2011屏基藥訊第四季

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1 PINGTUNG CHRISTIAN HOSPITAL 2011 No 16 PharmacyTime

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3 3 72 (Glasgow coma scale) % % (CT) (MRI) CT CT X CT

4 (osmotic diuretics) (1)Mannitol 1g/Kg B.W cc mannitol (rebound phenomenon) (2)Glycerol (3)Furosemide ( early posttraumatic seizures ) 1 ( l a t e posttraumatic seizure ) ( ) ( ) () (Seizure Prophylaxis) ( P h e n y t o i n ) ( carbamazepine ) ( phenobarbital ) ( valproate ) GCS score ( ) 70% 10% 5%~10% 80% 4

5 () () ( ) () 20% ( ) () ( ) 參 1. Brain Injury Foundation, AANS. Guidelines for the management of severe head injury. J Neurotrauma 1996;13: Schierhout et al. Anti-epileptic drugs for preventing seizures following acute traumatic brain injury (Cochrane Review)

6 3. Brain Injury Special Interest Group, A A P M R. A r c h P h y s R e h a b i l 1998;79: Healthwise : Carbamazepine (Tegretol) 3~4 ( 2 ) 6

7 Phenobarbital (Luminal ) 2~4 Vigabatrin (Sabril ) Clonazepam (Rivotril ) 2~3 Gabapentin ( Neurontin) 3~4 7

8 Phenytoin (Dilantin ) 1~2 Topiramate ( Topamax) 2 Lamotrigine (Lamictal ) Primidone (Mysoline ) 3 8

9 Valproate (Depakine ) 3~4 ( 2 ) Levetiracetam ( Keppra) 2 9

10 / 3 ( ) ( ) ( ) ( )39 ( ) ( ) ( / / / ) ( ) ( )( 1 2 ( //) ( ) // / ( ) ( ) ( ) 58 5 ( ) 10

11 Brand name KCl 1.49mg/NaCl 9mg/ml,500cc/bot KCl 2.98mg/NaCl 9mg/ml,500cc/bot Indication Treatment or prevention of hypokalemia. Dosage Adult Potassium chloride in NaCl IKCLN IKCLN2 C Normal daily requirements: I.V.: meq/day Serum potassium >2.5 meq/l: Maximum infusion rate: 10 meq/hour; maximumm concentration: 40 meq/l; maximum 24-hour dose: 200 meq Serum potassium <2 meq/l and symptomatic (excluding emergency treatment of cardiac arrest): Maximum infusion rate (central line only): 40 meq/hour in presence of continuous ECG monitoring and frequent lab monitoring; In selected situations, patients may require up to 400 meq/24 hours. Contraindication Severe renal impairment, heat cramps, severe tissue trauma. Side effect Hyperkalemia, diarrhea, nausea, vomiting Contains Glimepiride 2mg Metformin 500mg Amaryl M OAMARM Indication Treatment of NIDDM patients who are having inadequate glycemic control with metformin or sulfonylurea monotherapy. Dosage 1 tab once or twice per day before or with meals. Contraindication IDDM, diabetic ketonemia, diabetic coma or precoma, acute or chronic metabolic acidosis. Known hypersensitivity to sulfonylureas, sulfonamides or biguanide. Severe hepatic or renal dysfunctions. Side effect Hypoglycemia, dizziness, nausea, flatulence, lactic acidosis Precaution 1.) Careful monitoring during the 1st treatment week for patients or conditions at risk of hypoglycemia 2.) Temporarily discontinue in patients undergoing radiologic studies in which intravascular iodinated contrast media are utilized. C Brand name Onglyza 5 mg/f.c tab Saxagliptin B OONGL 11

12 Indication Type DM Dosage 2.5-5mg qd. Side effect Headache,.Sinuitis, UTI, peripheral edema. Brand name Videx 250mg/cap Didanosine OVIDE B Indication Treatment of HIV infection. Dosage Oral dosing based on patient weight 20 kg to <25 kg: 200 mg once daily 25 kg to <60 kg: 250 mg once daily >=60 kg: 400 mg once daily Dosing: Renal Impairment CrCl >=60 : >=60 kg: 400 mg once daily < 60 kg: 250 mg once daily CrCl : >=60 kg: 200 mg once daily < 60 kg: 125 mg once daily CrCl : >=60 kg: 125 mg once daily < 60 kg: 125 mg once daily CrCl <10 : >=60 kg: 125 mg once daily < 60 kg: use alternate formulation. Contraindication Concurrent administration with allopurinol or ribavirin. Side effect Diarrhea, peripheral neuropathy, rash, pancreatitis, liver failure, retinal changes and optic neuritis Precaution Administer on an empty stomach at least 1 hour before or 2 hours after eating; swallow capsule whole. Brand name Mirapex 0.25mg /tab Indication Parkinson s syndrome Primary Restless Legs Syndrome Pramipexole Dosage 0.375mg mg / : 0.125mg mg/ OMIRA C 12

13 Side effect Precaution 着 Brand name Aclasta 5mg/100ml/bot Zoledronic acid IACLA C Indication paget s disease Dosage Paget's disease: I.V.: 5 mg infused over at least 15 minutes Osteoporosis, prevention (5 mg infused over at least 15 minutes every 2 years Osteoporosis, treatment 5 mg infused over at least 15 minutes once a year Side effect Contraindication Precaution 1.) aclasta ) clcr 35ml/min 3.) 13

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