Lub xaib qhia cov ntawv pov thawj rau cov ntaub ntawv xov xwm nkaus xwb. Kev kuaj thiab kho kab mob yuav tsum tau nqa tawm los ntawm kev saib xyuas ntawm tus kws tshaj lij. Txhua yam tshuaj muaj contraindications. Yuav tsum tau kev sab laj tshwj xeeb!

Yam tshuaj twg zoo tshaj plaws pab rau kev kub taub hau heev - paracetamol lossis tshuaj aspirin?

Ob qho tshuaj - ob qho tshuaj paracetamol thiab tshuaj aspirin muaj cov nyhuv antipyretic zoo. Txawm li cas los xij, ntxiv rau qhov txo qis kub kom zoo, cov tshuaj no muaj cov yam ntxwv sib txawv, uas yuav tsum tau coj mus rau hauv qhov taub kom nkag siab tias yam tshuaj twg hauv qhov xwm txheej tshwj xeeb no yuav zoo tshaj plaws rau txo qhov ntsuas kub.

Hais lus nruj me ntsis, cov yam ntxwv ntawm paracetamol thiab cov tshuaj aspirin yuav tsum tau hais tias lawv tsis zoo ib yam nkaus ntawm kev ua haujlwm ntawm txo qis dua qhov kub. Cov tshuaj aspirin ua tau zoo dua thiab sai dua nyob rau hauv qis dua kub dua li nrog Paracetamol. Txawm li cas los xij, muaj lwm yam sib raug zoo ntawm cov tshuaj no. Yog tias tsis muaj lwm yam ntawm kev nqis tes ntawm cov tshuaj no yog qhov txaus siab rau ib tus neeg, nws tuaj yeem siv txhua yam tshuaj.

Tab sis yog tias koj coj mus rau hauv tus account lwm yam ntawm kev nqis tes ntawm paracetamol thiab tshuaj aspirin, tom qab ntawd txhua cov tshuaj yuav zoo dua rau qee kis. Firstly, paracetamol yog suav tias yog qhov tshuaj tiv thaiv kev puas tsuaj tshaj plaws hauv ntiaj teb. Yog li, paracetamol raug tso cai rau tshaj tawm kev tshaj tawm thiab kev tswj hwm tus kheej ntawm qhov kub ntawm lub cev.

Cov tshuaj aspirin zoo dua ua rau kub taub hau, tab sis tuaj yeem yog ib qho tshuaj txaus ntshai. Qhov phom sij tiag tiag ntawm cov tshuaj muaj aspirin yog tias lawv ua rau tib lub siab cov hlwb ua qee yam kab mob uas ua rau mob khaub thuas. Yog li ntawd, lub siab ua haujlwm nyob rau hauv ntau qhov ua haujlwm ntxiv thiab muaj lub zog loj tsis zoo rau ib txhij los ntawm Aspirin thiab kab mob. Nyob hauv kev cuam tshuam ntawm cov tshuaj aspirin thiab kis ua mob lom, lub siab ua rau lub siab puas lawm, thiab muaj ib qho mob hnyav thiab txaus ntshai hu ua Reye syndrome tshwm Qhov kab mob kab mob no yog los ntawm cov teeb meem ntawm cov tshuaj aspirin.

Tus Mob Reye's syndrome yog ib tus mob hnyav heev, kev tuag ntawm tus neeg mus txog 80 - 90%. Yog li, kev siv cov tshuaj aspirin mus rau qhov kub tsawg dua yog qhov txaus ntshai. Tab sis Paracetamol tsis muaj cov kev pheej hmoo no. Yog li, kev xaiv ntawm Paracetamol thiab Aspirin, ntxiv rau kev sib piv lawv cov hauj lwm zoo, muaj lwm qhov - qhov tsis txaus ntshai. Cov tshuaj aspirin zoo dua nyob rau txo qis dua qhov kub thiab txias, tab sis nws tuaj yeem ua rau muaj kev phom sij txaus ntshai, thaum Paracetamol muaj kev phem dua ntawm kev tswj hwm tshav kub, tab sis nws muaj kev nyab xeeb tag nrho thiab tsis ua rau muaj kev tuag txawm tias muaj ntau dhau. Ntawd yog, kev xaiv nyob nruab nrab ntawm cov tshuaj zoo tab sis txaus ntshai thiab tsawg dua kev tiv thaiv, tab sis muaj kev nyab xeeb kiag li.

Nws yog vim muaj feem ntau ntawm kev tsim muaj Reye's syndrome uas cov tshuaj aspirin tsis pom zoo siv rau qhov kub qis dua hauv cov voos kis. Txo qhov ntsuas kub kom txo cov kab mob khaub thuas, nws raug nquahu kom siv cov tshuaj Paracetamol npaj. Thiab nrog rau ib yam kab mob, xws li tonsillitis, pyelonephritis thiab lwm tus, Aspirin muaj kev nyab xeeb tag nrho thiab tuaj yeem siv los ua cov tshuaj tiv thaiv zoo tshaj plaws.

Dab tsi los xaiv: Aspirin lossis Paracetamol?

Yog tias koj xav xaiv cov tshuaj tiv thaiv kab mob zoo tshaj plaws, cov lus nug feem ntau tshwm sim, uas yog qhov zoo dua - Aspirin lossis Paracetamol. Cov tshuaj no muaj tib lub zog: lawv txo pyrethic lub cev kub (kub taub hau), nres qhov mob ib nrab. Tab sis cov tshuaj no muaj cov khoom siv sib txawv, sib txawv hauv cov txheej txheem ntawm kev txiav txim thiab contraindications.

Tshuaj aspirin los yog Paracetamol txo pyrethic lub cev kub (ua npaws), tsis txhob mob me ntsis.

Cov tshuaj aspirin Tus Kheej

Cov tshuaj aspirin yog tsim los ntawm lub tuam txhab tshuaj German lag luam Bayer AG. Daim ntawv teev cov tshuaj ntawm cov kev npaj yog dawb puag ncig biconvex ntsiav tshuaj, uas tau kos (Bayer tus ntoo khaub lig thiab lub npe ASPIRIN 0.5).

Cov khoom xyaw dhia: acetylsalicylic acid.

Cov muaj mob siab: pob kws hmoov txhuv nplej siab thiab microcrystalline cellulose.

Cov tshuaj aspirin muaj acetylsalicylic acid (ASA) hauv kev noj tshuaj 500 mg / tab. Cov tshuaj yog rau cov tshuaj pab pawg ntawm cov tshuaj uas tsis yog tshuaj steroidal anti-inflammatory (NSAIDs). ASA tseem yog qhov tsis yog-narcotic analgesic thiab antipyretic, vim hais tias nws cuam tshuam rau hauv nruab nrab lub paj hlwb thiab qhov chaw ntawm qhov mob thiab thermoregulation nyob hauv lub hlwb. Acetylsalicylic acid belongs rau thawj pab pawg ntawm NSAIDs, i.e. yog ib yam khoom uas hais tawm los tiv thaiv kev ntaus.

Lub tshuab kev ua ntawm ASA yog ua raws li kev tsis tuaj yeem ua thaiv ntawm cyclooxygenase (COX) cov pa roj ntawm hom 1 thiab 2. Kev txhawb nqa ntawm kev tsim ntawm COX-2 muaj cov tshuaj antipyretic thiab analgesic. Kev txwv tsis pub coj los ua ke ntawm COX-1 muaj ntau lub txim:

• inhibition ntawm cov synthesis ntawm prostaglandins (PG) thiab interleukins,
• txo cytoprotective cov yam ntxwv ntawm cov ntaub so ntswg,
• inhibition of thrombooxygenase hluavtaws.

Cov nyhuv ntawm ASA ntawm lub cev yog koob tshuaj-siv. Qhov no txhais tau tias cov chaw muag tshuaj ntawm cov tshuaj sib txawv raws li cov koob tshuaj txhua hnub.

Noj ASA hauv kev noj tshuaj me (30-325 mg / hnub) yog siv los tiv thaiv cov kab mob plawv uas yuav tshwm sim los ntawm kev muaj ntshav ntau ntxiv.

Ntawm cov tshuaj no, acetylsalicylic acid muaj cov tshuaj tiv thaiv antiaggregant: nws inhibits tsim ntawm thromboxane A2, uas nce platelet aggregation thiab provokes vasoconstriction loj.

Txhawm rau kom txo qis mob ib nrab thiab txo qis pyrethic lub cev kub thaum lub sij hawm kub taub hau, cov tshuaj nruab nrab ntawm ASA (1.5-2 g / hnub) yog qhov ua tau zoo, uas txaus los thaiv COX-2 enzymes. Cov koob tshuaj loj ntawm acetylsalicylic acid (4-6 g / hnub) txo qhov hnyav ntawm cov txheej txheem inflammatory, vim tias ASA tsis ua haujlwm cuam tshuam cov pa roj carbon monoxide COX-1, txwv tsis pub tsim PG.

Thaum siv ASA hauv kev noj tshuaj ntau dua li 4 g / hnub, nws cov nyhuv uricosuric zoo dua, thiab kev siv cov koob tshuaj me thiab nruab nrab txhua hnub (txog 4 g / hnub) ua rau txo qis hauv cov zis urinary acid.

Ib qho tshwm sim ntawm Aspirin yog nws txoj kev mob plab, uas tshwm sim vim qhov txo qis ntawm cytoprotection ntawm lub plab thiab duodenal mucosa thaum ntsib nrog acetylsalicylic acid. Kev ua txhaum ntawm lub peev xwm ntawm cov hlwb ua kom rov qab tau ua rau kev tsim cov txheej txheem ntawm kev ua haujlwm ntawm phab ntsa ntawm lub voos.

Txhawm rau txo qis kev mob nkeeg ntawm ASA, Bayer tsim cov tshuaj aspirin Cardio - cov ntsiav tshuaj enteric-coated thiab dragees. Cov tshuaj no yog tsom rau kev tiv thaiv cov kab mob plawv, yog li ntawd, ASA muaj nyob hauv nws hauv cov tshuaj qis dua (100 thiab 300 mg).

Paracetamol Ua Haujlwm Li Cas

Paracetamol hauv daim ntawv ntawm cov ntsiav tshuaj (200, 325 lossis 500 mg / tab.) Muaj nyob ntawm ntau cov chaw tsim khoom.

Cov tshuaj phiv tshuaj yog paracetamol (acetaminophen).

Cov tsis muaj zog: pob kws hmoov txhuv nplej siab, qos hmoov txhuv nplej siab, gelatin, croscarmellose sodium, stearic acid.

Paracetamol yog nyob rau pab pawg thib ob ntawm NSAIDs (tshuaj muaj zog tiv thaiv kev ua kom tsis muaj zog). Acetaminophen yog ib qho kev sib txuas ntawm paraaminophenol. Lub tshuab kev ua haujlwm ntawm cov khoom no yog raws li kev thaiv cov pa roj carbon monoxide COX thiab kev txwv ntawm GHG synthesis.

Kev ua hauj lwm qis los tiv thaiv qhov ua tau zoo yog vim qhov tseeb tias peroxidases ntawm peripheral cov ntaub so ntswg hlwb neutralize qhov thaiv ntawm cyclooxygenase (COX-2) cov kab mob uas tshwm sim los ntawm qhov kev ua ntawm Paracetamol. Cov nyhuv ntawm acetaminophen txuas ntxiv mus rau lub hauv nruab nrab cov hlab hlwb thiab cov chaw ntawm thermoregulation thiab mob hauv lub hlwb.

Kev nyab xeeb ntawm kev sib raug zoo ntawm Paracetamol rau lub plab zom zaws yog piav qhia los ntawm qhov tsis muaj inhibition of GHG synthesis hauv cov ntaub so ntswg ib puag ncig thiab khaws cia ntawm cytoprotective cov yam ntxwv ntawm cov ntaub so ntswg. Kev phiv tshuaj ntawm acetaminophen cuam tshuam nrog nws cov hepatotoxicity, yog li ntawd, cov tshuaj yog contraindicated rau cov neeg kev txom nyem los ntawm kev quav dej caw. Kev siv tshuaj lom rau daim siab yog txhim kho nrog kev siv ua ke ntawm Paracetamol nrog rau lwm tus NSAIDs lossis nrog anticonvulsants.

Kev Sib piv Cov Tshuaj

Cov tshuaj no yog koom nrog cov tshuaj tsis-narcotic analgesics thiab antipyretics, thiab kuj tseem muaj nyob hauv pawg neeg cov tshuaj tsis-steroidal anti-inflammatory tshuaj (NSAIDs).

Cov tshuaj muaj sib npaug nrog cov tshuaj tua kabmob (antipyretic) thiab siv los daws qhov kub taub hau. Tag nrho ob qho tshuaj raug muab faib hauv cov khw muag tshuaj yam tsis muaj tshuaj.

Qhov ntsuas ntawm cov tshuaj no yog qhov qub:

• txo nyob rau hauv kom lub cev kub,
• tshem tawm cov mob me
• qhov txo qis ntawm qhov kev siv ntawm o.

Cov tshuaj tiv thaiv rau ob qho tshuaj no yog:

• mob siab, raum lossis lub plawv tsis ua haujlwm,
• piam thaj-6-phosphate dehydrogenase tsis txaus.

Cov tshuaj aspirin tsis yog siv los kho cov menyuam yaus vim yog qhov muaj pheej hmoo ua mob hnyav rau cov menyuam yaus uas muaj mob voos (Reye syndrome).

Dab tsi yog qhov txawv

Cov tshuaj muaj ntau yam kev ua los tiv thaiv: Paracetamol - tsis muaj zog, Aspirin - hais tau.

Txij li cov nquag nyob hauv cov tshuaj no txawv, lub ntsiab contraindications rau lawv kom tsawg kuj sib txawv. Tshuaj aspirin nyob rau hauv:

• hemorrhagic diathesis,
• stratification ntawm aortic aneurysm,
• mob rwj (nrog rau keeb kwm),
• kev pheej hmoo siab ntawm lub plab zom mov,
• tsis txaus siab rau ASA thiab lwm yam NSAIDs,
• bronchial hawb pob nyuaj los ntawm lub qhov ntswg polyposis,
• hemophilia
• portal tawg
• Vitamin K tsis txaus

Txawm hais tias muaj qhov tawm tsam thiab tawm tsam los ntawm lub cev, Aspirin tsis yog siv los kho cov menyuam yaus vim tias muaj kev pheej hmoo loj los ntawm kev muaj mob rau daim siab tsis ua haujlwm hauv cov menyuam yaus uas kis tus kab mob (Reye's syndrome). Koj tsis tuaj yeem siv cov tshuaj nrog mob txhab ntawm lub plab thiab duodenum thiab nrog kev pheej hmoo siab ntawm sab hauv los ntshav. Cov tshuaj aspirin nyob rau hauv cov menyuam yaus hnub nyoog qis dua 15 xyoos, cov pojniam thaum cev xeeb tub (I thiab III trimesters), thiab cov niam tu mob.

Paracetamol tsis pom zoo rau kev siv nrog:

• hyperbilirubinemia,
• kis mob siab
• dej cawv lub siab puas tsuaj.

Acetaminophen yog suav tias yog NSAID kev nyab xeeb dua li acetylsalicylic acid, vim tias nws tsis ua rau kev loj hlob ntawm Reye's syndrome, tsis yog gastrotoxic, thiab tsis txo thrombosis (tsuas yog ASA muaj cov cuab yeej antiplatelet). Yog li, Paracetamol pom zoo yog tias muaj cov lus hauv qab no txuas rau Aspirin:

• bronchial hawb pob,
• ulcerative keeb kwm
• cov me nyuam muaj hnub nyoog
• cev xeeb tub
• lactation lub sijhawm.

Yog li, paracetamol tuaj yeem raug coj los ntawm menyuam yaus, cev xeeb tub thiab lactating poj niam.

Paracetamol feem ntau cuam tshuam rau lub hauv nruab nrab lub paj hlwb thiab txoj haujlwm ua haujlwm ntawm qhov mob thiab cov thermoregulation chaw. Yog li, cov tshuaj no ua raws li ib qho kev ua kom loog. Kev ua rau lub cev tsis muaj zog tiv thaiv kev ua kom pom tsuas yog muaj cov ntsiab lus tsawg ntawm peroxide sib txuas hauv cov ntaub so ntswg (nrog mob txha nqaj qaum, mob nqaij mos mos zoo nkauj), tab sis tsis mob rheumatism. Cov tshuaj aspirin siv tau rau kev mob somatic thiab mob rheumatic syndrome.

Txhawm rau kom txo qis kub taub hau thaum kub cev thiab kom daws tau mob taub hau thiab mob hniav, nws zoo dua yog siv Paracetamol, vim tias nws muaj tsawg dua phiv.

Uas yog pheej yig dua

Paracetamol ntsiav tshuaj yog pheej yig dua li cov tshuaj aspirin.

Qhov twg yog qhov zoo dua - Aspirin lossis Paracetamol

Qhov kev xaiv ntawm cov tshuaj yog nyob ntawm cov hauv qab no:

• qhov xwm ntawm tus kabmob (nrog rau kis kis, Aspirin yog contraindicated),
• tus neeg mob hnub nyoog (tshuaj aspirin tsis yog siv rau hauv kev kho menyuam yaus),
• lub hom phiaj ntawm txoj kev kho (txo qis lub cev qhov kub lossis qhov sib xyaw ntawm cov txheej txheem inflammatory, inhibition of thrombosis lossis nyem ntawm qhov mob).

Rau kev tiv thaiv kab mob plawv, tsuas yog siv cov tshuaj aspirin, txij li ASA hauv kev txhaj tshuaj me me cuam tshuam lub zog ntawm thromboxane A2. Paracetamol tsis muaj cov khoom ntawd.

Thaum xaiv qhov ua kom loog, koj yuav tsum xav txog qhov mob. Nrog mob rheumatic thiab kev puas tsuaj rau cov ntaub so ntswg peripheral, Paracetamol yog qhov tsis muaj txiaj ntsig, vim nws cov nyhuv tsuas yog siv rau lub hauv nruab nrab cov hlab ntsha. Hauv cov xwm txheej zoo li no, nws yog qhov zoo dua los siv tshuaj Aspirin.

Txhawm rau cheem cov txheej txheem ua mob rau hauv tus neeg mob cov neeg laus, kev siv tshuaj Aspirin kuj ua haujlwm dua, vim tias nws muaj qhov cuam tshuam tawm tsam ntau dua.

Ntawm qhov kub

Raws li cov tshuaj tiv thaiv kev ua npaws rau kev kub taub hau, ob qho tib si Aspirin thiab Paracetamol siv.

Tshuaj aspirin raug txwv tsis pub siv rau hauv kev kho mob pediatrics vim qhov pheej hmoo ntawm kev tsim muaj tus mob Reye's syndrome hauv txoj kev kho mob vais mob rau menyuam yaus. Txhawm rau kom tsis txhob mob thiab txo qhov kub ntawm lub cev hauv menyuam yaus, nws raug nquahu kom siv Paracetamol raws li cov lus qhia.

Lub tswv yim ntawm cov kws kho mob

Petrova A. Yu., Pediatrician: "Rau kev kho mob ntawm cov menyuam yaus, nws yog qhov zoo dua los siv kev npaj muaj paracetamol los ua kua phoov (Panadol)."

Kim L. I., kws kho mob: “Cov tshuaj no tsis kho tus kab mob tseem ceeb - lawv tsuas yog txo tus neeg mob lub mob xwb. Koj tuaj yeem siv cov tshuaj no yam tsis muaj kev kho kom tsim nyog tsis pub dhau 3 hnub. Yog tias cov tsos mob ntawm tus mob khaub thuas tsis ploj, tom qab ntawd lub cev tiv thaiv kab mob tsis tuaj yeem tiv thaiv qhov mob tshwm sim ntawm nws tus kheej. Txhawm rau zam kom tsis txhob muaj teeb meem, koj yuav tsum tau mus ntsib kws kho mob. ”

Kev Ntsuam Xyuas Neeg Mob rau Aspirin thiab Paracetamol

Alina, 24 xyoo, Ufa: “Tshuaj aspirin yog cov tshuaj kim kim uas muaj ntau yam kev sib txuam thiab cov kev mob tshwm sim. Paracetamol kuj tsis muaj kev phom sij thiab, tab sis nyab xeeb dua. "

Oleg, hnub nyoog 36 xyoo, Omsk: “Kuv siv tshuaj Aspirin (cov ntsiav tshuaj soluble) rau kev kho mob taub hau lossis mob khaub thuas. Kuv tsis pom muaj cov kev mob tshwm sim. "

Paracetamol Cov Qauv Cim

Cov tshuaj pab ua kom txo lub cev kub. Tshem tawm qhov mob, nres txoj kev loj hlob ntawm cov txheej txheem mob. Cov tshuaj nquag hauv cov muaj pes tsawg leeg yog paracetamol. Nws inhibits qhov tsim ntawm prostaglandins thiab ua rau ntawm thermoregulation chaw hauv lub diencephalon. Lub cuab yeej tiv thaiv qhov pom ntawm kev mob, tshem tawm kev kub taub hau. Nws muaj cov nyhuv tiv thaiv me ntsis.

Qhia tshuaj rau qhov tshuaj txhawm rau qhov mob nraub qaum, cov leeg, pob qij txha. Nws ua rau mob taub hau, tsis xis nyob hauv plab hauv poj niam coj khaub ncaws. Nws raug nquahu rau mob khaub thuas thiab mob khaub thuas kom txo qis lub cev kub thiab txhim kho kev noj qab haus huv tag nrho. Txais tos yog contraindicated nyob rau hauv cov kab mob hauv qab no thiab tej yam kev mob:

• cev xeeb tub
• pub niam mis
• haus dej caw
• kev puas tsuaj hnyav rau daim siab thiab lub raum,
• ntshav kab mob
• txo cov ntshav hauv lub cev suav,
• piam thaj-6-phosphate dehydrogenase tsis txaus.

Cov tshuaj yuav ua rau muaj kev fab tshuaj. Muaj qee zaus, mob anaphylaxis, xeev siab, bronchospasm, urticaria, thiab mob plab yog pom tom qab kev saib xyuas. Nkag mus rau hauv lub plab zom mov. Cov tshuaj muaj zog khi rau cov protein, yauv ua lub cev biotransformation hauv daim siab thiab tawm mus rau hauv cov qauv ua kom lub cev tsis ua haujlwm nyob hauv cov zis rau 8-10 teev. Nws tsis cuam tshuam zoo rau qhov sib npaug ntawm dej thiab ntsev hauv lub cev. Nws pib ua nyob rau hauv 15-30 feeb.

Qhov twg yog qhov zoo dua - Paracetamol lossis Aspirin

Paracetamol muaj kev nyab xeeb dua rau lub plab zom mov. Nws tuaj yeem siv txawm tias tiv thaiv keeb kwm yav dhau los ntawm peptic rwj, txawm hais tias lub siab mob siab los ntawm cov tshuaj.Qhov tshuaj muaj qhov cuam tshuam tsis zoo rau lub cev, yog li feem ntau cov neeg mob tawm qhov tawm tswv yim txog qis dua.Nrog mob hnyav, kub taub hau thiab mob, nws yog qhov zoo dua rau noj tshuaj acetylsalicylic acid.

Nrog mob khaub thuas

Rau mob khaub thuas, ib tus neeg laus yog qhov zoo dua li noj tshuaj Acetylsalicylic acid. Cov tshuaj tiv thaiv nrog kub, o thiab mob ib ce ceev ceev dua. Yuav kom nce qhov kev ua tau zoo, tus kws kho mob sau ntawv tawm tshuaj rau tus neeg siv tshuaj tua kabmob.

Hauv thaum yau, nws zoo dua rau kev noj tshuaj Paracetamol. Nws ua ntau dua maj mam, yog li koj tsis tuaj yeem ntshai ntawm kev mob tshwm sim hnyav. Muab cov tshuaj aspirin rau cov menyuam hnub nyoog qis dua 15 xyoos. Nws yuav tsum tau coj raws li cov koob tshuaj uas tau qhia hauv cov lus qhia thiab tsuas yog tsis muaj contraindications.

Kev Xyuas Tus Neeg Mob rau Paracetamol thiab Aspirin

Anna, 29 xyoo, Murmansk

Cov tshuaj aspirin zoo dua li Paracetamol. Kuv nqa nrog ARVI. Qhov kub ib teev tawm hauv ib teev mus rau qhov tseem ceeb. Mob taub hau ploj mus me ntsis thiab qhov mob tshwm sim. Kuv lees txais thaum muaj xwm ceev, vim tias cov tshuaj muaj kev phom sij rau lub cev nrog kev siv ntau zaus.

Kristina, 35 xyoo, Samara

Paracetamol tau muab rau tus menyuam. Tshav kub maj mam muab tso qeeb qeeb, tab sis ntev mus. Nws muaj tsawg kawg nkaus ntawm contraindications thiab phiv. Ua ke nrog antipyretics, koj yuav tsum haus dej kom ntau thiab haus cov vitamins.