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Deprecated: Function eregi() is deprecated in /home/dowontech/www_home/lib/common.lib.php on line 183
Deprecated: Function eregi() is deprecated in /home/dowontech/www_home/lib/common.lib.php on line 183
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¥ : 25-03-22 18:16
ȸ : 130
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 https://dlv7.viaplus69.top (83) | | | http://dowontech.co.kr/bbs/logout.php?url=https://dlv7.viaplus69.top%2 (79) | |
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????? 1+1???(20pack)
??? ?? ???
????????? ???
?? ???? ??????????, ???????(sexual stimulation)?? ????? ???. ?? ???? ?????? ???? ?????? ?? ?????????? ???? ??´?.
???? ?? ?뷮
?? ??????.
???? ?????????? ????
?? ???? ???? ?뷮?? 20mg???, ??????? ?? ???? ???? ??翡 ???????? ???????.
?????? (tadalafil) 10mg?? ?????? ????? ??????? ??? ??????? 20 mg?? ???????? ????. ?? ???? ???? ?? ???? 30 ?? ?????? ?????? ?? ???.
??? ???? ???? ?????? 1?? 1????, ?? ???? ???? ?????? ???? ???Ŀ? ??? ?? ???? ????, ?쿩?? ?? ???? ???????.
?????? ???? ???? ?Ŀ? ???? ???? ???????? ??????? ????, ???? ?? ???? ????? ???? ??? ??? ?????? ?????? ?? ?????? ?????????? ???? ??????? ???? ????? ???????? ??´?. [1.???? ?? ?? 11.1) ???????? ??? ?? ????]
???? ?????????? ????
???? ?????? ?뷮 ???? (dosage adjustments)?? ????? ???? ??´?.
????? ????? ??? ?????????? ????
???? ???? ????? ??????? ??? ?????? ?뷮?????? ????? ???? ??´?. ???? ?????? ?????? ??? ?????뷮?? 10mg???. [11.2) ?????? ??? ?? ????].
?? ???? ????? ??? ?????????? ????
???? ?뷮?? 10mg???, ??????? ?? ???? ???? ??翡 ???????? ???????. ???? ????????? ???(Child-Pugh Class C)???? ?? ???? ???????? ???? ???????? ?????????? ?????? ????, ????? ??????? ?????? ????/????(benefit/risk) ?? ????????? ???. ?? ???? (hepatic impairment) ?????? 10mg ???? ???뷮?? ?????? ??? ????. [3.???? ?????? ?????? ?????? ?? ?? ?? 11.2) ?????? ??? ?? ????].
?索???? ??? ?????????? ????
?索?? ?????? ?뷮 ?????? ????? ???? ??´?.
??? ?? ???????? ????
?? ???? 18?? ????? ???????? ????????? ?? ???.
????????
- ?????????? ????? ??????? ????? ?? ??????? ????? ?????? ???????뷮?? ?????????.
- ??????? ???? ?? ??????, ???? ???? ?????? ????????? ????? ?? ?????.
- ???о??? ???? ???? ???? ?????????? ??? ???????.
- ???????? ????? ??? ???? ?????????? ??? ???????.
- ????????? 4?ð? ??? ?????? ??翡?? ???????.
???????? ???????
[?????????(??????), ??????????-9182, 2021.01.05]
1. ????
1)?? ?????? ??????? ????? ??? ?? ?? ??? ?? ???? ?????? ???꿰 ???? ??? NO ?????? (????α??????, ?????????, ????????????꿰) ?? ??????? ???? ???а???????? ??????? ??????? ?????? ?????? ?? ??????? ????? ?? ???? ?????? ???? ???? ???꿰 ???? ?? NO ???????? ???????? ?????? ?????? ???????? ??? ?? ?? ???? ?? ?? ???? ?? ???꿰 ???? ?? NO ???????? ???????? ????? ????????.
2)????? ???? ???? ?? ??????? ??????? ???? ???????? ??????????? ???? ???? ???? ????????? ???????????? ???????? ???? ?????? ?????? ???????? ???.
3)???????? ????? ???? ?????? ???????? ?? ???? ???? ???? ?????? ??????? ???????? ?? ???? ?????? ????????? ??????? ???????? ???¸? ??????? ???????? ???????? ??? ??????? ???????? ????? ???.
4)?? ???? ????? ????????? ???? ??? ?????? ??????? ????? ?????? ???? ????????? ??? (???? ??밨??: 8.4/5.5 mmHg) ?? ??????. ??? ?????? ???????? ??????? ???? ?? ?????? ?? ???? ??????? ???? ????????? ???????? ????????? ???? ???? ??? ???????? ?? ???? ????? ???????????? ???? ????????? ???? ??????? ?????? ????????? ???.
5)???? ???? ???? ?? ???? ???????? ???????? ????? ????? ???????? ????. ?? ???? ?????? ??????? ???
- ???? 6???? ??? ?????? ??????? ???????? ????? ???
- ????? ??? ??? ??????? ???????? ??????? ?????????????
- ????????? (90/50 ???) ??? ????????? (170/100 ???)
- ????? ?????????
6)4?ð? ????? ????? ??? ?? ???????? (6?ð? ????? ?????? ?????? ???) ?? ???? ?Ŀ? ???? ?????????. 4?ð? ??? ??? ????? ???? ???? ????? ???? ?? ?????? ???? ???. ?????????? ????? ??????? ?????? ???? ??????? ?? ??????? ???? ?????? ????? ?? ???.
7)?½?????????? (??: ?뵿?? ?????? ?? ??????뵿???? ??? ??????)?? ???? ???????????????? ?????? ????? ???? PDE5 ???????? ?????? ??????????? ??뿡 ????? ?? ???.
8)?????????? ???????? ?????????? ?????? ????????? ???? ?????? ?? 11?? ???? ?????? ?????????? ??????? ?????? ?? ???? ??????? ???? ????????? ???. ???????? ???????? ?????? ???κ??? ???? ????? ??????? ???. ???????? ???????? ?????? ???? ?ð?????? ?????? ???? ???? ???????. ???뷮?? ??????? (200-800 mg) ?? ?????? ????? ?????? ?? ??ο???? ???? ????, ???, ?????? ?????????. ?????????? ??????? ???????? ??????? ???? ??????? ???????? ??????? ????????? ?뷮?? ????? ???? ??? ???? ???????.
9) ?? ?? ??????? ??? ????????? ???????? ??????? ?????? ???????????? ????????, ?????????? ???븦 ?????? ??? ??? ??????????? ?????????? ?????? ???????? ?? ?? (?????? ???????? ????)
* 1?? ???뷮????
?????? ????? WHO???差(40mg/kg/1??)????? ????(???????? ???? ????)?? ??.
60kg ???? : 1?? ??뺹?뷮 2.4g
2. ???? ?????? ???????? ?? ??
1) ?? ?? ??? ?? ???? ???????п? ???ι??? ???
2) ???? ?????? ???? ???꿰 ???? (????α??????, ????????????꿰, ?????????, ???????????????) ???? ?????????? ??? ?????????? ??????? ???
: ?? ???? ?????? ?Ŀ? ??信 ???? ???꿰 ?????? ??????? ?? ????, ???? ??????? ???? ?????????? ??????? ????? ???? ???. ????? ???? ??????? ???? ???? 100 mg ???? ?????? ?????? ?????? ????????? ??????? ??, ???? ?? 24?ð??? ???? ?????????? ?? ???? ???? ?????? ?? 2 ng/mL??? (??? ???? ?????? ?? 440 ng/mL).
?????? ???? ???? - ??, 65?? ????? ??????, ?????? ???(??, ???溯), ?????? ????? ???(??, ??????????????? 30 mL/min ????) ????? CYP3A4?? ???? ?????? ??????(??, ??????θ????)?? ??????? ???? - ???? ???? ?? 24?ð??? ???? ?????????? ?? ???? ???? ?????? ????? ????????? ?????? ????? 3-8?? ?? ???? ?????? ?????????. ???? ?? 24?ð??? ???? ?????????? ????????? ???? ?????? ??? ???? ?????? ???? ?ξ? ??????, ?? ???????? ???꿰 ???? ??????? ???? ?????? ???? ??????? ????? ???? ???.
3) ???????? ??? ???? ??????? ??????? ???????? ??? ???: ??????? ?????? ??? ???? ??????? ???? ???? ?????? ?????
4) ???? ?????? ???
5) ?????? (???? 90/50 mmHg ???) ??? ???????? ??? ?????? ??? (???? ?????? ???? 170 mmHg ???, ???? ???? ???? 100 mmHg ???)
6) ??? 6???? ??? ?????? ??????? ??????, ??????, ?????? ??? ???????? ????? ???
7) ????? ?????? ???(????? ????? ?????? ???? ?????? PDE?? ?????? ????? ????)
8) ??? ??????? ??????? ???????? ??? (?? ???? ??? ??????? ????????? ?????????? ???? ????????????? ?????? ?? ????)
9) ?????? PDE5 ?????? ???? ???ο? ????????, ?????????????????????? (Non-arteritic anterior ischemic optic neuropathy, NAION) ???? ???? ???? ???? ?÷??? ???? ???
10) 18?? ?????? ???, ????
11) ??????п??꿰(????)?? ???????? ???
12) ????????? ?? guanylate cyclase ????? ???? ??? (?????????? ???а???? ???? ?????? ???????? ????? ?? ????)
3. ???? ?????? ?????? ?????? ??
1)????????? ?????? ???? ??? (??????, ???????? ???????????? ??? ????δ??(Peyronie's disease))
2)?????????? ?????? ???? ?? ??? ?????? ??? (????????????, ???? ??????, ??????)
3)??????? ??? ????? ???????? ??? (????????????????? ?????? ???????? ????? ????????? ?????? ???δ?. ??????? ??? ????? ???????? ???? ???? ???????? ?????? ???? ???.)
4)?????? (????????? ????????? ??????? ???? ???????????? ??? ?? ???? ???뷮 (25 mg) ???? ??????? ???.)
5)???????????? (????????????? 30 mL/min ????) (?????????? ??????? ???? ???????????? ??? ?뷮?? ???뷮(25 mg) ???? ??????? ???.)
6)?????? ???(?????????? ??????? ???? ???????????? ??? ?뷮?? ???뷮 (25 mg) ???? ??????? ???.)
7)CYP3A4 ???????? ???????? ??? (?????????? ??????? ???? ???????????? ??? ?뷮?? ???뷮 (25 mg) ???? ??????? ???.)
8)???????? ???????? ???
9)?索???? ?????? ??? (?? ???? ?索???? ?????? ???? ???? ???????? ???????? ???????? ?????.????? ?????? ??????? ????? ?? ??????? ???.)
10)??? ??? ?뷮???? 100 mg?? ????? ????? ???? ??????? ???????? ?????? ?? ???.
11)???? ?????? ???? ???? ???????? ??? ???, ??????, ??????, ???????? ?????? ??? ?????? ?????? ???? ???????? ????? ???? ???? ?????? ???????? ???. ?? ???? ?????? ??????? ???? ????? ???????? ???¿? ???? ??????? ????????? ???.
???????? ???? ????? ?????? ??? ???? ??? ???????? ?????????? ???? ???? ?????? ?? ?? ???. ???????? ?????? ?? ??? ????? ????(??, ??????, ??????, ????)?? ?????? ???? ??? ???? ?? ????? ?????? ???? ?? ?????? ???? ??????????? ????????? ???.
12)???? ???? ?????? (???? ???????? ???? (Shy-Drager syndrome) ??) ?? ??? ??? (?? ???? ??????? ????? ????? ???? ????? ???? ????? ?????? ???¸? ?????? ?? ???.)
4. ???????
????????? ????????? ???????? ?? ?????? ???????? ???????. ?????뷮 ???????? ??? ????????? ?뷮?? ???? ???????? ?????????. ?????????? ???? ??????? ?????? ??? ?????뷮 ?????? ??????? ????? ?????뷮 ?????? ?????????.
??. 74???? ??????, ???????? 2/3/4?? ???????
???? ????? ?????? ????????? ???? ?? ???????.
???????(74???? ??????, ???????? 2/3/4?? ????) ?? ?????? ???翡?? ?????? ????????? ??? [? 1]?? ???? ?? ???????? ???????? ???????? ?????? ?????????
*?????? ???翡?? ?????? ???????
?????뷮 ???? ????? ?뷮????, ????????? ???? ??????? ?????????, ????????? ?? ??????? ?????????.
??. ???????? ???? ???????
1)6???? ?????뷮, ???? ???? ????????? ?? ???? ???差???? ???????? ?? ?????? ???? ????????? ?????????.
?ð????**: ????? ??????? ???? ???? (???), ???????? ????, ?þ? ??. ?? ???????? ?? ?? ???? ?????? ?ð???????? ???? ?????????, ????? ?????? 100 mg ??? ?? ????? ???? ?? ???? ???? ????? ???????.
2) 2% ??? ????? ??????? ?? ?????????? ???? ?????? ????? ????????? ?????? ????: ??????, ??????, ???÷??? ???ı?, ??????.
3)?????뷮 ???????? ?????? (17 %) ?? ?ð???? (11 %) ?? 100 mg ?뷮???? ?? ?????? ?뷮???? ??????? ???????. ?????뷮???? ???? ?뷮???? ?????? ???? ??????????? ????????? ?? ?????? ?? ?????.
4)?????? ???? ??????????? 6???? ?????뷮, ???? ??? ?????? 2 % ????? ?????? ?????????, ?? ?????? ????????? ??????? ???. ?????? ????????? ?? ?????? ???? ??????? ??? ??????, ?????? ???? ?????? ??????? ???? ?????? ??????????? ???? ?????.
(1) ????: ????, ??? ????, ?????????, ???, ??????, ????, ????, ?쿬?? ????(accidental fall), ????, ??????? ????, ????????, ?쿬?? ???
(2) ????????: ??????, ????????, ??????, ????, ?????, ?????????, ?????Т?, ????? ??????, ???????, ????????, ??????, ?????, ?????? ???, ??????, ???????.
(3) ???????: ??????, ??????, ????, ????, ???????, ????, ????, ?????, ??????, ??????????, ?????? ???, ???? ????, ?????.
(4) ????? ??????: ?????? ?????? ??????.
(5) ?????? ?? ??????: ????, ????, ???, ??????? ?索??, ????????, ???????, ??????????, ????????, ?????????.
(6) ??????: ??????, ??????, ????????, ???Ŀ?, ???????, ??????, ???????, ?????.
(7) ?????: ??????, ????????, ?????, ?????, ???????, ????, ??????, ??????, ?????, ??????, ?? ???, ??????? ????, ????????.
(8) ???????: ???, ???????, ??ο?, ?εο?, ?κ?????, ????????, ????????, ??ħ????, ??????.
(9) ??? ?? ?μ????: ?ε???, ???????, ??????, ????, ??α??, ??????ο?, ??? ??ο?.
(10) ???????: ??????? ??°??? ??? ???, ?굿, ????, ???ν??, ???, ????????, ????, ??????, ????, ???????????.
(11) ???????ı???: ????, ?????, ????, ???????, ?????, ????????, ???ı? ???? ?? ?????????, ?????? ???.
??????? ???????? ???? 1300 ??-?? (person-years)???, ???? ???????? ???? 700 ??-?? (person-years)????? ?????? ??????? ??????, ???????? ????????? ?м?????, ????????? ?????? ?????????? ?????????? ??????? ???????? ????? ???? ???????? ?????? ???????? ?????? ???????? ?? ????? ??????. ?????????? ?????? ????????? ???????? ?????? ?????? ???????? ???????? ???? 100 ??-?? (person-years) ?? 1.1?????. ???????? ????? ???? ???????? ?? ?????? ???? 100 ??-?? (person-years) ?? 0.3?????.
5)??????????? ????, ???, ????, ?ð???? ???? ??????? ??????? ??? ??????? ???????? ????? ???? ???.
??. ???? ?? ????
1)??????, ????????, ??? ??????, ???????? ????, ??????? ?????? ???? ?? ?????? ???? ????? ???????? ????????? ?? ?? ?????? ??????? ???? ?? ????????? ?????????. ?? ??? ?? ???κ??? ???????? ????????? ???? ??? ???????? ????? ??????? ?? ????? ?????? ???? ??? ???Ŀ? ???????? ????? ???? ?????? ???? ?? ?? ???? ???Ŀ? ????? ?????? ?????????. ????? ???? ?? ???? ???? ?? ?????? ???? ???ð????? ???? ????? ????????. ????? ??????????? ???? ?? ???? ?????? ?????, ???????? ?????? ?????, ??????????? ???? ??? ?????? ????? ?????? ?????, ????? ???ε??? ?????? ????? ??? ??? ???? ?????????? ???????? ????.
2)???? ?? ??????? ??°??? ??? ????? ???? ????????? ??? ?? ???? ?????? PDE5 ???????? ???????? ???????? ??? ?????? ???????. ??? ??????? ??????¿? ??? ???ε??? ??°? ????? ????????? ?????? ???? ??????? ???? ???????, ???κ??? ??????? ????? ???????? ?? ?? ??? ?????? ???????? ???????? ??ε??? ????. ????? ????????? ?? ???? ?????? ???????? ?????? ?????, ????? ???????? ??? ????????? ???? ??????, ????? ????? ???? ?????? ??? ?? ???? ??? ????? ???? ???????? ???????? ????.
3)???? ?? ?????, ?????Т?, ?????? ?????????.
4)???? ????????? ??-???????? ?????????? ?? ???????? ??????? ???? ?????.
5)?? ???? ??????? ???? ?? ?????? ??? ??????????? ?? ???? ???????? ??????? ??????, ?????? ??????? ??ε??? ???? ????????? ?????? ????.
(1) ?????: ?????
(2) ???????ı???: ?????? ?????, ????
(3) ?????? ???: ?????
(4) ????: ???ι?????
(5) ??: ????, ????? ?ð?????/?÷?????, ????, ?? ?????, ?????/?з?, ????????? ????, ??????????? ?? ????, ????? ???/???? ?? ???????? ????, ??????????????????????*
*?????????????????????? (Non-arteritic anterior ischemic optic neuropathy, NAION, ???????? ?÷? ?????? ?????? ?÷? ?????? ?????? ??) ?? ???? ?? ???翡?? ???? ?????????, ??? ?? ???? ?????? ???? PDE5 ???????? ???????? ???????? ??? ?????? ???????. ?????? ???????, ???κ??? ?????? ???????????????????????? ?????? ?? ??? ??????? ??? ???????? ????????? ?????? ?????: ???? ??????? ???? (low cup/disc ratio), 50?? ????? ????, ?索??, ??????, ???????????, ????????, ??.
PDE5 ?????? ?迭 ???? ??? ?????? ?????????????????????? ??? ?????? ???????? ???????? ???θ? ??????? ???? ???? ????, PDE5 ?????? ???? ?? ??????? 5?? ?ð? ??????? ???????????????????????? ?????? ?? 2?? ??????? ?????? ???????. ????? ???? ??????, ???????????????????????? ???? ??????? 50?? ??? ????? ???? 100,000 ?? ?? ???? 2.5-11.8?????.
6)???? ???? ?? ????????
(1) ??????? ??? 8,751???? ???????? ????? ???뼺?????? ????
???????? ????? ????? 8,751???? ???????? ????? ???? ?? ???뼺?? ???????? ?????? ??????? ???????? ??????? ???????????? 6.62 % (579??, 701??/8,751??) ?? ?????????, ?? ?? ?? ?????? ??????? ?????? ?? ???? ????????? 6.21 % (543/8,751??) ?????.
????? 3.75 % (328/8,751??)?? ???? ????????, ???? 1.83 % (160/8,751??), ?????? 0.23 % (20/8,751??), ??????, ????????? ?? 0.22 % (19/8,751??), ??????? 0.15 % (13/8,751??), ?ð???? 0.11 % (10/8,751??) ???? ?????? ?????????.
?? ??? 0.1% ????? ?????? ????????? ???????? ?з???? ?????? ????.
- ???? ?? ????????: ??????, ???
- ???????: ????, ????, ??????, ????, ????, ????, ???????, ?????, ???????????, ????????, ???????
- ??: ?þ?????, ????, ??? ??????
- ????????: ????, ???????, ??????
- ???????: ????, ??????, ???????, ???? ????
- ?? ?? ????: AST ????, ALT ????
- ????????: ???, ?????, ????
- ???ı???: ???? ?????, ???ı? ????
- ???: ????? ?????, ????, ???????, ???????, ????????, ????, ???????, ???, ????????? ????, ????, ???, ??????, ??????
???? ?? ???? ?? ????????? ??????? ???? ???ο? ??????????? ?????? ??????? ?????? ?? ???? ????????? ??????? 3??, ??????, ??? ?? 2??, ????? ?????, ?????, ???????????, ????????, ??????????????? ?? 1??? ?????????.
(2)????? ??????? ???? ????
???????? ???? ?? ????????? ?????? ??????? ?? ???? ?? ??????? ??ε??? ??????? ???? ???? ?? ???翡?? ?? ?????? ???????? ??????? ??? ?????? ?????? ??????????δ? ?? ????, ????????, ?÷?????, ????????? ????, ????, ??????????? ?? ????, ???, ??????? ?ð?????, ???????, ??????, ?????, ?????? ??? ???????.
?豹?? ??????? ????????? ?м?-?????? ???? ?????? ????????? ??????.
- ????: ??????, ????/?????, ????????
- ?? ?? ????: ????/???????
- ???????ı???: ????????, ??????, ?????
- ??: ?쳻??, ????
- ?????: ??????
- ???: ????
??. ????????? ???
?? ????, ?? ?? (?????? ?????? ?뷮: 25mg - 50mg) ?? ?????? 157???? ?????? ?? 40?? (25.48 %) ????? ????????? ??????????? 31?? (19.75 %) ????? ??? ?????? ????? ????? ?????????.
???? ?????? ????????? ????(20??; 12.74%), ???(16??; 10.19%), ?ð????(?????? 1??, ?????????? 1??, ???? 1??: ?? 3?? 1.91%) ?????. ???? ?????? ??? ?????? ????? ????? ?????????????(CK) ??????? ????????? ???? ???? 132?? ?? 9?? (6.82%) ???? ?????????.
?????? ????????? ?????? ???? ????? ???? ?????? ?뷮?? ?????? ?????? ?????? ??? ????????? ?????? ???? ?????? ????? ????? ???.
1): ????? ???? ?????? ???? ?????? ?? ?? ???? ????
2): ??????? ????????? ???????, ?? ???? ?????? ?? ???????? ??????? ???? ?? ???? ?????
5. ????? ????
1)?? ???? ???? ???????? ??????? ?? ????????? ??????? ???? ?????? ??????? ??? ????? ???????? ?????? ???? ?????? ????? ???? ????????? ???.
2)???????? ?????? ?????? ??????? ?????? ??? ??????? ???? ???????? ???¿? ????? ?????? ???. ?? ???? ?????????뿡 ???? ???а???????? ???? ??? ?????? ???꿰 ??? NO ???????? ???а???????? ??????? ?? ???.
3)??? 6???? ????? ??????, ??????, ???????? ?????? ???? ???????? ????? ??? ?? ?????? ??????, ??????, ???????? ?????? ??? ?????? ?????? ???? ???????? ????? ???? ???? ?????? ???????? ???.
4)????????? ???????? ????? ?????? ???? ???? ?????? ????? ???? ?????????? ????????? ??????, ?? ???? ???? ??????? ???? ????? ??? ??????? ?? ????? ?????? ???.
5)???? ?? ??????????¿? ????? ????: ????????? ?? ???? ?????? ???? ??????, ??? 100 mg ?????? ?? ?? ?????? ???? ?ð? ???, ???????? ???????????? ??????? ???? ???? ?? ????????? ???. ???? ???? ??? ?????????? ??? ???? ?????? ????? ?? ?? ???? ????????? ?? ???? ???, ????? ??? ???? ?????? ??? ???.
6)???????????? ???? ??? ??? ?????? ?? ???? ????? ??????? ???? ??? ?????? ???? ????? ???????? ?????? ?? ???. ?????? 25 mg?? ?????? ?? ???? ???????????? ??????? ???쿡?? ?? ???? ?????????? ???? ?? 4?ð? ????? ????????? ????. ????? ????? ???????? ?????? ??????? ????? ?? ???? ??? ??????? ???? ???? ???????????? ??????????????? ???????? ???????? ???, ??? ?뷮?? ???뷮???? ?????? ???? ????????? ???. ????, ????? ????? ???????? ?????? ??????? ???? ????? ?????? ?????? ???????? ???.
7)?? ?????? ????????, ??ε??? 5 mg, 10 mg?? ?? ?? 100 mg?? ?????? ?????? ???? ?????? ???? ???? ???а? ?????? ?????? ???? ???? 7 mmHg, 8 mmHg?? ?????? ???? ?????????. ?? ???? ??? ?????? ????? ???? ???????뿡 ???? ?????? ???????? ????.
8)?? ???? ??????? ??? ???????? ??? ?????? ???? ?????ð??? ??? ?????? ????? ????. ???? ???????? ????? ???????? ?????? ????????? ????????????????? ?????? ????? ????????? ???? ???. ?? ???? ???ĸ??? ?????? ?????? ?????? ?????ð??? ???? ???????? ?????? ?????, ????? ???????? ?????????? ???????? ????.
9)????? ?? (???? ??? ???? ??) ?? ??????? ?÷? ?????? ?????? ????, ????? ?? ???? ?????? PDE5 ???????? ?????? ?????? ???? ?????? ?????? ???????? ????? ?????? ???. ????? ?????? ?????????????????????? (Non-arteritic anterior ischemic optic neuropathy, NAION, ???????? ?÷? ?????? ?????? ?÷? ?????? ?????? ??)?? ¡??? ?? ?? ??????, ??? ???? ?? ???翡?? ???? ?????????, ?? ???? ?????? ????PDE5 ???????? ?????? ???????? ???????? ??? ?????? ???????. ??????? ?÷? ?????? ??????? ????, ?? ???? ?????? ??????? ???? ????? ????????? ?????? ????? ???.
???????????????????????? ??? ?????? ???? ??? ?????? ????, ???????????????????????? ???? ?????? ?????? ?? ????. ?????? ????? ????? ?????? PDE5 ???????? ???뿡 ???? ??????? ????? ?????? ???? ?? ?????? ??? ?????? ????? ???. ??? ?????? ?? ???? ?????? PDE5 ???????? ?????? ?????? ????? ?????? ???, ??????? ??????? ?????? ?????? ???쿡?? ??????? ???.
10)??????? ??°??? ??? ??? (????? ???????? ????? ?? ????) ?? ?????? ????, ????? ?? ???? ?????? PDE5 ???????? ?????? ?????? ???? ?????? ?????? ???? ???????? ????? ?????? ???.
11)?? ???? ???????? ???????????? ????? ??????? ????? ??????? ?????? ?????? ?? ????.
12)??????? ??? ?????? ???? ???? ??? ??????? ???캸?? ????????ð??? ?????? ?? ???.
13) ?? ???? ?????? ???????? ??????? ????? ?????? ?? ????.
14) ?? ???? ??? PDE5??????, ????????? ?????? ???????????(PAH) ?????, ??? ??? ??????? ??????? ???????????? ?????? ?? ??????? ???? ?????? ???????? ???????, ??? ?????????? ???????? ??´?.
6. ??????
1)?? ???? ????????? ????????? ??
(1) ???????? ???????? ????????? ?????? ??? CYP3A4 (?????) ?? 2C9 (?????)?? ???? ??????. ?????? ????? CYP-450 ???????? ????????? ???? ?????? ??????? ?? ???.
(2) ??????????? ??????? CYP-450 ???????? ?ø????(800 mg) ?? ????? ???????? ?? ?? (50 mg) ?? ?????????? ???? ????????? ?????????? 56% ?????????.
(3) ?? ???? 100 mg ????뷮?? ??? CYP3A4???????? ??????θ???? (500 mg, 1?? 2?, 5??)?? ???????¿??? ?????? ???? ????????? ???????(AUC?)?? 182 % ???? ?????. ??????, ????? ???? ??????? ???????? ??????? ???????? CYP3A4 ???????? HIV protease ?????? ???????????? ???? ?? ???????¿??? (1,200 mg, 1?? 3?) ?? ??(100 mg, ??? ????)?? ?????? ?? ????????? Cmax?? AUC?? ???? 140 %, 210 % ???????????, ?????????, ???????????? ???? ?? ?????? CYP3A4 ???????? ?? ? ?????? ??? ?? ???.
(4) ??????????? ???? ?????? ????? ?????????, ??????θ???? ??? ?ø???? ???? ???? CYP3A4 ???????? ?????????? ???? ??????? ??????? ????? ??????.
(5) ???????? ???? ???? ?????? CYP3A4 ???????? ???? ???? ?? ????????, ?????? ???? ?? ???? ?????뷮?? ????????? ?? ???? ???.
(6) HIV protease ???????? ?????????? ??? ?????? CYP-450 ???????μ? ????? ???? ??????? ???????? ?? ???????? ?????????? ??(500 mg, 1?? 2?) ?? ??(100 mg, ??? ????)?? ?????? ???? ????????? Cmax?? AUC?? ???? 300 %(4??), 1000 %(11??) ?????????. ????????? ??????? ?? ?????????? ?? 5 ng/mL?? ??? ??????? 24?ð? ?Ŀ??? ?????????? ?? 200 ng/mL?? ?????????. ????? ?????????? ???????? ?????? CYP-450 ?????? ???? ????? ?????? ????? ????? ?????? ?????.
(7) ??? protease ???????? ?? ?? ?????? ???????? ?????? ?? ?????? ???????? ?? ????????? ??????? ?????? ???????.
(8) ?????? CYP3A4 ???????? ???? ???? ?????? ???? ?뷮?? ????????? ?????? ????, ?? ???????? ????????? ??? ???? ???? ?????? 200 nM?? ???? ??????? ??? ?????? ????????.
(9) ????? ???? ??????? ?????????? ??????, ??????? ???????? ?????(CYP3A4 [???], CYP2C9 ????????? ?? ????? CYP2C19 ??????)?? ????????(125 mg 1?? 2? ????)???? ?????????? ??????? (80 mg 1?? 3? ????)?? ???? ??, ?????????AUC ?? Cmax?? ???? 62.6% ??55.4% ????????. ????????? ???????AUC ??Cmax ?? ???? 49.8% ??42%???? ?????????.
(10) ??????? ???? ??????CYP3A4 ???????? ???????? ?? ???? ??????? ?????????? ?????? ????? ???????.
(11) ??????(???????????/???????????)?? ??? ?????? ?? ???? ?????????? ?????? ????? ????.
(12) ???? ?????? ??? ?м?????, ??????????, ????ĸ??? ???? CYP2C9 ?????? ?? SSRI ????(?????? ???????? ?????? ??????), ????? ????????? ???? CYP2D6 ??????, ??????? ?? ?? ?迭?? ?????, ACE ?????? ?? ??? ???? ?????????? ????????? ???????п? ????? ?????? ????? ????. ??????繰?? N-??????? ????????? AUC?? loop ????? ?? ??????? ??????? ???? 62 % ????????? ??????? ??????????? ???? 102 % ?????????. ?????깰?? ???? ????? ?????? ????? ??????? ??? ?????? ?????? ??´?.
(13) ????? ???? ?????????, ??????θ????(1?? 500 mg?? 3????? ????)?? ??????? ??? ????????? ??? ?????????? AUC, Cmax, Tmax, ????? ????(elimination rate constant) ?? ????? ?????? ?????? ????? ????.
(14) ???????? ????ν??????? ?????뿡 ???? ?????? ????.
2)??? ???? ???? ?? ???? ????
(1) ???????? ???????? ????????? CYP-450 isoform 1A2, 2C9, 2C19, 2D6, 2E1 ?? 3A4(IC50: > 150 ??M)?? ?? ??????? ?????????. ?????뷮 ???? ?? ????????? ??? ???? ?????? ?? 1 ??M???? ??????? ?? ???? ????? ??????? ?????? ??????? ?????? ??????? ????.
(2) ???????????, ?????? ?????? ?? ?? 100 mg?? ??ε??? 5 mg, 10 mg?? ?????????? ???? ???? ??? ???п? ???? ???????? ???? ???? ???? 8 mmHg, 7 mmHg ?????????.
(3) ?? ???? ?????? ??? ?????????? ???? ??????? PDE ?????????? ?????뿡 ???? ?????? ????.
(4) ???????????, CYP2C9?? ???? ??????? ??????????(250 mg)?? ????ĸ?(40 mg)?? ?????? ???? ?????????? ?????? ????.
(5) ?? ??(50 mg)?? ??????(150 mg)?? ???? ????? ?????ð??? ?????? ????????? ????.
(6) ????????? ???? ????? ?????? 80 mg/dL?? ????? ????????? ???? ??? ?? ?????? ????? ???? ?????? ?? ???????? (???? 3.5 ?? 6.1 mmHg).
(7) ???????(100 mg)?? ????? ??????????? ???? ???????? CYP3A4?? ???? ?????? HIV protease ?????? ???????????? ?????????? ???????¿????? ?????¿? ?????? ????? ????.
(8) ????????? ???????¿???(80 mg 1?? 3? ????) ?????(125 mg, 1?? 2? ????)?? AUC ?? Cmax?? 49.8%, 42%????????? ( 1) ?? ???? ????????? ????????? ?? ????).
3)?????????? ??????? ??? ?缺 ???????????? ???? ???????? ???????????? ???????? (4 mg ?? 8 mg) ?? ??????? (25 mg, 50 mg ??? 100 mg) ?? ????? ?????? ????, ???? ????????? ?????? ???? ???? 7/7 mmHg, 9/5 mmHg, 8/4 mmHg?? ?? ???????? ?? ??? ????????? ?????? ???? ???? 6/6 mmHg, 11/4 mmHg, 4/5 mmHg?? ?? ????? ???? ?????????. ?????????? ??????? ??? ?????? 25 mg???? ?? ???뷮?? ????????? ????? ?????? ????, ?????? ?? 1?ð? ???? 4?ð? ????? ????, ???????? ?????? ????? ????? ???????? ?????? ?????? ???? ??????????? ????? ???????? ????.
4)???????????? ???뿡 ???? ???а???????? ?????? ?? ???.
5)??????п??꿰?? ???? QTc???? ????? ?????? ?? ???.
7.??? ?? ?????ο? ???? ????
1)?? ???? ???????? ?????? ?? ????.
2)?????????? ?? 200 mg/kg/day?? ??? ???? ????????? ???????? ?????????? ????? ???????????, ?? ?뷮?? ????? ???? ??? ???? ?뷮?? 100 mg?? ???????? ????????? ?? ?????? ?????? 60?? ????? ?????? ?????? ??????? ?? ?? ??? ??????? ???? ?? ???? ?? ?????? ?????????.
3)???? ????? ????????? ?????? 60 mg/kg ?????? ??????????? ???????????, ???? ???? ????? ?? ?????? ??? ?????? ????????? ???????? ??? ??? ?뷮?? 30 mg/kg/day?? 36??? ?????? ???????. ??????? ???? ??????, ?? ?뷮?????? AUC?? ???????? ?????? AUC?? ?? 20????.
4)??? ?? ?????ο? ???? ?????? ?????? ????.
8. ???? ???? ????
?? ???? ?????, ??18?? ?????? ?????? ?????? ?? ????(??2. ?????????? ???????? ?? ??? ????).
9.??????? ???? ????
?????? ????? ??????(65?? ???)???? ????????? ??????? ?????????. ???? ?????? ???? ???? ????? ??????? ???????? ???? ?????? ?? ??????? ??? ?뷮???? 25 mg?? ????????? ???.
10.???????????? ??
1)????? ??????? ???? ???????? ??? 800 mg???? ??? ?????? ???? ????????? ???뷮 ???????? ????????? ??????????? ??????? ????? ?? ???????? ?????????. 200 mg?? ???????? ?? ????? ???????? ??????? ??????? (????, ???, ??????, ??????, ?????, ?ð????) ??????? ?? ?????? ?????? ?????????. 100 mg?? ???????? ?? ????????? ?????? ???? ?뷮?? 25 - 50 mg ???????? ?????? ????? ?????.
2)?????????? ???? ?????????? ????????? ???. ????????? ???? ??????????? ???? ???? ?輳???? ??????? ???????????? ?????? ????????? ?????.
11.???? ?? ??????? ???????
1)?????? ???? ???? ??? ???? ???????.
2)??? ???? ???? ??? ???? ?????????? ???? ??? ???????? ????????? ??????? ??? ???????.
12. ???
1)??????? ?? ?? ?????깰?? ???? ?? ????????? (AUCs) ?? ??? ????????? ??? ???差?? 100 mg ???? ?? ?????? ?????? ???? 29?? ?? 42?? ?????? ?뷮???? ?????? ???? ?? ??????? 24???? ???? ???????? ?? ?????? ?????? ????.
2)????????? ??????(mg/m2) ???? ??? ??? ?????뷮?? ?? 0.6?? ?????? 1?? kg ?? 10 mg?? ??????뷮(MTD)???? ???콺???? 18-21???? ???? ???????? ?? ?????? ?????? ???????, ??????? ?? ??????깰?? ?? ????????? ??? ?????뷮?? ???????? ???? ?? ?????? ???????? ???? ???????.
3)???? ???????? ?? 1???????? ?? ???? ??????, 45 mg/kg?? 200 mg/kg ?뷮???? ??? ???? ????? (mesenteric arteritis) ?? ?????????. ?????, ???? ???????? ?? 6???? ?? ?????????? ???? ???????? ???????? ????. ??????? ???????? ?? 6?????? 12?????? ???? ?? ???? ?????? ??? ?뷮?? 50 mg/kg?? ???????? ?? ??????? ???? ???? ????????? (idiopathic juvenile polyarteritis) ?? ?????????. ????? ????? ????????? ?????? ??????? ???? ?????? ???????.
4)????????? ????????? ??????? ???? ???????? ??????? ?? ????? ??????? ???? ???? ?м????? ?? ???????? ??????? ??????? ???? ???????? ???? ?????????? ?? ??? ???콺 ???? ?????? ?????????.
5)???? AUC?? 25?? ????? AUC??? ?????? ?뷮?? 1?? kg?? 60 mg?????? ?뷮?? ??????? 36??, ??????? 102?? ?????? ???? ??????? ????? ?????? ????.
6)????? ???? ????????? 100 mg ??? ?뷮 ?????? ?? ?????? ???? ??? ???¿? ????? ?????? ????? ????.
7)??????? ????? ??????? ?? ???????/???¿? ???? ????????? ???? ???? ?????? ????.
Remen`s ???? 2+2??
?þ????20mg 16??+16??
????? 1+1??(200?)
????????(D8) 2+2??
?????? 2+2??
??????? 1+1??(60ĸ??)
?????? 1+1??(40ĸ??)
??????100mg 1+1??(60??)
????? 1+1??(20ĸ??)
?þ????20mg 8??+8??
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