Thu6clem PAC,FUM M dazotam 5 mq/fr

IHANH PHAN
1 ml chra M dazo am hydro.loid 5 56 mg
tuono duong vd M dazoah 5 00 mq
Td dddc: xem phar Darrrrdc /b de.
DANG BAO CH€
Duns dch lhu6c ti6m
Duhg d ch lh!6ctong su61 khong mau pH 2,9-3 7
N6n! dd osmo/kg du.q d ch 275 305 mosmoik!
OAC OIEM LAM SANG

chi dinh di6u tii

Thu6. Gm PAC FUM {Midazolam 5 mg/1 mt) a thu6c say nqU iac duno norn duqc chi dinh:
Orgudi ldn
. ANTHANTiNHtudcvahngkhichando,nhoecronqquafinhditsuhc6haykh6ngc6gaylCcuc
. cAYME
- Tidnmetudckhicemongme
Cam Sng me
- Nhul, m6ilhanh phananthanrong gaymephi5 hdp
. a\ rivoolv Drd\u daM 5oL oA- B L

. ANTHANTINHT!dcvehonskhichandoanhoicrofgqlehnhdraLtic6haykh6fgc6qaylCcuc

- Tcf metu6ckhicem!,ngm6l
. AN THAN TRONG PHdNG CHAM S6C OAC B ET
Li6! loons v: cach si dqns
LIEU LUoNG I EU cHUAN
Midazoam la m6tthu6c an ihan manh ycu clu th6m dd du va li6m cham. Khuy6n cao phai rhfc hen
r1"-oo':LdadJr,r.rhd or9-L6r o.do1.ra;gta-,rlq-hEna-a
I 6 .dt .6-da'o.io..goo,ot o, Do .oroe ...; -er oOrrd o sL,,tLo. -oa.roDi-- ral
iinhvabenhnh liaudlngphiidoo.x,cdinhcSnthafvetuurd6ncacy6;16iguycoclatiingbCnh
nhan CaclE! chLan du,qccung c5ptheo ban! du6i day

LCu khdi dau:2 2 5 ms

T6fs raur 3.5'7 5 ms

Dudngti@ctang>6than.
0305mg/kg
da i6u tut! d6n kh dat

0070lmg/kq

0 15-0,2 mg/kg (0 3- 0 05 -0,15 mg/kg (0.15-

0 35.rig/kg ieu khdng

lilu khuyan cao d6 vd!

Dudng tinh m?ch dG so

Lau nan o03 O3 mgrks lingdan 1 25 m9
LaLc:t.i 403.02mg/k!/Oid 0 03 mg/kg/gid
oDong linh m?ch dtd so
sinh > 32 iuin va taem

0 06 mg/ks/g d
oudng tinh mach d b6nh

L-A!nap:0,0502mS/kS

. B6nh nhen nhi dudi 6 thanq t!at: bCnh nhan nhr duc 5 rh.ns tuo rhuona d.c b er de bi la. nohan
dudng thd va qi,nr th0ng khi Vt ti do ral duno thu.c de an th:n rinh 6 ke em d!.o 6 tha.;tL6i
kh6n9 duoc khuyCn khich
, a6-hrfar rr r. or.a.! dA1. t.; eL.td d".o'5oa o. I o.9 l6io :Ld-, O6-9.r
*; d d-' eroAodrd;. .enc 6' -L 1o.9., or --..q.o.q .a .. o.q e-. da.rb;o ra
.r.dr.r;.L.ooa .aro. ogdrrd.qt-,orE 6-q,d d.r ,.r.aotoi
. Benhnhannh tnEd6.12tra tdukhd dauOO25denO05mq/to Tdns reudenO4mq/[qdent6i
dalo.mocoth6,canrh6rTacdwoanrh.nreoaaLanguycogjmrnongrhroth"dt;nquan
dar e! cao hon
. B"11 .".',,.r ,oe. 'o.Lo' 1F1o..9te .!L 9 o to
SidunOquadudnordcringtangiaumidazoamrhonqlhuongruOJden0,5mg/[ssddungduns
oa r o1o o o oJ" dLo"o r . -".q drocfL. -er ra q a,!-, o."q.. ." o:.,"" .o o I
i:- \.1.. | -r(r. i o.io.'"rro o r;o."l.e-. o d;oa.oe.. Et r,O^.-o.ai;1 "*.e.
duoc s& dlns m61 r:n va ranh lep ai vi+c si duns qua dudng kuc rang Khuyei ceo kh6,iS n6n s,
dufg cho ta dud 6 rhens iu6 vi s6 iCu co d nh6m b6nh nha. niy h han;h6
T6rnbdp: i6u{dungveokhoAnggiuaOosvao.l5mg/kq T6nqta! dnhdnto,Omg akh6nscan
th el Chj nen si du.q dudng difg n,y ifong cac rudns hop ngcai a Ncn ding qua lrpc tang hdn
vi lcm bip gay dau
dtdemdudi15kgthakong.khuy6ncao[hongsidungcacdunsdEhmdazoam!o n6nadoudo
r o- . o a rc -oro do, 6 d.o pra ,o..9 d-r t rq.
"o, o.
L]EU LUONG GAY MF
TIIN ME
T;!n ma !d mrdazobm duo. rh c hre. nSay trudc khi tian hanh thi thuat da am an thln (qay bu6n
nguhoacnqrqavat;mq;mcl.toaulva amg,mtifh6hudcphSuthuar Mdazotamcongc6$A
droc.aoL.9.e. oo,o,e!r.6".h"rg..o,1e.9r ,or9c. d. 1d, -da2o; j.. d.; -._
,it ne(5iod t.m.ap.;. o.t.20de-oOp.i..,,o | ..m a e no".
,.Ilo,qlaoLo,o1,,,a.ool,.ea'er,ol.,o.,a1a.lJ
khidnngSu6clanmeadeubitbudc!isfnhaycamciaUngc,nhanc6khacbiOtveheuchGns
que r6u c6 tha xay E
O nguot bn
Dd an thln tudc phau thuat va da tam g Am ti nhd v6 cec su ken ti6n phau thuet tiCu khuyCn cao
d6i vdr nsud 6n c6 o eu kian ThA .h;t thu6c nh6m va I iheo phen roa cia HiCp h6i oav mc Hoa
-,,.SA.."o.o 60'rd r_ -q.F. dLq(r.a( a.d;1!rroar6.c. o:o-"-On no".
'r 00'del 0' o.o.e " o;D .; p.j '..-d. a;. re r.a o-,.1 p.. op .eo r,.q cjr r .r,,
"r
e. !.- _. -cchblrda.205.0 F. .. aa., dr
00?ider00 o.Sr"nbJpdio "1-.oLo.oo
-.1i6 .,o ..
do !t.,o.9tqpd,1o q,. .
g;_ ia- moazoam I -L I or o.F, o.o.r 2 da1 . -S ".."

Tre so sih ve b en dtbi 6 hehg tudi

KhOng khuy6n cao dlng M dazo am cho 116 en dudi 6 th,no iu6 vi dn ieu.6n han cha
TreenGn 6thanq tud:
Sidunqquadudng tuc tangr ta! midazotah ih6nqlhudnq khojng O 3rd O 5 ms/ko rCn duoc
T6ns
.loLro'd;a.oo..r.Lo. sio..souiqonr(onqarqqJ,d,orq.;:,".od-,-
ao . .o.o-o bo_ 1e- N6- _1J .ors r-e jr : q"" .uo_.o.";
pha them nudc da dd duoc t6fg ihA tich a 10 h
S0duisquadudnsudmb;p:vtramb:pgaydaunhuc duongdunanaychrduo.dlnqdenrong
nhrng tudng hop ngoa rC N6n chon dudng tru. [.n9 Tu/ nh en ieu ru O OB dd. 0,2 mg;s s, durs
qLa dudng rcm bdp 16 ra h -6u qua va an rdn d ( a lu I ru6r den t5 t!6 .ac eu (ao hon
rh;o ry 6 so
vdi ngud dn va luong quan vd lhalrong.
dtaemdudir5kqtharons khuyancdokh6nqn6nsldungmidazoamdcecna.gdicaohonlmg/
m Cac ndn. da.a. h.n n6i duoc pha oanq diin lmq/m
 CAM UNG ME

\", .odzotd.oLo..lo. oo"(a. ,.9 1-rJo.., .d.ra.i a 9d,i -I c.oLo- o..q

diD q d, ,d,do. ".o..9-;.dro oo -.d;dr-aA -e.o Lorr,r
'o ".t;.5.o
l'|Eo Lai.;r rt ra. o.. -.,o :d oe ..1i1 ^1.. odlo,d-oroc., d.1Sr,o .a".o.9 .e|op,o . a
tec nhan khecqua dudngtinh dach hay qua dudns khi duno d6.am onq mC l6u khd dj! cia m6 iac
'1a1o-ddJo.gdmor o.; oL gd-,,61q,or.,".-oL qr6.0fro.q Ldrr q.r o V.
do9"J-4-'or6 d"'o,o.r'eo'r..b,o rlo6t- ir s.ao.oq r,-"
"!-.
ciamdazoamnCndoocsidunstllDiheohodnslensd:n M6ibudctengdjnkh6nsqudsmsmi
an sC duoc t6nr tn 20 d;n 30 g ay cho ph6p khoang c,ch h 2 phnt s oa cac t,n tang
. d"o:o.ororo oOr.ooao o 'F-ap r-o-qh/olo 6Lre-qLa1. a.rrIO op.O/-a
.oddaOo-o meo,or6oL6r'-.oL9.odec.o.olo.oO))^a-oq;d
./o.9r'-.- \"1 ': !'erd; i ,g " o" oa o116.oo o.,ecuoo. -dq
,q o :uLhd dE. Cd- .,onF o*etoa"roa. 1ri. 9a. -eo..o o1q 1,o1,9 1or9r.Lo.q
hopdakhans.l6ngraudafO6mqrkscothaduocsldunqd6dmongm;.fhuisd rau-onho;
nay cnng cblhe k6o da su hdl phuc
. d .gud dn tcn 60 lud da duoc Gn me benh nhen
b suy nhuo. hav b benh men rinh. jau fef
duocqiamddngkC.vid! lamrnhmachglamru6nscdno05Oi5ms/ksiicmrong2030sayva
.ho ph6p dat hl6u qua sa! 2 ph& Th6ns ihudng ngudi tdn rcn 60 t!6r kh6ng c6 rdn ma dn d6n
nh au midazolam hon d6 cin 0ig me khly6i cao :iig ieu krd diu r, o 1s-dCn O 3 mg/kq Cac
b; 1l;1tq6.odLr9 ,F .ecooFil .od1t.d..q.6- -o-qroo. ).r'rnLo. .1o,9 1ro g,o
. :.,;moazo". r ;p.o-d;cd^ L s p o 9 1ro.c.eJ.-6 d",.1 o.5o-- 0,,: a

THANH PHANAN THAN TRoNG GAY ME PHd HgP

Cd lha si duhs M dazoram nhu a thanh phan gay an thin trons say m6 ph6t hop bjnq ca.h hoa. si
dungihunhofg aunh6giendoanqladud.qtinhmachilaugoa0,6vaO,lmg/kg)hoactuy;.icn
tlcquadudnglinhmach(lCui,06va01mg/kq/gid),decb-;rk6lhqpvdtcacrhu6csiemdau Liau
uong va khoa.g cach gira cac t Au thay dAi ty thu6c lro phan nng cia tlng b6nh fhan
O.OUd dn rtu 60 t!6 benh nhan suy nhuoc hay c6 b6nh maf tifh sc dinq rAL duy fi rh5p hon
AN THAN TRONG CHAM S6COAC BIET
M0c do g,y me mono mu6n dalduoctheotUnq bu6c.hu,n d6 M dazoam b:ng cach hoectuyin dich
len iu. ho5. Iem lnng h6 Oy theo y6u c,u Em sanq linh hang ha chjl t!6i va sf ph6i hqp thu6c
(xem phan Tuono l c vdl cac thu6c va cac Iuong l c khac)

S&dung tong nh&nq nh6m dec blet:

d b6nh.h5n sly ihan {dO thanh lha < 1o mr/ph!t) th6ng s6 dudc d6.9 hoc.ia M dazo am kh6ng ien
k6tsau khi t6m linh mach li;u doniht g 6iO vdt baoc6o;ia nhong ng;di tinh nguyen kh6e manh: Tuy
fh 6n, saL kh tuy6n kao da hons phd.g chem s6c dec bi6l ( CU), lhdi gian an rhan tuns binh tons
nh6m benh nhan suy lh6n b qa tang dang ka hiu nhudo s! tich !y d- hydro,ymdazoamglucuro.ide
Khong c6 Gi eu d;c biet d befh nhan suy than Gm trong (hanh $ai creatinfe du6i 30 m /phnr) sn
du.O midazolam dA cam Uns mc

Suy gan am giim thafh lha mdazoam tiCm linh hach vo s+ 1.n! tho 9an ban thar. Do do {a. duils
an sa 'o ri
9 "ii .o . .a L-o oai .o, -ioazour o r! o qrd- ,a ot ai iie;
h,nh Oiem sat dUng cech nhens d:u hieu song con txem ph;n ainh bro dd. b,Ft iA tha. t;ana dic
bLnttunS s0d,nS)
Nhbntaen:
Xemdteh va mucCanh bao d,c b-arv, than tofs ddc b6t rong s0 dung
ch6nq chidinh
- S&dungthu6.naychocac bCnh nhan dudcbi6tque m5n camv6 benzod azepine hoacb,tk!ihanh
pr;, r"o '" l.rac.
- S0 duno thu6cnay da anlhantinh vdi cac b6nh nhen b suy hO hjpddronq hosc suy h6 hdp cap
S&dungihu6cchonsudibis6c h6nmehoacnhiemd6cruo!.ap(kamlheodjuh6unjnsdedo6
tinh mang)
Nguoi bi glaucom g6c d6ig
Canh b6o dlc biCtvathan tong dac biettoog sOdqng
Midazolam chinen dudc s0 dung bdi b,cs, c6 k nh nghiCm v) duqctang bi cecrhiCt b theo d6 va ha
2 9 10 ^do !m -a(-,a bo . o. or dd dLo! oao kod. 1r". o-,", : J, a,... o.-9.1o1s
mong m!6n ey ra b.o gom.;p.uu ho hip va I m mach Ta. dug khdng mons mu6n nghi6m trons
t6rimmachdeduocbaocao Baogdmca.te!cho.Orsuyh6hjp ngrngthd,ngilrgh6hjphoa.
ngungtim NhongiAcdungphudedoatinh mang nhuvaythudngxayrakhirAhqu, nhanhhoacnem
ld!cao Thanhngdacbetvdikhidnnganlhanri.hchobenh;ha;bigidmchocnangsuyh6hap
Belh-!3'rhrdLoro hc.g J6.oa( o.erd;brS.).o 9Flouols16,a9im rc!r L rle,ec
ld.inbchunddvoinhunqllunhotangdardBdatdudcticdu.gamsangvacinrhi6tth€od6
nhip hd hro vl ldm soat su beo hoa d^v
Khl snd!ng midazolamdeidm ti6n me theo d6i benh fhEn chdrchesau khitiem a b:tbuocvi su nhay
cam d llng banh nhen c6 thay d6 khac nhau va.,c keu.hnng qud tau c6 th6 xay ra.
Thaf fung dAc bi6t n6. duo. thu. h en khi si dung md.zoam chocac bCnh nhan c6 ngly co cao
. ngudl dn ten 60 tu6
. b6nh fhen bi benh men tinh hoac sLy nhuoc
cec benh nhan suy h6 h6p men
.a. benh nhan suy than man thi6u nang ga. hodc suy ch0c nan! I h
. banh nha. ih dic bict cacre c6 cac bCnh v6rm mach kh6ng 6n dinh.
Ca: ba.i ii;n nquy co .ao nay y6! ;! i6u uonq hap hon I,em Lreu uong !a .a.h dung) va ph,
.oo.oe0a - r d"r....o-.e.a.t r crJ,a.qs6rq ;n
"/dod
Nen than tQng khi si duno Benzodazepf d cac banh nhen c6ldn s+ ngh fu ruqu va malny
Cnrq nhu d6l vd cacthu6c am dlu h6 thAn khh tuno uong valhoec c,clhu6c gien co cen than hon!
dacbietkhisidungmdazoram chocecbenhnhan b chong nhuocconanq

Oa c6 ci. bao cao mitm6t s6tacdung khis+ dung mdazoam dA gay an lh:n k6o da a ph6ng cham
s6.dr.hlFr/aLrl
 ."a d'-
Kh mdazoam duoc si dunq d6 g,y an rh:n keo de d CU, nen nhd rlns su e thu6c vc iha chjt !o
midazoamc6rh6phahe. nguycova alhu6crhu6cgahngcJngvd !;u;Ungvathd qiandauir
noly co cifs 6n hon d benh nhan c6 idn s& ngh an ruou hoic a; dung th!6c -
Cecbleu chhg cat nghien
Trois thdi gian di6u r k6o dai vdi mrdazotam tat cU su, e rhudcihu6c va th6 ch:r c6 rh6 phal tEn
Dodo 'oIode - .6r,oo,..o 1r,q a.^ohre-.d..]er h-lqtreo>dr o
rhe,i\ a dL o; ddl.o toa' d9.h,.o r"o Jc arrar roragS. mr q:la
o r t.a,
ddi tinh thr, jo q.. va (o q,1 V ngu, cocacfi6u chong cai nghi6r 6n io; sau kh iau.g diau ri d61
ng6l khuyin cao n6. liim t.u dan
Ch'ns hay quen
Midazo am gay n6n chnno quen v; sau (h6ng thuono rac dung.a/ duoc.ro.g
j,q.a,i. cac rudng
ra tro.s
rdo-h,r..o..a.o1o .!.:..1-r.dqrar..-. j do"rr-L ^ay
oo,"o
. drrS Cqr-a p-l"oorcoy:ad,.e -drs6dr d6do6ir"oda .d- ",coar ,r- qrqio o"
".0
iualvensaukhicanlhiCp Saukhidingmidazolamquadudngti6mtuyan b6ih.hanchidu;cruar
v6n hay phbng khoa chikhi cd nsud ch6m s6cdi kam
cac phan 1ng nghich j!
Eecdbaocao!Acecphaiunqnghchtinhu[rchd6ns c.cci.dong[hongchitam(baog6hcocung]
1e,oor9.Ld .e: r.r;or9r.t prr:.,arrt
"-" ,
i a.or-oa/.td-,r o.i ..g.". or.l,a,,r6re. ao ",oa.t i ro d_o,1-- onn
a':c doit,r,e ot,r,-o'".o,,orbdo co q. to r6
" ". "d.d"-.a
Ihay d6i thAi tn nidazatan
V,- ;,1 To. oarro.t:oro!rd,dd ooe. it...,ardro .d. op.tarqd . ..-_;..d-
enq CYP3A4 (rem pdn Tudng tacvd cacthu6cvd c6cdans tuonq 6ckhac)
V&rhi ru mdao.m o he b .ham ? o.tc bcnh nhan c6 ch!,cneng Oa. kh6ng hoal dong 16r hjcu
.r, r,""o5l-D.o.dd"a.o. o.a(n10 0e1r..3. dd oi.,
tA sinh hon ve so sinh
Vl c6 nluy co Oia ting fgar th6. khuy6n c6o v6 c!n! than hang khi
sey af lhan d G snh non hoac
tudc d6 b snh non Thai tong rheo doi nh p h6 hjp va d6 bao hda dxy Tra.h 1em nhanh d rhom
benh nhan nh sdsinh
Chncnangcacbophan6ftsosinhbihanch6v,/ho,cnonyCuv,changcifgd6b tacha doce.rac
dung sau va/hoec k6o de
Gn h6 hjp cna midazoram
T,c duns batio r6n huy6td6fg hoc da duoc beo cbo dc6c be.h nhan nh kh6ng an dnh v;tm mach
ndn Gnh ti6m buyCn nhanh qua dudnq tinh mach A nh6m benh nhan ndy
Benh nhan nhi nhi ho.6thana ilt1i
Tron! nham b6nh nhan nay mdazoam.hi du?c chi dnh an lhan bon! CU BCnh nhan nh nh6 hof
..o..6 a".oG.oeo
".. " o.erd.o,o.o.d9j-,r 6.o.t
d;ntheota..d!ng.msanqva.:nthergjhsatnhiph6hjpvad6beohdaoxy.enrhaniremphan
-.." -o o.ho c..q
"";" ""
tu snh non dh6n)
Sn dung d6ns thdt ti alc.h.jlcac ch* nc chi thAh kinh iluno uonq
\er ra,'.Jo'.ooo,o a, o-d.od ,ar ," . ..^,..-.
hop hay c6 nguy co am tenq t,c dufg tah sang .ia midazotam g6h an lhan nans ha, u. .h; hd h;p
o-} .o"o ra. ,o . r. .rLo. .t d .,.a. oa:q .q . ,.. ,:;
fiin stllah dLng alcahaL haythu6c
Nan tznh s! dug Mdazoam.ung nhu cac benzodazepf khac d b6nh nhan cd ri6n
si am duls
al.oho ha/ lhuo.
fieL cht\n xuitvi.n
54, l' .a oLr o r o".ota o1o19 .t rm 1
\ de 1,d o 9.o 1d. .ii o q ord F ..o
"o06,oa "oo" "-"
San ph,h ney chra 3,a7 mg Nafl ronq m6 ml
saf pham nay can duoc xem r€r khi siduns cho cac banh nhan can ch6 d6
a. kam soat mu6
Iuong t6c vdi cac rhu6c va cec d?ng tuong 6c khac
Tuo.o t,c duoc d6no hoc:
Midazoiam duoc chuydn hda bd Cyp3A4 Ca. ch;t 0c ch6 va cem Lng Cyp3A4 c6 nguy co tam t,fq
 hayq,mn6nsd6tonOh!y6tthanhva,dod6 l6cdgngcnaMidazolamyC!caudiCuchinhlicuch
phnhdp IuongEcduocd6nghacv6ichlt0cch6haychetcamnngCYP3A4rddnghonkhidnrg
m cazolam dldng u6nq so vd tCm tinh ma.h. vl CYP3A4 hau nhul6n ta d dudng teu h6a ten OGu
nay bd vl qua dudng u6ng ca mlcthanh thaitoan thanve sinh khaduns b thay d6 torg kh vd dudng
temchic6thay d6 sulhanh thaito,D lhan a br inh hudn! Sau khltCmtinh m?ch leu don mdazolad
a.h huang t6n ld. dun! 5m sln! td da do chet,c cha CYP3A4 s6 duoc s em hng kh lhd gran lac
d!.0 c6 th6 b keo dai Tuy nhlan. sau khi dtng midazo am keo dai ca c!dng dO v, lhdl g an lac du.q
se b ran!,o su h ran den cia.hit ac.h6 CYP3A4
Khang cO nhong nghen .uu vE su b6. d6-cia CYP3AA en duoc d6ng hoc.ia mdazoam sau kh
dnns dudng tu. tang hay tem b,p Cd the nhrnq tuons tic iay sC ( hon 16 rang khi duns dudns
tlctrangso!d dnfqdudnsu6nqbd vlthu6.pha d quadudnqieuh6ahon!kh seukh lCmb,p
lic duns d6u briin .ia CYP3A4 khdng c6 su khrc biEt deng k6 so vdL nhnng quan sal duqc kh tiem

Do dd khuy6n cao gam sat cin than e.h hud.g am sang va diu hlcu s6ns c.i tons khi s! dlng
Mda:oao..a.remx6lr;nq.hin!.6thdmanhhdnvak6ode honsa!kh dnnqchunsvdichit&cch6
CYP3A4 c6thA chiduocdin! chunq m6l ,. Dang ch! i dlng a! cao hoachuyh lau dai mdazoiam
chobcnhnhandn.qchat0cchccYP3a4manh vldutofs.hims6cd,cbel cothakeodarbcdlng
gay ngi cham ha phuc vA nc che h6 hep do dd can d au chhh l e!
Dai !d .hit cam ,n9 c6 th6 xem x6t qua tinh cam ong .,n vd ngay dA dat duoc tac dlng t6r da va
h:u nhu va ilay da oal b6 Tre !d di;u ti vai nsay vd chit cim nng. d6u t ngin han duqc ki vong
am giam tuong tacth!6c vd M dazoam
Tuy nhCn d6i vd .hrl cim unq manh cid &ng nqay ca sa! kh dicu k ngin han c6 th6 kh6ns dudc
oai d M dazoam kh6ig duoc brSt am lhay dd duoc uc hac.na nhano thu6c khac
Thu6c kheng n,m Azolel
Keloconazolel;ngndngd6tfDnshuy6tthanh.iamdazolamtemlnhnrachgap5 intongkhLthdi
gar od' la c 9.,o.r9 rero.o dJlo.arao.o ( d r! ."; P'4.
manh nhu kelo.onazoe n6n dodcthuc hle. tong lC! hay n. tuong tq dB d;m bio qiem sat ah
sans cin than !a qua. It y khoa phi hoptong tuong hop ncch; hd hip vai hoa. an lh,n kaodai
Phar rem x6t Ieu xen ka va dau chhh eu dac biet n6u rhlau hon 1 iau don r6m tinh mach dudc
dLn! Khly6nc6oluongtrcathadpdufgchonhonglhu6.khanenimkhacixemnhnngph;nti6p
theol bdi vl 6ng ta. cung af than cJa M dazo an 1 6m linh mach mac d! kam hon da duoc bao

Vorconazo e g a l,ng sf phol nhi:nr m dazolam ti6m tinh ma.h gap 3 dn irong kh thd s an ban thel
cialhudctans khoanq 3 in
Ca ha F lconazoe v, raconazo e am l:ng ndng d6 tong huyet thanh cia nr dazo am t 6m tnh
mach 2'3 :n cn quan d6n mic ta.g nia thd g an b,n lha 2 4 :f d6 vd ilracona:o e v, I 5,n d6

Pos!.onazoleldmt,ngn6.gd6konsh!y6tthanhcaamidazolamiiCmtinhmachkhoeng2:n
Ph; uu i dns n6u ndazoam dnnq dudng u6ng, su pho nh 6m cia lhudc s6cao hon ih au sov6
nhonq lhu6c ke tcn d;c bEt a v6i ketoconazole, itaconazoe vori.onazole
MidazoLam &on! 6ns kh6ns duoc.hi dnh u6ng.
Khang sinh Macrolide:
E,r o^ r'9 o'!oo1oro1 ,- r-.,, .Ld'dazoia-!.''.1 .ro;'o o1 lr
" "
kem theolans thd g an bin tha cia mdazoam ld I 5 1 8 an
C arrhromyc n lam tang ndng d6 tons h!y6tthanh cia m dazolam cho dan 2,5 lan kem theo tang lhd
san ban rhai la r 5 2 an
- Rorrhromy.ntrongkhkh6.qcdlhonqhnvbluongtacgnarox(hromy.fviindazoahti6mllnh
mach anh hudnq il lCn thd g an b,i lhe cia Midazolam dudns u6.s ting khoang 30%, chnng 6
dnh hudng coa Rorithromy. n en M dazo am ti6m tinh mach c6 tha,t nha
ch,t rc chE Hlv Protease:
ao e. .ailr'g.ia ;o '" '
"'
th; lat ra md su ta.g dang ka nang n6 mida2o am Trong ! ac drns chunq vd riona! r cdng them
opnavr,nAngdOtonghuy6tlhanhciamida:oamtCmtinhmachling5! an kemtheomictang
t,d.a xr lhdl qian b6n rhi N;u midazolam ti6m durcding ch!.g vdi chi! ncch; Hlv protease k6
".o'o'9!d'e o9r a,...id.o'
Thano ln ba sui. ra m dazolam dudno u6na
clacacch,t0ccheCYF3A4 n6nsd6hdazoamdoocdudoen caohondang k6kh
ding dudng !6i! Do d6, c,cchSt 0c cha prolease kh6ng nen dung cing voi mdazoalm dudng u6ng
Thu6c chen kCnh Canri
D lazem: MOt iau don d luazem em leng n6ng dO tong huy6tthanh cia midlzolam lemfnh mach
khoa.g 25% va thd gian ban thi b k6o de khoang 43%

verapaml/dilazem dmtanqnA.qd6ciaMdazolamdudngu6ngran ud3 4lAn Thd qianbantha

cinq 6ng 41% vd 49% luong nng

- Atoruaslatin lam t:ng nang do t.ns hlydt tuong cia M dazoam liem iinh mach gip 1 4 j. kh so
sanh vd nh6m chrnq

I +i"."a"mg *g oO nuy6t tu onq coa udazo am 6n srp 4,6 lAn cnng vdi tanq lhdi gian
bir lhal a. 1 6 dn
.- 'L,1r6c,aod,'olqaa^p-pa1ra"'dr9ro'9do-o'q'-,atuo'o.laMoaroam-hrorlg
' ouo"q o q rar o ),3 d- 5aL.h o.'q lp. 30' q rqr, i6r Dp.o r". I 2 "r''o Irr oalrrai
Thu6c saycam onq CYP3A4:
- Riiampicn am g am na.g d6 rong huy;t thafh caa midazolam ti6m linh mach khoang 60% saL 7
ngay dlrg iau don 600 ms riiampicin Thd Oian ban lha b giam khoanq 50-6c%
Nhoio lh6no tn b6 suno.ho mdazoam u6na
: - Rirampicn dh aiam ndns d6 tons huyCl thanh cna midazoam u6ns khoang 96% a ngu'd khde
manh va iecdungten temlhln van d6ng cia mdazoam hau nhu bi mel hoen loen
- Carbamazepn/phenytoin:La!lEpalciaCarbamazepnhayphenytoinamgamn6ngdOtong
huy6tthanh cia midazolam udngden 90% va Em ngin thdi gian b6n lh,l khdng 600Z
- Eravrenz: Lim tano 5 lan ti 6 CYP3A4 ho ra chSt chuy6. h6a a-hydroxymldazoam tn midazolan
khing dlnh tacdung cam rng CYP3A4ciathuiic.

St Johns wod am siam nAng d6 tong huyCt ihanh cia midazoam khoans 2040% kem iheo giam
thdiglanbanihaikhoangl5rT% Phulhu6cvaodanqchiiitxueicuthaciaStJohnsWofr,t,cdunq
cdm ong CYP3A4 c6!h6 kh,c nhau
Tuonotacthu6c thuiicdmc l&hoclDDll:
sudinschunqmidazoLamvdnhDngthu6canthan/thu6cngikhdcvathu6cucchiihcthanknhtug
uonq, bao g6m alcoho lam l;ng iac dung an thln v, &c chd ha hip.
Nhenq vi du baog6m cacd,. xu,l oplal {duocs& duno nhuthuiic giam dau. thu6c ho hay d-A! t thay
th6) thu6cch6ng oanrh:n,.hrnsben:odazepnduocdlng.h6nsloauhaythu6cigi barbitLrat.
propoio ketamn eiomidat .n th)n ch6ng tam cam. khang h siamin Hr th6 he cn vi thu6c h? huval
aplacdong tLns uong
A coho c6fia llh lins tac durg an ihan 16 ret cia fiidazolam. TuyCl d6 t,nh sidung alcohol khi dang
si dlig mdazolam (xem phaf Cenh bao da. bi6iva thsn trons dac biathng srdLng)
Mldazolam am giim ndng dO t6 ih au d phc nans (MAC) cia thu6. gav ma khi dunq
Thdi ki mang thai va chocon bn
r1o19'ooa,oLG.s6 eL!-mo"/ola-ded." gL rFdo-1roal: o" "o'.J';':"d
C" Lo q er." rc-do1s,er.h6rg 'od".'r o.'ogS oLr'l'" 11'q emdd bzo".'d;
duocqLansalv6icecbenzodazeplnkh,c KhOngc6s6rguvdtudnghopngudlphun*nanqthaibi
pho nhi6m kong 2 gial doan d)u cialhal ki
De c6 nhang beo ceo va viec si durg midazolam d Bu cao lrong ki c!6i cia ihdl ki mang thai, tong
khl sinh hoA; khi duoc si dung nhu mdt lac nhan lan mc dE sinh n6 de gav ra cac tac dug kh6rg
monqmuiSntfCnngud mehoS;t6nbaoihai(ngLycdhilvAodngudime nhipimkhdngd6Ldbao
thai, gam tuonq uc bn kem gamthan nhetva suy h6 hip d ta sd sinh)
-drnJa,fa.r11'dr..lLnooa-eo'9.r'oe"odazeorl,oro,Lar"orgq"rdo+1"J6':o
rdr! l,,od ap'ar,Gr(1rT.e'1J6. *,6c.ed e.-:..r(l'o oI'6co.19 "' 1qL, o
re.a!
acL chrng ca nghi6n dlhd ki hau snh
Do d6 kh6ng nCn s& dung midazoLad tong !c nang th: tl khi Ihat sf dn thr6t T6l hon nen 6nh
sidung tong sinh m6
Phai xel den nsuy co d6i vd re so snh khi sn dLfg midazoam cho bil ki cloc qiei phau nao gAn

Midazo am di qua sn'a me vd udnA nhd Ce. ba me chc ccn ba i jcc ir!v6. -. 13 -":r1' c:
I',t.j:
sea me 24gdsau khi si dung midaoam
Anh hd.q d6n kha nans 6iva van hanh mrv m6c
An lhan. chuns quen su kem tap tung va suv chGc neng co ci th6 arh hudns bjl ld d6n kh' niig
di6u kh an phuong ticn gao th6ng ve van hinh mev Trud. kh diig mdazo:m benh 'he' n6' duo'
rhl," ao.aa,; d ' p' ioE,'' q,'o 'o'o .a .i- !t _ 'a !' _ o "
rai ea.- -qrrro L' o/t1""nGi '' 1 _ar'iern'n '' d
"o.',lodtd"LlaG!rcdrooo
ngudi di cing b6nh nhan ve nha
T6c dqnq khdng honq mu6n
Caclecdunq kh6ng mong m!6n sau day duoc bao cio daxav ra khil6m mdazolam
Tin su;t cia caciacdlng kh6ng mong mu6n duoc phan nh6m nhu sau
R5r haygap >1t1o
Thudng gAp > 1/100 d6n < r/10
i1 o;p > l/1ooo d6n < 1/loo
Hl6m sep > 1/IOOOO d6n < i/1000
Rii hi6m < 1/ 10000
chu,a 16: kh6ng lha d6nh s a dua tcn s6 'au da c6 L

R6itoan he thdrsni6n dich:

Phan oio qua mer chunq lphan ons da phan ong tim mach co th:t ph6 q!'n) shock phan ve

Lin, tam tang sifq khoeL ao giac

q (r -'rlc-do-s foa dolo'Lorg uchL'oaooh-cidn'qcocr"o gi*
r.r.qpra"J.q''a
r.' /a'L- Lo, E.qdoE lalnr -6-0 dor or,n, 9'1-'.o''ro ohir L
"
bicl dtAem ve nqudi l6n tL6i

Sio-novrca/o.a_ ror',ao r". dierv'or-6oa lo 'ro-!rtp-l'+Lo il'dc e'16cndlSr

jac' da bel' qiro dJ! IhL6c ddi loot (o I e ker
khr sl dino rem Lrn br oai q. -q s' d.!
'."ore.1."q.",'q''r oaogon ogar !1e- \e oh, Ct'r blodtcbrPl
vdlhan tong rong sS d!ng)
Rdi laan ha tu6ng th:n knh

Anmanl.ooa oE--i--arc.q'qdl rhr..a. '-o g . rard'L'oa a'l-"'1erp'"_ 'lt'rg

qal
o,en .e sa-'ri"o oai ca' r:'o ra, ui' 6p le' qlrr der'61 oa s] dl'o c5iao o e' \P
lop ''e'a l' re oLi' reo da
co fiE /in l6n ar der lro qL, hrh \d da @ ooo 'ao ra. uLolo "tjt
Co glal cnng de duoc bao caodG sinh non ve tE sdsrh
,nanungpnqrghemhnstcntimmachdaxavra Nho.gph'nongnayg6mng!re-lm'hahuv6tap
.ir";.itia..;'mr"a"ooafmach Nh+nspiir!nqdedoatinhmanohaunh!rivradnqud.ldn
r,#io,ra, *,ioi h; h,p tud; dav hav suv chnc ntns 1 m, dac b el khi ticm nhanh hav
"l.no"o
lau cao (xem ph5. Cd.h bao"uvda. bla valhan tong tong s& duns)

i..n:n.rn.on,nohe o-.pooogoas" oldp lgdrrro ro'Tfo lol o

;;:."-',', ;', sr o"ooa " -a." ot!. "'o i'a d-qro' or "''60'Lo:'a'hiTr eLo b
c q;'16L"Dr ro_ddr 1", 9an ril' -a 9'a oacb'''trer o i'harr to'('L d''rc ao

lrem Canh bao dac bctvelhan hng tona sa dunq)

cac di \a?n vi dudng tiet hba.

Buan n6n. non mia, leo b6n kh6 mens

RAibanvi dava phen Phr

May day phatban da nona

ca. 6 taan ban thAn va tat vi ti ti6n:

ta vi ti tcm, viam ft
Mct m6i, ban dd va dau h mach hlvet kh6 h!v;t kh6
Ch:n thfung sqnhi6n dAcveb6nchtns:

C6 ghi nhsn graleng nguy co nsa va gey xudng d nsud gie sidung benzodazepn

trLo"oqa,lglromomd.deLlod oa''a'rqo-'i
-ro.onn-.a(o"'/od,az-p'
:.:"i'".-,a' .1 deooc'r'na-s,.1r-.6!\:drqmo "ni rrlro
o etp.noa orrhe.
.heo"nb,m-o1;1 a.qd' 10 1or-re ap J' ';r' -"' ar'eall-or-" ts6 ' e 'F' a'
-or.r qonnr"q,o""'"oo d" oe doe'r'i"'sia -J(d"o
i".-"*re"*
L,B-l-od.zep'r' ramr'onq-or 11;. ob'' rrSr'obe''ho ;p
- chel;'"p
dwg ch,l nc th:n nh tuns uong khac bao gam aboho
Benzod azep i Em tang Uc cec ch6 he k

I eL-619!o1."r.J.r''1G(oP oraplo rooro''-io o a sc'g Da'be

oe1, i rd .o'r; dJo( d,"- "r rFU. --nq cd' ;-' rJa' 9' - rc.l "' "e l a- rrnr rrls uorg
N6u0.ch6heihAnknhtunsuorgtjmtrong c6thaxehi6tsodungfluma2eni ch:td6ikhenq
;";,;","."r'." -- dLo s!oL,ed;d.s. o,a-sar':'F5 -'6''orLddo Ezril o;lerqro
oodobe--rhdr dao q Lr aze.r .d'duo''1'ooo sdIr- a dr19'-a'rJo da"e
.um"zjn' drq .lo- g.o Fe s''''a-_oor' coa'1or-r'9'oilLo'L oartro g o'
donqt.h,, dJrlro'6'qr" d-'.o's - r'io''_ ro a6'o" d'o't' to'LFr/'nr de
"
.o thEm tho.a hn tono vre. si dQnq dunq thud. nev.
cAcgAc orEM Dugc Li

Nh6mdudc lr: lhu6cngi va an th,n: d6n xu5tbenzodlazepin

than dau
Midazolam la m6i d5n iuet thuoc nh6m imidazobenzodlazepin Oang base tu do 3 h6t chat
_idazoL- cLrS
N.nooen (o oa. o . rr 2 cLa 1'\org '1dr7ob
,. *" *" uolq .Jo! Dd c) .ro 'a dJT dci thl6' rcn 6 l li ol drr
", "
ld- o6no o,o.1, .i" " olzo"r dd. ar q 06'ho'gral 1qa' do s' be- d6 clJ,"l roa
EC oo"q
h; ."qA,!1_a No rng ora'd''9"i rhrrg o
.r*" riozoumrcucoLor '

i" .ri,o.qo,"o o"s i6-odp'oa oL.drors'11macl 'nlnso-e- isau ro'otototar

.qan a, 'a oain --"' .h6rg 11o .a' >, "Fl i/ ra r'o.q L' rr 6r co lar dLrq adlh ' "ar

HAp thn sau khi ti6n beq

Srn5ohrmoazor' r ro o'1r''crr 'o'g d'oa-!o.' \61qoo oidatoTnLJe'l_o'ooa'
;;.;'"-0..s op L \ ''-iao"'o' ,e do'dJ'1 Ieroap "''e1e0"'
HAp thu sau khi sndung qua dudng th lkng
Su, hi s+ aung qua auOng trqc tAng mdazolam dtrdc.h:p thu nhanh N;ng do t6 da tons hLv6t
luoig datduocirons vdnq ao phut sinh kha duns tuvel d6i khoan! s0%

- - - da/ata- d ta I 6n qlr d rorg lr- maLl ddo'q oro \e f o gEl - tre do 0oro l!r' u^ry
,n. ln:. mornoa hd o' a oldl oa'o a' q -'e_'1 pt51 b0 d'6 19 t
proterl''.et
; o,o,m 16r a"1 .o, ca Dror"il "ons -. /er rLong sL oA- tar "1l,e _:r ph5n dor-
r,.n. :doaloJm. oaor'uo'q roaToar'Ld\dl 6-q'o'1q"c 1 otad tnaolr/
o -i".. *-".* n' oiqrr 11aJ a"'1aa'a o ao"4'hr
)L r';r ho;r cua l"a vor
uong nh6 ".".c1J! 1im hav tunq sna me
M dazo am cnrg duoc

P'"-oo"''a' :r. 1"' Jca

loalroa, o dao,la dooe, od,,1'o(
'i1,J#"",.,
a-..*,i.." {{Oo! V'oazo.e b'1rd'o ) 1or06 ! 'oJar ';ol;r or lal( ''F oaro_o
;;: ;;..- dizot- Nore dolole r L,' r or o'1" "p'" 5\d'o.'
",."ii;"", """.-,*",
."azo".Uaq',""olqao-uaoo'arqo'Apl"_1dro''-idazola-t'h;l'ol;'dL'o0rorrv
i --;i;;o-r'qopplal:rd I'!o: s looo' ao'r( duneclar'oa/oam'F- I1' dc'

dmuo nnh no.,!1-1oea"- l1o qar D.t la.l"-'dazold' o qrla rca1g 5 2 59d SJ-'rr'h
;i;;.;."-;;; ,o -oat 'oo ioo r pln M dazo'r' '1i )'J dao '1; o a r-il 60-a0o; e '
intr",l'-"."|-I.d,d"odarq"pla'1)dro' rd"zo'a gl'Jnordl'ieliooD"o'"o_dFI
aro,' r"ar r oco nro,'i;, dro' da g ttta' 06 r' r' r':' r drzoamq'a dLol0trF m:'1'
do-a , ,c I o. dao trr tt6 g .o or 'na! 'o !o 1 I em bor F
DNc dang hoc d cac hhdn bChh nhen dAc biCt

N;ud dn ten 60tua,i, thdi qian banfiai c616 k6o d'i d6n b6n ljn

MrLd6nao nJo cd'd-qrr "ralld'_e-"-o_'o 9" "'udloJo o ' '-oi "1'oL'g

-hiono;15rs 1;sa.r'r''ol-oo'adro'snr'mactadroqr'dcra19m
n6rnhonotrdI lOl.6 r' l.5qo, ' 'o orrqLo o' >L lacb'eln',o5iroo\o 5u angciuven
h;. rhanh thai dkd em.

dr.\.srh Lno oanoal li rr"ootr"darruo_ 2go.11e -r;'a1!leooqar "1rapra ri61

..".mran,asu o"rr+a r qif uonq'empF)'';11baodd oe a I'a' o1o ro 9'' dL'I

Tnor6"noannlvr oD11o qro oeopn'|lo holso o|o o't-o'gbeoor 5o{ o' 0o-'
1-rlc5o16-0torg'rog'ra or-e
o..:a,oo."qiar"q "o."o'0""',;lclp's-06dJo("eL
qLa'"os 'ao"1r l-i beoo'' d'161sb:oo'
s"*""" rul,i-o"" - oe o"

i;" ob"r rfrr 'oed' or "oo" as''r"rr r1o ''ao1o1'o o rrLnqlsro

'01
"', "".;,
.'.J;",-."e-eh oaoo". o,+""'dr 'o !"orosloL o\

ftAiq"nUannlyOAo$aiab6nhnhansuvlhanm5ntinh3ii'nliuihuiitnentJcrllr_'-j'-

Benh nhan b1nh n1ns

Thdi gian ban hiy da;tha caa midazoam bi k6odai bn d6n6 :n d benh nhen enh nang

nh!'rs nsu'd kh6e manh (xem phan

O o!"n **.v6tthdl sian ban thaL d'i hon so vdL
c,nh "*"i,r,,-
beo dac biet!d than tanstong sldung)
OACOIEM DUqC PHAM
Danh mqcG du@:

vdi cac dlrs dich tiemtuvdn khl' nso'i nh&ng duoc n6l d'n hons
si
t""r",".iniin *o" on"
pnA. HNng den s0dung/baa ".ns
quan

L:" ta.to"vu*grhtnrrudckhisidqngn6u nhuc6idnh phat6nvd cachu6ckhac

;;.;*'*,-"";t,* o' c''r DLarbo'"r /e mar r'r J)er durs och ram dazou-
';"i""-,:'-;;;;;r' "Lrq doLod-1 odaor rrnq'rFrcd''e' Nerm'da/oram
d.
'oq il1til b-'era rrL'olorpFar'
a,.. *.i*-;",.' "mo
""- ' ",; i;;'l:';", :;;;."." ."" ,a':oe .obaolrr
ao,. ar"'r r dr'oa( tr L"'ooe''r' r'" v*rloo.a slrrrrero
;: ;" ", "'..." *--
azol sa rao ra lel ria mau t5r9 _aL [alo h' D1d o atri''""r v6
_" rr....' a.- naa, I 60 I eo s'L'J rdo \erid
' -nn
.efrazldrm suonq mu dud. rto th,nh
r' "rcr1pr' oco'io lvdroorod"ed!h
:;,";;,"";;;i;'.'; -er "'e'-a
p-d o oaep''/o' 'u o''oo'iuo ola z''aL ri te IUa aLndJ v6
"^.-;..--;,;"
nafi ro;carnei Phat sinh khi.
rdilLa i'o q .e' o . -'dclorar'o'': lo\ " h' m' al'eola'' or''ri accdzold' dial'oam
' '"tto'ri ld" o'c oorrbra
""t
tometamol' urokinase
i"i e"*rca., mtL *urcum lheophvll
'
H?n d!ng
361h6ng k;ln ngey san xuat.
Han duno sa! lhr.ha dno
;:";;-;* rFraroa q --r' , lod'ad"oc( ' onr- "1 phr hJo'oo:-cl1
qa'
*"i- J;. ;;re ." d /2 o.o ; 25 c r;- pham pra'oa1s' er sl d.s' -er' ra'quor
n'hr.o
r.. i "i.q* "-"1" ore*", ,1o 9.ar.dd-L,ieno; 'r'o-1oru'(!"c5
l n phd'oc-qdJo'! rie'ndni
1o.d,"..a ..-""oo)'coer 8"' ''r
:L;i,q,:;;:;;Jol-;
,"- :.a"-"'i" o^r! so", "< .'q-" 'o''r-c
Dia; ki6nbao quan dic biet
Baoquan nol kh6, nhrctd6dud 3o'C Kh6ng dong ?nh
Beo quanlhu6ctong hop cadon o; tanh sdnq'
'anh
Ori ceci d6ng 96i
Ong ihiy tinh kh6ng mau (thiv tinh loa l) choa I
m dung dich'

I H6p 10 6ns 1 ml
, Hwno d:n cach su dqng/b.o qu;n
:"*r1" ,"* -o a'o od' o
' T:"'";;;,:-.;;
.h:! hra. co Gn va oar bo dunq d(h thua
.,r";,1Lo ne o"/oa 'o+.o'o oaoas/or\'e15mend''
:;;',..";* ";',
,0" odo- ,o :0i,. s.a' dfgoc r'''r _aidrv N"Llo9"' de/'o'e5% 'a r0"'
-"..'. P'o_ d'"le
..o.rqo
Treu.hudn: \rd 'al '."r
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