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1 : : : : : 252 / Allopurinol / / (Thrombosis) (Venous thromboembolism; VTE) : (Deep vein thrombosis, DVT) (Pulmonary embolism, PE) 0.1% 0.5% (1) Heit JA (Chemotherapy) 1/200 (2) (3) (4)

2 8 (5) (6) (Anticoagulants) (Parenteral anticoagulants) : (1)Heparin(2)Low-molecularweight heparin (LMWH) (3)Fondaparinux (Thromboprophylaxis) Warfarin Low-molecular-weight heparin Warfarin (1) (recurrent rate) (7) (2)Low-molecular-weight heparin (Fixed weight-adjusted dose) (INR ) (8) Low-molecular-weight heparin Low-molecular-weight heparin (9) Warfarin Low-molecular-weight heparin Warfarin Warfarin INR (1) (10, (2) (3) (4) 11) (Thrombocytopenia) Warfarin

3 (6) LMWH

4 HeparinLMWHFondaparinux Idrabiotaparinux (6) (6) Factor Xa Thrombin inhibitor Factor Xa inhibitors (Fixed weight adjusted dose) (8) indirect inhibitors direct inhibitor (12)

5 Indirect inhibitors( ) FondaparinuxIdraparinux Drabiotaparinux Idrabiotaparinux (SSR126517) Idraparinux Idrabiotaparinux Idrabiotaparinux H ( Biotin ) ( Avidin ) ( Avidin ) H ( Biotin ) ( Avidin-drug complex) ( Avidin-drug complex ) (13) Drabiotaparinux (Pentasaccharide) (80 ) Direct inhibitor( ) RivaroxabanApixaban Dabigatran etexilate Rivaroxaban 1/3 CYP450 3A4 CYP450 3A4 inhibitor P-glycoprotein inhibitor ( (16, Ketoconazole ritanovir) 17) Apixaban 25% 55% CYP450 3A4 Sulfotransferase 1A1 CYP450 3A4 inhibitor (Ketoconazole Clarithromycin) Apixaban (17) Dabigatran etexilator Dabigatran (Prodrug) 酶 ( Esterase ) Dabigatran Thrombin Dabigatran P-glycoprotein inhibitor (Quinidine) (14, 15) Dabigatran Warfarin

6 Silverstein MD, Heit JA, Mohr DN, et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158(6): Heit JA, Silverstein MD, Mohr DN, et al. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 2000; 160(6): Falanga A, Marchetti M. Venous thromboembolism in the hematologic malignancies. J Clin Oncol 2009; 27(29): Noble S, Pasl J. Epidemiology and pathophysiology of cancer-associated thrombosis. Br J Cancer 2010; 102(Suppl 1): s2-s9. Prandoni P, Lensing AW, Cogo A, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 1996; 125(1): 1-7. Weitz JI. Potential of new anticoagulants in patients with cancer. Thrombosis Research 2010; 125 (Suppl. 2): s30-s35. Lee AY, Levine MN, baker RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349(2): Weitz JI. Low-molecular-weight heparin. N Engl J Med 1997; 337(10): Nutescu EA, Spinler SA, Wittkowsky A, et al. Low-molecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings. Ann Pharmacother 2009; 43(6): Prandoni P, Lensing AW, Piccioli A, et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous throbosis. Blood 2002; 100(10): Hutten BA, Prins MH, Gent M, et al. Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism in relation to both malignancy and achieved international normalized ratio: a retrospective analysis. J Clin Oncol 2000; 18(17): Gross PL, Weitz JI. New anticoagulants for treatment of venous thromboembolism 2008; 28(3): Harenberg J. Development of idraparinux and idrabiotaparinux for anticoagulant therapy.

7 Thromb Haemost 2009; 102(5): Stangier J. Clinical pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor dabigatran etexilate. Clin Pharmacokinet 2008; 47(5): Sanford M, Ploser GL. Dabigatran etexilate. Drugs 2008; 68(12): Kubitza D, Becka M, Wensing G, et al. Safety, pharmacodynamics and pharmacokinetics of BAY an oral direct factor Xa inhibitor after multiple dosing in healthy male subjects. Eur J Clin Pharmacol 2005; 61(12): Eriksson BI, Quinlan DJ, Weitz JI. Xomparactive pharmacodynamics and pharmacokinetics of oral direct thrombin and factor Xa inhibitors in development. Clin Pharmacokinet 2009; 48(1): 1-22.

8 Allopurinol ADMA (Asymmetric dimethylarginine) 為內生性一氧化氮合成酶 (Nitric oxide synthase) (NO) (NO) (Afterload) ADMA ADMA (Reactive oxygen species, ROS) ADMA ( Dimethylarginine dimethylaminohydrolase, DDAH) ADMA ADMA Dimethylarginine dimethylaminohydrolase Reactive oxygen (ROS)/ Xanthine oxidase ADMA ADMA ( ROS ) ( ROS generating enzyme ) ( Xanthine oxidase ) ADMA Allopurinol ADMA Allopurinol Allopurinol

9 Allopurinol ( Xanthine oxidase ) ( Xanthine ) ( Uric acid ) ( ROS ) ADMA ( DDAH ) ADMA ADMA (NO) ( Afterload ) ( ) ( ) Allopurinol ADMA Allopurinol 2010 Clinical pharmacology & Therapeutic ( n=26) ( n=113) ADMA (P )( ) (NYHA ) ADMA NYHA ADMA ( )

10 ( ) ( ) ( ) ADMA ( ) ( ) ( ) ADMA ( =60.2%) 17.7% (95% CI = %)48.7% ( 95% CI = %) ADMA (95% CI = , P ) (95% CI= , P0.0002)NYHA (95% CI= , P

11 0.0001) (Left ventricular ejection fraction) (95% CI= , P ) (95% CI= , P0.0001) (95% CI= , P0.0001) ( Body Mass Index, BMI) ADMA ADMA ADMA ( BMI ) ADMA ADMA (589±86 vs. 572±92 nmol/lp0.3) ( )ADMA ( )ADMA

12 Allopurinol placebo ( Xanthine oxidase ) (Uric acid) ADMA ( 533±78nmol/l 505±79nmol/l; P0.022) ADMA ( ) ( ) Allopurinol(300mg QD)(a)ADMA (b) (c) ADMA ADMA Allopurinol (xanthine oxidase) Allopurinol ( Xanthine oxidase ) Benzbromarone(Euricon ) Allopurinal Benzbromarone 1. S von Haehling1, SM Bode-Böger, J Martens-Lobenhoffer, et al. Elevated Levels of Asymmetric Dimethylarginine in Chronic Heart Failure: A Pathophysiologic Link Between Oxygen Radical Load and Impaired Vasodilator Capacity and the Therapeutic Effect of Allopurinol. Clinical pharmacology & Therapeutics 2010.

13 doi: /clpt A D Struthers, P T Donnan, P Lindsay, et al. Effect of allopurinol on mortality and hospitalisations in chronic heart failure: a retrospective cohort study. Heart 2002;87: W Doehner, S D Anker. Xanthine oxidase inhibition for chronic heart failure: is allopurinol the next therapeutic advance in heart failure. Heart 2005;91: Wolfram Doehner, Nina Schoene, Mathias Rauchhaus, et al. Effects of Xanthine Oxidase Inhibition With Allopurinol on Endothelial Function and Peripheral Blood Flow in Hyperuricemic Patients With Chronic Heart Failure Results From 2 Placebo-Controlled Studies. Circulation. 2002; 105:

14 Taiwan Antidote Network ( index.htm) (TEL FAX ). Physostigmine Salicylate Inj. 2 mg/2 ml/ Amp Adult2mg IM or slow IV (< 1mg/min) Pediatric0.02mg/kg IM or slow (Anticholinergic) IV (< 0.5mg/min)

15 Methylene Blue Inj. 100 mg/10ml/vial Cyanide Antidote Package Cyanokit 2.5 g (Hydroxocobalamin) Calcium Disodium EDTA 0.5 g/10 ml/amp DMSA (Succicaptal 200mg/cap Dimaval (DMPS) 250mg/5ml/Amp 100mg/Capsule 0.1 ~ 0.2 ml/kg IV very slowly over few mins (Methemoglbinemia) (Cyanide) 1. Amyl Nitrite 1Amp ( Amyl Nitrite 0.3ml/Amp * Amp 15 Sodium Nitrite (NaNO2) NaNO2 300mg/10ml/Amp* 2Amp 2. IV NaNO2Adult 300mg Sodium thiosulfate (Na2S2O3) 12.5g/50ml (2.5-5 ml/min)pediatric 6- /Amp * 2 Amp) 8 ml/m 2 (0.2ml/kg) 10 ml 3. IV Na2S2O3Adult 12.5gPediatric 7g/m g NaNO2 Na2S2O Amyl Nitrite 1Amp NaNO2 5 g IVF > 15 min (15 ml/min) 70mg/kgIVF 25-30mins Sodium Nitroprusside 1-2 Amp/day * 5days 7 days 1-2 Amp/day * 5days Adult30 mg/kg/day (MAX: 1.8g) divided 3 doses * 5 days Pediatric10 mg/kg/day (350mg/m 2 /day) Q8H * 5 days, then Q12H * 14 days ( ( ) 1st day250mg Q3-4H ) 2nd day250mg Q4-6H 3rd day250mg Q6-8H

16 ANTIZOL Inj. (Fomepizole) (arsenic 4th day250mg Q8-12H hydride ) (1-2 /) caps/day caps/day mg/kg IV (Ethylene glycol, mg/kg Q12H * 4 doses )3. 15 mg/kg Q12H until ethylene (Methanol) glycol or methanol conc.20 mg/dl ( ) 24 ( ) ( ). ( ) ( )

17 ( ) 6 4 ( l (AB E )

18 (HRIG) (HRIG). Digoxin Immune FabFomepizole. ( ) ( ). ( ) BAL Na- DMS Specific Mamagement (> ) Mercury, Arsenic DMPS > DMSA > BAL ( )

19 Lead ( EDTA + BAL Na-DMS ) EDTA DMSA Copper ( ) Gold Iron Chromium ( ) Cadmium ( ) Manganese ( ) DMPS > BAL methemoglobinemia methylene blue DMPS or BAL Deferoxamine DMPS 125 mg IM/IV q12hr X 3-4 methemoglobinemia methylene blue Hemodialysis 24 Exchange transfusion DMPS or EDTA ( ) EDTA 1g in D5W 500ml IV q12-24h X 3-5. Fomepizole Ethanol Folic acid Leucovorin PH 7.3 Bicarbonate ( CO - 3 ) PH7.3. ( Bradycardia ) (Heart block) ( Ventricular dysrhythmia ) Digoxinspecific antibody Fab fragment.

20 ( ) Taiwan Antidote Network.

21 ( ) ( ) Rongifene 50mg (Buclizine 2HCl) (ORON) Lonzumin 25mg (Buclizine 2HCl) (OLONZ) 1. Allopurinol 100mg (Allopurinol) (OALL) Cefazolin 1g/vial (Cefazolin) (ICEFA) Zovirax oph oint 4.5g (Acyclovir) (TZOE) Tonsaric 100mg (Allopurinol) (OTONS) Winzolin 1g/vial (Cefazolin) (IWIN) Devirus Oph Oint 4.5gm (Acyclovir) (TDEV) 單純疱疹性角膜炎 ( ) ( ) Fosamax Plus 70mg (Alendronate Na, colecalciferol) (OFOSA-P) Alendronate 70mg (Alendronate Na) (OALE) 1. colecalciferol Ostelin 250mg (Glucosamine sulfate) (OOST) Serophene 50mg (Clomiphene) (OSERO) Pharmorubicin 10mg/5ml/vial (Epirubicin) (IPHA) Axol 30mg (Ambroxol) Kudona Cap. 250mg (Glucosamine sulfate) (OKUDO) Clomiphene 50mg (Clomiphene) (OCLOM) Epicin 50mg/25ml/vial (Epirubicin) (IEPIC) Musco 30 mg (Ambroxol)

22 (OAXO) Losec 40mg/vial (Omeprazole) (ILOS) Chemix (Sulfamethoxazole, trimethoprim) (OCHE) Augmentin 375mg (Amoxicillin/ clavulanate) (OAUG) Trimerin syrup 60ml (Trimethoprim/sulfam ethoxazle) (LTRI) (OMUSC) NEXIUM INJ.40mg (Esomeprazole Sodium) (INEUX) Morcasin Tab. (Sulfamethoxazole, trimethoprim) (OMORC) Curam F.C. 1g (Amoxicillin/ clavulanate) (OCUR) SulfacoTrim 60ml (Trimethoprim/sulfa methoxazle) (LSUL) 1. / NSAID 2. Grade AB Sulfamethoxazole 400mg, trimethoprim 80mg 1. Augmentin 375mg(Amoxicillin 250mg / clavulanate 125mg)Curam F.C. 1g (Amoxicillin 825mg / clavulanate 125mg) ( ) Acetamol INJ. 1g 1. (Propacetamol HCl) (IACET) " ",, ( :8432) "!! Lidopat Patch 5% 3 / 1. (Lidocaine) (TLIDP) 2. (1) NSAIDs (2) 3

23 2 (3) Gabapentin 3. (1) (2) 4. " ",, ( :8432) "!! Requip PD 1. " ",, (Ropinirole) ( :8432) "!! (OREQ2) 2. Requip 0.25mg (OREQ- 0.25)& Requip 1mg (OREQ) SynflorixTM (1. " ",, ) ( :8432) "!! (ISYNF) 2. ISYNF1ISYNF2ISYNF3 ISYNF4 Durogesic D- 1. TRANS12mcg/hr (1) (Fentanyl) (2) (TDU12) (3) 2. Fentanyl25mcgTransdermal Patch (TFE25) DUROGESIC mcg/hr (TDU50-D) Vimax Foaming Sol'n 1. (Clobetasol propionate) (TVIM) 2. " ",, ( :8432) "!! 3. & 4. Clobetasol 10gm/tube (TCLOB) ( ) Lexapro F.C. 10mg 1. (Escitalopram Oxalate) (OLEXA) 2. " ",, ( :8432) "!! LABedin F.C. Tab 200mg 1. (Labetalol) 2. " ",, (OLABE) ( :8432) "!! Dormicum F.C. 7.5mg 1.

24 (Midazolam) (ODORM) Finibax 0.25g/vial (Doripenem Hydrate) (IFIN) Omnitrope 5mg(15 Units)/1.5ml (Somatropine) (IOMNIT) SEROquel (Quetiapine) (OSEQ25) Durogesic D- TRANS12mcg/hr (Fentanyl) (TDU12) 2. " ",, ( :8432) "!! 1. Doripenem Hydrate ( ) 2. " ",, ( :8432) "!! 1. ; TURNER'S SYNDROME ;PRADER-WILLI SYNDROME ; ; Small for Gestational Age(SGA) ; Seroquel 100mg (OSEQ) 3. " ",, ( :8432) "!! 1. (1) (2) (3) 2. Fentanyl25mcgTransdermal Patch (TFE25) DUROGESIC mcg/hr (TDU50-D) ( ) ( ) Apo-Haloperidol 5mg Binin-U.5mg 1. ( ) (Haloperidol) (Haloperidol) (OHAL5) (OBIN) Vancomycin 500mg Vanco INJ. 500mg 1. (Vancomycin HCl) (Vancomycin HCl) 2. (IVAN2) (IVAN3) Combizym (Pancreatin, Protase EC Cap 1. Lipase, Protase, (Amylase, Protease, Amylase) Lipase) (OCOMB) (OPROT) 2. 3.

25 ( ) ( ) Indocin I.V 1mg/vial Pedea IV 1. (Indomethacin) 10mg/2ml/amp (IIND) (Ibuprofen) 2.!! (IPEDE) 3. Merpurine 50mg (Mercaptopurine) (OMERP) Mitomycin C 2mg (Mitomycin) (IMIT) Merkaptopurin 50mg (Mercaptopurine) (OMERK) Mitomycin C 10mg (Mitomycin) (IMIT10) ( ) 2. ( ) Rasilez F.C. Tab 150mg 1. (Aliskiren Hemifumarate) 2. (ORASI) A >= ACEI/ ARB B. a. b. GFR < 30 ml/min C. :