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Tác dụng phụ của ARV - Phần 2  

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08:03 27/03/2015

Thuốc ARV chỉ dùng cho bệnh nhân "Có chỉ định" vì không phải tất cả mọi người có HIV đều có chỉ định điều trị bằng ARV. Chỉ định điều trị phải dựa vào giai đoạn lâm sàng .. [..]

Thuốc ARV chỉ dùng cho bệnh nhân "Có chỉ định" vì không phải tất cả mọi người có HIV đều có chỉ định điều trị bằng ARV. Chỉ định điều trị phải dựa vào giai đoạn lâm sàng hoặc số tế bào lympho, CD4 hoặc đề điều trị dự phòng phơi nhiễm, dự phòng lây truyền từ mẹ sang con.


Một số độc tính, tác dụng phụ khác của thuốc ARV có thể gặp khi điều trị:

Bệnh lý thần kinh ngoại vi: biểu hiện rối loạn cảm giác ngoại vi, chủ yếu đầu chi, đi lại khó khăn. Thường gặp khi dùng d4T, ddI, các thuốc kháng retrovirus non-nucleosid. Cần dùng vitamin B liều cao, nếu nặng phải thay thế thuốc.

Viêm tụy: gặp khi dùng ddI, d4T. Cần dừng ngay thuốc và thay bằng ZDV.

Phân bố lại mỡ: khi dùng ddI, thuốc ức chế protease. Biểu hiện tăng tích tụ mỡ ở ngực, bụng, lưng, gáy; teo mô mỡ ở cánh tay, cẳng chân, mông, má.

Độc cho gan: NPV, EFV, ZDV và thuốc ức chế protease rất độc với gan, gây hủy hoại tế bào gan, tăng men gan. Cần ngừng thuốc nếu có tăng men gan gấp 5 lần bình thường.

Độc với thần kinh trung ương: EFV biểu hiện lẫn lộn, rối loạn tâm thần, trầm cảm. Cần dừng và thay thế thuốc khi bệnh nhân có vấn đề về tâm thần kinh.

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