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Transcription

1 員生醫院 常備藥品手冊 員生醫院藥劑科編訂 2017 年 8 月

2 Contents I. Antidotes in Poisoning II. Central Nervous System Drugs Drugs Used for Relief of Pain (1) Narcotic Analgesics (2) Non-Narcotic Antipyretics and Analgesics (3) Nonsteroidal Anti-inflammatory Agents (4) Agents for Gout (5) Agents for Migraine Psychopharmacologic Drugs (1) Anxiolytics, Sedatives and Hypnotics (a) Benzodiazepines (b) Miscellaneous (2) Antipsychotics (3) Antidepressants (4) Cholinesterase Inhibitors (5) Central Nervous Systemic Stimulants (6) Miscellaneous Neurologic Drugs (1) Anticonvulsants (2) Drugs Used in Parkinsonism (a) Centrally Active Anticholinergic Drugs (b) Dopaminergic Agents (c) Miscellaneous (3) Skeletal Muscle Relaxants (4) Drugs Used in Myasthenia Gravis (5) Antiemetic/Antivertigo Agents (6) Miscellaneous Agents Used in Anesthesia (1) Local Anesthetics (2) General Anesthetics (3) Neuromuscular Blocking Agents III. Cardiovascular Drugs I

3 1. Cardiac Glycosides Antiarrhythmics (1) Class IB (2) Class IC (3) Class II (4) Class III (5) Class IV (6) Miscellaneous Nitrates derivatives Angiotensin Converting Enzyme Inhibitors Angiotensin II Receptor Antagonists α adrenergic Blockers β adrenergic Blockers α/β adrenergic Blockers Calcium Channel Blockers Centrally Acting Antiadrenergic Agents Diuretics (1) Thiazides and related diuretics (2) Loop Diuretics (3) Potassium Sparing Diuretics (4) Carbonic Anhydrase Inhibitors (5) Osmotic Diuretics Antihyperlipidemic Agents (1) Fibric Acid Derivatives (2) HMG-CoA Reductase Inhibitors Vasopressors Used in Shock Peripheral Vasodilators Miscellaneous IV. Hematologic Drugs Iron Products Recombinant Human Erythropoietin Anticoagulants Antiplatelet Agents II

4 5. Thrombolytic Agents Blood Derivatives Blood Substituents Hemostatics V. Metabolic and Nutrient Agents Vitamins Electrolytes and fluids Parenteral Nutritions Miscellaneous VI. Hormones and Synthetic Substitutes Glucocorticoids Antidiabetic agents and glucose elevating agents (1) Insulins (2) Sulfonylureas (3) Biguanids (4) Glucosidase Inhibitors (5) Meglitinides (6) Thiazolidinediones (7) Glucagon-like Peptide-1 Agonists (8) Dipeptidyl Peptidase IV Inhibitors (9) Selective Sodium-Glucose Transporter-2 Inhibitors Agents Used to Treat Thyroid Diseases (1) Thyroid Hormones (2) Antithyroid Agents Agents Affecting Calcium Regulating Hormones Sex Hormones (1) Estrogens (2) Selective Estrogen Receptor Modulator (3) Progestins (4) Androgens and Anabolic Steroids (5) Androgen Hormone Inhibitor (6) Gonadotropins (7) Ovulation Stimulants III

5 6. Pituitary Hormones Oxytocin VII. Antihistamine Drugs VIII. Respiratory Drugs Bronchodilators (1) Sympathomimetics (2) Anticholinergics (3) Xanthine Derivatives Asthma Prophylactic Drugs Corticosteroids Inhalant Cough Suppressants Expectorants and Mucolytics Preparations for Common Cold IX. Gastrointestinal Agents Antacids Antispasmodics Histamine H2 Antagonists Agents to Hasten The Healing of Ulcer Proton Pump Inhibitors Antidiarrheals Laxatives GI Stimulants Antiflatulents Digestants Miscellaneous X. Immunologic Agents Vaccines and Toxoids XI. Antineoplastic Agents Antibiotics Antimetabolites Hormones and Antagonists XII. Anti-Microbial Agents Antibiotics (1) Penicillins IV

6 (a) Penicillinase Resistant Penicillins (b) Aminopenicillins (c) Extended Spectrum Penicillins (d) β- Lactam & β- Lactamase Inhibitors (2) Cephalosporins (a) First Generation (b) Second Generation (c) Third Generation (d) Fourth Generation (3) Carbapenem (4) Aminoglycosides (5) Chloramphenicol (6) Tetracyclines (7) Macrolides (8) Lincosamides (9) Fluoroquinolones (10) Miscellaneous Antifungal Agents Tuberculostatic Agents Sulfonamides Anti-Viral Agents Antimalarial Agents Antiprotozoals XIII. Urinary Tract Products Alkalinizers Cholinergic Stimulants for Urinary Retention Antispasmodics Agent For Impotence Agents For Benign Prostatic Hyperplasia Miscellaneous XIV. Topical Preparations Ophthalmic Preparations (1) Corticosteroids V

7 (2) Anti-infectives Agents ENT Preparations (1) Ear drops (2) Nasal Preparations Mouth and Throat Products (1) Corticosteroids (2) Nonsteroidal Anti-inflammatory Agents Dermatological Agents (1) Acne Products (2) Burn Preparations (3) Topical Anti-infectives (a) Antiviral Agents (b) Antibiotics (c) Antifungal Agents (4) Scabicides Pediculicides (5) Corticosteroids (6) Local Anesthetics (7) Nonsteroidal Anti-inflammatory Agents (8) Hemorrhoid Agents (9) Miscellaneous XV. Miscellaneous Products XVI.Appendix 新藥申請辦法 非常備用藥申請辦法 病房常用藥品儲存方式 急救車藥品給藥注意事項 英文索引 中文索引 VI

8 I. Antidotes in Poisoning Acetylcysteine Supply:Actein Effervescent 愛克痰發泡錠 600mg/Cap (OACTEIN) Flucil 福喜顆粒 100mg/2.5g/pack (OFLUIM3) Indications:Mucolytic, antidote of acetaminophen. ( 減少呼吸道粘膜分泌的粘稠性 蓄意或偶發之 ACETAMINOPHEN 中毒之解毒劑 ) Usual dose:acetaminophen overdose - Administer orally as a 5% solution, loading dose 140 mg/kg, then 70 mg/kg at 4 hrs intervals for a total of 17 doses. Mucolytic - 1 Cap qd-bid; or 1 pack tid. Side effects:vomiting, nausea, stomatitis, drowsiness, bronchospasm, irritation to the tracheal and bronchial tracts. Pregnancy:Category B. Note:Administer acetylcysteine immediately if 24 hrs have elapsed from the reported time of acetaminophen ingestion. Atropine Sulfate Supply:Atropine 硫酸阿托品 1mg/ml/Amp (IATROPI) Indications:Organophosphate poisoning, antispasmodic in GI disorders, bradyarrhythmia. ( 膽石症 幽門痙攣 胃酸過多 胃痙攣 有機磷化物 毛果芸香鹼中毒 診斷用散瞳 調節痙攣 乙醚等麻醉時之抑制支氣管分泌 ) Usual dose : Anticholinergic mg IV, SC. Preanesthetic medication mg, SC, IM or IV. Antidote of cholinesterase inhibitor - 2-4mg IV then 2mg, every 5-10min, IM, until muscarinic symptoms disappear or atropine toxicity appear. Side effects:tachycardia, increasing ocular tension, pupils dilatation, dry mouth, blurred vision, dysurea, headache, weakness, nausea, vomiting, restlessness, and rash. Charcoal Supply:Carbomix 蓋抹滅 831mg/g 61.5g/Bot (OCARBOM) Indications:Poisoning. ( 緊急治療藥物或化學品中毒之病人 ) Usual dose:po g (1-2g/kg) then 0.5g/kg Q4H; when administered with sorbitol, the recommended dose is 4.3ml/kg of 70% sorbitol Q4H until charcoal stool is passed. Children: Activated charcoal 1g/kg + 4.3ml/kg of 35% sorbitol Side effects:vomiting, constipation, diarrhea, stools will be black. 1

9 Flumazenil Supply:Anexate 安易醒 0.5mg/5ml/Amp (0.1 mg/ml) (IANEXAT) Indications:Benzodiazepine overdose, reversal benzodiazepine sedation. ( 用於麻醉及加護病房時回轉 Benzodiazepine 之中樞鎮靜作用 ) Usual dose:iv only. Benzodiazepine overdose Initial 0.2 mg IV over 30 sec. A further dose of 0.3 mg over another 30 sec. Further doses of 0.5 mg over 30 sec. at 1 min intervals up to a cumulative dose of 3 mg. Reversal benzodiazepine sedation - Initial 0.2 mg administered over 15 sec. a further dose of 0.2 mg can be injected and repeated at 60 sec. intervals where necessary to a max. total dose of 1 mg. Side effects:dizziness, nausea, vomiting, headache, hyperventilation. Leucovorin (Folinate) Supply:Folina 芙琳亞 15 mg/tab (OFOLIN) Indications:Cellular rescue from the adverse effects of high-dose methotrexate therapy. ( 超量使用葉酸拮抗劑時, 消滅其毒性及抵消其作用 治療因斯潑盧營養缺乏 妊娠及其幼齡等引起之巨初紅血球性貧血 ) Usual dose:high-dose methotrexate-rescue dose: Initial: Oral, I.M., I.V.: mg/m2; start 24 hrs after beginning methotrexate infusion; continue every 6 hrs for 10 doses, until methotrexate level is <0.05 micromole/l. Do not administer orally in the presence of nausea or vomiting. Doses >25 mg should be administered parenterally. Side effects:occasional allergic reactions. Naloxone Supply:Narcan 解麻 0.4mg/ml/Amp (INALOX) Indications:Narcotic overdose. ( 麻醉藥品過量之解毒劑 ) Usual dose:adults: IV, IM or SC mg, may repeat IV at 2-3 minute intervals. Children: IV 0.01 mg/kg, give a subsequent dose 0.1 mg/kg if needed. Side effects:abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, tachycardia, hypertension and tremulousness 2

10 Neostigmine Supply:Vagostin 安可健 0.5mg/ml/Amp (INEOSTI) Indications:Antidote for nondepolarizing neuromuscular blockers, symptomatic control of myasthenia gravis. ( 腸管麻痺 筋無力症 血管痙攣性疾患 眼筋無力症 ) Usual dose:antidote for nondepolarizing neuromuscular blockers -Adults: mg by slow IV injection, repeat as required; Children: mg/kg/dose. Control of myasthenia gravis - IM or SC 0.5 mg, individualize subsequent doses. Children: mg/kg/dose IM, IV or SC every 2-3 hrs as needed. Diagnosis of myasthenia gravis - Adults: IM mg/kg; Children: IM 0.04 mg/kg. Side effects:bronchoconstriction, nausea, vomiting, salivation, stomach cramps, diarrhea, urge to urinate. Pralidoxime Chloride Supply:Pampara 把母巴拉 500mg/25ml/Amp (25mg/ml) (IPAM) Indications:Organophosphate poisoning, anticholinesterase drug overdosage. ( 巴拉松 (parathion) 甲基巴拉松 (methyl parathion) 等有機磷劑 農藥中毒之解毒劑 ) Usual dose:organophosphate poisoning - Adults: 1-2 g/dose IV, preferably in 100 ml of salineas a mins infusion. After 1 hr, give a second dose of 1-2 g if muscle weakness is not relieved. Children: mg/kg/dose. Anticholinesterase overdosage 1-2 g IV followed by increments of 250 mg every 5 minutes. Side effects:tachycardia, hypertension, dizziness, headache, rash, nausea. Protamine Sulfate Supply: 硫酸魚精蛋白 50mg/5ml/Amp (10 mg/ml) (IPROTA) Indications:Heparin overdose. ( 中和過量的 heparin ) Usual dose:protamine 1mg neutralized 100 IU of heparin. In heparin overdose: it can be given as a loading of mg by slow IV injection, with the rest of calculated dose over 8-16 hrs. Side effects:sudden fall in BP, bradycardia, dyspnea, nausea, vomiting. 3

11 II. Central Nervous System Drugs 1. Drugs Used for Relief of Pain (1) Narcotic Analgesics Fentanyl ( 管二 ) Supply: 吩坦尼 0.1mg/2ml/Amp (0.05mg/ml) (IFENTA) Indications:Pain, induction of anesthesia. ( 麻醉和麻醉前給藥 急性劇烈疼痛之緊急治療 ) Usual dose:adult: Pre-medication for procedure: mcg IM or slow IV over 1-2 min, min prior to surgery. Adjunct to general anesthetic induction: mcg slow IV, repeated at 2-3 min intervals until the desired effect is achieved. Adjunct to regional anesthesia: mcg IM or slow IV 1-2 min. Post-OP pain: mcg IM or slowly IV, may repeat in 1-2 hr as needed. Side effects:sob, troubled breathing, slow heartbeat, BP, drowsiness. Pregnancy:Category C (D if used for prolonged period or in high dose). Lactation:Excreted in breast milk. (Usually compatible) Storage:Injection - Protect from light. Meperidine HCl (Demerol) ( 管二 ) Supply:Pethidine 鹽酸配西汀 50mg/ml/Amp (IPETHI) Indications:Relief of moderate to severe pain, preoperative medication. ( 鎮痛 ) Usual dose: Pain relief - IM or SC. Adults: mg q3-4h as necessary, Children: mg/kg q3-4h as necessary. Preoperative medication Adults: mg IM or SC, mins before beginning anesthesia. Children: mg/kg IM or SC. Side effects:hypotension, tiredness, nausea, vomiting, constipation, dizziness, headache, nervousness, biliary spasm. Pregnancy:Category B (D if used for prolonged period or in high dose ). Lactation:Excreted in breast milk. (Usually compatible) Morphine HCl ( 管一 ) Supply: 鹽酸嗎啡 10mg/ml/Amp (Morphine HCl) (IMORPHI) Indications:Relief of moderate to severe pain. ( 鎮痛 ) Usual dose:adults: SC: 5-15 mg Q 4hr; IV: 4-10 mg, dilute and inject slowly over a 2-3 min period. IV infusion 1-10 mg/hr, some patients with chronic pain may require a higher dosage. IM is painful and is not recommended. Children: PO: 0.3 mg/kg Q3-4 hr; IV: mg/kg Q4hr; IV infusion mg/kg/hr. Side effects:palpitation, hypotension, dizziness, nausea, vomiting, 4

12 constipation, dry mouth, weakness, respiratory depression. Pregnancy:Category C (D if used for prolonged period or in high dose). Lactation:Excreted in breast milk. (Usually compatible) (2) Non-Narcotic Antipyretics and Analgesics Acetaminophen Supply:Paran 理冒伯樂止痛錠 500mg/Tab (OACET03) Anti-Phen Syrup 安佳熱糖漿 24 mg/ml 60ml/Bot (OANTIPH) Indications:Mild to moderate pain and fever. ( 退燒, 止痛, 緩解頭痛, 牙痛, 咽喉痛, 關節痛, 神經痛, 肌肉酸痛, 月經痛 ) Usual dose:adults: mg q4-6h, Max. 4 g/day; Children: mg/kg/dose q4h, do not exceed 5 doses in 24 hrs. Side effects:hemolytic anemia, neutropenia, leukopenia, rash, jaundice. Pregnancy:Category B. Lactation:Excreted in breast milk. (Usually compatible) Propacetamol Supply:Acetamol 舒疼消熱 1g/Vial (IACETA) Indications:Severe pains and fever. ( 在無法使用口服投藥方式時, 用於疼痛或發燒之症狀治療 ) Usual dose:the usual dose is 1-2 g (equivalent to gm acetaminophen)every 4-6 hours by intravenous infusion over 15 minutes. The maximum daily dose should not exceed 8 g. Pediatrics (neonates and children): 20 to 30 mg/kg up to 4 times daily, not exceeding a maximum daily dose of 120 mg/kg propacetamol (equivalent to a daily dose of 60 mg/kg of paracetamol). Side effects:dizziness (most common), rash Pregnancy:Category B. Note: 開瓶後應ㄧ次使用完畢, 不得分次注射 ; 調配後必須於 30 分中內使用 ; 不可和其他藥物混合 Sumakin 舒麻肌 (OSUMAKI) Supply:each Tab contains Acetaminophen mg Chlorzoxazone mg Caffein mg Thiamine disulfide mg Indications:Pain, skeletal muscle spasm. ( 關節痛 肌肉痛 顏面神經痙攣 神經痛 關節周圍炎 捻挫打撲及其他有肌肉之痙攣 強直及疼痛等之諸症 ) Usual dose:1 Tab tid. Side effects:skin rash, hypersensitivity. 5

13 Ultracet 及通安 ( 管四 ) (OULTR) Supply:each Tab contains Tramadol mg Acetaminophen mg Indications:Moderate to severe pain. ( 使用非鴉片類止痛劑無效的中度至嚴重性疼痛 ) Usual dose:1-2 Tab q4-6h, Max. 8Tab/day. ClCr<30ml/min : increase the interval to every12 hour, Max. 4 tablets per day. Side effects:dizziness, nausea, constipation, headache, somnolence. (3) Nonsteroidal Anti-inflammatory Agents Aceclofenac Supply:Tonec 痛停錠 100mg/Tab (OACECLO) Indications:Relief of pain and inflammation in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. ( 治療退化性關節炎 類風濕性關節炎 僵直性脊椎炎所引起之疼痛及發炎症狀 ) Usual dose:po 100mg bid. Side effects:most adverse events are mild and reversible and primarily involve the GI system. Acemetacin Supply:Aceo 艾斯美特 60 mg/cap (OACEMET) Indications:Rhematoid arthritis, osteoarthritis, ankylosing spondylitis. ( 風濕性關炎 退化性關節炎 ( 骨關節炎 ) 僵直性脊椎炎 痛風 肌肉炎 腱鞘炎 滑囊炎 ) Usual dose: mg qd-tid. Side effects:g-i disturbance, rash, dizziness, headache. Celecoxib Supply:Celebrex 希樂葆 200 mg/cap (OCELEB2) Indications:Osteoarthritis(OA), rheumatoid arthritis(ra), familial adrenomatous polyposis(fap), acute pain, primary dysmenorrheal. ( 緩解骨關節炎之症狀與徵兆, 緩解成人類風濕性關節炎之症狀與徵兆, 緩解成人急性疼痛及治療原發性經痛, 緩解僵直性脊椎炎之症狀與徵兆 ) Usual dose:oa mg/day, qd-bid. RA mg bid. FAP 400 mg bid, take with food. acute pain, primary dysmenorrhea 400 mg initially, then 200 mg bid. Side effects:headache, dyspepsia, abdominal cramps/pain, diarrhea, nausea. 6

14 Diclofenac Supply:Cataflam 克他服寧 25 mg/tab (OCATAFL) Valtafen 抑疼炎栓劑 12.5 mg/supp (EVOLTA) Indications:Pain, rheumatoid arthritis, osteoarthritis. ( 緩解發炎及因發炎反應引起之疼痛 ) Usual dose:po mg/day in divided doses. Rectal mg/kg/day bid-tid. Side effects:epigastric pain, nausea, vomiting, diarrhea, dizziness, rash. Pregnancy:Category B. Lactation:Excreted in breast milk. Etodolac Supply : Etodolac 炎立舒泰 200 mg/cap (OLONIN) Indications : Arthritis, analgesia. ( 類風濕性關節炎, 骨關節炎, 止痛 ) Usual dose : Arthritis 300 mg bid-tid or mg bid. Analgesia mg q6-8h. Do not exceed 1200 mg/day. Side effects : Dyspepsia, nausea, diarrhea, abd. distress/cramps, flatulence. Ibuprofen Supply:Purfen 普服芬 400mg/Tab (OMOTRI) Idofen 舒抑痛 Oral Susp. 20 mg/ml 60ml/BT (OSCONIN) Indications:Fever, pain, inflammatory diseases. ( 一般疼痛之緩解及解熱 關節炎輕度疼痛之緩解 ) Usual dose:adults: 400mg PO Q4-6H; maximum recommended dose: 3200 mg daily; Children (6 months-12 yrs): 5-10 mg/kg/dose Q6-8H; maximum recommend dose 40 mg/kg/day. Side effects:nausea, dyspepsia, diarrhea, constipation, abdominal pain. Pregnancy:Category C (Risk factor D if used in 3rd trimester). Lactation:Excreted in breast milk. (Usually compatible) Indomethacin Supply:Indoy 炎達益 25mg/Cap (OINDO) Indications: 肌肉骨骼系統之炎症 疼痛 牙科手術後之腫脹 Usual dose:1 Cap bid-tid. Side effects:dizziness, rash, abdominal cramps, heartburn, indigestion. 7

15 Ketoprofen Supply:Ketoprofen 可多普洛菲 50mg/2ml/Amp (IKETOPR) Indications:Mild-moderate pain, rheumatoid arthritis, osteoarthritis. ( 消炎 解熱 鎮痛, 風濕性關節炎 骨關節炎 強硬性脊椎炎及痛風 腰酸背痛以及手術外傷後之疼痛 ) Usual dose:im mg qd-bid. Side effects:shock, nausea, vomiting, Lyell syndrome, pain at injection site. Ketorolac Supply : Paindocine 痛得息 30 mg/ml/amp (IKETO00) Indications:Moderately severe, acute pain. ( 短期 ( 5 天 ) 使用於緩解無法口服病人之中重度急性疼痛, 通常使用於手術後 ) Usual dose : Adults: PO: 10 mg Q4-6 hr PRN, to a maximum of 40 mg/day for 5 days (including IM/IV). IM or IV 30 mg or 60 mg( IM only) once, then mg Q6 hr; Children: aged 1-18 years 1 mg/kg as a loading dose followed by 0.5 mg/kg Q6H for hr. Side effects : Headache, dizziness, drowsiness, nausea, diarrhea, dyspepsia, epigastric/gi pain, edema. Pregnancy : Category C. Lactation:Enters beast milk/ contraindicated. Note : Ketorolac therapy is not to exceed 5 days. Lysine acetylsalicylate Supply:Lyacety 解你疼 1g/Vial ( 含 Aspirin 500mg) (IASPEGI) Indications: 對不能口服 NSAID 之成年病人強烈疼痛之短期治療 成人發燒症狀之緩解 Usual dose:iv or IM 1-2 vial. Side effects:headache, rash, abdominal cramps, heartburn, indigestion. Mefenamic Acid Supply:Johnstal 祥疏痛 500mg/Tab (OPONS) Indications:Pain ( 14y/o), dysmenorrheal. ( 神經痛 肌肉痛 頭痛 齒痛 月經痛 分娩後之疼痛 手術後之疼痛 ) Usual dose:500 mg, then 250 mg q6h, usually not to exceed 1 week. Side effects:abdominal cramps, dizziness, rash, hemolytic anemia. Pregnancy:Category C (D if used for prolonged periods, or near term.) Lactation:Excreted in breast milk. (Usually compatible) 8

16 Meloxicam Supply:Mobic 骨敏捷 7.5 mg/tab (OMOBIC) Indications:Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis. ( 類風濕性關節炎 骨關節炎及僵直性脊椎炎之症狀治療 ) Usaul dose:7.5 mg orally once a day, Max. 15 mg orally once a day. Side effects:gi disturbances, pruritus, skin rash, headache, edema, anemia. (4) Agents for Gout Allopurinol Supply:Urinol 威寧疼 100 mg/tab (OALLOP) Indications:Gout, hyperuricemia associated with malignancy. ( 痛風症 痛風性關節炎 尿酸結石 癌症或經化學治療產生之高尿酸血症 ) Usual dose:mild gout mg/day. Moderately severe gout mg/day. Divide doses that are > 300 mg. Max. 800 mg/day. Renal impairment: Ccr (ml/min) Dose mg/day mg/day mg/day mg on alternate days < mg 3 times/week Side effects:rash, Stevens-Johnson syndrome, drowsiness, nausea, vomiting, diarrhea, chills, fever, alkaline phosphatase. Lactation:Excreted in breast milk. (Usually compatible) Note:1.May increase the effects of Immuran, 6-MP. 2.Maintaining a high fluid intake and a neutral or alkaline urine are recommended. Benzbromarone Supply:Nogout 杏定痛 100 mg/tab (ONARCAR) Indications:Hyperuricemia associated with chronic gout. ( 痛風 高尿酸血症 ) Usual dose:oral: Initial: 25 to 50 mg once daily; maintenance dose: 50 mg 1 to 3 times. Drink plenty of water (at least 1.5 to 2 liters daily at therapy initiation). Side effects:diarrhea, skin rash, SGOT, SGTP. Note:Should not be used to treat acute gouty attacks. Colchicine Supply: 秋水仙鹼片 0.5 mg/tab (OCOLC02) Indications:Gout. ( 痛風 ) Usual dose:flare treatment: Initial: 1.2 mg at the first sign of flare, 9

17 followed in 1 hour with a single dose of 0.6 mg (maximum: 1.8 mg within 1 hour); Gout prophylaxis: 0.6 mg orally once or twice daily, MAX 1.2 mg/day; Familial Mediterranean fever: 1.2 to 2.4 mg orally daily; increase or decrease in increments of 0.3 mg/day. Side effects : GI disturbance, nausea, vomiting, diarrhea, alopecia, anorexia, bone marrow suppression, hepatotoxicity, rash. Lactation:Excreted in breast milk. (Usually compatible) Febuxostat Supply:Feburic 福避痛 80mg/Tab (OFEBU00) Indications:Chronic management of hypeuricemia in patients with gout. ( 治療慢性痛風患者的高尿酸血症, 不建議用於無症狀的高尿酸血症者 ) Usual dose:orally, start at 40mg once daily; may be increased to 80 mg once daily if serum uric acid levels of less than 6 mg/dl are not achieved after 2 weeks. Side effects:liver function abnormalities (5% to 7%), nausea, arthralgia and rash. (5) Agents for Migraine Ergoton 易克痛 (OCAFER) Supply:each Tab contains Ergotamine mg Caffeine mg Indications:Migraine. ( 血管性頭痛 如偏頭痛 組織胺性頭痛 ) Usual dose:1 Tab at the start of the attack, repeated after minutes if necessary. Max. 6 Tab/24hrs or 10 Tab/week. Side effects : Nausea, vomiting, numbness and tingling of fingers, tachycardia or bradycardia. Pregnancy:Category X. Lactation:Excreted in breast milk. (Contraindicated) Sumatriptan Supply:Imigran 英明格速溶錠 50mg/Tab (OIMIGRA) Indications: 有先兆或無先兆偏頭痛發作之急性緩解 本藥僅適用於有明確診斷之偏頭痛 Usual dose:1-2 Tab daily. Side effects:paresthesia, dizziness, warm/hot sensation, chest discomfort/pressure/tightness, jaw or neck tightness. 10

18 2. Psychopharmacologic Drugs (1) Anxiolytics, Sedatives and Hypnotics (a) Benzodiazepines Side effects:somnolence, dizziness, headache, dyspepsia, constipation, diarrhea, urticaria, respiratory depression, tachycardia, bradycardia. Alprazolam ( 管四 ) Supply:Alpraline 安柏寧 0.5 mg/tab (OALPRAZ) Indications:Anxiety, panic disorder. ( 焦慮狀態 ) Usual dose:anxiety disorder - initial mg tid, Max. 4 mg/day. Panic disorder mg tid, Max. dose 10 mg/day. Pregnancy:Category D. Lactation:Excreted in breast milk. (May be of concern) Note:Reduce gradually when terminating or decreasing daily dose. Bromazepam ( 管四 ) Supply:Lexotan 立舒定 1.5mg/Tab (OLEXOTA) Indications:Symptomatic treatment of anxiety. ( 焦慮狀態 ) Usual dose:1.5-3 mg TID for outpatient therapy; 6-12 mg BID to TID for severe cases. Brotizolam ( 管四 ) Supply:Lendormin 戀多眠 0.25 mg/tab (OLENDOR) Indications:Insomnia (short-term treatment). ( 失眠症的治療 ) Usual dose:adults: Oral: 0.25 mg at bedtime. The suggested dose for elderly and debilitated patients is mg. Pregnancy:Not recommended. Lactation:Not recommended. Diazepam ( 管四 ) Supply:Diazepam 煩靜 2 mg/tab (ODIAZ) Dianlin 得安寧 10 mg/2ml/amp (5 mg/ml) (IDIAZEP) Indications:Anxiety, convulsive disorders, muscle spasm, insomia. ( 焦慮狀態 失眠 肌肉痙攣 癲癇重積狀態 ) Usual dose:antianxiety - PO: 2-10 mg bid-qid; IM or IV: 2-10 mg, repeat in 3-4 hrs if necessary. Acute alcohol withdrawal - PO:10 mg tid-qid during the first 24 hrs, reduce to 5 mg tid-qid; IM or IV: 10 mg initially, followed by 5-10 mg in 3-4 hrs. Anticonvulsant - PO: 2-10 mg bid-qid; IM or IV: 5-10 mg initially, repeated as needed, Max. dose 30 mg. Muscle spasm - PO: 2-10 mg tid-qid; IM or IV: 5-10 mg initially, then 5-10 mg in 3-4 hrs. 11

19 Side effects:hypotension, drowsiness, ataxia, rash, change in libido, phlebitis, apnea, bradycardia. Pregnancy:Category D. Lactation:Excreted in breast milk. (May be of concern) Estazolam ( 管四 ) Supply:Eszo 艾斯樂錠 2 mg/tab (OESZO) Indications:Insomnia. ( 失眠 ) Usual dose:insomnia: 1-4mg at bedtime. Premedication: Preoperative night: a single dose of 1-2mg at bedtime. Preoperation: a single dose of 2-4mg. Smaller or older, debilitated patients: 0.5mg initially. Pregnancy:Category X. Fludiazepam ( 管四 ) Supply:Era 易舒 0.25 mg/tab (OFLUDIA) Indications:Psychosomatic disorders, autonomic imbalance. ( 焦慮狀態 失眠 肌肉痙攣 ) Usual dose:1 Tab tid. Flunitrazepam ( 管三 ) Supply:Modipanol 美得眠 2 mg/tab (OFM2) Indications:Insomnia. ( 失眠 ) Usual dose:insomnia mg hs. Pregnancy:Category D. Lactation:Excreted in breast milk. Lorazepam ( 管四 ) Supply:Lorazin 樂力靜 0.5 mg/tab (OLORAZE) Anxicam 安心平 2 mg/ml/amp (IANXIC) Indications:Anxiety, insomnia. ( 焦慮狀態 ) Usual dose:anxiety - Initial: 2-3 mg/day bid-tid. Insomnia mg hs. IM mg/kg up to a maximum of 4 mg. IV - initial 2 mg or mg/kg, as high as 0.05 mg/kg up to a total of 4 mg may be given. Pregnancy:Category D. Lactation:Excreted in breast milk. (May be of concern) Oxazolam ( 管四 ) Supply:Secorin 益可寧 10 mg/tab (OSEREN) Indications:Anxiety. ( 焦慮狀態 ) Usual dose:10-20 mg tid. 12

20 (b) Miscellaneous Buspirone Supply : Sepirone 怡必隆 5 mg/tab (OBUSPIR) Indications:Anxiety. ( 焦慮狀態 ) Usual dose : PO 5 mg tid, increase the dosage 5 mg/day at intervals of 2-3 days as needed. Max. 60 mg/day. Side effects : Dizziness, drowsiness, nausea, headache, nervousness. Pregnancy : Category B. Lactation:Excreted in breast milk. (May be of concern) Zolpidem ( 管四 ) Supply:Stilnox 使蒂諾斯 10 mg/tab (OSTILNO) Indications:Insomnia. ( 失眠症 ) Usual dose:5-10 mg at bedtime. Side effects : Daytime drowsiness, dizziness, headache, nausea, diarrhea, irritability, muscle tremor, dyspepsia. Pregnancy:Category B. Lactation:Excreted in breast milk. (Usually compatible) Zopiclone ( 管四 ) Supply:Zolon 樂比克 7.5 mg/tab (OZOPIC) Indications:Insomnia. ( 失眠症 ) Usual dose:sedative/hypnotic mg at bedtime. Side effects:dry mouth, bitter taste, residual sedation, psychomotor impairment. (2) Antipsychotics Aripiprazole Supply:Abimay 安怡美 20 mg/tab (OARIPI) Indications:Schizophrenia, Acute manic and mixed episodes associated with Bipolar I disorder. ( 成人和青少年 (13 至 17 歲 ) 的思覺失調症 ) Uaual dose:10-15 mg orally once daily without regard to meals; may be increased to a maximum of 30 mg once daily. Dosage titration should not be more frequent than every 2 weeks. Side effects:headache, agitation, insomnia, anxiety, lightheadedness, weight gain, nausea, dyspepsia, constipation, vomiting, blurred vision. Lactation:Excreted in breast milk. (Contraindicated) 13

21 Clotiapine Supply:Etumine 意妥明錠 40mg/Tab (OCLOTI) Indications:Acute schizophrenia or exacerbations of chronic schizophrenia; Manic-depressive psychosis, endogeneous and reactive manic phase of manic-depressive illness; sleep disorders. ( 精神病狀態 ) Uaual dose:psychosis: mg (initial), mg QD or TID (maintenance). Neurosis: mg QD or TID. Sleep disorders: mg before retiring. Side effects:common adverse effects include fatigue, drowsiness, tremor, constipation, tardive dyskinesia, extrapyramidal effects and neuroleptic malignant syndrome. Haloperidol Supply:Halosten 豁樂舒靜 1 mg/tab (OHALOS) Halin 哈寧 5mg/Tab (OHALIN) Binin-U 易寧優 5 mg/ml/amp (IHALDO) Haldomin 煩樂平 2mg/ml 15ml/Bot (OHALDOM) Indications:Agitation, psychosis, aggressive and agitated behavior. ( 躁病 精神病狀態 嘔吐 噁心 攻擊性與破壞性之行為障礙 舞蹈病 ) Usual dose:po mg bid-tid initially, Max.100 mg/day. IM mg for prompt control of the acutely agitated patients. Side effects:extrapyramidal effects, akathisia, dementia, leukopenia, torsades de pointes, weight gain, constipation, neuroleptic malignant syndrome. Lactation:Excreted in breast milk. (May be of concern) Jexit 欣解 (ODEANX2) Supply:each Tab contains Flupentixol mg Melitracen mg Indications: 焦慮症 憂鬱症 Usual dose:1 Tab bid. Side effects:insomnia. Lithium Carbonate Supply:Ligilin 鋰齊寧 300 mg/cap (OLITHIU) Indications:Mania. ( 躁病 預防躁鬱病 ) Uaual dose:acute mania mg tid, serum level range meq/l. Long-term use mg tid-qid, the desirable serum levels are meq/l. Side effects:polydipsia, polyuria, tremor, rash, arrhythmia, drowsiness. Pregnancy:Category D. Lactation:Excreted in breast milk. (Contraindicated) 14

22 Quetiapine Supply:Limus 輔思妥 25mg/Tab (OSERO25) Calm-EZ 康緒舒 100 mg/tab (OQUETI) Indications:Psychotic disorders. ( 思覺失調症, 雙極性疾患之躁症發作 ) Usual dose:initial 25 mg bid, with increases in increments of mg bid-tid on the second and third day, a target dose mg daily divided in 2 or 3 doses. Max. 800 mg/day. Side effects:postural hypotension, somnolence, dyspepsia, dizziness, tachycardia, constipation, weight gain. Risperidone Supply:Risperidone 瑞波 2 mg/tab (ORISPER) Indications:Schizophrenia or other psychotic disorders. ( 思覺失調症之相關症狀 雙極性疾患之躁症發作 治療失智症病人具嚴重攻擊性 躁動或精神病症狀 行為障礙和其他破壞性行為障礙 兒童及青少年自閉症之躁動症狀 ) Uaual dose:initial 1 mg bid, with increase in increments of 1 mg twice daily on the second and third day, as tolerated, to a target dose of 3 mg bid. Dose above 6 mg/day are not recommended. Side effects:insomnia, agitation, anxiety, extrapyramidal symptoms, headache, tachycardia, sedation, weight gain, constipation. Sulpiride Supply:Sulmatyl 思邁蒂 50 mg/tab (OSULPIR) Indications:Schizophrenia, anti-gastrin secretion. ( 精神病狀態 消化性潰瘍 ) Usual dose:schizophrenia mg bid, Max mg/day. Antidepressant mg/day. Duodenal ulcer mg tid. Side effects:parkinsonism, dry mouth, nausea, constipation, galactorrhea. (3) Antidepressants Citalopram (selective serotonin reuptake inhibitor) Supply:Sitalo 賽達樂 20 mg/tab (OCITALO) Indications:Depression. ( 鬱症之治療及預防復發 恐慌症 ) Usual dose:initial 20 mg once daily, dose may up to 40 mg/day. Side effects:insomnia, somnolence, nausea, dry mouth Note:Not be used in combination with an MAOI or within 14 days of discontinuing treatment with an MAOI. 15

23 Duloxetine (serotonin and norepinephrine reuptake inhibitor) Supply:Lexinping 樂心平 30mg/Cap (OLEXINP) Indications:For the treatment of Major depressive disorder, Diabetic peripheral neuropathy Pain, Generalized anxiety disorder, fibromyalgia. ( 用於治療重鬱症 糖尿病週邊神經痛 廣泛性焦慮症 纖維肌痛 ) Usual dose:initial: mg/day; dose may be divided, maintenance: 60 mg once daily. Side effects:nausea, dry mouth, constipation, diarrhea, appetite decreased, dizziness, somnolence, headache, insomnia. Note:Capsule should be swallowed whole; do not break open or crush. Escitalopram (selective serotonin reuptake inhibitor) Supply:Lepax 得緒安 10mg/Tab (OLEPAX) Indications:Major depression, Generalized anxiety disorder, Panic disorder with or without agoraphobia, Social anxiety disorder, Obsessive compulsive disorder. ( 鬱症之治療及預防復發, 恐慌症 社交焦慮症 泛焦慮症及強迫症之治療 ) Usual dose:usual dose 10 mg once daily, with or without food. Maximum dose 20 mg/day. In the elderly (>65 years), in panic disorder patients and in patients with reduced hepatic function an initial dose of 5 mg/day is recommended. Side effects:headache, somnolence, insomnia, nausea, ejaculation disorder, diarrhea, sweating increased, constipation, xerostomia. Imipramine (tricyclic antidepressant) Supply:Fronil 福樂你 25 mg/tab (OTOFRAN) Indications:Depression, childhood enuresis. ( 慮鬱病 夜尿 ) Usual dose:depression-hospitalized pt s: Initially mg/day in divided doses, may be increases to mg/day; outpatients: initially mg/day, do not exceed 200 mg/day maintenance mg/day. Childhood enuresis( 6 years) - Initially 25 mg/day 1 hr before bedtime, may increase up to 50 mg/night (< 12 y/o), 75 mg/night (> 12 y/o), do not exceed 2.5 mg/kg/day. Side effects:dizziness, drowsiness, dry mouth, headache, nausea, increased appetite, unpleasant taste, postural hypotension. Pregnancy:Category D. Lactation:Excreted in breast milk.(may be of concern) 16

24 Mirtazapine (tetracyclic antidepressant) Supply:Remeron 樂活優口溶錠 30 mg/tab (OREME3) Indications:Depression. ( 鬱症 ) Usual dose:starting dose - 15 mg/day, max. 45 mg/day. Do not change dose at intervals of <1 or 2 weeks. Side effects:somnolence, dry mouth, constipation, increased appetite, weight gain, drowsiness, asthenia. Note:MAOI should be discontinued at least 14 days before initiating mirtazapine therapy. Paroxetine (selective serotonin reuptake inhibitor) Supply : Setine 除憂定 20 mg/tab (OSETIN) Indications:Depression, obsessive compulsive disorder, OCD, panic disorder. ( 各種類型鬱症及鬱症伴隨焦慮症之症狀治療及預防復發 強迫症之症狀治療 恐慌症之症狀治療及預防復發 社交畏懼症 ( 社交焦慮症 ) 之治療 泛焦慮症之症狀治療及預防復發 (GAD) 創傷後壓力症候群之治療 (PTSD) ) Usual dose : Major depression: mg PO QD; initial doses of 10 mg, with a daily maximum of 40 mg are recommended in severe renal insufficiency, liver disease, and in the elderly or debilitated. Obsessive compulsive disorder or panic disorder: 40 mg once daily. Side effects : Headache, asthenia, somnolence, dizziness, dry mouth, insomnia, nausea. Lactation:Excreted in breast milk. (May be of concern) Sertraline (selective serotonin reuptake inhibitor) Supply:Kinloft 抗憂服 50 mg/tab (OSERTRA) Purtraline 克憂寧 50mg/Tab (OSERTR2) Indications:Depression, obsessive compulsive disorder, panic disorder. ( 鬱症 強迫症 恐慌症 創傷後壓力症候群 社交恐懼症 ) Usual dose:initial 50 mg qd, Max. 200 mg/day. Side effects : Headache, insomnia, somnolence, fatigue, nausea, diarrhea, rash, dizziness. Lactation:Excreted in breast milk. (May be of concern) Note: Do not use in combination with MAOI or within 14 days of discontinuing treatment. Trazodone Supply:Mesyrel 美舒鬱 25 mg/tab (OMESYRE) Indications:Depression. ( 治療各種型態之抑鬱症 ) Usual dose:initial 150 mg/day, may be increased by 50 mg/day q3-4 day. For outpatients - Max. 400 mg/day, for inpatients - Max

25 mg/day. Side effects:hypotension, dizziness, drowiness, palpitation, blurred vision, dry mouth. Lactation:Excreted in breast milk. (May be of concern) Venlafaxine HCl Supply : Calmdown 康緒平 37.5mg/Cap (OVENLAF) Indications : Depression, anxiety. ( 鬱症 泛焦慮症 社交焦慮症 恐慌症 ) Usual dose : PO, mg/day bid-tid, titrate at 4 day intervals. Max. 225 mg/day. Side effects : Headache, insomnia, dizziness, dry mouth, nausea, constipation. Lactation:Excreted in breast milk. (May be of concern) (4) Cholinesterase Inhibitors Donepezil Supply:Aricept 愛憶欣 5 mg/tab (OARICE5) Aricept 愛憶欣 10 mg/tab (OARICE) Indications:Mild to moderate dementia of the Alzheimer's disease. ( 阿滋海默症 ) Usual dose:initial 5 mg once daily, may increase to 10 mg/day. Side effects:headache, insomnia, dizziness, pain, nausea, diarrhea Rivastigmine Supply:Exelon 憶思能 1.5 mg/cap (OEXELON) Exelon 憶思能 4.5 mg/cap (OEXELO4) Exelon 憶思能穿皮貼片 4.6 mg/24hr/patch (EEXELON) Rivast 理曼提 2mg/ml 120ml/Bot (ORIVAST) Indications:Mild to moderate dementia of the Alzheimer's disease. ( 輕度至中度阿滋海默氏病之癡呆 ( 失智 ) 症 ) Usual dose:po: Initially 1.5mg BID then titrated to 6-12mg daily; do not exceed 12 mg/day. Patch: Initial: 4.6 mg/24 hours; if well tolerated, may be increased (after at least 4 weeks) to 9.5 mg/24 hours. Apply transdermal patch to upper or lower back (alternatively, may apply to upper arm or chest). Side effects:headache, insomnia, dizziness, nausea, vomiting, diarrhea, abdominal pain, anorexia Pregnancy:Category B. 18

26 (5) Central Nervous Systemic Stimulants Methylphenidate ( 管三 ) Supply:Apo-Methylphenidate 安保美喜 10 mg/tab (OAPOMPH) Indications:Attention deficit disorders, narcolepsy. ( 過動兒症侯群, 發作性嗜睡症 ) Usual dose:attention deficit disorders - Children 6years: 5 mg bid, increments 5-10 mg weekly, Max. 60 mg/day. Narcolepsy - individualize dosage, mg/day in 2-3 divided doses, Max. 60 mg/day. Side effects:dizziness, anorexia, insomnia, restlessness, vertigo, behavior disturbances, growth suppression, rash. Lactation:Excreted in breast milk. Note:Take the last dose before 6pm. (6) Miscellaneous Dihydroergotoxine Mesylate Supply:Hodrin 好如臨 1.5 mg/tab (OSCAMIN) Indications:Aged-related mental capacity decline. ( 老人痴呆之輔助治療 ) Usual dose:1 mg tid, may be up to 12 mg/day. Side effects:ergotism, bradycardia, porphyria, nausea, nasal stuffiness. Flunarizine HCl Supply:Sufuni 賜福您 5 mg/cap (OSIBELI) Indications:Migraine headache, peripheral vascular disease, vertigo. ( 噁心 眩暈 迷路障碍 暈動病 末梢血管循環障碍 ) Usual dose : Migraine headache prophylaxis, peripheral vascular disease mg/day. Vertigo - 20 mg tid. Side effects:sedation, drowsiness, extrapyramidal reactions, weight gain. Memantine Supply:Witgen 威智錠 10mg/Tab (OWITGEN) Indications:Alzheimer's disease (Moderate to Severe). ( 治療中重度及重度阿滋海默症 ) Usual dose:initial, 5 mg orally once daily; increase dose at minimum 1 week intervals in 5 mg increments to 10 mg/day (5 mg twice daily), 15 mg/day (5 mg and 10 mg in separate doses), and 20 mg/day (10 mg twice daily); The maximum daily dose is 20 mg daily. Side effects:dizziness (most common), headache, confusion, somnolence, constipation, vomiting, cough Pregnancy:Category B. 19

27 Nicotine Supply:Smokfree Nicotine TDDS No.15 淨菸經皮吸收戒菸貼片 31.2 mg/15cm 2 /patch 7patches/Box (ESMOK3) Indications:Adjunct to smoking cessation. ( 幫助戒菸 ) Usual dose:first 2-8 weeks: 15 cm 2 /day. Next 2-4 weeks: 10 cm 2 /day. Side effects:erythema, pruritus, burning at the application site. Pregnancy:Category D. Piracetam Supply:Rofew 諾復智 200 mg/ml 60ml/Bot (IPIRAC) Piracetam 派卡登 200 mg/ml 200ml/Bot (OPIRACE) Nootropil 腦寶 1200 mg/tab (ONOOPOL) Indications:Cerebrovascular insufficiencies, age-associated intelligence disturbance, cortical myoclonus. ( 對腦血管障礙及老化引起之智力障礙可能有效, 治療皮質性陣發性抽搐 ) Usual dose:orally, age-associated cognitive impairment: 1.2~2.4 g daily. Cortical myoclonus: 7.2 g daily in 2 or 3 divided doses, increasing by 4.8 g daily every 3 or 4 days up to a maximum of 24 g daily. ClCr 50 ~ 79 ml/min: 正常劑量的 2/3, 每日分二到三次服用 ; ClCr 30~ 49 ml/min: 正常劑量的 1/3, 每日分二次服用 ; ClCr ml/min: 正常劑量的 1/6, 每日一次 ; ClCr<20 ml/min: 禁用 Side effects:insomnia, somnolence, weight gain, hyperkinesia, nervousness, and depression. 3. Neurologic Drugs (1) Anticonvulsants Acetazolamide Supply: 乙醯胺基硫唑嘧 250 mg/tab (OACET01) Indications:Epilepsy, glaucoma, edema. ( 青光眼及下列疾患之輔助治療 : 水腫 癲癇 ) Usual dose:antiglaucoma: g/day in divided doses. Anticonvulsion: 8-30 mg/kg/day in divided doses; maximum daily dose: 1.5 g. Prophylaxis of mountain sickness: 250mg BID-TID prior to ascent. Diuresis: mg QD. Rapid tolerance to acetazolamide diuresis develops when used on daily basis. To obtain maximal diuretic effect, an alternate day dosing is recommended. In renal impairment: ClCr (ml/min)>50 Q6H;10 50 Q12H;<10 Not recommended. Pediatric Dosage: antiglaucoma: 8-30 mg/kg/day, anticonvulsion: as adults dose. Side effects:nausea, vomiting, abdominal pain, diarrhea or constipation, 20

28 thirst, dizziness, hyperkalemia. Lactation:Excreted in breast milk. (Usually compatible) Carbamazepine Supply:Tegretol CR 癲通長效 200 mg/tab (OTEGCR) Indications:Epilepsy, trigeminal neuralgia, bipolar disorder. ( 癲癇症 三叉神經痛 腎原性尿崩症 雙極性疾患 原發性舌咽神經痛 ) Usual dose:epilepsy: initial dose mg, 1-2 times daily, gradually increased of 200 mg/day to a usual maintenance dose of 0.8 to 1.2 g daily in 2-4 divided doses up to 1.6 g/day. Trigeminal neuralgia: initial dose 100 mg BID, increased by 200 mg daily up to 1.2 g daily, usual maintenance dose mg daily in 2-4 divided doses. Tegretol controlled release Tab can be divided into two parts but could not be crashed. For shifting from conventional tablet to controlled release form, increasing of 10-20% dose is recommended. Side effects:dizziness, ataxia, drowsiness, nausea, vomiting, agitation, tremor. Pregnancy:Category D. Lactation:Excreted in breast milk. (Usually compatible) Note:The effects may be by INAH, Danazol, Verapamil, Macrolides. Clonazepam ( 管四 ) Supply:Clonopam 克癇平 0.5 mg/tab (OCLON05) Clonopam 克癇平 2 mg/tab (OCLONA2) Indications:Petit mal variant, akinetic and myoclonic seizures. ( 癲癇 ) Usual dose:adults: initial dose 1.5 mg/day divided into 3 doses, followed by increased of mg/day every 3 day until seizures control is achieved, maintenance dosage should not exceed 20 mg daily, maximum dose: 20 mg/day. Children: initial dose 0.05 mg/kg/day divided into 2-3 doses, may be increased of 0.5 mg every 3 day, maintenance dosage should not exceeded 0.2 mg/kg/day Side effects: Drowsiness, fatigue, headache, rash, tachycardia, dry mouth, dysarthria, blurred vision. Pregnancy:Category D. Lactation:Excreted in breast milk. (May be of concern) Diazepam see page 11 21

29 Gabapentin Supply:Neurontin 鎮頑癲 100 mg/cap (ONEURO) Indications:Epilepsy, chronic pain. ( 治療成人及三歲以上兒童局部癲癇發作之輔助療法, 帶狀庖疹後神經痛 ) Usual dose: mg/day in 3 divided doses. Post-herpetic neuralgia: 300mg on Day 1, 300mg BID on Day2, 300mg TID on Day 3; may increase to 1800 mg/day (divided into 3 doses). Dosage adjustment in renal impairment: ClCr> 60ml/min : 400 mg TID; ClCr 30-59ml/min : 300 mg BID; ClCr 15-29ml/min : 300 mg QD; ClCr <15 : 300mg Q2D; hemodialysis : mg after dialysis. Side effects:peripheral edema, myalgia, somnolence, fatigue, dizziness, ataxia, nystagmus, weight gain, skin rash, blurred vision, diplopia, mood changes, tremor, hyperactive behavior, No interactions with other anticonvulsants have been reported. L.A. 樂安 (OLA) Supply:each Tab contains Phenytoin mg Phenobarbital mg Indications:Seizures. ( 真性癲癇 ( 尤其是癲癇大發作 ) 症候性癲癇 乍克森氏癲癇 精神分裂的發作 其他痙攣性之發作 ) Usual dose:1 Tab tid. Side effects:same as phenytoin and phenobarbital. Lamotrigine Supply:Lamictal 樂命達 50 mg/tab (OLAMICT) Indications:Adjunctive therapy in partial/secondary generalized seizures. ( 癲癇 ( 泛發性強直陣攣性發作及簡單性或複雜性局部發作 ) 成人與 12 歲以上兒童之單獨用藥治療 ; 成人與 2 歲以上兒童之輔助性治療 ; LENNOX-GASTAUT SYNDROME 徵候群之治療 處於明顯鬱期之雙極性疾患情感症狀之治療, 有明顯鬱期或鬱, 躁期循環之雙極性疾患之情感症狀之預防 ) Usual dose:adults and children (>16 yrs) receiving mg/day in two divided doses, up to 700 mg/day have been used in some cases mg/day are used with concomitant valproic acid. Side effects:dizziness, diplopia, somnolence, headache, ataxia, nausea, blurred vision, rhinitis, pharyngitis, rash. Lactation:Excreted in breast milk. (May be of concern) Note: The drug is not approved for use in patients below 16 of age, due to higher incidence of severe life-threatening skin rash than in adult. 22