim p chm
Cht trung gian ho hc:
H giao cm : Adrenaline v Noradrenaline, hj cm ng vi n c gi l Adrenergic
H ph giao cm : Acetylcholine, h cm ng gi l cholinergic
4.2. Thuc kch thch dy thn kinh giao cm

Adrenaline
Tc dng ln tim mch : tim p nhanh , co bp mnh, cung lng mu tng, tng huyt p.
Co mch mu ngoi bin nhng dn mch ni tng.
Tc dng ln h hp : dn kh qun (cha hen suyn), gy co mch mu nim mc kh qun
Tc dng ln tiu ha : gim nhu ng rut.
Tc dng ln s chuym ha : tng nng glucose huyt.
c tnh gy tng nhp tim, tng huyt p d dn ti cc tai bin tim mch.
Gy hoi t ch tim. Nu dng dung dch nng 1/1.000 do co mch ko di ti vng tim.
p dng lm sng:
Trong gy t : ko di thi gian gy t do tc dng co mch, thng phi hp vi thuc t
theo t l 9 phn thuc t vi 1 phn dung dch adrenalin 1/10.000 trong trng hp gy t
thm.
Cm mu ti ch : phun vo mng nhy mi hoc m nng 1/20.000 cho th nh,
1/10.000 cho th ln
Chng shock trong phn ng qu mn tc khc
Chch di da nng 1/1.000 : 0,5 ml / heo con
Chng ngng tim : nng 1/1.000 chch thng vo tim : t 0,5 1 ml / th.
Liu dng :
Tim di da, tim bp (dung dch 1/10.000)
Nga, b : 20 80 ml
Cu, heo : 10 30 ml
Ch, mo : 1 5 ml
Tim tnh mch (dung dch 1/10.000)
Liu cp t 1/5 n liu chch bp
4.3. Thuc lit giao cm:

L thuc c tc dng phong b hiu qu ca giy thn kinh giao cm, hay ni cch khc l
phong b tc ng kiu adrenaline
17
Tc dng : dn mch - h huyt p.
Cc loi thuc lit giao cm t c ng dng trong th y
4.4. Thuc kch thch ph giao cm:
CARBACHOL:
Tc dng:
Trn d dy - rut : tng nhu ng rut, tng trng lc d dy (dng cho th nhai li trong
bnh lit d c)
Kch thch tng bi thi nc bt
Trn t cung: co bp c t cung, tng sn dch (khng dng trn th mang thai)
Trn c ph qun: co c, lm gim ng thng kh
ng dng lm sng: (tim di da)

Tr colic (au bng do nghn rut, lit rut hoc chng hi (Tympany) hoc au bng do
nghn manh trng - kt trng.
Dng liu nh 1 - 2 mg, c 30 pht lp li, sau khi cho ung thuc x
Tr lit d c:
Dng 1 liu duy nht 4 mg / 500 kg th trng, c th gy c do nn chia lm 2 ln trong
30 - 60 pht.
Tng sn dch bnh vim t cung heo
2 mg / ni / ln, chch di da
Gy i ma ch trong tng hp n phi cht c
0,25 - 1 ml dung dch 1%
PILOCARPIN NITRATE:
Tc dng:
Kch thch bi tit nc bt, m hi
Kch thch tng trng lc d dy - rut
Dng tr bnh chung hi, khng tiu, lit d c, tt d l sch.
Liu dng: tim di da

Nga: 100 - 200 mg
B: 200 - 400 mg
Kch thch nhai li , hi : 50 - 60 mg
Heo: 2 - 50 mg
Ch: 5 - 20 mg
Mo: 1 - 3 mg
c tnh:
Gy kh th do co c kh qun
Gy ngng tim
Tiu chy - au bng d di
Gii c bng thuc i khng Atropin cho tng liu nh.
4.5. Thuc lit ph giao cm:

Thuc lit ph giao cm c tc dng ngn Acetylcholin pht sinh hiu qu trn nhng c quan
c dy hu hch phn b n.
Atropin sulphate:
Tc dng: ngn cn tng tc ca acetylcholin v ni tip thu trn t bo hiu ng.
18
Trn h thn kinh : kch thch nh h hp do tc ng nh ln h thn kinh trung ng
Trn tim mch : Liu iu tr thng thng khng nh hng n tim mch. Tuy nhin trong
trng hp tim b c ch do dy thn kinh Vagus b tc ng bi Ammoniac hoc
Chloroform , Nicotine Atropin c tc dng lm tng nhp tim do tc ng lm c ch dy
thn kinh Vagus.
Trn kh qun :
H ph giao cm c tc ng lm tng tit cht nhy, co rt c ph qun. Atropin phong b
xung ng thn kinh ph giao cm, do lm dn ph qun, gim s bi tit cht nhy, do
thng c s dng trong trng hp shock do dng thuc (gy co tht c ph qun)
Trn d dy - rut :
Atropin phong b hiu ng lm co tht c trn ca Acetylcholin, lm gim nhu ng rut,
chng co tht rut, do i khi c s dng trong trng hp au bng do co tht rut,
tiu chy qu nng gy mt nc
c tnh:
Triu chng ng c :
Kh ming, kht nc
Kh nut
To bn
Tim p nhanh, th nhanh - su
Ri lon vn ng
Run c
Co git
Suy yu h hp - cht.
Gii c Atropin:
Nu ng c qua ng ung : dng thuc gy i ma, kt hp ra d dy
Nu ng c qua ng tim di da : dng cc loi thuc tc ng kiu choline gii c
nh morphin chlohydrate tim di da gii c Atropin
p dng lm sng:
Cha ph phi gia sc
Gim co tht kh - ph qun trong shock hoc do d ng
Chng co tht c trn
c ch bi tit nc bt v cht nhy kh qun do thng c dng nh cht tin gy
m
Dng cha tr cc trng hp ng c :
Pilocarpin
Arecoline
Dipterex
Morphine
Chloroform
Cc loi thuc tr su, phospho hu c
Liu dng :
Tin gy m : 0,05 - 0,1mg / kg th trng , chch di da
c ch bi tit, chng co tht c trn v cc mc ch khc (chch di da)
Nga : 10 - 80 mg
Tru b : 30 - 100 mg
Heo : 10 - 30 mg
Ch : 1 mg
19
CHNG 3. THUC KHNG KHUN
1. KHI NIM
Vuillemin (1889) cp n t antibiosis vi ngha l s khng gia cc sinh
vt sng. Sau , vo nm 1942, Waksman nh ngha antibiotics l nhng cht c to
bi cc vi sinh vt, n chng li s pht trin hoc tiu dit cc vi sinh vt khc mt nng
nh.
Xt v mt t ng, antibiotics c ngha l khng sinh (anta = khng, bios = sinh vt).
ngha ny qu rng , c th bao gm c thuc st trng ng thi khng nu ln c tc
ng chuyn bit trn vi sinh vt gy bnh v tnh khng c cho c th sinh vt hu nh
liu iu tr.
Theo quan nim mi ngy nay, thuc khng sinh l tt c nhng cht ha hc, khng k
ngun gc (chit xut t mi trng nui cy vi sinh vt, bn tng hp hay tng hp) c kh
nng km hm s pht trin ca vi khun (bacteriostatic) hoc tiu dit vi khun (bactericidal)
bng cch tc ng chuyn bit trn mt giai on chuyn ha cn thit ca vi sinh vt.
Vi nh ngha ny, nhiu thuc trc y xp vo loi cht khng khun tng hp (nh
sulfamid, quinolone) by gi cng c xp vo loi khng sinh
2. PHN LOI
2.1. Theo cu trc ha hc

-Nhm beta-Lactam: penicillin, ampicillin, amoxicillin, cephalosporin...
-Nhm aminoglycosid: streptomycin, gentamicin, kanamycin, neomycin...
-Nhm polypeptid: colistin, bacitracin, polymyxin...
-Nhm tetracyclinee: tetracyclinee, oxytetracyclinee, chlotetracyclinee, doxycycline..
- Nhm phenicol: chloramphenicol, thamphenicol
- Nhm macrolide: erythromycin, spiramycin, tylosin...
- Nhm khng sinh gn gi vi macrolide: lincomycin, virginiamycin...
- Nhm sulfamid: sulfaguanidin, sulfacetamid, sulfamethoxazol...
- Nhm diaminopyrimidin: trimethoprim, diaveridin
- Nhm quinolonee: acid nalidixic, flumequin, norfloxacin...
- Nhm nitrofuran: nitrofurazol, furazolidon, furaltadon...
- Cc nhm khc: glycopeptid, pleuromutilin, polyether ionophore...
2.2. Theo c ch tc ng
2.2.1. Tc ng ln thnh t bo vi khun
Tt c cc t bo sng (vi khun v ng vt hu nh) u c mng t bo c cu trc
lipid phc tp, do u b tiu hy bi cht st trng. Nhng khc vi t bo ng vt hu
nh, t bo vi khun c p sut thm thu bn trong t bo cao hn nn chng cn c thnh t
bo bn ngoi mng t bo. Thnh t bo ny c cu to t cht peptidoglycan (= mucopeptid
= murein) gm nhiu dy polysaccharid thng dc v nhng on ngang pentapeptid.
Polysaccharid gm nhiu phn t ng mang amin: N-acetyl-glucosamine v N-acetyl-
muramic (ch c vi khun).
- Tin trnh hnh thnh thnh t bo bt u bng s chuyn i L. Alanin thnh D. Alanin.
Sau 2 D. Alanin kt hp vi nhau. Cycloserin c ch cnh tranh giai on ny, nn n tc
ng n c vi khun G+ v G-.
20
- Tip n D-alanin dipeptid ni vi 3 acid amin khc v 1 ng N-acetyl muramic acid
to thnh ng Pentapeptid. n lt n, n li cp i vi mt ng mang amin khc l
N- etylglucosamin. Ton b cu trc ny li kt hp vi 1 phn t mang lipid l Isoprenyl
phosphate ri di chuyn t t bo cht ra ngoi mng t bo. Ti y chng kt hp vi nhau
ko di thnh chui peptidoglycan. Bacitracin ngn cn tin trnh ny bng cch gn vi
Isoprenyl phosphate to phc hp v dng. Vancomycin ngn cn s di chuyn ng
pentapeptid thnh chui a phn t bn ngoi mng t bo.
- Giai on cui l hnh thnh dy ngang gia cc dy peptidoglycan bng cch ni D-alanin
ca 1 chui vi diaminopimelic acid ca chui k cn nh enzym transpeptidase. Penicillin c
ch giai on ny do cu trc ca n ging D-alanylalanin (1 v tr trn peptidoglycan m
enzym gn vo)
2.2.2. Khng sinh tc ng ln mng t bo cht (mng bo tng)

- Mng ny c nhim v bao bc v ngn cch dch tng bo vi v t bo. N c tnh thm
chn lc, iu ha s trao i vi mi trng bn ngoi. C t bo ng vt v t bo vi
khun u c cc yu t nh protein, lipid nhng lipid ca vi khun l phospholipid cn nm
mc l sterol.
- Khng sinh thuc nhm polypeptid (colistin, polymyxin) v polyens (cht khng nm) gn
kt trn cc cht ha hc ring bit lm xo trn chc nng thm thu khin cc cht trong
bo tng nh Mg2+, K+, Ca2+ thot ra ngoi (tc ng nh mt cht ty loi Cation)
2.2.3. Khng sinh tc ng ln s tng hp acid nucleic

- S nhn i DNA bt u bng phn ng tch hai chui DNA ra, mi chui l mt khun
gn cc nucleotid thch hp theo nguyn tc b sung. DNA polymerase xc tc s tng hp
cc lin kt gia cc nucleotid; DNA gyrase gip ni cc DNA trong qu trnh t hp v to
thnh cc vng xon.
- S sao m l qu trnh tng hp RNA do DNA lm khun theo nguyn tc b sung nh
enzym RNA polymerase v ion Mg2+
- Qu trnh tng hp acid nucleic bt u t vic tng hp acid folic ri thnh purin nh vo
mt s enzym: Dihydroteroat synthetase, dihydrofolat reductase...
- Quinolonee (acid nalidixic, norfloxacin: Quinolonee c fluor ha) c ch mnh s tng

hp DNA trong giai on nhn i do c ch DNA gyrase.
- Rifampin c ch tng hp RNA do c ch RNA polymerase.
- Sulfamides i khng cnh tranh vi PABA (p-aminobenzoic acid) mt tin cht tng
hp acid folic (ng vt hu nh dng folat c sn trong thc phm cn vi khun phi tng
hp folat). PABA kt hp vi pteroic acid hoc glutamic acid to pteroylglutamic acid
(PGA), cht ny ging nh 1 coenzym trong s tng hp purin v timin. PGA cng l 1 phn
ca phn t B12 c lin quan n s bin dng acid amin v purin. Do khi thiu PABA
s gy thiu purin, acid nucleic. iu ny cng gii thch ti sao cc vi khun t tng hp
c PABA th khng vi sulfamid v ti sao thymin, purin, methionin, v mt s acid
amin khc li i khng vi hiu qu sulfamid. Sulfamides ch c tc ng km khun.
- Trimethoprim c ch dihydrofolat reductase ngn qu trnh chuyn ha dihydrofolat thnh
tetrahydrofolat (dng hot ng ca acid folic).
2.2.4. Khng sinh tc ng n qu trnh tng hp protein ca t bo vi khun

Qu trnh ny xy ra thng qua vic chuyn giao thng tin di truyn c m ha
trn mRNA. n v chc nng ca qu trnh ny l ribosome. Khc vi t bo ng vt
(ribosome 80S), t bo vi khun c ribosome 70S, gm 2 tiu n v 30S v 50S.
21
* Giai on khi u: nh nhiu yu t khi u khc nhau m tiu n v 30S s gn vi

mRNA v tRNA c mang acid amin (amino acyl-t.RNA). Sau gn vi tiu n v 50S hnh
thnh nn ribosom 70S. t.RNA t v tr A (amino acyl) dch chuyn sang v tr P (peptidyl)
gii phng v tr A cho tRNA k tip.
* Giai on ko di: tin trnh trn c lp li n khi c ht on di truyn v protein c
hnh thnh.
* Giai on kt thc: cc yu t kt thc khc nhau lin quan n s phng thch chui
protein. Cc tiu n v 30S v 50S tch ri nhau ra, tham gia vo tp hp nhng tiu n v
t do trc khi ti kt hp vi mt on gene mi.
- Khng sinh aminoglycoside (aminoglycosid: streptomycine...) gn cht vi tiu n v 30S,

phong b hot ng bnh thng ca phc hp khi u, can thip tip cn tRNA , lm sai
on gen t hnh thnh cc protein khng c chc nng.
- Khng sinh tetracycline cng gn vo tiu n v 30S v phong b s kt hp ca tRNA vi
mRNA.
- Khng sinh chloramphenicol gn vi tiu n v 50S, c ch enzym peptidyl transferase
khng cho amino acid gn vo chui polypeptid
- Khng sinh macrolide (erythromycin...) tranh ginh v tr gn ribosom v ngn cn v tr
dch chuyn cc acid amin
2.3. Theo tc ng khng khun

Chia lm hai nhm:
Khng sinh km khun (hay tnh khun) khng c tc dng hy dit mm bnh m ch c
tc dng c ch s nhn ln ca chng
Khng sinh st khun (hay dit khun) c hot tnh tiu dit vi khun
S phn bit ny ch c tnh tng i v bt k khng sinh no cng c tc dng km khun
v st khun ty theo liu lng cung cp. Tuy nhin, i vi nhng khng sinh ch c tc
dng st khun nng rt cao trong mu (c th gy c tnh hoc tai bin) th ch c s
dng vi mc ch km khun liu thp hn.
2.3.1. Nhm cc khng sinh km khun

- Tetracycline
- Macrolide
- Lincosamid
- Synergistin
- Phenicol
- Sulfamid
- Diaminopyrimidin
2.3.2. Nhm cc khng sinh st khun

2.3.2.1. Khng sinh st khun ph thuc nng
Tc st khun ph thuc nng t c trong mu. Hiu lc ca nhng khng sinh ny
thng rt nhanh chng
- Nhm aminoglycoside
- Nhm fluoroquinolone tc ng trn vi khun G-
- Polypeptid
- Sulfamid + diaminopyrimidin
ngha: Ch cn cp khng sinh 1-2 ln trong ngy
22
2.3.2.2. Khng sinh st khun ph thuc thi gian
Tc st khun ph thuc thi gian vi khun tip xc khng sinh nng ln hn hay
bng nng c ch ti thiu (MIC). Hiu lc st khun ca nhng khng sinh ny thng
xy ra chm
- Nhm beta-Lactam
- Nhm glycopeptid
- Nhm quinolone trn Staphylococcus
- Nhm rifampicin
ngha: chia tng liu thnh nhiu liu nh trong ngy
(MIC: l nng ti thiu khng sinh c kh nng c ch s nhn ln ca vi khun invitro)
3. S KHNG CA VI KHUN
3.1. S khng t nhin

y cng l gii hn kh nng khng khun ca khng sinh
V d: Streptococcus khng t nhin vi aminoglycosidee do thnh vi khun khng cho
thuc qua
3.2. khng thu nhn

khng do t bin nhim sc th khng do plasmid
- Quinolone, nitrofuran, polypeptid - Cc nhm khc
- Tn xut thp: 10-9 -10-10 - Tn xut cao hn: 10-6 -10-7
- Him xy ra (10-20%) - Thng xy ra (80-90%)
- khng 1 loi khng sinh - khng nhiu KS, nhiu nhm
- Di truyn theo chiu dc - C dc v ngang
3.3. C ch ca s khng
- Vi khun sn xut cc enzym lm bin i hot v hot khng sinh
V d: vi khun sinh betalactamase ph hy cc betalactam
- Thay i cu trc im tip nhn (receptor)
V d: Thay i ribosom 30S khng cho aminoglycoside gn vo
- Ngn cn s vn chuyn khng sinh vo trong t bo
V d: vi khun khng vi tetracycline
- Thay i qu trnh bin dng
V d: vi khun khng vi sulfamide
4. S DNG KHNG SINH
4.1. Chn khng sinh: da vo

- Kt qu chn on bnh
- Tnh nhy cm ca 1 hay nhiu vi khun gy bnh i vi 1 khng sinh (da vo khng sinh
hoc nhng hiu bit v thng k dch t).
- Kh nng i ti bnh ca khng sinh (da vo hiu bit v tc ng dc l).
- C a ca th (c mang, bnh gan thn, th non...)
4.2. Nguyn tc ca liu php khng sinh

- Nhanh: trnh pht tn mm bnh
- Mnh: bt u bng liu c hiu lc (tng i cao) v tip theo l liu duy tr (thp hn).
- Lu: m bo duy tr nng khng sinh c hiu lc trong 5 ngy.
23
4.3. Bin php hn ch s khng thuc

- Khng s dng khng sinh c ph rng hoc khng sinh th h mi trong khi khng sinh c
ph hp, khng sinh c vn c hiu qu
- Thng xuyn nm bt thng tin v tnh hnh dch t v kh nng nhy cm khng sinh ca
h vi khun
- Khi kt hp khng sinh vi mc ch ngn khng, cc khng sinh thnh phn phi s
dng nguyn liu lng
5. PHI HP KHNG SINH
5.1. Mc ch
- M rng ph khng khun
V d: Penicillin + Streptomycin
- Tng hiu lc st khun
V d: Sulfamid + Trimethoprim
- Ngn s khng thuc
V d: Amoxcillin + acid clavulanic
5.2. Cc nguyn tc phi hp khng sinh
NHM BETA LACTAM

Cc penicillin
1. Ngun gc
Alexander Fleming (1929) pht hin trn mi trng nui cy nm Penicillinum notatum,
P.chrysogenum.
2. Cu to ha hc
Vng betalactam (amid ni vng)
Vng thiazolidin
-RCO: s thay i R cho cc khng sinh khc nhau trong nhm
3. L ha tnh
Km bn nht trong cc loi khng sinh. Rt ht m v b thy gii nhanh. pH ti u t 6-6,5,
mi trng acid, kim s ph hy penicillin. S h hng cng gia tng theo nhit .
Penicillin b cc tc nhn oxyha, kh ph hy (KMnO4). Cc ha cht c kim loi nng cng
lm mt tc dng ca penicillin (thuc ). Alcohol v cc hp cht c cha -SH cng i
khng vi penicillin. Vi khun trc trng c kh nng tit penicillinase, m vng betalactam
cng ph hy penicillin.
4. Dc ng
- Hp thu: Ch nhng penicillin bn trong mi trng acid mi c hp thu vo ng tiu
ho (nhm A, nhm M, penicillin V). Penicillin G ch dng ng tim chch (IM, SC, t
dng ng IV).
- Phn b: dch ngoi bo. Khuch tn tt vo phi, kh khuych tn vo mng no ty,
nhau thai tr khi nhng ni ny vim. Vo sa khi tim nhng liu ln.
- Chuyn ha:
24
- Bi thi: nhanh v ch yu qua ng thn.
Ngi ta thng ko di tc dng ca penicillin bng cch:
+ Phi hp vi procain, benzathin phng thch dn
+ Dng penicillin trong du
+ To mui ca penicillinc phn t lng cao thy gii chm
+ Phi hp vi probenecid cnh tranh o thi
5. Hot tnh dc lc:

- Tc ng st khun
- Ph khng khun: thay i ty tng nhm penicillin
5.1. Nhm G: penicillin G (Benzyl penicillin), penicillin V (penoxymethyl penicillin)
y l cc khng sinh c hot lc cao i vi vi khun G+ v khng khng penicillinase.
5.2. Nhm A: ampicillin, amoxcillin

Cc khng sinh ny c ph khng khun m rng trn vi khun G+ v G- nhng vn khng
khng c penicillinase. Ampicillin c nng cao trong mt. Amoxcillin c hp thu tt
hn, nng trong mu cao hn ampicillin gp 2 ln.
5.3. Nhm M: (methicillin) oxacillin, cloxacillin, floxacillin

Cc penicillin bn tng hp ny c ph khng khun rng, trn vi khun G+ v G-, bn trong
mi trng acid v khng penicillinase.
6. Ch nh
Bnh nhit thn, du son heo, vim v do Staphylococcus, Streptococcus, bnh do Leptospira,
vim nhim phi...
Chng ch nh: th, chut hamster
7. c tnh
L nhm khng sinh t c nht. Tuy nhin cn phng tnh trng d ng:penicillin c vai
tr nh 1 hapten. Khi vo c th ln th nht, chng s b bin i thnh acid penicilloic v
acid penicillenic. Cc cht ny kt hp vi protein thnh mt phc hp c tnh sinh khng th
chng li chnh phc hp ny. Cc Ig (ch yu l IgE) bm trn cc t bo bch cu v
Mastocyte. Khi penicillin vo c th ln th hai, chng mang tnh khng nguyn, kt hp vi
khng th c. Phn ng kt hp khng nguyn khng th dn n v cc t bo Mast v
bch cu, phng thch histamin gy cc triu chng: , sn, ph, co tht kh ph qun, co tht
c tim...
8. Liu lng:
- penicillin G (IM)10.000-20.000 U.I/kgP 1mg=1695 USP unit
- Na penicillin G: 4 gi/1liu 1mg=1211
- procain penicillin: 24 gi/ 1 liu 1mg= 1667
- benzathin penicillin: 2 tun/1 liu 1mg =1009
9. Tng tc thuc:
Hip lc: Aminoglycoside (penicillin+streptomycin); quinolone; polypeptid (ampicillin
+colistin); cht c ch betalactamase (amoxcillin + acid clavulanic)
i khng: Tetracycline, macrolide
25
Cc cephalosporin
Cc khng sinh ny c vng dihydrothiazin ni vi vng betalactam
cephalosporin th h I II III
Ph khng khun G+ G+, G- ng rut G+, G- k kh
khng cephalosporinase - + +
vo dch no ty - - +
i din cefalexin cefamandol ceftriazon
NHM AMINOGLYCOSIDE
(AMINOSIDE)
1. Ngun gc
-Streptomycin c chit t Streptomyces griseus
- Kanamycin c chit t Streptomyces kanamycetius
- Gentamicin c chit t Micromonospora purpurea
- Spectinomycin c chit t Streptomyces spectabilis
- Neomycin chit t S. fradiae
- Dihydrostreptomycin, apramycin l khng sinh bn tng hp
2. Cu to ha hc
Gm c cu trc vng aminocyclitol (aminocyclohexanol) ni vi 1 hay nhiu phn t ng
amin.
3. L ha tnh
- pH ti u t 6-8, pH 8 c th ph hy thuc. Do ngi ta thng dng cht m citrat Na
- Nhit v cc tc nhn oxyha kh cng lm h hng streptomycin.
- Cc hp cht c nhm -SH c th tc ng ln nhm aldehyd t do, h hng thuc.
- Mui Na, K, phodphate, tartrate lm gim hot tnh.
4. Dc ng
Hp thu: do tnh phn cc, cc aminoglycoside tan tt trong nc, khng hp thu qua ng
tiu ha. ng ung ch cho tc ng ti ch.
C th tim bp hoc tnh mch (tr DHS), khng tim di da
Phn b: dch ngoi bo. t nng tr liu khp, phi, dch phc mc
thn v tai trong: thuc tp trung vi nng cao
Vo dch no ty: kh v chm
Qua c nhau thai v nh hng bo thai
Bi thi: chm qua thn dng c hot tnh
5. Hot tnh dc lc
- Tc ng st khun ngoa tr spectinomycin
26
- Ph khng khun:
* Streptomycin c ph khng khun hp, tc ng trn vi khun G- (trc khun G- hiu kh),
Leptospira, Mycobacterium. t tc dng trn vi khun k kh do s thm ph thuc O2 v cn
nng lng.
* Gentamicin, kanamycin, neomycin tc ng trn c vi khun G- v G+ (Streptococcus),
ring gentamicin cn c hiu qu trn Proteus v Pseudomonas
* Spectinomycin ch c tc ng km khun nhng c hiu qu trn vi khun G-, G+ v
Mycoplasma (tr c CRD trn gia cm). Khng sinh ny t c trn thn nht.
Hot tnh ca streptomycin< kananycin<gentamicin<apramycin
- Tinh th lng tnh, ho tan trong nc km, dng mui Chlohydrat tan nhiu hn. Trong ,
Oxytetracycline tan nhiu nht (nhm OH)
- Tnh by bt (kelate ha) vi cc ion kim loi ha tr II (Ca, Mg...) lm cho cc tetracycline
b gim hp thu khi thc n c cc kim loi ny (ngoi tr Doxycyclin), ng thi gii thch i
lc tn tr m xng, rng.
4. Dc ng:
- Hp thu: qua ng tiu ha, t l hp thu khc nhau gia cc tetracycline
Chlotetracycline: 30% ; tetracycline, oxytetracycline 60-80%; doxycyclin 100%
Chlotetracycline khng c s dng tim bp v d gy kch ng, thng dng trong thuc
m tra mt.
Doxycyclin, tetracycline thng s dng dng ung (thuc bt, vin) nhng khng dng cho
loi nhai li v s nh hng h vi sinh vt d c
ng tim chch cho tc ng nhanh chng hn
- Phn b: ng u bn trong v bn ngoi t bo (homogene). Kh nng phn tn tt n
cc m trong c th nh phi, gan, thn, lch, xng (tr dch no ty v dch khp). Qua
c nhai thai v tuyn sa, gy nh hng bo thai. Tch ty m xng v rng
- Chuyn ha gan
- o thi: qua phn 40% (mt) v nc tiu 60%. Ring Doxycyclin o thi qua phn dng
khng hot tnh nn t nh hng h vi khun ng rut , an ton tr nhim trng ngoi
thn cho th suy thn.
5. Hot tnh dc lc
- Tc ng tnh khun
- Ph khng khun rng: G+ (Staphylococcus, Streptocoocus, Corynebacterium, c vi khun
k kh G+ nh Clostridium), G- (E.coli, Salmonella, Actinobacillus, vi khun ni bo nh
Mycoplasma (M. hyopneumonia, M galisepticum, M.synoviae, M. bovis), Brucella abortus,
Ricketsia (Ehrlichia canis), Chlamydia (C. psitaci), Leptospira (L. canicola).
Mycobacterium, Proteus, Pseudomonas... khng vi tetracycline
6. Ch nh
Nhim trng mu, nhim trng ng h hp, tit niu, tiu ha do cc vi khun nhy cm
gy ra.
7. c tnh
- Tc dng ph: ri lon tiu ha khi dng lu ngy, bi nhim nm mc, thiu vitamin B,K
- Nhy cm quang hc (photosensitive): doxycyclin lm tn thng da khi tip xc nh sng,
ni mn, vim da.
- Trn xng v rng: do s thnh lp phc hp tetracycline calcium- orthophosphat vi
xng v rng. Cht ny lng ng gy i mu men rng, chm pht trin . Chng ch nh
27
ngi mang thai v tr em di 8 tui.
8. Liu lng:
Ty theo loi gia sc v ng cp:
UNG TIM
- Gia sc ln: 500-1000mg/ngy 2-4mg/kgP/8h
- Gia sc nh: 1000-2000mg/ngy 2-8mg/kgP/8h
- Ch mo: 50mg/kgP 2-10mg/kgP/8h
- Gia cm: 1g/4,5L nuc
9. Tng tc thuc:
- i khng . Lactam, Barbituratesvi
- Hip ng vi cc khng sinh khc:
. Aminoglycoside: Neomycin + Oxytetracycline
. Macrolide: Ery +Tetra; Spira + Oxytetra
. Polypeptid: Polymyxin B+ Oxytetra
. Sulfamid: Sulfamethoxypyridazin+ Chlortetra
.Phenicol: tetracycline+chloramphenicol
- Kt hp vi khng vim, khng histamin:
Colistin+ Oxytetracycline + Prednisolon + Chlorpheramin
NHM PHENICOL
1. Ngun gc
Nm 1947, chloramphenicol c c lp t Streptomyces venezuelae. Do c ph khng khun
rng v kh nng phn tt b vo cc m trong c th nn chloramphenicol rt c a
chung trong tr liu. Tuy nhin t khi pht hin nhng c tnh ng k trn c quan to mu,
vic s dng cht ny c gii hn trong nhng qui nh quc t v khu vc
Thiamphenicol l dn cht tng hp ca chloramphenicol.
2. Cu to ha hc
2 cu t c bit: - para- nitrophenil
- Carbongemdiclor
3. L ha tnh
- Tinh th khng mu, v rt ng, bn 1000 C, pH=2-9, tan nhiu trong alcohol
- B mt hot tnh bi tc nhn oxyha (nhm alcohol nh cp), kh (nhm nitro)
4. Dc ng
- Hp thu: tt qua ng tiu ha (chloramphenicol 75-90%; thiamphenicol 100%) v ngoi
tiu ha (IM, IV, IP). Cc dng mui palmitat v sucsinat khng hot tnh, khi vo c th
c thy gii thnh dng c hot tnh
- Phn b: ng u trong dch ni v ngoi bo. Do tnh khng ionha, chloramphenicol tan
tt trong lipid, c phn phi rng khp cc m trong c th: nhau thai, sa, dch mt, phi,
tuyn prostate, k c dch no ty
- Chuyn ha: chloramphenicol chuyn ha gan (kt hp vi a. glucuronic) dng khng
hot tnh. mo v gia sc non, phn ng lin hp ny rt km nn khi dng cn ch gim
liu.Thiamphenicol khng b chuyn ha, cn nguyn vn do c dng tr nhim trng
gan mt v ng tiu.
28
- Bi thi: ch yu qua thn
5. Hot tnh dc lc:

- Tc dng tnh khun. Nhng i vi Haemophilus th c tc dng st khun
- Ph khng khun: G+, G-, vi khun ni bo (Ricketsia, Chlamydia) vi khun k kh
(Clostridium, Bacteroides...) . Mycoplasma t nhy cm
6. Ch nh
Do c tnh cao, phenicol ch gii hn s dng trong cc trng hp:
- Thng hn, ph thng hn do Salmonella
- Vim mng no, vim thanh kh qun, vim phi do Haemophilus
- Nhim trng k kh (thay th Metronidazol, Clindamycin)
- Nhim rickettsia
- Vim nhim tuyn prostate
- S dng ti ch: thuc nh mt, tai, kem bi da
Chng ch nh: trong thc n gia sc, thuc iu tr trn gia sc sn xut thc phm cho
ngi (b sa, g trng, ong mt...), ph n mang thai, cho con b, tr di 6 thng (h thng
kh c gan cha hon chnh)
7. c tnh
- Ri lon ty xng: suy ty khng hi phc (thiu mu bt sn)
- Try tim mch khi dng liu cao tr thng hn (c th do vi khun cht hng lot, phng
thch c t)
- R lon tiu ha: tiu chy, i ma
- Tc dng ph: suy gim min dch. Do khi ang chng nga cho gia sc, nu phi s
dng khng sinh th chn cc khng sinh khc
8. Liu lng
UNG TIM (IM)
Th ln 500- 1000mg/ngy 2-4mg/kgP/8-12h
Th nh 250-500mg/ ngy 4-10mg/kgP
9. Tng tc thuc
.- i khng vi -Lactam, Aminoglycoside, Lincomycin
- Hip lc vi Tetracycline (Chloramphenicol + Oxytetracycline +Prednisolon)
- Dng chung chloramphenicol+ sulfamethoxypyridazin s lm tn thng gan
- Khng dng chung vi pentoibarbital, codein, NSAID, coumarin v lm ko di tc ng do
c ch chuyn ha cc cht ny.
NHM MACROLIDE
1. Ngun gc
Chit xut t nm Streptomyces (Erythromycin t S. erythreus, Spriramycin t S.ambofacient)
2. Cu to ha hc
Gm mt vng Lacton ln (c t 12-16 nguyn t) gn vi cc phn t ng bng cc lin
kt glycosid
- Loi 12nguyn t: khng s dng trong lm sng
- 14 nguyn t: Erythromycin, Oleandomycin
29
- 16 nguyn t: Spiramycin, Tylosin
3. L ha tnh
- pH ti u =7,8-8, pH10 lm h hng thuc, do ngi ta bc vin nhng khi dng ng
ung
- Kh bn, km tan trong nc , tan tt trong dung mi hu c.
- Thng dng mui: lactobionat, thiocyanate (erythromycin); adipate (spiramycin);
chlohydrate (oleandomycin); tartrate, phosphate (tylosin)...
4. Dc ng
- Hp thu: Erythromycin base b hy bi acid dch v nn s dng ng ung phi dng
capsul hoc mu steroat, propionate. Cc macrolide mi thng hp thu tt hn v t b nh
hng bi thc n trong d dy
- Phn b: dch ni bo, khuych tn vo khp cc m nht l phi, xng, gan , nhau thai tr
dch no ty (khng nng tr liu)
- Bi thi: ch yu qua mt (khc penicillin), tuyn sa, nc bt dng cn hot tnh
5. Hot tnh dc lc
- Tc ng tnh khun
- Ph khng khun: vi khun G+, Mycoplasma, Rickettsia, Chlamydia.
6. Ch nh
u tin ch nh cc bnh ng h hp (CRD, PPLO gia cm, suyn heo, vim phi b
ngh), tiu chy (hng l heo do Treponema) vim v (do li im bi thi nhanh, t gy tn
d trong sa), du son, nhim trng tai mi hng ...
Thay th penicillin tr nhim trng do Staphylococcus
* Chng ch nh loi nga
7. c tnh
thp nht: st, nn ma, d ng da
9. Tng tc thuc:
- i khng vi - Lactam, chloramphenicol, lincomycin ngoi tr Tylosin c th phi hp
vi chloramphenicol
- Hip lc vi: polypeptid, tetracycline, sulfamid
NHM SULFONAMIDE
1. Ngun gc
y l nhm khng khun c t lu nht (thp nin 1940). Bt ngun t phn t Protonsil
(mt loi thuc nhum azo), cc sulfamid c tng hp, l nhng chuyn ha cht ca
sulfanilamid vi cc v tr th N1 v N4
2. Cu to ha hc
C nhm sulfamoil (-SO2NH2) trong phn t
3. L ha tnh
- Dng bt tinh th, tan tt pH=9-10, t tan trong nc v mi trng acid yu. C khuynh
hng kt tinh trong mi trng nc tiu pH acid.
30
- Tnh ha tan ca hn hp nhiu sulfamid cao hn ca tng cht ring l.
4. Dc ng
- Hp thu: qua ng tiu ha tt, ngoi tr cc sulfamid co tc ng ti ch
ng tim di da: dung dch tim cn phi c cht m v mui Na ca sulfamid c tnh
gy kch ng. Tim bp v tim tnh mch thng s dng hn nhng nng hu hiu trong
mu thng ngn, phi b sung bng cch cho ung
Tim vo v cc hn dch sulfamid trong du. t vo t cung, m o nhng vin nang
sulfamid+ urea (tng tnh ha tan) hoc phi hp vi cc khng sinh khc
- Phn b: dch ngoi bo, phn tn n khp c th bao gm cc m mm c h thn kinh
trung ng (dch no ty) v khp (dch khp). Vo c tuyn v nhng cha t n nng
tr liu
- Chuyn ha: xy ra gan vi 2 phn ng chnh
- Phn ng lin hp vi acid glucuronic thnh dng bt hot nhng c tnh ha tan
- Phn ng acetyl ha to thnh dng bt hot v khng tan nn thng gy c (hnh thnh
dng tinh th thn)
- Bi thi: Qua thn l ch yu (tr cc sulfamid khng khun ng rut), mt t qua phn,
sa
S lc qun cu thn: khuch tn th ng, tt c cc sulfamid u qua
S ti hp thu ng thn: qu trnh ny c s chn lc. iu ny gii thch ti sao mt s
sulfamid c duy tr trong c th lu hn cc sulfamid khc
V sulfamid c tnh acid yu nn vic kim ha nc tiu bng NaHCO3 s lm tng tnh ha
tan, trnh to tinh th gy h hi thn.
5. Hot tnh dc lc
- Tc ng khng khun:ch c tc ng tnh khun nn h min dch gi vai tr ch yu
trong vic loi tr tn gc s nhim trng. Sulfamid c hiu qu cao trong giai on u ca
nhim trng cp tnh v giai on ny vi khun c mc bin dng cao, d kt hp vi
sulfamid, thm vo kh nng thc bo cn mnh m v s khuych tn ca thuc cha b
cn tr bi qu trnh x ha trong vim mn tnh.
- Ph khng khun: rng, tc ng trn vi khun G+, G-, Protozoa (Coccidia, Toxoplasma)
6. Ch nh
-Nhim trng ng h hp, tiu ha, tit niu
- Vim v, vim t cung, vim a khp
- Tr cu trng, toxoplamosis
* sulfamid tc ng ton thn
+ sulfamid tc ng nhanh (3-6h), bi thi nhanh: sulfamerazin, sulfadimidin, sulfathiazol...
+ sulfamid na chm (6-10h): sulfapyridin, sulfamethxazol, sulfadiazin...
+ sulfamid bi thi chm (10-12h) (long-acting): sulfamethoxypyridazin, sulfadimethoxin,
sulfadoxin...
* sulfamid khng khun ng rut: sulfaguanidin, phtalylsulfathiazon...
* sulfamid tc ng ti ch (thuc nh mt): sulfacetamid, sulfadiazin bc...
* sulfamid tr cu trng (thng kt hp vi nhm diaminopyrimidin): sulfadimidin,
sulfaquinoxalin, sulfadimethoxin, sulfadoxin...
7. c tnh:
- Trn thn: sn thn, tiu ra mu do t qun cu thn n ng dn tiu, sulfamid c lm
m c 50 ln, s bi tit H+ vo ng thn lm nc tiu cng acid hn, gim tnh tan ca
sulfamid t to thnh tinh th trong ng thn.
31
phng c tnh trn thn khi s dng sulfamid:
. Nn s dng dng d ha tan
. Dng dng hn hp nhiu sulfamid (2-3)
. m bo cung cp nc trong thi gian iu tr
. Cp thm cc cht kim trong nc ung (Na2CO3, NaHCO3, Na lactate...)
- ng rut: mt cn bng h vi khun ch,h vi sinh vt d c, gy thiu vitamin nhm B,K
- Trn c quan to v trng: trng khng v hoc c v mng do c ch carbonic anhydrase
- Gic mc (ch): sng ho gic mc, nh hng n vic tit nc mt
- Trn mu: gim prothombin mu (sulfaquinoxalin) do c ch vitamin K reductase
- Nhy cm da, suy ty, ung th tuyn gip...
8. Liu lng
liu ban u liu duy tr (mg/kgP/24h P.O)
sulfadimethoxin 55 27.5
sulfamerazin 220 110
sulfadiazin 50 50
sulfamethoxypyrimidin 110 55
sulfapyridin 132 66
9. Tng tc thuc
- Hip lc bi tng vi nhm diaminopyrimidin (t l 5:1 hay 3:1). S phi hp ny cho tc
ng st khun mnh gp 20-100 ln so vi tc dng ca tng thuc ring l
sulfamethoxazol (5) +trimethoprim (1): Bactrim
sulfaquinoxalin (3) +trimethoprim (1)
- Kt hp vi cc sulfamid khc: sulfamerazin+sulfamethazin+sulfadiazin
- Vi cc khng sinh tnh khun khc: sulfamerazin+ tylosin, sulfamethazin+chlotetracycline
- Vi penicillin G procain
NHM DIAMINOPYRIMIDINE
1. Ngun gc
Cht khng khun tng hp: Trimethoprim (1956)
Pyrimethamin (1951)
Diaveridin
Ormethoprim
2. Cu to ha hc
3. L ha tnh
- Tnh base, tan trong lipid
4. Dc ng
-Hp thu nhanh qua ng tiu ha v tim chch
- Phn b: ni bo, khp c th (phi, thn gan, nh tuyn) c khuynh hng tp trung cc
m c tnh acid hn huyt tng (prostate)
- Bi thi qua thn (45-75%) v phn
5. Hot tnh dc lc
32
- Tc ng tnh khun khi dng mt mnh. Rt t khi dng n c do s gia tng tnh
khng. Thng phi hp vi sulfamid, lc ny s phi hp cho tc ng st khun
- Ph khng khun: vi khun G+,G-, cu trng.
Khng tc ng n Pseudomonas v Mycobacterium
6. Ch nh
- Phi hp vi sulfamid trong iu tr cc bnh nhim trng do cc vi sinh vt nhy cm gy
ra. S phi hp 1:5 s cho nng ti a trong huyt tng vi t l 1:20 l t l dit khun
ti u trn hu ht cc vi khun. S phi hp ny cn gip thuc phn tn tt vo dch no ty,
dch tai gia, ph qun phi, tuyn tin lit.
7. c tnh
- Thiu mu do thiu folate. C th cha bng cch cung cp acid folic
- Tiu chy, i ma
Pyrimethamin gn vi h enzym ca ng vt hu nh mnh hn Trimethoprim nn n c
hn.
NHM QUINOLONE
1. Ngun gc
y l nhm khng sinh nhn to gm nhng dn xut ca quinolein c pht trin trong
nhng thp k gn y. Ban u chng c ph st khun hp vi cc vi khun Gram m,
nhng cc quinolone hin nay c pht trin (fluor ha), chng gi vai tr quan trng
trong s nhng cht khng khun. Chng c u im l c tnh rt thp, pht sinh tnh
khng khng ng k v t gy tn ng trong sc sn
Th h 1: acid nalidixic (1960s), acid oxolinic
Th h 2: flumequin
Th h 3: norfloxacin, ciprofloxacin, enrofloxacin, pefloxacin...
2. Cu to ha hc
Nhn quinolein, nhm ceton v tr paraso vi phn t nitrogen ni vng, nhm -COOH v
tr C3
3. L ha tnh
- C tnh lng tnh, tan yu trong nc pH 6-8 (trong nc tiu ch mo d thy nhng
tinh th quinolone hnh kim)
- Hot tnh gim khi tip xc nh sng
- Tnh acid (do nhm -COOH) cho php to mui Na, d ion ha, d tan hn trong nc
- Tnh by bt (tng t tetracycline) vi cc ion ha tr II nhng quan trng nht l Mg2+
4. Dc ng
- Hp thu: tt qua ng tiu ha v ngoi tiu ha
- Phn b: cc quinolone th h I ch phn b ngoi bo, chng khuch tn vo cc m c
mch mu phong ph. Cc quinolone c fluor ha th phn b ng u c trong dch ni
v ngoi bo, phn b n hu ht cc c quan: phi, xng, tuyn tin lit, dch no ty, dch
tai, mi, hng...
- Chuyn ha: 2 phn ng qun trng l:
Thy phn to cc cht chuyn ha vn cn hot tnh sinh hc
33
Lin hp vi acid glucuronic to cc cht d tan v o thi ra ngoi
- Bi thi: cc quinolone bi thi ch yu qua ng tit niu vi nng dc phm cn
hot tnh cao hn c trong huyt thanh, do chng c ch nh trong cc nhim khun
ng tit niu.
Cc quinolone c ti hp thu th ng thn. i vi th n tht, pH acid ca nc tiu c
tc dng lm chm s bi thi d dn n tnh trng kt tinh th. i vi th n c, pH kim
ca nc tiu gip cc quinolone c bi thi nhanh hn.
Ring pefloxacin c bi thi ch yu qua mt.
5. Hot tnh dc lc:

- Tc ng khng khun: st khun
- Ph khng khun: Cc quinolone th h I, II (acid oxolinic, flumequin...) ch c tc ng
trn vi khun G-, c bit l vi khun ng rut. Cc quinolone th h III c ph khng
khun rng hn trn vi khun G-, G+, Mycoplasma v Clamydia
6. Ch nh
Cc quinolone th h I: nhim trng ng tit niu do vi khun G- gy ra
Cc quinolone th h II: nhim trng ng tiu ha do vi khun E.coli, Salmonella, Shigalla,
Proteus... gy ra
Cc quinolone th h III: nhim trng ton thn, ng tiu ha, ng h hp, vim mng
no, xng, khp, tuyn prostate.
7. c tnh
Rt thp: - Nhy cm quang hc
- Rt lon pht trin xng, sn (gt asin ngi) do hot tnh bt gi cc kim loi
8. Liu lng
Cho Ch mo
- Acid nalidixic: 3mg/kgP/P.O X 3 ln
- Norfloxacin: 10-20mg/kgP/P.O X 2 ln
- Enrofloxacin: 2,5mg/kgP/ P.O, S.C X 2 ln
Cho heo con, b ngh con: Enrofloxacin: 2,5mg/kgP/ P.O, S.C/ngy
9. Tng tc thuc:
- Hip lc vi: beta-lactam, aminoglycoside, clindamycin, metronidazole
- i khng: nitrfuran (lm tng c tnh v nguy c ri lon thn kinh)
CC KHNG SINH KHC

NHM LINCOSAMIDE
LINCOMYCIN V CLINDAMYCIN: c hot tnh ging macrolide
1. Ngun gc:
Lincomycin c chit t Streptomyces linconensis
Clindamyclin l dn xut bn tng hp 7. Chlor ca Lincomycin. Hot tnh ca Clindamycin
mnh hn Lincomycin
34
2. Dc ng:
- Hp thu: tt qua ng tiu ha (tan trong lipid)
- Phn b: dch ni bo c bit c kh nng qua sa, phi, gan, xng, rng.
- Bi thi: qua mt (80%) v nc tiu
3. Dc lc:
- Hot lc: tnh khun
- Ph khng khun: G+ (mt vi vi khun k kh), Mycoplasma
4. Ch nh:
- Vim phi, ng h hp do vk G+, Mycoplasma
- Vim v do Staphylococci
- Vim da (mn), rng, ming
5. Tng tc:
- Cng hng vi spectinomycin (T l2:1)
- i khng: - Lactam, macrolide, chloramphenicol
NHM SYNERGISTIN
VIRGINIAMYCIN
1. Ngun gc:
- T nm S. virginiae.
- C cu trc vng lacton (peptolid) tng t macrolide
2. c im dc l:
- Km hp thu qua ng tiu ha, ch c tc ng ti ch
- Khuych tn trong da, phi. Bi thi qua rut v mt t qua thn
- Tc dng trn vi khun G+ v Protozoa (Toxoplasma)
- C ch c ch tng hp Protein ti tiu n v 23S ca ribosom
3. Ch nh:
- iu tr ti ch: vim da, vim v (pomade)
- Trn trong thc n: kch thch tng trng:50-100ppm
4. Chng ch nh: gia sc ci thi k mang thai
NHM PLEUROMUTILIN
TIAMUTILIN
1. Ngun gc:
- T nm Pleurotus mutilis. C cu trc ca base diterpen
- Tan trong cac dung mi hu c, thng s dng dng fumarate.
2. c im dc l:
- Tc ng km khun .
- Ph khng khun: hp , gii hn trn vi khun G+, Mycoplasma, Treponema (Treponema
hyodysenteria), Haemophylus, Campylobacter
35
- C ch tc ng: c ch sinh tng hp protein do gn vo tiu th 50S c ch
Peptidyltranferase
3. Ch nh:
- Gia cm: Cc bnh ng h hp do Mycoplasma (CRD) 100mg/kg thc n /8-10 ngy
- Heo: Bnh vim phi, hng l (vim rut xut huyt do Treponema)
4. Chng ch nh:
gia cm: chng ch nh s dng chung vi cc polyether ionophore v c nguy c lm cht
sau mt hin tng tng tranh o thi.
NHM POLYETHER IONOPHORE
MONENSIN, SALINOMYCIN, AVOPARCINE, NARASIN...

1. Ngun gc t nm Streptomyces cinnamonensis
2. Dc l:
- Tc ng: st khun i vi vi khun G+ v cu trng
- C ch: Do lm thay i tnh thm i vi cc ion mng t bo vi khun, c ch s tng
hp ATP (mitochondria) ca cu trng gia on sinh sn
3. S dng: tr cu trng, kch thch tng trng
4. Chng ch nh: g mi , g ty, nht l nga.

- Ngng thuc trc khi git m 3-5 ngy.
NHM NITROFURAN
NITROFURAL, FURAZOLIDON, FURALTADONE, NITROFURANTOIN
1. Ngun gc: Nhm khng sinh tng hp
2. c im dc l:
- Thuc bt kt tinh mu vng ti, kh tan trong nc, km hp thu qua rut nhng c hot
tnh cao pH ng tiu ha nn n c vai tr nh cht khng khun ng rut. Phn b
dch ngoi bo. Bi thi gn nh hon ton qua phn .
- Hot tnh: km khun G+, G- (tr Proteus v Pseudomonas), Coccidia
3. Ch nh: + Vim rut tiu chy do E. Coli, Salmonella (thng hn, ph thng hn,
Bch l): 30-40mg/kgP ; 100-400g/ tn thc n
+ Cu trng g, th 0,4% /thc n hoc 3%/ nc ung
4. c tnh:
- Thn kinh (t lit, mt iu ha)
- Chy mu rut
- Nguy c ung th
36
5. Chng ch nh:
- Khng s dng cho loi thy cm v gia sc non do c tnh cao
- Khng dng lm cht b sung trong thc n ca b
NHM NITROIMIDAZOLE
METRONIDAZOLE
1. Ngun gc: Nhm khng sinh tng hp
2. Dc ng:
- Hp thu tt qua ng tiu ha
- Phn b: ni bo, khp cc ni trong c th
- Bi thi qua: nc tiu v mt
3. Dc lc:
- Tc ng tnh khun. C ch: xo trn bin i nng lng
- Ph khng khun: hp: G+, vi khun k kh (thay cho Vancomycin), Treponema (xon
khun), Trichomonas (Protozoa)
4. c tnh: thn kinh v nguy c gy ung th
NHM GLYCOPEPTIDE
VANCOMYCIN
- Ngun gc: Chit t S orientalis

- Tc ng khng khun: st khun do c ch tng hp thnh t bo
- Ph khng khun: cu khun G+ (c bit l Staphylococcus), Clostridium
- Hp thu: km qua ng tiu ha , t s dng trong th y
- c tnh cao trn thn, gim trng trn ch, h huyt p, nn ma
37
CHNG 4.
THUC KH TRNG V THUC ST TRNG
1. MT S KHI NIM
- Thuc kh trng (disinfactants) l nhng cht c kh nng tiu dit vi khun hoc cc vi sinh
vt nhim khc. Khc vi khng sinh, nhng cht kh trng ph hy nguyn sinh cht ca vi
khun v lun c vt ch. Do chng ch c s dng cho cc vt v sinh.
- Thuc st trng (antiseptics) l nhng cht c tc dng c ch s sinh trng v sinh sn ca vi
sinh vt hoc git cht vi khun mt nng khng lm nh hng n m bo vt ch. Do
chng c s dng cho cc m bnh ngn chn s nhim khun.
Ranh gii gia cht st trng v cht kh trng cng khng r rt, mt ha cht c th l cht
kh trng hoc st trng ty theo nng s dng v cc iu kin p dng.
2. NHNG NGUYN TC ST TRNG, KH TRNG THNG THNG

- t hiu qu, hu ht cc loi thuc st trng cn c mt thi gian pht sinh tc dng
V d: ra tay trc khi phu thut 5 pht vi savon, 5 pht vi chlohexidin
- gia tng hiu qu st trng cn ch v sinh sch s mi trng v dng c trc khi p
dng cc bin php ha hc hoc vt l v bi t, rc ri... c th to lp mng c hc ngn
cn tc ng trc tip ca thuc vo vi trng, cng nh lm thay i hoc gim hm lng thuc
V d: v sinh phng c trc khi xng formol
- Ra sch bng nc rt cn thit trnh i khng gia 2 loi ha dc
V d: ra tay bng nc ct gia 2 ln st trng bng ha cht trc phu thut
- u tin st trng bng nhit hn l ha cht (nu c th), trong nhit m c hiu qu v
nhanh hn nhit kh
V d: hp autoclave tt hn sy kh
- Cn la chn thuc st trng kh trng ph hp vi tnh nhy cm ca mm bnh
V d: virus b tiu dit bi cht kim nhng khng vi phenol
3. CHT ST TRNG NGOI DA
3.1. X phng (savon)

Thuc nhm cht hot din (surfactants). C tnh lng cc (RCOONa) mt u i nc,
mt u i cht bo. Khi s dng savon trn mt b mt c du (da) th nhng phn t ny s t
phn cc, mt u trong nc v mt u trong cht bo, ngn cn s kt dnh gia cc ht du,
duy tr tnh lin tc gia du v nc. Bng cch ny, cc phn t savon d nh tng ha cht
be trn da ng thi lm cho cc vi khun bm dnh b treo, khi ra s b tri i.
C tc dng trn vi khun G+ v khng acid nhng khng c tc dng trn vi khun G-
Hot tnh s gia tng khi c thm potassium iodine (KI) v gim i khi c nhiu Ca2+ (nc cng).
S dng: ra tay, vng phu thut, dng c
3.2. Cn (alcohol)
Cn lm bin tnh protein v lm gim sc cng b mt. Loi thng s dng nht l
ethanol 70% v isopropanol 50%. Thi gian p dng khong 3 pht
38
C tc dng trn cc t bo sinh dng (k c BK- trc khun lao, virus c v, nm) nhng
khng c tc dng trn bo t
Tng k vi HNO3, KMnO4, Na2SO4, CuSO4 (mui gy kt ta), mu m (albumin)
S dng: st trng tay, da.
3.3. Iod
Iod khuch tn vo t bo v can thip vo cc phn ng bin dng ca nguyn sinh cht.
Iod t gy c, ch gy kh da v c th hn ch bng cch bi glycerin.
C tc dng trn vi khun, virus, nm, trng k sinh trng c bit l c vi khun lao v cc vi
khun c nha bo
Cc ch phm:
* Dung dch cn iod 1%, khi ha tan trong cn, tc dng khng khun ca iod mnh hn.
* PVP iodine 10% (polyvinylpyrrolidone iodine- iod hu dng 1%) - Iodophore: gm I2, cht ty,
cht lm t, cht ha tan, cht mang (phng thch dn iod)
S dng:st trng da ni sp phu thut, ni tim, thin, rn, nhng v vim, ra c quan sinh
dc...
3.4. Thuc (mercurochrome)

Ch yu c tc ng tnh khun, hot tnh b gim mnh khi tip xc vi cc cht hu c.
Dung dch thng dng l 2-5 %. Ngy nay, cc cht hu c c thy ngn t c v t kch ng
hn dn dn thay th (phenylmercuric nitrate). Tuy nhin, do tc ng nhim mi trng ca
cc kim loi nng, chng cng t c dng hn nhng ha cht khc
Dng st trng cc b ni vt thng, thin, pxe, tht ra t cung
3.5. Nc oxygi (peroxid hydrogen H2O2)

Thuc nhm tc nhn oxyha v phng thch oxy ang sinh [O] khi tip xc vi mng
nhy hay c catalase. Kt hp nhanh chng vi cht hu c
Cc tc dng st trng nh trn cc vi khun hiu kh G+, G- nhng khng dit c bo t.
Cng dng ch yu l r vt thng v lm mt mi hi.
3.6. Thuc tm (permanganate potassium KMnO4)

Phng thch [O] khi tip xc cht hu c nhng ch c tc dng bn ngoi. Khi dung
dch chuyn sang mu nu th khng cn hot tnh.
C tc dng st trng tay, vt thng, mn lot (dung dch 0,1%), ra t cung (dung dch 0,3%).
Gim c tnh ca cc alkaloid (strychnin, morphin).
3.7. Xanh methylen (tetramethylthionin HCl)

Dung dch 1% st trng bn ngoi: vim ming, mn nc, vim mng, ra c quan sinh
dc. St trng bn trong: ng tit niu
4. THUC ST TRNG PHNG TH NGHIM, CHUNG TRI, DNG C CHN

NUI
Tc nhn vt l
4.1. Nhit
Nhit kh Nhit m
39
C ch st khun oxyha v t chy ng kt protein

Yu cu thi gian lu, nhit cao vo cht hu c (ha
cht khng vo c)
S dng sy cc dng c thy tinh hp cc mi trng
iu kin 180oC trong 2-3 gi 121oC/1atm trong 15-20
4.2. nh sng: tia cc tm (ultra violet UV)

= 2500-2800 Ao
Chng c vi khun G- v vi khun khng sinh bo t nhng Staphylococcus, Streptococcus th
khng
S dng kh trng phng th nghim, bung cy, phng gii phu
Tc nhn ha hc
4.3. Acid
HCl, H2SO4 0,1-1N: s dng hn ch v c im n mn
Acid boric: kh nng dit trng yu
4.4. NaOH (Lye, soda lye)

Thm nhp vo cc phn t bm dnh, vi sinh vt, lm tan chng hoc bin i chng
C kh nng tiu dit hu ht cc vi khun gy bnh thng thng, virus (dch t heo, FMD).
nng m c (5%) c th tiu dit c bo t nhit thn.
Dung dch long 4-8 0/00 dng st trng dng c (mng n, x, cuc xng...) nn, sn, tng,
rnh phn, ng i, xe ch gia sc, h tiu c. C th phi hp vi dung dch vi sa 5%.
4.5. CaO (lime, quicklime)

Ht m (H2O) v CO2 trong khng kh to Ca(OH)2 v sinh nhit, nu lu ngoi khng kh th
CaO tc dng vi CO2 to CaCO3 (tr khng cn tc dng na)
Khng c tc dng trn bo t nhit thn v Clostridium
S dng rc trn sn, nn xi mng, t. Khi dng nn ch c th gy kh da v mng th
4.6. Ca(OH)2 bt trng xp

Cha ti thiu 0,14g/100 ml nc vi sa, d tan trong nc nng. Dung dch pha cn y k
trnh to vng trn b mt lm trm hin Ca di y
Ca(OH)2 + CO2 CaCO3
Dng st trng chung tri, thuc khng acid.
4.7. Amonium bc 4 th h I: Benzalkoniumchloride (Zephiran, Antigerm).

Thuc nhm cht hot din cation. Ion i nc ca phn t amonium bc 4 s phn ly mang in
tch dng do nn trnh dng chung vi savon (cht hot din anion). Thnh vi khun hp ph
ha cht ny rt cao, ni s pht sinh tc dng. 99% vi khun b tiu dit, tuy nhin nhng vi
khun co cm pha trong s pht sinh tnh khng
Tc dng st khun trn vi khun G+, G- nhng khng c hiu qu i vi virus, bo t v vi
khun lao
St trng da, vt thng: dung dch 1/2000-1/1000
40
Tht ra t cung dung dch 1/20000

Kh trng chung tri dung dch 10%
4.8. Chloramin T (cha 12% Cl hot tnh)

Di tc dng ca nc, Chloramin T to thnh acid hypocloro (HOCl) ri phng thch Cl c tc
dng c ch cc phn ng enzyme ca t bo, thoi bin protein v bt hot acid nhn
Tc dng trn vi khun, virus, nm mc (1ppm), BK (50ppm)
Dng ra sn nh, dng c vt sa, vt thng, ni nhim trng
4.9. Phenol
c Lister khm ph u tin, l cht chuyn ha t hc n, than . Ngy nay, do c tnh cao,
kch ng m nn t c s dng
Tc ng gy c i vi nguyn sinh cht, ph hy thnh t bo, ng kt protein
Dung dch 5% c th tiu dit nha bo nhit thn, BK
Thng dng tiu c chung tri, dng c th y (dung dch 3-5%), tiu c qun o, ra vt
thng (dung dch 3%), chng nga, tr gh (dung dch 1%). Ch khng s dng tiu c l st
sinh v s li mi hi
4.10. Crezol (Crezylic acid, Crezylol, Crezyl)

Tc dng st khun v dit nm gp 3 ln phenol nhng tc ng yu trn virus. c bit vn gi
c hiu lc khi c cht hu c v t c hn phenol
Dung dch 0,2-0,5% dng st trng tay, dung dch 2% st trng chung tri. Hi Crezol c th st
trng lng g, my p trng, nh my thc n...
4.11. Formol (Formalin, Formaldehyd) c cha 34-38% Formaldehyd

L cht kh trng mnh, lm ng cng protein. V hot vi sinh vt bng cch alkylha nhm -
NH2 , -SH ca protein v vng nitrogen trong cc base purin
C tc dng trn hu ht cc vi khun, vi khun sinh bo t, trc khun BK, virus
S dng kh trng dng c , chung tri, phng c, l p, bo qun mu bnh phm v iu
ch vaccin
- Dung dch 4% dng st trng thng thng v bo qun mu bnh
- 15-30ml dung dch formol +100ml nc dng kh trng my p trng, bung cy vi trng,
chung tri
- 1,5L Formol 36% +1600g KMnO4 kh trng c 100m2 phng lm vic
Do c tnh sinh hi, kch ng nim mc, lm cht biu m, mt cm gic, c nguy c gy ung
th nn khi dng phi eo gng, khu trang...
4.12. Cc thuc kh trng, st trng phi hp

Ngy nay, gia tng hiu lc ca cc thuc st trng v gim bt c tnh ca chng, cc nh
sn xut a ra th trng mt s loi thuc st trng phi hp:
V d: VIRKON (BAYER): peroxygen, cht hot din b mt

(surfactants), acid hu c, acid v c
PROPHYL (COOPHAVET): 4 chloro 3-methyl phenol, 3-benzyl
4 chlorophenol
TH4 (SOGEVAL): glutaraldehyd, phc hp amonium bc 4,
terpineol, du thng
41
CHNG 5.
THUC TR K SINH TRNG V NM
1. TM TT CC LOI THUC TR K SINH TRNG V NM
1.1. Nhm tr c ni v ngoi k sinh 1.2.2. Nhm thuc tr sn dy

1.1.1. Nhm Avermectines: 1.2.2.1 Nhm Halogenophenol
Abamectin Bithinoloxyle
Doramectin 1.2.2.2. Nhm Salicylanilide
Ivermectin Niclosamide
Eprinomectin 1.2.2.3. Benzimidazoles
1.1.2. Nhm Milbemycines 1.2.2.4. Nhm khc
Moxidectin Nitroscanate
Milbenmycin oxim Praziquantel
1.2. Nhm thuc tr giun sn 1.2.3. Thuc tr sn l

1.2.1. Thuc tr giun trn 1.2.3.1. Thuc tr sn l gan cha trng
1.2.1.1 Nhm Avermectines thnh
1.2.1.2 Nhm Milbenmycines - Nhm Halogenophenol
1.2.1.3 Nhm Benzimidazoles Bithinoloxyle
Albendazole - Nhm Salicylanilide
Fenbendazole Oxyclozanide
Flubendazole -Nhm Disulfonamides
Mebendazole Clorsulon
Ofendazole 1.2.3.2. Thuc tr sn l gan trng thnh
Oxibendazole & u trng
Thiabendazole - Nhm Benzimidazol
1.2.1.4. Nhm Albendazole
Pro-benzimidazoles - Halogenophenol
Thiophanate Nitroxinil
Febantel - Salicylanilide
Netobimin Closantel
1.2.1.5. Nhm 1.2.3.3. Thuc tr sn l gan nh
Imidazothiazoles Albendazole
Tetramisole Thiophanate
Levamisole Notobimin
1.2.1.6 Nhm Tetrahydropyrimidines
Pyrantel 1.3. Thuc tr cu trng
Morantel 1.3.1. Nhm Sulfonamides
1.2.1.7 Nhm Organophosphates Sulfaquinoxalin
Diclovos Sulfaguanidine
Metrifonate Sulfadimethoxine
1.2.1.8. Nhm Salicylanilide Sulfadimidine
Closantel 1.3.2. Nhm Diaminopyrimidine
1.2.1.9. Piperazine Diaveridine
Piperazin Pyrimethamine
1.2.1.10. Nhm khc 1.3.3. Nitrofuran
Nitroscanate Furazolidon
1.3.4. Dn xut Benzenic
42
Ethopabate Rotenone
Dinitolmide 1.4.8. Organo arsenic
Robenidine Roxarsone
1.3.5. Cc hp cht d vng 1.4.9. Polyether ionophore
Clazuril
Toltrazuril 1.5. Thuc tr KST ng mu
Diclazuril 1.5.1. Nhm Diamidine
Phoxim Pentamidine
Phosmet Phenamidine
Narasin 1.5.2. Carbanilides
Salinomycin Imidocarbe
Amprolium 1.5.3. Nhm khc
Halofuginone Berenil
1.3.6. Nhm polyether ionphore Trypamidium
Monensin
Narasin 1.6. Thuc tr nguyn sinh V
Salinomycin 1.6.1. Nhm Nitroimidazole
Dimetridazole
1.4. Thuc tr ngoi k sinh Carnidazole
1.4.1. Nhm organochlor Ronidazole
Lindane 1.6.2. Organo arsenic
1.4.2. Organophosphore Roxarsone
Coumaphos 1.6.3. Dn xut Antimoine
Diclovos Antimoniate
Malathion
Fenthion 1.7. Thuc tr nm
1.4.3. Nhm Carbamate 1.7.1. Nhm khng sinh
Carbaryl Griseofulvine
Methomyl Natamycin
Bendiocarb Nystatin
1.4.4. Nhm Pyrethines 1.7.2. Dn xut Imidazole
Pyrethrin Ketoconazole
Deltamethrin Enilconazole
Cyfluthrin Myconazole
Phenotrine 1.7.3. Cht hot din cation
1.4.5. Nhm Avermectin Benzalkonium
1.4.6. Nhm Phenylpyrazoles 1.7.4. Acid hu c
Fipronil A. Boric
1.4.7. Nhm khc A. Salicylic
Amitraz
Closantel * Ngun: Dictionaire des Mdicaments Veterinaires
Piperonyl 1997
43
2. MT S NGUYN TC KHI S DNG THUC TR K SINH TRNG
- Mi loi giun sn nhy cm vi 1 vi loi thuc c hiu do cn phi xc nh bng xt

nghim (phn, mu...)
- Sau khi chm dt thi gian iu tr, 2 tun sau cng cn xt nghim li
- Cn bit vng i ca k sinh trng s dng liu lp li
- Cn nm c khong an ton (ch s an ton -safe index) ca tng thuc
Ch s an ton l liu c th cung cp cho gia sc m cha c nhng phn ng ph hay c
tnh xy ra, thng cao hn liu khuyn co.
Khong an ton:
Rng: SI > 6 (Benzimidazole)
Va: SI = 6 (Levamisole)
Hp: SI 3 (thuc tr sn l gan)
- m bo ngng thuc trc thi gian git m

Thuc tr cu trng : 3-5 ngy (ring sulfaquinoxalin :10 ngy ) Thuc tr giun sn : 8-14 ngy
( ring nitroxynil : 21-30 ngy)
Thuc tr ngoi k sinh: 0-60 ngy
-Hu ht cc thuc tr k sinh trng u chng ch nh trong trng hp c thai, gia sc non
( t hn 2-3 thng tui)
- S dng thuc tr ngoi k sinh cn trnh vy nhim ln nim mc mt, mi, tai v hn ch
s ngn cn tip xc vi thuc bng cch co lng nhng vng nhim k sinh trng
III. Cc nhm tr c ni v ngoi k sinh

3.1. Ivermectin
- y l mt loi thuc tr k sinh trng nm trong nhm Avermectin c cu trc ha hc lin
quan n vng macrolid. Avermectin c chit t nm Streptomyces avermitilis, Ivermectin
l cht bn tng hp t avermectin
- C ch tc ng : phong b s dn truyn xung ng thn kinh do tng phng thch GABA
(gama amino butyric acid) cht trung gian ha hc ny lm t lit ( paralyse)k sinh vt v k
sinh tan ra ( lyse)
- Ph tc ng : rng, tc ng trn c giun trng thnh v giun cha trng thnh, tt c
giun trn ng tiu ha v phi, mt s ngoi k sinh tru b, cu, nga, heo; giun trn
ng rut, gh tai, gh Sarcoptes ch; mt s giun trn ng tiu ha v ngoi k sinh
g (mt, rn, ch...)
Khng c hoc c rt t hiu qu trn sn dy, sn l v nguyn sinh ng vt
- Liu lng :
Tru b : 0,2mg/kgP (SC,P.O)
Heo : 0,3mg/kgP (S.C)
g/kgP - 0,5mg/kgP( S.C) (ty theo mc ch s dng )Ch : 5
Gia cm : 0.2-0,3mg/kgP (S.C, P.O)
-Khong an ton rng ( c tnh xy ra liu ln gp 60-100 ln liu iu tr ty tng loi gia
sc) v c th s dng cho th ging, th mang thai
3.2. Milbemycin oxim

- Thuc nhm Milbemycin, l sn phm ln men t S.hygroscopicus aureolacrimosus. Ch
yu s dng cho ch mo.
- C ch tc ng : tng t ivermectin
43
- Ph tc ng : giun tim, giun a, giun mc , gh Demodex ch mo; giun trn v ngoi k
sinh trn cc loi gia sc khc
- S dng : Do c kh nng tiu dit L3 - L5 ca giun tim, ngi ta thng dng phng
nga giun tim cho ch 0.5-0.99mg/kgP, hoc tr khi nhim giun : 0,5mg/kgP
IV. Thuc tr giun trn

4.1. Nhm avermectin v milbemycin
4.2. Nhm benzimidazol
- Cht tng hp u tin l thiabendazole (thp nin 1960), sau hng trm cht c
pht trin, nhng cht c hiu qu v an ton gm : albendazole, cambendazole, fenbendazole,
flubendazole, mebendazole, oxfendazole, oxibendazole, parbendazole, thiophanate
Theo FDA (USA) thiabendazole c s dng cho nga, heo, b, cu
fenbendazole c dng cho nga, ch, heo, tru b
mebendazole v oxibendazole cho nga, ch
oxfendazole v albendazole cho tru bo
- C ch tc ng: nhit cao trong c th ng vt hu nh, cc benzimidazole c i lc
vi giun sn hn. Chng gn vo cu trc hnh ng ca t bo rut giun sn ngn cn s tng
hp t bo rut, c ch hot ng ca fumarate reductase, , ngn cn s hp thu glucose, gim
d tr glycogen lm cht i k sinh c dng trng thnh v cha trng thnh
- Ph tc ng :
Trn tru b : tr c giun phi, giun tc, mt s sn dy, sn l (albendazole, fenbendazole)
Trn heo : tr giun a, , giun tc, giun bao t, giun phi, , giun kt ht, giun thn
Trn ch : tr giun a, giun mc, giun tc , sn dy Taenia
Trn gia cm: tr giun trn v sn dy (Moniezia)
- c tnh :
Khong an ton rng: liu gy c ti thiu tru b l 750mg/kgP ( khong 100 ln liu tr
liu)
Thi gian ngng thuc trc git m hay s dng sa thay i t 6 ngy (parbendazole) n
28 ngy (cambendazole)
Chng ch nh gia sc c thai nht l trong thai k u
- Liu lng : P.O tru b: 66-110mg/kgP
Heo : 75 mg/kgP
Gia cm : 20-50mg/kgP
4.3. Febantel
- Thuc nhm Probenzimidazol, ch cht chuyn ha ca chng trong c th mi c hiu lc
dit k sinh
- C ch tc ng : xo trn chuyn ha nng lng bng cch cn tr hot ng ca enzym
fumarate reductase
- Ph tc ng : rng, c hiu qu trn giun trn ch mo, nga, tru b, heo
Khi dng cho ch, febantel thng c phi hp vi praziquantel hoc pyrantel tiu dit
c giun trn v sn dy
- c tnh : febantel c khong an ton rng, c th dng cho th ging v th mang thai
trong sut thai k
Liu gy c nga >240mg/kgP (> 40 ln liu iu tr )
- Liu lng : Ch mo > 6 thng : 10mg/kgP X 3 ngy
Ch mo con : 15mg/kgP X 3 ngy
Nga : 6mg/kgP
4.4. Levamisole
- Thuc nhm imidazothiazole, l dng ng phn quay tri ca tetramisole nhng an ton
44
hn
- C ch: lm giun b t lit . Levamisole c tc ng kch thch hch ging cholin nhng sau
l phong b s dn truyn thn kinh c.
- Ph tc ng: dit tt c cc loi giun trn k sinh trn ng h hp v tiu ha ca tru b
(giun phi, giun kt ht), nga, heo (giun a, giun phi, giun kt ht, giun thn), ch (giun
a, giun mc, giun tc, giun tim) v th hoang d.
Khng c hiu qu i v sn l, sn dy v nguyn sinh ng vt.
- c tnh: so vi benzimidazole th levamisole c khong an ton hp hn (liu gy c gp
2-6 ln liu tr liu)
Thi gian ngng thuc trc git m v dng sa: 48h
- Liu lng:
Tru b, d cu, heo: 8-15mg/kgP (P.O,SC) nhng khng qu 4,5g
4.5. Pyrantel
- Thuc nhm tetrahydropyrimidine. Hp thu d dng qua ng tiu ha ca heo, ch
- C ch tc ng: tng t levamisole, morantel. Chng l cht ch vn cholinergic. S co
c qu mc s dn n lit c v giun ni lng v tr bm vo vt ch.
- Ph tc ng: rng, dit cc loi giun trn k c giun trng thnh, giun cha trng thnh
v u trng trn cc loi gia sc nh heo (giun a, giun kt ht), tru b, ch (giun mc, giun
a)
Khng c hiu qu trn giun tc, giun phi, giun xon bao t heo; giun tim, giun xon, sn
dy ch.
- c tnh: khng c cho tt c cc loi liu 7 ln ln hn liu tr liu, dng c cho ch
mi la tui k c ch mang thai v ang cho sa.
- Liu lng:
Pyrantel tartrate: Heo: 22mg/kgP ti a 2g/con
Tru b: 25mg/kgP
Pyrantel palmoate: Ch:2,2kg: 5mg/kgP
4.6. Piperazine
- Thuc nhm phc cht d vng n gin c pht hin t rt lu (1950s). Tan tt v c
hp thu hon ton phn trn ng tiu ha, c loi thi nhanh qua thn sau 24h.
- C ch: lm t lit giun do c ch tc ng ca acetylcholin (anticholinergic action) trn tm
ng c vn t li thi giun ra khi ng tiu ha.
- Ph tc ng: Rt c hiu qu i vi giun a v giun kt ht cc loi gia sc, km hiu
qu hn trn giun xon. Khng c hiu qu i vi cc k sinh trng khc. Giun trng thnh
thng nhy cm vi thuc hn giun non v u trng
- c tnh: khong an ton va (liu gy c 4-7 ln liu iu tr), th non (b con 4 tun tui)
khng b nh hng
- Liu lng:
Piperazine base: Ch mo: 45-65mg/kgP
Tru b, heo: 110mg/kgP
Gia cm: 32mg/kgP (khong 0,3g/con)
4.6. Nitroscanate
- y l loi thuc dit ki sinh trng ph rng, c hiu qu loi tr giun trn, giun mc v c
sn dy (tr E. granulosus) trn ch. 100% giun b loi thi sau 24h, ch nh sau liu th 2.
An ton cho ch mang thai.
- C ch: Lm tng tnh thm ca mng t bo giun i vi Ca, lm tng s co c, lit c
ng thi to cc khng bo lm phn r v lm giun cht.
45
- Ph tc ng: giun a ch mo, giun mc ch, sn dy ch
- c tnh: c kh nng to nitrosamin
- Liu lng: 50mg/kgP (P.O)
5. THUC TR SN DY
5.1. Niclosamid
- Thuc nhm cht hu c tng hp, bt vng nht, khng v, khng tan trong nc nhng tan
trong cn.
- C ch tc ng: c ch hp thu glucose ca sn dy, tch i cc phn ng phosphoryl
oxyha ty th, kt qu l phong b chu trnh Krebs, tch lu acid lactic, git cht k sinh.
Sn dy cht s c tiu ha trc khi ra khi c th v th chng ta khng th thy cc t
sn trong phn gia sc.
- Ph tc ng: sn dy loi nhai li (Moniezia), sn dy ch mo (Taenia, Dipylidium), sn
dy gia cm (Raillietia).
t c hiu qu i vi Echnococcus granulosus.
- c tnh: khong an ton rng (liu gy c > 40 ln liu iu tr tru b), khng nh
hng xu n th mang thai trong sut thai k. Kh c i vi ngng.
- Liu lng: Ch mo: 100-157mg/kgP (P.O)
Tru b: 50mg/kg
Thng c phi hp vi cc thuc tr giun trn: pyrantel, levamisole, oxibendazole m
rng ph tc ng.
5.2. Praziquantel
- Tinh th khng mu, khng mi, tan trong cc dung mi hu c. c hp thu hon ton v
nhanh chng vo ng tiu ha, phn b n khp cc c quan (c, no, khoang bng, rut,
ti mt...). Chuyn ha gan v bi thi qua nc tiu.
- C ch tc ng: c hp thu nhanh chng vo c th sn dy, sn l, praziquantel lm
tng tinh thm ca mng t bo giun vi Ca, s co bp qu mc s dn n t lit.
- Ph tc ng: C hiu qu trn c sn dy trng thnh v u trng ca cc loi gia sc, k
c Echinococcus. Tiu dit mt s sn l (sn l rut heo Fasciolopsis buski, sn l ty tng
cu Eurytrema pancreaticum, sn l c)
- c tnh: Khong an ton tng i rng (liu gy c >5 ln liu tr liu ch mo). C
th dng cho th ging v th mang thai.
- Liu lng: Ch mo: 2-5mg/.kgP
Tru b, heo: 10-15mg/kgP
6. THUC TR SN L
6.1. Oxyclozanide
- Dng tinh th trng, khng tan trong nc. Phn b nhiu gan, thn rut. Bi thi nhanh
qua mt.
- C ch tc ng: cha r rng nhng oxyclozanide tch i phn ng phosphoryl oxyha
ty th.
- Ph tc ng: rt c hiu qu tiu dit sn l gan nhng km hiu qu trn sn l d c v
ch c hiu qu trn sn l trng thnh
- c tnh: thp, liu gy c > 6 ln liu iu tr. Khng nh hng khi dng cho th c thai.
Tn tr t nn thi gian ngng thuc trc git m ngn v khng cn ngng trc khi dng
sa.
- Liu lng: Loi nhai li: 10-15mg/kgP / P.O
46
6.2. Closantel
- Cht bt trng khng tan trong nc, bi thi qua mt
- C ch: gia tng tnh thm ca ty th, c ch qu trnh sinh nng lng bng cch tch i
phn ng phosphoryl oxyha.
- C tc ng trn sn l gan dng trng thnh v cha trng thnh, dit c giun trn ht
mu (Heamonchus contortus), giun mc ch
- c tnh thp, tn d trong sc sn t, khng nh hng cc ch tiu sinh sn ca th
- Liu lng: 5-7,5mg/kgP (IM)
10-15mg/kgP (P.O)
6.3. Nitroxinil
- Cht bt vng tan trong nc, c th dng ng ung nhng tim di da l ng cp
hiu qu nht.
- C hiu qu tt trong iu tr sn l gan dng trng thnh v cha trng thnh, c hiu
qu hn ivermectin v benzimidazole trong iu tr Heamoncus. Tuy nhin cng khng dit
c sn l d c Paramphistomum.
- Bi thi rt chm cho nn thi gian ngng thuc trc khi dng tht l 2 thng v khng
dng cho b sa ang cung cp sa cho tiu dng.
- Liu lng: 10mg/kgP /S.C
7. THUC TR CU TRNG
7.1. Sulfamide v diaminopyrimidin

- Sulfamid v diaminopyrimidin hip lc vi nhau trong iu tr cu trng. Mi cht tc ng
ln hai bc k tip nhau ca qu trnh bin dng. C hiu qu hn trong giai on sinh sn
v tnh ca cu trng.
- Ch nh trong vic phng v tr tt c cc loi cu trng, bnh do Toxoplasma gy ra
- Chng ch nh: g trng thng phm
- Phi hp:
* Sulfaquinoxalin + Diaveridin + vitamin K
* Sulfadimidin + Sulfadimethoxine + Diaveridin + vitamin K
* Sulfaquinoxalin + Pyrimethamin
- Cch dng: cho gia cm: thng trn trong thc n hoc pha trong nc ung
iu tr: 3-5 ngy
Phng: ung 2 ngy-ngh 3 ngy- ung 2 ngy
7.2. Monensin
- Thuc nhm khng sinh polyether ionophore, chit t nm Streptomyces cinamonensis. t
tan trong nc, hp thu qua rut v bi thi nhanh qua mt
- C ch: chng cu trng trong giai on u ca chu k sinh sn bng cch c ch s tng
hp ATP do to thnh phc cht vi cc ion (Na+, K+, Ca2+) v i qua mng sinh hc.
- Khng dng cho g thng phm v ngng thuc trc git m 3-5 ngy
- Liu lng: 90-100ppm (90-100g/ tn thc n)
7.3. Amprolium
- Cht bt rtng tan trong nc. Tc ng vo th h u tin schizolnt v l cht i khng
cnh tranh vi thiamin, ngn cn s sinh sn ca merozoite.
- c dng phng cu trng cho gia cm. liu phng, khng cn thi gian ngng thuc
trc git m
47
Trn thc n: 35-110 ppm
Pha nc ung: 0.012%.
8. THUC TR NGOI K SINH
8.1. Lindan
- Thuc hp cht Clo hu c, nhm hexachlorocyclohexan. L cht t gy tn ng trong mi
trng nht . dung dch nng 75% lindan xm nhp d dng vo lng da ca gia sc gia
cm
- C ch: lindan lm gim s gn kt vi GABA ca cc ion Cl
- S dng: dit ngoi k sinh: gh, ve, b cht, mt, rn... bng cch ngm, phun xt, p ni
c k sinh. Nn thc hin vo sng sm hoc chiu mt v lp li sau 10-14 ngy.
8.2. Coumaphos
- Tinh th khng tan trong nc nhng tan trong cc dung mi hu c. C c tnh cao nn
trnh tip xc nim mc, da tay, thc n nc ung...
- C ch: c ch cholinesterase lm t lit k sinh
- Tc ng: kim sot tt c cc giai on ca ve i gia sc, heo, ch, ngoi ra cn c tc
ng n giun trn.
- S dng: nhng hoc phun xt: 0,6 kg/1200-1300L
8.3. Amitraz
- Thuc nhm formamidine, tinh th vng nht, tan hon ton trong dung mi hu c
- C ch: ngn cn enzym monoamin oxidase c vai tr trong s chuyn ha amin hin din
trong h thn kinh ca ngoi k sinh. Amitraz phn tn khp c th c bit l n lng da t
gy c v gy cht k sinh c bit trong giai on u trng v nymph t ngn cn s
bm vo lng da ca k sinh.
- Ch nh: . dit ve, b cht tru b, d cu, heo, ch mo
c bit gh Demodex v Sarcoptes ch mo
- S dng: Phun xt, thoa ln vng nhim k sinh: 500mg/1L nc
Vng eo c c cha thuc
- c tnh: tng i c nn khi dng phi thn trong trnh tip xc vi da, nim mc, thc
n, nc ung.
9. THUC TR K SINH TRNG NG MU
9.1. Pentamidin
- Thuc nhm cht c ngun gc t diamidin
- Ch nh: L dng trng (Babesia, Theileria) tru b, d cu, nga, ch
Tim mao trng (Trypanosoma, Leishmania) b nga, ch
- S dng: ch: liu c s =4mg/kgP (IM, khng nn tim SC) lp li sau 2 ngy. i vi
Leishmania, cn lp li 5 mi, tng dn t 2-3-4mg/kgP
Tru b: 3 mg/kgP / IM (dung dch 4%)
9.2. Imidocarb
- Dng bt tan trong nc, cng thuc nhm cht c ngun gc t Diamidin
- Ch nh: L dng trng, bin trng tru b, nga, ch mo
- Liu lng: Gia sc ln: 1-3 mg/kgP (SC, IM). Ch mo: 5 mg/kgP
10. THUC TR NM
48
10.1. Griseofulvin
- C ngun gc t nm Penicillinum griseofulvin. Bt khng mu, km tan trong nc, hp
thu tt trong thc n giu cht bo. Phn b tt n da, tc, mng
- C ch tc ng: gn vo cu trc hnh ng lm v thoi phn bo, c ch s phn bo ca
nm v hnh thnh nhng t bo nm c nhiu nhn. Ngoi ra cn lm xo trn s tng hp
thnh t bo si nm lm si nm xon vo, cong queo.
- Ph tc ng: trn nhiu dng vi nm ngoi da: Microsporum, Trichophyton,
Epidermophyton. Khng c hiu qu iu tr nm gy bnh ni tng: Candida, Actinomyces.
- Ch nh: nm da, mng, lng do cc nm nhy cm gy ra cho gia sc
- Liu lng: B ngh: 10mg/kg (P.O)
Ch mo: 20-50mg/kgP
10.2. Ketoconazole
- Thuc nhm imidazole. Hp thu tt ngay trong mi trng acid nhng s gim nu thc n
c cht antacid. Phn b tt n cc m
- C ch: phong b s tng hp esgosterol bng cch loi b nhm methyl ca lanosterol, t
lm thay i tnh thm ca mng t bo. ng thi lm xo trn cc hot ng ca enzym
peroxidase, H2O2 s gy c cho t bo hoc lm cht t bo.
- Ph tc ng: nm ngoi da v nm ni tng: Candida, Blastomyces, Histoplasma. Khng
c hiu qu i vi Aspergillus.
- Liu lng: Ch: 10-20mg/kgP (P.O hoc tm gi) trong 2-8 tun
Nga: 3-6 mg/kgP
- Ch : nguy c gy c cho gan s gia tng khi dng chung vi griseofulvin
49
CHNG 6.
KHNG VIM V KHNG HISTAMIN
1. KHI NIM QU TRNH VIM
1.1. Vim l g?
Vim l mt chui cc hin tng do nhiu tc nhn nh nhim trng, cc phn ng
min dch, tn thng do nhit hoc vt l...gy ra cc du hiu lm sng c trng : sng,
nng, , au.
1.2. Cc giai on ca qu trnh vim

1.2.1. Giai on cp :
M tn thng tit ra cc cht trung gian ni sinh gy xo trn chc nng c quan b vim
Cht trung gian Ngun gc Dn mch Tng tnh thm mch Ho hng ng Gy au

Histamin T bo Mast ++ - -
-
Serotonin Tiu cu +/ - -
+++
Brandykinin Huyt tng + + + -
+
Prostaglandin E2 M +++ ++ +
Leukotrien M - +++ -
1.2.2. Giai on p ng min dch

Cc i thc bo, bch cu trung tnh, lympho tp trung vo vim tiu dit tc nhn
gy vim bng cch thc bo hoc trung ha c t k n l giai on dn sch cc mnh
vn m, cht hot t v thay th bng nhng t bo mi.
1.2.3. Giai on vim mn

M tit ra interleukin 123 v cc cht khc lm sn xut protaglandin hot ha cc t
bo bch cu lm phng thch cc gc t do nh H2O2 (hydrogen peroxid), gc hydroxyl lm
tn thng xng, sn dn n thp khp.
Ni chung vim l phn ng c li cho c th nhng nu vt qu mc (vim mn) s gy
tn hi mo, lm di tn bch cu, to cc m si khng c li cho c th na
1.3. Cc cht khng vim

Cc cht khng vim khng o ngc c qu trnh ny m ch gii hn hoc lm chm
qu trnh vim bng cch c ch vic sn xut cc cht trung gian gy vim
2. C CH TC NG CA THUC KHNG VIM
50
Tc nhn gy vim
Phospholipid mng t bo
Corticosteroid Phospholipase A2
Cyclooxygenase Lypooxygenase
Endoperoxid vng Acid Arachidonic Leucotrien
NSAIDs, Acetaminiphen NSAIDs mi
Prostaglandin Thromboxan VIM
VIM KT TP TIU CU
3. PHN LOI
3.1. Thuc khng vim glucocorticoid
3.1.1. Glucocorticoid t nhin

Hydrocortison (cortisol) v cortison l cc glucocorticoid t nhin uc tit ra t v thng
thn theo co ch phn hi m tnh. Tuy nhin do hot tnh khng vim thp v c tnh (gi
mui) cn cao nn cc glucocorticoid tng hp ra i.
3.1.2. Glucocorticoid tng hp

- Tc ng : Hai c ch khng vim chnh ca nhm ny l
Gim lng bch cu v i thc bo vim, ngn nhng t bo ny tit ra cc cht trung
gian ha hc lm tng tnh thm thnh mch, dn mch gy nng , sng, au.
c ch enzym phospholipase A2, ngn to thnh cc yu t gy vim nh prostaglandin,
leucotrien, thromboxan
- Tc dng ph :
Tc dng ca mineralcorticoid nn c khuynh hng gi Na, gi nc gy ph
Tc dng tn to ng c th gy cao ng huyt
Tc dng thy gii m , tch tr lipid di da c, mt (moonface)
Lm xo trn chuyn ha Ca: gim hp thu v tng bi thi qua thn, dng lu di s gy
long xng
Gim hot ng ca cc m lympho v hot ng sn xut khng th, suy yu h min dch.
- Ch nh
D ng do thc n, cn trng cn t
Khng vim do bt k nguyn nhn g (c hc, ha hc, nhim trng, min dch...)
Cp cu khi shock do c t, chy mu, shock phn v, try h hp (thng phi hp vi
adrenalin)
- Chng ch nh
Tiu ng (do tc ng lm gim glucose ngoi bin)
Long xng, xp xng (do tng loi thi Ca qua nc tiu)
Lot gic mc (do lm chm lnh vt thng)
Bnh thn, khp, vim mt do virus, nm, lao (do tc dng suy yu h min dch)
Mang thai (co nguy c gy sy thai, cht thai, st nhau)
51
MT S THUC KHNG VIM GLUCOCORTICOID
TN HOT CHT KHNG VIM GI MUI THI GIAN TC NG LIU DNG

Hydrocortison (Cortisol) 1 1 Ngn 2 10mg/kgP (PO)
Cortison 0.8 0.8 (T1/2=6-12h)
Prednison 4 0.3 Trung bnh (T1/2=12-24h) 0.6-2,5 mg/kgP (PO)
Prednisolon 5 0.3
Betamethason 25 0 Di
Dexamethazon 30 0 (T1/2=24-36h) 0,2-2 mg/kgP (PO)
3.2. Thuc khng vim khng steroid (non-steroidal anti-inflammatory drugs- NSAID)
3.2.1. Cc NSAID c
Aspirin (acid acetyl salicylic) c tc dng khng vim, gim au, h st. Tuy nhin Aspirin
c nhiu tc dng ph nh
- Kch thch nim mc d dy c th gy chy mu d dy do aspirin lm gim tng hp
prostaglandin I2 v prostaglandin E2 (cht c ch tit acid d dy, tng tit dch nhy bo v
nim mc d dy)
- Tn thng gan do aspirin v cc bnh do virus gy h hi ty th
- Vim thn k khi dng thuc lu di
- Tng thi gian chy mu do c ch khng hi phc cyclooxygenase tiu cu do c ch
tng hp thromboxan A2 mt yu t gy kt tp tiu cu.
Do , vic s dng aspirin nh mt thuc khng vim ngy nay rt hn ch.
Acetaminophen (paracetamol)
Khng c tc ng khng vim do tc ng c ch tng hp prostaglandin ngai bin yu
nn ch c tc dng gim au v h st. ng thi gim ng k cc c tnh ca aspirin.
3.2.2. Cc NSAID mi
- C tc dng khng vim, h st, gim au, ngn kt tp tiu cu c hi phc (khc vi
aspirin ngn kt tp tiu cu khng hi phc), khng vim liu thp (aspirin ch c tc dng
khng vim liu cao).
- Ch nh :
Vim khpxng, vim thp khp, vim t sng
Khng vim mt thi gian di (trong vim mn)
- Chng ch nh:
Suy gan, thn
Lot d dy, mang thai
Chy mu
D ng vi aspirin
MT S THUC NSAID MI
TN THUC T1/2 C IM
Phenylbutazon 65 Khng vim rt hiu qu, nhiu tc dng ph, khng s dng lu di
Piroxicam 57 Nguy c chy mu d dy cao, ngy dng 1 ln
Ibuprofen 2 Dung np tt hn aspirin
Diclofenac 1,1 Hiu lc khng vim mnh hn nhiu cht khc
52
4. HISTAMIN
4.1. Ngun gc
Histamin c d tr trong cc ht ca t bo mast ( da, nim mc ph qun, nim mc rut)
v cc t bo bch cu i kim (trong mu) dng phi hp vi polysaccharid-heparin v
protein.
4.2. Phng thch

Khi khng nguyn tip xc c th, khng nguyn s gn kt vi khng th IgE c sn trn b
mt t bo mast v basophil lm v cc t bo ny phng thch histamin ra ngoi. phn ng
ny i hi c nng lng, Ca v theo c ch phn hi m tnh.
4.3. Tc ng
Histamin s gn kt vi cc receptor H1 ( tim mch, kh qun, rut, tuyn nc bt, h thn
kinh), H2 ( tim, d dy, thn kinh trung ng) v H3 ( h thn kihn trung ng) gy nn
nhng xo trn :
Gin cc tiu ng mch gy mu mao mch
Tng tnh thm thnh mch, lm huyt tng thot ra dch k
Co tht c tim
Co tht c trn kh ph qun
Kch thch thn kinh cm gic
Tt c cc xo trn trn s th hin ra cc triu chng : da, sn, ph, au tht tim, kh th,
ngt th, au, nga...
5. THUC KHNG HISTAMIN
Cc thuc khng histamin thng c phi hp vi adrenalin v cc corticoid trong cc

trng hp d ng, vim, phng nga qu mn
Nhm Tn thuc Receptor c im Liu dng
Alkylamin Chlorphenilamin H1 An thn nh 0,2-1mg/kgP (IM, IV,

Ethanolamin Diphenylamin (BENADRYL) H1 An thn r rt PO)
Phenothiazin Promethazin (PHENERGAN) H1 An thn r rt 2,5-10 mg/kgP (PO) gia
Piperidin Astemizole (HISTALONG) H1 Khng an thn sc nh
53
CHNG 7.
THUC TC NG LN H MU
1. THIU MU V THUC CHNG THIU MU

1.1. Thiu mu
Thiu mu l s thiu ht th tch mu, gim s lng hng cu, gim hm lng hemoglobin
xung di mc hng s sinh l.
1.2. Phn loi

Thiu mu do thiu st: do mt mu (cp tnh hoc kinh nin), do hp thu km, do nu cu
dinh dng gia tng trong cc gia on pht trin (heo con s sinh, gia sc mang thai). Lc
ny hng cu s nh hn bnh thung v hm lng hemoglobin s gim.
Thiu mu do mt mu mn tnh: thng gp nht l do nguyn nhn k sinh trng (giun
mc...)
Thiu mu do tiu huyt: cc t bo hng cu b ph hy do nguyn sinh ng vt (tin mao
trng, l dng trng...), vi khun, virus, cht c ha hc...
Thiu mu v to: vi s suy yu ca cc c quan sn sinh hng cu do bnh truyn nhim
do virus (Carr), cht ha hc (chloramphenicol). Lc ny kch thc v s lng hng cu
vn bnh thng nhng s lng th gim.
1.3. Cc yu t lin quan n qu trnh to mu

1.3.1 Hemoglobin
Tng hp hemoglobin l giai on u ca qu trnh sn xut hng cu. S tng hp nhn
hem xy ra ch yu ty th. Succinyl CoA sn phm t chu trnh Krebs s kt hp vi
glycin qua mt s bc to nn pyrole. 4 pyrole hnh thnh 1 phn t protoporphyrin. Sau
, Fe c gn kt vo to thnh nhn hem. Cui cng, 4 nhn hem gn kt vi phn t
globin to thnh hemoglobin.
1.3.2 St
Mt trong nhng yu t c bn tham gia qu trnh to mu l Fe. Fe3+ trong thc n c HCl
d dy kh thnh Fe2+ v c hp thu nhiu nht t trng. Fe s gn vi apoferitin thnh
ferritin. Khi cn thit ferriin s nh Fe ra cho Transferin vn chuyn n nhng ni cn thit
Thiu mu do thiu st heo con

Heo con nui theo li cng nghip c nng sut cao v phng thc nui nht (khng nhn
c ngun cung cp st no ngoi thc n) nn nhu cu Fe cao. Nu ch b sa m th heo
con s b thu Fe. Trong 3 tun u, heo con tng khong 4500g, nhu cu Fe khong 300mg.
Fe c cung cp t sa u khong 21mg (tng ng 1mg/ ngy), Fe d tr khong 20mg.
Do cn phi cung cp b sung Fe cho heo con trong 21 ngy u. Thng cp vo ngy
th 3 v th 10 (100mg/ con , IM)
1.3.3. Protein
Protein l ngun cung cp nguyn liu to globin. Do , chng ta khng th tch ri vic
iu tr thiu mu vi mt khu phn u protein (m ng vt).
53
1.3.4. Vitamin B12
Vitamin B12 l coenzym methylcobalamin, B12 cng vi acid Folic s tham gia vo qu trnh
vn chuyn nhm methyl hnh thnh nhn purin v pyrimidin; chuyn ha propionate thnh
succinyl coA cho qu trnh tng hp porphyrin.
1.3.5. Vitamin Folacin (acid folic)

Acid folic gi vai tr quan trng trong s tng hp purin v pyrimidin, qu trnh chuyn ha
serin v glycin (cht cho nhm methyl). Do folic rt quan trng trong s tng hp acid nucleic
nn cc m c tc phn chia nhanh (cao) nh t bo nim mc rut, t bo ty xng rt
cn folic.
1.3.6. Vitamin B6
Vitamin B6 tham gia trong giai on u ca qu trnh tng hp porphyrin khi succinyl coA
v Glycin to thnh acid aminolevulinic
1.3.7. Cobalt (Co)

Cobalt l mt thnh phn ca vitamin B12 (Cyanocobalamin) c vai tr l mt ng yu t
(Cofactor) trong s tng hp purin , pyrimidin v s hnh thnh hng cu.
1.3.8. ng (Cu)
ng l mt ng yu t cho nhiu enzym oxyhakim loi nh ferroxidase oxyha Fe2+ d
tr trong Ferritin thnh Fe3+ c vn chuyn bi Transferrin v kt hp vi nhn hem, hoc
tham gia vo h thng Cytocrom C oxidase vn chuyn in t trong chui h hp m bo
tng hp ATP
1.3.9. Cc yu t khc: vitamin nhm B, vitamin C, vitamin E, Mn...

1.4. Mt s loi thuc chng thiu mu
1.4.1 . Thnh phn gm:
Iron dextran: 200mg/ml
Phng nga thiu st cho heo con, mt liu duy nht (IM) vo ngy tui th 3.
1.4.2. Thnh phn gm:

Ferrous 100mg/ml
g/mlB12 75
S dng cho heo con: 2ml (IM)
1.4.3. Thnh phn gm:

Fe 18mg
Cu carbonate 6mg
Co sulfate 3,75mg
Vin nang dng cho ch t 10-15kg -1 vin
5kg -1/2 vin
1.4.4. Thnh phn gm:

Fe 27,5,g
B12 20mg
Folic 3,3 g
Cobalt 33,3mg
54
Dextrose
Bt dng cho nga 15-30g/ ngy ty theo tnh trng thiu mu
1.4.5. Thnh phn trong 1 gi 30g gm:

Fe 230mg
B1 15mg
B2 25mg
B5 300mg
B6 15mg
gB12 500
Folic 7,5mg
Cu 18mg
Co 1mg
Glycin 100mg
Lysin 200mg
Methionin 100mg
Dng cho nga (450-500kg) 1 gi / 10 ngy
1.4.6. Thnh phn gm

Vitamin C 100mg
gB12 15
Fe fumarate 300mg=100mgFe
Folic 1,5mg
Dng cho ngi ln: 1vin/ ngy (trnh kch ng bng cch ung trc ba n)
2. NG MU- THUC NG MU- THUC KHNG NG

2.1. ng mu: l hin tng mu t th lng chuyn thnh th c sau khi ra khi mao
mch 2-4 pht. Hin tng ng mu l do s chuyn nhng phn t fibrinogen ha tan trong
huyt tng thnh nhng si fibrin khng ha tan nh xc tc ca thrombin.
Bnh thng trong mu khng c thrombin ch c tin cht ca thrombin l prothrombin. Nh
xc tc ca prothrombinkinase, prothrombin mi bin thnh thrombin. Prothrombinkinase
c thnh lp theo 2 ng
Cc yu t trong qu trnh ng mu
I: Fibrinogen
II: Prothrombin
III: Thromboplastin m
IV: Ca2+
V: Proacelerin
VI: Proconvertin
VII: AHG
IX: Throbaplastin huyt tng
X: Struart- Prothrombinkinase
XI: PTA
XII: Hegeman
XIII: nh fibrin
55
ng mu ni sinh ng mu ngoi sinh

B mt ni m tn thng Thromboplastin & Phosphorlipid mu
Ca2+
XII XII* XII XII*
XI XI*
IX IX*
VIII VIII*
X X*
V V*
Tng hp
Gan prothrombin thrombin XIII*
Vitamin K Ca2+
Fibrinogen Fibrin tan Fibrin khng tan
2.2. Thuc ng mu
2.2.1. Thuc ng mu ti ch (cm mu)
- Cc yu t tp trung (concentrated factor) gm c: throboplastin, thrombin, fibrinogen,
gelatin c tc dng cm mu trong phu thut i vi mch mu nh.
- Cht lm se: FeSO4, acid tanic, nitrate bc c tc ng cm mu ti ch do lm trm
hin protein mu
- Epinephrin (Norepinephrin)1/10.000-1/20.000: c tc ng cm mu ti ch trn
mng nhy (mt, ni, ming) do tc ng co mch ngoi vi
2.2.2. Thuc ng mu h thng

- Vitamin K: thng thiu gia cm do lng prothrombin thp, thm vo bnh
cu trng v tnh trng s dng khng sinh lu di lm gim s lng vi sinh vt tng
hp vitamin d dn n xut huyt.
- Phng nga: b sung vitamin K trong khu phn 0,36mg/kg thc n
Vitamin K1: 2,5/kg/12h (PO) hoc 0,25mg/kgP/12h (IM, SC)
Vitamin K3 hp thu chm hn nn p dng trong cc trng hp thiu mn tnh.
- Calci (CaCl2. 6H2O, Calcigluconate)
C tc dng ng mu do hot ha men thrombokinase v gy co mch
Tiu gia sc: 0,01-0,03g/kgP pha dung dch 10% (IM)
2.3. Thuc khng ng

2.3.1. Thuc khng ng dng trn c th
(v trong phng th nghim)
Heparin: trong c th, heparin nm trong t bo mast, cc t bo ny tp trung gn
mch mu khi c ng mu mch s c heparin ngay. Heparin sodium c iu
ch t m gan, rut, phi (heo, b).
- C ch tc ng: heparin tng cng tc ng ca antithrombin III (1 yu t chng
ng mu) antithrombin kt hp vi thrombin thnh 1 phc hp bn . phn ng ny s
nhanh gp 1000 ln khi c heparin. Nh vy, heparin lm chm s ng mu v bn
56
thn n khng phi l cht ng mu. Tuy nhin, liu cao, heparin c ch kt tp
tiu cu.
- p dng lm sng:
+ Ngn s ng mu cc khi truyn tnh mch.
+ Ly mu khng ng.
+ Ngn to huyt khi khi nghn mch vnh (bnh tim).
- Liu dng
- Ch: 75-130 IU/kgP (1mg=100 IU) IV (khng dng ng tim bp v s gy khi t
mu, khng dng ng ung v khng hp thu qua ng tiu ha)
Coumarin
- L nhng cht tng hp dn xut ca 4-hydroxy coumarin.
- C ch tc ng: vitamin K phi hp vi proenzym trong gan to thnh enzym c
hot tnh tham gia tng hp prothrombin, cc thuc khng ng loi coumarin i
khng cnh tranh vi vitamin K.
- S dng: Warafin dng vin hoc dung dch: 2,5-4mg/kgP/12h (PO).
2.3.2. Thuc khng ng dng trong phng th nghim

Citrate sodium
Citrate sodium kt hp vi Ca2+ trong mu, ngn cn prothrombin bin thnh thrombin.
Dng Citrate sodium nh cht khng ng c th lm nhn v h hng t bo mu.
S dng: - Bo qun mu: dung dch 2,5-3,8%.
- Cc xt nghim nghin cu v mu.
EDTA (ethylen diamino tetra acetic acid)
EDTA t lm bin i hnh thi v kh nng bt mu ca cc t bo mu
S dng: 1mg/1ml mu
Oxalate potassium , Oxalate amonium

Ch dng trong cc xt nghim mu
Oxalate potassium: 2mg/ml mu
3. MT S DUNG DCH TIM TRUYN

3.1. Mt nc
Mt nc l hin tng i km vi mt cn bng acid base. chng li nhng xo trn
v pH mu (trng c toan, trng c kim), c th c cc c ch iu ha nh vo:
- 4 h thng m (bicarbonate, phosphate, Hb, protein)
- Phn ng lin hp vi acid glucuronic gan
- H thng thng kh phi
- Qu trnh loi thi H+ v ti hp thu HCO3- thn.
3.2. Trng c toan (H+)

Trng c toan do thm vo c th 1 acid (trong trng hp bnh ketose, bnh tiu ng,
hay c lm vic qu mc) hoc mt i 1 base lin hp (trng hp tiu chy d di), vi
c trng l s thiu ht HCO3- v potassium.
Cc dung dch ng trng c th cung cp trong trng hp ny l: NaCl, KCl, NaHCO3.
Liu lng cp cn cn c vo tnh trng mt nc, tuy nhin liu c bn c th cp l:
40ml/kgP (PO, IV)
3.3. Trng c kim (HCO3-)
57
Trng c kim do thm vo c th 1 base (trng hp ng c NH3) hoc mt H+
(trng hp nn ma th n v) vi c trng l s thiu ht Cl-
Cc dung dch ng trng c th cung cp l: NaCl, KCl, CaCl2, Ringers.
3.4. Cc mc mt nc
Nh: mt nc 4%: gp trong trng hp tiu chy, i ma. Biu hin l da mt n tnh
nh, nim mc vn cn t, c biu hin kht.
Trung bnh: mt nc khong 6%: lc ny n hi ca da km, nim mc kh, lng x
xc, hng vn cn t.
Nng: mt nc khong 8%: da mt n tnh v mm mi, nim mc v hng kh, cu
mt mm v hm su.
58
CHNG 8.
THUC TC NG TRN H H HP
V TIU HA
1. H THNG H HP
- ng h hp l ni O2 c cung cp vo c th v CO2 c thi ra ngoi qua cc
c quan nh mi, xoang mi, yt hu, thanh qun, kh qun, ph qun. S trao i kh
xy ra ph nang.
- H thng phng v trn ng h hp gm nhiu yu t m bo cho s thng sut
ca qu trnh dn kh v trao i kh.
H thng lng rung v cht nhy, dch nhy do t bo hnh ly tit ra, thanh dch
(serous fluid) ch yu do chic tuyn di nim (submucosal gland) tit ra, gip bi
thi cc vt l ra ngoi.
Phn x ht hi v ho c tc ng c hc gip tng ngoai vt ra ngoi.
Cc i thc bo ph nang c vai tr thc bo vt l.
H thng lympho dc ng h hp (hch) c nhim v x l cc cht ha tan.
Ngoi ra cn c interferron, lysosym, cc khng th tit ti ch (IgA, IgG) min dch
qua trung gian t bo cng l mt phn ca h thng phng v.
Vim nhim ng h hp v phi do rt nhiu nguyn nhn khc nhau (ha cht kch
ng, vi khun, virus, Mycoplasma, k sinh trng, nm...) gy nhng xo trn thng
gp nht l cc du hiu: th nhanh, kh th, tit dch t mi, ho...
2. THUC TC NG TRN H H HP
2.1. Nguyn tc chung
- H tr h thng phng v ca c th: gi m, cung cp dinh dng y , gim cc
yu t gy stress.
- Tng vic loi thi cc cht dch qu nhiu trong ng h hp: thuc iu ha tit
dch, thuc lm long cht nhy, long m.
- Gim tnh trng ho khan qu mc v ko di gy mt sc: thuc gim ho
- Gia tng s thng thong kh trn ng h hp: thuc gin ph qun, thuc chng
sung huyt.
- Gim thiu nhng nh hng do vim nhim gy ra: thuc khng sinh, thuc tr k
sinh trng, nm, thuc khng vim.
2.2. Thuc gin ph qun

2.2.1. Theophyllin v cc cht thuc nhm xanthin (cafein, theobromin)
C tc dng lm gin c trn kh ph qun do c ch phosphodiesterase, lm gia tng
cAMP trong t bo Theophyllin c ch adenosin ti receptor ca n. Adenosin gy co tht
kh qun, tng phng thch histamin t phi
Ch nh: trong cc trng hp kh th do co tht
Ch mo: 5-10mg/kgP/ ngy (P.O).
Nga, tru b: 5mg/kgP.
2.2.2. Cc thuc khc: c th s dng

- Ephedrin: 1-3mg/kgP/8h/ P.O cho ch mo
- Atropin: 0,02-0,04mg/kg (I.V, I.M, S.C).
60
- Khng vim (xem bi thuc khng vim)
2.3. Thuc iu ha dich tit kh ph qun

iu ha dch tit trn ng h hp, ta c th dng cc cch sau: gim lng nhy,
tng pha nc lm long m, tng hoat ng ca h thng lng rung.
2.3.1. Bromhexine
- Lm gim phn tit dch nhy bng cch iu ha hot ng ca cc t bo hnh ly,
ng thi gip cc lng rung nim mc ng h hp hot ng y dch nhy ra
ngoi. Ngai ra bromhexine cn c kh nng gia tng tp trung ca khng sinh trn
ng h hp.
- Ch nh: cc trng hp tng tit dch c m (mucous) trong cc bnh vim thanh
kh qun, vim ph qun phi, vim phi.
- Liu lng: Nga: 0,1-0,25mg/kgP/ ngy x 7 ngy
- B ngh: 0,5-1mg/kg/ ngy.
- Ch mo: 1mg/kg/ 2ln /ngy.
2.3.2. N. Acetylcystein.
- C ch: phn hy cc mucoprotein qua cc ni disulfide bng cc gc sulhydryl t do.
m s tan ra thnh cc phn t nh, s khng to nhy v t c tnh cht gy vim, d
thi ra ngoi. Tuy nhin, thuc ny co th lm bt hot penicillin, d gy ho, i.
2.4. Thuc gim ho

2.4.1. Codein v cc chuyn ha cht t opioid (opium, hydromorphin).
- c ch phn x ho do tc ng ln trung hku ho hnh ty, thuc nhm thuc ho
narcotic (c khuynh hng gy nghin).
- Ch nh: cc trng hp ho khan (khng tit dch) v ko di.
- Liu lng: Ch mo: 1-2mg/kgP/ P.O.
Heo: 15-60mg
Nga: 0,2-2 g
2.4.2. Cc thuc khc

Eucalyptus, terpin, menthol ...cng thng c mt trong thuc ho nhng tc dng ch yu
ca chng l st trng ng h hp.
3. THUC TC NG LN H TIU HA
3.1. Nguyn tc chung
- Bin php h tr: iu quan trng nht l gi cn bng nc v cht in gii cho c th,
lp li nhu ng bnh thng ng tiu ha, gim nguy c tiu chy do s ln men ca
vi sinh vt rut gi...
- Bin php iu tr c tnh h thng: s dng cc yu t kim sot v iu chnh cc du
hiu lm sng: chng nn, iu ha nhu ng rut, iu ha lng acid tng tit qu mc,
hp ph cht c, bo v nim mc, kch thch s ngon ming...
- Bin php iu tr c hiu: nhm vo cc nguyn nhn gy ra ri lon: thuc khng sinh,
thuc tr k sinh trng, thuc chng tit dch, thuc nhun trng.
3.2. Thuc tr tiu chy

Tiu chy bnh thng l mt phn ng c li cho c th tng nhanh cht c ra ngoi.
nhng nu tiu chy qu mc, c th mt nc qu nhiu s nguy him n tnh mng
61
(mt nc ngoai bo v mt nc ni bo). Do phi dng thuc cm tiu chy hay
thuc lm gim co tht c trn ng tiu ha.
3.2.1. Atropin
- Thuc nhm lit ph giao cm (anticholinergic agents) do i khng cnh tranh vi
cht dn truyn thn kinh ph giao cm (acetylcholin). Ngoi tc ng chng co tht
c trn, atropin cn c cc tc dng ca mt thuc cng giao cm:
* Tc ng trn mt ; lm gin ng t . p dng soi y mt.
* Trn tim mch: tng nhp tim, dn mch mu da, dng chng try tim.
* Trn h h hp: gin kh ph qun, gim tit dch , dng tr hen suyn, thuc tin m.
* Trn h tiu ha: gam co tht c trn, gim tit dch, dm cm tiu chy.
* Gii c khi ng c cc thuc cng ph giao cm (pilocarpin).
- Liu lng: 0,02-0,04mg/kgP S.C/ IV
3.2.2. Loperamid (Imodium)

- Thuc nhm thuc gim au piperidin opioid, c tng hp c tc ng chuyn
bit trn c quan tiu ha. Hp thu chm ng tiu ha, chuyn ha hon ton
gan v bi thi qua mt theo phn.
- Ch nh: tiu chy khng do nguyn nhn Salmonella, Shigella gy ra.
- Chng ch nh: mo.
- Liu lng: 0,08 mg/kgP (PO).
3.3. Thuc bo v nim mc

- L cc cht hp ph c t, vi khun, dch, kh . thuc ny khng c hp thu vo h
tun hon nn t c tc dng ph. Tuy nhin cc cht ny khng tr c tiu chy cp,
nng.
3.3.1. Aluminum magnesium trisilicate (Attapulgit)
- Phosphate aluminum th keo (Phosphalugel)
- Aluminum silicate hydate ha t nhin (Kaolin)
- Cc thuc ny to thnh nhng lp gel, sa lng trn b mt nim mc, bo v nim
mc trnh khi cc cht c ng thi gim nhu ng rut v tng c ca phn do
kh nng hp thu mt lng nc ln (gp 8 ln trng lng ca n).
- Liu lng: Mo: 50-100mg
Ch: 100-200mg
Tru b: 30g
- Chng ch nh: dng chung vi khng sinh nhm tetracyclin v quinolon
3.3.2. Than hot tnh

- Than hot tnh khng c hp thu t ng tiu ha nhng c kh nng hp thu cc
cht lng nhanh chng , t hp ph cc cht c v lm tng c ca phn.
- Ch nh: tiu chy do y hi, n khng tiu, trng c ng tiu ha.
- Liu lng: 20-120 mg/kg.
3.4. Thuc nhun trng, thuc x (Laxative Cathartics)

- Ch nh: trng hp to bn, loi b vt l, cht c khi ng tiu ha, loi b
phn trc khi phu thut.
- Chng ch nh: Vim rut, co tht do nghn rut, th mang thai.
3.4.1. Paraffin
62
- Thuc nhm thuc nhun trng lm mm, trn. C ngun gc t du khong. Dng lu
c th lm gim hp thu vitamin ADEK. Nn ung lc i.
- Liu lng: Mo: 2-6ml
Ch: 5-30 ml
Heo: 25-300ml
Tru b: 250-500ml
3.4.2. MgSO4 , Mg(OH)2 , Mg3(PO4)2

- Thuc nhm thuc nhun trng thm thu. Cc thuc ny to mt gradient y nc
vo rut gi, tng nhu ng rut ng thi kch thch hot tnh ca cholecystokinin
pancreozymin lm tng tit dch vo lng rut.
- Ch cung cp y nc, thn trng th c bnh thn.
- Liu lng: Mo: 2-5g
Ch: 5-25g
Heo: 25-125g
Tru b: 250-500g
3.5. Thuc gy nn.

- Thng s dng cho ch, t s dng cho heo v khng dng cho cc loi khc v tru
b, nga, loi gm nhm khng c phn x nn.
- Ch nh: gy nn loi b cht c.
- Chng ch nh: nghn thanh qun, herni, nghn rut, bt tnh.
- C ch: kch thch im tip nhn ngoi vi hoc cc trung khu trung ng.
3.5.1. Cc cht kch thch vng ngoi vi

- Bm nc m, nc oxy gi, nc mui vo d dy rut.
- ZnSO4: Liu lng cho ch: 10-30ml P.O
- Siro ipecac: Liu lng cho mo: 2-6ml P.O
3.5.2. Cc cht kch thch trung khu trung ng

- Apomorphin: liu cho ch 0.05mg/kg S.C
- Xylazin: liu cho mo 0,05-1mg/kgP I.M
3.6. Thuc chng nn

Trung khu nn hnh ty nhn cc xung lc t vng CRTZ (cheomoreceptor trigger zone)
no tht IV. T trung khu nn xut hin xung lc n c honh, c bng gy ng tc nn.
Ti vng CRT c cc receptor ca dopamin, histamin, acetylcholin
Metoclopramide (Primperan), Domperidone: thuc nhm Benzamin c ch receptor

dopamin. Khng qua hng ro mu no nn tng i an ton.
Liu lng: cho ch 0,1-0.5mg/kgP (IM, PO, SC); 0,02mg/kgP (IV).
Chlorpromazin, Acepromazin: thuc nhm Phenothiazin, cht khng histamin, khng

dopaminergic, khng cholinergic.
Liu lng: cho ch 0,5-1mg/kgP (SC, PO).
63
CHNG 9.
THUC TC NG LN H SINH DC
V TIT NIU
1. NI TIT T SINH DC.

Cc hat ng trong chu k sinh dc c iu khin bi h thn kinh v ni tit theo
c ch phn hi m tnh (negative feedback) hay iu khin ngc. T h tng th gic,
GnRH (gonadotropin releasing hormone) sinh dc hnh phn t c chuyn n no thy
trc kch thch s phn tt FSH (follicle stimulatin hormone) nang non hu6ng phn t v
LH (luteinizing hormone) hong th hng phn t. Di tc ng ca FSH, nang non trn
bung trng pht trin v chn (de graff). Lng estrogen tit ra ngy cng nhiu s l mt
kch thch (positive feedback) i vi h tng th gic ri tuyn no thy phn tit LH. Khi
hm lng LH/FSH khong 3/1 trng s rng v hong th c thnh lp. Progesteron tit ra
t hong th s c ch s rng trng (negative feedback). Nu gia sc c thai, hong th tn
ti sut thai k v phn tit Progesteron. Nu gia sc khng c thai hong th s thoi ha.
cui thai) tit ra t ni mc (PGF2) k hoc cui gia on ngh ngi prostaglandin F2 t
cung s ph v hong th, lng Progesteron st gim s l mt kch thch n tuyn no thy
phn tit Oxytoxin gy hin tng sinh hoc ng dc tr li.
2. THUC TC NG LN T CUNG V BUNG TRNG.

2.1. PMS (Pregnant Mare Serum) huyt thanh nga cha
- L mt loi sinh dc hng phn t (GnRH) tit ra lp ni mc t cung nga cc c
mang. C hot tnh sinh hc ging FSH v mt t ca LH. C tc dng lm nang non
pht trin
- Ch nh:
Cc trng hp chm pht trin sinh dc do dinh dng hoc ni tit.
Gy siu bi non b trong cng tc chuyn cy phi.
- Liu lng:
Heo: 1000 UI (SC, IM).
B: 1500-3000 UI vo khong ngy th 8 13 ca chu k. Nu thu phi th sau 48h
tim PG F2.
Ch: 110 UI/kgP.
2.2. HCG (Human Chorionic Gonadotropin) sinh dc hng phn t

- c chit t nhau thai ngi. C tc dng ging LH v mt t tnh cht ca FSH nn
c tc dng gy rng trng.
- Ch nh:
Nang thng bung trng, bo nang cng b, nga, ch do trng khng rng uc.
ng dc thm lng do non nang nh.
Kch thch c (m) sm v nhiu.
- Liu lng:
B: 1500-3000 UI (IM, SC).
Ch: sau khi s dng PMS: 500 UI (IM, IV).
2.3. Mt s ch phm phi hp

- PG 600: 400UI PMS +200UI HCG.
64
- Synovet: 400UI PMS +200UI HCG.
- S dng iu tr chm ng dc cho heo ni (7-10 ngy sau cai sa) s gy ln ging
sau khong 5 ngy.
2.4. Oestrogen
- Ch nh:
Khng ng dc do dinh dng hoc ni tit.
Vim da do ni tit ch.
Gy sy thai trc khi trng lm t loi n tht.
Tho sch dch vim t cung b (thai cht lu, vim t cung c m...).
- Liu lng
Tru b: 3-5mg.
Heo 2-4mg.
Ch 0,01-0,1mg.
2.5. Progesteron
- Ch nh:
An thai, phng nga sy thai.
Chng bo nang cng, u nang bung trng.
Gy ln ging ng lot tru b.
- Liu lng
Tru b: 100mg hng ngy trc ngy th 15 ca chu k.
Ch: 2-3mg/kg/ngy phng nga sy thai.
2.6. Prostaglandin F2 analog, Cloprostenol, c hot tnh tng t: Dinoprost, PGF2

Fenprostalen...
- Ch nh:
Trng hp hkng ln ging, v sinh do tn hong th
Gy sy thai theo mun: trong trng hp thai cht lu, cht phi, bc m trong t
cung
- Liu lng:
B: Dinoprost 25mg
Cloprostenol 0,5mg
Fenprostalen 1mg
Heo: Etiproston 1,7mg (IM)
2.7. Oxytoxin- kch t thc

- Do h tng th gic tit ra v c d tr tuyn no thy).
- Ch nh:
Phng tr chng lit t cung hoc t cung co bp yu.
y cht lng trong cc bnh l t cung (vim ni mc, vim bc m, st nhau).
Cm mu sau khi , r mu sau phu thut sn khoa.
Chng ch nh: trong khi c t cung cha m

- Liu lng:
i gia sc: 10-40 UI (IV, IM, SC).
Heo: 5-20 UI
Ch mo 1-2 UI
65
2. THUC LI TIU
2.1. Furosemid:
- Thuc nhm thuc li tiu tc ng ti quai Henle, c tc ng manh hn cc loi
khc.
- C ch: c ch ti hp thu K+ v Na+ ng thi tng bi thi K+, Ca++, Mg++.
- Ch nh: Ph thng do tim gan thn (ph phi, suy tim...), tng Ca huyt.
- Chng ch nh: b tiu, mang thai, dng chung cc thuc gy c thnh gic.
- Liu lng: ch: 2-4mg/kg (IV, PO).
2.2. Triamteren, Amilorid

- Thuc nhm li tiu tit kim K+
- C ch: c ch ti hp thu Na+ ng ln xa. in th trong biu m ng thn gim
nn gim bi tit K+ vo nc tiu.
- Liu lng: cho ch 0,5-2mg/kgP (PO).
66
TI LIU THAM KHO
1. Nguyn Duy Cng v Nguyn Hu Qunh, 1999. Bch khoa t in Dc hc. NXB
T in Bch khoa.
2. L Xun Cng, 1999. Bi ging Sinh l sinh sn Cao hc Th y. i hc Nng lm
TP. H Ch Minh.
3. Trn Th Thu Hng, 1996. Dc lc hc. T sch Trng i hc Y dc Tp. H Ch
Minh.
4. Phm Khc Hiu v L Th Ngc Dip, 1997. Dc l hc Th Y. NXB Nng nghip.
H Ni.
5. Lng Vn Hun v L Hu Khng, 1999. K sinh v bnh k sinh gia sc, gia
cm. Tp I, II. NXB Nng nghip.
6. Trn Vn Thun, 1998. Dc l hc Th y. T sch Trng i hc Nng lm Tp. H
Ch Minh.
7. MIMS Vit Nam, 1998. Cm nang s dng thuc. MIMS xut bn.
8. Nguyn Phc Tng, 1994. Thuc v bit dc th y. NXB Nng nghip.
9. Meissonner E., Devisme P., et Lambert P.J., 1997. Dictionaire medicaments veterinaire.
France
10. IVS (Index veterinary specialises) annual, 1993. Autralia
11. Kalant H., and Roschlau W.H.E., 1989. Principles of medical pharmacology. 5th
edition, Philadelphia. USA.
12. Puyt J.D., 1996. Antibiotiques antibiomimetiques. Ecole Nationale Veterinaire de
Nantes.
13. Quinn P. J., Carter M.E., Markey B.K. and Carter G.R. 1998. Clinical veterinary
microbiology. England
14. Richard H.A. 1995. Veterinary pharmacology and therapeutics. 7 th Edition. USA
15. The merck veterinary manual. 1991. 7th Edition. USA
67

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Ging vin bin son :

I. Gii thiu mn hc:

- Dc ng hc (Pharmacokinetics) nghin cu v tc ng ca c th i vi thuc hay

- Dc lc hc (Pharmacodynamics) nghin cu v tc ng ca thuc i vi c th v mt

2.1.1.2. Vn chuyn ch ng (tch cc)

2.1.2. Cc ng cp thuc thng dng trong th y

Nhc im l s hp thu ph thuc nhiu yu t nh tnh trng ca d dy rut, thnh phn

2.1.2.2. ng tim chch (ng ngoi tiu ha, parenteral)

Hn ch ca ng tim chch l i hi iu kin v trng, ngi cp thuc phi c k thut.

* Tim di da (subcutaneous injection, S.C)

* Tim bp (intramuscular, I.M)

* Tim tnh mch (intravenous, I.V)

Cn ht sc thn trng khi dng ng cp ny, lu s ng trng, tc cp thuc v

* Tim phc m (intraperitoneal, I.P)

ng cp ny thng dng khi cn cp mt lng ln thuc trong thi gian ngn m ng

2.1.2.3. Cc ng cp thuc khc:

* ng trc trng (rectum mucosa)

* ng bi ngoi da, t vo m o, t cung...

Vic phn b thuc mu ph thuc vo s v tr gn v i lc ca thuc vi protein. m,

2.3. Chuyn ha (bin i sinh hc)

S bi thi thuc qua thn ph thuc 3 c ch:

V d: + Ng c cc cht kim yu (Amphetamin, quinidin...) dng NH4Cl acid ha nc

V bn cht ha hc, receptor l cc i phn t sinh hc nh acid nucleic, lipid mng t bo

3.2. Cc cch tc dng ca thuc

3.3. Tng tc gia hai dc phm (thuc)

IV. Nhng yu t nh hng n tc dng ca dc phm

- Tnh cht vt l: c lin quan n

- Liu dng v nng

- Nhp cung cp thuc: ph thuc vo thi gian bn hy (T1/2) ca thuc

V. Thng tin v mt loi thuc

- Tn hot cht (generic name): cn gi l tn chung, c gi theo qui nh chung ca quc

- Tn thng mi (brand name): cn gi l bit dc. Tn ny thay i ty theo cch t ca

5.2. Ch nh v chng ch nh (indications v contraindications).

5.3. Liu lng v ng cung cp (Dosage v Administration)

5.4. Dng trnh by (Presention)

5.5. Bo qun (storage)

5.6. Hn dng (expiration date)

5.7. Thi gian ngng thuc (Withholding periods)

1.1. THUC M: (GENERAL ANESTHETICS)

ngha ca vic dng thuc m :

S la chn thuc m cho cc loi gia sc :

Giai on 2: Hng phn khng ty

Giai on 3: M gii phu

Giai on 4: T lit hnh ty

Nhng tai bin lc gy m v cch phng

Cc loi thuc m dng trong th y:

Liu lng v cch s dng:

1.2. THUC AN THN THUC NG V CHNG CO GIT

Dng liu cao s gy ng, cao hn na chng co git

1.3. THUC GIM AU - H ST - CHNG VIM:

1.3.1. Salicylates: gm Sodium Salicylic v Aspirin

1.3.4. Codein phosphate:

2. THUC KCH THCH H THN KINH TRUNG NG

2.1. NIKETHAMIDE. (CORAMIN)

2.2. AMPHETAMINE SUPHATE

Gia sc Ung / con / ln Tim di da/ngy.

3. THUC TC NG TRN DY THN KINH NGOI BIN

3.2. Cc phng php gy t:

3.4. Cc loi thuc t:

4.1. Tng quan v h thn kinh t tr:

4.2. Thuc kch thch dy thn kinh giao cm

4.3. Thuc lit giao cm: