麻酔薬および麻酔関連薬使用ガイドライン 第3版 Ⅰ …

1 5 -1 3 2009-2014 3 4 I 3 GABAA GABAA Cl 2 2 estazolam 6 oxazolam 8 diazepam 10 secobarbital sodium 13 zopiclone 15 dexmedetomidine hydrochloride 17 triazolam 19 nitrazepam 21 hydorxyzine pamoate hydroxyzine hydrochloride 22 flunitrazepam 25 flumazenil 27 flurazepam hydrochloride 30 brotizolam 32 bromazepam 34 pentobarbital calcium 36 midazolam 386 -2 3 2009 3 estazolam 1 1 GABAA / /Cl GABA GABAA Cl Cl 2 3 4 mg 24 2 1 2

2 3 1 1 1 4 mg 1 mg 2 mg mg 1 2 1 2 mg 2 4 mg 1 4 1 4 6 2 HIV P450 3 7 -3 3 2009 3 4 5 2 3 4

3 5 6 5 I II-a II-b II-c III 1 2000 1 p42 2 Safra MJ, Oakley GP Jr : Association between cleft lip with or without cleft palate and exposure to diazepam. Lancet 1975 ; 2 : 478-480 III 3 Rosenberg L, Mitchell AA, Parsells JL, et al : Lack of relation of oral clefts to diazepam use during pregnancy. N Engl J Med 1983 ; 309 : 1282-1285 II-b 4 Dolovich LR, Addis A, Vaillancourt JM, et al : Benzodiazepine use in pregnancy and major malformation or oral cleft : meta-analysis of cohort and case-control studies.

4 BMJ 1998 ; 317 : 839-843 II-b 5 Stewart CH : ; 7 1988 pp408-423 III I 8 -4 3 2009-2014 3 4 oxazolam1 1 GABA 1 2 2 3 3 20 mg 8 56 N- 120 N- 2- -5- 2- -5- -4- 4 2 1 2 3 3 1 1 10 20mg 1 3 2 1 2 mg/kg 50 kg 100mg 1 20 mg 1 60 mg

5 4 1 2 3 4 5 a b c a 6 7 9 -5 3 2009-2014 3 4 8 5 I II-a II-b II-c III 1 : No 22.

6 1977 III 2 : - CS-300 1970 : 47 ; 714-716 I 3 : Minor Tranquilizer CS-300 1970 : 74 ; 292-302 I 4 Yamazaki Y, Iwai T, Ninomiya T, et al : Pharmacokinetics in man following oral administration of oxazolam. 1980 : 32 ; 104-113 I I 10 -6 3 2009-2014 3 4 diazepam IX X 1 1 GABA GABA GABAA GABA Cl- GABAA 2 2 1 5 GABAA 1 GABAA 2 GABAA 1 GABA 1 2 3 5 2 1 GABAA GABAA GABA GABA GABAA Cl- 2 GABA 2

7 3 P450(CYP) CYP3A4 CYP2C19 tmax hr tmax hr 60 L/kg 1 2 2 1 2 3 4 5 6 7 3 8 9

8 11 -7 3 2009-2014 3 4 1 2 10 mg mg/kg a 10 20 mg b 20 mg 2 6 1 2 1/2 1/4 10 15 30mg 2 10 mg 1 2 4 15 30 mg 1 1 mg/kg 1 1 2 3 2 10 mg mg/kg conscious sedation mg/30 sec 4 3 mg/kg/2 4 hr 4 1 a b c d e a 6 8 b c d e f 2 HIV P450 3 4 I 12 -8 3 2009-2014 3 4 5 4 1 2mg 50

9 5 I II-a II-b II-c III 1 M hler H, Fritschy JM, Rudolph U : A new benzodiazepine pharmacology. J Pharmacol Exp Ther 2002 ; 300 : 2-8 III 2 : 2007 ; 56 : S1-S5 III 3 Young CC, Prielipp RC : Benzodiazepines in the intensive care unit. Crit Care Clin 2001 ; 17 : 843-862 III I 13 -9 3 2009 3 secobarbital sodium1 1 1 3 1 2 GABA 1 GABAA GABA 1,2 3 2 45 2 mg/kg 4 mg/kg 4 mg/kg 10 60 5 6 3 5 7.

10 8 2 4 mg/kg 30 40 g/mL 4 2 mg/kg/hr 4 25 g/mL 9 2 1 2 3 1 200 mg 4 mL 1 100 200 mg 4 1 5% pH 11 pH 2