PINGTUNG CHRISTIAN HOSPITAL 2011 No 13 PharmacyTime B... 3... 7... 8 60 08-7368686-1117 2 5 8 11
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B B B 300 (15-20%) B 50-120 B B B ealt 2 e (deoxyribonucleic acid, DNA) ALT 2 B B B HBeAg e95% B 85% 7.8% e6-8% 80% B 90% 5 25-50% 5% B 1. HBsAg HBeAg ALT ALT 5X 2. HBsAg HBeAg ALT 2X ALT 5X HBV- DNA 20,000IU/ML HBcAgD C 3. HBsAg HBeAg ALT ALT 2X HBV-DNA 2,000IU/ MLH cag DC B B 1. Lamivudine AdefovirEntecavir Telbivudine 2. α 3. α (Thymosinα) 3
4 B Lamivudine 1999 88 B 100 e e 3~6 6 HBV DNA300 copies/ml 2~4 15~20% B 2 40% 366% B Adefovir 2002 932 BDNA 酶 B B3 5 50% 30mg/d 10 Entecavir 2006 959 B 酶 B
5 0.5 1 2 15 Telbivudine 2007 967 (thymidine nucleoside analogue) B DNA 酶 (polymerase) e 600 52 76 e GOT/GPT 100mg e 2008 600 B B (BC ) 2 10% 20% 5 6 1.2% ( Interferon, IFN ) B α β γ α 3 ( B S ) α GPT 2~5α α
α α 20~40% α 30~40% 25% GPT HBV DNA α 參 1. 102 2. MICROMEDEX 3. 4. http://www.liver.org.tw 5. http://tw.myblog.yahoo.com 6. http://adr.doh.gov.tw α α 6
M2 M3 α1 β3 (α-agonists β-agonists) benzodiazepines (BZDs) selective serotonin reuptake inhibitors (SSRIs) nonsteroidalanti-inflammatory drugs (NSAIDs) calcium channel blockers (CCBs) 濳 methylnaltrexone methylnaltrexone anticholinergics antispasmodics musclerelaxants tricylic antidepressants ( ) Beersʼ criteria Beersʼ criteria chlorpheniramine diphenhydramine α-agonists αagonists α1b α1a/d α-agonists α-agonists ( pseudoephedrine phenylephrine ) α-agonists αagonists β-agonists ( isoproterenol terbutaline ) β-agonists β β-agonists β-agonists 7
Benzodiazepines (BZDs) BZDs BZDs ( clonazepam diazepam) BZDs ( )BZDs Selective Serotonin Reuptake Inhibitors (SSRIs) 1993Garnier 299 fluvoxamine 2007 Chung fluoxetine 54 30 mg fluoxetine fluoxetine 70 mg SSRIs serotonin serotonin 5-HT2 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Prostaglandin E2 (PGE2) cyclooxygenase(cox)-2 prostaglandin PGE2 tachykinins neurokinin ( :) NSAIDs COX( COX-2)PGE2 Verhamme NSAIDs 2.2 (95%:1.23-3.31) 1 COX-2 NSAIDs COX-2 PGE2 NSAIDs Calcium Channel Blockers (CCBs) 1999Meigs CCBs 2.2(95% :1.2-3.9) nicardipine CCBs CCBs BZDs SSRIs NSAIDs CCBs 參 1. Verhamme KM, et al. Drug-induced urinary retention: incidence, management andprevention. Drug Saf 2008; 31: 373-88. 2. Fick DM, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus 8
panel of experts. Arch Intern Med 2003; 163:2716-24. 3. Meigs JB, et al. Incidence rates and risk factors for acute urinary retention: the healthprofessionals followup study. J Urol 1999; 162: 376-82. 4. Rosow CE, et al. Reversal of opioidinduced bladder dysfunction by intravenousnaloxone and methylnaltrexone. Clin Pharmacol Ther 2007; 82: 48-53. 5. Drake MJ, et al. Drug-induced bladder and urinary disorders. Incidence, prevention andmanagement. Drug Saf 1998; 19:45-55. 6. Caksen H, Odabas D. Urinary retention due to clonazepam in a child with dyskinetic cerebral palsy. J Emerg Med 2004; 26: 244. 7. Garnier R, et al. Acute fluvoxamine poisoning. J Int Med Res 1993; 21: 197-208. 8. Chung AK, Chua SE. Acute urinary retention associated with selective serotonin reuptake inhibitors and ziprasidone. J Clin Psychopharmacol 2007; 27: 517-9. 9. Thor KB. Serotonin and norepinephrine involvement in efferent pathways to the urethral rhabdosphincter: implications for treating stress urinary incontinence. Urology 2003; 62: 3-9. 10. Verhamme KM, et al. Nonsteroidal antiinflammatory drugs and increased risk of acute urinary retention. Arch Intern Med 2005; 165: 1547-51. 9
Brand name Lendormin 250mcg/tab Indication Dosage 0.25 qd Contraindication CNS depression Side effect CNS depression Brotizolam C OLEND Pemetrexed Brand name Alimta 100mg/vial IALIM1 Indication cisplatin Dosage 21 500mg/m2 10 30 cisplatin 75mg/m2 2 cisplatin Side effect / Precaution 2. corticteroid D 10
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