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Tác dụng phụ của các thuốc dự phòng phơi nhiễm HIV phòng tránh và khắc phục  

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09:04 24/04/2017

Điều trị dự phòng bằng các thuốc ARV cho những đối tượng sau phơi nhiễm HIV cần tiến hành càng sớm càng tốt trong vòng 72 giờ. Tuy nhiên, trong quá trình điều trị, bệnh n.. [..]

Điều trị dự phòng bằng các thuốc ARV cho những đối tượng sau phơi nhiễm HIV cần tiến hành càng sớm càng tốt trong vòng 72 giờ. Tuy nhiên, trong quá trình điều trị, bệnh nhân có thể gặp một số tác dụng phụ cần lưu ý.

Trên thần kinh trung ương:

  • Đau đầu: thường gặp trong những ngày đầu điều trị với lamivudin (3TC), efavirenz (EFV). Để giảm đau, bênh nhân có thể dùng các thuốc giảm đau thông thường như paracetamol.
  • Rối loạn giấc ngủ, ác mộng, choáng váng: hay gặp trong vài tuần đầu khi dùng các thuốc: lamivudin (3TC), efavirenz (EFV). Các triệu chứng này thường không kéo dài. Nên dùng vào buổi tối, trước khi đi ngủ. Có thể dùng các loại thuốc an thần, thuốc ngủ.

Trên thần kinh ngoại vi:

hiếm gặp với các triệu chứng đau chi, dị cảm, có thể xảy ra khi dùng efavirenz (EFV). Điều trị bằng vitamin B liều cao.

Trên tiêu hóa:

  • Buồn nôn: Hay gặp khi dùng các thuốc zidovudine (ZDV), tenofovir (TDF), efavirenz (EFV). Để hạn chế tác dụng phụ này, có thể cho uống thuốc trong bữa ăn hoặc dùng thuốc chống nôn nếu cần.
  • Tiêu chảy: Thường gặp khi dùng các thuốc: zidovudine (ZDV), tenofovir (TDF), efavirenz (EFV). Khi bị tiêu chảy cần bù nước điện giải đầy đủ bằng đường uống (oresol) hoặc đường truyền nếu nặng. Có thể phải dùng các thuốc chống tiêu chảy như loperamid để hạn chế tiêu chảy tạm thời. Cần ăn đồ dễ tiêu, tránh thức ăn khó tiêu như đồ nhiều dầu mỡ, đường.
  • Đau bụng, khó chịu ở bụng: cần theo dõi kỹ triệu chứng này, nếu cần có thể đổi phác đồ.

Dị ứng:

  • Nhẹ thì có biểu hiện ban đỏ rải rác, ngứa... hết khi điều trị bằng kháng histamin.
  • Trong trường hợp bị dị ứng nặng như hội chứng Stevens Johnson, Lyell có thể đe dọa tính mạng (có thể gặp khi dùng thuốc efavirenz), cần ngừng thuốc ngay và điều trị tại bệnh viện.

Độc với gan: Các thuốc có thể làm tăng men gan như tenofovir (TDF), efavirenz (EFV). Do đó cần theo dõi chức năng gan trước và trong quá trình điều trị. Có thể điều trị hỗ trợ bằng các thuốc bổ gan. Cần ngừng thuốc nếu men gan tăng gấp 5 lần bình thường.


Nếu bạn gặp phải những tác dụng phụ trên hãy đến gặp bác sĩ kê đơn cho bạn hoặc gọi điện thoại đến tổng đài 19006180 để được các bác sĩ chuyên khoa tư vấn trực tiếp.


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