16.การปฏิบัติงานระบบเภสัชกรรม

fll'jtJniWi~TU'j~UlJ!ilN"lffl'j'jlJ
s
'5'~'U'U,rID~!11 b'5'.:'WtJ1'U1~ (Formulary System) LN'V'lmu'")~il'WLtltJ,")tI~'1L~1~1~iln1~HmL'U'V'l,")~
••
~'")tln1~~il1'Wuru~tI'")LN'V'ltl,")U'")~iOlv:r'")~'1mm tInL1'Wn~ru~LL'V'l'VlUL~'W~'")~th tlil fl'n~9,") LU'W~'fl'l1~m'W'flnuru~m~ q ---" ~
•..•9 'i' d' • 1:V d ...,.~:v
1.unmsn b'5'.:I'rltl1'U1~~~1~.:In'5'tu1J~:::n'flU~'Jm,")t1n1~m'Vlflru~mJ'~n1n'J"llm~~'fl'W~(;l~~w 4 q
"', ,
~~L~'flnLL~~{~~'")mL~'")~'")9'")Wt.htl1'WLN'V'lmu'")~~'J~i1'1ntln1~mYl~'")tllJl~"l!n~~~1~~Un1~'fl'W~1~~~(;lLYi'flHq
nu~thtl1'Wh'l'V'lmu'")~(;l'")~~'")i'lLL'V'l'Vl~flru~m~~n1n'J"l!nn~'fl,")iOliiTv''W~Lb'W'J'Vl,")'1Lb~~~'fl'W1"11n1~i'lliDm~'")~~u
mU,")'1~,")t1n1~L~'fll~Ln~n'")~liDm1'WL~'1'V'lmU1~'flth'ltJ~'fl~Jitlbb~~b~~1~~~Uru~t11L~'1'V'lmU1~iOlv:r,")~'1mm{~~ q
1.1 tl1"l'lJU'l!:atl1'V1~mb~.:J"1i1~LU'W~1t1n1~m(;l1~tJ~~n1~flru~m~~n1mvi'l"l!1~~1'Wm
tJ~~n'flU~'JtlU'1J~ti'fltl5 U'1J~11~bbriU'1J~n, U'1J~"11,U'1J~fl, U'1J~'I U'1J~iOl(1)bL~~U'1J~iOl(2)
1rl'll~"'~lUUC1!~mEi'1lU5 UC1!~Iill~tJr::nlMru::nn~mrLL'vi~'lI1iii~hum ~'1l~UC1!~m",~mL'vi~'lI1iii'l'U'1.2551lii~cl'
"UC1!~n" "'~lUrl'll~~l numrm~1",rU~HnU'I'lm1J1f'lY.lm::liiu Ltlunumrmmlilr~lu~1il1umj'u'1l~nULLf'l::LLnl'lJ1:rC1!"'1~!lrn'l'l~'I'luti'1lU
ii",~n 31U'll1i1L"lU~'lUU'lltum r1il iitJr::'lu mmim r1il1utJr::LVIM1V1U'1lEil~'I'l'1lLWU~LLf'l::LtI'Wm~rl'lrl~ rum 1L~'1ln1ilLtlulluliiu urnIill~~'1lti~1il!l'1l~m
"UC1!~'il" "'~lUrl'll~'ll numrm~1il~1",rU~'1lti~1il",1'il1rrl1J1~'lIuli1~1ilm1uuC1!~ nhJ1~ ",1'1l1>il~~f'l",1'il1ilLtlumLLVlUm1uuC1!~n Iill~
rl'll~~lLtlU
"UC1!~rl" "'~lUrl'l1~'llrlUmrm~M'1l~1il1u1rrlL'il'l'l1::YI1~ tIi1U~'l11'W1C1!",1'1l~~1~ru~'1lU",mU"lln~~1'W'lUmr!l'1l~MnU'l'lm1J1f'lJu 1LIi1U
iJ~llilrm rn 1num r1il ~~'ltl1u'l'lm1J1f'l~1il"l::M'1l~iirl'll~'I'l'f'il~ ~~LLIiimj'1ih'ilu"luii~ nlriii Ii1lill~~f'lm rrm:n Lrt'1l~"llnu1n~~;:f Ltlum~ nl1ill>i QnM'il~
'1l1"lLn1i1~1:t",1'ilLiJUllUlilnU1ii'1l~u'lu",1'1lLiJU~lL",V!1~Lnli1L;('1l~'1lml~~lu ",1'1lLiJum~iJ LLU'ltU~Ium j'1ill>iIilN Iill~~'1lti~;{",1'1l1>i~~ril",1'1liJm nll1tJ1il
1uYl1~~tjIi1",1'1liJ",~n<ilU'lUU'llrum j'1il~~1 nli1",1'iliitJj'::~u m rrumj' 1il1utJr::LVIM1V1U'1lEil~~1nli1",1'1liln rll LL'I'l~n'llm~U 1unli~ L~tJ'lnuu ~ •
"UC1!~~""'~lUrl'll~'ll numj'm~iJ"'f'llu~'1lti~1il LLliiiirl'llW"'~1::'l~~"l::1ilLWU~1J1~~'1lti~1il",1'1liiLLu'ltu~"l::iimj'i~1ilml>iQnM'1l~ ",1'1l
LiJunumrm~iinmLL'I'l~ 9~LiJun~~m~iJrl'l1~~lLiJuM'1l~iJmn::1.j~'1lti~1ilLLf'l::~'1l'Wl!1mri~1ilmmr1iluC1!~m",~nLL'vi~'lI1iiiltJ~1~;S~1um1LUn~lU
rl'l rUl~'1lti~1ilLLf'l::~'1lUl!1nlri~1illtJtJr::n'1lu1urn j'W"llrrul'1llt~1i n1j'LUn~lUq~"l::n'1ltJr::tU'lIU~~~Ii1
i~ilm1uuC1!~ ~ ~lLiJuM'1l~1il~1",rU~U'lUUlmU LLIii'il1"lvll1~LnIi11l'Wli]j'1ulii'1l~u'lu"'1'1ln'1lUC1!"'lL;('1l~'1lm~lULLNmj'i~1ilm~'1M'1l~1~'l~
L"'V!~f'lLnli1rl'll~~~ril'l~tJj':: tU'lIU"l::M'1l~'1l1I'1Umj'1ilj''l"l1U"l'iluLLf'l::l1"l1run LIi1U~'l11UlC1!L'U'I'l1::trrl~l~fu mr"tJnsu j'~1U~l!111'l11~L~tJ'l~'il~"llnsmu
"tJn'1lm~",1'1l1~ru1Iil1ulilr",1'tmu~~'1l'1llt~1i"l1nLL'I'lVlEJ~rn",1miulil LL'I'lVlEJ'lrnLvilJU
LLf'l::1r~'I'lm1J1f'l"l::M'1l~iJr::uumrnlnutJr::Li1uLLf'l::lilr'l"l'l'1lumr1~m(Drug Utilization Evaluation, DUE) tli1uM'1l~iimrLiiu~'ill;lf'lmj'1~mL"'lilJUL~'1l
Iilr'l"l'l'1lu1u'1lulrllill~
"UC1!~"l" "'~lUrl'll~~l
(,,) rlumrm~l",fuLrlNmj'~LMl:t!I'rl-.lm::Yij''l-.l VlU'l-.lm~ ",1'rl",U'lU~lU!l'rl-.lfj ~iimj'nl"'UIi1'ifimr1~LL~::mj'iiili1lill~tJr::Li1umr1~mlill).J
LrlNmr tIi1Uii",U'lU-.lluJurU~Ii1'l1'1lU
(I!J) nEJmml~l",rU~u'lu~iirl'll~~lLiJUL'il'l'll:: ~~iimr4'li1nf'llnnf'l1~LiJuWLM1:t1'W1.'hnum1L~lii'lmrnEJ1Mrl'l1~rU~Ii1'l1'ilui'mn'W!I'il'lr::uu
tJj'::nu~!I[n'l'l!l'1l'ltJj'::LVlM~~~LLf'ltIi1EJnmUC1!~n~l'1(r::uU'l'r~~mrrn1:t1'1'lm1J1~~lrl'l1mr) m::YI1'Nmrrl~~ ~lun~lutJr::n'W~~rl~ m::YI1'l~LLN~l'W
LLf'l::~lun~lu",~ntJ r::nul1!1rn'l'lLL'vi~'lI1iii

1.2 t11'U'fInUt1J~t11'V1~mb ~~"1f1&i btl'WJ"wJn'lJ'm~1~n1 'WUJ'~n'lf'lltJ'ru~mVlin bb'lA'I"l!1~ bb~ibtl'W~ ~
I 9/ iI I
J'1tJn'lJ'mYl Aruen J'J'~mn ')"l!n J'J'~'el'W~~1~n91'V!'khtJ1 'WtHYlm1J1~ vl'ltlb~m.JJ'~ ttJ"l!'W1'Wn'lJ'(9Ibb~~m~1~lhtJ
q '" '"
2. t11'U'emutll~t11b'a~'V-ltl1'U1~ (Nonformulary Drugs) Vl1mb'V'l'Vl~nA,)1~b"'W~191btl'W~'el'l1~m~
hj'el~1 'WtJ'ru~m"1l'el'ltJ''1'V'lm1J1~ ~'el'l"1l'el'el'W~IOl1n ~~1'W')tJms tJ"l'V'lm1J1~Vl1'elnn~rn J'UJ'~bi1'Wn'lJ'1~m ~n~~qJ Q.I q cu
1~m'W'elrnl'1J~m tJ"l'V'lm1J1 ~Vl1'elbb1J1Jn1ri1Jrns 1~m
3. t11brPl-;'t13J~1'V11'UtJtJ'Jtlb'U'V-l1~'a1t1(Extemporaneous Preparation) mnn~nm1'WUJ'~b'Vlf'llbb~~
•••
bb'V'l'Vl~b~'W'elA,)1~91 btl'W'Vl1'1mru 'V'l'Vlt.Jb~'el1~ ri1J~lhtJ b'U'V'l1~J'1tJ1~ b~'W'elAru~mJ'~ n'ln,)"l!mJ'~~IOl1J'ru1 Vl1n ~1tJ
I '"
bJl~"l!mJ'~~1~1J't1 e.J~1911~1~1~ uri ~lhtJ b'U'V'l1~J'1tJ1911~~1~'1 bb'V'l'Vlt.Jwh'l!'W
'"
1. bb'V'l'Vlt.J~il~'Vlii'lm 1~bbribb'V'l'Vlt.J1.JJ'~91h'l'V'lm1J1~(Staff) bb'V'l'Vlt.JL9l'eltJ'el(91(Fellow) bb'V'l'Vlt.J1JJ'~91ih'W
'"I '" I
(Resident) bb~~bb'V'l'Vlt.JYll~~1Jn'lnbL9l'l19l'llOl1n ~~1'W')tJm J'tJ''1'V'lm1J1~ mruU~ 19lb,)"l!u.ntT~h~tJ'W11J~'1m ~'el'ln bb'V'l'Vlt.J~
'" ~ '"er I I 9/
n~'Vlfi~'1Hm~'1~1tJiJ'el~'eln1ri1J'VlnA~'1q
11J~,)'Wbb~~bb'V'l'Vlt.J91btl'W~'el'li'lm ~')m11Ol1 'V'ltJ11J1~~'el'l'Vl,)'W~1i'lm'el~1'1J'~~ (9IJ'~i'l Vli'llOl1mr'W bb'V'l'Vlt.J~'el'lb~tJ'W
i'lm~'11'W~1i'lm 1~b~'J~~ (9Ibvh~~1~1J't1Vi11~bbL9l1~A'Jnn'W24 {'J t~'1q
3. hJA'Jn~tJ'W~1~1 R.M. Vl1'elRepeat Medicine 1'Wb,)"l!J'~bUtJ'W
4. n'ln~tJ'W~1i'lm1'W11Ji'lm A,)J'UD1J1i(9)'1tl
4.1 b~tJ'W~')tJ~1tJiJ'el~!l1'Wl~~1mb~~-n (91blOl'W
4.2 'V'lmm~i'l1~mt(9ltJH~'el~1~ru'Vl1'1m (Generic Name) tJm~'Wm~btl'W~l9lJ'e.J~~
~ '"
I '" I
4.3 ~1~'1m A'JJ'nA,)1~ AJ'1J~')'W-n(9IblOl'Wvl'l~'elm J'Ubb1J1J"1I'el'ltJ1A,)1~ bbJ''1"1I'W1(9I1JJ'J'IOl';jfln'lJ'HtJ1
'" ,
iI iI j.I I
IOlih~'1mrnbi'hw'W vl'ltlb~'elA,)1~U~'el(9lJltJ1'Wn'lJ'Hm,
4.5 n'lJ'i'ltJ1 eJ1'WJ'~1J1J~1J'~'Wb'Vlf'll"1l'el'ltJ"l'V'lm1J1~ 1~uD~ 1911~bb'W,)'Vl1'1~tJ''1'V'lm1J1~n1V1'W(9I
5. mb~'V'l~(9I1~t'VlM1'WuJ'~bJl'Vl21~D~19l1~bb'W,)'Vl1'1n'lnunr.i1t.Jmb~'V'l~(9I1~t'VlM1'WuJ'~bJl'Vl 2 ('!j
b'eln~1J'VI~1m~"1I1)
6. mUJ'~bJl'Vlil9l'l'el'eln~'VliL9l'el~l9lbb~~UJ'~~1'Vl1~UD~19l1~bb'W'J'V11'1n1nUn91tJmrJl9lq'fl'fln~'V1ii?l'fl9l'l
bb~:;lh:;~1'V1(b'fln~1J'VI~1m~"1J 2)
2

,..
th:;n'elUWlnUnroi'u..ILL~dJ-n'WI?l'el'WlWUJL'eln~I~VI~lm~"lI3 nnllLLYlVltl1~.h:;uLVlI?l~~fllt11~:;f:lm:;U~ILU'W "fllmq q ClJ q
8. ntlWl~m~nlV1'W(?)L1'el'Wl"l1Wl~i'lHm~LLYlVltJ~'el'lL~t1'W1uih:;n'elUWl~i'l1~ml~LLri
8.1 m1'WU'1!~t11V1~mLvI'l"llI~U'1!~~(2) Lu'Wltll?ll~tl~:;Wlflr1ru:;nn~m~~l?J.J'Wl~::;UUm
LLvI'l"llI~L(?)tlfllV1'W(?)ntlm~m~mj'lH LL~:;LLYlVltJ~L~m"llI'1!t(?)t1~'el'lL~t1'WLLUUyJ'elf~Wl~Hm(L'eln~l~
VI~It1L~"lI4)
8.2 U'1!~m~1~b'WL'UYlI:;hr1~::;L'f'l~iJnr11~'lLL~:;'el~JlIt1b~Wl~r1'JU'1~(High cost cancer drug
under regulation, HCCD-UR) (b'eln~I~VI~lm~"lI 5)
8.3 ~1t1m~m~nlV1'W(?)~'el'Wl"l1~'el'lH1utl~::;n'elUWl~i'l1~m(L'eln~I~VI~lm~"lI 6)
9. m~LUml"llm~hJ1~ l~LLri
- ir1~'W~IV1~UU'el'ln'Whr1
- m~'l~1~H1'Wm~ulu(?)~mnhrolt(?)t1I?l~'l L"ll'Wm'W'J(?)L~'elU~nVlI'ellm~mL~'elWln~1~ml~
'l1'WVl1'eliJ~n~ru::;Wl~HLU'WLr1i'el'l~I'ell'l~L"ll'W~tJ LL"ll~Ylm~n~I~'J ~1 m~n~I~~~::;~I'W LU'W~'W
'" "
,
- 'ellV11~VlI'lmm YlVltJVlb~VlI'ltllnVl1'elVll'l~It1m'l
- mtl~::;IJlVl';j1?l1~'WLL~:;LLffill?l~Lu'Wm'W'elnuru~mVl~ nLLvI'l"ll1~q ~
- mUI L~I~ln 19i1'ltl~:;LVlflt(?)t1~JllWl"ll1(?)1Vltl Vl1'el'el'l~m~'Wl ~5'lhJ1~iJWl~~'WVl:;LiJtI'Wnu
rolru:;m~~Wl~'ellV11m~:;m
10. nl~i'l1~t11~U'JtI'W'eln
",,.. ,
10.1 m~i'ltllLLri~U'JtI'W'elnVlnrol~'lbihLYlVltJu'WVin~'lb'WL'J"ll~:;Lijtl'W~u'JtI'W'elnbL~:;L~t1'W~li'lm
" q "
, ,.. ,
~'lb'W1ui'lm Yl~'el~vi'l~It1~'el~'elLL~:;~,r~LLYlVltJ
10.2 ~:;t1:;L'J~1m~i'lroilt1t11 LL~:;~~fll m ~roilt1m~u'JtI'W'eln~Vlfi~I~I"ll rns tlJ':;n'Wi'l r1~LL~::;
" '", , ,..
~tJ'Jtlul?lJ'tlJ'::;n'W~"lIJlIYl~'J'WVlibi'lroilt1ml~hh1i'W 4 L~'el'Wl9i'elbUi'ltll1 bULL~::;~~fllm~roilt1t11rol~'l~:;hJLn'W
'" q "
100,000 U1VlnnllLLYlVltJi'lroilt1mLn'Wn~l~nlV1'W(?)bihLYlVltJLLtlnbui'lm b~nu~tJ'JtI
'"
10.3 ~u'JtI'W'eln~~I~UWl~~n~I'W'elnL'J~ln"llWl~~~'el'lI?l~'J~t~rol'Um~'WLL~:;~'el'lI?l~'J~t~rolL'J"llm~~
" q
vr'Jb1Jroilt1mhlLn'W5 i'W
11. nl~i'l1~t11~U'Jtl1'W'lI
11.1 Wl~i'lmLLri~U'Jtlb'W 1~LLYlVltJL~t1'W~li'lm~'lb'WPhysician's order sheet Vl1'el
,
••• 1 tr ~ cv ~ ~
LLUUy~'el~~Vlrolru:;m~~Wl~Yll?J.J'WI~:;UUL'J"ll~::;LUtI'W'el'W~I?lq
3

3. m~r.i1~m~'fl~1~'1d (Generic Drugs) V1(91bbVl'W~1~'tmuuH~r.i1~'t'Wnnll~bbl'~V1Ub~~'W~'fl~1~'1d
V11'lm (Generic Name) vi'f'flnnlJ~ml'lVl~1~~(91b~'W't~~'flmJ'~1(Trade name) ~1'fl1?l1~'lh~mf'l1"lJ'fl'lbHYimU1~
4. m~r.i1~m~1lJ't~dJniOl1n~'Wi'ln(91 't~tllJilliI?l1~~~dJ~umnunr.i1~rohfm~1~mU1'6'lI?l1~tl~~mPl
"lJ'fl'lm~V1~(F.Im~roli'l ~1'fl1?l1~tl~~m PI"ll'fl..:Jn'fl..:J'Vj'W(;]1..:J1
5. mJ'r.i1~mbbri~U')~~~~1'~~mJ'fm~1~mU1'6'l"ll'fl'l~1l1m"Jl1(911V1~ 1~r.i1~LVn~bb'W,)V11'ltllJu1i
b"li'Wb~mnu~1'~~mJ'fm~1~mU1'6'l~1~1"JlmJ' ~1'fl1?l1~~b~'l~mU1'6'ltl~~mPl b(91~~1i'lr.i1~m"ll'fl..:Jbb~V1UtlJ'::;~1
"
bN~mU1'6'l bvhw'W
6. mnunr.i1~~1"ll'fl..:Jliu,)~~V1fi~1'~~mJ'~1l1m"Jl1(911V1~ bf.l1V1ib~bb'6'l~m'flUrolf') '6'lnf.l1'li,)rol~1,) li1~fu
'lJ 'lJ 'lJ
"
th'W1'1d D.~l?lbb~V1U,rn~m~n~~1U1'6'l ,rn~~'W~"li')~~mU1'6'l bb'6'l~,rn~m~nf'l~bVlrolD.rol%tllJu1i~'ltl
n. liU,)~~'fl'l~'W'tui'lm~~'fl~b,)"JlJ'~biJ~'Wliu,)~~J'~umJ'~D.iOlll~hrol'lJ 'lJ •
"ll. bb~V1tJli~~V1ii'l't-n~11~bbri bb~V1tJtlJ'~~1bN~~1U1'6'l (Staff) nnn~bb~V1tJtlJ'~~1ih'WdJ'Wlii'l'lJ 'lJ
1-nm~'fl..:J~bb~V1Utl~~~1bN~mU1'6'l'6'l'l'6'l1~ij'fl~'flri1nu
o
mVl'W(91
n1'a~(9l1P11:JJbb~~'a1~.:J1t.!fI 'J1 :JJtJ~'fl (9l,n ~~1nn1'a1.~~11.'Ub'a.:J'Vi ~1'U1~
1Jfl'Cl1mVl1..:Jmru ~VlU'VJ n~ 1"ll1~Vl'ib~ bb'Cl~fl'J1l-J1U~ Vl'll'elU1'WmJ'ntJ..:J1'Wf1'J1l-JU'Cl'elVl.nm1 nrnr 13jjm1'W
bN~mU1'Cl i..:J1'W~1'Wfl'J1l-J~ Vl~'Cl1VliOl1nm J'13jjm'el1m J''fl'Whj~..:J1.h~~..:Jr1iOl1nm J'13jjm bb'Cl~~ u'W'JVl1..:JmJ'uBu~~
1 bb'W'JVl1..:JuBlliimJ'~runtJmJ'm1nM1~mU1'Cl~:LhtJ1'W (~b'eln~1J'Vll-J1m'1'l'll7 )
2 bL'W'JVl1..:JuBu~L~tJ'JnumHigh Alert Drugs 1'WbN~mU1'Cl'111'1'Cl.mnlr(~b'eln~1J'Vll-J1m'Cl"ll8)
3 Lb'W'JVl1..:JmJ'uBllii..:J1'W1'Wmru~:Lh~~'fl1mJ'hj~..:JuJ'~~..:Jr1r.nnmJ'13jjm(~b'eln~1JVll-J1m'Cl"ll9)
4 bb'W,)Vl1..:JmJ'uBu~mru~umJ'i..:J13jjm~~~uBffiml?i'eln'Wr'WbbN (Major drug interaction) 1'WbN~mU1'Cl (~
b'eln~1JVll-J1m'Cl"ll10)
4-

LL'J'J'VI1~n1'ii'LiJn"htltl1L~'W~ IPlbm'VI'IYb 'JtJ'ii'~LJ1'V1 2
1.LL'V'l'V1~lL'1fJ'Wrl1i'l1~t.J1L~'V'l~(?)1i:1t'V1111'Wlh~Jl'V12 LLt.Jnr.nn11Ji'lt.J1vf'lhj'V'l~'ilJ-m'W1JLLlJlJt.J~.5~m''iln~'ilJ-J~
••
" , ,
fldlJll'l'W( !?11J-Jm'~'V1d'l'l ~1fi1dru~"lInTI"'W(?))'V'l~'ilJ-J~'ld~1.J~fi1~t.J1 LL~~~'iltd~lf~''il'il1 n1dVl~'il'l1~t.J1
~ I r I
2. LL'V'l'V1Ulh~r,htN'V'lt.J11J1~Lvl11!'WVliJ~'V1fi~'l'W1J-J1'W11Ji'lt.J1LL~~LLlJlJt.J~.5
3.91'W'l'Wm~r.ht.Jl~ ~'lcl'
3.1 ~tht.J1'W1i:191t.Jt.J1f1J1.h~'V11'WLL~~t.J1LLtl~'ihl"1!'l91'W'l'WLvl1~1~91'lLL~~llJLn'W~¥'l~~7 r)'Wt.J1~(?)91t.Jt.J1
, "
91'W'l'WLvl1Vl1~91'lLL~~llJLn'W~f'l~~1 r)'W
3.2 ~tht.J'W'iln 1i:191t.Jt.J1flJtld~'V11'WLL~~t.J1LLtl~n'l'l-l1!'l91'W'l'WLvl1~1~91'lLL~~llJLn'W~¥'l~~ 1 L~'il'W(t.Jm~'W
Methadone syrup ~1'1-lflJ~tht.J91n~~iln9!?1 L'l"ll91t.JllJLn'W~¥'l~~7 r)'W)t.J1~(?)1i:1~'llJfjJ-Jn1d1~L'U'V'l1~~(?)1'Wh'l'V'lt.J11J1~
" , "
Lvl11!'WLL~~91t.Jt.J191'W'l'WLvl1Vl1~91'lLL~~llJLn'W~f'l~~ 1 r)'W
4.d1t.Jn1dt.J1L~'V'l~(?)1i:1t'V1111'Wtld~Jl'V12 ~m'WtN'V'lt.J11J1~9l41~'lnmn~LLri
•
1) Cocaine injection 10%, 10 mL
2) Fentanyl injection 50 mcg/mL, 2 mL
3) Fentanyl injection 50 mcg/mL, 10 mL
4) Fentanyl pad 12 mcg/hr
7) Meperidine (Pethidine) injection 50 mg/mL, 1 mL
8) Methadone syrup 1 mg/mL
9) Morphine immediated release tablet 10 mg
10) Morphine prolonged-released tablet 10 mg
11) Morphine prolonged-released tablet 30 mg
12) Morphine sustained release capsule 20 mg
13) Morphine sustained release capsule 50 mg
14) Morphine oral solution 10 mg/mL, 60 mL
15) Morphine injection 10 mg/mL, 1 mL
, "
'I-l~1m'l-l!?1- ihi'l'flu1.'WJ':;l-l~1'l{(?)~1tJJ':;n1~tNYm11J1~ t(?)rmnt"1JL~~L&1~1.'W~'fl2 dJ'W~'ll• 'll
'" I r I I
2. LL'V'l'V1Utld~91tN'V'lt.J11J1~Lvl11!'WVliJ~'V1fi~'l'W1J-J1'W11Ji'lt.J1LL~~LLlJlJt.J~.5 t.Jm~'W~tht.J1'WVl91LtJ'W~'il'll~flJn1d
fn111~'lt.Jt.J1L~'V'l&1(?)1.i:lt 'Vl111.'WtJJ':;Jl'Vl21.'W"ll'".l'l'W'flnL'".l~1J'1"lln1J'1i:1LL'V'l'V1Utld~91U1'WtJ3 :t'Wltl~1mdn~'l'W1J-Jl~

bbu 'J'VI1.:1 mst ijn~1t1!.I111P1r1'el'eln t'j'VI~ lPi'el~IPIbb~~t1'i~~1'V1
•,,, "
1. bbYl'VlUilr.l1tJtJ'lil?l~'fl'fln~'Vlfil?i'fl~l?lbb~:;tl~:;~1'Vlb'UVn:;Htiu~tJ'JtJ"1J'fllh.:JYltJ1U1~bVh,r'W
2. tl111P1r1'el'eln t'j'VI~lPi'el~IPIbb~~t1'i~~1'V11.t.ltI'i~bll'VI 2
•
2.1 b~t1'W~1il1~tnil?l~'fl'fln~vti~'fl~l?lbb~~tl~~~1Vl1'Wtl~~bJlVl 2 bbtln
ro
nn1uiltl1i'Jbtl
iI I Ir' I I I I
2.2 uYl'Vlutl~:;91U1'W~'WbtlVlij~'Vlfi~I'W1~1 'WluiltJ'l un b~'W1?l1~~'fl'Wb "1JbYl~ b~~Vl ih~'W(?)"1J'fll~1tJ mstn
i.I I I I
~tJ'JtJ'W'fln 1~djnr.l1tJhJ bn'Wf1t'I~:; 1 b~'fl'W~1'fl1?l1~ ~'fl'Wb "1JbYl~ b~~Vln1~'W(?)"1J'fll
'll
"
ntJn1~tJ'l,r'W1
I e: I '"
~1tJ~'fltJ'lil?l~'fl'flnq'Vlfil?i'fl~l?lbb~:;tl~:;~1'Vl1'Wtl~:;bJl'Vl 2 Vlij1'WtNYltJ1U1~r.rY:r1~,mn-W ;111
Ephedrine injection 30 mg/mL, 1 mL b'ill'l1:::~1tJfjlt1!t1Jfj'Vlt.l1 '.-I!l~thtJ ICU LL'Cl:::ml'Jm'J<Jlf"11~1?l1
~m;u'W
Flunitrazepam tablet 1 mg
Zolpidem tablet 10 mg
Methylphenidate tablet 10 mg L'ill'l1:::LLl'l'Vlcl'tl~:::41Ldll'lt.l1lJ1'Cl ~1tJ~1?lL'J<Jlf"11~1?l1WW'JtJ
l.h:::~ 1'Vlfj'Vlt.I1 ml'JtJ~ W-J'W1mn91ry L~lJLI?lLL'Cl:::fl~i!n fl'J13-J
~rnun~'lJ!l,.m1d''W!l'WWirlJ bL'Cl:::LLl'l'Vlcl'Ud':::41U1'WU3 bL'Cl:::U4
Methylphenidate extened release
tablet 18 mg
tablet 27 mg
tablet 36 mg
b'ill'l1:::bbl'l'Vlcl'Ud':::41Ld'll'lt.l1lJ1'Cl ~1tJ~l?lb'J<Jlf"11~I?lf m .•'JtJ
Ud':::~1'Vlfj'Vlt.l1 ml'JtJ~W-J'W1mn91t1! b~lJLI?l
Midazolam tablet 15 mg
1) b'ill'l1:::bbl'l'Vlcl'Ud':::41bd'll'lt.l1lJ1'Cl ~1tJ~ I?lb'J<Jlf"11~I?lfLvht!'W
bL'Cl:::r.l1tJ13Jbn'Wflfl'Cl:::1 Lt1!l'WbL'Cl:::hhn'W41'W'J'W30 biJrn
2) b'ill'l1:::Ul'l'Vlcl'Ud':::41h:Jl'lt.l1lJ1'Cl l·ih ~!lVi1'rl?lnmd'l'W
LNl'lt.l1lJ1mL'Cl:::i'l'·htl1~flf'l'Cl::: 1 LiJ(?)

Midazolam injection 5 mg/mL, 1 mL
Midazolam injection 5 mg/mL, 3 mL
, .,
tr(;1bln'lj1'Wh:rV'mlul~ i'lr.llt11~flf'l~::: 1 ~~'ilWl
Pseudoephedrine tablet 60 mg
Pseudoephedrine 60 mg &
Triprolidrine 2.5 mg tablet
Pseudoephedrine 30 mg & Triprolidrine
Syrup 1.25 mg/5 mL, 60 mL
Pseudoephedrine Syrup 30 mg/5 mL,
60 mL
ll'l'mETi'lr.lltlm1~tWltlhi~'il'llltl n"'l1nIu i'l m vr'J11J
nnn~thtl'W!Jn..
, .,
ll'V'l'VlETi'lr.llt1mhlln'Wflf'l~:::2 "1I'JWI
Alprazolam tablet 0.25 mg , 0.5 mg
LL~:::1 mg
3. !I1-J1?I'}'fl'fl n'1'VIt~'fl~ I?Ibb~~tI'a~~I'V1i. uti 'a~bll'VI 4
3.1 LL~'Vlthh:::~lih'W~'W1u~~~'Vti'tl'l'Wl~1 'W1ui'l m ~1'il (;11~~'il'W1"1IL~~ L~~~ nl~'WWI"1I'il'ljlt1mJ'tI1
, .,
3.2 mnunrohmn ~thtJ1'W1~Lun91tJ(;11~~I'W'J'WL'VhYl1.jj91'l~thtJ'W'iln1ihun91tJhJLn'Wflf'l'tl::: 3.. ~
r , .,
ntJ mJ'tI11' (;1~'il'il nq'Vlfl~'il~ ~LL'tl:::UJ':::~1'Vl1'WUJ':::I.ll'Vl4 Yl~1'WtJ''l~tI1Ul'tl'1Yl'I'tl'l mnJ ;'ltl
1) Chloral hydrate syrup 500 mg/5 mL, 30 mL
2) Chlordiazepoxide & Clinidium Bromide tablet 5 mg/2.5 mg
3) Clobazam tablet 5 mg
4) Clonazepam tablet 0.5 mg LL'tl:::2 mg
5) Clorazepate capsule 5 mg
6) Diazepam tablet 2 mg bL'tl:::5 mg
7) Diazepam injection 5 mg/mL, 1 mL
8) Lorazepam tablet 0.5 mg LL'tl:::1 mg
9) Phenobarbital tablet 30 mg LL'tl:::60 mg
10) Phenobabital injection 200 mg/mL, 1 mL

.. '
v t-v et
V1'lIlVrml1 1 ~Hl1flll 2555.
'J;,!UCll-l
"} 'mr~v11,rllln1{J"i:. m'1~NflTll'll.gfJ1 KED !llm11~'md'iA-f 1'1~'~~tltJ11"ED. ,
I tjlhmf>31lJ'~'~tlm"~:'llJhnU~I~mJJ~flU1Jfll'HUfl~l(Jcnl'ED ~}Yu~ill I
••
B'{)~rn
1. 11'1~11"t1lJ!HI'lNo1u'1JJ~CJlt1lJliJ}'m iHii~~m.h~fltlUfll'lIUfl~lUtJll'EDh1'm~lh~.
I
}.I ,,; q ~ J. .!
- ll'D-lV11i1fJ !U'l1JHH!VHJu'i!tlU1Jfnl
!Ufl~lmJl KED Hl-lu'IiJkU.Jll~!ihH1RT1~llJ
'._I ~ , ~ YY_'f
U'l;;fHJUtllHUfl1l1tJCllNED rHflu'1U'J
liJfl~ism NED ~I'lvii)lirnrWlU{Ul~;'lfl'l'rH'I'hfli'
"~fl mh <MuG
!I1i~'l11~uulu~u·iB·.j!l~iJU'i!;T)uU!11nUi'~Win
i1:D mlllu!ft~ v

+"",-",~
~"""'-*'
A
'IIh'll IlHl1!d . ......•......... 11t>•.
J
<I
•. rHfjf>Jil'ltIHlm1itlHlOfltJtVio1'11ti'mnh'lniij
A. IOtltllllII'liilnht;i'mfllllltlltf1(1Hl~(J ttiflTuJ'ml,nfl'lmi'uJ¥o m.ll mi~1fl;;
o. Hat) 1T1!1lI!'lilfl ~III71mlmHtiH 1'1ii1';!n'1111it~1iamftmHil'liltlin l.WlHili ton ~ 11H11l1ftliIHilJ
C 'hjJJnt)lJtn1Hii'ljJ1icmnrl1miH'I;T11t'H P¥l~tl'lJiJjJWIllJ'D 1.tlul1HlI11%tJ n'of il11yfflti.tlfri1 ;flm~djrrllHti'wll1i'1l11lJ
t1)U,fn11l1l11i tlllll1HlIttl!
o. ~lhlJiif)1'1::1I1nhtl~ltm"~i.llhjiiil!1iBtjltltl1£Jl1r (absolute <:mllrllllltiii.:3Iiwl) H~fJii1rI'H!lIJr1 n1f!t111I!jil!~11IJilH(nd.l
C')l1traindicnletlis.eriousirIMjoT drug interaction 1114thu ~llrhft!o·~''0 crlnlOI1~u:lb;1.x
r. l.nhniqJ1ilrlm1Wni '1fli1ibl lHlHtl'l1 ('UltiJfl1m~u.{l
f. Jlhtl!lfHHH) m~nl!lt)~ni1 il'Ui1 llijJ}
illl:nJ11IJd¥!60I'lfll'iliU111l'utY;1l1HifmlliuI1VlUil¥»n'utu;ml1flant)'lUHfihtr~lth/lnmfllffhillun'$o1,rOlnitinfI'ti
,
1l!f"J~'lt:I1itrn:j~tt)Ul100thnfJ!lmliHtnl1';InUOmJru~tJ11lalluti'llllfiocl,murfil'J;jfiofil11h::dl1!'UO'I~"1'j')'l)aOll"V '~

~" "1'·1nVl1Jl!1l ~ Hl !1·Ir11 .11
" .1 '"
IS73l'1'i. '11Jl1 4 H~1~lJ'llnU
1l9l 'P11 O~mm·l10)30
.~ ! ID .td
f!k '~$ ;;:m ,&,.;
q V.~.I' ...• ?'i :1 v ,::v d -v, t· , ,~
ll'iW'~u'JU1U1iU''tfUlllenUi~r)ltlnHmllllHJWI
'Wtl~l (l.nmnmu i UVfm[~!rul).•............................•......•.......... .,................•....... lul.h'tmJtll'lf.~nn<).!fD'mflll~ 1 .~
"'t ".1' ~ .••.",,. ~ tl ,.. >'iJlU'UUtn1li1Jhl IHIW 1J1fl~rnMji".l~m; l'Hfltll .•.......•...•" .....................•..•..........•..........•IMm illl fl1tj 11.1......•••.......•.......•.•.....•..•.....•
It ~ "'1 ~ .:a1 •• ~ ..., j Sf - ~ ~! -y ja?
ImmlJ1l'i il1:I1Tl'HH!.! lnMIN1"~flHII nJintti'l ...••.....•.•................••......................•....." ................•.....•...•.~[nm ~') ~ib61JfnUJv'lmHHH "If
.-
In .! 0 rnjUJ~!.n 11'nfHb~i~'in;'; 1lun 1'1IIlfH!R·l ~D' liil. .
1i1 , - oiJ":';, .v ., 4
*' 1fU'lIlli'Y'lItmm: l1U1JH)I)UqjYtIllHm1Hi4Yllil
A B C D E F
A B C D E F
A B C D E F
A B C D E F
A B C D E F
A B C D E F
2
4
s
6
" lliflwll"'iJ~J)n'{tJ)"onU~;uninfll.ni4'lnn
••• l<1 ,~ .1 " •• 11'; ~Vljl~ ~ '" ~ , •••
A. tTl9101tnl!llVNu'ttU'Ftll1mnH'HHlfl!nmmmo!'l1 311. I!'lWl1H'lfl mnli'l
B. Hrmnlf1j "lim ltl!~">l UltllUr 11Ll:K~tI11tniflj1itJ1H6'na l1'J'ttl?lfI11J'M11Jmfi'i' 1.1nWi'flt:l1U 1:1" u ~
C. 'hj~n~lIfn 'h~';W;lJ1W~flUH'4'l1l~1n<¥ Ilf,lfHh!J~fnllJ91l11uH111 '1'El,clRW, eU~H'~'l~~l.HltilEl.l;1~n!')fh4nmmmt rn'Hlfl1)
'*' 'iJ ' ~
il1fflJHIltU
".' '" ..,1 ./., < v 1 < ". ". . • - "' ••• ".. 't"'~ ~ ••, ~.
D.. JJtJ1tmn 1;UHI Hrn"I~J'O'llU (IJ"IHWHi'i iJHU(ab:;cJu~ curraiadicarioe) n ~'O'HUJrJ 7'~lf1;.IU(IJ'ln111l1
(contraindicated/serious, major drug iuteraCtion) ~~I11gh~u'fiB~l~!)cimlftfll~fH'li'~
E. !Jl'.Illru~tJnthnmi11fI~iJll1111l1"~n"h(iUl;4t11'lIJfi'mtl)¥ ,
F. GihIJHn'YHfl11IilinH~c~ 11 (tUI/hiLi~)
'l-l~O ...•.. >< ••••• " •••••• ~ ••••••••••••••••••••••••••••••••••••••••••••••••••••
(.....•........•" - ....................•• )

bb'IJ'lJyj'f)hJfl1r"'lJm~HtJ1Botulinum A toxin
~'f)'ll~H b~flfl'f)ii(9l (cervical dystonia) '1ltJ(9lhj'VIn'IJ~1b'l,.ll7!(idiopathic)
~'f)'ll~H b~fl1'IJ'I,.I{bm:::l?lnfli~~n (hemifacial spasm) 'lltJ(9lhi'VI~1'IJ~1b'l,.ll?l(idiopathic), ,
bb'IJ'lJyj'f)hJfl1r"'lJm~HtJ1Human immunoglobulin, intravenous (IVIG)
~'f)'ll~1:nhflfll'd1'llln~:::rJ:::b~rJ'IJ'V'li'W(acute phase of Kawasaki disease)
~'f)'ll~Hhfl1Jil~~n'W'lJn'V'li'f)~uj~1Jil (primary immunodeficiency diseases)
~'f)'ll~1:nb~fl idiopathic thrombocytopenic purpura (ITP) 'lltJ(9lt'WbbN
~'f)'ll~H autoimmune hemolytic anemia (AIHA) ~hJI?l'f)'IJ~'W'f)~1>i'f)m~fm~n[9]1~.ff'W[9]'f)'W'lI'f)~m[9]~j1'Wm~fmnm'l:::~
'f)1m ~t'Wbb~~~'f)1~dJ'W'1i'W[9]~lrJt1~bbri~';J[9]
~'f)'ll~1:nGuillain - Barre syndrome ~~'f)lm~t'WbbN
"~'f)'ll~H b~fln'ih~bu'f)'fi'f)'WbbN'lltJ(9l~lrJ~:::rJ:::';Jn~[9](myasthenia gravis, acute exacerbation '1,.11'f)myasthenic
crisis)
~'f)'ll~H pemphigus vulgaris ~~'f)lm~t'Wbb~~ bb~:::hJ[9]'f)'IJ~'W'f)~1>i'f)m~fm~n
"(9l'drJ~ll?l~~l'W
os
~'f)'ll~1:nhemophagocytic Iymphohistiocytosis (HLH)
bb'IJ'lJyj'f)f~fhi'IJm~HtJ1 Letrozole ~'f)'ll~H ~:::b~~b~l'W~~~hormone receptor biJ'W'IJ'dn
bb'IJ'lJyj'f)f~fl1r"'lJm~1:ntJ1Leuprorelin acetate
~'f)'ll~HJl1'd:::central (gonadotrophin dependent) precocious puberty
bb'IJ'lJyj'f)f~ihn'IJm~HtJ1 Docetaxel
~'f)'ll~H ~:::b~~b~l'W~~:::rJ:::~mn~
~'f)'ll~H ~:::b~~U'f)i?I'lltJi?Inon-small cell ~:::rJ:::~n~l~
~'f)'ll~1:n~:::b~~1>i'f)~~n'l,.lmm:::tJ:::bb'V'lim:::~1rJ
bb'IJ'lJyj'f)f~nln'IJm~1:ntJ1Liposomal amphotericin B
bb'IJ'lJyj'f)f~n1n'IJm~HtJ1 Epoetin alpha/beta
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 Imatinib mesilate
~'f)'ll~H chronic myelogenous leukemia (CML) ~:::rJ:::Chronic stable phase
~'f)'ll~H gastrointestinal stromal tumors (GISTs) ~:::rJ:::~n~1~'I,.I1'f)iimm~:::~lrJ'lI'f)~b~fl
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 Voriconazole ~'f)'ll~Hb~fl Invasive aspergillosis
bb'IJ'lJyj'f)f~nln'IJm~1:ntJ1Trastuzumab 1'W~tJ'drJ~:::b~~b~1'W~~:::rJ:::d-~~'W~~ HER 2 receptor dJ'W'IJ'dn~
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 Nilotinib ;'f)'ll~H chronic myeloid leukemia (CML) ~:::rJ:::chronic '1,.11'f)accelerated phase ~
hj~l~l~ClH imatinib 1~
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 Dasatinib ;'f)'ll~H chronic myeloid leukemia (CML) ~:::tJ:::chronic '1,.11'f)accelerated phase
~hj~l~l~ClH Nilotinib 1~
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 peginterferon 1'W~tJ'drJj;f'IJ'1im~'IJ~'f)f~~lrJ'rl''W~1 '1,.11'f)2 '1,.11'f)3 '1,.11'f)6 '1,.11'f)n~~~tJ'drJ~~m~
.c::. J ,'"
[9]i?lb'll'f)HIV ~'d~i?I'drJ
bb'IJ'lJyj'f)f~nln'IJm~HtJ1 Darunavir (DRV)
11

bb'U'Uvl'el~~r'hnJnl·ii'1.ifl1 Botulinum A toxin
i~'li.:tl.'li·hM'flil€i1 (cervical dystonia) 'l!U~,j'VI';l'IJ%'!lWjfi'J(idiopathic)
(z'!u~~ltltlc"'fnS'141tl'(hhV)fS'"-.'Jfj·~'*l'nu.'W,)Ylr'1n~!nurn~<1~ntnU·N!:~ijiln-"l~.'l~D~nfJFJ~l"'il:'-;l-il.~(1!(..J';;'lVnlJl"infiH)l-l~nL~",,~"!nm)
._--- ----,
JL~~_~~~L~_~__~1_Y~'~_~__1'U__'_~_~_~_~_'~_~_"'VI__~ 1
;'il~'l1J~t!11Jl'11 . . . .. ... _
d'h..l~r:1·1u~~tn1n'llj':;!1i'U!]M~'.tl1JiJ;] Excellent center
, '
~"M'Yl'l1£J~Yi,mtfmn lu1..h:;nt11.pi'll,~ylL'I'J)mn!fi'IVI _
~th.jLL'r1V1£l~L:8m'l!I'1!~1cilf1Jm~~ihJ'iJ'_!m.hi!-'illli':lurM"Ilml'(jVltJl'll11hUll'In lQ1[J lh':;1'l1'Vl1VJrJ1.; l')'1IW1'l~iffi'W':l
~u hhCII~::l.j
i'ellj~€iJ'lID. ~ ....._.~. ,,__ ._. ,..__...._... ._~
:nil-lJl)jl;'lf'J'Cl. . Hr~ AN _.__ . ._..._ ..... ..__._
~Y1fir1nun "] ~lilmjr:;fl'W~'1Ill1'Yl()r;, •.<-lUl0 tlr::n'Wi~A1J Ur.1r.iiln11fm~lYi£Jlm'l_!iln'!lnl1
('{it'll; '!!'1t! n'I-Irj'l <)'WL~'i'nJt"nVl_ 1_1_. ... __ 'il1!J U
~'II'iJu~lnh::A,H~rJLh:;'ll,'l1'. CJC-':-)C]C]DDDDCJCJe]CJ
~51tlth~rl'tlllm"i'il~24ilh~tl:::.;'il~llf11'1"l;-NI!t1 .r'.j-biii'fl'.j-;'Jm~m '__
'ltl';(j1n~'2ln-n'2l)Ja'l,rl'l1tJ,hu'VI~'el"l.~~A~'fl.:l'~~1~./ 1.u'li'el.:l.ylt1l';.:IntJA'lI~~tJu<!l!l..•• ••••• "I v :"1 ,/j
n. nnUn1'j'llil,()'PJ£'In1~b"lf£l11.1JUI'l'1.:1bb';n
1) q'l1'lt!tl~liU1''l~terminally ill
2) :jU9'i!8m)J~nCU'l1 'A1J11dJ'Wh"'IIlNlill)Jiil'llj_lHf~t:::1.Jllltm1JlJyj'iJf)Ji5
3) ~1l'lmAtJlv1f1Jn1tfnl:t1J)'1tJ1fi~~J~'11~1~t.Jft
~::1.JntJ~::L~tJi11mtfmn---------------------
Clh iJ hJl<f,
o t'ri 1'-1 hn'ii
:'::':h _Jhi1'1i
~
4) ~lJ')!'J51r]')n1?r.mN~::rK1J,jlUm'l1~1hJltJ C]1'1i [!hihl
.4 ~ (EJ _ .J t~ ,t. ....
5) 'lI'Wl~tl1VJH r : Borax unit ('1JU'li11tJl~1U.U:::U'lfl'1l50-150 unit 1il'iJ1 Ann1~tn1:il)
..~ ® .,,; O.<:!J '"
[Dysport unit ('lIUl~1fJ1Y1lLU::U1F1'1l250-500 unit ui'1l1 flf~n1rfmn)
1) r~lhrJ'iJ~lwl1"l::: terminally ill , n'ii
••• _ G "'.:s.... "",J: ,
2) r::'4>Jfln lWll:tl f1')1)Jt'-JL'NlI'!l'l'1l1nl ~1Jll1lf1N'1INnflll.J LtJ'1l1.m'lCUi''1W'iJU__ %L~'il:::'iilnl ~'.J'l(iflfilfl~ %
..., 1. ,...
3) n,rfnl:t'1('lf~lhh'l"llnflf-:,L1n'W'1'Wn~1 3 LfI'1JtJ
4) 'lItJ1V1tl1~H [] Botox ® unit
" <ID
5) "iItJ'W1EJ1~::'l1:W;..1 Botax
(lZ)
Dysport" unit
i.)l)
.....Dyspart _unit ('t~Ln.!1000 unitJU)
1)
2)
.. .3) n1~fnl:t1r_1f_li11Al'191nflf-lri!lUU1Unil 3 L~'5'W
• ® C ®
6) lIul~H~nViH [J Botox unit • Dysport unit
,. @ 1'~ -!'I (' @ 1 '"7) "iIt!Ii11t!I!:::'llJ U 8otox unit ( l-!mu 300 un'tlu) I Oysport unit ( li,n..•1000 unitl1.!)
._l!.'_J2E1.;U~.' (]·)5'tJ!p-irh::iw11i!...LJ1arjlhv!J.i/JI'illJlI1.J1'I-Jiiiflmrfm:11u1a(j'! hi'IfIWb,~!']::terminally iil
I
~ , . ]• ••.•• i.o .- f. s. 9 •.. .:.j ~I Si ~ •. I '" r •... 4.c4 1 "1..1 oJI, 't .
ftJ}i11!!;j'§411..0 mg'lltJ-HtIV,flj'.J'Y!tll)JL1JJmHu(;l'1J~IilN()llm~:U'Yliil--lW'l'il 1) .~ .-n 2) l'l!:~:: 3!....:_'l! . _
~th8'ilfLUJl1'1:; tenninally ill
~lhtJ~~f'1~IWf11J~u'il-.l~11Jm1fnl:tl~~~ljFl")rli1t11r;i'ilhj

'II'ilf'J~'[wiliiTl~flih~~'ULtl'UR'll~"Il~V)nUT:;nl~
~~'Ul~~~~~~k~1i§1 _
_ .J
'lUYl--' / _
- .I
'lUYl / ,
----------------------------------------------------------------
,
- ..1U1'_j ,
105

I,I,UlJvI'fl~~riln'IJnl'i"li'l'Il Botulinum A toxin
i'fJti~"li'1'i~i.'IJ<t<l'Ir,nn[lln~~~:an (hemifacial spasm) "l!ti&1hh'l'a'I1J6'll'''Wl (idiopathic), ,
(1'ltJ~:::~flf.)(i!r(1i'1-Di.nLtht1ltll-!t)~r"nnmJ,)"r1·Nnint:nlrl-n'C.nufl:::~i.lfJf~""'·5'1-5tj')~th.Jft}.j·~.-wr·lftR·1~-nJrv;gtT'~~nll~'1"cl~)
~'1l~mV'Y'jfJ1U1'l _
LlJV,1CliU'YW11!1'll':::rfiJCJ iili.iitl<~jj n Excellent center
,
~m(''rVi8qV!1Tl1J'fnh~I . .. _.. 1lJ1..i1:::n!J'J?'Il,~VH'l'lln'SnJVWllV1 _
d"hmvmrT~,~tJ'l'llllV~lM1J1.111"~llll"!l1f,i1.1r'1l'l~UM r"'lnbL"I'i'llSflf11 lUl1i'!:!11(l)L. ur:::tl'1Y11Yltn [. >'l'llA,r. iil~,,;j
r I ur:;f:YlA'lW'lI~(llf [-l 4'n~1YIrJI li ~Ul LthM:::l.j __ ;;==============,---
I
l..n'el'.-l~~thg
AN .__
~Y!fin1nun [] 'Aii'nul':::nml'lJtn'l'lCl'l1J1,11Jl[] ljj':;n'U~~R~ Cl 'l1r.ii1n1j'fm~lYim1J1i'l-!i1l";'lln1j'
lVlI'1 [] 'Il'ltI Cl -I[Q'! 1u"~'El'Urhii(iJ __ 1_1 'El-lti U
LI'l'1lUi!lfUl':;'h,T'l'Li1:::'WIIU C-]C:D[~JC]CJCJCJC:JOCOD
I" --1 .....". "I"'. ~ '" ..,.,d.,!V JI 'Ilil~a'U'.ren'i1l'IJfl1'i'i1lt!3JI1I~I/iI::"lI'i1l~'tH11'i~'lfel 'JtHI1I'tl'U-1J'VlLVlm. =.:.:/.=:..:.:====
~_I ""l •. " •• 0).../ ..,j -1""1 ..) "" ~ '"' '"
l1J~i1ln1'tln'll'fl~~~VlA'i'IJ~<HJVI'i'fl m~I'1'i'el~VI~n!l b'U"!I'el'l'Vli1l"'ln1JA'Jlm'!.J'U~~·-
•• •.••• "l" ~I ,!;
n. n'irum'i'll'tl'i1l'l{'-Jl1Inl1 b'll~lL1J'UA'1.m••n
1) ~thnfl~1w[l-I')~ terminally ill
, .2) 1i:9't1817l1~mu .n Y'lU'il,lh,h::'Wlr~i1l1~'liTIlj.1H'V7:;LJ1-1lULL'Juviilf~v'
3) ~thtM'fJl0.f'Un17fn'1:-10.'ltJ?ii~ULVfi';1.nrX'Ji'l
iJ ' < 11Jl'li.'11 ~
n h 1<. ,
~l'll
..
1'li
~,
hi1-ti, ___.J
r. 111 ~ hih
6) ~tl'l~Jil~i.W11,):; terminally ill
.., ~.-; .J ",..,,;J'
7) r:::1jt:.l'tilnlnmtl (peak improvement 111 6 «tJrl1v) l'.,.n~~'WLLN~I'El~'1l1nlm~:::li)nYlhn11.ni1l~!V__ (XJ
8) il1~fnhlAf.)d"h~91nf'l¥-.:jLimU'I'Un'il 3 I~hl'u C] l'ii
.,ILv,--, ® ~ ®
9} 'lI1.illiltnYl 'll L Botox unit LJ Dysport unit
® ®
10) 'lI'Wl(i181P:;P ~i [i Botox _. _~ __ unl t Cl;j(nU 1OO~~::.,fI::.:iv~i'J-:.!.)_-=:....::D:!:y.::~,:::.po::::''.:.1---=====:...'U:::.'n:::it~(~h~i::..Li'i:.:u:.:IJ::O:::O~l~tn~itl~r:.:]~:..'--,
o '-",... •••••••. Cl t,..o ~"! .•..~<J ~ r""' ••••~ 1 '11 ~ , I~.JJdlJL~ n'11VlltnllJU~I~-.1V1.!:~'::'~'il-.1Ii1NtWllJlnru'l'lCfl'lt!P,t!1) L~ 'n L,,,::: 3) ,', ~
A. n'irun11i.i'£llrk.mr;iAf~~'Gll:1-l f11'j'i,i'ffilAf.3d.tJ'JAf.s~ _
1) ~,j'ltJll~i.'Ui'll'l:; terminally ill
2) ~lhmr~A~liltl'U1'l''El--lI1i'Eln1ri''rn:t1~~p)'!A,)11i1tJ1Iii·a 10
3)
Ll h C11lJl'i
li 1'6 Cl hn'd
LJ 1-i [J 1.il'1i
~ . .nl1fm~I;'1f~ihh-.l"llnfl1>lrii1'Wn'Wn~1 3 ~0'tlU
A) 'II'W1Cf1m~H [] Botox® unit
10
Botox . unit (hhii'Wl 00 u'1ill:Ji
1
__ '1"
i Dysport" .__ . unll
.. .®
I ' Dysoort
106

~ .J
'l1..l'Yl 1 1 ._
lihwvnl~
-------------------
~ .J
'J1..I'Vl I ---'
._-------------------------
_ .J
'l1..l'Yl __ 1 ,
107

bb'U'Uvl'elhHiln'Unl7'i.-n1'J1 Human normal immunoglobulin, intravenous (IVIG)
.u'.."J.:li.-nhIi'11'11'l1'Jj1n~~:::biil'J'U'Via1..l (acute phase of Kawasaki disease)
(ntl!'l:;L:a Wnn111'n'J 1tu ~~ill-.lt1.J~ '1nLL1..I'lYll-lnlr1tJn'l rl-ifVI LLl1:;~ij'iln lr 1'ifVl'il til-.l t.~Jl", [;)t.J~l1n~Urv~ t!T'1~mL"i-.l'l!lili)
~'1lt1cntJYlm1J1!'l .
LlltJt.cntJ"'1m1J1~~:;~tJ [J Y)[;1~t!lJjj[] [;1~v1Jjj:J Excellent center Cl ~tJ"1'hJr[;1~:;1i __ _.. _
?lll-11ttltJ1r'l''l echocardiogram 1~ fl'Vrl
t1~11tl!i-.lr;i'1lL~'el(il~'l9echocardiogram 1rifmvltJL'l!'llhhntJ 2 ({umlfU1J"l'ln1tJ~1,xn1rll'~~tJt~'''1 [;h!
~'1lLlYlYltJ~YI1rnl'fm:tl_ __ 11J,jr:;n'1lU1·rt-I~YIL'l'!lnnlJLfl'lJ~ _
dJtJLLr~Vlvr~I~V'l'l! 1 ru~~1a;ftJ",11~~~'1ltJlTMv.1'1l'l!iP1.TfIlr"l1 nu YlYltJ'M'" ltJl'll~!1'l~ r-i n jJI j' l'1 '!lA ll'l ".f'It IV ' <t
[lhJ1'Ji
CJhj"/c
C mnn'l'll1'l1I'llilfbl'1tr'lh
[~~~~€tJ~._IOl _
~'1l-tJ'llJl'l~fl . . HN .. AN
n ~tJ.., tU1~1:;lJ
-~----.-,:----.---.------ ._-----
----------------------------~
lYif1 C 'lilt! i .I ~t~'" 1'.tl~'autllnVl _ '_ t11qR R •••• _._.tJ _. . .__ L~f}tJ
Lft'IJlh::"h(ii"l'lh::'l!1"!1'.'lJfl-.l~1l'ltl(illlJkm,J1Vl:;LiJtl'UUI,," C DDOLJO OCJCJO n~C
~fl-'..llJZlf'l~1Jfl"r~'1.lnY1nN _
i'el~'lIt1 ~I'l 'il'Unl'i'tl'ilffl u.~:::-n'il~:!,iInl'l"L-na1 -r'U-bR'el.::..:.:'U:...-tl='V1:.:.ffi..::"':.:."..=!J..::'=::..:.:=::..:.====J
tt17'(;1n7''!ln'li''ellJ~''LtrFl7''U~'lU "'~'eli.'i'ibFl'4'el~mna ./ 1.'!.!'li'fJ~;lI>l7'-ln'UIi'1~':IJ~i:l1..l''l~.:l
"•• •.••. ~ '" ?I ~
n, n7'tUnl'i'JI'tl'el'L:!lJl>ln1'l ~"JltJlblJUFl'i.:lbb7'n
1) qU'lml~1u:n'l:: terrr-inally ill
4 ~ _ ~, :'1 ~ v " vd 't~ ..1 ~ .1i
7) 'l'U9'lltJl?lllJLnCU'fl 'r11J'l'1lu.n!'Y1(;)N(;)llJ'jJfl'U.:l.'1lVl~::'Ll'1 ~'ULLtJtJl"I'tlnJU
3) ij.lml·:jl"l~tJ~m:tm:;l(il L.: mUtJIi}.;LnrU"fl Ch)iP1~tJ[;lI~U1m'i1 (incomplete Kawasaki disease)
4) 1'UL~!l.ln~fIl5''l''l echocardiogram _/_1 _
e.Jfln'lr!;Wl9 ..
1JiLL.I1Jj;Jjn11(;1 t'l9'1i'~ l''il~j rlUl,uuV'lfl fl.JULl~'i'l
,.
5) ~li''l''1YllJ~mtm::V1'1''fl~iln~-l~i'ill'1.lu
lhi
B ,~tJi1111'l'l.l~n(il'1(bulbar) LLV!-l~j;f1~r~l'l'eWih~~tilrJh;~:ffj;f1
iin'1i'L'1.l~tJtJmJM'Il1J~1lJelulnLL~::~~fl'L!'litJ~'1.lrll
LOWrJ [1 1lJllulmL[;1-l [j ili'flULLtlnmlJ'il'1.l111::::
[--1 h t.Jhjhi
C 1'li Clh!1i
.:: c. ~ t; d
muu.Ili)lJ lW:;lJ?l L~.:IY1~1 tJej!'l?llill"llltJ'8t
:J j'jY1'il'cl'iltlLLI1l..:-afi'wnI1lL"l.l
iin'1rlu~m.m'1.lft.J~!J.JiJ,Jt.nr-.ltJ1L'lmii'ilLLt'l:;lYil
(tilui'l [ chiimLVl.:! !J ChYilll1l-l 0 ~fltJ'llJ fJ lYi1tJ'll-J
~~'!.!~')1J.f"~mj'O.l::"'~nquLLCJtJ (polymorphous rash)
fl'i'1Y1tJl1itllJ~1l~fl.:ltJ1L'lru~hR'il LPI£!ii'IJn~ ll?lf111 1.5 L'lIU&iLJJ!Il1
[IiIU 0 f'l'i1YI'LJLY1tJ":t'hiJll11~h'U.l~.:J'iI~"i1f1'il
C 'tJiftJn111ij,911ULLfJ:Jt~f'l~;:hl1n1i'A1ilfJr1'WmJmL~'l
----~~~----------------------
LJhili
Cbi
nh
108

6) ltll'kjm7(i]1,)9Y;"1~~f)~lJDui'1~18~Ulj'<'ll{'Un'l'J'1j"l;.i[J mm Incomplete Kawasa)« disease •_j 111 ;-~ l:.i','rl
D i'11'i,[SH 2. 40 mm/hour 0 i:d l 'hJh fi ll.i16i'rn?'l'1
h
•...."
hJ1,t
..
'['d IJ 13jl.-ri,
~...,. 1~1~l"'n i.__
:':J l.i !-~
1:J'L'rl
rl
141
r-:
l:tl'iI ~ t
,-1
' ' L. 1:j1iI~
r-")
1.'ii r- hil'i~...j L,.
0''''
1'li 0 'hJl'uL!
E ALT ~~n'i12,5 VVi'l'!1'1'l.:Jl'htln&1
WBC count 2. 15,OOOfrnrn
3
:::[11'1:: h1i:111l'l1~(liir,) tv,mJliJt)'1 q'll'f1~~" 'hfl)
platelet count z 450.000irnm' (l.hnnwi1 7 ')u)
serum albumin ~ 3g/dl
,--------_ ,.._----_ _----- _..._---_._ ..._-------_._ ...._.._.__._....__...._.-- ...-_.._----,
F 11!1')'lYnJA')1:JiJ~1t1ni;hJ'1Nechocardiograrn
-!it) i 0 '~'li (f.Jri"-nJfl!J 1 T'3) ,,~:: E 1i ('ilr!1~1'3U 3 Ji'1l)
'ii~It) F l'ri
._------ _.._---_. __._-----_._-._-------,-------_._ ... _._.-
7) '!J'IJ'lii1[J'm~::'1::tJ:;L'l~·)~·~ftJ'l
",j,'l',.n1'nirJ _. i'it",ni'l-l
" 'V '" "
'!l1.nAtnifi'!'l'r'U~f.~l·nuAT"i1 nfl-J Ri11lU.'lJnliltJl nhw',[;~,mrMj.·l 1 n(,,(11,
, ,
r::ti::I?'1l1Yi'lii'!r!"ll.!fi1vll-ji11 .. '1'lll-i1
. ..J .• 4' /' LV. . f ~. , ~..... !.:. '.... ~
('lI'.J1fjtJ')YILb'U::tnfl'i] 2 gikgldose V. continuous drip 'i11m?:.J'lJ"',)~O.6mUkg/hr ~Vi'::'.1~lJ'tl('1nflNfi:;m(il'lY]n 301n'l1
"ll.!1.ii'i1111~1IVIG .umL'!.i 12 *'ltiJ~",t?l'llti1Pll.J1n~~,;)1:.i,nJ 4.8mUkg/hr)
8) nVeJ!'l~'~LiiifJ-l"nnm:Htn
:::tjnrJfl:;,;atJ51__ ,._._.._ _. .
Cll'1i
~ ~ 'I" ••• ./:...J
11. f1HUn'l'i'n'el'tJtpJI1If11'i b'i1S1.tJl.,'i.:JVlll'1l~
1) ~tl1rJ'il~lwn'l:: terminally ill
,-.) ,. 'I ." ~ '" ~..J.I', ~ ~ . 1 !:
2) un .•~u1fjln"lAl')'1'1l1m·::tJ:;L'UmJY1~uyli5ltllil'i)m~~nwli>1')fj iVI(; W'ij":m~n
'll-j :lhii'li
'--tor "1 hl14i
v .••.•....• I, ,!""''''_ •.... ),.' ", v v , 0:::0
1'1mj'U:;rn-3fl~ un uaen 1101 t'l ','111'1 .I '1)'" 'L DlJ i':m W~ A~,~j '-I(f1nu .if) f)1 '; '1~1n
v ' ..J ~
tJ~ii11,)"l ).JYI'Ui'l1L~Vl1J'Ul'J'f.)-:J I'll
" ,
.Ii'i'ol"nrm:Hi IViG dose "mL'<'I1"l:nu1,J'Lii'll.!1'U1'1'il 36 ,48 i'jhJ~~U'ltJ£~f)~:J'l~!l~ c:l'11 '1hi'li
" t-' •. I ,.' to- v
f111lf(nflf--lud-IHn1~1,~;JlJ~f-lvL (Vlnm1M~yj<iIH1.nl-u IVIG ·jhLV.fj" ; l'Ir-wli'nlui
[Il'll
~ " ~
n1~,1iitJ'l~f~Uti'"1-.l~in?if"rir.c~
v ,
3) n11l-ufJ1f'f--lri~tJl:.iLiiVl~~ih~.firNVimN .••"nn1Tl,x.rn
4) 'U'U')Iilt!I~,"':;~::tJ::;lr),,"~1-Uti1
•..
11'1'.-nl'ni'l
'!J'Ul!'1tn!li,i)'rJ~~4i.i1'UAf~~, n1'l-! Rlj1th.'lI'UIAf.!1
.J •.. '
1:;f.i:;''l~1"rl hml -n'l'G.!~
.J 'I "
('Ilti'WlmYlll'.J::;U,)~'il 2 g/kg/dose Hi continuous drip lfjjfJihJ~Jtil!11 O.6rnUkg/hr ll"::l'vbJ'ii'(i1nAr1~::L>"'1iT'ly;n 30 my,
, ,
"l'U1~'ii'(l11iVIG ~lJI1l1'U 12 i'lt~N1.1~'il'tJ1JiffllJ,nVi'<'1vl1;.hfh. L.8mLikg!hr)
•..
f11'wMnl1t.1UnA'l 'I m~nf).J
t» Lr'~~fl'ih~lAtJ-.l"llnrn)'HtJ1
~::1.J11tJfi:;.tif.IP1, _

•"'''-'i."a"1.l12.J1,!,'I't'V1~~~..'l 'If!J1 . _
~U~~ I _
----------_._._-_ ...._---_.-------------------
_ ...J
'l,l.';1 __ ' _
" _ J
tfll;jft ru'l'.JYI 30 mn!.!'ll'l~2552
110

I.I.U'lV11"I11nl.Jn1'i'1.rA'~1 Human normal immunoglobulin, intravenous (lVIG)
-H'ell.i""t.;t'i~{]i:i..j)Jnu'l.Jn'Vi-i'el,,tl..l3J{]3J (primary immunodeficiency diseases)
(nl'Jl:;£lI'J~lm1<iimhl~~lv·Ni)~"'·lnu.u'J'I1-Hfilr1Um111mltl:;~;:'lj)n11H!J1j)!l·)~ll-Il1(;jt.J!ivn!1tj;V~U11zi·nm.i.''lllR)
J iil~a1ltl1U'I'f'lI'1.J1al.l.~::I.I.'Vi'fl!j ._~ _'
~~~nlu~Vlul~ _
djJflcn'..lV'ltn1Jl~~:;ui1J [J "I)MtJ1.]ij (;~ltYfrUt.llr-1~'il'tJ1t~MLLfl:;~'l'V1:;i1tJJVlLl~')nuwJ'ltWl'Wl·lr'rU~Ll~lllri'~litJ')'j:r'l!~ "l(2))
[] [lA~J[J~[j Excellent center
, ,
~'8Lt'W'V1cl'~'klnl1fm~n hJ'Lli':;n~1J1"]jl;nYiL'l'llnmJLfI"liY1 _
o <,v...J cl, ,,~ ~ "" _.. - ~ " I ':'i' _ Jf
dJUlIYiYltJ~L"1ltJ')'Il-lCllYILi1I~1Jv.U>l1l'1ltl~[lv.r'il1W<-I1J!1I1"llmL'ViYl!J1l1l1,Ufl 1'!l1bl? r)l.JIH·~';IPI'lfl!1li' rl'HiH~L'li}
.Q rpJll-L'J·M'1·;Mlfl1Pi,~l.iLL~lLt';:;1J::1~l-Inu:=?1£p0Ifl!1lfhA~(11L~'iJ ~J'ill!~j'PI'lfl!1lfli'PiJJj:JLVhL~:;.~~~~JnUVn~A~i1n
[] ~U1 ~cJTl'I'J'ltJml·'[Ni'lrJ·ltnfl~HJtJ.1:JltJ (nHl1unL~u',{!tJni1't1':)~'il'?i~(;i'lv.~·~~)r~'lltJ"fj''l) 1~:lJ
" . .---------
~'tHn~flQ~ .....__ ~. _ HN ,AN _
~'I1finlmjn C} ~l~mJ:t:::nu~'!l/1lYitbu,..n:i'1 [] ur::nUII-lI'llJ C !'1'l!'1Anl1fm11"t'ltn1Jlfl1h11'l1n"1l'
LYIPiCJ 'l!lfJ [J'ilcl'l ?UL6iiluud1i1' _ 1_1 'i.11!.!__ u__ LiihJ'L.!
~'llu1::41r1'ltl1::~1'llU'iltl'l~tJ'l!Jl?llJ~1LJ1Yl::L{jtJu':h1..l 0000000000000
'll'1l-1JI~~Qg'l'!J'1l~~tlnl'1n1'l_
1. eY1.:brJilrJ1 UJ11'l:: terminally ill Cl l'li [] h.n'll" ..
2.~~nl~1U~~rJl~~ . _
3. -H'tl~Gl'il"~n'tlUn1"1U,,,.r~
3.1 qthmn(lf'ltJtJln1r~(ijL~'iJl1.lj':;U1J .
------ ..-------
3.1.2 cl-3rm'l"~igG trough level Cl lltb'li Cll'1i rJi:l IgG .__ mg/dL ,ri~6'.J~ _
3.1.:3 "~!JH!rU blood transfusion [] 'bJl'J! C 1'1i LV'1ulMu blood transfusion f¥.:!'<il'i'(ilLjj'iJ'lU~ . "._.
3.1.4 dJ'Unll'frl'!:tll'Jnl'ru LJ Emergency (life-threateninq) (] Regular treatment [J ~t.l1(l'::tll__. _
3.1.51Mu pre-authorization [J lln'li [J l'li pre-authonzaticn ~U'i'(11'l1..l~__ . .. _
[J Complete blood count (CBC) ttlll'1'UVt _1--.-1 (1UIL;itlWU)
I ] Ouantitative serum immunoglobulin (lgG, IgA. I~JMand IgE) levels Lfi'1l'l'WVi_i_.-I (rJWLr.1flWtl)
IgG(mg!dL)_. IgA(mgldL) __ ....__ IgM(mgidL) __.__ loUILJ!rnL) __
i 8-(;ell, T-cell function . l~'t6H~ .__ J_I (-1Wl(')'i1W:J)
,--, ~ d~d v":"1
UnI~!;11'l"n'iU~mnJ ll.J~'l'..l'VI_.L__I ('lUM1'iJWu)
Cl ~Ul (r:;li) . ..' __. . dj!l-J'l.!'Vl J (It.VL~'il,J1J)
111

Brand, : Body weight kg: Dosage _ gram; Start time __.. Finish time _
('DUltJt!ll~u.unhA'el 400-600 mg/kgfdose VJn2-4 ~tllill,r r.nmlutlfur::l'i'u11X IgG trough level mnn~l 500 mgidL vi1'1l
1iimnnC)l 800 mg/dL nm1~ljbronchiectasis '-Ij'1lm~&1(11b~71~~.m~~)
Premedication: 0 hJ1ii [I H (hJrIil5'::tl'l!Uvm~::'jj'WlIil8-1)
o antihistamine . _ .. __ _.._-_.__._--- _------
oantipyretic . _
[1cortlcosteroic . _
--_ .. _._._-_ .. __....._-----_ ..._..
C ~U1 _
'1ITlhlj'B-l~-1<iiTll;!f'l;;1"M .••.••tluA'l1lJ"I'i,lYJmJ~:;mr
ff •.••..v~1V
'6l~Ul:f..1U.'I'i'l'ltl~?{~~'Jj~n-------.
.._J __..
1ii1bbVlU-Il, _
~ d
14"11 __ .1 . .....1_.. _
112

$~'U1).J«tlr.::~il'U, _
(
1!V;__ 1 ~
113

,l,l.Jl.J¥l'eJhJfh';l.Jm~'l.i'sl Human normal immunoglobulin. intravenous (1VIG)
-D'ilt.i'l'l...1h~ idiopathic thrombocytopenic purpura (ITP) "llilt1l~'Uu.~'l
(n!Jfl::lil!J("m11-Du'l~tlr~)ti'hl~~"I1'"lllU'l'ln~n1n' In"liullLl'I::~ili)r1tl-DU1mh~n).1l~!1jUftvr:1JUt!4i!!1lftnv.,kn'l~)
.I-D'il~~i'lmUYl~1'IJ1~,l,~~U.Vi'Vl!l . .... _
~'il'lcn1.JVi1Ji1..n" ------
dJ'W'lm1.J'YiiJ'IU1~r::P)J :J V):;iV;;JiJ (~~1Ji1L mpJiil afi::l~Y1::LiJtJl~11LLt'1rlu"111'lU~1"Wri-lnu~Ilflrn1!i~'Hf[J1u!lJl1 '~(2))
Cl l'lmtJIJij C Excellent center
LUtit'cn"W'YitJ1'Ul~~iii'l'l1~Vlr'1l~1'Wn1r1U"l'ilm,'il:;&iVll'lllJCJj'lm~i'mjl~,1~fi·1YI::LutJ1.JHm~''l [J 1'ri r I 1<.ih
~'1lLLViVl8~·111n1l'fntn. .. __ _. .. _11nh:;n'fllJ1'hl~1~l'l'llnn~LWlJ~ . .. _
!"l 4-l/" .J .•.l~v..... •.... ~ •....••.•• •••••.. 'l ' r ~ Cl
LUULLiW)8~L'IlI'!'l'llIc).YI,J)'Ij'1J1A'lNt1'iltl'lfw!P.1j"1l1IilJtJCilt"l'lm"'IYI!Jl'lmt~'l'l'lJ1Ibl :....: f]'l!:JH'l'lM!Hi'I"1V,"<'tlCil
[lLfiii!il1V1tJ1Uj'l::~:;L~-.l1'lJLi11n[] ~u hl~::CiI::.:'j'~::;~LJ1=========== =- _
-n'elj..!ati'{]·'2£1., ..
~il·t..lllJ'H)fi .... _ HN Ahl
~Ylfirnnun [J "'imJ1:;n'W~'lJJl1'YiLi''l'lJ'nj, [J u1::;nw.r-.lA~ i] 'l1'I'l~mrfmj'WltJiU1j'1~h5''1't1n1r
LViI'![J "If"J U IAcij.J 1'1.,!~tl'WU.iiV1_ 1_ 'ill~ __ 1]__ L~~U
LI'l'llur:A,tiT'lth-::'lll'llU OOfiDDDDDOrlC)l-lC]
~tl''Ul~'lqfl~Unl'lrtl-.l (L'UYi1::liu'lmtil n)
1) ~lh£Jtl~1.Wl1'l::; terminally ill
2)~1"l~iJlin:mnru'l'l '1,.YhL~JhPl ITP~i'hnnl1tmN !iil:mnru'l'lf'lTUc1'lU"1n'iitl51",d
A ihfl'ilV1tl'iln~(;)tlnm~Ln!11"1,n";l'lJ'lULtl~I11;~'il!11~'
C'l'll :Jhl'li
,
11'1l ! l<.ih
I 1'ii .: hi1'1i
"'h .11<.i't·jB i:i isolated thrombocytopenia i'l~j1i'lJiJ41'1..1'l'l..lmegakaryocyte l'Whm:;~mJn~
;j'~JL6itlUU~j;)r'l'"l 1_ (peripheral blooe smear Lfi:;bone rrerrow examination)
1('(LLut! mml ~j;) l''l''llJ lYi~mJ nULLUt!vl'tlflJiiL~'l L:h iJll.11'li
01'ii [.J 1.:1'li
[J l'ii OhJ1'1l
lJ 1i !1hn'!i
~..Jltrl [j 'tlil'1i
.. ..C bjiJ'l1L1t'!'iJ'Wl'lJ'1l.J41'U'l'Win~V1i~'tlV1riil'li'W~j;)L~'iJ1J'l L1Jwlhl
------. ----~----. --------,
~'l1hdi'iJ1..!lJm inru'iln1~1U"l't1iJ~'i) 1) 1;11'1 2) t'll f'l1UVln1J'iJ
--==--_ __._.,-_._--_.._,--........:_--'-.------------,,-------------
3..nHU absolute indication ~U'l8>Uut1A ITP ~ihnnlr~ULlN YI'lmnru'l'lPl1UO'luYjn-ii'i)51"d
o iJ~'l'W'l'WLn~(;)'~'ilr;)ihltJn<)l 20.000/mm"
E i'J111'l::;L~ilV1tltln~uur.JVlfln"")Jj;jtl'ii5~l
,::;1J.'hLl"'tl.Jl~ ..aV1tJ'rln1'W,~1'1'£J'l::ihA'1JLJ~;.J'il.J C Ltlli1: -nil.JVl<iHI 8u1 ~::;LJ------
F ~thtJl<.i!il'iJ,J~,J'Cl.Jf1i~)n1rfn1t'lmf1!r:l'1u L'liU ann-Rho (0) Immune globulin,
tn:i PIL~tll1ll~::;1"1'il filitl'll'l L!)~mJv1
,rUl;''1l1.J1J~LilJluA'1lrnLI'l~LI1tj''5tJ~ ' _
~::;l..J~'il!J1__________ ~::;'l!'Il"''ll1lm ;Jl'l~nf~j~11,;rn~'1 1 ntl~nh!i'rU
r:;'l!91U':ni.nii(i)L~'1lV1!11tJ"'~~rn:r1,,;(I'l'ElfmlA~L[;r'1lt!v1 ~imm3
'i.lL~ilUtJ~(;Wl"l_ 1_1__ . _
Ccl;~~~)timlmC1.l'1'1n17'%9't1!Jabsolute indication Fi'il 3} 1~muV)n-iitl ,--.~-_._-~~-~~.=_._-----..__..._...__-._--_----.-J
114

50.000/mm3'J.~
5. '!I'Wll1ltl1LL~::~·::t!::L'J<'I·)~lilr.n'hhn'W 2 n~~/n'i:an~)Jfii'fln1'i~uHl.u'i:'i"'VW1Ula1 Af." [] 1'li [hJi..d
~ •... v •••.•... .cl.. .••.."" ..... ,~ •...•.... """,~ v < •.••• ~ •• , «I! ••••.
Ulm.m(i!') nL<'Innl ('!I',lVl81'YlLL'U:;1n 'lJ1~lVl400 l-ll'l<'lnnJIi1~j'Wl'l~tJn(il'J1 n'll'lmlJI?1'1''l'U th.'J~n2-5 'J'Wm'~l mw
J,m1nrf'll 111l'lnfl-l 1~m~'A¥'-1~l'l8'l 24 i'lti-l.n,,~~l,"rnF~·.mm)
<1ULR'auuvh'h.il.:1£J1_/_' 1:;V::'Jfll~Nm 5'..
'm'wl~n~l!Zl~J~l~Ahm¥-lU n¥l-Ji'i~ILuu'au'll'1rn nfl-Jr;]'D~l'mrnjJ'J 1 nll'lnh,
6. :.JMltfm~rl
6.1 Lnl1lt-l'l'l-ih..nR!w·nnmrHElI
r::1F1EJ'i'l::Liit!(i1
6.2 ~tl'JUIi181Jf1'W8-1(;i'ilnl1fmn
-----------.--------
vilmni-3 . _
~ .J
'J'W'Yl __ I i _
•

Lb1J1Jvl'fl{~rn'ifhn1Jno~i.il!n Human normal immunoglobulin, intravenous (IVIG)
iI ,~I,.o d" ' I...... ~ <:IV
'll'P)1J~~'il autoimmune hemolytic anemia (AIHA) '11 ~3-I(;I'il1J1l'U'il~"''Bn1'j~nt!1V11lJ'lJ'UV1'el'U'lJ'el~),jlt'1'j~1'!Jn1~'mt!1
u,'&l~ii'enn1'j~'!J Iw"iilw19 61J'U-B'W(?Wl~~'l tri~l(;1
(~"1Uft~~eEJ~n"111~t.nhJffj)i5"'4V~t·;nrmtnYl!"fhnurn,.1.jjtJIL~f"l::fjjjvrnr-ntlf.Jth'~~l.JtvtT!t.Jf1(Jl·1)'JJr1J~fJ~V(rntl1A'.1~O"l(;i)
'1r-'lI-"-"i)-~-~-?l-·{l-1-'U-~-I'.I-'1'lJ-'-'-~U.1I::L"'~~ .. ~
;'iJ~Cl1'UY;r.l1'Vl21
d:J'U~Cl1'UVltJ1U1'il1::~'V:J 'Il~fJl1i1 (~~'ll1ifu'ilm~llfl::fl-J'rl::Li:i!.lu1'lll!1'lnU'All-JtN·1Hhri·urilllflnJ1i~Hitj'nIC1I~ '1(2)), '" ~ I t1
D (;I&itJ1Jii0 Excellent center
. ,
d~h.jlL~vU~L~8'l'll1C1.JVi'1Pifi.J'I.Il1~~flm.p1~hi·hllW'll.rmr.nmL~'rltJi1.rn1'..jl'11'l1111nL; 'Cllt!H'ilj'Hilf Cl '~nrpl'ilMIf(ri'1L~fl(;l
[] ~'U1 hJri1lr::1..j UJrlmvr~ 'WfJlpJmfJ'larrul&nh.t1ifi1iJHtl
I ~ '~." . ....---.------.--'IJ'fl~~~i.hg .
=ifl-,.,lJ~'ljl------------
HN ~AN _
~'IIfin1~LUn [J "'~m.J~:::n'..l"l'lJnlYit'h'U"'Ul [] u1::n'!Jl-ll'IlJ 0 1'l-rI'l~mnm:t1YitJ1U1fl.;r111'!!nl~'
LViI'!n "Il')tJcJ .I,,}~ 1UL~tlutJLl'i(j _ 1_ 'en£J u
L~'lJU~~tlr:;~,vr'l'.J~:;"Il'l'!l'!J []CJODDDOCDCJCJOO
1) qU'l~l'il~"Wl1,):: terminally ill
2) 1U"li'rlWllJbnC1J'r1 Yli.J~1ltJ'!JhPl(;lN""lJ.;rtlu~lii~r:;1ilrl1.iLblJlJ~~tlhlU
1Ul~a'!JU~1lr.l~ti _I_i _
L61fJVl~19v.uanljru:;m-1l"1~iln~-1!Ji'ilLtJd
A ii'fJ')n1mMI~~'!l'ln''l::;1:~ii'''''l1~LL~::;~'li')'W
B "'S-'l"l~liJtJfi~a~ ViUanljru:::"ll'iN hemolytic anemla
Li1ldJ C spherocytosis fJ polychromasia LL~::: fJ nucleated red blood cell
-r'WL~tl"U~I.l1),'l"_/_1 lJ1b('U'iJe.J,n1~"'n"ll-n'1rtll-ln1JLi1JUw'ilfl-Jdu~'l
l.- "I"""~.ri '/ .•...
r,,,mn;;r'l"l'll1-:1WB~u{]'V(;lnlr'il,J~'ilVlAfl'1NmJ/11'l::; hernotytic anernia
llMl • direct Coornbs' test lv.e.J~U'ln [J 1'li LJ hi1'ii
• iJn1nvilJ~1.."ll'1l-3reticulocyte count [] l'il Ul,J1'J
r:::l~<l'U'l'!J~1J'Il'1l"reticulocyte(absolutc reticulocyte count) .__ ipL
• (Il1'l"l'Y'lUbilirubin l'Ul1'Zl~1'l::; [J h :JltJl-rl
CJh Uhn'1i
[;hn-i
c
LJ 'bJl'li
CJ LJJ1'n
3) ih~'iJj"'lIn.,rH!'J11i'l11Jc'hullllljlnnn11tiiwi
E ~1hrJhj[;j~)utl'Wtl,wi'1ln1Trnljl;''l!'.J corticosteroid
1jL~'il'WiJ~dl,j·;v.n1jfm~lrihtJ corticosteroid _1--1 _
, .r::'~~tltJ1 "lIU11>1fl11::;tJ:::L,)!i11Yil~m _
[]h [J 'hn-rl
Cl1'1i [11tJ11l

F
1~bri ] unstable angina [J myocardial infarction _J heart failure L_' stroke
Cii-l1fllq'il~~ Lnn.!ovlrnr'El'4l-iiiiA'8 E 1'li F 1'll ~
> 4) 'lItJ'lA7J'1VCl:;~:;!.J:;L')rnVll~rYl
..w,I,rnlJ1'i rt~nflJ
1'uLiii'ilutl~~lJ t~!Jl_/_I _
('lJU1A£J'~bLU::;j'A'1l 400 - 500 nR~nflJl'i'ilJ'J.!tJnlJ1')l nlflnrlJiIi'1),)u ({'JUl'ifll 4-5 1'1.1..11'i'l1 nhl~if11l'11-nrn!il') 1 ntflnflJvi'i.l
'ltJ.L1Jumn 2 '1tJ. 'l!l-nl1l'i,,~1~bn'U 2 n~)4I1i'P)hl~unm'J 1 mM~lJoiilr'U LLR::hi'1l'4~Wi1~ifrn~,1tJ.rmfm~nMr'1')L&itJ'lntJ.
5) c.Jfln11fmtl
riiitil1A'IVIG Hemoglobin __ g/dL lr'El Hematocrit __ % !j'(L~'el'wtl~!1ln"l_1_..1 _
I~_llv.IVIG 3 -ru Hemoglobin __ g/dL !1'il Hematocrit __ % ?tiL~'ilu.iJ;;101n'l_1_1 _
6) LiiAc.Jfl-ih~,i'itJ.:J"l1nn11Hm
r:;l~:i")~J'i:-;LlltJA---- •.-------
r" ,'_ L'i!
----------------------
~ d
'lWIl __ I i _
fJ him~~
(ih~bnjll
------
--------_ ..._--..--.._---_ ...._.._...._.._--_..••..... -.._---_._------_ .._.._.
~ d
'iUVl __ / _
118
•

r
u.1J1J'Yi'Vf~n1 ••rhn1Jn-l ••i.-A'1'l1Human normal immunoglobulin, intravenous (IVIG)
l.tJ.n'S'Ll,,"l-A'Guillain - Barre syndrome v!ihl1m ••~tJu."-1
(ntJft:;lfi(JiJlm11-1itJl,[tl:'(')~h ..'ii,"nnUU1Yll,rhl1J~l1',iltJ'ILfl:;~i1~rnl·lil'j'1!lth'f11JLW~tJnUlllJ1.Tr!iltJ'mf1'nLlV:~'ol&i)
~r.-i-'V-~-f-'6'I-Cl-1-'U-Yl-!l-1-'U-'1-~-~~:::UYl'l'lS
J
,th.('i()'l1JYjtn1J'!~n;'jJ 0 I'llfttJJjii ::] Excellent center
d ,.,,' v 11Jur::n'iJiJ:')'n~"''''l'llnmJL~'n~'ll'ilLLYl'VltlfJ'VllnlT1n1:t'1_.. __ ' _ ,_, __
d~hJuYlVlcl'~L~t1'l'jj1'lJ~lMiJ',nr,,~1'l'il'_pji;hi1'iJl~Uiflt~')mYl'll!J~Jl11lJ211'!J11i110t1~::~'m~~'Ilm[] rpJlm'l!l'Il~mf,Jr:;",)Vl1Y1tn
:] ~l.!J lU1i11r::1I
I·... "'.'1
. 'll'el~'iiI~u'l!l
....J-------------------~ ..'..-.--.....--------------------.J
'Il'iJ'.JllJ21r;<'I . HN AN _
~'YIijnlnun [] "'~'lu)'::n~j~'lIml~rr'llJ...,,:r, Cl lJ~:;f'_'{.'lP1l.J C ~._r~&in11fnl!iIYltniJ1f<iiln'lln')j'
iYlII[J '!lltJ Cj "'(~_.1 <)uL~s'_'ud'i61_ I_! till! __ JJ __ l~'iJU
, ~ , ~ . "~":=:JrT-l ':=J'-'C"-- (- n ~~r ,-,I"b~'1ll.h:;~'1m'l1Jj':;·n'll'_'1J'iJ_.11;ltJ1tJ&nlJ~ltUlvl:;mtMnl.!I. .,.l A. L.J.,...il_J ...Ji_ ~ _IU ,)
~'t1,1Jl~J('1flii'lI'8_.1 ~tJnfit'8'1__..._
~=-J
1. €thtl'el~rhum::: terminally ill [] 1-1i c] hn'ii
2, ~il"l~S(1l1~~nru'l>1"11iJ,:h,1h.!t~f'1GuiHain - Barre syndrome ~nacute respiratory failure ",'h severe weakness
;:; Auionomic dysfunction
[1"l~ C]hn'li
[J 1'li L..J ~ 'fl '.l-J."Jl
l ! h
'··-1
" " ,; ,..~.--, llJ .'Jl
hi
,~
1 '. ,1_...J r., ,lJ I"Jl
CJ h [j1~1'1i
0 1-li [J 1~'l'li
[J hi " hihi
c',
1-d
r--;
h,ii.-rlL...i L ...!
[J h ; ,
hihL._;
LJ 1'1i [J hit'li
[J 1"1i
:-m ..!
'hJl·ou
[J 'l'O ~.]hJ1'li
A jj Weakness of both arms and legs
B i1'iJ1nlttk'llL~iil_Jt;'hJ~'-'O"~ILN~~P1hhnl.! 4 ~Ji?l1tf
c l:l Absent or depressed deep tendon reflexes
D i1 Severity of weakness: dlstal?:: proximal
E jj Sensory symptoms and signs
F jj Cranial nerve involvement esp. bilateral facial palsy. LMN type
G Recovery beginning two to four weeks after progression ceases
H ~ Absence of fever at onset
K il severe weakness
119

2.3.1 eJan'~I'l~'l~ CSF YllJ Elevated cerebrospinal fluid protein
with <-to cells/m' (sometimes a rise in protein content is not seen untu
the end of the second week or illness)
2.3.2 tlam'i;;''i'l~ Electrodiagnostic features (n10) y~USlow nerve conduction velocity C] l'ii ["]hl1'Ji
or conduction block. normal or small compound muscle action potentials. absent
or prolonged F-waves. acute denervation or decreased recruitment I interference
pattern ( The findings depend on timing of electrodiaqnostlc test)
~ .
'jJ'niM.n~~1AlJ@V1H' nr'_l
L_-=~='1=1-1=i'1:::Uc.J::::fl~U:!,=lJ~=i;j~"!J::U::.'1:ifl~.tJ~'1:.-I~V~IG~1~~~::..n~'U~2~n:....r:.::W:/~m~iI~n~.r.:JJ:.-I'l:·~'tI~n~'1.:'i.:.-ilJ~'b.:.li.~'U~t~'i~'l~~~I!l:..'~lJ:'~"il~1~A.:f~~.._. J
4. ";'n'1'i~m,n"lii Plasma exchange (PE) -i'l~;'l1!l1-11'iJhi [Jl'rl [Jhih
r------------------------------------- -------.-.-----------,
'l!'iJl"lJ1·eN')1ii~1l;!l:lii1~f,f·~tlUfl'/·1'-l"l1-3'YJn1.h::n1r
a.l1J'2-lbbYiVl~ ti#~i...rtn<u ..--------~-.--~- ..-•. ---- ..•
1UYi __ i / _
120

u.tltlvl~~J.JI11'ln'l1)iJnl'ii.'lI1!lI Human normal immunoglobulin, intravenous (IVIG)
'lI'€I'Ij..'l"lihA mhlJ~;f'€li'flUWi-l!'lfuCllfltl~{'j:::~ nqlM
(myasthenia gravis, acute exacerbation ~1'€1myasthenic crisis)
(1'!Jft~LfltJilJn111-n!J1ltl1C1lti'1~ih"'nLLU'l1'l14ri1[iun1T1ltJ1LU1~~i'l!ln1THtniltl'wl11Im"1~,wl·'l.J1J'I!:O!J1mrnlL1A-l'll1m)
~'il'lln'.JYltJ'lUI'~ _
bUJ0H;ntmfYlin",:r::::!ilu .J ~Jifl8iJij ::J Excellenl cenler
-----.-----------------.-- •..-----
, .
~'illlYl'lltr~Vi,1nlrfm11 ...• l1JtJl';;n'!l1J'i'ill1.Y;L'l'nnn~J L~l'lJYi
dhLL'Ii'llrJ~b;tJ'l'll,nJ~1MU'wJ~~-eJ'm+~iMv.1'El1~tTl11~~lflYl'll<!Ml11"''l1'IJ",1(;1 0 1.J1;;'ll'1l1'1lfJ'1
=-rp.nm'ilWll~lftl5'::::'lIYl1YJtJl::::;~"'lltl::.1:.::(;l~T::.:;.:i1.J================- ---,
I ~''fl~ll~tb!!l
••'l!'1l-'tJ1lJfHll'l HN AN
~'YItimmjnLJ v.ftn1h:;n •••'l~I:nYICi':a.v.tilr-l tl1::n'Wft'lAJ.l :J 'l-r'li'i1l15'fnl.11Y1tn1J'l~.yr,n'llnl1
LYfPllJ "jjltJ [J ~cD~rJu~Ci1nJlhtt?l_ 1_ 1 .. 'Enf.j ._...._U __ .....~~'Q'U
It'l'jjth';;'~lM')l.1r:;-nl'ilU'll'il~~1l';VI111)J~IL'W1Vl::::ltltJ'Wih'WOOOOOOODOOUOC]
~'il-Ul)J'lfj~'ll'ti':!I:itlnm'!l~
•.•• et •••• 4-d ..... 4" J' ,~ ,
3.1 1iI'11"l-Jn1rv.ltJl~l'll.iLV.<l'),l!~l.i'lI''..1"l~lnn:::1J<l~~''1T'anl'lI:.1L1.Hll':::'..1';I.:!'Iltl'lN'ii't)!LLj'':!
3.2 i'ltlln1m'<'19HYll.:!I'l~i:!n-n'fl"l.liIi'OlVl.cr~~l~~
J
i"-l "L.~ flhl1'rl
~ 1'li [J hili
0 1'1i
r->
'bi't-rlu
Cl 1'1i Cl 'bn'li
'] 111 r;hll'1i
Ohi '.:.=1,jh
[1 1'li ~~'bJ1-ci
!:,,
~j1.lJl-rli-.;
.'ll
<;'.1 '" "I w ., •• ilJ •• ~"l. ,.. ~ 41"
bl.J'ililn'3'fln'il'il~i'l .VlI'I':itlCl,;}U ~':i'fl '&'IhA':i'ililVl3Jl!J U'If'€l.:!'VI!11':i·mUI'I'd'3Jh'U'W"I'i.:!
1. ~thrl'€l~i'.U!l17:t terminally ill
00.""" _ 4', Pt '>' v .!, .:>. l' q
2. 'l'W"~l'llYll~.mU'Vl ~~lnlLlJ'Uti'ln~ll~L'W'fl'il'1l.mN'i1tili1~lm:::ti:::'ln'l[ii
A W',lU.:![1J1vlnl~Wll''{.ntl'W ..,i~'1in1m~~1n!il1i.J(iJtlnM (oculomoror disturbance)
c i1 generaiized weakness ",1'Cl proximal muscle weakness
o i1 fluctuation of weakness
.1"'.... co _I -- A'" ~ Q ''.1 i'l,..J •• / "I • •••
3. tllI'VI1~l.J!l'IJlilnl'i~'i'fl1Jr.;'J{IIn1"'J'U~'UE! MG ,11Il-lbl.J'i11l,&<'I'l"'fj-l!'l.unl'lv 'iN b'U'/!'fl'l'VIIil'a''lr,;Y{tl
E i1{lu~nlUtlr:;-liii'hd~hJ hl'lnfill.J~f1'1i'!J'Wllf'l'llU(iJhtl(MG) U 1<rl l:Jhn'li
F Prostigrnine lest (1':::1!e.!~) .
G Repetitive nerve stimulation test (1:;l!c.l~L _
H Single·fiber electromyography (SFEMG) (:r:;lJe.!I1L.__ . . . .....
---_ .._ _ __ •._.••....... _--._ _ _.........• ----_._ _---_.__.._-_._ _---...,
122

~ .J
'l'W'I'I __ , _
'---
w ..l
'l1.'I'I __ 1 1 _
-------------_ .•........... __....
·)'UYi __ I I _
12.3

U'U'lVl1.3flln'IJn1'i1itl1 Human normal immunoglobulin, intravenous (IVIG)
.n'flt.l{l.i pemphigus vulgaris vI~'fllm~~'Uu~" LL~::hjfil'il'IJ~'U'fl~9i'Vm~-rnHl~''ll!Jtl1).J1fi1~51'U. ~
(11tJfI::;LfltJlfin'11Hmltl7~t'i-Hfl'l"l1mLwml~ri1nun111i5U1uR:;~;:jtln'ltHv,tl!.h~I'I~IIM,!r-I!:;nIJJ'V-ntn~ftnLV~'li1~)
[i;l;~tl1'U'I'fll'/J1i1~''&1::I.''''V1!1
••'Iltl~n1U'Y1rJl1n~ _
dJ'U'lCl1U'Y1m1J1",~::5i.Jr ] !1~w::jj0 Excellent center
~'iJLL'Y1'11V~;11nlj'fm:n _
_ ._-----------_----.1
. HN AN _
~YI~fl1nUfl U '.I<lntlr::ri.••..~'lIJl1'td'i1'U-lUIC tJr:-;riJ«~Al-I[J '1~iiinlrfm:;-l'NtJ1u-1Wihn'tlnl~
LYH'IIJ 'tI'ltJ 0 'vIcij~ 1.jL~·tl'Ji:hn!il__ 1 ._i '1l1£.J i'J
L"''lJuril~tll'::h~l')tl:r::·r.'l'Jl.l DDDl.JCJCJCJ[]OO[]OD
Ltl~(.in~'fln"l.,r'W'IJ r;i''l'U'iI~'fl1?iI.A1'fl.:J'IUl'ltl ,"I.'U"1i'fl"v!91~.:Jn'IJA'niHI:l'U~~.:J
1. ~11'ltJtl~1um'l:; terminally ill --1-rl
2.~lh[M·¥Ufl11iil"l'il'tvhLiJ'U pemphigus vulgaris 1il£.J;j~1..~~t. (body surface area involvement) %
;jtl1fl11Y11~PI~nn~tl . _
3. r.J1m11ri1l''l''l'l11..J,x!l.nJD1.Jv1mT
3.1 histopathology (1:-;11) _
'-I1'il 3.2 direct immunofluorescence study (r::'tJ) _
IT'il 3.3 indirect immunofluorescence study (~:-;:.j) .... _
'IA~'1l3.4enzyme link irnmunosorbent assay (ELISA) for desrnoqteln 1 lLtl:-;3 (1::11) _
4. tJr::'M~lhmltl1..Hm IVIG
4.1 ~.M'U!J1steroid ~'il m 1J-I11il nlgikg/rlny
~~tbc;i J .._I O..J I ' (')/MJ)
4.21~3"utnn(il.1Jii~l.Hitj ~'il m, ~WWI mg/kg/day
mg/kg/day
.~~lllii 1 1 r..J 1 1 ('l/tll/u)
.'jIltJn~') nt~nhJ t,'lU~..J
124

"il'1lftlffi-.l'hif'1lJJa;rl~!li'.J.LtlUf'l'l1~·i1~YJmJr:;n1r. ,
a.sUll1u,'Vmicii"i.i'tIl~ ,--------------------
~ J
'lU'Yl __ 1 _-- __ 1__ -
~lU,UU" _
~ .J
'lU'Vl__ I I _
" •• ..J 2
'!ltll;jll III 'l1..!VI30 ti1f1!J1f11J 255 _ 125

u,'U'U~'el~~ml'Hhrl'Un1'.li,i'81Human normal immunoglobulin, intravenous (IVIG)
i~'!.l,{l.i'hemophagocytic lyrnphohistiocytosis (HLH)
(rltJft:;~f.ltJ:yn !r~lir.n~'lhw:)l'lU-!~1f1l~J'1Y1~nlnunlf onl!: ur)::~i!t)w'11-ntJ'Jfl{)' 1,1'Ai.J.:.wr"jftHlf..nj'~~:ntr"v,i¥ /ju~~lll:m)
._----------
.I i'll~a"'tlluYl!lI'UI'&I.t'&~t~Yl'Ylt1
~'il'HmJ..•Mnlnfl _
LU'U'Ml1'JVirJ'nni11:;,ilJ [ (II~WJ~ [J Excellent center
~ilYil,6e'hiln,j'j'm:tl 11Jtlj'~n'iJlJ~'n'1:nY'il')'ilnmJL"1J~. ----- ..•-.-.......•~- ...-,. ----..---~--..----
LU'ULL'VIVl~j'q~tJ'l'l!!~~'tJiflJ1~,r-l~'1lil~lJM1.{j'fl1lii:1tr(;] ~~lnLL'r'IVllJt1Jll1'U'Il'lJ11Vl I . '["iA(II~'Yl,Jll"t.l:;~i::;~-l1'Ub:lin
o rp.nrL'l'l!f'11'1Mfl1f'liii(ll~'il 0 ~Ul hh:1Jj':;1!
~'il'UI~~~j1 _
~Vlfin1i'iJn [1 t-1~mh::;r'f'Ji'l'tliYIy;t'h'J1A{fl [J .h:;n'Uil~M~ CJ 'I11'110n117m:tl'Y'irllUl!1;;I11'1!nl1
('(H'! ; J 'IlI,J r'l miJ-l l'Ubiii'fl'UtlLn@1 _ 1_._1 !lltl. __ t1 __ ._Liii'il'U
~'l11h::;·hnllh::"llI'n'..J'tI'il~~thtH;ril.Jiil''U1Vl:;LiJm.j'U1'J oon:iOC1ooor'-lCJC][::
~'il' •••·l.Jt rlWll'il~ql m,.,l"il-l
1.~thrJ'r)~11Un'l::terminally ill
2tJ!'lf1111i'i.,'ll'filrA . .
.---.-
Major Criteria Yes No
1. Fever
2. Splenomegaly
3. Hemophagocytosis
4. Neutropenia
5. Thrombocytopenia
6. Anemia
.1.h.l'WnriJ''l .• .
~'U,~81~'il1U . _
..----.•..__.--------- ..•.,._._ ..•....... "._._ .•.._-
-
Alternative Criteria Yes No
7. Hypertrigiyceridernia I
8. Hypofibrinogenernia
-
9. Serum ferritin> 500 iJg/L
..... . (.yWl~·1lJltJ)
_ 'lU
'UJJ'IfJI'Vifi}
t 1JfJ I, 2 UfI:: 3 ~fJ,'J;jn1'J(1J"'j"lW1Jfl1lJn'juJ" 3 1rfJ
tt 1ffJ 4, 5 Hrl:: 6 tli'fNifmslilt'J'l'W1Jf)(!h:l1JfW 2 'lw 3 iffJ
rrr wfJn'nniffJ'l"lifnt'JFl~'j'"l'WjJiffJ 7, 8 LW:: 9 :.;/fJ<'I,ylJ?1ttwn·}~';'jiJ"ffvrrfmv~'7iu

'Il'ilfU~'il"~'1;;'il~t'l;r1";;'UltJ'U~'l1l.J"l1"·~mJ~:;n1~
~~'U1~~~~§~k~1i~1 _
~ .J
'l'U'VI __ I --'
_ .J
'lU'VI __ I I _
_ .J
')I'VI__ I I _
itll;lfl (j -1uy. 30 mnO'lPll.J 2552 127

I.b1J1Jw.e1.hJrhn1Jn1.3..t..a-£I1Letrozole ..a-';Ju,tl...a-)J::l~'1bllllu~V1i:l hormone receptor b1JU1J'Jn
(r1!.1fl::ifltlVln111-ff!.l·lhl1U1ii')~ii~'nni.I'lVl')~ri1nurn11ojj!J1u.fl:::~::J,[)n111il!nilth~fll-lV"1WI'li1ll).jtT!ll~r.nvl1nmi~'IIl~)
1.n'il:.!~lIlt1''J'I'I!!n'U,-alJ.iI:;IJ.'I'I'Vlg
••~~rtnlu~VIUI~ _
L,jUI:(11U~~mU1~T:;Pi'IJ[] "lmtl.IJ~ ra~lm1u'tl1.flJijiltft:-;ft4Y1:-;lumiVhlft'lfium~'l!Jnwhlu~ltM11i"1-ntJ11}rl:n "1(2))
[] l1liiitJlJiJ11Excellent center
>4 ..-'" 0 .•..•
'i!'tlil~Y1!Jf;iVlln'wj'mn ._.__ .
dJ'JL~Y1£i~l~tl'l'llIClJ~'l?fu',nr~~'1l'1l1t~~1'illt;J:hrl1l),"llmLYlmJ'lrnlu'lI'll11(;1 0 '1l1flj'?I'll1lf~::1~:'jVl!.n
[If-l~fn~lla::l-I::lr-l:'j"{JEJI[] '1lt'lI'lJI~atlI"lIMf~:;lj-~1Y1!'J1[] ~'Jl 'h.hI1l1:;1j
I____, I[ i'flllJZI~thro
~~.~-----------------------------------------------------------
~t1-'U'1l-1i'1t1ft HN ________ AN _
~YlfinlmJn 0 '.l~mJr:;nul'l'lJm~cl'Juv.ih 0 lh:;f,1.J~4I'1l-1 ::J i'i·r~~n·lffnttl'f1r.nlJIr<-tiln'lln1~
i'U~'!lUUnV1 __ /_ J ~11rj..---u 1't.L~'1luiJ~'A~~ur:;~ll~'1lUIl11~Dm.l'llliii_ i_ , _
L~'!Ilh:;,h~lr)'Jt:;'lI1'llU C.JCJO C1000[:.JOC)OOO
[~l~tl_=.?'tltln''i'2ltK~bl,'t1:;.nill~nl~1,rtl1 . ---'-~~-;~~tJvrlV~I_/ / ---]
tij.~Vln'i'ilt1-n'f)l.J~i. ,rfl'iU ~1'U ",l'il'l?lbl;;;~'e)~'1nJ11U./ i.u"l1'2l~VI(9)'3~nuWJ1l-JLtJ'U~~-3v .
~ •.••. ~ '" ':'1 ,/;
n. n'i~n1'i<Jj'f)'il~l.Jl1lm'i ~'lI~1~'Ll'W"''i-3~'in
1) ~'lhm)~hun'):;terminally ill
2) iD.9~tJml~nnJ'l'i~u'h,jul1'l'ImNm1lJ-iitlti~H'~j':-;1jl-nul~1JUI'ltlfl-Jii
3) tJrlI111mj"J'~hormone receptor d:Jutnn
J1i LJ'll-ihi
L_ll'ri Uhi1'li
Cl "l'li [11" ._' ".I L'il
4) ~1.l'J~?lFJ1WlI'l::"!l.J@JtJ1':;"hdii'1lU!ilI'JLnruof.Yh::l.M ('ilti1~Ul.ltJ 1 -if'tl) [] 1:rl 01l-it'li
4, 1 ~U'ltJij'111t!,.jlnn'h60 U [J 1,ci Lj ll-il'li
4.2 ~tl')tJ1Mun:rr.hi£1lf~1'!i'tl'1ln~-l1.Ul!1lj h :.1 1l-ihi
4.3 ~t1'l!:J1.-ll,JI1ll.h:;r.iIL~'ilUI1l11.jfi1T~"t'ArhJ'wl11nn!illJ::Lr'lLr.h'..ltJ 'n.!~nnn,j, 1 U :-j l,ci [i 1lJl<d
5) dJ'!.Jn1:/b1!'J11unl'rJ1£1l
[] l-I:;tr-lt~,'U:.n:;tJ:;LLYl1m:;91tl (advanced breast cancer)
o l-Id~LWhu)'l1:;tJ:;LLm'lv1tJHtJ1~L,jllmLrt'hJ(adjuvant therapy) luqu'w~ltilfutn tarnoxifen ri'1lU"'h.ll'lal
____ Liiitl1Jj':;tJ::L,)~1nlrHtI1letrozole j',)~Hl1J1':;t1::L'l~,mrVj'tamoxifen r'l~_, L~'il'..l
(tl.!~l«l·n(;')r'Jl-Jnuhhn'U 60 L~'tlU)
Cl ~:;LT~Llfil'wlJ1::EJ:;Lm t&1tJHtI1~LtJlJmL~1l-J (adjuvant therapy) 'lu~lh!i~'1JiflJtn letrozole n'tl'Wl'Lhwll'n
, So' loo , • " ,~
6) 'lJlJll>1my1ifi'lf,lil i}~~nfl-i/1~ ('lJ,nPlYiLu:;i1,FJ'il 2,5 i1~Rnf~(;j'ij1U):i'::ti:;L'Jl'lIY1lv.tJVlf~u 'ru
128
•

'll n~t:1hl'~",itllcff<lLl,IfiAf<lvt'i1'fl'l
1) ~lhtJ'El~'um'l:; terminally ill
2) ~lhtJfJ<lfll(i)I'l1JfU'ill.,j'iln11~'n'd"m~:;Yl1.Wi1-iil'lLAtN"llmj'j'lwfi~1l-lWirl)tJll1il'lhJ
·L._~_1ld_f_u_a_tJ_+_lf"_(fl_n_1_t l_<D_tJ_l_d._J·'_Wfl_f_,,_~_~_~_~'~_~'iJ_';_(fl_;_;~_'1_-~_;_~n_'~_'~_"~_'~_n-_A_;_'~'_;_"ll_Jl_~_tl'l_:;_2)_'_l"li -_'-_-"-_-'~~~===~~J
3) t)u~dl-lli1tJ'lAf'mm _ _ ('lvliA'in-l111)
4) p:rrul-ifd'IU1Jlt'l'il-l IJl:h:Mff1J'J1 tamox:fen nm.<tUU"il1J(,)'ilU ~:;tJ:;nil-ln1?HtJ,)tetrozole t'l<HiJ
~~ •• -1"" "" u ~ '1 ' ~ ., "" a v ~ ~ u ..11
r::tJ:TlfllP'j)' ~'ll tarnoxifen :r'Jl.J LW~'W('1nil-ll'l 1~I'll L~,r'mn1.Mn'W 60 Ll11f)1J)1.17'i) l.J::NLlfil'WJ.Jr::U::,lm bIil8,'lltJ'l11
dj1.81''l1J.J (adjuvant therapy) l1J~lhrJ~'tMu'J1letrozole ri'1ludJUl'JI'l-t l~'tllJ r:::1'J::t"t'-lrn~Htnletrozote :nj.j
rl1Jr::U:::L'lillW1111ftarnoxiten 1?J.J L~'il'W ('1l'lt~W11fl<1'tAn'H'i'uhjdlu 60 '~'iJ'W) ~l"d;'1J~lhlJh!lJ
..J"I"" ::.. Ji .••. ""'I ....." ..J., «8 ••• <:> '" , .., ,J v !: .J:f
5) 'l!1.nfi1!J1Y1,'llflNU ~J'l'1lIl1l.J/'n' ('lJ1.<ll111'1UlJ:::1.II'l'E2.5 l.J'1li:'HitllRI'l?V) r:::tJ:::l?tnYl1o1tJ·1A:·'1! .5u
v "'"1.'VI. __ I _
v .J
1'.)'11_ ..__ . _
.._---_._-_ .... _....." ._---
,--------------_._ -.---------- _".",,-_ ..•_--
-----------------------_ ,,_._ ..
129

~~'U'Uvl'fl~;Jri1n'Um'.li.i'!Jl Leuprorelin acetate
-n'ilU"i.i'111'l:; central (gonadotrophin dependent) precocious puberty
(1'Uft:;lfiul1l(1'11-ii'U1tthl1l4i'1~e~"l'lm".~Y,~nln'Jn,!Hitnu!'i:;~ih)nl'1ii!Jltl!.h':]~lJlY1~lW!(lllJlkll~1Jl'~~nll"'':]'1n~)
••'llfli'ltn'U'litn'Ulft _
dJ'U2Cl1'UVl!Jll..i11'l1:;r;1'U[] ~~tJJJi1 (~~1~fU~~I~ Ilfl::fl-lVl::ujuu11lljhlU-!th8~lwi1nU~LjWI1k11'i!tnur!'D 'i(2))
Cl lil~tJ1Jij Ll Excellent center
~,!lL'liVltJt;f'r'j1n1Tfm:n .__ Il..ith::mllJ:j'l!1;"n'l'linl'1'IJL!'l'll~
dJ'ULL'Ii'VI6~L~f.J'l'll1 '1J~1~f1.J'l'w~~fl'1l'4m;"i1fll fi:jutil191 nu 'Ii'VIElM 111..!'tl'4~1'll1rp.ll1 L'l'll ~ 1~ MfLUI r;ifl,J Wvi'i)Li'!::l;..iM:::Utl ii'i'l l-I
[] 1.,n [J hl1'll [] ~'U1 ttli'M~::'4.... .....
L.~'il~a~'l~ . _ .._... ~
J
'll'1l.1..!ll-l'i'l'1I'l • HN AN _
flYlBn''HUn 0 1-1~mh::ri.~'lln1'1i{)'l1..!'1v:l to] th::n1..!<1-lfl-IrJ 'i'1'~~nlrfmj'1'1itn1.nfliil,'1·nn1t
L'liM[] 'lilt! [J '.I~'l ~UL~'1l'UULn~_ ,_, tlfj __ U __ L~!lU
• - ~... v (=:]nO'--CI'-'O"lr-)r]r'rl('Lml1.J'::"'11i1"ltJr:;'I!1'll'U'1l'&3~U'ltJlill).J~lL1..!1'Y1:;L1..J81..!'IJ1U.... L....I L.J -,L._J .Jl.__'-."., L.!
~'1l-Ull-1~'1fl"ll'1l-lr~tJnAr'iJ~
-,----
ttl'S'(;}n'i'fln,j''fl:J-J~1'''fl'S'Ud''J'U,"-;''fl1?ibFl~'tl'',"a.JIt1 ¥' i.U'J1'tH~j;)'S'"nUfl1I:lH1JU"l~"
...•• ......"., .1 • ~I •• i. J ~I l:.
n. n"ClAfl1""II'il'il~a.JUln'l'S'~'lf!lllJ"i!:"I'l1l (O'.l'tlO"ll'fl:l;:!iI 'U~'l'U'UlJa:; 1 A"~)
1) ~u')tJ'iJ~1UI11,):; terminally ill
, ~
2) :jU'I'i1tJlIlll.)Lnru'l'l Ylu'hdJ'Jb~!1I1.J!1I1lJii'f}tl'{lif~h::1il11.uLL1.J1.Jvl'iJflJU
1t!l~'iJUu~:jil"itJ _'_' __ .__ 1cii'lLU1JtJt-1011fJ11'l"lJl'1i1flJnl..iLl'Uu~~'iJf'Jd
, ,
(1l-lihnmrdltl'il'ltj U L~'iJl
3) n1n1!'J.j'nv'1~L'Ii!"i"ljjjr.LQS1(secondary sex characteristics)
3.1 r1'1lU'ill!:j 8 tnuLJ1nl-lcV,"
3.2 ntlUtl1t:j 91JtUlJ1n'!lltJ
T1.J~~ ~:;1!r:tJ'i1:-:ItltJ:l
:' 1, Jh11'1i
=:N Ohi1-li
fJ1-d O11.i1-l1
Ohn'i
'J lJ.iL-rl
4) '~,ml'n __ i'll'iln1'IJ ~'l1..!l-l __ ''l!Ui!iLIJ~!~'
5) f1'nlJl,:j'll'iJ.Ju~n __ "'ouiihlJfJ1T1'l'11~J~-l'!J'iJ~W1~?n__ l'llU&illJIIl1 f1'l'i'JPl'UnmJ1.l~ijl71'm'i1:::.n1i11' __ l'llu11hlJfiil'
6) tJl1n':1'r~1'l"l'Vil~~'il'llJ{jlTilin11
6.11:;~Utl'1lfll-JU (-ii'1l191-ii'imU-l) 0 'l'li c:11J1"fi
6.1.1 nbasal LH __ lUll ;1.:!lJlnn-ll 0,3-0.5 lUlL
.•... v "" d. ,
6.1.2 peak LH "HNn1:;C;r~J~'ltJGnRH __ .lUlL '!!.:!lJ1nrm 6 IUiL (leMA)
1.Iffi 10 lUlL (RIA)
6.1.3 1:;~1.J LH/FSH '.I~,m1:;~util,)tJ GnRH mnn11 1 (1:-:1..ir::r;11.JFSH .__ IU/L)
6.2 t11Qn1:-:~n__ U ; .•J'11Ul'1l1tY'1r" •.nnrrh t.o so 'll'iJ-l'tll~l>Il'IJtll)~'Utlth~1'l~L~'l
132
l., hi Uhit'li
C1'li ~Jhili
t..J 1'li LJhit'li
[] 1'1i •• 11Jl'1i

6.3 ml'V1~,,)"l MRI 'lJ!)~'ll-J'el~LLfl:;~'i)lJllii'llJ'el.J
6.3.1 nnullilwlI1t1 (r;l'il-l11l1'l'1'>'lnntJ)
~
.rUl~!)u;jYif~nr.; _I _/ 1~llU'Jt.J~nll'iJ11?~1.!1Yi¥'ill-.lnUlLUUyl'!lfl.J1
:Jh
[.: l'ii
6.3.2 nn1L~n,lro-l
6.3.2.1 l~l_.l~!)1n1nn'el'el,~~,n1' 7 tl
1UIMI'J1..lrJ~V1l''l''l _'_I 1UiLIUUCJi'ln1j·f1l''l''ll-.l1'(;T'ilW1tlllU'LIYi'ilflJU
...: .••.• cl • !"'I • ~ """ ,~
6.3.2.2 l1l-Jl-J'i)1n1l'il-J'elmf~:J1nn'1'1 7 u LL'l'i::til1'lr,WI-lrntl'YiU-",~t.Jtn'L1nV1
.•.. d dl.J 1v •.. ~ -- ~
'lUllil'ilU1JYliJ1:i''l''l _1_1 tliIIUlJt.Jl'lm1V11'l"llJl'Yinll.Jn:JLlUU'AmlJU
••6.4 Ul'lfl1:i'tilt'l"l'ilU
6.4.1 ultrasound pelvis lu'YiI''1ro~ _
.rJLM'ClUtJ~i1l1''l''l---.1 .._..J . 1tr11.lU1J~Il'lrn),i1l1'l"llJ1'1ir'ill.JnULLlJUYhlflJt:
6.42 ~U1 hJl'i1Il'::l.J11t1'l'i::lBVlil _
,r'W'~'Cl1.!ilYiIill''l'" ---.1_1 lfi'iLLUUt.J'l'im1I1lr'l"ll.!1'I'IT'illJr'lulllJ1JyfjiJi'lJU
[I'D
=J l'ii
Cl'ii
!:J l.Jh
iJ llJ1'ii
[Jhlbi
iJhJ't'li
fu"111J;hlJ~J:}~Lnru'l1n1:r'lJ'il'il11~n'wHtn A!)
m(ll~n"lj1fJ 1) hJ1."1i31) 1'li 61) l'ii 6.2) 't'li bLl'l::6.3.1) 't"1i
mT:1~nmli'Hrlf~~1n~17iJ 1)'W1"1i32)1'li 61)i:ri 6.1.1)-61.3)h (-!i'il'ti1l-n'il'.l11~)62)1'ii 63.2.1)1-li
nnlllJiDm~-l 'tl1f!~nnnrj, 7 t11) llJ1'll 3.2) 1'li 6.1) 1'ri 6.1.1 )-6.1.3) 1'l (ii!)1i1l-nm"ti~)6.2) 1'1i6.3.2.2) h
"I) rnrfn~1~')tJ leuprorelin acetate
7.1 'ell<i~ti'lfJ~~l.Jlli1f'LJn1'j'fn~I__ iJ__ L~il1.J
• <-
7.2 ~JU1Ulr.nPlf-::t1 'b./lFlrn1lJAVldJU llJtf'lm1wnL'i'1nflJ1~m''ltl1fi [1 IM C; se
1UL~'1)uu~1-Mr.n_1_1 "llU1f;)r.n~::'llJ1'll.J 1lJLRm1lJ
'lIU1~tn~LL1.J::inl,n-n100-150 LlJlflmflJ/fit'i'1nflJ IM v.1'1lse V)n4 ~tJ(;nMv.~"'''l1nHtn1tJLL~'l 3-6 i~!)U mn'!lU1t11
tI1v1-.ln~1'lhJ~'1lJ1~'''~i1lr::;~u<I'1lfllJJfN1Ji(peak LH ,l~-l~liItI11-2 'l!lJ. Fl'lrtJ'ilWl':i14-5lUlL) 't~tJflJ'!!1.JIIiltnL~~11;;
"l'W~~ 300 'Ll.ILAmfl-l/ilLRn1lJ 'l')n4 «Ui1l1,,
"lI. n'iiiln1'/I.,re1&-.lI.l.~A;f~~~'eJ~(n'i'eln,r'fl~~'l.'W~huif'Vlnf1f~vtl.trtnenL1uiim'in'i'f)ni''illJ~'l.'W••b'W n.)u. ~
1) ~ll'ltl'1)~l1.JJn'l:: terminally ill [11'!i [J 1:JL-d
"2) U1mrn __ ntlilnhJ fhu~." __ L'lIUii1ll.!!il~ Fll1lJ~-lbiJl'.1lJ1~J l'1!uiiiLlJJI1
3) qtl"lVtJ~~A'l1lJr.'hLtl1.Jrii'1)"'Hm!ii'ilh.l
4) ~'l'inTi'M~,)"lpeak LH v.~·~illiltl11·2 <]'ll.l.'(t'hil) whrl1J lUlL
'rUl~'1lUU~17l1'l"l__ J_I lJiLl1.J1Jt.J<'In1H~t'l"llJ1~~r·mlnu"uu~+llflJ1
~fln11{;lW'l1h..]iif'WtJ'1)~m'il 4·5 lUlL
5} ~t1'ltH'm1iflm1~tJfu"ll'W1Ii1m
6) '111.J1(1ltl1Flf."il 10l1m'nflJRIiILUU 1lJt?!mrlJ/nL'l'inf:.JHrii'ltl11l LJ IM
l'WL~fluil~l-Mm_1_1 m1hltnPlf."dh:l"l1nl'lf"'riilt~ ~I"t11.f
7) 'lJU171m~::f'1lJ1'llJ 1l.J1Plmfl-J ?.lL~'i)utJ~l~mAf"'LLmJ__..L. .._._
8) n1~fn~"l::l'IrUnl"IUI' 1 tJ"'~."n'lr!)ttl-1&1A¥"'ri'il1.JLd'tJ1i1l__.-1_1 __(1WL~'1lUl1J)
C::hi [} l:J1-Jl
t] t'li [J hJt'ii
C se
'l -s-rvv

'!l~Tt)r~~'i1;r'BlJfl-ii'N Ulu(UUrI 'l1)J"l1 ~'r1 nu!:: rns" ,
t'l~U1)J~~'Y1l3er-k~1.isl" ._---------
____ 1__ -
1ii1LL"',j~
-----------
~ ...rrWYl __ f _
134
•

!.l1J1JW'OI.f3Jr11ntln'l'a'l,-tl£l'l Docetaxel 'li'OlU,,'l,'li3J:::~~!lI,~1'Um:t;£l:t;~mn3J
.(n'1J(l:;~tltJMrnTHl'I'lhh'ltl'N.a'l"'H'llU'll11'1rhnlJm1HtY)(lt:::~iJ"m11-ntnl)thl~I-l,.V(')W('H''nJ1Jr!;.1l'JrI'A5nLlli.'l'illiii)
[ 'li'il~iI~'rnJ!V,e11J111,;at:WVlVl9 .. ..
••'lI'fl~:nHYi£Jl1Jll'l _
rh.j'lmHl~U11Jl~T::;v1lJ[] MMtJIJil L] Excellent center
~fllLYiYltJ~~in1~fmt1 1lJl.h::;nfl'1J~'Jl1~Vjl'l·nrlnl-Jl'C1'n~ _
dJULYiYl6~l~£J·J'jj1ry~1MuM1!-.1~fltl1•.)m1-l1tll,yjjUr;J~"l1mLYiYlm.'l111.!ill'!111R [J '1l1~1PiI~l1lhJ::;L~-.11YIfJ1I] l'imIPilMfl-J::lT~
1V11T10 f~~fn1:tllll1::;l-J:';l1-l7h1m
_____ HN AN .....
~'1fimnun 0 ;~mJr::;n.!"l'lJmi"ltl'l'U'V1~l [] th:;n1.Jl1~fI.JU f1ifl~mj'frilt'1i"1fJr1Jlil1f1n'llW!1
'l1-lR'1l1.lthnt1l .. 1__ tl1tl tJ
~'!Irfi1nh:;~'lvl"11?::'1I1'li1.J0000000000000
[J 1'll
1'll
Uhj1-ri
LJhiN
[Jhn-n
[J hn'g
CI1lH'li
[J 1'li
3.2) 'Afanthracycline Ll~'lhi1JlNI'l llfl::1Jru:;~1~11-ltpl1ll~'1iianthracycune Lli1" 141 hn'rl
, ,
?1Jl~tlUtJV11MtJm antnracyctine __ ! I__ 11.lIAil'cltlV,'Vl,!AYJi__ 1 ..._1 __
4) ~11171m1m::"llfJ'lJ'tI~tj'1' U 11, C]hrl'ri
tUJAr::1JAlbb~I~-l'!l'f"lrn~m':;'~lfj [J (ju [J ~l-J'1N [J 1.J!lA [J nr::;~n [J ~1J1
i1Jl~'ilUi'l~r;J5''l''l __ I I__ l#fLlU1Jr.ll'lnl~l'1r'l"mi"l~"llJn1J(l1J1.J'vl'ilhl~
5) ~m'Wh"n1tJ'lJtl~~thtJil~'U~:;~'1J1f' U [COG 0 U [COG 1 [1[COG 2 [J ECOG ::I
!: •..... 4>.~ V ..J Co. Ji cJq, I
6) 1J1V11Jr1 n.flm':I-J .~'lUl'" L'lIUJHl·J(,'11Yl1JY,c.l'lj'i'lnltJ_._... ~ filll"NllWJ;'
7) '111Jl(iltJl1'i'il11J~i-.1HlUfJf.jd i)(liinfu i',c;)lUW/J1-I1AtJl .... ~~1nfl-J~i'illjllnmJr;!T
('!J1J1L'1rn~ll1-l:;lh1UAull1!Jfi'1l 75 i1~anrw;ifl~U~f,j'l 1 liI'Ij'1~ll-HiJ:r)
~.~ ~ ~~ •• , v
8) ~u'l!J u,1'1Jchemotherapy i)1-Inl-J"yltJ
U l'il [J "~n'rl
[J ECOG 4 C: hn~th:;l~1.J
q ~ ~ 'V .e . ~ ~
'11. Mrurni'll'fl'fl~~t1!f11'l ~'i1f)lii'1-'lb1,i1JAi''l'VIl1'fl~
1) ~u'J(J'il~lum'l:; terminally iil CJ1'll [J llJl'il
IV ••• ~d"":., v ~ , 1.< '" ,
2) 'l1JIAil1-luYll~l-J.~81M,mm 1_ .._ 11111iftJ1i1f..,UdJ1J cycle Y: (1vl:ilmlA1l-id'iu 8 cycle)
.J~ !;.)J ", d ~ -I f '
3) L1-ll7lfJ'i'YllmnANu nlm.nfl'ill'~'il-:)";nA1·:mm l.l 11'1m'll11-l~'''l'1nnlj''At!AmilAt'1') (drug holiday)
, ,
4) nnmiftJll'i'ildl'1l"'~U'lfJ8~f'H(i]'il1J'l1J'€l0r;]<ilmlfnljr'll'i'~;'1utJfl'ih"'l0V'-l9,nm'1.tiJ~,'''';Jf1'Jl'1iftJ1M!lloJ [J h i] hihi
hhfilm~fiI'l'V1~n'i''WI~l'J'vh:;1JVflH1X')1i'tlPI. Ml1J!h".. ,
'135

6) JlmXn nt'(lnf~ j'j'm~-1 ''Il,.AilJiIl1 ~j~W'll:,;jmfl 1;1'1n~"JMl'
, .•.. .J I !:.. ~ ••••••• 'V 4. ~ "'" "" oV ,
7) 'lJ'Ul£'1tn~I'iI'l'U'Vl~.JH1'UAN'U lJflflnnJ f'll1LlJ~.'lJU1Atll lJflflnnJiIl'ilillln;),lJ!1ij"
8) ~tl .•.m1t1ii"tJ chemotherapy ~t,!i')~~'lV
u
9) 1,j1i1l1::;'4~'1lm _
>'t. ~liInT:,fn'j,;l
1) -rU,iililtJU~Cfm"l f I__ 1:::tI:::l'l'l1'h~"'nm11-MtllAi:~LlmU1u .. __ ~Ufll';
•... d"",_ ...,
2) t:iflnl1Ii1n"YIl;j~N'l'lU"l'!lV
1:i1"U1.1m~mrill1'l"llJ1Y1 t'illJ rltllllJ1JvJfl flJ~
iJ hll'vnrJthw'l (complete)
[J n®w.,j::'~-.l}J'lJ'Wlm£1n'l~'v11'i1'v1!Jhl1J'Hll'l'U (partial)
iJ hjill'1l1JM'W8;j{il'1lm~fm1'1'-i1'i1iJm~~nfl'1lJ'lJ'1l~hA(stable 'v'§'e] progressive)
3) ~1.:htlA'l11Mtlm~....,tjiJIm (drug holiday) Ltilf~"nnm~iIl'illJfl1.J'il-l~lrm
4)
'lIilf'J18~rJloliill;lflolil~tif'UltluR'lllJ"l1;jYlmJr:::m1
a.:julm~'YiVllicri-1l't-Kal
~ -------------
v .J
'lU'YI I _
136

~ .J
'lUV1__ / .._I_~ __
• u .J
'!lfll.JI1 tu ~f'/l 30 n1fl!l1IU 2552
13/

LbtJtn-l'eJhui1ntJn1,;tli'm Docetaxel i'eJtI-3"li' lJ:;&nJ'flC?l'lliiC?l non-small cell 'i:;tl:;~n"ilnlJ.(n!lft:;lfifJt;lmr1ifV1t1l1",iil~tl'91mlU1Vil,nlrun111o!i't!111tl~~i1flrn11-n!n1J!h.J~'Jl<ri)[.Jfl!JI-tl-J1I'I!iiu-,<:i'nll"'~'ln~)
~'iJfl(1')'Uytm'lJ'1~
Ltlufl(1')'Umn'lJl~r:;P1'lJ L.J~lUir.Jl.Ji10 Excellent center
~ r~ 0 ~ ~ J ~.. .J
"'iJLlYiYltJt;!Y11n'11~'nf'l nn 1::ntU')'l!I'l1VWj'nnnmmJYI
lthm 'ViYltJ~L~~J'l'jjltlJ~lJif1J'.1V:~il'1l '1l'lil--iii'm"1'il1W)ufiI~91 nu ViYltl,q!l1tt.I,qI'!J11ti10 'iJ 1'FI'i, 11Qlhi:;lj-~~Y1tn
[] ~'itli'lfl~lfl-J:;Lh';)V1tn 0 f-lifm!tllL'i::lJ::LT~~Y1t11_0 ~1..IJhhM~:;1.J__
r-.£:.'Ii'£l:!-l~ertl';a
~~'.~--------~-------------------------~-----------.---------
~'il-'UllJjllf, _ HN ~AN _
flv(iinl:nun 0 '.1fi'm.h:::f1'".j~'lJ1l1'1'l,h'U'.1Ul 0 u1::n'Ul,jAlJ [J f'i'fl§in1rfnl::tIYltnU1~'ihr1')jn1~
lYlfi'l[J 'lI1r.JD '.-1~~'i''!l~'1l'Uihn(iJ 1 1__ 'il1tJ U
~~~~~ 0000000000000
~U'i~n'i'ilni'tl~~"l,rR'i1J r;l';'U ~~'el"l'lhR1'£l~~3J1!'l ./ 1.'U'll'fl-3v1Ci'1'i~nmnllJbtJ'W"ll~
•• ""'" "I '" ~I .r,
n. n'ir;un1T'l1'£l'el~lJ!llnl'i ~'lftllLu'WR'1~Wm
1) qU·1r.J'1l~1ull1,)::: terminally ili
2) liU••'iltl1l11~LnN'I'l V;1J':hdJuhl'filNml--J_iifllj,:rH~j':;'tJ1-n'UlluuYI'iJflJd
'i''Ul~'1lUU~ln''i1lJ __ f C 1~LlUlJ~flnlrfil1')'~lJiV;r'1ll-JnULLUJvi'ElflJ;1
.-
3) ~u')tJntJ1fllJl'I,)11~fu docetaxel (nFUI1::1..JL'.1!i)CJflfilllJ_ii'1l 3.1 1-11'1132)
3.1) hii'lllJ11C1li platinum 1~ Llh
[] 1-rl [J bJt"li
[] 1:!l [] 1~·~'li
·l'li .:J 1~1'rl
::J 1,non
'ilhi1lr::l.jl1tlfl::LtiElVi ... .__
32) H platinum LL~'ll~J1rl.'CJ'i'lLb'i:::"1!tl:::dlu'1'vl,!i1ln11Hplatinum ll~,) Dbi Dl11l'll
~ '" ,.,.J1 ,,~ , ~ .• "".1
'J'ULM8U1JYILVirum platinum __ 1 1__ 'lUli1l'1l'UUYl'.1~V1tn__ 1 1_... _
4) iln1nL~1im::"lltJ'I1·Mt:rfl CJN II hl1-A
hhi1l1::1JIii,m'vl1.l.:)'I'1l~mm~:: ••'1tI Cl cilu D fll-J'1l--lD m:::l(ln U ~'UJ _
'i'tJL~'1ltJU~(;ll''l •• __ I I ltiflbUUt.lMI1{1l1')"il-JiV;r'1llJnUlLUuvl'ilfi.l;1 [] 1'li COl 1l.n'li
5) I'illlv;hmIEl'jJ'1l-3~ti'ltJ'El~lt.1:::P1u1i1l D ECOG 0 0 ECOG 1 D ECOG 2 [J ECOG 3 D ECOG 4 fJ 1:.i1011h'::lij'U
" " .6) ~''vlV:n nt'i'lnfl-l 'Ii,)U~'l l'l!'UuiLlJ(;l1 wuViU'lhlfllEl Qllnm.11l11
7) 'DtJ1i1lm!ii'1l'i''U~i,:rH1tJAf~d ijflfinfl--f Ai1lLthJ-'ll'tnVlm iifl~nflJfii~lL'l1n~LlJfilr
...l • d _ •••• •... • J' d_
('ll.!'(;ltl1V1LltJ::tJll'i'il 60-75 lJfl'i'lm}JIil'1lYl'UY,:.I'l 1 c;nn,H}J&lr)
8) ~1.h'-f1tifflJ chemotherapy ~1.,li,)l-Jr.r'ltJ
hhfil1:;l..J;'Eltl1 ._------------------------------------------.--------
••• ~ ~ •.. ~ • ~..:.I
'11. n'itun1T'l1'tl'el~l-lVln1'i .'l!tll(MI.1.IJl~.,~'VI?l'tl.:J
1) ~ll'ltJ'1l~l'tUlI'):: terminally ill
2) 'i'tJbei'1ltJu~LjlJllfmAf,mm __ 1 1 _
n1r'llfmflhddJu cycle ~ (t(MJi')1ubLU::~11ift·lftl1 4 cycle LJ.~·dlJLntJ 6 cycle)
3) ~thVri,lR~ll1fl1.J~Ull,:rc;i'1ln1:d:ntl"ILb~::Y1'UW~.jf,_.3LA tl-.3"i-,ntl11';;;~ i'1lJA'J~l lfV1~i '1l'hl.'(UT~lL~~_!l1_1~ln~iU!Wll_i~5':;tJ1_nulf'l_ii'Cl A. tif1'W~h_!l
.. ,
138

4) ~Jl1Ylh~nJtJ'lltl~~1J'ltJtl~h.r:;~'!Jl~)[I ECOG 0 [] ECOG 1 CJECOG 2 0 ECOG 3 [] ECOG 4 0 1~1tlflh:;jjti
5) J,.>nrn nt'lnf)J ~1ti~" 'llU~)J(ilrv1u~ehh'JnJ8 (illn~)J(ilr
'6) '!Iti'lillVl';tl1..l~i'~'l-ntil'1f~~ iJ~anflJ ~iIILUti'!ltil(i1m j'Jf'!?inf~~il(illn~LlJIM
7) qth81~fu chemotherapy ~'Ui1lJtii1fJ LJ 1'11 C 'l~'l'li
8) hh!/lr:;l..I~tlEJ1 . _
[--.~1llflJ::itl~!.J~ Lnru~~lr'lJ£l'ilttl-1Ml..xLJIf'lf-.l~'ltl~ltJurJitihJfi£l1) hi1'ri-3) hi 4) ECOG 0 ~~1 ,Lf'!:;7) hn'li J
A. CJ'i'lnl'iTf1111
~ •• :'l.J , , v ::. ~ J ,.
1) 'l'lMHlUtJYlL'lJ''l'll__ t;__ 1__ J·:;tJ:;'l~·lWN"l'lnrnr~tnf'11,lllrm,n1..! ('jt (11'1'1-1
2) ~mn11(i11'l<;Y11'Jf~~1{j"'l'iltJ
HilLUlJUf'lnJ1(i1n"llm~r'1J)JrlUmJu'l'l'ilflJ~ [} h [J 11Jl'li
[J Tl'ltnvLtJ'HlJIII(complete)
[] nm,!lJ:;L1~iJ'lI'U1Vlt~1l1'l·niftl'Hlv1tl1J1_l~'l'U(partial)
olJ.Jmilu~ti'iNIli'flnJrf1l'1:tl'H1'1lil1l11i'lnl'l'llJ'lIfl-lhl'l (stable 'Htfl progressive)
3) ~lhv"m1;,fu1l1~~(iltJ1itifl'J"Illl1ll1Li1'iJUi'ltifl1~ n1'll
•• •... '" d! od &.<' V r"Jtj
4} f'1'lm!Ji1ltnlLI'l:;1~"I'l1rulrn~/!l'lmLti'li'i·N'1l'ULUfl_l"l1nnl~m~~lJl~f'l'l L..J 'Ii
o1JJ1'li
ohi'l-i
~ .J
'ltiyL. I I _
~" ....,
a1Ul~~~i'i~~~~)J~----------
fiilLL'VI~~
-------------
1U1 I _
139

("iTUfl!:li)v~!rnr1~tntUj'V1i5-!~t3'~'1'·ln~.nni-'1'·i-..1!1~:nurn'/t-nul~~n:;:~ii1Jr:'lrl·G~nDdrl,a~ll~1A::r;e.J'f1(WI).Jl~f!l}~tJT~tln~lv'...;"ti'im)
[~~~'tl~m'U'W£Jl1J'1~~~~tt'W'Vl!3_" _
d
~'!l~m·.J'tnl.J"I~ _
-l-------- ...-__ ..._...._._......__ . -l_
dj..!'.'lm..!wtnl.J1f11':::vll.J0 MAtJJ;)i-l [I Excellent center
~tJu.~Yl£1~,hnl~fm~l-Jl.J1Jl':::nmPi'Jj,I~~wl'mtt:mfl'lJ~ _
d'J'Wll'W'I1£1~l~m"ll'lrv~1MtJwtl~~'1l'1l'4f1Mvr'1l1~UMt91n uYi1V?11r111.Ul1'lJ11A [] 'fl1~7?ll~~lf'):;lr·.'~'I1m
[J f1f1£Ji'll"Hil~l.J::l~-l1Yl~n [] f-1Mm~1blfl:::lJ:::l~-lll1tn !] ~Ul hJrAj':::~
I .rfJ'~fliiJ'}s . . ---------
;il-U·IJ.j'i'l~fI HN .. AN _
1) ~tl'lu'tl~l'WJn'l:; terminally ill
2) 7jU"1'il'wWll.iLmWrl ~1tJ?1dJ'Wt7fIIilN(Y!'1J.j1i'tlu~H~r:.:1Nf1.'W"'U1JvJ~]h!i1
••..• 4 ~J..:t.4 ••.. 1'V ~/.." •••1'" 1:
'l'Wl,WilUuYl'lU"lfltJ I ....i._.. ..._ .flLL'W'lJej"nlj'I71~·'l"ll.Jl"tl1'tlj.JnULt1Jlly·fflnjU
3',1 ,,,! "'u J~ (f )' v." '-"
,uU~ 'l8'11A'fl re ractory (lj'tin11rn111A'lfJ!'Jlll'1l1·1:J.!U
..• <-TI'r:::1.J'n£tJ1LLfI:::'lJU1AtJl'Vl _. .. .. . _
4) 1':;;1.rh~.'l!11~~11'ltJ1Jffunll'fn1'n':hmJ11.'f'f)ftJ.J'W
•... d !"id"": ~ .•... e! dd
'lUb!1l£'Wu'ml'J.J1';1tJ'HI'1lftJ.JU __ 1 ._. '- __ 'lU&1'il'WUwm.)V1tJ1 __ 1 /__
5) nnlmv/im:;"llfJ'll'il.,'ll:rA
hJ:rlilf:;1l(hl'>l'tkjJfi~{mm:;;"nu0AtJ 0'll't1(;) D~j.J't1~ Cn~:;l{in C] ~'1------
,
1'ubf)'1l't~ilYltllT'Y'l_ 1 t: ..lrilmJlJw~nlj'I1I~')'nn't1mJ61JL1J1JY1'1lf~11 [J 14i C] l~n'li
6) ~fl1';'lh-lnlfJ~J'il-l~l'hrj'il~1tn:;;'lJl,~ lJ ECOG 0 !] ECOG 1 [J ECOG 2 [I ECOG 3 fJ ECOC3 4 :Jllnti'th:;,~u
;') J,tnXn nt~nf'j 1'l'lJ~'l l'llullillJf11l' ~u~thh.:ln1tJ ~nn~l).J[i]i'
8} 'Jti1i1lmr;i'iJ'r1.J~i-llf'luAf'li1 ilflfinsl.Ji'li1llthJ'!J.!1iJifJ1 ii"finhJ!M)lrm!~bl.J(1I7
('ll·cJl&lfJl~m.:::j'1imwlm}~'iJ 60-75 il'lilnflJlfi'1l~u~tl'l 1 f;llnlt~if;l1li1lWlliH'i'll-lnlJ prednisolone f"11'l'ilVl'rl'i..J'll'iWm
:J 1'li
:J lii
j LT
Dhji:~
lJ 111
fntl''1)
9} qU'ltJ1JihJ chemotherapy V'wi'llJJi'JU
~~~~~ lmWl'1n1i·~J'il'il1.f~~lift!1Af~m~'il1) l:Jl'li 2) 111 3) 1'i 5) ~ __ ~L~CO_~..~_~~C1:; 9) 1~~~ _
"/l. n'i,llrn~'lI'f)'f)u:iT6ln1'i'l,i£ll &.:jttV'i~'l'f.,'}vl~'El.!J,
1) ~1.1'ltJ'1l~l'W[n'l:::terminally ill
>V d ?1uJ";' 'V !'"
2) 'lUblil'!lUU~L1~hmA~~l1n __ 1"" ...."_..,,.._1. _
nl11if81Ar'llkiJ'U cycle ~ .. __. (1..n'ifm~lbJLntJ 6 cycle)
3) ~lhml'lf'NVl1'l1.J~'U'i1Wl~)n'11fn~lhl'l::;Yl'WWt'I.;h..,lAtW~lntJl1t1i~-l'll.JA'l1'1iftJ1!?i!l11i
hhi1lLL~~~'1ii'nWl1.!IFl'W~l'::u1~1u«r,I'lJ'ilfI. tlh'U~h~.. ,
4) 1.'l1l1Yih~n'1tJ~!l~~'l.h8'il~bJ~;0ulffl 0 ECOG 0 '1 ECOC.; 1 '] ECOG 2 CJ ECOG 3 Ll ECOG 4 Cl hJ1p,1.h:.:dJU
5) ~'1'1rn ntflnfl~ 1'l'm~'-l ... 'iil.lfitl.)liI~~'W~~hi1-.1nltJ (1111'1-.1,),11111
, IV ..J' :::.~ .••."""•... >Q. en "" Qo ••.. I
6) '!Jtn[1itJ'!(il'1J'lJ~~-ll-n1..!ANU 'jf01nn.l Al1hUU'!JU11i1t!1..,, .J0it'innJlil'il!ill1'l-lll-lll1f
141

•
7) ~U'1fJIMU chernotherapy ~'U~t'l~tlhtJ
<.,_ , d
8) 11.m'ls::l.)'!lmn, _ .----- ._•..••._---_ .._--_ .._-------
-----_ _ _•.•..
2) e.Jl'H!1r&ljVJ~Yl1-.'Jf~?t~u~~tJ
1ti(L~U1J~!ftn11[i11'l"l~1Yir'tl).JnuLL'U'U.,,'tlf~~
otfi4wmhhnH11 (complete)
o ri'1lU).J:;LS~~'lJUIL'1l~n~~lf1tllfltj11Jtn~zi'.lu(partial)
[J hiv1'1lU~u'1l-lui'1lnlttntl·rH~''11;:Jnl1fjnfn).J'!J1Ntf'' (stable l~r'dprooress.ve)
3) ~l.htlF'nt.fJf'Un'lr"'ljM1LU'tl,1""nf11T~l'f)ljl:1J'1l~6i
""' ~... ,.~ .J ....: .,. •....
4) WiT.l!JVl tJ '1LlT1::Yi''i'1rr u'1mtl1 W, nu J'l~11-l'ElJJ'tl~"Ilnn'1S1 mj'j~).jL'o~1'l
Uh
rll'li
~..... '" ,... .;_~j L~JIII
_ ..J
":1..;1. ' _
Pilll'l-1l.i~ _
_ d
'lWfl __ I _
-----------_ __ _.._-_ _-------------
--------_. __ -----

bbUUvJ'fl~3-Jn1'arhnun1'ab'lftn Liposomal amphotericin B
-ll'flU'Ib"l!L'a1Pl invasive fungal infections b'U~lhtJv1hj'i!l13-J1'atl'Vl'Ul'imn Conventional amphotericin B
(ntJl'I:;L~tJi1In1~H'tJ1hhi1l4r1~:fi~"lnLL'U'l'VI1~nlntJn1~H'tJ1LLI'I:;~ij'1ln1~H'tJ1'1lth~I'll-JL"'[;J~I'IIn1l-JUn.!~tJ1"'iinLLYi~'111~)
••~~~nlu~ulul~ _
dJU~mU~mUl~j':;rKu U ~~Wlij U Excellent center~
~~ bm'VltJ~vhn1j'fmt1 1ulh:;nmPl'lll:n~ b'J'llnnl-Jb~'lJ~ _
djuLb~'VItJ~b~m'lllCJ.!~1!ilfu"nr'l~~mpJiiivl~~11?D'!J~Jr.nmL~'VIu~1l11um~~l'lJl n 'fll~j'f'1l~~flJr1~"1b~'il n 'fll~Jf'1lMlflJr1
J:;uunlJVllu1"l bL~:;1l1'J:;'1n~~tJr1J:;UUnlj"i,nu1"l J ~l-JlJb'J~f'1l~~flJr1 ~t'l b~'il = ~l-JlJb'J~f'1l~~flJr1J::;UUnlJVllU1"l
o~U1hht'lJ:;i.J
••~'il-Ull-J~~~ HN ~AN _
~'VIfinlJbun J VI~mJJ::;nU~'lJ1l1~tl'JUVI'l:h c::: LJJ::;nU~'1A3_J0 ~-r~~nlJ~mn~mUl~oihn~n1J
b~f'1U 'lllU _ VI~'1 1'UL~'ilutJbnt'l _ /_ 'ill~ __ 1'1 __ b~'ilU
0000000000000
<hJ'i(?ln'i'fln.n'fl3J~1.,r~'iUt1'J'i'! ~i'fl 1.~b~~'fl'l~3-J1t1./ 1.tI-n'fl'lv1(?l'i'ltlu WJ1:JJ b1JtI"'l~'1
1) ~1..l'JU'il~1U1l1'J::;terminally ill
2) lMUnlJ1D"l1lULrWJlLUULrA invasive fungal infections
~m1ru::;Yi1V,''l1lU U uilunu (definite) L._ buulLJ1!il (probable)
i1'li
J1'li
" ,c:S q PI
b~~'VIbUU~lbVl~ _
, >-
o ,.::::.10::::. ~
mLbVlU'I'VIf?lt'lL~'il _
'1D"l1lU"lln _
b,.hVll-Jlu1unlJ~n'l1lUlu~~LJt'lli 0 2 ~LJt'lli 0 4 ~LJt'lli 0 8 ~LJt'lli J 12 ~LJt'lli =~U1J::;i.J ~LJlilli
3) lMUnlJ1D"l1lU,hhj~l3_JlJn'VIul?i'ilm conventional amphotericin B (!il'mbnru"V1oii~11i1V1~'1rK'I!il~lLJ~)
3.1 serum creatinine ~'1~U (LLJJt'lJ::;ut:_J~mJ~J'J"lserum creatinine)~ ,
ri'ilu1~m conventional amphotericin B (cAM B) -ru~ _/ /__ b'Vhnu _
VI~'11~m conventional amphotericin B (cAM B) -ru~ _/ /__ L'Vhnu _
3.2 iJt:_J~oiil'lb~U'I~1l_i~l3_JlJnr1'Ju'.p.J!il'Ju1fimJ~U11!il~t'lI?i'ilnU~Ul'liJ~u 3 -ru
(LLJJt'lJ::;1.Jt:_J~oiil'lb~U'IrK'In~l'J) _
3. 3 risum Jfn'l1l1!ilfum J1D"l1lU1liJ1l1'J::;l~v1l'lluun~~~'1~~ b~:WLt'ltJfOil
serum creatinine 2: 3.0 mg/dL
4) cJu'JUtJ'IiJr1'Jl3_J~lbUU~'1l'l1.jfLiposomal amphotericin B l?i~hJ (m3_Jbnru"V1'V1noii~rK'II?i'1l1LJ~)~ .
4.1 J::;u::;b'J~l1unlj'~nt.ntJ'Ill_ir1j'u~3_JJn1rf?ll3-J~~'1b,.hVl3-Jlu1-nu-ii~2
4.2 tJ'Ihj~l3_JlJtl1~m'VIl'lthmbri~u'JtJl!il
4.3 t:_J~b~l::;b~~1l_iiJm~u~1~t:_J~1:1_iLb~nl?il"nuVl1~~n1l1m_n'VIt'lbb'VIU
4.4 cJu'JmJ.~r1'lI?l'ilu'6'lU'1l'lI?i'1lmJfn'l1lrJhtJliposomal amphotericin B~
J1'li
U1'li
Dhi1'li
L hJ1'li
mg/dL
mg/dL
U1'li L 1:1_i1'li
D1'li c::: 1:1_i1'li
~1'li U 1:1_i1'li
i1'li n1:1_i1'li
J1'li JhJ1'li
~1'li ., 1:1_i1'li
J1'll J 1:1_i1'll
~lVlfuq~'4dJiii bnru"V1mJ'lJ'il'1l'4dJiii1~mr1f,mJnA'il 1) 1:1_i1'li2) 1'li bb~::;3) 1'li
bnru"V1mj''lJ~'il'43_J'111~mAf,,~2 ~u1LJi'1'il1) 1:1_i1'li2) 1'li 3) 1'li bb~::;4) 1'li ('Vln-ii'1l)
5

5) n1dH'tnfPlt'l~b'LJUn1d'lJ'1l'1l'4mln1dH'tnfPlt'l~I
hib(lU 7 1u )
6) 1Ub~'1lUU~'1I'1l'1l'4~'1in1dH'tnfPlt'l~_1 __ 1__ 1Ub~'1lUU~'lJ'1l'1l'4~Anld1oiitn01t'lri'1lU_1 __ 1__
7) '1IUli?1tn~H' ntl~nfW1u Ai?1bU'W1R~lrutn~~U'ltJH'91'1 vials6u
1UVl__ / / _
~" ....,.
l'l-:Jt.n:J.JbbW'V1tlli;!'el~:J.J(9l _
rihuVlu-:J'--------------
~ "'"
'lU'V1__ / /__
1UVl__ / _
6

bb'IJ'lJvJ'fl~3-Jm"a"l,otl!'Jl Epoetin alpha/beta (epoetin alpha/beta: EPO)
"I "'.'1 ••• 'i' 1. d' ov cl1. ' col cl ov 1. '"b'UI:J1J1!'JJl11:;b'Cl'flCPI"n:J"lln b"a~ I9lb"a'fl"a.:J'Vl3-J'V'l'IJ'6'llb'VII9l'fl'U'Vl"am~l CPI~ q
,
~~~~lU~Ul'IJ1~ _
bilu~mu~m'lJ1~J'::;wl'IJ 0 'Yl~u.1JiJ 0 l'l~u.1JiJ :J Excellent center
o ~mu~m'lJ1~~iib,";~~'lyj~nb~~i?lrX'JUbl;;;~'~'l1l'lbVlmJ ~~lUn1J'f'IJJ'~'l"'llnbb~'VlU~ll1
~~bb~'Vl6~v'hn1J'fmn ~ ~ 1'IJ'LLj'::;nm.J1'll1~~b'J'llnmJb~'lJ~ _
bilUbb~'Vl6e:;b~m'lllru~1rXf'IJVI't!'l?l~~'U~~vi~~'JiiJ'jUI9lJ''''llmb~'VlU~1l11 U~1'lJl1i?l ::J n~ln'1'l!"'il~i?lflJ'(Al1l'l 0mm"'il~l9lflJ'(Al1l'l'IJ QI '4 q q q
n f"J~ln'1'l!"'il~l'lf ~1rXf'IJ~~'lJVI~IU"'llnbb~'VltJ~b~m'l!l "k}'Vll'lrXlub(Al1l'lVl~~~ ~'EllU'JUn1J' h-l~m'lJ1~~~'lJVlmu
o ~lm"'il~l'lf ~1rXf'IJ~~'lJVI~IU"'llmb~'VltJe:;b~m'l!lru'Vl1'lrX,utJ'(Al1l'lVl~~~e:;~''W'JUn1J'b'l~m'lJ1~~~'lJVlmu
~~-'Wl~~f"J~ HN AN ~ _
~'Vlfin1niJn 0 VI~n1JJ'::;n'W~'lJll1~rr'J'WVlih 0 l..h::;n'W~'l(Al~ 0 ~1'~~n1J'fmi,~m'lJ1~ojj',J'I'l!n1J'
b~"'i 0 'l!IU 0 VlciJ'l 1''Wb~~'WtJbili?l ~ /~ / ~l~ tJ
b~'lJUmUJ'::;~,wl'J1..h::;'l!I'l!'W 0000000000000
1. e:;u'Ju~tl1'W1l1'J::; terminally ill~ ~
""'''' OV'i' 0 ~I ••• 'i' 1. d' ov cl1. ' col clov 1.'"2. 1:J'Clm"a1'U"l~!'J b"a~ b1J'UJll1:; b'Cl'flCPI"ll.:J"lln b"a~ 191b"a'fl"a.:J'Vl3-J'V'l'IJ'6'l1b'VIIP!'fl'U'Vl"am~l CPI
ti?lmil'We:;u'Jub(Al1l'lbi~f'l (Chronic kidney disease) ~~i?l~tl1'W 0 Stage 4 0 Stage 5~ ~
3. m"afm~I1"l,'U~.f.:Jdb1j'Ubb'IJ'IJ 0 Initial Phase 0 Maintenance Phase 1rXf'IJm(Alf'l~I~i?lb~~ ~/ / 1''WIb~~'W/tJ
rn- OhJ1'll
4. l:J'Clm"aI9l"a1"l'V11.:J~'fl.:JuD~m"a
eo: "I '" •••• "'.'1 ~I 'i' 1. d' ov cl4.1 "a:;!'J:;b"a3-Jb'VI!'Jl (Initial Phase) n"aru~1J1!'Jb1J'Ub"a~ I9lb"a'fl"a.:J"a:;!'J:;'Vl4 bb'Cl:;5
4.1.1 rK'fl.:J19l"a1"l'V'l'IJ~.:Jb'VI'&hd'Vln.n'fl"l,'U~U1!'JrI'fl'Um"afm~lrK1!'J!'J1 EPO
-.--- ~
o i1fil Hemoglobin (Hb) v119l"a1"l1~u'el!'Jn11 10 gldL 'VI~'eli1fil Hematoerit ( Het) U'fl!'Jn11 30 %
o ~f'il Serum ferritin mnn~, 100 ng/mL
o ~f'il Percent transferrin saturation (TSAT) ~lnn~IV1~~b'Yhn'IJ 20%
o e:;u'Jmil'Ub(Al1l'lbi~f'l (Chronic kidney disease) stage 5 (~f'il GFR ii~un~l 15 mLlmin/1. 73 m2 VI~~
~
<':!:I c:I , , ••.••. 2
end-stage renal disease) VlJ'~ stage 4 (~(All GFR b'Vlln1J 15 - 30 mLlmin/1.73 m )
4.1.2 rK'fl.:J19l"a1"lhj'V'l'IJ~.:Jb'Vl'Gi1d'Vln.n'fl"l,'U~U1!'Jri'fl'Wm"afm~1 ~'J!'J!'Jl EPO
-.--- ~
o e:;u'Jurh~'l~JI1'J::;b~~i?l~~n ( active bleeding)v
o e:;U'Ju~~m1ru:;'Vll'l(Al~ijn VI~~ e.J~n1J'l'lJ''J'''l'Vll'lun~n1J't~~l'l:')'Vlm~'W~l'W ~b<jh1rXn'IJn~~'i:J'(Al EPO-resistant'U dJ d..9 q
bone marrow disease 1rXbbrlaplastic anemia, myelodysplastic syndrome, myelofibrosis, myelopthisic
anemia VI~~ e:;~1M'lJn1J'~i:J"'l'i!'mb!,~'J~1~1l1'J:; pure red cell aplasia (PRCA)~
o e:;U'JU~ll1'J::; megaloblastic anemia ~'l~VI~n~1'W'1.hb~~1rX~lbni?l"'llnn1J''lJli?l'i:yjbt-ll'l VI~~ ~l'lliJ'W1J 12
~ ..
4.1.3 ~u'J!'Ji1h~i'J3-J (eo-morbid disease) ~'U"J I.rKbbrl _
~
44

o ~1'jrlmfltJ1cli:f1.mlJ''tl'W:w~lm.jj'tJ1 EPO bb1i'lv ,
D ~u'lmfltJ1cli'r11 dialysis bb1i'l'vl1'tlhi C bfltJ D hhmJ
D 1'Wmru~ilmJ''r11 dialysis bb1i'lilmm~(i1H"h KtIV rntJl'W'li'llb'lrn1~bn'W 3 b~'tl'W(r1'tl'W~'W~'W'lI'tlbiJntJ1)
o ilmJ'I7lJ''l'"lV'll Serum ferritin rntJl'W'li'llb'lrn1~bn'W 6 b~'tl't,l(tl?ltJfl'lJ'ilV'll Serum ferritin mnn~,
100 ng/mL)
o ilmJ'I7lJ''l'"lV'll TSAT rntJl'W'li'llb'l'in1~bn'W 6 b~'tl'W(tl?ltJfl'lJ'ilV'll TSAT mnn~l'v1'1'tlbyhnu 20%)
4.2.1.2 !9l'el..:JrW~'d"'l1:JJ~U~_!lbVl'6'hm'W~tl'd~ri'el'Wm'arm~1!9l'd~m EPO
o e':iU'ltJil~m~ru~'Vll1fl~'Wn 'vI'1'tl~~mJ'(9IJ''l'"l'Vll11JJhJiimJ'ttri:1I7l~'VltJ1~'W'il'W~bolh1clinun~:wtJ'fl~ ~ ~ ~
EPO- resistant bone marrow disease 1clibbr1aplastic anemia, myelodysplastic syndrome,
myelofibrosis, myelopthisic anemia 'vI'1'tl~~1MumJ'1'W'"l'!lmb~'l~lilrn'l~ pure red cell aplasia
(PRCA)
",'I "'i' ' col 1'"4.2.1.3 ~U'd~:Wb';l~';I'd:W (eo-morbid disease) 'el'W"J iPlbbn _
o ~u'lmfltJ1MumJ''tl'W~lm.jj'tJ1 EPO bb~'lv ,
o ilmJ'I7lJ"l'"l Serum ferritin rntJl'W'li'llb'l~11~bn'W 6 b~'tl'W(tl?ltJV'llSerum ferritin fl'lJ'mnn~, 100 ng/mL)
o ilmJ'I7lJ''l'"l TSAT rntJl'W,h.:Jl'l~11~ln'W 6 l~'tl'W(tl?ltJV'llTSAT fl'lnJ1nn~l'v1'1'tllYhnu 20%)
4.2.2.2 !9l'el_!lI9l';l'd"'l1:JJ~U~_!lbVl'6'ilm'WeJtl'd~ri'el'Wm';lrn'l,nrK'd~m Erythropoietin (EPO)
'"
o ~U'ltJil~n~ru~'Vll1fl~'Wn 'vI1'tl~~mJ'I7lJ''l'"l'Vll11J:DLJiimJ't~iI7l~'VltJ1~'WJ1'W~lo1'11clinun~l-Jhfl EPO- resistant
bone marrow disease 1clillr1aplastic anemia, myelodysplastic syndrome, myelofibrosis, myelopthisic
anemia 'vI'1'tle':i~1cli:f'lJmJ'1'W'"l'!lml~'l~lil[l1'l::; pure red cell aplasia (PRCA)v
",'I "'i' ' col ~",
4.2.2.3 ~U'd~:Wb';l~';I'd:W (eo-morbid disease) 'el'W"J biPIbbn _
5. 'lI'WliP1bb'Gl~1fim';l"l.nm
5.1 tJ1 Erythropoietin (EPO) ~ilHt(i1ml'V'lVl~lU'W']j'W1?l
o EPO Alpha (vu'Y'n::; 1000, 2000, 3000, 4000, 5000 IU) ~'tlmJ'fh _
o EPO Beta (l'il'V'll~ 2000, 3000, 5000 IU)
"'" ..,
']j'tlnlJ'fll _
..,
5.3 Body weight kg, dose A1lfl:fl IU, Route of Administration 0 SC 0 IV
'VJn J'~tJ~vJ~lmJ''lImiJntJ1 ~1J(i11'lf
'lI'Wl(i1tJ1EPO alpha/beta ~bl'W~1111'Wrn'l::;l~1l(i1'"ll1'"llntJ'f)1I7lli1l:fl• 0m'kJ 50 - 150 units/kg/week bl~::;l~n 50 - 200
units/kg/week (J,wWnf1''W'lrutl?ltJH ideal body weight) ll~~~fiu1'v11J'tJ11i1'Vl11IV'vI'11lSC
45

'lJ'1lflJ~'1l.,:j~l-ii'1l~~-iil.,:j~'WbU'W~'dl~r.ihvlmJ~:::;nl~, ,
'6'l..:!'Wl:IJu'Y'l'VI~er-t..:!i,im
~ -------------------
~'WVi _
~" .....,.
'6'l..:!'Wl:IJbb'Y'l'VI!!J ~~~:IJ 191 _
19i1bb'VIU..:!
-----------------------
~'WVi__ / _
". I ••
'6'l..:!'Wl:IJ~u~~b:IJ'W-----------------------
~ '"'d'W'Vl / _
46

bL'1J'1J'We~~fhn'1Jnl'lliS£.Il lmatinlb rnesilate
1Jau11iS chronic myelogenous leukernia (CML) ";i:-;tJ~ chronic stable phase
(11U"::LDU(iJnl11-llUl1tJ'l(iJehJ1l.J,,lnLLU1Yl1.Jr'nt1Unl11-lluliL,,::Iii1onl11iUl0£hl").jLYI>J~"m).jUnlilU1Y1~nLLvi.J'll1~)
~ .."
2. HN
3. AN
U
lJ
o
o
5. by.J1'10'lJ1Ll0 'YI~"
8. b~'1I1.J~:::~nCilllh:::'lJl'lJ'W
1o.1~1U pre-authorization bb~h D10
ti 0hi1'Ii
7. €llLl iJ biii€l'W,
11. authorization number ..
1'UL~ElU1J.yf[";U1 ../ J .
1'uL~Elu1JVi1U~QU J J .
1. i!hlw1J-i€WL'Wn11::: terminally ill (1J-ifJ'W~~n1'JH!.Jl,rr'Wi!ilh!.J terminally ill)'l.I 'U ~ 'l.I
2. lU~.;lLlvn:l.Jbnru1i 'V'lU':hdJ'W1'J1"l1'l'J"l'll:l,l'iimjlHyi"J:::u111'Wbbuu'WfJ{l-Jt1,
3. N~n1'Jml~~l!.J quantitative chromosome study 1~N~ Philadelphia chromosome biJuuln
'rtH&i€l'WiJ~I'l'Jl~ ! 1 .
4. ~mnl'JI'l'Jlv~ltJ polymerase chain reaction (PCR) 1~Nl:'l BCR-ABL blhJ1Jln
l'WbiiifJ'WlJ~I'l'JrJ~ ./ / .
5. Nl:'lnl'JI'l'Jlv~l!.J fluorescent in situ hybridization (FISH) l~v,m BCR-ABL dJu1Jln
l'Wbiii€l'WlJ~ml'l 1 1 .
6, 'lJ'Wl~!.Jl imatinib «tiJ.... ~l:'l~n1l-J!1'W ('1I'Wl~!.J1Yibb'W:::n1ufI'W1vl!.JfifJ1J-idltJ400 ~~~n-Jl-Jl7i€lltJ)
7. 1:::LI:::bl~1~«"HtJ11'WPI~lt1. . 1'W ~,,ml7i../......J ~" ! J (ltJ/biiifJ'WJlJ)
1'uL~h:n..!1J.yf[";U1 ../ J ..
-ruL~Elu1Jvib~:IJ1";U1~.f,m':in /.../
1. i!i1.Jwhimn'Wn11::: terminally ill (1:IJf)u:IT~nl'J1iJtJ1,rr'Wi!iUl!.J terminally ill)J 'l.I q 'iJ
2. NUltJ iJlPI"l'lfJU~'Wf)"vif)nl'J-J mn bb~:::V1UN~'ih"b~tJl~lntJ11~.fi"~l-JPI11 1'11tJlvifJ1tJ
'U
3. 'lJ'Wl~!.Jl imatinib «toE :W~~n1l-J!1'W (olJ'Wl~tJl~bb'W:::n1'WPI'W1V1tJfifJ1:IJdl.j400 ~~~n1l-J~€l1'W)
""k'l'" 1 to,'!(
4, 1:::tJ:::blI'l1V1(;'llb'lJtJ1'WfI'JltJ .
"
.......... 1'W Cillbb~..j 1... Ql J / .
! }
)

A. lJan1~;mt1 (CBC LU~::bone marrow)
1. mrJ'VI~lfllJ~mn 3 b~m! N~fllJMJ1~;HJl16JiJ metaphase
l"H~e:J'wtJ~9lJTiJdJ I .
2. mfJ'Y1~lfllJ~mn 6 b~€JU N~fll'J(>IJ1'Vl~ complete hematologic response
lUb~mJtJ~MJ1'Vd.dj J .
,~
~ 3. Jl'lfJ'Y1~lfllJ~mn 12 L~fJU N~mlJ(>IJ,I'Vl(ii major cytogenetic response
:::l
./ ..
4. [nfJ'Y1~lfllJ~1l'l~n 18 b&leJUNl'lfllJMJTiJltJ1 complete cytogenetic response
I
.... -.. .t
I
.... --./ .
5. fll'JVlJl'Vlh:::i!n1JmfJ'Y1~l"llnl~ complete cytogenic response 'Wu'htJll6JSJ relapse 'lWl1JR
'rUb~flu1Jv1V1"J'I'V J.d . J ..
lUYl .... d •• J ... lUYl dd. dJ d d.J ....1..

4. ~'V1ljnTHDn 0
o
5. l'V>il4 0'Jj1tJ 0
2. HN .
3. AN
o
o €it,<J ,:;1JI , .
7. entJ 1J l~f),W,
8. l~'lJ1.J'J:;~1~11J'1:;')j1'lfW
10. 1~1'1J pre-authorization lltih 1'b [J 1lJ'('lJ
~
12. ,:'nvnrn~l Ahn1'J-J 13. ~1'W0.J
"
11. authorization number
..................... 1')j'W~IJ-J9J
1. r:illltJ 1~JDtJL'WJl11:; terminally ill (1~D'W~r&lnTJ1'.lJtJ1f11'Wr:illltJ terminally ill)
'iJ 'lJ ~ 'iJ
2. lil~.QtJ('n~ lnnd; 'l"J1Jl1 dj'W1'J1'l9J.J(9J1~ojjmj.J 1'.lJ~J:;1J 111 'Wlb1J1J'V'ldJ-Jll,
3. lJ~n1'J(9J'Jl~~ltJ Kit (CD117) 1ViN~1Jln
'r'Wl&1El'W1J~(91'J'l'V I.... ./ ..
4. 111'lfltJL 'W1:; 1.):;t'ln t'llJ-JVl~1~(i11~1~'YI~eJij 11111l'J:;")1 U"lJEl.JlWI'IJ ,
v
5. ~l'Wltj'lJElH'i!EllEln
'r'Wl&1El'W1J~9J')'V .. I. . j
6. 'lJ'W1V1tJ1 imatinib ~1'.lJ nt'l~n1'J-J/l'.j ('lJ'.nVltJ1~bb1.!:;t!1'hH;'ltj1'V1tJf;iDl~ln'W 400 nfl~n1'J-JIiiEll'W)
7. 'J:;tJ:;I')t'l'I~N'l1,EtJ'11'W1'l#l1l ..
~
....... l1J ~llllii / f. . . .1..I ..
"'''.~'''''''''~''''''_ """"w"",,,,,,,,,,_,,.,,,,, ''''''''''''''''''' __ ,, __ ''' ••••,''''''''''''
l1i use 6.'1::1J1.I'lJl~Hm1J'lJlullmnnru7i.....--.----"l1i 2. l1i 3. l1i 4.1.
1.1. n~ru1.le:JeJ'lJ3j6in1~titJ1~lbb9iVl'iliitf2h'l
•
Ntl'ltJ1~i1Jn1~im?J1341bb~'lvTl~u~"ul..... L~t1U
••
-r'IJt~e:J'lJiJiitVitn ..1 .1 •••.
-rub~t1uiJiiL~341VitJ1AflLL~n ..1 •..• .1 .•
1. r:ill'whiDtJLwl'n:; terminally ill terminally ill)
v "
2. r:illl tJrJlI'll9D1J0'WD.J1iiDIII'11'mn 11t'l:;'V1'.jNfl'iJ1) lA 1.).J'V1n tJ11~~.J S1~l'll'J'r VitJ11iiiJ11J
'lJ
3. 'lJ'W')Vl1n imatinib ~H
4. 'J:; U:; blfl1~N'l't "iiu11 'W1'l#l1l lH &(.Jalii I .. . ....f.
"'M~~·m_··"."""·"" ""'" """","_"""""""""q,, ."",,,_,,.,,,,,,.,, ._ ",,,~.,,,,_.,,,,.,,,, "",,,,,,,,,,,,,,,,,_,,_,,,,,,,
l1i uae 3.-a::1J1.I'lJlI'U.m1Ju1u!1m.nnru7i--...

fl. ~~n1'ii'm~1(CBC use bone marrow)
1. l'Wb~e:J'wiJ~(;ljl1V . .J.. . .J, .
j:::tJ::: L1i;il'1"hl1VlnmJ 1VltJ'1f1%lrlfJ'Wtn'W
2. VJi;ilmj~Jl"J'Vl1l1lil'tl't1"JQtJ(;l1:l-J SWaG (Southwest Oncology Group) 'Vl1fJ RECIST criteria
• hA'VlltJ1tJ'Vl:l-J~ (complete)
~'W'11tJd~d:::1J ,
AlYi (stable)
l'WYi J J l'WYi J... . J .

•
fftlff'l1.01/1O/2555 _
~~u.1JtJ-w'ai~rhntJn1'ii·'litl1voriconazole i'Elu~"it'lf'l invasive aspergillosis
1.~'il-~fl~ ·· ·.... 2. HN .
4. ~Ylfin11Lijn 0 ~YlfiVl~m.h'::riu~'lIJl1V'1tl'l'WVlih 0 t11::n'W~'1f'l~ 3. AN .
o ~r)~~n1'l'fm:nYim1Jlftn'l!nTj' 0 ~u1 'l':;lJ .
O 0 A ~ •• !"lA ::0 ••
5. LV'lf'! 'li1EJ VltIJ~ 6. 'l'WL(;l'ilUlJLn(il ../. ./.......... 7.tl1fj lJ L(i'ilU
8. L~'JJ~t1'l'::;41~'ltl1::'ill'll'W0 DODO 00000 DD 0 9. 'l'tr~tNV'lt.nU'1~ .
10. ltXfu post-authorization u,~'l 0 I'll 0 hit'!! 11. Authorization number .
12. ~'il-'Wll.1~~~~t1nf'l'l"il'l (l'ilYn::~tl'lm~n) 1'l'l'1~~~~'Wfi .
h:··r@j~~·~~q~~t(!i1LtJURf.~i~~n;i:.:..•.,••..··;;··.·::i::~··,';.:CW;:::.:1.:H'(',:~~(~#~~;~~~~K~;;.:·V.(.;~.}~~':;l..,~';:-.i::ii'{·~
"L,j l~',j
1, ~tl'lEJ'il~l'WJl1'l::; terminally ill (Wt)~~~n1'l'1iEJ'1U1J~u'lEJ terminally ill) 0 0
t'l'f'ltl'l'::~'1~'l~thEJ 0 'Wi1D i1'l'::tj .
2. ~il"l'ilEJVl1).1Lnru'l'1V'lu~1('l'I'lI1l·Nvn3-Jif'ilti~tif~'l'::;tjl11.uu,uutlt:lf~li 0 0
~n1:tru~il"l'ilEJ 0 U,U'W'il'W(definite) 0 d1uhJltX (probable) 0 ~'W11::tj .
Iii'1LlVlU-l~lii(1}L~'f) , .
AA ~" '" .:: ~
'l'W"I'ilEJ"I'1nn1'l'l1lr.l"lEJt)).J n1'l'LV'll::i'll'tl C-I~m1ffln"l"jj'W.iU'tl .
LillV1~IEJ1'Wm'l'fn~'W'1'W~~t11'11~D 2 ~tl(illl1 0 4 ~t1(illl-1D 8 ~t1£ii1l-1D 12 ~tl(;l1~ D~'W1 1::;tj .
2.1 l~fumilil"l'tltl~'1L{j'WL'l'f'l invasive aspergillosis L(iEJihnru'l'1milu"l'iltl;r'ill(i-!i'ilVln-l~-l~'iJ1tJd
2.1.1. j;J'l"l"l'rUJL~'il11Xtl~1EJ(hyphae) iLUU dichrotomous branching septate hyphae LUlEJm'l'ffl'l"l"l'Yl11n~fll
"lftYl'l'~f'lU";1flYl1~WEJ1fif)YltJ1V1re'Yl1-lL'I!flWi'Vlm'1lfll~lt'llffln"lYh~91nn1~~CIl~'Wdj'tlVl1'tln11L"Il::(;lCll"l1n. .
~1lL~UI~tlrlf'l"l1m~t:l (sterile site) 0 0
.r~ ~nl ..11" ~;.r dO •• ..1
2.1.2. lV'l1~L'lI'il'llU'l'1Aspergillus spp. "nn'('l~'('lll1ln"l'Vl l'l"l'1nm1fflCllll'WLUflVlnJn1'l'i"l'1::'!l(;r.nn(jl1Ll~'W-l'Vl
tl111'1"llm~fl 0 0
2.1.3. ili.l"l~m~tII~'fln1"Ln(;l invasive fungal infection tmnUt:llm1V111f'lftln~Lih'~CIlEJf'l1~l~'W'llfll
•.." ..I ". ~ •• .r.r.r ~ nl .J~_! • .J
LiV'l'YlEJ~L"jjEJ'l"jj1t1Jl1'1~'ll'il3 'l"l).JnUIil'l"l"lWU",'l'tlLW1::L'lIfl'llUL'lI'il'l'1Aspergillus "I'1n01~'Ci~l1ln"lYlUJ stenle llJ'W
L~~VI:: sinus aspirate ~1'flC-lftffln"lL~fll'l galactomannan l,xl:Jftu'ln 0 0

ffllff'ti.01/10/2555 _
lUJ'lULYlI'jL-UmtUYl)JU<1i4'mu~ Ll~:;tnm1l'l1~I'l~QndhHi LL~UJt'1'llJ11mnU~~~I~n"lL~tll1ln"l~'ltJn~'61'~";f'I,r}lffi
~I galactomannan U.~'lLLlJi1tlt.J~tl~Lmim voriconazole rifd1umcU~m~urif 7 tJUt'hQ1.buhil1ltllJi'lUtl'll'itln11fnl;')
L""lI~!itn voriconazole -nuYi
~rlm1(;1n<1igalactomannan (nlN1LLUUc.J~HnuuUUy.JflflJ)
I'll LaJ1'11
..J12f ;-, - v ~ - 1'1 ..J
1" - - v l;' v. v ~'i' v v
3. '!IU1111tnvoriconazole 'Vl'Jl •...•••.•. ~~flnnJ/'lu I'lI7lLuU'lIU1I11tnYl~ l-lf'1t'ln1l-l1'U1'1-1Unl1l'l1n I~nnl/'Ju
('lJU1fi1tn~UU:;U1LLUU~fi1~tls unznn nn 12 .ft''JLlJlLutJULL1nUt'l:::vnl-l~'lU4lJn.lnn. 'I'1n12 .ff'')LlJ~LL~:::llU1i1l. ,
uU:;lhlltlltnLLlJlJnU~tl200 lJn.tJut'l:::2 f1fl, lUL~nfir;,11I1lJ~1l11!n~'J4l-ln.lnn 'Yln12 .ff'1LlJI)
mlJ1cwtn~l/)~tJl.l'Jtll-!i"ll~ 'l!Q~~~ 50 ij~~nfw'!l,)~ ~1U,)U '!I1~6u 'l!ilV1100 il~~nflJ/'D'J11I~1U,)U '!I'JV16u
"
th~ilJ€'fl'i3M 1. 0 't~1"ll 2. 01'll LL~:::3. 1:::11'!lU1VltnLUUUVl'llJLnN'Y1
lIlJ1aLlIl1l: tl'4lJ1l""iinliftn~f'1fl~:::UJLrh.! 141U
4. 1:::U:;L,)~11Un1ITn~l LL~:::LnO.!cr1n1rvl'1JV1Htn L""~l.l'ltlYl~!?lLiltnultlii LnNcr111111nlJ;rtllVl;rflYl~I~tl1ud
4.1 ~l.l,)U~tllJ~lJtll~tln11fn1t1 Ll1Itlfll-l1,J1nJLVitl1:::tl:::L'l~11'Un"l1fm=t1ihnN'Y1~ll'ifl11.Ie
4.1.1. n'JrUinvasive aspergillosis l-xt~"luni1'f)1n11l'l11I'l~ilnll1tl1uLL~:;1tltlL'1f'11Wl1't"iflfl'.ntl1tJ}l1tlL}l~tl
UtlU~~11tV1u~')hJu1:;l-nN 4-12 trum,r 0 0
4.2 ~1.btJhll1lfllJ~lJtl,wltlm1fm;-111~lltXtn1uLL~,)7-14 1U ~llIlJ1tJnl;r'flLV1;rtlYl~~~I~'fl1ud
..• 0" 'i' ,... .' .It , .•• X .It
4.2.1. l-ln11V11LUUI1f'1U1'fJLlJtll(persistent) L'l1U~~m1LYi1:::L'l1flLUm:;LL~L~tll1l'!llJL'lltl(;1~'f)Vt
4.2.2. tl1n11Y11I'l~QnlULLNl-Iln~W.i1tlmYifl~Ll~Vt~fl"l1~tl~1l'm~l-nn~',&
tPltJ~~1l-J11t1tlfiU1tl"',)U~1LlIl'j~',& 0
4.2.3. 'Vl'nlJi1L~tl~t:l~'tltJ1voriconazole "l1mJ~LYi1::L~tl 0
4.3 ~'ll-l11t11;rmr;huL~tl'M'IlQti~ul',&n1Tfn1t11~tJ~hjuf1ln~l1null1t:l~ni1L"llu~"nmmL';;'1:;Li'f) 0
4.4 ~t11lJ::hl'l~lL~l-J'!It:ll~l.l'Jmu~U'ULUu~l.l'Jm::tl:;~tiYhtl(terminally ill) 0
o
.1:'!r:~:tt~~tq·}~~!~'~m!n~~~!LJM~U}r.··:~'~:!"~fh~~~~:~i,~t~t~}~~j[:;(.·:~,11ji~;::.;;jt:!·i
1'l1 Ll-J1'l1
1. ~1.l,)tJt:l~1'W111,)::terminally ill (~tl1f~mT1ifmmU~U'JtJ terminally ill)
2. ~U'ltltT'liifl,)1l-J41LU'Uilitll1ilvoriconazole flit:ll1..lU1lJmN'I'1"ln'li'tl;(~uit:llue
2.1 1:::tJ:::L')mlum1fm=ntTlhiI'11lJ~lJl1nr"m.J~~~Lihlll-l1tM1'U'if'f)n. 2
2.2 ~~ml:::L~tll~ilm~u~1""tJft UJLLVln~hlnUll1tl~ni1 LL~'Ml'l1'.]nni1Lmif'Vll1lLLYlU
2.3 ~1.htltTlI'11f1lt:llJt'lutl~lIitlmTfn1t1"'')tJvoriconazole
2.4 tl1m1Y1~fI~UntTIhhn u1ULLft:::1t:lu1'11'11'W111't"if'l~tT~LlIflt:lt)~
o 0
o
o 0
o 0
o 0
o 0
o
o
o
o

nUff~.Ol/10/2555 IIIIIIIIIII
3. '!IU1~t.n voriconazole Yl1cjf ilftAnT).Ji1u ~~djU'lJU111lmYl1if i1~ftnT).J/U1"nrnrn'.l 1 m~nf).Ji1u
('!IU1Ii1tn~LL~U1UUU~Ii1R'fl6 unznn. Vln 12 .['lL).J-.l1u1'uu1n LLft:::{il1).J~,.lt.I4un.znn. Yjn 12 i'.lL).J~ Ufl:::'lJU1CilUu..'".h
"" .'!I'fl-.lE.I1UUUnU~f)200 ).In.1'ufl::: 2 ~f~.1uL~n~l1lm).J,:n~Unrn'.l4 ).In.lnn,Yjn 12 i'.l~~ )
m).J1um~Ii1~~1.htJ1~~1~ "liUl1l50 ilflftnf).J/lI'.l{;l ~1U'.ll.! 'lJ'll1li1u 'llU1i1100 ilflftnT).J/'ll'l{;l 41l.!'lU '!I'l~/1'l.!
-d1,..rue7'aU~ 1. 0 'Wt'li 2. 01-d LL~::;3. 1::' 1'lIl.!1Ii1mLill.!hJ{;)1).JLnN'f'l.. . .,
( )
~~"lJ~1.ulh~n'f1u'hro1M~,j~
., ..I
'l .I." ./ ./ .

16.การปฏิบัติงานระบบเภสัชกรรม

16.การปฏิบัติงานระบบเภสัชกรรม

Recommended

Recommended

More Related Content

What's hot

What's hot (17)

Similar to 16.การปฏิบัติงานระบบเภสัชกรรม

Similar to 16.การปฏิบัติงานระบบเภสัชกรรม (20)

More from งานพัฒนาบุคลากร โรงพยาบาลจุฬาลงกรณ์

More from งานพัฒนาบุคลากร โรงพยาบาลจุฬาลงกรณ์ (20)

16.การปฏิบัติงานระบบเภสัชกรรม