2014년 01월호vol .2
TRANSCRIPT
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2014 12 VOL .06
Circadin PR tab. 2mg ( )
. /
.
(, : HH844) () () , ()
: 2014
, , , , , ,
134-090 892 [TEL] 02.440.6977 / 02.440.6992() [FAX] 02.440.6984
15.01.27 / http://pharm.khnmc.or.kr
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Circadin PR tab. 2mg (Melatonin)
1.
2.
Melatonin 2mg
3.
4.
Melatonin (pineal gland)
(pinealocytes)
5.
55
6.
1 1 1 1~2
13
7.
Tmax : 2~4hr
(Vd): 35L
Tmax : 2~4()
: (CYP1A)
(6- Hydroxylation Sulfation Glucuronidase)
: 3.5~4
: AUC .
.
: (~85%)
: 630~960 mL/min
8.
, , , ,
1 2014 12
9.
CYP3A
fluvoxamine :
- CYP1A2, CYP2C19
-
nifedipine
warfarin
10.
1) .
2) (galactose intolerance), Lapp
(Lapp lactase deficiency) -
(glucose-galactose malabsorption)
11.
:
:
12.
, (25)
.
.
.
.
.
Journal Review
Prolonged release melatonin in the treatment of primary insomnia : evaluation of the age cut-off or short - and long-term response: Prolonged Release Melatonin (PRM) (Alan G. Wade et al., Current Medical Research & Opinion, 2011, 87-88)
DSM-IV* 18-80, sleep latency( ) 20 3 6
PRM . PRM 18-54, 55-80
.
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2 2014 12
, 1 sleep latency 55-80
(-15.4 vs -5.5min, p=0.014)(Figure 2), 18-80
(-14.6 vs -7.9min,
p=0.129).(Table 3) 2 sleep diary parameters,
PSQI** global scores, component scores, questione 2 & 4, CGI-S**. CGI-
I**( ), WHO-5 well-being Index( ) 55-80
(Table 4). 6
,
rebound insomnia .
* DSM-IV : Diagnostic and Statistical Manual for Mental Disorders -IV * PSQI : Pittsburgh Sleep Quality Index CGI-S: Clinical Global Impression -Severity of Illness Scale CGI-I: Clinical Global Impression of Improvement
Lasting treatment effects in postmarketing surveillance study of Prolonged Release Melatonin (PRM): PRM (Gran Hajaka et al., International Clinical Psychopharmacology, 2014)
PRM rebound insomnia, prospective,
referenced, cohort . 3 PRM , 2 (early
withdrawal) 2 (late withdrawal) site .
Sleep quality, Morning alertness , 1~5 ,
. PRM rebound insomnia 1 .
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3 2014 12
, sleep quality, morning alertness (1~3) 42(7.1%) 462(77.4%), 87
(14.6%) 472(79.1%) .(Fig.3) rebound insomnia , PRM
(Fig.4), PRM , 10.2% .(Fig.5)
, PRM , rebound insomnia,
. PRM 55 1 , 2010
3 13 .
Nightly treatment of primary insomnia with Prolonged Release Melatonin (PRM) for 6months : a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety: PRM (Wade et al., BMC Medicine, 2010, 8:51)
,
. PRM
(18-80) (65 /65 )
(low/high) 3 6 PRM
.
1 sleep diary sleep latency ,
PRM
(-9.0 vs -9.0min, p=0.924), (65-80
) PRM .(-19.1 vs -1.7min, p=0.002)
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4 2014 12
-. /
Special Issue
1 .
-
- : -
- : , () ( )
- : , , , , , ()
- .
KCl inj.
3g/20ml(40mEq)
(Pot.Chloride)
-
- KCL .
- : 80mEq/L
- : 200mEq/L
- : 10mEq
. 20-40mEq/hr
.
-
.
- : []
(T
, QRS , ST , P
) . ,
.
- : .
.
NaCl inj.
2.34g/20ml
(40mEq)
(Sod.chloride)
- :
iv infusion .
-
- : , , ,
.
- : .
.
Sodium Chloride
3% 500ml Bag
- iv infusion .
Masi inj. 50%
20ml (Magnesium
sulfate)
- : 20% .
40g/24hrs .
- 2g/hr,
4g/hr.
- : 4 knees up , ,
urine output
.
- : ,
, , , ,
.
- : .
.
() . .
-
- : -
- : , () ( )
- . 4 ,
, , .
Heparin inj.
25000IU/5ml,
Heparin inj.
20000IU/20ml
- EMR (HOAP, Heparin
order & administration program) .
- , aPTT, ACT
-
-
.
- : (Protamine sulfate inj.
50mg/5mL) 1000unit 1-1.5 mL
(10~15mg) .
-
5 2014 12
2 .
(vial) Humalog inj.1000IU/10mL
HumulinN 1000IU/10ml
HumulinR 1000IU/10mL
Lantus inj. Vial 1000U/10ml
Novorapid inj. 1000IU/10ml
Apidra inj. 1000U/10ml/V
- ( )
-
()
Actilyse inj. 50mg, 20mg
Urokinase inj. 500,000IU , 100,000IU
Urotine inj.50,000IU
-
(look-alike), (sound-
alike),
-
- [!] , EMR
, , ,
> Zoloft tab. 50mg[!](Sertraline)
-
, ,
> IsopTIN SR tab. 180mg[X] (Verapamil)
- ,
, , ,
>Adalat oros tab. 30mg, Adalat oros tab. 60mg
- : 2-8,
- : -20 ,
- :
,
,
> IsopTIN SR tab. 180mg[X] (Verapamil)
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-
6 2014 12
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1) spill kit (Nitrile glove) .
2) spill kit .( .)
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Reference 1. 2. 3.
: , (), ()
-
7 2014 12
(, : HH844)
1. : 1(3g) (JP) 2050mg, (JP) 2.0g,
(JP) 2.0g, (JP) 2.0g, (JP) 2.0g, (JP) 1.0g,
(JP) 1.0g, (JP) 0.5g, (JP) 0.25g
2. : 3g/
3.
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1. DC,
2. , ,( 2003)
3. , , ()(2012)
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11. : 36, , (1~30)
: wafarin,
aspirin, clopidogrel, enoxaparin
: glimepiride, glyburide,
insulin, metformin
: azathioprine,
cyclosporine, sirolimus
Digoxin, furosemide,
hydrochlorothiazide, thiazide
: metoprolol, verapamil,
diltiazem
: glimepiride, lyburide,
insulin, metformin, pioglitazone,
rosiglitazone
: nifedipine,
verapamil, diltiazem, felodipine
-
8 2014 12
:
(2014-123, 2014.7.29) 2014 8 1 .
(Nutrition Support Team, NST) , .
.
: NST NST
: NST NST
: (PN) NST (02)440-6978)
(EN) NST (02)440-7568)
8-1
(Therapy by Nutrition Support Team)
(Therapy by Nutrition Support Team) , , , , . . : . : 1 (1) 3.0g/dl (2) (3) (4) (5) (6) 5percentile ( ) . : 1 ( 4 )
2014
2014 2 12 19 . 8 11
15 .
.
[]Codenal syr. 1ML []Codenal Solution. 1ML , 2014.12.1 .
Isepacin inj. 200mg/2mL (Isepamicin)
Isepamicin inj. 200mg/2mL (Isepamicin)
, . EDI .