8/27/2017

NI DUNG HC TP
1. Phn bit thuc nh mt v thuc m tra mt
THUC 2. Phn tch ngha v yu cu ng trng v
NH MT bit cch tnh ton lng cht ng trng
3. Phn tch c ngha ca pH i vi TNM
4. Hiu c ngha v khun i vi TNM.
Nu cc cht bo qun dng trong TNM
B mn Bo ch - CND

GII PHU SINH L MT GII PHU SINH L MT

GIC MC
t mch mu,
nhiu dy TK
KT MC
Nhiu mch mu,
nhiu dy TK
thm thuc
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CC DNG THUC DNG CHO MT CC DNG THUC DNG CHO MT

THUC NH MT
Thuc nh mt
- DD nc, DD du hoc Hn dch v khun
Thuc m tra mt ca 1 hay nhiu HC nh vo mt
- Dng bt kh v khun pha hn dch (khi
Thuc ra mt c yu cu)

Mng film t vo mt
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THUC NH MT THUC M TRA MT

U IM NHC IM - Tra vo ti kt mc hoc b m mt
Thi gian lu ngn - T dc do dnh nh vaselin, lanolin khan
D dng, t tc dng
5-10 pht nhiu - Tuyt i khng c c :
ph dng ph bin
ln / ngy T cu vng: Staphyllococcus aureus

Thuc chy xung Trc khun m xanh: Pseudomonas aeruginosa

ming v ng

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THUC M TRA MT THUC RA MT

U IM NHC IM - DD nc , v khun
Lu gi lu (15 20) M mt tm thi - Dng ra, ngm mt
Gim s ln /ngy Dng ban m - Cha HC c tnh st khun nh, chng xung
Tc dng tt > TNM trc khi ng huyt, khng c hoc cha cht m, cht
Khng to v ng ng trng ha, cht dn...
ming - Dng khong 5 10 ml.
- ng gi khng qu 200 ml
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MNG FILM T VO MT THNH PHN THUC NH MT

-Dng phng thch ko di HOT CHT CHT PH

Tc dng mnh C% thp Dung mi
- Cha hot cht nhiu liu
(do thi gian lu ngn) Cht bo qun
- Kt hp vi polyme
n nh > 1 nm Cht iu chnh pH
-Chit sut nc mt (n=1,33)
Khng sinh sulfamid, khng Cht ng trng
Mng film + Nc mt Ha tan khun, khng vim, co dn Cht chng oxy ha
Phng thch T tiu ng t, vitamin, khng Cht tng nht
histamin, thuc t... Cht din hot
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DUNG MI YU CU K THUT
Thng dng nht l nc ct v khun
- Tnh cht ging nc mt (trnh kch ng)
Du thc vt :
- Cht lng tng ng thuc tim
- Phi th lng nhit phng
- Cc giai on iu ch:
- Khng c gy kch ng mt Pha ch DM, cht dn c cht bo qun
- Thng dng du thu du lm du mt Ha tan HC v TD
Lc trong hoc tit khun
V chai, ng kn
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CHNH XC TINH KHIT TRONG SUT CHNH XC TINH KHIT TRONG SUT

CHNH XC TINH KHIT

- Hot cht: Lu loi ngm nc kt tinh, - HC v TD: loi dc dng hoc tinh khit cao
loi khan nc hoc d ht m - DM: nc ct pha tim. Du TV (du oliu,
du u phng): trung tnh ha, khng b i
- DC pha ch: TNM pha ch v ng gi th
kht, tit khun 135 1400C/1 gi
tch nh 5 30 ml dng c thch hp v
chnh xc

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CHNH XC TINH KHIT TRONG SUT V KHUN

TRONG SUT YU CU CHUNG

Lc dung dch TNM TNM dng nhiu ln: phi v khun sut
bng giy lc dy, phu
thi gian s dng dng cht bo qun
thy tinh xp G3, mng
H tr suy gim hot tnh lysozyme
lc milipore...
m bo nng tr liu
- Khng lc TNM hn dch: phn tn li khi lc TNM dng 1 ln : quy trnh pha ch phi v
nh. Kch thc ht 5 25 mcm (max 50 mcm) khun, khng dng cht bo qun
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TIT KHUN
HP TIT TRNG
Thuc nh mt dng 1 ln :
o Nhit:
100oC/30 pht
120oC/20 pht
70oC/60 pht trong 3 ngy (Tyndall)
o Lc v khun, siu lc ( 0,2 m)
TNM dng nhiu ln: cht bo qun
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LC TIT KHUN CHT BO QUN (ST KHUN)

MC CH
Chng li s pht trin ca vi khun, nm mc xm
nhp
YU CU
Dng nng thp (% hay )
Dit khun nhanh
Ph khng khun/nm rng, dit c Pseudomonas
Khng c, khng gy kch ng, d ng
Tan trong DM (nc)

CC NHM CHT BO QUN THY NGN HU C

1. Thy ngn hu c - Ph rng, bao gm Pseudomonas aeruginosa
2. Alcol v dn cht - Khng kch ng , dng lu gy d ng
3. Amoni bc 4 - Ch bn trong mi trng kim
4. Paraben = Nipa-este - Dng lu c th to cn Hg trn mt
5. Cc cht khc Nitrat Phenyl Mercuric
Borat Phenyl Mercuric
Na Merthiolat

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ALCOL V DN CHT ALCOL V DN CHT

- Hiu lc vi Pseudomonas aeruginosa Phenyl Etylic :
- Khng kch ng , d ng Rt tan trong du

- Khng bn : OH- , to cao Tc dng chm Pseudomonas aeruginosa

Tng k : AgNO3, Hg Cl2
Clobutanol :
dng khan nc tan trong DM du
Benzylic :

dng ngm nc tan trong DM nc Tan trong Du TNM dung mi Du

Tng k : Ag+, Sulphamid, OH- , nhit cao

AMONI BC 4 PARABEN (NIPA-ESTE)

- Cht din hot tng hp thu R Tn thng mi Tn gi tt
-CH3 Nipagin M Metyl paraben
- Khng c & kch ng, khng bay hi, bn -C2H5 Nipagin A Etyl paraben
Benzalkonium Clorid: -C3H7 Nipagin P (Nipasol) Propyl paraben

Ph rng & mnh, gm Pseudomonas aeruginosa

D tan trong nc & cn to pH kim
Khng tc dng khng nm
Tng k: Fluorescein, Sulfamid, Borat,
- D tng hp, bn nhit, khng c Dc phm,
M phm, Thc phm.
- R di : tc dng tng, tan/ nc gim

Cacbonat, Nitrat, Salicylat - Thng dng Nipagin M + Nipagin P phi hp theo

t l 0,15 : 0,03 %

CC CHT KHC Mt s lu cht v st khun thng dng

Benzalkonium
D to bt, khng nn khuy nhiu
(0,01% 0,02%)
Clohexidin acetat: dit khun Gram (+)
Clorobutanol Dng cho thuc nh mt dng du
(0,5%)
Clorocresol: dit khun, dit nm
Methyl parapen Dit khun tt hn dit nm
(0,05% 0,1%)
Polymycin sulfat 1000 UI/ml: khng sinh
Propyl parapen Dit nm tt hn dit khun

Dinatri edetat Gip cht st khun thm voTBVK

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CHT IU CHNH pH MT S HNG DN pH

pHnc mt (6,3 - 8,6) pHTB 7,4
pH 5,5 : Adrenalin, Procain, Novocain
pHTNM 7,4 Khng gy kch ng mt
pH 6 : AgNO3, Ephedrin
pH c th khc 7,4 :
pH 6,3 : ZnSO4
Khng gy kch ng mt
n nh hot cht, ko di tui th thuc
pH 6,5 : Atropin SO4, Pilocarpin, Homatropin

Gip hot cht d hp thu pH 6,8 : Fluorescein, Ag keo

Cn nhc chn pH ti u

H M THNG DNG H M THNG DNG

Hind Goyan Palitzsch:

Nhm pha pH 5 - 5,5: Acid boric DD1: Borax 0,05M

Nhm pha pH 6 - 6,5: NaH2PO4 v Na2HPO4 DD2: Acid boric 0,2M

Acid boric Natri acetat
Gifford: pH 4,6 8,5
DD1: pH = 7,6 Natri acetat 2%
DD1: Acid boric 0,2M
DD2: pH = 5 Acid boric 1,9 %
DD2: Na2CO3 khan 0,2M
Acid boric Natri propionate
Palitzsch:
Sorensen: NaH2PO4 v Na2HPO4
DD1: Borax 0,05M
DD1: Na2HPO4 0,15M
DD2: Acid boric 0,2M
DD2: Na2HPO4 0,15M

Mt s h m iu chnh pH NG TRNG HA
DUNG DCH TNM khng ng trng kch ng mt, nc
pH 5
ACID BORIC mt tit nhiu y thuc ra ngoi
1,9% DC d tan v n nh trong acid
Hm lng HC trong TNM thng thp DD
H M
C tnh st khun nhc trng hn so vi nc mt
BORIC - BORAT
Cn ng trng ha TNM
H M pH t 5,9 8,0
PHOSPHAT Cc cht ng trng
NaH2PO4 v Na2HPO4
ha thng dng:
H M
Kha cc kim loi nng nn thch NaCl, KCl, NaNO3...
CITRIC-CITRAT hp vi cc dc cht d b oxh

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NG TRNG HA H BNG IM
[- 0,52]

HOT HOT
CHT 1 CHT 2

[- t1] [- t2 ] 0,52 [ t1 ] [ t2 ]

NaCl TH

NG TRNG HA NG TRNG HA
V d: tnh lng NaCl cn ng trng ha
TNM sau
Km sulfat 0,2 g
Cocain.HCl 1g
Nc ct pha tim v 100 ml
Bit t ca km sulfat 1% = - 0,083 0C
t ca cocain.HCl 1% = - 0,09 0C
t ca NaCl 1% = - 0,58 0C

NG TRNG HA NG TRNG HA
NG LNG NaCl: lng NaCl khi ha
vo cng mt th tch DM to h bng im
(hay Pthm thu) = 1g hot cht

Cht in ly cng mnh L cng cao

C% cng m c L cng gim

Cht khng in ly : L khng i theo C%

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NG LNG NaCl: NG TRNG HA

V d: tnh lng NaCl cn ng trng
TNM sau
NC tng
Homatropin HCl 0,6 g
HOT CHT Nc ct v 60 ml
Bit L NaCl Homatropin HCl 1% = 0,17
NaCl tng
Lng NaCl cn TH 60 ml nc ct :
NaCl HC NaCl TH
60 x 0,9 /100 = 0,54 g NaCl
0,6 g Homatropin 0,6 x 0,17 = 0,102 g NaCl
NaCl TH = NaCl tng _ NaCl HC Lng NaCl cn TH 60 ml dd TNM :
0,54 0,102 = 0,438 g NaCl

NG TRNG HA TR S SPROWLS
TR S SPROWLS:
NC tng
s ml nc + 1g hot cht DD ng trng
DC CHT TR S SPOWLS Tnh c tng s HOT CHT 1 HOT CHT 2
(1g) NC CT (ml)
Atropin SO4 14,3 ml nc cn ha NC 1 NC 2 NC TH
Cocain HCl 17,7 tan cc hot cht
Homatropin HBr 19
S ml nc d
Neomycin SO4 12,3 NC TH = NC tng _ NC 1 _ NC 2
Pilocarpin HCl 26,7 S g NaCl cn
Na Sulfacetamid 25,7
ng trng ha NaCl TH
ZnSO4 16,7

NG TRNG HA NG TRNG HA
V d: tnh lng NaCl cn ng trng
TNM sau WHITE VINCENT: V=W.E.v
Atropin SO4 Ba mi centigam (0,30 g) V : ml nc cn ha tan HC thnh DD ng
Nc ct pha tim v 60 ml trng
Tra bng tr s Sprowls Atropin SO4 = 14,3
W: lng hot cht
VH2O cn ha tan Atropin: 14,3 x 0,3 = 4,2 ml
E : ng lng NaCl ca hot cht
VH2O d: 60 4,2 = 55,8 ml
v : 111,1 ml nc ct cn ha tan 1g NaCl thnh
Lng NaCl cn TH
dung dch ng trng
55,8 x 0,9/100 = 0,502 g NaCl

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CHT LM TNG NHT CHT LM TNG NHT

Mt s cht : Methyl cellulose, HPMC, PVP,
Gip ko di tc dng ca thuc
CMC, PEG, Alcol poly vinylic, Alcol Propylic
Lm bng, gi m cho mt kh
Lu : s to phc lm chm, gim tc dng
Lm bn hn dch thuc nh mt
PVP + Sulfamid, Khng sinh
Kh lc qua mng
MC + cht bo qun Nipaeste, Nitrat phenyl Hg
Khng dng cho TNM phu thut
PEG + cc cht trn

CHT CHNG OXY HA CHT DIN HOT

Dng khi DC d b oxy ha: Adrenalin, Physostigmin Tng tan ca hot cht t tan
Mt s cht chng oxy ha thng dng:
Tng kh nng hp thu thuc
Natri sulfit 0,1% - 0,5%
Gip phn tn ng nht dc cht trong
Natri bisulfit 0,1% - 0,5%
hn dch thuc nh mt
Natri methabisulfit 0,1% - 0,5%
Dinatri edetat 0,01% - 0,03% Thng dng Tween 20, Tween 80,

Ngoi ra, sc kh N2 vo dung dch thuc trc khi Belzalkonium clorid: 0,01 - 0,02%
ng l

MT S CNG THC THUC NH MT MT S CNG THC THUC NH MT

Thuc nh mt Cloramphenicol Thuc nh mt Km Sulfat 0,5%
Cloramphenicol 0,4 g HOT CHT Km Sulfat 0,5 g HOT CHT
Acid boric khan 1,1 g H M +
H M Acid boric khan 1,7 g CHT NG
Natri borat.10H2O 0,2g TRNG
CHT NG
NaCl khan 0,2 g TRNG DD Nipagin M 20% 0,25ml CHT BQ
DD Nipagin M 20% 0,25ml CHT BQ Nc ct pha tim v 100ml DUNG MI
Nc ct pha tim v 100ml DUNG MI

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QUY TRNH PHA DUNG DCH TNM QUY TRNH PHA CH HN DCH TNM

Ha tan Lc Tit khun Ha tan cc TP vo nc cht dn

Ha tan: Ton b t dc/dung mi + dc cht
Lc: Phn tn DC rn
Dung dch thng mng lc 0,45 m
Dung dch nht mng lc 0,8 12 m
Lc v khun mng lc 0,22 m iu chnh th cht
Tit khun:
Nhit m 1210C 20 pht (thuc bn nhit)
ng chai, dn nhn
98 1000C 30 pht (thuc khng bn nhit cao)

BAO B THUC NH MT YU CU CHT LNG THUC NH MT

1. Th tch
p ng yu cu theo PL 17.3.3 - DVN
2. trong
TNM nhiu ln V= 3 30ml, 3. v khun
4. pH
C b phn nh git thch hp 5. nh tnh
6. nh lng
Chai l c trong ph hp
7. ng trng

Thy tinh trung tnh, sch, kh 8. mn dc cht (dng hn dch)

9. nht
V khun, khng tng k vi thuc 10. Yu cu khc.

BO QUN V NHN THUC NH MT

Bo qun trong chai l kn ni kh thong,

trnh nh sng...
CM N S CH
Nhn TNM ghi theo quy ch
Ghi tn cht st khun trn CP
THEO DI CA
TNM nhiu liu: ghi r thi hn s dng CC BN
(khng qu 4 tun)

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