Transcription of 腎障害時の薬剤チェックリスト - kure-kyosai.jp
1 5050 3130 11 10 2400 3600 3 - M 3 (MCLS - >80 40mg >50 20m 110 day - 1 max5mg - M3 AUC HD 11 * 100 300 2 350 1100 3 HD HD 1 50 HD 100 3 ** 1000 2000 2500 1500 2500 1000 250 500 * 15mg 15 Ccr<30 <15 - 15 S400 2 CKD 2012 <50 <10 - 20 30 /kg 50 4020mg/ 1 <40 HD.)
2 - 500 250 500 48hr 1 250 500 48hr HD ** - 15 * 10 1 2 - >60600 2400 359-30400 1000 229-15200 500 1 HD <5 * 1500 4000 3 <10 2 <30 - 20 160 1 2 - 1 6 1 2 - $ Ccr mL/ * Ca Ca 1 CCr50ml/min M 1(MAX5mg) 2 1 2 80 50 / 1/day Ccr<10mL/min - 20 60mg t1/2 - 100 150 2 3(MAX225mg)
3 25 50 25 50 HD HD 25 25 / 60kg ** 500 24 36hr 48 g 224 g 10 Ccr15 50 Ccr<15 eGFR 50>eGFR>31 30>eGFR>11 10>eGFR * eGFR CC <30 5 1 1 25 50 1 1 2 50 100 10 1 MAX20 10 ( (HD HD ) 14-5100 200 1 200 NSAID 500 1000 2<40 1 Ccr<15 10mg 2 80 60kg 2 5 21 / 5 5050 3130 11 10 eGFR 50>eGFR>31 30>eGFR>11 10>eGFR * eGFR CC KY 48hr <30 2 4 TDM 2 ** 300 450 325 1 * 50 100 25 50 1)
4 * $ 100 1 25 HD - 50 (MAX100mg) -<30 100 149-30 100 50 129-15 100 25 114-5 35 15 1<5 35 10 1 50% * 50 100 -<50 200 400 CKD 2012 <50 - 1800 4200 - 80 320 ECG HD S-Cr - 10 200 1000 HD 200 / - 400 800 1 4 HD HD HD HD * 75 1 <10 75 5 * 75 <10
5 * 10 50 - 1 HD <30 * 1 11 T E * 80 / 2 FU - Ccr 50 Ccr 30 AUC 21 150 600 325 125mg 1orHD 50mg ** AUC 400 2 - 1 1( /2 3 1 /2 3 /3 1 /3 /7 1 /7 /7 1 /7 HD * 1/3 2/3 100 750 75 1 1 24hr 150 2 75 2 HD 75 2 50-10400 600 3 ( 50 300 3 25 150 100 1 2<10orHD200 400mg 1 2or 3 400mg ( 1 1 2 4mg max8mg 4mg 1 100 2 3 75 12 / 5 5050 3130 11 10 eGFR 50>eGFR>31 30>eGFR>11 10>eGFR * eGFR CC 300 1200 2 3/4 3/4 - 25 3/4 - 59-40 900 450 39-25 450 1 450 24-10 450 450 2 60)))
6 1800mg 2 900mg 1* 3000 32000 21000 1500 1 250mg 1HD HD * 250 1 HD HD * 15 45 1 - 2 Max 3<20 1 Max 1 >20 <20 * 100 150 /dayTDM100 2 TDM 70-30 AUC 2 <30 2 AUC3 * 270 360 M1 3 1 HD - >501500 3<10250 148hr 250 3 * >50750 3<10125 148hr 125 3 * OD20 40 1 20 1 210 1 HD 20 * 300 220 2 5 4 30ml/min P 70 220 2 HD - 500 2000 1 2 - $ SR200 400 50<CCr<60 200 S-Cr>2 CCr<50 -Cr>2 * 25mg (eGFR15 29)
7 EGFR15 29mL/ 25mg * <50 30 -<30 10 110 2 1 10 3 1 10mg 1 10 1 HD 35%* 1500 4000 3 HD - 25 100 CKD 2012 <50 <10 - 150 450 * 1 1 (1 ) 1 1 - 1000 2500 1 50mg 1 50-101 500mg 1 1 2 20 2 3 1 10 15 10mg 15mg 1300mg 1150 300 200 1 2 ( HD 50-101 250mg 1 1 2 50-20 2 Max 2 3 / 5 5050 3130 11 10 eGFR 50>eGFR>31 30>eGFR>11 10>eGFR * eGFR CC ( ))
8 2 6 week - 100 600 50 /day 100 HD 50 600mg HD:50mg/ - 500 2250 <30 45 <50 ( -HD * M 10 15 CKD 2012 <50 <10 - 1 - 25 150 - AMPC AMPC - AMPC AMPC AMPC CAM - 6 16 / 6 16 / ( ) - 30mg 15mg 30 AUC,t1/2 - R300 20 50150 200 10 20100 - HD - 6 >50 50% - 160 S-Cr - 200 3 HD 100 200 - ( >60150 600 260-3075 300 1 330-1525 150 1 2<1525 75 1HD 25 150 >60150 450 260-3075 225 1 330-1525 150 1 2<1525 75 1HD 25 75 AUC t1/2 * 600 1 600 48hr (CC 30 60)))
9 - 5 10 1 HD HD * 10 (MAX20mg) F 15 HD HD - 200 1 CCr<50 8mg 2 4 16mg 2 Max24mg 10 Ccr<50 10 Ccr * 50% 50% HD <15 *50 75 5mg 5 20 1 ( 2mg ,MAX3mg 1mg MAX2mg 1mg MAX 2 S-Cr /day 5 10 1 4 / 5 5050 3130 11 10 eGFR 50>eGFR>31 30>eGFR>11 10>eGFR * eGFR CC 60 180 CKD 2012 <50 <10 - - HP M ( s))
10 <30 HD 3 1 2012 2 ( ( 5 / 5))
