??????? ??°? | ??????? ???? | ??????? ????

https://wh67.vijj.top
????????? ??????, ?þ?????? ?¼? ??????? ?????? ??????? ?????????. ????????? ???? 2003?? ??? ???? ???????????. ??????, ???? 4?? ??? ?????? ?????????? ?????? ????????? ??? ?е??? ????? ???? ?¶??ξ????? ??????? ????????? ??????? ??????? ?????? ??????.
1.100% ???????
????????? 100%????? ???????,?????? ???????? ?????? ????? ????? ????? ????????.
2.????????? ???????
????????? ???빰?? ???????????????????????? ?????? ?????? ???????? ?????帳???.
3.1+1 ????
??????? 1?? ????? 1?? ?? ?帳???.1+1?? ??????? ?帳???.
4.????????
????3???????? ???????ø? ????? ???? ???????.
??????? ???-????-????
??????? ??? ??????? ?????????? PDE-5?? ???????? ??? ???? ??????? ?????? ????? ?? ???????? ?ð??? ???? ª??? ?????? ???. ????????? ????? ???????? ?????? ???? ?? ???? ????? ???? ?????? ???? ???? ?????δ? ???????? ????? ????? ?????? ?? ??? ???? (??? ????) ????? ?????????? ?ð??? ?? ???? ?÷???? ????? ???. ??? ???????? ?????? ?????? ???????? ???? ????? ???? ??????? ??????? ????? ???????? ?? ???? ?????? ??????? ???? ???.
???? ?з?-?????? ???????? ???? > ???????ı??? ?? ??????? > ????? ???????ı??? ?? ???????
????-???? ????
????(????) ?????-??????????
?????????? ????-????
????? ??? ????-1???? : ????? ???????
???? ???-18?? ???
????-?????????
????-????
????-???
??????-???, 20
????????-????????, 25?????? ????
??????? ???? ?? ???????
1. ????
1) ???????? ?? ???? ???? ???? ?????? ??? ?????? ??????? ??? ??????? ???? ????? ?????????¸? ?????? ?????? ???. ?? ???? ?????? ??????? ??????? ???????? ??????? ?????? ????? ???????? ???????? ??? ??????? ????????? ???????? ??´?.
2) ?? ???? ??????? ???????? ???? ???? ?? ????? ????????? ????? ???? ???. ?½??????????(??: ?뵿?? ?????? ?? ???? ????? ?뵿???? ??? ??????)?? ??? ???? PDE5 ???????? ?????? ??????????? ??뿡 ????? ?? ???.
3) ?? ???? ?????? ?? ?迭?? ?????? 4?ð? ????? ????? ??? ?? ????????(6?ð? ????? ?????? ?????? ???)?? ???? ?????????. 4?ð? ??? ??? ????? ???? ???? ????? ?????? ???????, ?????????? ????? ??????? ?????? ???? ??????? ?? ??????? ?????????? ????? ?? ???.
4) ?? ???? ??????? ????? ??????? ???? ?? ?????? ?? ???? ?????? ???꿰 ???? ??? NO ?????? (????α??????, ??г?????????, ?????????????)?? ??????? ???? ???а???????? ??????? ??????? ?????? ?????? ?? ??????? ????? ?? ???? ?????? ???? ???? ???꿰 ???? ?? NO ???????? ???????? ?????? ?????? ???????? ???, ?? ?? ???? ?? ?? ???? ?? ???꿰 ???? ?? NO ???????? ???????? ????? ????????.
2. ???? ?????? ???????? ?? ??
1) ?? ?? ??? ?? ???? ???п? ???????? ??? ???
2) ???꿰 ???? ??? ???????(NO) ??????(????α??????, ??г?????????, ????????????? ??)?? ?????????? ??? ?????????? ??????? ??? (???а???????? ??????? ?????? ?? ????)
3) ???? ?????? ??? (Child-Pugh C)
4) ?????? ????? ???? ?????????
5) ?????? ??? (?????? ???? 90/50mmHg ???)
6) ??? 6???? ???? ?????? ??? ???????? ????? ???
7) ??????? ?????? ???
8) ???????? ???????? ??? ????(??, ??????? ?????? ??? ???? ????? [NYHA III ??? IV] ???? ???? ???????????)
9) ??? ????? ???????? ???? ????????? (??: ????? ??????)
10) ?????? PDE5 ?????? ???? ???ο? ???????? ??????????????????????(Non-arteritic anterior ischemic optic neuropathy, NAION)???? ???? ???? ???? ?÷??? ???? ???
11) ??? ??????? ??????? ???? ???? ??? (??? ??????? ??????? ???? ?????? ?????? ??????? ??? ??????? ??????? ??? ???????????? ?? ??)
12) ?????? CYP3A4 ???????μ? ?????????? ?????? ?????? HIV ????????? ???????? ?ε????? ??? ???????? ??? ?? ?????? ???? ??? ??? (6. ???????? ????)
13) 75?? ????? ???????μ? ?????? CYP3A4???????? ?????????? ?? ??????????? ???? ??? ???
14) 18?? ????? ????
15) ???뼺 ?????? ??? ???(sGC) ??????? ??????????? ???? ??? ??? ??? (6. ?????? ????)
3. ???? ?????? ?????? ?????? ??
1) ??????????? ?????? ?????? ??? (??: ??????, ???????? ?????? ??? ???δ??)
2) ?????????? ?????? ???? ?? ??? ?????? ??? (??: ?????????? ????, ???? ?????? ??? ??????)
3) ??????? ??? ????? ???????? ??? (??????? ??? ????? ???????????? ???? ???????? ?????? ???? ??????? ????? ??????? ?????/?????? ?????? ?? ?????? ???????.)
4) ??? ??? ?????? CYP3A4 ??????(?????????, ??????????, ???????θ???? ?? ????????θ???? ??) ??? ???????????? ???? ??? ??? (5. ??????????? ?? 6. ???????? ????)
5) ??????? QT ???? ??? ?? QT ?????? ??????? ?? ??? ???? ???? ??? ??? (5. ??????????? ????)
4. ???????
1) ????????? ??? ???????????? ?????? ???????? ????????? ?????? ????????? ?????? ????.
?1. ????????? ??? ???????????? ?????? ???????? ??????????? ?????? ???????
| ????? | ??????? | ???????(N=9155) | ????(N=5500) |
| ????? ??? | ???? ???????? | 11.1% 1.4% | 2.7% 0.8% |
| ???? ???? | ??????? | 9.6% | 1.1% |
???????, ???? ?? ???????? | ?????? ???????? | 4.2% 1.1% | 0.7% 0.6% |
| ?????? ??? | ?????? ???????? ?? ???????? ???? | 2.5% 1.1% 1.3% 1.1% | 0.4% 1.0% 0.4% 0.5% |
?????? ?? ???????? ???? | ?? ???? ???????? ?? ???? ????????????????? | 1.3% 1.1% 1.2% | 1.0% 0.6% 0.8% |
2?????????????±???????????????????????????????????????????????
?2.???????????±????????????????????????????????????????| ????? | ???????(??1/10) | ????(??1/100~ <1/10) | ??????(??1/1,000 ~<1/100) | ????(??1/10,000 ~ <1/1,000) |
| ???? | | | | ???? |
| ??????? | | | ??????????? ?? ???????? | ??????????? |
| ???? ???? | | | ???????? | ??? |
????? ??? | ???? | ????????(Dizziness) | ??????? ?? ??????? ???? | ??? ???????? ???? |
| ?? ??? | | | ?÷????? ???? ???? ?ð?????? ???? ???? ?? ???? ???ν? | ??л??? |
?? ?? ??? ??? | | | ??? ????????(Vertigo) | |
| ???? ???? | | | ??????????? | ?????? ???????? ?????????? |
| ???? ???? | | ??????? | | ?????? |
???????, ???? ?? ???? ???? | | ?????? | ??????? ???????? | |
?????? ??? | | ?????? | ???? ???? ?? ???????? ???????? ???? ??-?????????? ???? ???? | |
?????? ??? | | | ??????????? ???? | |
| ??? ?? ?????????? ??? | | | ??? ???? | ?????ι??? |
?????? ?? ???????????? | | | ???? ?????? ????????????? ???? ???????? ???? ?? ???? ?????? | |
????? ?? ???????? | | | ??? ???? | ?????? |
?????? ??? ?? ???????? ???? | | | ???? | ???? |
3????? 40mg??????????뷮?? 2?????????? 1??????????? 2?????????????????????
4???????????????뷮?? 2??????????ð??????????????????????????????????? 1?ð????/?쿵???????????????????????????λ????????????????
5???????????????????????????????磬???????????????????????????????????????????????????????????????ð?????????????°????ν????????翡????????????
6????????????????????????? 1????????????????????????????????????????????????¼??????????????????????????????????????????????????????????????????????????????????????????????????ο?????????????????????
7???????????翡???÷????????????¿??????????þ??????????????????÷°????????????½÷??????????????????????????????????????????????ο???????????¹????????????
8?????????ν÷????????????÷°??????????????º???????????????????????Non-arteritic anterior ischemic optic neuropathy, NAION????????????翡???????????????????????????? PDE5 ???????????????λ?????????°????γ????????????¾???????????κ?????????????????????????????????????????????????????????????????????????????????? : ?????????????????low cup/disc ratio, crowded disc???? 50????????????索?????????У??????????????????????????
????????????? PDE5 ?????????????????????ο??????????????????????????????????????????????????????????????????????????????????????±?????????????????????¹????????????
2????????~???????????????? PDE 5 ???????????? NAION?????????????????????????? NAION????????? 2????????°????γ?????????????? PDE5 ????????????? NAION??????????????????????????5.?????????????????
9???????????????????翡???????????°?????³????????????????????????????? PDE5 ???????????????λ?????????°????γ?????????λ????????????¿??????ε?????°???????????????????????????????º???????????????κ???????????????????????????????????????????????????ε????????????????????????????????????????ο???????????????????????γ???????????????????????????????????????????±?????????????????????¹????????????
10?????????65?????????????????? 20mg??????????????루16.2%vs 11.8%??????????????3.7%vs 0.7%??????Σ?65????????????????????????????????????????????????????????????????????????????????
11????????????????????
?????????????????? 6???? 3,156???????????????ν???????????????????????????????????????????????????? 2.97%??94??/3,156?? 109????γ???????磬????????????????????????????¾???????????????? 2.91%??92??/3,156?? 106?????????????????????δ¾????? 1.65%??52??/3,156?? 52????????? 0.98%??31 ??/3,156?? 32????????????? 0.19%??6??/3,156?? 6???????? 0.16%??5??/3,156?? 5????????? 0.09%??3??/3,156?? 3??????????? 0.09%??3??/3,156?? 3??????????????????????룬?α??????ð???????????????? 0.03%??1??/3,156?? 1????????????????????
????????? ?þ???? ??????? ??°? | ???? | ???? | ????
?????? ??????? ?¶??????????? ??????????? ??? ????????
??????? ????? ???뿡 ???? ???
- ????????? ????????
- ????????? ????? ??????
- ??????? ???? ?? ???????
- ??????? ???? ?? ???? ?? ??
????????? ?????? ?????? ????? ??????? ?? ?????? ??? ????????. ??????? ??????????? ?????? ??????? ??? ???? ?????? ?????? ????? ??????. ????????? ????? ????? ????? ????, ?????? ?뷮?? ???????? ?????? ????.
????????? ????? ????????? ???? ?? 30?п??? 1?ð? ???? ???????, ??? 5?ð????? ????? ?? ??????. ????ð? ??? ???????? ?????? ??? ?? ???? ?? ????? ?????? ?? ??????? ????? ???????. ????, ?????? ????? ??? ???? ????? ???? ???? ????????? ?? ????.
??????? ???? ????? ????? ???? ??? ??????? ???? ???? ?????? ????. ?¶??ο??? ????? ???к??? ??????? ????? ?????? ??????? ??????, ????? ????? ?????? ????? ?? ??????. ????? ???? ????? ????? ???????? ?????? ?? ?? ??????? ??????? ????.
??????? ???? ?????? ????? ??? ???¸? ????? ??????, ????? ??????? ?????? ?????? ?????? ???? ???????. ??????? ????? ???? ???? ?????? ?????? ???????? ?????? ???? ????.
?????: ???????, ??????? ????, ??????? ????, ??? ???? ?????, ?????????
??????????????
????? ?? ?????
?þ???? ??? ????
??? ?????? ???
?????þ?
????? ?? ?þ????
?þ? ???? ??????
?þ???????
?? ??? ?? ??????
?????? ????????
13m3wh67