강동경희대학교병원 약품정보지 - khnmc.or.kr

1 2014 12 VOL .06 circadin PR tab. 2mg ( ) I. / II. ( , : HH844) ( ) ( ) , ( ) : 2014 , , , , , , 134-090 892 [TEL] / ( ) [FAX] / circadin PR tab. 2mg (Melatonin) 1. 2. Melatonin 2mg 3. 4. Melatonin (pineal gland) (pinealocytes) 5.

2 55 6. 1 1 1 1~2 13 7. Tmax : 2~4hr (Vd): 35L Tmax : 2~4 ( ) : (CYP1A) (6- Hydroxylation Sulfation Glucuronidase) : ~4 : AUC .. : (~85%) : 630~960 mL/min 8. , , , , 1 2014 12 9. CYP3A fluvoxamine : - CYP1A2, CYP2C19 - nifedipine warfarin 10. 1) . 2) (galactose intolerance), Lapp (Lapp lactase deficiency) - (glucose-galactose malabsorption) 11.

3 : : 12. , (25 C ) .. Journal Review Prolonged release melatonin in the treatment of primary insomnia : evaluation of the age cut-off or short - and long-term response: Prolonged Release Melatonin (PRM) (Alan G. Wade et al., Current Medical Research & Opinion, 2011, 87-88) DSM-IV* 18-80 , sleep latency( ) 20 3 6 PRM . PRM 18-54 , 55-80 . 2 2014 12 , 1 sleep latency 55-80 ( vs , p= )(Figure 2), 18-80 ( vs , p= ).

4 (Table 3) 2 sleep diary parameters, PSQI** global scores, component scores, questione 2 & 4, CGI-S**. CGI-I**( ), WHO-5 well-being Index( ) 55-80 (Table 4). 6 , rebound insomnia . * DSM-IV : Diagnostic and Statistical Manual for Mental Disorders -IV * PSQI : Pittsburgh Sleep Quality Index CGI-S: Clinical Global Impression -Severity of Illness Scale CGI-I: Clinical Global Impression of Improvement Lasting treatment effects in postmarketing surveillance study of Prolonged Release Melatonin (PRM): PRM (G ran Hajaka et al., International Clinical Psychopharmacology, 2014) PRM rebound insomnia, prospective, referenced, cohort.

5 3 PRM , 2 (early withdrawal) 2 (late withdrawal) site . Sleep quality, Morning alertness , 1~5 , . PRM rebound insomnia 1 . 3 2014 12 , sleep quality, morning alertness (1~3 ) 42 ( ) 462 ( ), 87 ( ) 472 ( ) .( ) rebound insomnia , PRM ( ), PRM , .( ) , PRM , rebound insomnia.

6 PRM 55 1 , 2010 3 13 . Nightly treatment of primary insomnia with Prolonged Release Melatonin (PRM) for 6months : a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety: PRM (Wade et al., BMC Medicine, 2010, 8:51) , . PRM (18-80 ) (65 /65 ) (low/high) 3 6 PRM . 1 sleep diary sleep latency , PRM ( vs , p= ), (65-80 ) PRM.

7 ( vs , p= ) 4 2014 12 -I. / Special Issue 1 . - - : - - : , ( ) ( ) - : , , , , , ( ) - . KCl inj. 3g/20ml(40mEq) ( ) - - KCL . - : 80mEq/L - : 200mEq/L - : 10mEq . 20-40mEq/hr . - . - : [ ] (T , QRS , ST , P ).

8 , . - : .. NaCl inj. (40mEq) ( ) - : iv infusion . - - : , , , . - : .. Sodium Chloride 3% 500ml Bag - iv infusion . Masi inj. 50% 20ml (Magnesium sulfate) - : 20% . 40g/24hrs . - 2g/hr, 4g/hr . - : 4 knees up , , urine output.

9 ( ) II.. - - : - - : , ( ) ( ) - . 4 , , , . Heparin inj. 25000IU/5ml, Heparin inj. 20000IU/20ml - EMR (HOAP, Heparin order & administration program) . - , aPTT, ACT - - . - : (Protamine sulfate inj. 50mg/5mL) 1000unit mL (10~15mg) . 5 2014 12 2.

10 (vial) Humalog HumulinN 1000IU/10ml HumulinR 1000IU/10mL Lantus inj. Vial 1000U/10ml Novorapid inj. 1000IU/10ml Apidra inj. 1000U/10ml/V - ( ) - ( ) Actilyse inj. 50mg, 20mg Urokinase inj. 500,000IU , 100,000IU Urotine ,000IU - (look-alike), (sound-alike), - - [ !] , EMR , , , > Zoloft tab. 50mg[ !](Sertraline) - , , > IsopTIN SR tab. 180mg[ X] (Verapamil) - , , , , >Adalat oros tab.