This document summarizes the key aspects of Thailand's formulary system and drug utilization policies. It discusses: 1. Thailand's Formulary System which determines which drugs will be covered for government employees and citizens. 2. How non-formulary drugs may still be obtained but require additional approval processes. 3. The process for extemporaneous drug preparations to meet patient needs in a customized way. It also outlines the roles of medical staff, residents, and fellows in the drug utilization evaluation process and how repeat medications and outpatient drug utilization are managed.

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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
5) Fentanyl pad 25 mcg/hr
6) Fentanyl pad 50 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~

6. 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
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ntJn1~tJ'l,r'W1
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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
Methylphenidate extened release
tablet 27 mg
Methylphenidate extened release
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(?)

7. 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.. ~
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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

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B. Hrmnlf1j "lim ltl!~">l UltllUr 11Ll:K~tI11tniflj1itJ1H6'na l1'J'ttl?lfI11J'M11Jmfi'i' 1.1nWi'flt:l1U 1:1" u ~
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(contraindicated/serious, major drug iuteraCtion) ~~I11gh~u'fiB~l~!)cimlftfll~fH'li'~
E. !Jl'.Illru~tJnthnmi11fI~iJll1111l1"~n"h(iUl;4t11'lIJfi'mtl)¥ ,
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11. 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

12. 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)
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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
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~
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

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

14. 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

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

16. 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

17. 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, _

18. •"'''-'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

19. 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

20. 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

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

22. ,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

23. 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 _
•

24. ~ .,J
'lU'VI __ / ,/ _
116

25. 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

26. 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
•

27. 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

28. 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

29. v .,J
1U~ I ,
121

30. 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

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

32. 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

33. "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

34. 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

35. '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

36. 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
•

37. '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

38. ~~'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

39. 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
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'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

48. •
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 _
-----------_ __ _.._-_ _-------------
--------_. __ -----

49. 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

50. 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

51. 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

52. 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

53. '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

54. 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 / .
! }
)

55. 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..

56. 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--...

57. 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 .

58. •
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

59. 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

60. 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." ./ ./ .

61. Trastuzurnab : ~tJ~'jj. 07/10/57 _
0.... .v iI.'" "1 "'.'1 os", ~ ", cl.. ~I
uuumnumaae "Jj!)1 trastuzurnab b'lHJu1!.1:I.J~b'ii'.:JbI?11'U:I.J'ii'~!.I~b'ii':I.J(?l'U'Vl:I.JHER 2 recepter bu'U'LI1n
'"
od .1 0 ~ ~
'jj'il.~f)~ b~'lIuJ':::"I1IWl13 ~~n HN .
~1(;]U
... 1'll hJ1'llnEl~:::b'ilElV1
1. hhu'U~U1tJ~~tJ~?!VlVlltJ (terminally ill)'U •
2. l~-ru fll~~lIilVlnB'Ul.J~b ~~~ b~l'Ul.JB BflVll.JVlbb~1 bb"~lJ fll''ifl'l~ ~ltJl LJ~~Bl.Jt11 bVl~B~~
•.. v
'lflbb'l
3. lJ Eastern Co-operation Oncology Group (ECOG) performance status
'"
Iil~bb~ 0 fi~ 2
4. ~mfl1'lVh~1'U'lJB~~1h m1~1VltJ 2D-echocardiogram Vl~B MUGA 1~[;.mLVEF innrrn
Vl~mvhnu 50%
(J':::Lle.J~bb~:::iUVlI?1J'''l''l.......... I.............I ............. )
5. (;J"fl1'lm1~V11~'Vm151V1tJ11VltJfl1~tJBl.J~1tJ Immuno-histrochemistry 1X(;J" HER-2- IHC FISH
neu bU'U 3+ uae FISH test bU'U'U1fl
v d
(J':::Lle.J~bb~:::"lUVI(;IJ'''l''l .......... I............ .I............. )
lJ EBC Node bU'U inn (positive)
,
6. (iUVl (;IJ'''l''l.......... 1............ .1............. )
7. mru EBC Node bU'U"U (ER/PR negative) ~B~lJ tumor grade 2 Vl~B 3
"" Turnor gradeuaeu
•..
Tumor l.Jlflfll1 2 cm.'lJ'U1Vl'lJB~flB'U
, Turnor size
(J':::Lle.J~bb~:::iUVl(;lJ'''l''l .......... I ............ .I ............. )
8. ~~n1'ii'1?1'ii'1~n1'ii'~1.:J1'U~~.:J,r11.~ J':::Lle.J~
•• d
(J':::Lle.J~bb~:::iUVl(;lJ'''l''l .......... I ............ .I ............. )LV1'ilUVI3
•• d
,
LV1'ilUVI6 (J':::Lle.J~LL~:::iUVl(;lJ'''l''l .......... I ............ .I ............. )
•• d ~ d
LV1'ilUVI9 (J':::Lle.J~LL~:::"lUVI(;IJ'''l''l.......... I............ .I............. )
, ,
L~'ilUVl12 (J':::Lle.J~LL~:::iUVl(;lJ'''l''l .......... I............ ./.. ........... )
<-
(e.J~mJ'm"l"lmJ'vh-l1'U'lI'il-l,r"l1"1w~"-l~'U~V1mJ'fuEJ11ih:::Ll1u opd card ~1'il chart ~thEl)
9. ~~m'ii'I?1'ii'1"1~'U11?1 bb~~m'ii'bb'Viin'ii'~"I1!.1 turner 'lIU1V1 i11l1.1~
LLYi1m:::"I1 El
•• d
,
bln'ilUVI 3 (J':::Lle.J~bb~:::iUVl(;lJ'''l''l .......... I ............ .I ............. )
•• d v d
bln'ilUVI 6 (J':::Lle.J~LL~:::"lUVI(;IJ'''l''l.......... I............ .I............. )
•• .d ,
LIn'ilUVI9 (J':::Lle.J~bb~:::iUVl(;lJ'''l''l .......... I ............. I ............. )
aim, "" "'tl ""bn'LIb~n1ll1'ii''U 'U chart 'Wa~ OPD card ~ 1!.1 b'Vi~'ii'~m'ii'I?1'ii'1"1111~'LI)
( ) LLYiVltJ~fm:n (iUVl I .!. )

62. Nilotinib : ~tJ~'1l.07/10/57 _
.jf'elti~"I.-ifchronic myeloid leukemia (CMl) 'i:::~:::chronic vii'el accelerated phase ~l~'6'Il3Jl'i{l"l.-if imatinib 1~
,
•• .1 0 ~ ~
'1l'1l'~fl~ L~'1Iu~:;r,nln':l13',~n HN .
1'll
2. btJ'U~'tl'JCJ~1~-run1';iiil':ilumtJ'UCML ';i~CJ~chronic 'Vl~tJ,accelerated phase
(iuVl';j'J.''l'lltJ .I. ./. )
3. ~eJ~hMJ'U~tJ,.JI'J~ell:tl,'U"a:::~:::blastic phase CML.•.• .•.•
4. ~'th~1~n1';i1-ifCJ1imatinib bb~d~u.rrtJ'Vl~--1.rrtJ1~~--1d
1 H imatinib ~~vitJtl'U 3 b~tJ'Ubb~d cJ--1hj~ucomplete hematologic
response (CHR)
2 H imatinib ~~vitJtl'U 6 b~tJ'Ubb~d hJbn~ minor cytogenic response
31-if imatinib ~~vitJtl'U 12 b~tJ'Ubb~d 1~bnVlmajor cytogenic response
41-if imatinib bb~dbnVlmd~tJ1n1';ihJ~--1th~G'f~Avim~UUb~tJ~ ~~rnlm'Ubb';i--1';i~~U,
4 ~~vitJtl'U'Ul'U tJ~l--1U€lCJ7 1'1..1
51~ imatinib bb~dbnVlmd~tJ1n1';ihJ~--1th~G'f--1A5'U~~rnllJ';i'Ubb';i--1';i~~U 3 ~'UhJ
" " '
'1..11'1..11 b~tJ'U'Vl~tJ~tJ1n1';i'llllJlflflll 3 1"l-r--1
6.bn~ md~ cytpgenetic relapse
7 ?In~~u mutation ~~tJl'itJ Imatinib bb?l'bvi€lnilotinib b'l1'UF317L, V299L,
M224V,G250E,Q252H, H396R
5. ~udCJ~~'th~1~1';il"lbUl'Vldl'U'Vl~tJ1'1JlJ'U1'Ub~tJ~G'f--1~';i'Ubb';i~ ~eJ~eJ~1'U.n1"J::~fl"JtJfllJ'J 'U 'I 'U ,
eJ1n1"al~
6. . ./ ./ .
7. m~';idlJ'1J€l--1t:-.mn1';i';id':ilCBC
b~€l'UVi 1 m~';idlJtJn~
,
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8.
,
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8.
•• d
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1~j;J[;1Complete hematologic response
,
(iuVlIn~':l"l ./ I )
biltJ1'UVi / ./ .
9.
j;J[;1n1';i?l';id':ilchromosomal cytogenetic response
1~j;J[;1minor hematologic response biltJ1'UVi / ./ .
1~j;J[;1major hematologic response bil€ll'UVi / ./.. .
G'fllJl';i(1md~ chromosomal cytogenetic J1Bfll"lfwj~--11 'Umru~?I';id~flf--1bb';imb~dhJ
~U metaphase
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d Q.I od
blJtJd'UVI 1 ./ .
( ) LL'I"IVltJ~fm:tl.
,
(iuVl ./ 1 )

63. Dasatinib : ~1.l~'l!. 07/10/57 _
-if'£lti·:tl..jfchronic myeloid leukemia (CML) 'i~!I~chronic ".1-'£1 accelerated phase vlhl~1~1·Hli,.jf Nilotinib 1~
,
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••.. cJ.::::.-=- ••..
blastic phase ('dUVl'dU"l'il.£J ./ .I )
3. ljLhd'~f11';i1offt.J1imatinib LL~l ~u-rreJVI~-1-rreJ1~til.rd'
110ff imatinib ~~~eJn'U 3 L~eJ'ULL~l cJ-1hJ~ucomplete hernatologlc
response (CHR)
210ff imatinib ~~~eJn'U 6 L~eJ'ULL~l hhn~ minor cytogenic response
310ff imatinib ~~~eJn'U 12 L~eJ'ULL~l hJLn~ major cytogenic response
4 Himatinib LL~lLn~[l11~eJlf11';ihJ-W-1'1.h~'Nr1~eJ';i~UUL~eJ~~ljmlm'ULL ';i-1';i~~U,
4 ~~~eJn'U'Ul'UeJ~l-1i!eJt.J7 l'U
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v v
'Ul'U 1 L~eJ'UVI~eJljeJlf11';i'lllmf1f111 3 f'l1'-1
6.Ln~ [l11~ cytogenetic relapse
7 ?1';ilJ~Umutation ~~eJ~eJImatinib LL~b~eJnilotinib L-d'UF317L, V299L,
M224V,G250E,Q252H, H396R
4. lj'tJ';i~1~f11';i1offt.JlNilotinib LL~l ~u-rreJVI~-1-rreJ1~~-1d
1 hJll9i' complete hernatologic response 1'U 3 L~eJ'U
21:w119i'minor cytogenetic response 1'U 6 L~eJ'UVI~eJ
3 hJ119i'major cytogenetic response 1'U 12 L~eJ'UVI~eJ
4 ?1';ilJ~Umutation ~~eJ~eJNilotinib 119i'LLnT3151, Y253F/H, E255K/V,
F359V1I/C
.•.•..•. .1 •.•.•..•.. .1.. •.
.. .. mgl1l'fliu
7. [l1~';il:w'IJeJ-1t:-JM1';i';i1JCBC
L~eJ'UVi 1 [l1~';il:w'tJf1~
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,
(iuVi(;]r'd"l .I .I. )
,
(iuVi(;lr'd"l .I. .I. )
,
(iuVi(;]r'd"l .I. .I )
d Q.I d
L:wm'U'Vl ./. ./. .

64. Dasatinib : ~1.l~'l!.07/10/57 _
8.
9.
10.
e.J~fl1'j(91'jl~ chromosomal cytogenetic response
. .
1~e.J~ minor hematologic response biie:rJ'UVi ../. ../. .
1~e.J~ major hernatologic response bii€rJ'UVi ../. ../. .
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'V'ltJ metaphase
fl1'jth~bij'U molecular response iie.J~e)(91'jlcil'U CDR-ABL vieJ ABL
•• od
bli1eJ'UV13
. .••••• Q
blJeld'UV1 ../. ../....... 'j~tJe.J~,
•• od
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. .
biieJl'UVl ../. ../............. 'j~tJe.J~,
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bli1eJ'UV1 blJeld'UV1 ../. ./............. 'j~tJe.J~,
11. ml~'V'ltJ mutation ~~eJvieJ Nilotinib l~bbri T3151, Y253F/H, E255K/V, F359V1I1C
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•• od
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,
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66. bb'U'Uv.JeJ{~,Jf11n'Ufl1'ab.utl1 Darunavir (DRV)
-UeJU.:Jb-U bUU alternative drug bumru~~eJ~eJtl1n~:w protease inhibitor (PI) 'Vi~eJ
'V1Ue-J~-U1.:Jb~tI.:JOUeJ.:Jlopinavir + ritonavir (LPV/r) uae atazanavir + ritonavir (ATV/r) hi1~
('i11J6'1~l~1JIiln1'i1oil'1J11t1'ililel1~~hil1ml 'LI1V11~rh n'Un1'i1oil'1J1ll6'1~ri~eJnl'i1 oil'1J1eJ~l~?I:WlVlIil?l:W~6'1{i)1:WUru~1J1Vl~nu'Ii~'!J1~)
~ 'v
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"
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~mL~V18erVhn1'i1mf1 1'UtI'i~neJ'Ul'!J1~~ll'!Jn'i'i:wl6'1'lJ~'J --------------------------------------- --------------------------------
LtJ'LILl~V18~1~1'Un1'i~'LIVI~lutJ'LIn'UVltiltJ~1'L1~V15t1'i~ltJ'lJUll~10 hi ol:w1'1i
.uell6't~tJ11J
NAP No. D4-LJULJLJ-LJLJLJLJLJ Vl~eJl6'1'lJ~t1'i~~1~lth~'!J1'!J'LI(n'iruhl~ NAP No.) LJ-LJLJLJLJ-LJLJLJLJLJ-LJLJ-LJ
l~1'l 0 '!J11J 0 Vlqj'l l'LIl~eJ'LItJLillil I ...!..... eJ1~ tJ
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o ~'LI 'l 'i~~ .
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1. erh1J€l1J1WI11~terminaLLy ill~ ~
2. ltJ'LIer~lilb~m€l'!Jlf11~'lltJ'LIhJ{i)1:wl~f1'L11'lJoil'€l1Iiloil'eJVl~'1(;]€lhJ,1~
2.1 milJer~~€l(;]€ltJ1n~:wprotease inhibitor (PI) ~'1~€l~ilV'l(1J?1lJU~muVlnoil'B~~,1('liB1~ll'LI'lJe..J"~ J' ••
n1':i{i)'il~'J"j:W1ru111?1bl6'1~n1'i~€ltJ1l¥l€l'J'i~neJ'Un1'iYl~1'iru1)
o r11~'11'U'J'i~V11'L1?1{i)'i1J1~ilPI lL"~V'I'I~€l~l'1tleJ1J6 L~eJ'LI~
o ~~"n1'i{i)'il~'J~mrub1?1 (viral load) ~~'LItJ'LI11iln1'i1m~1~lJLVlm (viral load > 1,000
copies/rot)
o il~"n1'il'l'n~n1'i~€l1J1 (genotype) ~iln1'i~f1tJ1~'1 3 n~:w (NRTls, NNRTls, PI) llil1J~€l
tJ1n~:W"~f1~1'1tlfl1J1 '!JUIilLl"~Iil~ln~6'1{i)'il~ n1'i~€l1J11'LIfI~{i)~'1Vl:WIil'lJfI~er~IilL~fl'i1mr'LI'l, ~ ~
o ih:,mn1'iml~n1'i~f1tJ1 (genotype) ~iln1'i~€l1J11'L1n~:wPlllil1Jil major PI mutations
€l~l~tlmJ 2 mutations [D30N, V321, M461, 147A,G48C, 150L, 150V, 154L, 154M, T74P,
L76V, V82A, V82F, V82L, V82S, V82T, 184V,N88S, L90M]
o il~"n1'iml~n1'l~f1tJ1~~'Ul1l~f1tJ'IV'I'Ib(;]€l1J1 darunavir (no evidence of resistance)
o tJ~V'I'IiltJ11'L1n~lJ~'LI~n€l~1'1tl€l1J1 '!JUIil~l~€ltJ'Ib€l~ LL"~?l1lJ1'lflH~1:lJfl'U darunavir 1~• v
o 1:w1~r11~~HVl~€l~~loil'1J1~~llJH~1:wn'Udarunavir
2.2 n~:wer~lill~mfl'1l1€l1~~ll tJ'LI~€l'l1oil'1J1PI Ll(;]ileJ1n1'llbvi1J1Vl1f11li?lllJ1'iflVl'LI(;]€le..J6'1oil'l'1bfi1J'I'lJ€l'l, ~
~'1tJ1 lopinavir/ritonavir Lb"~tJ1atazanavir/ritonavir
'i:::'4eJ1n1'i1liYl~tI'i:::<I~f1'l1nn1'i1offm lopinavir /ritonavir uasm atazanavir Iritonavir
oVvl,Ji1/V1Gi'njJ1U1.b:::ml'u .
v v ~ trJtJ ~
'i~liltJfnllJ1'ULVj~ l'ULlilv'U VI 'i:mm.J .J .
VllJ1IJLVI'l:LL~~VlV~~bbi1i'11lJl'i(ltJ':i~dJ,J'[Iil(J%'LL'UlVll~l1lllJDivisioo of Aids Table for Grading the Severity
of Adult and Pediatric Adverse Events Version 1 0 December 2004 Clarification Au~ust 2009
I.
o 1'1i o 1:w1'1i
ol'1i o 1lJ1'1i
o1'1i o 1:w1'1i
o1'1i o 1:w1'1i
o1'1i o 1lJ1'1i
o1'1i o 1lJ1'1i
o 1'1i o 1lJ1'1i
o1'1i
o1'1i
o1'1i
o1'1i
o 1:w1'li
o 1:w1'li
o llJ1'li
o 1:w1'1i

67. 3. ~l'Illl.nl1L ~1)~e)'v'ml1~~(1lL~e:J'il~G11~l'Hl~UU~~'V11UG1Vl'itll~~darunavi r l~1)~l'lG1~lLG1~1)uae~ ~
~ adherence ~~Vll1'l 95% - 100%
4. oU'1)~i.'ln1~H1.Jl
~
4.1 ~Vl~1.J1~lUll~G11Vl;J .. __ __.__ .__.. .__ __.__.. __.. . __ __.. __ .
4.2 'llU1(1l1.J1darunavir ffioU'-rUU~~'V11Urlf'li.'l~ ~n. 1Ui.'l~ __.. .__ flf'l
4.3 'llU1(1l1.J1ritonavir ffii ~UU~~'V11Uflf'l1.'l~ __ :lJn. 1U1.'l~ .. __.__flf'l
4A 1.J15u'1 ~l~-ru .__ __ .. __ __ __ __ .. __. _
cl 'I" •...•. :etl.,!'!"
I'll. mruVl~(1l'·lm1, l'UL(ilBUu'VlbVlCJ1. J J .
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rll1~1ULm~'lLLlib~~u 3 ~'Ulu (grade ~ 3 severe)
1~1..jB1nl'ibjV;~'.h~(~l'hl1nnl'l1.;rtJ1 DRV __ __ __ __.. __ __ .
';;m;!<1/'.j.rnJi11.Jtl'l~nBU..............................•••........•..••.•..........•••..•••.•••..••• __•• __••••••..
v V Q udtl Q
1~(j)um1lJ11.JLL1~.. __.. __ ......•.. 11.JLIilB1.JVI 1::LlJ1.J __.. .1 .__.1..__ .
2. ~Ul1.JijC-Ji.'lml'il'V11'l'l11)~u~'tNinWV'lUl1~1)~'il1.J1darunavir Vl1~Lnru'l1~1)lud (oU'Bl(iloU'BVl,j~)
2.1 viral load ~lnnl'l 400 copies/ml VlGi'-1~UU~~VI1U81G1~lLG1:IJ1)'U11.J6 L~BU Vl~1)
2.2 viral load mnnl1 50 copies/ml VlGi'~-ruth~'V11U1.J1G1~lLG1:IJBU1U12 L~1)UVl~1)
2.3 ~u~~1~11C-Ji.'lviral load UB1.Jnl1 50 copies/ml LLti'lnGi'u~viral load ~lnn-l1 50
copies/ml 'llru~~v~-rUU~~'V11U1.J1~1'Ull-rG1B~
o t'li
ol'1i
ol'1i
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lU'V1 ~/ ~/ _
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1.'l'lU1:IJLLYl'V11.J~B'4:IJVl _
11l1LLVl1.l'l _
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--------~----------~-----------I I
1UVl--------~----------~-----------I I

68. tb1.J1.ll'IJrl1n'IJn1'a1.i!l1 High Cost
LUfi1riunI'i'L.lfim 5-Azacytidine (vidaza")
Lwi1riun'wLilm Bevacizumab (Avastin")
Lun'uiunI'i'Lilm Bortezomib (velcade")
LUn1rlUnI'i'Lilm Cabazitaxel (Jevtana")
LUn1rlUnI'i'bilm Cetuximab (Erbltux")
LUn1rlUnI'i'Lilm Dasatinib (Sprycel")
LUn1rlUnI'i'Lilm Decitabine (Dacoqen")
LUn1rlUnI'i'bilm Gefitinib (lressa') or Erlotinib (Tarceva")
LUn1rlUnI'i'Lilm Everolimus (Atlnltor")
LUn1rlUnI'i'Lilm Fluvestrant (Faslodex")
LUn1rlUnI'i'Lilm Granulocyte Colony Stimulating Factor (G-CSF)
LUn1rlUnI'i'L.lfim Imatinib (Glivec")
LUn1rlUnI'i'Lilm Ixabepilone (lxernpra")
LUn1rlUnI'i'L.lfim Lapatinib (Tykerb®)
LUn1rlUnI'i'Lilm Lenalidomide (Revlimid~
LUn1rlUnI'i'bilm Liposomal doxorubicin (Caelyx , Lipo-dox)
LUn1rlUnI'i'bilm Nilotinib (Tasiqna")
LUn1rlUnI'i'Lilm Pazopanib (votrient")
LUn1rlUnI'i'Lilm Pemetrexed (Ahrnta")
LUn1rlUmslilm Rituximab(Ma bthera®)
LUn1rlUnI'i'Lilm Sorafenib (Nexavar")
LUn1rlUnI'i'Lilm Sunitinib (Sutent")
LUn1rlUnI'i'Lilm Temozolomide (Temocal")
LUn1rlUnI'i'Lilm Thalidomide
LUn1rlUnI'i'bilm Topotecan (Hycarntin")
LUn1rlUnI'i'Lilm Trastuzumab (Herceptin")
LUn1rlUnI'i'Lilm Zoledronate (Zolennic/Zorneta")

69. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
1ur'hnunl11irn
'll'tllJil>JlhtJ
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d
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2
'lltl .. .. ... ... . ... ..... .... .. ........... . ..... ........ . . . . ...... l~f1
HN ........ .. ... ........ ... .. '0 . D frlR&lnl'~5nHl'w[Jl'IJ1~'1rl'J"ll"fll'S" D filfnVn~ D ~':'jH<:'lWl::;ilmD~ o ~U"
5-Azacytidine (Vidaza®)
~D~il'lh:tn D'iJnl':lD~ar&lUil:t~D ~ <lrrrs1-6'~n:
t'll':ilPlmDn~DiIJ<l1'1-i'~':i'iJ.lTI.j,'Vl1D1l'il~~DJ'VliIJltJ ./1'H>'liDJ1'1-i'fi1':iJn'iJWniIJltJ'H>.-J~J
~DtiJ1-6'ri1~~'iJnl':iii'H>'I1:tliitJ'H>n'iJril"nJl'H>~rn:tn':i':iiIJnl':iDl'Vl1':iU<l:ttJl
o High-risk Myelodysplastic syndrome (WPSS score 2: 2)
WPSS score = .
0 1 2 3
WHO type RAlRARS/5q- RCMD/RSCMD RAEB 1 RAEB 2
Karyotype -Y, 5q-, 20q- Others Complex, 7 abnormality
Transfusion No Yes
~DtiJ 1-6'g'H>'1
o Acute myeloid leukemia with marrow blast count :'S 30% ~l~fflJJ1'ln'i1'U<;itltn Induction chemotherapy 1.1
Bone marrow blast count
'lJ'H>1IPltJl~'lJDD~ar&i1-6' (lfltJMlJlllb11 ........ cycles m'll1ltl1Jff'Utl~~1~l1Ifl8 ....... ..... ..... ...... ....... ...... 1'UYi. .......... ................. )
o 5-Azacytidine 100 mg/m
2
..... 1'U (5-7 1'U) 'iil'U1'U . (8'iP~flf~f:I~1~ln'U 4 cycles)...... cycles
l'Vl1ll~<l'lJDJ rrrs1.J5tJl'H>Dnu qJ-25tJl'Vl<1n IIvi,'j'l51&i 0 A OB OC OD D E D F
'lJD~'iJ':iD,'j-h~DiIJ<l~1,'j~'H>liJ'H>~11i1J.-J~J'Y]n'll':i:tnl'j'
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Update: Aug 2013 Page 1 of 1

70. KINGCHU LALO N G KO RN M EM 0 R I A LH 0 SPIT A L
High Cost Oncology Drug Under Regulation
Iu rll nunl11if.n
d
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HN .
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o Urine dipstick <2+ 'Vi1fl urineprotein< 1 gm/ 24 h
DhJiJJ1TJ~ml~i1uhI'Viill~~~llJ~l~l'mm1J~~l<il (SBP >160 VI"le
DBP >10066~11,~1<il11Jtnm1J~~)
D~m'l'Yh~lU'lJe~eltJl~<iil~ ']iIll~6m,r1<iielud
o Total bilirubin <2 ULN UnVhnlU~Li'J"Gilbert's disease;,11'V1~1l~lhu advanced colorectal carcinoma
o First line treatment L'yh~u
o 1V:<h~n1J oxaliplatinVl"le irinotecan based
o 'l~tJ~mnn'l'lhhJ~llJlnu 6 l~llU
o Serum transaminase <5 ULN
o Absolute neutrophil count (ANC) >1000 Imcl
o Platelet count> 75000/mcl
'lJ"1IilUl~'lJBB'l!iaJ0i1'1i'
1. DBevacizumab 5.0 mg/kg
2. DBevacizumab 7.5 mg/kg
... mg/dose nn 2 ~U~1'l-1<J11:lJ~<JId[Jlbf)illhtJ~~b~EJnH
, ~
... mg/dose nn 3 ~U~1'l-1<J11:lJ~<JId1Jlbf)il1l1tJ~~b~elnH, ~
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v "
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, " ,
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~ etJ1uJ~VI-:il~m'l'lJlloulJ~H'iJln OCPA
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:::: hj<ilo~'lJ00'lt~~'iJln OCPA d'ie-J,lnllJlumh1mn,lnmmJb)!1imn-J
---------------------------------------------
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6''l-'~ 6l 'V <V 6'
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l"n .I .L. .
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mlilmuVlt"1.r~1Jnl,rjll11W metastatectomy DDnVllJ" 1;hm~,b1V11,r bevacizumab mlJVlt"nl,rjll11mr"
,~u~mnnl'jhl1lldl" 6 L~tl"
iJI~u'U.£T,,1~cn~11T1LiJn~..-1V1"njri1 maintenance. naive 2
nd
line ~1tl 2
nd
line beyond progression
~mn1~'lJBB'l!iaJOiHul
De'ltml1 VllitJl1'il tJlun'iil tJM9l1~,y mj~ 1i~~u'Yl~d:J tJun1JfI rn~ mJ~nl'mlVll'Hliil~ tn
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Update Aug 2013 Page 1 of 1

71. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
1urhnunl11illl
DD 0 E o F
'"'lH) .
HN .
b~~ 0 'liltJ BW kg Ht cm BSA m
2
Bortezomib (Velcade'"]
~tl:l;l<l1.h"::;nnu nl"~tl~~&u<l::;~tl:l;l <Irrrs1iitJl:
TtI":llP1n':itln'lJtl!J<Il~A":l1Jll'J'I-b'Vl~tllribA~tlJ'Vlm tJ ./ 11--b'litlJl~?mnu Adl3Jbll1--b'l1J
~tltiJ'lii
1. 0 First line treatment for multiple myeloma and a candidate for stem cell transplantation
2. 0 First line treatment for multiple myeloma with renal impairment and high tumor burden
3. 0 First line treatment for multiple myeloma used with melphalan/prednisolone (MPV)
4. 0 Second or third line treatment of multiple myeloma without history of bortezomib-resistance
V1--bllP1tJlriVtltl~~&lii (bl'1tJl.r:IJlbbtl"l cycles nl''1lElDflUEl~~l~'1l~El bdEl )
2 et. "-' •... "I
o Bortezomib 1.3 mg/m x4 mo/cycle 'Yln 21-28"lu cycles (mp.i..~1'11oi.1~bj,hilu 4 cycles)
Vtl~u":ltlJ';h~ tl !J<I~lJ !ll1--bbll1--bA"ll!J'l1J'Y]mh::; nl.
c,..,;.. 6l ~ ~ «
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lwn .! .! .
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o El'.ml1'V11itJll'1l1'1ltJl.JElci1'1.'J!m..i"1irfll:lJl,blbun~ltJl.r, ~
o 5u 'l .
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Update Aug 2013 Page 1 of 1

72. KING CHU LALO N G KO RNME MO RI ALHO S PIT A L
High Cost Oncology Drug Under Regulation
lu rll nu n l J1il:Jl
'!!El~fI~t11tJ
d
BW ............. kg Ht ............ cm BSA ........... m
2
'IW ... .......... ....... .. .. ..... .. . ...... . ...... ........ l~1'1 'llltJ
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Cabazitaxel [Jevtana")
VB:l;!<lilsenau nl'W '11aJ&ibb<l:::VB:l;!<lms 'l-6'tri:
hh(OmBmJB~J<l'l"'~':i1JnTI"''lIl-;;B'l<ib~~B~'lIl3-J1tJ v''l"'liB~'l'''@l':i~n1JWn;j.Jbj'Jm)1,'l
Cycle or montho1'to2nd03'do4tho5tho6thoihOSth09th010th
vmj,'l'l-6'
~1'V11U1'lfllJ!b1~'iiEllJ~nmJ1m!tJ!~mnlJlb~im!9Jl u M1
o1.EltJ1UJll1! castration resistance,
01.r1u orchiectomy v1~ androgen deprivation therapy bb.11iJresistance
01.l11J[Jl antiandrogenlJlbb.118thJU~U1 1lU<il bb,hiJ resistance
o mrn~~thtJl~l.l1UnlJl'11 orchiectomy .l[)Jilfil serum testosterone U~fJnll 50 ng/dL
02.~.hunTj"1ntll~ltJ docetaxel lJl bbt11**
vmj~'l-6D" Tl.l':i(O·m-!
'IJU1~tJ1~'IJElEl!lY@iH
oCabazitaxel 25 mg/m
2
dose ........... .. mg every 3 weeks ~lmu hibilu 10 cycles
, '" '"~1~lUl<?lflt<?le)'l. .••................................................. 'U1Y1 x .................. t<?lflU
(1..1~ ~ 1 I -=- ~ ~ t 'j.I ~ ~
~:::U:::t1~lflU3J<?l~~l~::: mnu 3 t<?lflU 'i):::t~3J '15Ul1UYI ............. ./............. ./ ...................,
mrn'IJ El'iiElill ~tilJbb'iifl1~YiHJ~
f.jiml.1ntll iJm''ilElUflUEl~
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lwn ..............I..............I...................
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1. :iJprogressive disease 1Il,:IJRECIST criteria
2. :iJprogression 'llilJ serum PSA 1Il1:IJtnrn'l'i'PCWG2 i'iil
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b. ~hri!Yi:IJ~~,r"!ii'£JJtii"£J~lJ%mJ 2.0 ng/ml 'illn nadir
c. :iJn1.1I'1Jlil~lJ%£JtJ?I£JJlfJ~"j~1J~b16l1vilJn~il~1~%£JtJ 3 iUl'Il'lf
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Update Aug 2013 Page 1 of 1

73. KINGCHU LALO NG KORNMEM ORIAL HO SPIT AL
High Cost Oncology Drug Under Regulation
1urhnunl11iLll
'JJEl~"~lhtJ
d
'l5El...
HN.
BW kg Ht.. cm BSA m2
Cetuximab (Erbitux®)
Cycle or montho f'02nd03'd04'hO 5'h06'h07'hOS'h09'hO 10'hO11'h012'hO .
1. Colorectal cancer
01.1 Advanced metastatic colorectal cancer 2
nd
or 3'd line
therapy
o li':hwlllirinotecan based regimen
OI'lEl~rhum'lli oxaliplatin ~~,,~irinotecan based <J1rim.,
OlJr.wm'l<?l'll'J K-ras~lI'U wild type
01.2 Advanced metastatic colorectal cancer i" line therapy
01iillJrlllOXaliplatinVl1El irinotecan based regimen
OlJ~~eJ'U~'J:r-hl'li1~v11l1vil1'1complete resection
O:lJeJrml'ii1'll'J K-ras~U'U wild type
2. Squamous cell carcinoma of the head and neck (SCCHN)
OH·:hlJrl1.Jnl'lQltJ1~~ (radiation therapy)
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o hlf!1<J1'lbl1vi'm'lr-hl'li11vi'VI1tJ'lJ1i11.r
o hllJm'l~~vdm:'JltJluu~ClltJl:~'U (distant metastasis)
o ~lhtJlJ'JJClvi'llJm'lHtJ1lf1lJU1Ui1illJrl1.Jnl'lQltJ:r~~
1. 0 Cetuximab loading 400 mg/m2 mg then 250 mg/m2 mg every week or 500 mg/m2 mg every 2-
weeks ~lI'UtJ1b~tJ1 Vl1ClHillJrllltJ1f!i1'l IFL or single agent irinotecan li1m:tJ:nl'l~Hli1"bJlil'U 6 b<ilCl'U,
2. 0 Cetuximab loading 400 mg/m2 mg then 250 mg/m2 mg every week for 8 weeks illJrlllm'lQltJ1~~
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Cetuximab130101Page 1 of 1
l'U~ ..... .l. .... .L,

74. KIN GCHULALONG KORN MEMORIA LHOSPIT AL
High Cost Oncology Drug Under Regulation
1urll nun l j 1"If[J l
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2
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Dasatinib (Sprycel@)
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tu •. 1 •. •. '" l' d "1' 1" ~ 11 ~":l~n":l£)n'lJ£)3;j&l'Il~":l1Jtl1'j.!,'Il":l£)?H~":l£),j'll3JlfJ 'j.!,~£),j 'Il(;)":l,jn1J~113Jl 'j.!,v":l,j
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1::;[J::;b1i11Yllil1Dimatinib ... b~tl1.4
c.Ji1m":l'7ltl1J"1.4tl~~''''7Iliitlimatinib ..... " ..... ....... 11.4Yl......... ..........
q
~OIBCR/Abl mutation (il1iJ) .
2. OChronic myeloid leukemia (iltl~iJ Ph positive bbOl::;/v1tlBCR/Abl positive) ~1:U"1lJ11bl'Yl1.4~i1.;r'~bfitJ,]imatinib fitl . ...... ......... ............
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DDasatinib ........ .... mg/d (l:Ubn1.4100 mg/d) .. .. b~tl1.4(mpJ~f1f"~::;l:Ubn1.4 3 b~tl1.4)
!'Il(;)1-I&l'lJ£),jm":l106fJl'j.!,£)nuruilfJl'1l.1 n It vi,j~l& 0 A OB OC OD 0 E 0 Fq v
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6'~.l. 61 ~ "-' ({
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lwn ./ ./ .
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Update: Aug 2013 Page 1 of 1

75. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
Iu Tllnunl1 1i!Jl
'limJ<Hrii1tJ
~ v
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2
.. .. . .. .. .. ... ....... ....... ........ l'W~
HN ........... .. .. .... - . .... ..... ....................... D R'1R'lflnl'·i~nb'lwtJlulnl1l"il'nnl'5 of]linYln~ o[,4tl~ft;iltl~ilJ O~tl~ .... - ...................... ....... '.'
Decitabine (Dacogen®)
'llu!;l<ltb~n au n1~U~3J&iU<I~'llU!;l <In1~ 1'li'tri:
Ttb~ mu n'llu :IJ<l1";~~lln'nn'l~u 'h<il~~U""II<IJltJ ./ 1'W>06u" 1";lil~" nll A,l:IJ ttJWiJ~"
'llm.1,,1'li'
1. o High-risk Myelodysplastic syndrome (WPSS scora > 2)
WPSS score = .
0 1 2 3
WHO type RA/RARS/5q- RCMD/RSCMD RAEB 1 RAEB 2
Karyotype -Y, 5q-, 20q- Others Complex, 7 abnormality
Transfusion No Yes
'll'W>lliltJl~'llUult3J1ii1'li' (tf1tJl~lJltl<i1 ........ cycles nTlil1lUl1"U1l~~l~il~1l ............................. ........ -Juri ..... -.- ..-.- ....- ..-.-_ .. ..)
o Decitabine 20 mg/m
2
5-JU ;ilU1U ... ..... cycle (1l,*lJ~f1f~<I:11idlu 4 cycles)
t"lllili!-l<l'llU" rrrs 1'li'tJl'W>unu ru7itJl"11.1nu vi"'11"1&i 0 A OB DC OD 0 E 0 F, ~
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o ~u 'l , , .
... ./ ..... ../..
Update. Aug 2013 Page 1 of 1

76. KIN GC HULA LO N G KO RN M E M 0 R I A LH 0 S PIT A L
High Cost Oncology Drug Under Regulation
lufhnunl11iul
1l'1J~~~ihll
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2
'Jj8.. . ... . ... ...... . . ... ... -" ....... . .... .
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Gefitinib [lressa'"] or Erlotinib (Tarceva®)
.fJfJ!;!OItI"i"~nfJum"i"fJ~if&luOI~.fJfJ!;!OIm"i"17fu1:
TtI"i"lPImfJn.fJ8:JJOIL~1PI"i"Und"Vl~fJlaLIPI~fJJVl:JJ1U ,1'1wifJJ 1~IPI"i"Jnu 1P111:JJLllm)"}J
Cycle or montho 1"02"d03'd04'h05'h06'hOih08'h09tho 1O'hO11"o12'
h
o ...........
.fJ01.iJH
~lVl~1J~lhu advanced non-small cell lung cancer
OSecond or third line treatment
o mrnHd'Ju z" line NUll1m.,iJ8111 >70 U, .
o HbUU monotherapy bYi1JU
OhhlPlull'l~um"i"~mt11'l1UUl EGFR TKI mnfJ"
.fJ01.iJl7fl'i" TtI"i"IPI"i":::~
'1mlIP1Ul.yj'lJfJfJ~if&ll7f
1. o Gefitinib 250 mg/ tab 1 tab po daily
2. o Erlotinib 075 mg/ day 0100 mg/ day 0 150 mg/ day
"lm1l1.i8b~8U ................................................. U11'1x .. .... ..... .... b~8U
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mrn"ll 8.i8 81 ~i1~bb.iflr~Yi~8~
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" q
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= [)tl1U.,~wj1~m""lI88ul1'~1ilJln OCPA
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~OIn1"i"'lJfJfJ"if&lHul,
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Update: Aug 2013 Page 1 of 1

77. KIN GCHULALON G KO RN M E MO RIALH 0 SPI TA L
High Cost Oncology Drug Under Regulation
1ufhnunl11iul
,rvlJOl~1J--W
~ ~
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2
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Everolimus (Afinitor"]
VOl~<lth:::n OlUnl':iOl'I'PJ&iU<l:::VOl~<lms 1i'tll:
TthlPl n':iOlnvOl !.J<l1.Ji'I':iUi1TWVI~Ol1ri bi'l~Ol"VI!.J1tI v'1ll>1i0l" 1.J (iI':iJnmnl!.J! j'J~~1J
Cycle or month01"02'd03'd04'h05'h06'hOih08'h09'hO 1O'h011'hO 12'hO .. ........
vmj,,1i'
Advanced renal cell carcinoma
OlJ~b1"'lIv,,1.,1u'i::;tJ~~mnlJ'V~v~1~~llJl'in~.hi.,M Obfwl.-l1UtJ1 sunitinib'V~v sorafenib 'V1[) VEGF targeted therapy
Ojjt:-JOl'WtJl~'i1'1tJlblluclear cell 'V~[)predominantly clear lJlrivUbb<i',jj progressive disease
cell carcinoma
vmj,,1i'~~ IU':iIPl':i:::U,
'l,"1~HJ1~'ll0lm.PJ&i1i'
Everolimus 0 5 mg/day 0 10 mg/day
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~A l: l' A Q .,; 1" ~ d
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mni'llv'>i1l1l1~i~bb'>i"1~ri~v~
t:-JOlnT'l1mn jjm':i"vu~U1l.:J --"CR, :=PR, DSD, ::::PD
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Update' Aug 2013 Page1 of 1

78. KINGCHU LALO N G KO RNME M 0 RI A LH 0 SP I TA L
High Cost Oncology Drug Under Regulation
Iu rll nunrrl ilJl
'll'D~,,~tht!
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2
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Fluvestrant (Faslodex"]
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~ 'u
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Update: Aug 2013 Page 1 of 1

79. KING CHULALONG KO RN MEMO RIALHO SPIT A L
High Cost Oncology Drug Under Regulation
Iu rh nu rrrr 1itJl
,Jil~Cl~thtJ
..'lfil .. .. L'I'lf1O 'lfltJ O'l'ltD~ BW kg Ht cm BSA m
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Granulocyte Colony Stimulating Factor (G-CSF)
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llm.J,,'l'li 4. 0 Treatment of febrile neutropenia 1~tJ.Jil~iiil",)tJL~tJ~11;J
1. OPrimary prophylaxis llltJ'I'It1~nT11vtJlLf1iill1U~~ii1ilm~Ln~ ,J1l1~1J1l'l'l~~ii1lhld'
o Sepsis syndrome
o Dl~> 65 11
9
o ANC <0.1 x lOlL
o Expectedneutropenia > 10 1"
neutropenia> 20%*
2. OPrimary prophylaxis llltJ'I'It1~nT11vtJlbf1iill1U~~ii11lm~bn~
neutropenia 10-20% **b'i:l,vn::'l"~l tJcurative/adjuvant 1~tJii
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o al~>65 n
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o Documented source of infection eq. pneumonia
o Invasive fungal infection
5. 0 Peripheral blood stem cell mobilization
6. 0 Severe congenital. cyclic '1'11ilidiopathic neutropenia fijj
ANC < 0.5 x 109/L 11;Jnuihh~~severe '1'111lreCurrent
SI ,.;. ••.• ." ""
o Preexisting ANC < 1.5 x 10 IL naUt11Jn111mn 1I1tlIJ bone marrow
metastasis
o Preexisting conditionsjjn11~~L;aIl1ajjU~"LiJ~. I11Ullti'Jn11~h<il~111'li
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7. D HIV infection Y1jjANC <1.0 x 10
9
/L bLCl~ljj.nm~mLf11.'lJl.J
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o iin11l'l1J1U"lJaJ1Ol (creatirune clearance < 30ml/min) 1I1a<ilu(TB> 2
mg/dl) ",""JDU1Jjji'uihflty
3. DSecondary prophylaxis 'I'Or~nTHii~ febrile neutropenia 1'i1
1
st
cycle 'IJ1l~m~1n'j,rl b"vn::'l"~"1tJ curative/adjuvant
'lJl-l>ll'1tJlri'lJBB'I1if@i'l'li
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2. OFilgrastim (Neupogen®, Neutromax®) 5 mcg/kg BW > 70 kg 480 mcg ~lm'il Dose (H 5-10 lU)
3. OLenograstim (Granocyte®) 2 mcg/kg BW < 70 kg 100 mcg ~lU1U Dose (H5-10 lU)
4. OLenograstim (Granocyte®) 2 mcg/kg BW > 70 kg 250 mcg ~lmu Dose (H 5-1 0 lU)
5. OPEG-filgrastim (Neulastim®) 6 mg/0.6 ml ~l'ilTU. 1 Dose (Hltl'l'l1U chemotherapy 3-wk-cycle L'yh,fu)
(hJ"l~~::~) .
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l"ri .I .I .
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update: Aug 2013 Pagel of 2

80. KINGCHULALO N G KO RN MEMO RIALHO SPIT A L
High Cost Oncology Drug Under Regulation
1ufhnunl11irJl
q., A
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n11L'll G-CSF A'J1f1.-Jl1n,1L'I-I>mri1,'ih::;LtJ'151X~l~t9l'llflln111mnbrifl~l'l''l-1l curative/adjuvant b1Jm'l~n ~ihtJ
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<Example of frequently used chemotherapy regimens with> 20% reported rate of febrile neutropenia
MVAC
2
0 Docetaxel 100 mg/m
0 Docetaxel combinations (TAC)
0 Topotecan
0 Lymphoma (ICE, RICE, CHOP-14, MINE, DHAP, ESAHP, BEACOPP, HypercVAD)
Sarcoma chemotherapy regimens with Doxorubicin> 60 mg/m
2
0
0 Testicular cancer (BEP, VIP, VeIP, TIP)
«Example of frequently used chemotherapy regimens with 10-20% reported rate of febrile neutropenia
Docetaxel 75 mg/m
2
single agent or combination0
2 2
0 Anthracycline single agent or combination (doxorubicin 50-60 mg/m and epirubicin> 75 mg/m )
0 Lymphoma (CHOP +1- rituximab, EPOCH, ACOD, GDP, FM, ABVD)
0 Small-cell lung cancer (Carboplatin/Etoposide)
0 Non-small-cell lung cancer (Cisplatin/Etoposide, Cisplatin/vinorelbine, Carboplatin (AUC6) IPaclitaxel
2
(200mg/m ))
*** hiA'J1L'll G-CSF L'I-I> capecitabine containing regimen
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Update Aug 2013 Page2 of 2

81. KIN GC H U LALON G KO RN M EM 0 R I A LH 0 S PI TA L
High Cost Oncology Drug Under Regulation
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3. D Hypereosinophilic syndrome/chronic eosinophilic leukemia (1lTiliJ FIP1 L1-POGFRalpha positive)
4. oSystemic mastocytosis (1lTiliJ FIP1L 1-POGFRalpha positive)
5. OGastrointestinal stromal tumor (GIST)
6. oOermatofibrosarcoma protuberans (DFSP)
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/d (~lhtJL~n)
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,y1lu~H 6 o Imatinib 800 mg/d
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Update: Aug 2013 Page 1 of 1

82. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
lurllrlunl11irn
od
'IHl .. ........... bVjf1 D 'lilU DVlq), BW kg Ht cm BSA m
2
Ixabepilone (lxempra®)
~t):I;l<lth::nt)unl'i't)'lt3Y&hb<l::~t):I;l<lnl'i''l-6!Jl:
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2 1a- ~u e:
Ixabepilone 40 mg/m mg 'VI'Yln3 ~ ~1'VI
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Update Aug 2013 Page 1 of 1

83. KING CHU LALONG KO RN M EM 0 RIALHO SPIT A L
High Cost Oncology Drug Under Regulation
Iu rll nurrrs 1-nUl
00 0 E o F
d
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Update: Aug 2013 Page 1 of 1

84. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
1u rll nu nT~1i!,Jl
OD 0 E o F
d
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Lenalidomide (Revlimid®)
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o Relapsed multiple myeloma
vmJ~1'lf5"'l
o Myelodysplastic syndrome with isolated chromosome 5q deletion
oUmj"H~ 10 Lenalidomide 25 mg/d x 21 d (28-day cycle) ~l'Ul'U cycles (811mi.l,,,:hhfl'U 4 cycles)
oUmj,H~ 20 Lenalidomide 10 mg/d x 21 d (28-day cycle) ~lm'U cycles (DllJ"ifl1,,,:hibfl'U 4 cycles)
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Update: Aug 2013 Page 1 of 1

85. KIN GCHU LA LON G KO R N ME M 0 R I A L HO SPIT A L
High Cost Oncology Drug Under Regulation
1ufhnunl11irn
d
'lW t~~O 'liltJ O'lli!l~ BW kg Ht.. cm BSA m
2
HN.
liposomal doxorubicin (Caelyx I lipo-dox)
vm~Gl1.h:::n BU nT~B'ltaJ&lt!Gl:::VB:lJGlm-:;106t11:
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2. D .11'111rUHIV associated-Kaposi sarcoma iivmj,jl'li'I'1,ji!
o lJ visceral organ involvement'll1<l extensive skin lesion
o 1~tJ1d'Ju monotherapy
DlJtt~Wil: 1~antiretroviral
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Update: Aug 2013 Page 1 of 1

86. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
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Update Aug 2013 Page 1 of 1

87. KING CHULALON G KO RN M EM 0 RIALH 0 S PIT A L
High Cost Oncology Drug Under Regulation
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Update Aug 2013 Page1 of 1

88. +KINGCHULALONGKORNMEMORIALHOSPIT AL
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

89. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

90. KIN G CHULALON G K 0 RN MEM 0 RIA LH 0 SPI TA L
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 2

91. KINGCHULALON G KO RNMEMO R I A LHO SPIT A L
High Cost Oncology Drug Under Regulation
1'lJnl n'lJ nl J1"If!'.Jl
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* INR <1.8 1.8-2.3 >2.3
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Update Aug 2013 Page 2 of 2

92. KINGCHULALON G KO RN M E MO RIALH 0 SPIT A L
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Pagel of 1

93. KINGCHULALON G KORN ME MO RIA LH 0 S PI TA L
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

94. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

95. KING CUU LALO N G KO RN M E M 0 R I A LH 0 SPIT AL
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

96. KING CHULALONGKORN MEMORIAL HOSPITAL
High Cost Oncology Drug Under Regulation
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Update: Aug 2013 Page 1 of 1

97. KINGCHULALON G KORNME MORI ALHOS PIT AL
High Cost Oncology Drug Under Regulation
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Update 02!2014Zoledronate Page 1 of 1

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1mh:;nllumJ'i'l1~t11 Rivaroxaban
1u1JJ':;nllumJ'l'l1~m Ertapenem
1u1JJ':;nllumJ'l'lb~m TICAGRELOR bNV'lmU1~IOlYl1~'lnJ'nrq
'lu1JJ'~nllUmJ'l'lb~t11OMEGA 3-ACID ETHYL ESTER'l'WtJ''lV'ltl1U1'i'lIOlYl1~'lnJ'nrq

99. !--IN
lil~l:[InlltN~1l'lt;J1mm41A:01ii:[u:{QYn2e.Y3D
[]I, Horncphiua with higr1 ir:hibltor (tuer> tOEU)
o 2. Acquired Mmopt1!lia Wlttl riigh Inr1il)ltcr (trt0r -;. 'OBU}
CJ 3. Congenitai factor VII deficiency
f~lid'lLtl::lnl't jftl.1.tiQY9.Q.e..'L!2D
o '1. ~lhtlYijjHe threatGllif'9 biG80!f19 (intracranial ilernorrhaqe, severe bleH0ing witll shock vnJ
,.j" " t-e- j I' ' "> ,... "'-,l;'i' •• -;
severe bleocling 1-1~lf;~~19l11J rec cc' transtus.on ::....v uruts w~thll'l;{ hours r~''YV1tlJ~~n~PJ) Vir] z...30
mLfkg witrun 4 hours (~-1VflJ~t;'-lCJ,.Yinl
'" -4 I A 1<: 4~~ _ 'oil ,.... ••. _..... ~~
)~}rljJi~J.~~1J()tJt!1:';U1~rrwU~~~~<i.l~J~'~Y:iJtJ...,L~!lJ~~f':.l"rt~~I':-lR·fii.).rH1f:l,lYltY1,il r andor-uzeo controueo tnats Ui~::::
systernatk reviews 'h.Hrl~"l~~tr!NOVOS(~VE~n
i'ln
1tY1~tJl:'fu1!
"1 J.J 'lH .. .t,lt otn 1!:1J1"11'1'l 1 m'l!; 2 llf('17iV,"11i'1 YO~lg !Kg !oose
~'l.hmJt:::UlVt~3 'i-li!'J'1"i1l"ni1l 30 pg i kg / (jOSE!
...J -1~" ,- . '
mnliiJJl'YrllllJlJi1WL'J1 ( unnu :1rtoses:
.. 1119 .UTYI)
92
•

100. •
~'!lfl-.l'~iir1l'l·
Under!ylng oiseases.. .;.~=~=~;;...:=~==~=~==~==~=~===::.[:..j:::C.:.:u:,:!":::;[.'::i,'."'e,-.::::.:..::r~a:ll~ia.':li:::ve:..-:C':.' ~T:er~n::,1i".'n::;a!
- " -.:tI'ililljlJilIfl'Hllm !iilJli:Jfm,m~CL iL1:;'l1.!Jrwlwumj,lil 2 U(~4 l'l'Ji.1f1'!'IH voriconaz ole 1,JWll1m:n invasive asperqillos.s h;"1;ni'Hi!J n.
(~11l!)e1t~r,nli?ilJ~~i)~nttltJ1e~d't)~lfII"Jtl{f't)1J~;~~)..J1iJaffl-'ln1tH1,je).J~·:JnHllrj}
n. ,j~.J~;jf0 1) Invasive fungal infeClionO 1.1) candidiasis 0 1.2) asperotuosis 0 1,3) mucormycosis 0 1.4)
... Hi'-!.
oProbablea-1I'1IiWl"lAV
Proven mh~iilJtJ 1 ifl
o !-JftMr'l"V11~YlmiFi'r1tIWllj 0 yeast 0 septate hyphae 0 nonseptate hyphae ~'1invade tissue (llJtJrJmJl0l~ti)
o nn't!ru:;i1fmr1Lln:;m~fli{dh'lJinlJn-lr:ii:1!I:ntln hWltJ'i'ltJ 0 yeast 0 septate hypnae 0 nonseptate hyphae 1lI~tJ~H-1!l
~'11~1ii1'l"l~dJ1.!sterile site "nn 0 mllYn:::l~fl (m1JwfllJ1~i1tJ) 0 n'I?A1'l"lrli'lLJnlitl~'~mlr?wtS (11JWil-rmW,"'ljtlT'I"Hj~
il'~tTwe.mrm!>l1'l"l) M~t:L.. .., ('W~J1N'l!.)
o Proven
Probable (not apply to candicnasis) a;fl1jjfl11J.;r~ 3 ifl)
o ili19'4''1JL~1J~JhJqlhtJ At),.
o lj5m:fC1J;;V!1-1"'ftnn1flii11ff1ntJn'1J1"'l~flj"1 Ae ,
o iil1'l''lY11.1 0 septate 0 non septate hyphae hi non-sterile site -;le;sputum BAL, bronchial brush. sinus aspirate c·no
o n'1:i'l~'n:;~;i)(tl'WtJrJ~;un~(n.J) 0 n'!~vlt'"J'ijJirHJnfliJ'1/iri"~1U!t1 (UUlJtH'l"i1'f)fI".J'nJf1T"(·lnl~uJijueH'Ini~"~t(y.:;.)
A
tl-l'n-tL )
~7'flserum galactomahnan ..:00 cut off> 1.0 (L1JLC-J~~_nJ11tJ) «:ijfi.J:::~-J(l1t'I"'l'tJtJTdfJ;a1U::itfJ ..
02) Refractory invasive aspergillosis (rlHm-li!Jl;!f11,l-iitl1j,~~ 1 Jhu) ~-l1jJl1Itl1J(J!l'lOifJstandaro (realm,"n!
o 3) Empirica! therapy in tebrite neutropenia
o 4) Fungal prophylaxis in patients undergoing nernatopoletlc stem celt transplantation
'IL 1)i'lllU1TIl'l'l'UrM'il conventional amphotericin B (cAMS) ~;j'il4<nn 0 Rena! impairment (creatinine'::.2 mg!dLJ ll1i::hil:iiih chronic dialysis
o iJwfI-ii'mf1!.i~~hJMmmi'l'lw.p'J#i,)!.i7jfi~1.) 1~r)(ii!ln1.Jmh1Jer:j:)1.1 fif.)
Creatinine baseline l-'tJnfl1h~ cAM8 = ..rngfdL ,)J~ .. '
v , _~....t
~'?jpl11.!"I'Umrfll'llm1,
ANC < 500 cell~!mrn' '>J1Llth.
.. ll':h1l41t11vrm1vm.,., .~u,'n-iJim'h.bl'l. ...,,~U~l1';
.. 'i'1.J;fhl'!i1I1'u~". ...ANC =. ' (r;~< 500 fll"''-;I''l:::djwun~1u ..5e;); Cr ..JngicIL >lJY1..
1i~ I-.J; 2) " . "n,,, .. (_i_J._,_.~4--.J_i-.J; I·lite .ifl'U'1.
----~----r_--~~. " .t If-- n_'_'_!il_tl_1J_~_1-i_fl_.~_fil_il_tJ_'_If_."_.V_."'_"l.l_,11 Complete Partial Stable Worso NI
lJitnl).".,.",.{
o 0 0 0 0Local symptoms & signs ..
~t~~'·~~";~L.:.:..:.:.:~_"::,:",::",::,,:",:,:,·:.:.::..:.:.:=:..:.:..:.~"";"'Er.""c!..':"t:2.::"~;:.:..:.:.::.::.:.::::..:~,;;;,;,,~,,,,ttc!..':~;~,d=:.:.=:..::..:.:.:..ll-c--O'::.! __ ,_L~_9_;,.--'--O---'-0-1
o Lldr'" i Culture ~tJ ;(".'''''0<1 .'ljl'1~lYh!.i~~W .. .·rlHlrn~llj~u
" ,. ~-- _ ..- ~, ~:'ll'i!Jl.Y.,lW')j!lI!i11b1~ 7 ·rH) l'urt;cJI'Ii(.JLi conventional amphotericin B
o Liposornal arnpnotenc.n B -limj"~ 01.2 01.3
oeaspofungin -iimj-1~ 01.1 02 0.3
o Micafungin t!Ju~~ 04 50 mg/day = 21.028 :rm/"tI~n';:
o Aniculafungin -limi'l:jj 01
o Voriconazole intravenous 1imi'l~ 01.2 03
ovoriconazole ora; (OIPD 7 ')'U l--ttl OOPD 14 '11) ii'1)1i,; 01.2
50 mg/'jay
1':;0mg/ciay .0 186.081 u"iw,f,bnl1
50 mq/day ~ 62,230 U'IYli1hJon"f
100 rng/day
400 mg/day
400 "Og/day 25.578 IJlYliriJc·n~
fYlllJ~ilUlV1~J0iI!.,
R~~'!ll~'tWI!li.lT:;~'1hv ... rJUYl
•. .J
'1UYl,
~1'1-1ruLL~'I1ftl~ft~I1lL~'il iJ11!l'ill~'if'!1~11l'; '1-11'il'I'l'l'ltlhftftl1ll:a'illih~IJ~11l1'if1'f1?lfil1
o!Jjl1v1 0 hJmll1v1ld'l.N"l,n,
....
o fltll1v1 0 'llJtl111.171(~'1w:nn .
ft~~fjq'fhlnt1nl1tr,n"1V'lJl~'1v1i~,~n1ruV.~ur~uviu..
(.n'tl-:!mJ1'~n,!)lJnW!li39ljU;;IJ'''''UI~il~1 n:ru'Viin~h'UC>111./1.1fl~)
93

101. .~ . •• s y
'lfO-Jl~tTf.lll : HN tTVll1fl11l 0111 .
Diagnosis 1 , ,., .
2 , , , .
3 " , , .
'11 'I It,
_~ ,~ .., ., SI 0 ••• SI SI •• jI , Y. jI 'I " ....Y., ••~" '" ".'1
'U6'U~'U'iHlf)'IlM01'j '11 (Vlltfl'HJ-1l'1'l,Jltf X l'IJl'IHI'YIl'lfNflI'5 'I) vlM1~Wil91·NQ1J'UQ1J~'II11 !'H)'B'IIO~f:Ju1tJ
o Major hepatic resection ~1J1lJ11tr'l)1f)fl1~1~1'fl,.U'lft1r1t'W
o Liver transplantation l~V!'lJ'U'1lJV lfllnnlJ~ llJ~ ':l1Hl::D€lr1'U ".llni'€l Ul.:l~'WU'j ~,th~'l1ci'.:l~.h9i'f1 '1-1.• )lv~ljtrmJtll::
nru 3 D'j~fmfi€l serum albumin < 2.5 gm%, PCWP < 12 lJlJ.1hf.l'Vl ('Yi~€l CVP < 8 tiJllJ.J,), U'ft~ Het
> 30%
o Acute hepatic failure I~€l:rfl'tfl colloid osmotic pressure 11~V r11~~ toxin 1~vlii dialysis ~1V albumin
o Cirrhosis ~ij peritonitis l~fliJfl~n'W1mlV
o Nephrotic Syndrome ~1J1lJ~'W~'WUH 1~v'1l~0'Uff'W€l~~flVl.;r'UiJffffll~
.d~ ~sv .q
o Cerebral edema l'ViO'H1'I:Jl!'Yi cerebral perfusion pressure Uf1Yl
o Enteral feeding intolerance ~lj~€l'llcrvrwm~ tIt'!:: serum albumin < 2 gm%
O "...'1 d ,et
~u1VVlff'lffV11l~lJfll~ hepatorenal syndrome
.0 i'W~iJ1v~~tJ'l1~ Heart-lung machine
. ~ ..l!" .''''.v '...... , SI jI , v 0 PI •• v 1_':'1 Vv i·'.l!'
tfl'!J'-J'UOlJ-:J'II€!-lmn1'UV!I'l'H ~lTnH)lIV'H!lg)l'):J JlI'l1'Y>lI'il'.A 'W'li8~11~"11'W"'.:l
, 1I~ , ~.a. od r.:t 0 •••• I a.; •• I G.I _I If.et,
01'1 'IIVlllJt1J'1'UtJl')lf~JVlf1C) lJlYW'lNft serum albumin ~l, 1'I'lJ8tl'Wtlmff'U, u'j'~fl1Ju'i:::f1€l-'l'J~'U'U L""'(H1V'W'S~'111'lYh
dialysis, 1ln:;~iJ"J{jhJj:;tJ:;-q~-nlV
'Il'.Alijv)ii'IJ~all~ ('hitn'W 5 1'W)
20% Albumin ~T.nw 'lJ1r1 x 894.-111'11 ('i1lJd'h.u1'W 1Il'Vl)
J J I1v ••• '<'I.l' •.•'1•...!:'.." '-1-'1 v, ~ V f •• V ::. f v J
61l11tJUY1l1tJij1lJNij'l!OlJg)I!~ij]J1tJj)o/I'LtHrn.J:il'G1illill..l...li:PJ.nml-J'lJf.)lN'lfij:!lmtlJ Ut'l;;M't!ti1tl'11YlI9'H11tm~'tT1'l1nU't1l1V
., ••.•• 1_"" , Si...... ". v '. , " ,... __
'HD1Wl1'!Jtl '1U'HIJt!'lJ1'l!n11'tnl'tnWCfH'UtNe)91·HJuY111t!0l1llJ1~'HYt)0I1")1]'l!nll't!6]9l'HJ1lJYl11lJlIlzeijHfl
.. .~ 14" fit v .••• 4 "I ~ '4 <J , "" •••
J~tlIVll)llJH"MMJ)(J):IQ'II'!J 1!91 !'l1J11't!l!l!tly1"Hr 'tf'lfVll'll'YlY'lt1f)JdVl'n;nYOl)
~.• I 0" A' ~
Hl'I'YIVu'i:;ll'U)'W ~N'lH) , 'J'11ff .
" 0' ~ Q,I
011)1'i VIlVi'YIV ..•.•....•....•.•......•...................... ,....••........ fl~'ll'tl , '.i 11ff , .
'" d
1'W'Vl , , .
o '1'fi'ml)11Vl':;I~U~f1lnJ€l Hn.,j8lJ"m'UO'J'WVlllJ~r1TI1'.j~
M~mml'lfm , .
•:. ti',m€lfl.,J0lJ" 11;m'U~J'W ):;'hjff1lJm)~lVV1't,rO'U~tJlu''fi'
• 'I ~ ., ~ • ., ~}! A • 'JJ Si
•• + L'YittH'I''lfm ';i1'U';i1lJ iumnums ('If !'W'€)'WllJl'Y1'U'YI1'Wmlll)fwl'€)'l'18~"J€l~t'!

102. 1'Ufl1o'Ut1l"a'''m 5<Yo albumin ''Uh~'Wm1Jltl~'Yfltl-1f)"JtU Ward ......................•..
Diagnosis
~O-'l;jl'l4"Qe.. ,......•.. , ,.HN , , tl111hrrrlfrwl .
1..............•......................•......................••.....• ,.., " , , , .
2 , , ,."., ,..,..,'~•.U.II ••• " •• ' •• "'t., •••., ••.. " ••1••• "•••• 1,., •••·•••••• , ••••••• , ••••• " ••••••• ,.~ ••••••• 'Il •• " •••••• 'j •••••
3 " · ,., .
v • I _ •• ,
11 '" .., <) 11 0 '" Y 11 "'.l' ''Lv.... 'Ill Y.'" "'~ 11 •.•• ":1'111:11J~1l'l1nfl'UMf)1~.'If ('Yll!ft1M'l1l-Jltl X 'l1'Ul'U~'VlVIMfll'.i !'D) l1f.).:1'J::W'IWl'J.:ill'lj'lJfllJ.:I"lI'Ylt'IHI'.l-.1'IJtl1£pOtt
d ,,31 v a tj.o::::(.et w1..1' d .Iq!J.l : ••••
Major hepatic resection ~11J1IJ'illmm't'l1~l1t'h 'l1Hl1::1J1.1 mW'lIJ'Wlrl'UYleJ'I .J.)!H'l'l'l1tN I'Ylftl'J''Wl'l1t.lfHlt.l
Liver transplantation !~elh ~t1'lJ'l.h::flB'l1::'lJ'lJ 1"HHlmJ'.i::'I111'l~,h~~ '11tl'i'lJ'l.JfJlJ81fl1'j'lJ1}J'flll.wi1lLl'~
'llt)YI'lJ1mJvcil-.1{'WUJl'lh,:rYfi1~p'h1ill l.mv~tinn'Y[lj~frnJ 3 'lln;f11'jfiv serum albumin -c 2.5 gm%,
•
PCWP < 12 lJlJ.lhv'l'l ('-11'9CV? < 8 <JIlUJ1), ut'!:: Hct > 30%
o
o
o
o
o
o
o
o
o
o
o
o
Acute hepatic failure l~1'l~m;J1 colloid osmotic pressure 'H~V ~,f)1'I toxin 1fiIJ1TI dialysis ll"ltJ albumin
..d l I tI _
CirrhOSIS 'Vl!'iJl~'WltlVfl'llln'lrV.:j'VIfl~ > 5 'Ml~
Cirrhosis with renal insufficiency ~!'lll~Jlat)tl'llltlie'l1{t).:jLl~'iJ::;-w'VVf1 ...h 5 iitw!
Cirrhosis ~iiperitonitis r~P.lilB.:jf)'W~{4I"n{j
Nephrotic Syndrome ~'U11J~'W1'WUN iYl!/bj~il1H1'WeN~e)tJ1'11'l.Jtltl'ffl1::;
Cerebral edema ~~iJ~mn1,rcerebral perfusion pressure 'tln$i
Plasmapheresis> 20 lJi.'llflrf. (l'11'lMt'1'iJl~'Wm~lJtvltlMl'll7lJlf;l!fln'~ albumin)
••~" :..... l''I''12!
NeonataJ volume expansion 'VIt'Ht'1'l't.l1V'Wl-!l10 lJalflfl.tLtrd III 'i'l?H'1
Severe Bum > 30(7'0 1'W'lf1~ 24-72 hr usn.
Major pediatric and major congenital cardiac surgery 1'W'l'::11il'ltll:l::'I'I"":Hhnl'l
o Enteral feeding intolerance ~iille~LihJ~'H!'J~H'ft: serum albumin < 2gm%
o f~{hu~tl'~ff/.dl1):!nflll::; hepatorenal syndrome
o 1'W~lhtJ~~eJ'IH Heart-lung machine
}I" ""~ ,:t ",,' , " .l' 1'" .~_..'l •• ~Jt" .'1."" ~<V ~"",
m.rn.~'lJ6'IJ,tl!ftIDJUJ'I1-3Yl'H 11j~mJV~1ll!.Q::iL'l.H't'l'jVl!'il'W ~t4'lIel'Ill l~ l'.H'm
1111~m,jf.•.n1i' albumin fie lk~tJ~Nil serum albumin ~i, ~1JBv'U8mtl'1J, 'lln;I'i'lJ'll-.n::f1e~n'IJ'IJ't'l1t'l11q'W'J~'1"~'vnh
dialysis, H!:'I::;~iJ1!Jlt4'j::;tI::;f.j~1i'lo
:m~~wni' (i.:l.llii'W 5 lU)
5% Albumin ~1'W1'W 'J"l~ X 1,709.- 'l.n'l'l (1TjJ!.fl'Wl~'W " .....•...... " "." ...•." ...•.'J1'Y1)
"I . Jllv ••• ~~'I £ ~ J{_fi.'l _1E~....... 2.;.",,! .••:!Lv, A fl VIV :',,' v d
al'iJl1!'J1tm1tJ~'j'lJs::!rlll~!ilIiJJ.I'JfJil~!.1L!:lillID.lillJ.l.l.JUil.Vlltt1!QJ.1~.:~ft~mrrlli~~-q'ij[6!'tl'll?lI'iJ',I~11JYl.:j tT1'tltIU'Vl'YIt!
1 .•.• '11;'1.. 'I •.""" ,,,. 'V I "'" V _~
lHl'UH'YI'Ue!~illlJ1.TIirn~ 11U1"lfJ1"Jj''H..'H'J~1:))')nfJ!l'VnUJf)lmJ!U1Ja(;'fl'4'Wl'lf)ni.'llAllinl~ Y(tl)'I)l':lm'IJYlU~ftW:W
.. ,
lY1tJ'~~1IiJHWf:)'1t1:nlu!ll;)ml1'ill.rj:1~!!u;;;·rtl;T1lii'€l!j)llirlef)lAl1'j11)t:Itl.1!.
U'l'l'l'lU'll~::;~lDTW " .. " .. "." " " ..•............ ". M~'U '''., ..'' "" " ':i"'ft " .
ff' If' d
fllil17tJU'l'I11V.., " tl'l'J1'l , ".." :n1tl'., " .
1'WVi.. , , .
Ml1':l"l'J'J lmi::;!~Vllfl1'J'tJ'e1 HMvj(Hi)'j,JilJ1.lmlJ~nl'l1'W1'Io
•• ••
n~'lfV!.flt''lif1'J ,.. , , , , ,
.:- t11fl'J'eJtlt{ftl'l,ln 'hJm'U(1'W '!l;;·hjff1lJl'j'fl~lmJ1Mn1J~lhv1~
.:. 1'111ili'b'fl'.i ~·J'l.J'jllJl'IJfhl'lJf11'lH 1~eJ'l11lJl'l'l'I.J'l'l1'Wmlu~fl~€l-:l'lJt).:j~mJfl

103. ~tl~1J1f.l . HN .
~lfll'Ull'l (lll'fl)
'"
'lJeJl'll
Simvastatin 10 rnq, 20 rnq, 40 me (Bestatin ®)
Atorvastatin 40 mo (Lioitor ®)*
(
. ®
Atorvastatin 40 mq Atorvastatin Sandoz )
Nicotinic acid 100 mg 1.00
Gemfibrozil 300 rnq, 600 rno (Hidil ®) 1.50 , 1.50
Gemfibrozil 300 rno , 600 me ( Lopid ®) 5.75 , 9.50
Fenofibrate 100 mg, 300 mg ( Lexemin ®) 5.75, 8.00
1'l11l,,''UlY~~eJll,yW;1'l m~ilIl'li~'lJlfl* Mm)
'"
'lJeJl'll
Fenofibrate 145 rnq ( Supralip NT®)
Atorvastatin 20 (Atorvastatin Sandoz ®)
Ezetimibe 10 rnq (Ezetrol®)*
Atorvastatin 20 mg & Amlodipine 10 mg (Caduet®)
~lfll'Ull'l(lll'fl)
'"
'lJeJl'll
Pravastatin 40 mq ( Mevalotin®)
Rosuvastatin 10, 20 rno ( Crestor®)
Nicotinic acid Extended Release 500 mo (Niaspan®)
Pitavastatin 2 mg (Livalo ®)
25.50
19.00
51.00
71.50
~lfll'UlI'J(lll'fl)
1.50,1.75,3.00
61.50
24.50
~lfll'UlI'J(1Jm)
41.00
43.50, 61.50
20.50
33.00
~ ~~l'lllntll~~!J1il!!'YIflU~!~I'l?'lJlqJ~il,,1'Jlll,mjllJ~1HI'Jl 'vl!!~!!'YIflUth~,hNltl!Jl£J1fll1:m{ mhm1'l:ltlfl11l.JfI111!Jfl !!l:l~mhtJfrl:ltlfl111.J1.h~ITlfl mW!!'YIflUIT1'U1
tiutf11,nM!!uulmh~fl!Jufll1tf11J1l,lVl''1Ji(ulu!i'ieJVl !!l,l:::lMll'YIflUl1f1111UVll,l1un!1ulmh:::fl!)Ufl11tf1tllvlllJ
I'll
oI. l'UlJl.ll.H~tJli1!1titJ'utll1~mJ1Cholesterol> 200 mg/dL , LDL-C > 100 mg/dL,
CHOHDL-C < 4.5 ~m::/'H?0 TG > 200 mg/dL
2. Primary Prevention: ~1J1l1lJl[J LDL-C < 130 mg/dL jJtJj),yIJl~[J~lJlrlrll12 'lItI'fI
mwlJ HDL-C _ 60 mg/dL .r81lJtJ),ym~[J~m;m.i'81J 3 <U8'j{mi
i'I11lJ.r~h}1i1!1 (BP> 140/90 mmHg)
r
o
o
o
o
HDL-C < 40 mg/dL
lh::1Rf11tJlJf1~l!1'J'Hhi'I'Mll) hl~'lI1()tJlq::S 55U ~'Hti11tJlq ::s 65U
m~: 'lI1tJ2: 45 U, 'Hti112: 55 U
3. Secondary Prevention;
tihl1lJltJ LDL-C < 100 mg/dL l~f1~lJ~iJhrnhh lf1h'Wl~ hmu'wmfleJ'fICllJeJ1peripheral vascular disease,
adorninal aortic aneurysm hfll1i'1eJ'fI!fleJ'fIU'fl11'11Jl1~m1m)lf1fi'm.I'1'UJJ11(atherosclerosis) lli'1~t,m1JlrnHI
i1J1l1lJltJ LDL-C < 70 mg/dL hl~tJltJ~lhiJd~'Ul'fl!flD'fI~WIJ 1
o
[]
"':'1~4. Hl'YI1::;fl'mHTl'lJ1'l1Atorvastatin tablet 40 mg
Him simvastatin u~,l1r·H'l.u11Ifill1 f18 o
Hilll simvastatin ll,l1;l:: 40 mg 'l1581ll[l:: 10 mg Iri8Hi'hlJf1U Amiodarone,Verapamil,
Diltiazem,gemfibrozillllll 6 liiiulWKl hJ(1'l:lJl~ [l1il LDL -C l~mlJliJl'l1:lJlll
5,1U'YI1::;fl~W~lHI'Jl Ezetimibe (Ezetrol®)*
l~lIl[llill 'UJJlllll!~ul'lfl~lJ Statins 'Ullllil1:l111~J lJ.Jl~rl[l
6. 1U'YIl::;Il~W~~H'fJl Nicotinic acid High dose Extended Release (Niaspan®)
o
r
" ,!lVWlf)~lJ Statin o
J:;~1J1'UJJlIfi()l!fll~ff11Jl Total Cholesterol.. .... TG . .HDL-C CHO:HDL
Total Cholesterol. TG .. ..... HDL-C CHOHDL, .
• _ v
II'Y'l'11[JI';p flloj1 ,.............. ':i mr. .
1I'Y'l'mJ~lh::&I.j ':i'l1IT ..
o
o
o
r
o
o
o
r
o
r
o

104. ••
h-1'1'lm'U1i'l~'I4'1'&Nn'HU
1.'Uthj"~n·mJn1-:Jt.:ltl1'iN£Ol'fl1n1-:J~m~'!..Jn~:J,JCOX-2 INHIBITORSq
~'flNiJ'ltl 'fI1t1 11~ . HN .
~la{i)1l1mj'in1l...'lJihm.!!~mYjl1.'li'1.~
:B'tltJ1
IBUPROFEN Tab. 200 rng (HEIDI®)
IBUPROFEN Tab. 400 O1g (HEIDI®)
INDOMETHACIN Cap. 25 mg (INDOMED@)
1.50
...
'll'tlfJ1
NAPROXEN Na. Tab. 250 mg (PROXEN®)
NIMESULlDE Tab 100 rng (NIDm('Il)
D!CLOFENAC Na. Tab. 25 mg
(OOSANAC@. VOl TAREN®)
OICLOFENAC Na Tab 75 mg (VOLTAREN SR®)
PIROXICAM Cap. 10 mg (FLAMIC®, FELOENE®)
>11'11'111!l
1.50
>1Wl'lJ1!9
1.00
9.50
1.00 1.00,6.50
MEFENAMIC ACID Cap. 250 mg (MEONIL ®)
MEFENAMIC ACID Tab 500 mg(MEONIL ®,PONSTAN®)
1.00
1.50, 3.75
18.50
1.S0.11.00
1'rllimlJn:wimllujYD~iJ COX-2 INHIBITORS YM'il"t!DllMJ1!.1-a.Yl'i1J1J:i~:lm
:B'iltn 'ilI'11'l11g
@
MELOXICAM Tab. 7.5 m9 (MOBIC ) 18.00
:.3'afJ1
ETOR!COXIB Tab 60,90,120 mg (ARCOXIA ®)
PARECOXIB Inj.40 mg (DYNASTAT®)
>11'11'lJ11'J
4000.40.00,47.50
CELECOXIB 200 rnq, 400 m9 cap.(CELEBREX@) 31.00,48.50 269.00
~lIDll~.D11k"S1 ; tll€tJ'ltlVlii-n'tlti~1.1i' RA,OA '~'l'il~L''l'iVlt1~·:Btl1'Jjlcyt!'i:;'hiJ11'J«atH'f11l~i'V'VflfitJfln~ iJlm'J'JjA11lIili~u'lj ihtJ'tllfJ~l'Illllilj
~hJ1un'iru Acute pain 'il'l'il::ih!'l~:ffty~VltJl iJ·1tJ«~tJf111lliljiJ1tJ«atH'flll~lj'1l'il{tfitJiiin.1 (mb!j~l:jLiiuRf~",:; 14 -JU 1'J1~~l:j(nlflf~~:; 5
VIAL) UI'I:; Primary Dysmenorrhea L~'In::iJ')tJfl~U~L'J'llA')alfli n~IJLL'Ymg;;:1J;t't:j1~T.;'Ll1~uuu1utl.,~nll1Jn'lnr~tJ1COX-2 INHIBITORS ~1tJ
1. Indication o RA OA 0:i Acute Pain
2. ijlPl'Jla.Jb~t1~~~;j~~Lnl?l Serious gastrointestinal adverse events 1vl'IMi...
i.'Ii La.J"l'li
0 0
0 0
0 11'
U
0 0
0 0
-a~~.
1. dj'ti.~tl')tJ~~tl'1tJ( !l'1~!~ 60 U)<U u " 'i
2. ~1.htJilth::~L'UUgastroduodenal ulcer, gastrointestinal bleeding
or gastroduodenal perforation
3. eJ~1-ii'tnAnticoagulants LL~:;/'...I1'() Steroids
. '
il Co-rnorbioity Hul COPD, Chronic renal failure, Ischemic heart disease,4.
Coronary artery disease, Liver Cirrhosis
ti1.J-a::::bil'W ..".""" ..... "",,,
"..., ..'J'W'Yl

105. t1J1.h~nmJnl'H~'ll..6~,
AVELOX ® 400 mg (Moxifloxacin)
2i8t:Yil'lu.... HN .
'U
81l:.1 ..•••....•..•..•• iJ
•
I ' .:~1A1'7J1l:.1'il'HH3J1A (1.11'11)
·------------·-Ir--------
IAVELOX®(Moxifloxacin) 400 mg 117.00
.• ~ <'1" , 1 ~ d' '1' . r ~" ,t - - ~,,; ",-~.• 1"h'IDH'!Jnl1iil~ "tltll : tUyn:wnv 'Jfl~~H"lm VI'.nu 1fl!J1l<11Vl1.IlfJL1f1lJlmYlbLR~~htJ "~1 fW .Il,mlYW' mnmWYlf.Jiill'Ulill.laWIHJ1 VlII.1J
llJ1.h:n f.JUrn1i~ 1'ii·tJlri>il,nl1ti'l~.ij1.l hI nu YI'YIunrl''VI·''.11-r'li'~'1l·u,(>'·Jtl
1. Indication
o First-line treatment in Chronic Sinusitis
o Second-line Treatment in Acute Bacterial Sinusitis
o Second-line Treatment in Otitis Media
o Second-line Treatment in community-acquired pneumonia
6",,~
bLl~'Y10~a'.J .
-u
.. 'lVlrt ....
~'1.h:;dJ" . 'li" .
luYi a ••••••••••••••• a •••••••••••••
97

106. .--.--.---------------~
hJ'I'i!J1U111~~ln"n·Hl~
bUU~~n£)Un1~ilbitl1Azithromycin Capsule U>iiI~ Clarithromycin Tablet
.d •.•.'1
~lH)lJ.IlJ'l:J••.••..•..••••............•.•••.••..•.......•.... HN .
•• EI1~ •........•...••.. 11•
66.00
-----,,;--------------------f----.- -..-- -- ---- -..--
ZITHROMAX®(Azithromydn) Capsule 2S0 mg
-_ .._-- ®
AZITH . (Azithromycin) Capsule 250 rng
ZITHR'~~~®;~~i;~;~;"YCin) Syrup 200 mglmL. 15-~~'··-----····'···-
----_ •.•....__..._......•.............• _------_ ..__._-_.
27.00
203.00
(Clarilhromycin) Tablet 500 mg
eR) - ..•.~---..--.~----.
KLACID MR' (Clarithromycin) Tablet 500 mg
"~~~~N® (Clarithromycin) Tablet 250";;;~- -----------
CLARON® (Clarithromycin) Tabl~t 500·-m-g-------------···-- _ _-- ·;9~OO-----·-·-
KLACIO® (ClarithrOmy~~~~;·~~;~ 25 m-gJ-s-m-L-.-6-0-m-L-----------l--·--- ..-2S0.00
64.00
64.00
12.50
~!l1.4''lJnTH~·_.l1·5!.nAZITHROMYCIN : 'uwl::'V.htJhfl~<;Hiu ""',iltJhf11J!l<1) ~"htJrn~iii.'IltJh VlU1Uhfll;)iJLLvi'Vi,V?I'il1l1tn LLIil~
r:lltJl~'1! ft1l nl&niY1!n '1!1~iElti~Hh"hrJ1:;n1l'L! mrn~L~~mj~1Il5.1,~~1'IirJ1html!llJ
l.h:n1l1Jm1;~1·ntnff_h4f._111.h:dj.tlliltml·fY1tj"~fl·l'V'.'ilH1j"li1"'~'l1J
L~01.4'1.'!Jrm~~1iFJ1CLARITHROMYCIN : buW1::',il()hf1~~i8 ',tb!JhfltlfJ~ VI~'l!Jm~I&1.1,(l()l"lYli',whflnijlLl4' vnil!JI'l"l'imn
. .
1J,00::i.hulli!~ftf) .Ilffn'i'r1Ul m;J'lj'1llj~Hhl1J1b::nm.J 11<l::ihM1lJmm'!l~VI~U H.Pylori '(~
~lh!JPeptic Ulcer Disease m.'l't1;;:'H.btlh~'l11JL~"u1'Hl ••U<l::ihtJvl<lUmill1lf win
Llvm6f!1'lng'l4~~1iu11iLL.uluh::n!lun'm~·~1i'()lrie.i1.1,mjtiJ~tiJ.Ihlun~1u~ri"m1.4$lHil~i1.4
~,u
-----------------------------------------------------'
OTreatment and Prophylaxis of Mycobacterium Avium Complex (MAC)
DTreatment of lower respiratory tract infection
oSecond-fine Treatment of upper respiratory tract infection
OOther Atypical Mycobacterium Infection of skin
Dqlh[Jjjth::1~m~rnTl~~ Penicillins 'VI1tlQuinolones Yi'hjfflm";im~tlTlH'U'i~"l~'U.~l<;)
1'ilmnYi)jth::~LL'I'l1<;)mL. .
D'!Ji'ilL~8 H. Pylori h~lhu Peptic Ulcer Disease
~~~ ~
LL1'l'l'1tJ~ff,j ·mff .
·1I'Vi.....
98

107. 1'WYi .
~'flertl"J~................................ HN .
••
'fll~ TI.
.n'fl3J~'l.h:::n'fl'I.Jm':i'1i'm
..
d • r;;t;
"1i'flm ':i'1~1"l11~IPl'flL3J1n('I.JI'V1)
AUGMENTIN SR tablet (m'W!lmJ'1!~mVl~nbb'.i'l']jl~) 25.50
Amoxicillin 1000 mg & Clavulanic 62.5 mg
Dosage 2 tablets BID
L~'fl'W1"l1nl':i'-i-:J1i'~1: VU'V'lI~bb'V'l'Vl~Vnl'dtJhA~(9)b~tlVltbtJL],AJJtl(9)Vltbm'll~b~hmltJl"l bb'6'l~~ltJL~[9lV'1tl
Ul~ n-;')'VltJ1bb'6'l~fitl~muJJ ]'~ntlU i~H'm bbUUV~~tl:J.J1ui~tJ 11U~U'dtJ'Vln]'ltJ nnll-u q
,
inru'l'lm nr~10ifm
o Treatment of penicillin- resistance Streptococcaus pneumonia (PRSP)-culture positive
o Treatment of lower respiratory tract infection (LRTI) 1~bbflacute exacerbation of COPD or
AECB, aspiration pneumonia, community-acquired pneumonia
o Treatment of acute /subacute /chronic bacterial rhinosinusitis VI~tl otitis media bU
, " "'!In 11 al .::;:I c::..:::!.I.=,j ~ c;!J n9
~u'dtJ'VlbAtJ:J.Jm]'[9l(9)b'lltlVl]'tlbAtJ:J.Je..J'6'lb'V'll~b'lltlbuUpenici Ilin- resistance Streptococcaus pneumonia
(PRSP)
o Treatment of acute /subacute /chronic bacterial rhinosinusitis VI~tl otitis media 'lu
~U'dtJ~JJJJ]'~1iifuJJ]'~'VllumJJD~'dU~ amoxicillin, cephalosporin, new macrolides 1U"1l'd'l4
~JJ(9) Tl,f~~,hU:J.J1
o Treatment of acute/subacute/chronic bacterial sinusitis 1u2itl'dtJ~JJJll'd:;b~tJ'I (9]tlm]'~(9)b~tl'lJ
~Ubb],'11~bbfl Sphenoid Sinusitisbb'6'l~~U'dtJimmunocompromised host (HIV, AIDs, on high dose
steroid, on immunosuppressive drug, transplantation, chemotherapy) ~'1bUun~:J.J~u'dtJ~16JA'd],
H' amoxicilin (first line drug) bum]'fmn
,
~'V Q./ Q./ "
bb'V'l'VltJ~~'1 , ]'VI~bb'V'l'VltJ , .
""0 I = ~ «:
bb'V'l'VltJe..Ju],~b:J.JU , , ]'VI~bb'V'l'VltJ , .'lJ
Updated August 2011

108. ~ ~ ® ®
i.'lJ'l.J'a~n'e:l'lJn1'a~,!"l"1itJ1CLOPIDOGREL (APOLETS ,PLAVIX )
1'alWtJ1'lJ1~~'Vf1~ln'iW
•
~'el~':htl....... HN .
'"
-n'el:I-J~tI'i~n'el'Um'i"tim PLAVIX<u
1. u'rfV1~~3j'ell'lJ1tQj~I'U1:l-Jkl"timhlbbrl b'U~1~ u ~'Vl~tI'i~~1 iJ1t1'el1tI 'a~1'cll91f VI'l.!1t1~~ tln'i'a:I-J'Vl'a'JI'fln
'" .bb~~VI'l.!1t1~~ tin 'a'a:I-JtI'a~~1'Vl n 'im u~'Vl~~1"lJ1~'Ukl"t im"t ,xbb'U'U"t'Uti 'a~n'fl'U m 'ikl"t imvi ~1'Ums
tI'a~ d:J'Ub~su ~'Vl~vin1V1'U ~1rj'-n1l1Pl'U19l'JtI
a a
2. PLAVIX TABLET 'i1f'11"lJ1m:I-J~~~ 88.50 'U1'VlAPOLETS TABLET 'a1f'11"lJ1m:I-J~~~27.50 'U1'Vl
3. "t'UtI'i~n'el'U.Q1Pl'elln'i'eln1,xf'l'i'Uvfl 2 '6Ii'J'U
D
D
D
D
D
Secondary prevention of vascular ischemic events
Myocardial infarction
Stroke/transient ischemic attack
Unstable angina
Peripheral vascular disease
, cl cl... "1'"
~'J'U'Vl 2 : bVlI?l(:..l~'VlI?l'fll~"l! CLOPIDOGREL
•
Other vascular disease (specify) .
D
D
D
D
D
~lh,Hn(91 Vascular event "lJru~~f1JUJ'~'V1TW aspirin VI~'ElTiclopidine 'EltJ~ ~
~'l.J'Jmb~m aspirin~
~'l.J'JtJl"Jlh~1'&l dJ'W peptic ulcer
~
~'l.J'JtJl!P1fumJ'b~ stent Jl1tJb'W 1-6 b~'El'W~'W1lU"l!ti(91"lJ'Ellstent ~bojf~
Unstable angina, high risk bb~~ non-ST segment elevation MI Jl1tJb'W 9 b~'El'W
~l~'fl 'i~~ .
~tI'i~dJ'U 'i~~ .
'"
•... cl
'J'U'Vl .

109. , ®
''Ulh~tlf}'Uf)l1i{lm lOSEC (Omeprazole)
ci 'JI 1V1 IV SJ tU ~tf!i'.t:i t1
nW¥1f}lf)l'1 'tl11~f)'UmV1l'iml'1Umft''U'YI nH'tlft'AV1f1'nmVl(NSAIDs)
(r~tlVtllfiml'1!f)Vl G! Side effect)
~6~ilJtI. HN . tllfJ .............•.•. 1J
LOSEC ® (OMEPRAZOLE) 20 mg
------_._---_._ - ---------
66.50
1. !th.j~ihtl€llBl~ ( ellQ ~ 6011)
2. i~NSAIDs hj'U'-n~~'J
3. 1~NSAIDs -jlJJnnHllLJ~1
4. '~fJ1 NSAIDs j"n-,JihJtll Anticoagulants
5. 1.~rnNSAlDs 1'mnmn Steroids
6. 1~cJlNSAIDs n~1Ln~BlfnY Dyspepsia
[J
[]
Cl J WQ ~ 0:::::1 •
7. m J::::--:WHJtJ'l Peptic ulcer disease 11'JBlJ Ulcer complications
8. ~hfl~'W"1~":nJ'f1"';II'Jhl'Ufi COPD, CRF, IHD, CAD, Cirrhosis
<I<p ~ <.V
UYl'Yltlr;j'IT'l 'Jl1'IT .
v'hh:;;!,i/tj .
'"
114V1 .
100

110. 11JtJ~~m)'unTn~''IHnMiacalcic Nasal Spray (Salmon Calcitonin)
mu, ........ tJ HN .
tU'l'n::IL 'i'I'Y1rJ~rL:;hJ1'l51 rui.J;-::~le:Jl tJ~YI'luW1 ffo/lf1.l ,rfD&in ~ c:JiUti'lff'fl (io/lf~.•.•~~blfl::V,'ii! u11f1if)
'I v "
mr1b'i'l'Y1rJf1'1'lJl~••.•kJH'lv."naJhJlh::nmml'jk~'l-6fn Miacalcic Nasal Spray .yj~hu n1'5u"J:::dJ••.•l(il1J
1, Osteoporosis flii Acute Vertebral Fracture
.Jd G..' j'
2, Severe Bone Pain 'r1:W[lil::~hjU
n
2.2 ~ihr.Jl~1JldJTHlhrtn1un~dJ Oral Bisphosphonates 1<tY'l ,
o
o
o
2.1 dJu~ihr.JYihrmhnlfiln.Jlh::mwri'.l, Bed-ridden
'I
3. Paget's disease
1. X-Ray o
o
o
2. Bone Densitometry
3. Other (1::~, " )
1'Vf! .
~tlj::l~U .
'J
..1'Vf! .
-Juri .
101
I

111. ~'l-~laJ?I~<l HN UYlBn1'l:~nM-,) .
Ell~ .................•........ lVl~ ..............•......•......... ltll'lt1:n kg vii creatinine mg/dL
1. iauJlinT'iLirn Rivaroxaban (thlA~<hll'lIJ1U)( '(1-lo'lia"al1-1~UaJ)
[] Total hip arthroplasty
CJ Total knee arthroplasty
[] Other major orthopedic surgery of lower limbs
.. JlTJ::L~!l?lililn1~Ul'iJ rnulw 2 Rlbn-J
Jl"n::t'i1t~ilJJ (fh creatinine clearance ..rilun"il 30 mllmin)
fil creatinine clearance 'lJ!l~~thu = ml/rnin
[J ~iiluli systemic strong CYP 3A4 inhibitors ~q!l P-glycoprotein Inhibitors vIi.•• ketoconazole,
rtraconazote. posaconazoie. ritonavir dJuvl'u
[j ft'il~nm'lr:~~i) ff'i11YlhiUlJD'iI"i,
3. ~eA"'l:l'h""n.,ril~ihtJ 1!>n1Jn...•.,,;...•Neuraxial (epidural/spinal) Anesthcsia &1Ja
LJ hhn'io!l'il epidural catheter 11n11 18 ilt1J~ Y,~~1Ul.h::YIl1H.n rivaroxaban rl'i)'l'~nl1U
[] hjf1l"iL~lJ11Jl.l'i::YllUUl rivaroxaban t!!,ni"l 6 ilhm~~.Jo!l~ epidural catheter
- ~ .I ~ ::: .I ~- ~
4. fJl Rivaroxaban '2J1-lo1P110 mg '1l'HW'iUu'i:;YllH lH<'::: 1 A'h' 'i:;u::nfnYI'2JtJ<J~;W1l ')H
Total hip arthroplasty Uti:: Other major orthopedic surgery of lower limbs LJ.iLnt.l 14 -ru
Total knee arthroplasty 1;jli1 101.
iilUmh~nUlJn ..l"ih1!.n Rivaroxaban ,'mliJ'1!fl~ 303.00 inn li'l1.j,1J1WmJnJ:nul'1~mll..;J'ln~
~
lm .....
r •.
use fll'l11tJlL ~~'YItJ . .........n~ ... 1'..<Yi ....

112. • 'V ®
b1JtJ~~n,£)1Jn1~~,,:tl!5Jj«c.J1 Ertapenem (INVANZ )
lLJ~1, " .' .. ,..... '.,,",
".'1 ••
f,ju')tJ'll'fl-LJ'1~~n'i'l ... " ".,,, '"... . ",H,N""". ",.,,,,,,,,AN,,,,,,, , "Vl'fle:iij,)'J,.•.
, ,
L11~1-nLJl'WYi.,.., ". ,,, .
Ertapenem injection 1 gm (tn'U'Plntrt1J~tnVl-Kmbvi~"jjl~) ':i'1f'l1'll117l'i<::: 1,650.00 'lJl'Yl
I • 'to
"" 1 <V ~ s> D'I ~ .-, 'i' = "" 'I «: .'1 •. """1
~~'fltJ 'lI nl'a'6'l.:l b"Iltl1 : b'ilr'il~>-,J1tJl4tltJ fA11~1?lJ''VI'W'J!:JbJ'I?lI?l(;Wn'fl'lJ'fl-,'jr.JltJmtJJ'pjl~Anb~~wltJ~~nn'J'll fi'!l~l?lm'i'l~A'fl-,'j~ ru
th:::n'El'lJ m J'H'm u'W'lJ'V&F.l~l'U,i.:mlL 'We:ilhl:J'YlnntJ n :rrubbYi'VltJ~I'lJl~'Wi.:j l-nm ~f'fl.:jrJl'Wn1J'U:r:::biJ'W'"ll nuYmtJ~ nl'V1'W(?)
'" ,
, ,
O ~ """""":'1 ~ ""
Empiric therapy for intra-abdominal infection of mild-or rnito-to-rnoderate severity b'WnJ'ru'Vl~'lJ'"l'"lm~tJ.:jr.ijln
"= ""
m:ft?1i?lb'll'flESBL-producing bacteria
o Empiric therapy for community- acquired skin and sott-tissue infection (mixed infections including
moderateisevere diabetic foot infections, necrotizing fascutis type I)
o Aspiration pneumonia (mixeci aerobic and anaerobic infections)
o Out-patient parenteral antibiotic therapy (OPAT) ~TVlf'lJ community-acquired intra-abdominal infection,
skin and soft-tissue infection
o bU~mJ"lln Antibiotic ~'WmH Ertapenem L'WmruvfUdJ'W ESBL -prooucino bacterial infection
,." ~.:j1"l!9i'flm Ertapenem
o bL~m " " ,,,... .
.. . nX'(1 Ll'YH1 if .
LbYi'Vit1lSu:r::liJ:'J " J~i'HLY'l'VlU
"
updated August 2011

113. H.N .
I. 1l'V'l'YlMiiih'WlHl~'WllJ~~HeJl : lU'V'Il:;Il'V'l'YlVlh:;hYlVlCJhmh11ltm:;Ht1tl~ti1tl~ N1CJtllCJ<Hn(1'~{~ ,
m rull'V'l'YlVm'lJlt'W~ ~1"lfCJl'l1ill 'WD'1J1J~:; naums ~~HCJ1~~l'il ms ils:;lil'W1~CJll'V'I'Ylv~fhH'W~'1l<Ul~~'W
2. Ticagrelor (BRILlNTA"') nfll'IJ1CJl~~t1:; 57.50 inn H1m:; 21~~ ~lml'itll'W rvilflD 115.00 inn
Clopidogrel (PLAVIX@)~lm'IJ1CJl~~t1:; 88.50 inn. Clopidogrel (APOLETS"') ~lm'IJ1CJl~~r1:; 27.50 um
3. '1J1h:;fltl1J'ci'~tl~me)fll1im1J1~~ 2 tYl'W
"SI '''''
'llelm'lf
tYl'W~ I • ~lhtJlhh:;;l~ admit ~ltJ Acute Coronary Syndrome trim~lJ'IAi'Jl'HWll~tJl~ltJfll'JllJ'J1!tJ
o ST-elevation Myocardial Infarction (STEMI)
o Non ST-elevation Myocardial Infarction (NSTEMI)
o Unstable angina
o 1. ~thtJ~dJ'W STEM I ~ihbe.J'W"l:;lMun1l'Vll primary PCI bb~:;hhAtJ1Mu fibrinolytic therapy n1tJl'W 24 'IllJ.
o 2. ~l}ltJ~dJ'W NSTEMI - ACS 1'llJrlu 2 criteria "l1f1 3 oiJ'elrl~IJi'elhJU
o 2.1 ST change "l1f1 EKG ~bb<'li11~n~n1'l:;~'ll"l'llli11b~'eli11
o (i) 'ell~ ? 60 tJ
o (ii) i:hh:::-riil MI Vl1-'elbAtJ1MUn1l'Vll CABG
o (iv) iitil':::-riil Ischemic stroke. TIA, Carotid stenosis > 50% Vl1-mAtJVll Cerebral revascularization
o (v) Diabetes mellitus (OM)
o (vi) Peripheral arterial disease (PAD)
o (vii) Chronic renal dysfunction (Creatinine clearance S 60 mLlmin)
Acute Coronary Syndrome 'lIru:::~rulh:::'Yll'Wm-0'~<'l'el~A'le'el~
'.unmVll'1 : TICAGRELOR 1M1JD'WlJ~"'lln~'W~.Aru:;nddlJmJ'El1V11Jbb~:;tJ1 (DtJ.) 1~i,'ii~'mn1J ASPIRIN 1'W~1I'dtJ~b'ih:r1Ji 'I 'U
m~:rm~l~htJ Acute Coronary Syndrome dJ'Wb'd'Cll12 b~D'W
, ,
~~~'elbb'V'l'YltJ~~'1 .
~~~'elbb'V'l'YltJ~'l.h:;bn'W .....
.
JtX~ .
JtX~ .
~ ""
'd'W'Yl .
Update March 2013

114. ",tJtI~~n'f)tJn1~~~",i~1 OMEGA 3-ACID ETHYL ESTER (OMACOR®)
H.N .
I. l!Vl'Ylv~ih)l'WlIH'l~'WllJrl'~HfJl : !llVll~llVl'YlV'l.h~~l'!nhv h'f1'y'h h(!ft~'!1ftB~lnB~ i,hvB1Q'Hnft'~{llft~~B~i1b
ils ~nnurns rl'~HVlll'W UVlf BlJ' url' ~Vl m ruIIVl'YlVft'l'U1t1.1 rl'~HV1~B~~1'Wfll'llh~ dhHJlflU Vl'YlV~fh'!1'W~'lJl~~'W
2. Omega-3 Acid Ethyl Ester (OMACOR
c
,,) 11f!1'J1V!~l'!ft~ 46.00 urn
~'jI v t I
3. hJ'l.h~f)B'IJ'W9!B;jmBf)hlf!1'IJ'Yl;j 2 t'l'1'W
"91 ''''
'IHlU~'tf
ff1'WViI : N'lbV!f!tJii'l.hd~llft~M~'lJfll1ii!1Jl!tJ·;hl'tl'W
'"
D Myocardial Infarction (MI) ''W1~tJ~l1m1li-wBtJf)-jl 3 I~B'W
~')'W~ 2 : b'v1~~~~~reJ'lHtJ1tfq
D ~'1lHJ~UJ'::;rW1hJ~1:W1J'Cl'Vl'Wi9ltltJ1 aspirin bb~::; clopidoqrel lf'IJ
D Other (specify) .
beta blockers, ACE inhibitors ~l'v1¥'1JnnW secondary prevention l'W~1J')tJ Myocardial Infarction
.
~,)1:W b~'Wb-W:Wb~:W :
.... J'~~ .
f'WYl .
Update October 2012

115. LL1..1 'J'VII.(jtl i)mlm 'i'6'4,[tl'11!In1'i!J1~nti1't'UI1 'l..J1~ ~tJ'J!li. 1..1
L~'El1ilm:;u'l'Wmj'~lUj'ltJmj'm'lJ'El'l~u'ltJ1'W iJf)'lIJ.HJn~'El'l[?lN[?lIJ.Jm[?lj'31'WV11'1mnL~V1tJ LU'WUj':;btJ'll,r(?]'Elmj'r?JLL~
fm~I~U'ltJ[?llJ.Jmj'-Wr.nmni'lJ.Jn'Wj':;vdl'1~VI~I'lJlfj'llI;~ 9'1r'hVl'Wt?1LL'W'lV11'1UDu~1'Wmj'~lUntJmj'm r;l'l.Q
1. 1ilL~IV1'WI~~'WtJmj''1~U'ltJ ;'1-WJ.J~1J'Ell;l~mLif'El'l~'W'"llm:;UUf)'ElJ.J-W'lL[?l'ElfLL'WUL~J.J1~1'WL'l'llj':;LUtJ'WVlill~1;'1mj'
fm~n
2. 1il~m!-J1~Uj':;~IV1'El~U'ltJ eDnuj':;~~U'ltJ[?liJ.Jm[?lj'31'Wfj'llI;~ LL~:;u'W'ViniJ'Ell;l~m~'11'W1u~luj'ltJmj'mr;l'lnth'l
" 0 ~
~j''ElJ.J~'1'WIJ.Jmnu
3. L~'ElLL~V1tJ~fmn[?lj''l'"l~U'ltJ~tJU~'EltJLL~'l1ilu'WYiniJ'ElJ.J~mL~J.JL~J.J~'11'WMUj'ItJmj'm~ ~ ~ ~

116. 1. m 1-wn~3-JHigh Alert Drugs~'1lm~nfl'JI3-JL~tJ'I~'1~'1l'l~:;,r (;l~:;r)'1Lth.!'vhPlMhn~Ln(;lfl'Jl3-JfI'1'lI(;lLfI~'1l'W1-w~:;uun~:;r.ntJ
m 'l~LLri m~i'lHm. m~r.lltJm . mJ'u1',IJ'm m':JL'flm~~(;l~'1'l1t?19:;hJ3-JlnLL~,rmu'Wm~1~Ln(;lfl'JI3-J~C1!L~tJ
'flth'lmnnu~thtJ m~U1mJ'LL'1'l~~m'W~mU1'1'lL'fl'l mn~3-Ji1~'lLU'WL1JI',mtJ1'WmJ''1'l(;lr)"J13-JL~tJ'l~~lriru
'iJ 'lI " cv
2. m~J':;1.JLU'Wmn~3-JHigh Alert Drugs (m~nfl'JI3-JL~tJ'I~'1) 1'WLJ''1~mU1'1'l'1'111'1'l'lnJ'CWn(?)'li1
2.1 n~3-Jr)(?1~'fl'1ln~Vli~'1l9(?1tlJ'~~IVlLL'1'l~mL~'"I~(;l1~LVlM
2.2 n~3-JmLflnUIUt?1 (Cytotoxin Drugs)
2,3 Digoxin Injection. Tablet. Elixir (Lanoxin ®)
2.4 Heparin Injedtion
2.5 Insulin Injection
2.6 Phenytoin Injection
2.7 Theophylline Tablet (Nuelin ®)
2.8 Warfarin Tablet (Orfarin ®)
2.9 Noradrenaline Injection (LevoPhed®)
2.10 Potassium IV Injection (KCI LL'1'l~Dipotassium Phosphate)
2.11 ~1J''1'l:;'1'lltJelectrolyte l.,rmr'W~'U"l '~unMagnesium Sulfate Injection; Calcium Gluconate Injection; 3% Sodium
Chloride Injection
3. LL'W'JVl1'ltlDu~L~mnUmn~3-J High Alert Drugs ~1',fu1.JflmnJ'Vl1'lmJ'LL'"IVlfJ
1'WLJ''l~mU1'1'l
3.1 L~'fl1J'fl'ln'WfI,)I3-J~t?1'"1'C'l1t?11'WmJ'i'l1~91mL'"IVlfJ~i'lm
1~L~tJ'Wi'lm1~til'Wl~i(;lL9'W
',~nL~tJ'ImJ'1~~It1'1l'll'1l'l~'flm
l~HlC1!~nMru "u" LLVl'W"units"
1~L~tJ'W"rnl" LLVl'W~Ir)1"cc"
hJ1~~'WfJ(?113-J',~nVlPlUtJ3-JL'll'W 10.0 mg LL~1~1~~'WfJ'IllWWI'1(;lVlPlUtJ3-JL~'1li'lm~n'll'WI~l'W'fltJnr)1 1 L'll'W
0.1 ml
3.2 L~'fl1J'fl'ln'WfI,)I3-J~(;l~'C'l1(;l1'WmJ'4'(;l- r.lltJm 1~~lm!1l'llnJ'J'3-J~ILU'WmJ'(?)'li1
3.2.1 ~(;l~~mn'flf~LLt?1'1 "High Alert Drugs" U'W'il.'1'llnm~I',fu~u')tJ1'WLL'C'l~~(;lu'W1ui'lm~I',fu~thtJ'W'fln
~'f'fl3-Jvf'lvillC1!~nMru"A A" U'W'il.'C'llnm L~'flL~3-JfI')lm~,r(;lJ'~r)'l1'WmJ'4'(;lm
(?1J',)9~'flUri(;lnJ''fl'l ~li'l1 ~m 1~b n ~'fl'l L(;ltJL!1l'llnJ' L~'fl1J'fl'ln'WfI,)l3-J
"
3.2.2
~t?1~'C'lI(;l
3.2.3 L!1l'llnJ'~'l3-J'flumn~3-J High Alert Drugs '"I'f'fl3-JL'fln~IJ'~1LL'W~'IllmJ'Hm l~~u,)tJ'W'flnLL'1'l:;~u,)tJn~u
th'W1'Wnnil~u,)tJ1'W
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117. 3.3.1
3.3.2
3.3.3
3.3.4
3.3.5
3.3.6
G , ~1~ ~.'I
fI'J~~I?ln1nnumn~~t.! ')ut.!l-I'El~u(JtJ
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..=t G -=I iJ' o:v cv
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, , v
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118. LI1I§lL'I1.rr.f1kf1L'ttH.L~~G~ 'JllA.M"
n.
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119. PHENYTOIN (DILANTIN@}
U'rftUr & 'rH.l11J1 n
(;I'-1v~f)lJ
o 1::1.Jml3Jbb1.J"lJ€l.J[m:iJ~ii 50 mg use
100 mg
heparin
o <n'J1,;)~€l1J'hi.J mm[Jlu<n~~3J1u
~
NSS brhuu
o <n11,;)~€lmhi.J mm£J1b:iJ~ 100 mg
~ d ~ q
wiuune 1J~ 'VI1m,W1b3J~[Jl
th:aiht./u ll.:::li" rr111£.I
••
o Maintenance dose ~11u ~€l
300 mg/lu
o mmii Loading dose b!li'1l'm~€l.J1~
'hU~mn'VI~€lbbu::ttln111i'[J1~1[Ji1b€l.J
o 'VIlnii€lln1,-1-Jj' b~1Jfl€l b~€l.J<nl'VIU11iu
b~1Jflm1~ln~u U1~~h'l!r:: U1<nb~€l[J
€llb~[JU l'1€l.Jbff[Jii~u 1W1i1.J 2 b~€lU
u1n"lJ€l.Jn1'J1i'[Jl 1~'VI[J<n[Jlbb~::3J1~1J
••.... '"
u~rwY1U Y1
nmt.lt-rm
o <n11,;)~€l1Jml3Jt1n~€l.J"lJ€l.J£J1
'IJ
o b<n1[J3J£J1<n13J'hi.Jbb~Y1cl"Yf.J"lJm~[Jl1mi'
bb~::1::[J::b1~1.yh~
o b~€l,;)1.J~1[J~11~::~1[J NSS b~3J€l
o 'VI~n b~[J.Jn111~113Jn1J [Jl~iiu"'ty'VI1~lUml3J
b·lhnu1~bb~::ml3Jfl.Ji1 (drug compatibility)
b'1lUamikacin, doBUtamine, heparin,
morphine, pethidine, KCI
o ~1.J~1[J~1[J NSS ri€lU-'VIi.J1~£J1Y11.JbiUb~€l~
~
~lY1nfl-r.J
•
11m:::1t-r£.11
o 1::3J~1::1.Jn1'J1~[Jl1u~J1[J1<n11[J, i1J11[J,
'IJ
pulmonary fibrosis, asthma bb~::heart failure
o 1::1.Jn111~[Jl1u rate ~3Jlnnl1 50 mg/min
';)::rh1~di~ml3Jiuh~<n~1'V1~€l CNS
depression (<nlm::<nn i1J~U bl[Ju$i1'l!r::)
•
bb~::cardiac arrhythmia
'Vi~llt-rm
o <n11,;)~€l1J1J1b1rn.yh~[Jlmh.J~Jlb~3J€l
bU€l.J,;)ln€l1''ildi<nn1'Jeln b~1J1J1b1 rnbiub~ €l~
1~~1[J bb~::di~n111::mm~€l.JbQ~1::~
o Monitor ~~ lab: CBC, PG, LFT bb~::thyroid
function
o 'VIln~J1[J1~-r1J£J1~~Ci€lnuCimii€l.J m1iin11
'IJ
<n11';)1~1::i1J"lJ€l.J[Jlbtlm::[J:: 6j (therapeutic
level = 10 - 20 mcg/mL)

120. HEPARIN
LL'Vfn~ & 'VU.I11J1n
HEPARIN
" ,
D 'Yl1J'Yl"Jl.6Jil~a£J11JtU~1nlJ1
o 1:;l-1'lJ1~HJ1f1~1tJf11JDilantin ® Injection
o i1:IJi-lIM
0
.... e- •..•
1::1-1LGl'lJ"~'I.l.rJ"nu "U" (Unit)
th::::LiJU/LLu::::,.t, erih vl'Vi f) erih v
d d
o Lnufm~1m1wirL£j'l.l. 'VI~eJeJrn'VIl1iltllLil'l.l.
'IJ • 'IJ
25 eJ-lVl1L'D'm<iirJfi
rlf)ul~V1
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~ ~ ~ ~
o L~~rJ:lJm protamine 1i~feJ:IJ ~1'V1fuhl'U.mnt
heparin overdose
o i1:IJhlr'l.l.~tJ1rJ~iiLn1~L~eJ~~11'1.l.LL1-1 (severe
'IJ •
thrombocytopenia)
o i1:IJhl'1.l.m1~,h~~~1 fi:IJeJ-ILLGl::t'lJi'l.l.'VIi-l
o i1:IJ1i'Y11-1 IM L'iieJ-I'oij1neJ1'oijLn~pain, irritation,
hematoma
'lIm::::l~V1
o cndd'Cij~f)1J~'Ul~tJ1n1Jf11i~Lb~'YltJ
o
o
L~El~~l rate= 12 - 18 uniUkg/hr
o ~11'oijfieJum1t'VI Gl'lJeJ-IrJ1~~1'1.l.Lf1~eJ-l1ifi11Gl::~1rJ
1~rJ'VIrJ~L'JJl'VGleJ~L~eJ~~1LU'l.l.1:;rJ:; mh-lLfI'f-lf1f~
o 'VI~m~rJ-lm11irJlg'l.l.'j L'JJl'n1-1Li'l.l.L~eJ~L~rJ1nu~
1iheparin
'Viill~v1 :
o ~~~1:IJm1LL"iJ-I~1'lJeJ-lL~eJ~l~rJfh PTT m1mJ
'IJ
1Wrl1-1 55 - 90 imri
o Monitor sign of bleeding
o ~~m:IJ~Gl lab - PTT, Hb, Platelet 51
f11 PTT> 2,5 L'Yh
f11 Hb < 10 g/dL
, 3
m platelet < 100,000 Imm
1i11rJ-l1'U.LLwncl'
o JeJ-ln'l.l.eJU~L'VI~~eJ1'oijLn~nu~tJ1 rJ~'oij::y'h1iLn~
•• 'IJ
LL~Gl'VI~eJdeJrJ-wn.ff1
o 'VI~m~rJ-lm1~nf~~1'1.l.LL1-1 'VI1mhLu'l.l.!ilEl-lli~,h
'IJ •
tbJ 'j1eJ-lr1eJ'I.l.Lfi:IJeJLLGl::m1'oijfieJUU1L1rnri~nf~
• 'IJ
ath -Ifiii1 Lfi:IJe
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LLGl:;i-lLn~m1:IJ~~l.Jn~~1-1 'j L"li'U.1.J1~L~UU1L1rn
+nm rJoyf-leJlrJ1::m rJ1'I.l.LLGl::muuan

121. WARFARIN (ORFARIN@}
Uffn~ & fW11J1a
(;l"1~1,'(f)1J
D ,.::1"m1aJLb,." 3 mg ~~1 , 5 mg ~"lfaJ'W
'IJ
D Max dose ~ 10 mg <ieJ1'U.131Ln'U.1'U.~::
1 flf" (£Jm1'U.3jm,.1-ir.nn~aJ enzyme
~
inducers L'J5'U.rifampicin, carbamazepine)
'VI1n£"Ln'U. <ileJ"fl'U.EJ'U.fh£"1-i£J1.J'1
l.h::LijU/LL u::ib~ibtJu
D lh::L3J'U.fh INR 1'd:IJr1tJii11i£J1
D
D
~ IS' Q.I 6"..,
Il1'd::IiJ"m~Il LL,;)"LL'W'Yl£JIiJ'd£J
n1~:lJf1J1.h::'Y11'U.£J1131'U.1'U.Ln'U.12 -i'dLaJ"
1~f1J1.h:: 'Y11'U.rl 'U.ViY1iln1<il
o ~1nLL~YlEftrCi1ii1~CfiC1n1~~1El~liCi1
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Cl , •••
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D 1~~ihm~-"LnliJeJ1m~ bleeding aJ1n
'IJ
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L~ElIiJElElnIiJ1:IJh'lr'U.tl"'~~1'd:: 'VI1El
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fenofibrate, omeprazole, cotrimoxazole,
fish oil, etc.
rif)U'l,~tJ1
D LIiJ~£JaJ£J1vitamin K, FFP 1~'W"fEl:IJ~1'V1ftJ
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o <il~1'CJtiEl1J!!jJ,"1<iltJlnlJ"1i~LLVfnrj'
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prothrombin time, hematocrit , INR
D 'VI~m~£J"m~1~El1'V11,.Y13jc.J~L~:IJvitamin
K L'J5'U."lf1L'iim -1i~mLb'IJ tJ~Elf1Lf1~
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precaution

122. INTRAVENOUS POTASSIUM
Llli~n";i LL'W'mJ& 'WlI1U16'1
;I";i1'V,",€IU nm~L~lI1
D
Q."I I ~ Q,.I d Q..r Q,; od
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l1YlLf1t1nl-l.L-ri'l-I.aqua, calcium gluconate, (hypokalemia : ~e:ll-l.LL,..J~e:ll-l.LY-l~u
doPAmin EKG iiin~rn:: arrhythmia l..r~~11::e:le:lmnn
D ~~~mLwYl£f Vl1ni.Jm13JL-lliJ'lil-l.~lirm LLfl::~3J,r13J1n~lIl't.Jn~
• I ~ ~ .J" I
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hyperkalernia : e:le:ll-l.LY-lfltlnfl13JLl-I.e:le:le:ll-l.LL,..J
central line > 150 mEq/L
iu~l-I. Vl1t1h~1U1n "lJ1'1f1rf.J2 'li1.J
D m13JL11~1V1"~hjYlTH11nl1 20 mEq/hr
EKG ii tall wave, depress ST segment,
D ~l';ifl:: fl1 t11~hj ii~:: n e:ll-l.
prolonged O'T segment
fl1i.J1'1itl1<iie:l.Jt~H IV Push
D ~"1,;)~e:lU"lJl-I.1~t11ne:ll-l.1i
D
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cardiac arrest t<ii
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LVl3J1::~3JYle:l
peripheral line: 20 - 60 mEq/L
central line: 20 mEq/100 mL
D i13J1itl11l-1.el~"1L11 > 20 mEq/hr
'VI~lL~~1
D
Q,.I .d Q,; ~
uunn VIS, urine output (,.::1.Jm urine output
< 30 mLlhr)

123. ~k e!Wale>jOdA4
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unu... '"
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124. MORPHINE SULFATE
bbvnuf & fH.J11J1G'1
(;l11~G'lvU
o rJ1bl.rV'l~1il1'V11'Yl'lY1.h::blWl2 il1ir.J11lilrJ1i
uuu u.e. 5
o 1UbblJlJrJ1~~1'.l,hlVW1lJ1~
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- "lfitlilflJU1::'Yl1'.l, :
1. Morphine Extended I Prolonged release
Tablet 10 mg, 30 mg
2. Morphine Sustained release Capsule
20 mg, 50 mg
3. Morphine Immediated release Tablet 10
mg
"J5-u.IilUIil: Morphine Injection 10 mg/mL
"1J'.l,1IillJ11';) 1 mL,
o llm.h~Jli1~bbfi
..,od ••. I CL.tc:t. 'L' ..r
1. ~:JJLJ1::1IilbbVW1'.l,
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2. ~J1rJ~bU'.l,hfl'VIeJUv:lilbUrJUY-li'.l, 'VI1eJ
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'VIeJlJV:1il1'.l,bb11,
3. Severe respiratory depression ~1aJii
bfl~eJI"lh rJ;rilil'VI1mfl~eJI"1i1rJ~1 h
4. Increase intracranial pressure
5. r1eJlb~rJ,;)1n Pseudomembranous
colitis 'VI1eJ1~flJ~11~'lY
6. Cardiac arrhythmia
7. Heart failure secondary to chronic
lung disease
8. Upper airway obstruction
l.h:bij,"/u '":"1 ~ihII
••
o eJ1n1113J~lU1::~lfi',;)1nr.J1 1~bbfi
Cardiovascular: m1:JJcimh ~1hb~'.l,i1
Respiratory : nliln11'V11rJh
CNS : ij'.l,II U11il~1'lY:: ~11.n:JJ in
d Yj ~ d ••••
GI : fI~'.l, b~ eJ1b,;)rJ'.l,'YleJI~n
'U
Ocular : :JJeJl1l1Y-1blJ~eJ
o bb'.l,::U1 - rJ1'deJ1,;)'Yh1~~11.n:JJ 13Jm11irJ1d
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..: .•..
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o uurufiu rJ1-tt'bi. '.l,~illil0J51ilbb~::~nrubb,;)~ eJfI
, w
I "I"nv,"b'VIll1
o 1il11,;)~eJlJm1:JJnn~eJI"1J eJIr.J1
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'U
mg/ 70 kg in 4-5 mL 1~rJ1m'.l,ni1 5 '.l,1Yi
o IV push b~eJ,;)111'.l,0-5-W 1'V1i.~m1:JJb"li:JJ"li'.l,
1"" ..I0.1-1 mg/mL bb~::m1 'VI~1'.l,bmeJI infusion
pump 1'.l,m11~r.J1
o IM 'VI~v se 1~rn1'.l,"1J'.l,11il5-20 mg/ 70 kg in
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o "1Jmlilm11~r.J11'.l,b~n SCIIM 1irJ1"1J'.l,11il 0.1-0.2
mg/kg "1JmlilrJ1~I~1il13Jbn'.l, 15 mg'U ,
o ~1:JJ1ir.J1b~eJ~n11Iilnlil::neJ'.l,'VI1eJ~~b'VI~eJlb"li:JJ.ff'.l,
o bIil1rJ:JJr.J1~1'.l,~'lY1~Y-IfeJ:JJ1~bbTi Naloxone
'lIm:l-H'tI1
o 1~~J1rJeJci1wyh'.l,eJ'.l,"1Jrn::1~rJ1 b~eJ~Iiln11bnlil
'U 'IJ
Orthostatic hypotension
o bb'.l,::U1~J1rJi1 "~1:JJ~m~'.l," eJci11,xeJrJ30 '.l,1Yi
'U ,
'VIi"1-H'lI1
o uwYiniqJqJ1rn;rY-l"1JeJI~J1rJ 1~bbri BP, RR, HR
o Monitor pulse oximetry 'VIil1~furJ1 30 mYi
~ 6"ca:. Q..I od •..• I
'VI1eJCi!1:JJbbY-l'YlrJ~Iuunn O2 Sat 'VI1n'.l,eJrJn11
95% 1~11rJl1'.l,bbY-l'Ylrf
O .-.....• ..1 = VI "".1 .-
11 ueruu Y-I'Ylunuruu mnlil eJ1n11 b:JJY-IlLJ1::~lfI
1~bbri n11nliln11'V11rJh (RR < 12 flfl/'.l,1Yi)
m1:JJci'.l,h~Iil~1 (BP < 90/60 mmHg) ~1
hb~'.l,i1 .n:JJ~I

125. PETHIDINE
LLVi'mf& ViV1111~
Gl"1~l>'H)1J
o tI1b~l'l~~1'Vl1m~1.h::bl1'Yl2 il1'lftl11~rJ1'lfmJlJ
u.e, 5
o "lhblJlJtI1Q~ ml3Jbb,.I50 mg/mL "1JU1~m,.';l~ ,
1 mL
o ~€I'14'€I1i.~bbfi Meperidine
o l1fl~1~i~
i.~bbri~ihh::11ibbvrrJ1.u 'Vlrulctlfln.r1'Vl1€11i~ ~
U3JlJm bb~::~rii.~flJm,.fnM1~1rJtI1n~3J MAO,~ ,
inhibitor 'Vl1mflrJi.~flJtI1d3J1ri€lU 14-21 1U
lh::Lihl./LL"::"1 ~thvd
o m,.1'lftl11u"1JU1~3J1nn11600 mg/day 'Vl1€11'lf
~~~€lflUUTI.1.n112 1U byj3Jml3Jb~rJl1um"ii1
1idl~ €I1m,.in bli€ll';llniim"~::~3J"1J €II
Nomeperidine
o €I1m,.i.3.i~ll.h::~I~';llnrJ1 i.~bbrifI~ui.i
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~
in
o m,.1'lftl11u"1JU1Cil~I';l::nm::lJlJlh::~l'Yl
~
Ghun~l1 n~m"'Vl1rJh i1hb~'.I.'lf1
pulmonary edema bn~I;'.I.in
r;: '"
n1,.Lnll,.n-a1V1
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I "I"ntJ"L'IUn
o 1fi"1';l~€IlJml3Jtln~€I1"1Jflltl1~
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D-5-W, Dextrose-saline combination -;llU1U
mhl,x€lrJ 5 mL 1iml3Jb'JJ3J'JJu,xflrJn1110
mg/mL
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0.1-1 mg/mL
o IM 'VI1flse i.3.i~€I1b~f)';ll1
o 'Vl~m~rJlm,.1'lf·h3JfllJtI1riiit.l"'q}'Vl1~lUml3J
b'JJ1nui.~bb~::ml3JfIlci1(drug compatibility)
i.~bbriAminophylline, Furosemide, Heparin,
Morphine, Phenobarbital, Phenytonin,
Cefoperazone, Imipenem, Amphotericin B,
Sodium Bicarbonate
'lIm::i~V1
o 1i~J1rJf)t!1U'ri1'.1.fl'.l."1Jrn::1irJ1b~f)~Cilm"bn~
~ ~
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'VIili~V1
o uU'nn;ruru1rniil'l"1Jfll~J1rJ i.~bbri BP, RR, HR~ ~ ~
o Monitor pulse oximetry 'Vlili.~flJtI1 30 U1Yi
'Vl1flCi113Jbbl'l'Yl£1iluU'nn O2 Sat'Vl1n,xflrJn11
95% 1i,.lrJl1Ubbl'l'Yl£1
o ,.1rJl1Ubbl'l'Yl£1'YlUYibrlabnCilfl1m,.i.3.i~lt.l"::~I~
i.~bbrim,.nCilm"'Vl1rJh (RR < 12 flfl/U1Yi)
ml3Jciuh~Cil~l (BP < 90/60 mmHg) i1hb~U

126. MAGNESIUM SULFATE INJECTION in Obstetrics
LL'W'mi'& m.l11J1G'1
<;t,.1,n'Hl1J
o "ubb'lJ'lJrim"ll'1uh"'VH.n1J1~1~LLfi
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1. 10 % 'lJU1~'lJ1"d"il10 mL
•
2. 50% 'lJU1~'lJdd"il 2 mL
•
o d:::l"£J1b']lIU~e)'l4'€J" 1~bbri MO, morphine
sulfate
~ " ') ""'ilel'VI13JL~
1. Myasthenia gravis
2. Renal failure
3. Respiratory failure
o Enmdl~~"ud:::ff"fl"illn lIlriih:::~'lJff" 1Ub~El~
'U
1~bbri ,,~uli€Jlb~lIu b'VI~€J€J€Jn'VIt!lbb~"
iiu"" mtl3Jbit€J~€JUbbd" Elm'n~ 'VIlI~'VIll1h
•
rl ell!.'1"; tJ1
o ~d1"i1ff€J'lJml3Jnn~ €J"'lJ€I"£J1
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D IV push (loading)
- 10% solution ~lU1U 5 'VI~€J~'lJ1"d"illu
•
syringe 50 mL Q~b"JJ1'V1~€J~b~El~4h
luEl~dl 10 mLlmin.
D IV infusion (maintenance)
- 50% solution ~lU1U 10 'VI~€J~C-Jff3Jlu
ffld~:::~ll1 D-5-W 'VI1€JNSS U~3J1rn
1,000 mL 1~b"JJ1'V1~€J~b~€J~<ih~·huinfusion
2!!!!}Q 100 mLlhr
'lIm:::'l";V1
D l~Elmlmd'VIll1h Elmlmdb~U'lJ€J"~lh bb~:::
ml3J<iluh~1i1 'Y1n15 U1Yi dl3J 2 "of" uae
•
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•
D lffffll1ff1UU"'ffffl1:::mlrb~€Jl~U~3J1rnU"'ffff11:::
~""iI:::~€J,,1~u€JlIn11 30 mLlhr
D Elmlmd'VIl IIh~ €I"1~u€J lIn11 12 "f,,<ii ElU1Yi
D ~d1"i1 knee jerk nn 4 ';113J" win 1~'I'I'lJ reflex
•
l~~"iIldrnl'V1l1~lIl
•
D b~1l13J antidote ~€J 10% calcium gluconate
'VI1€J10% calcium chloride 10 mL 'I'Ii'El:IJli
~~€J~b1~11~lIllhbn Magnesium toxicity ~€J
l~"f,,~::: 10 mL b"JJ1'V1l.'l€J~b~El~<ih
'VI~I'l";V1
o u'U.'Yinirurulrn~'I'I'lJ€J,,~J1l1 1~bbri BP, RR, HR~ ~ 'U
D dlII"1 'U.bb'l'l'YlElrluYibrl€lbn~€Jlmdl~~"Ud:::ff"fl
1~bbri
- n~md'VIll1h b'liU 'VIll1hiln11 12 "f"iU1Yi
- ~1".n:IJ 'VIUlbb~" mtl:IJbit€J~€JUbbd" 1~ii reflex
"JJ€lb"lh
- U"'ffffl1:::€J€JnU€JlIn1130 mLlhr
lit ••.
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D bbllmn'lJ £J1111uriii~ii~bbl.'l:::iinrubb"il~€J".~

127. NOREPINEPHRINE Vi~u NORADRENALINE (LEVOPHED®)
u'W'mf & 'WtJ1111~
Gl'n;)avll
o ~"iT;)a'Elu~mnlirm~Ell "i::l1tn~ii~ElfHflrJn'U
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L-rl'Uephedrine, epinephrine (adrenaline)
o fhill'1irJl~Ell"i::UTl113JL-iJ3J-iJ'UL,j'Umg/mL
•, .. ,
L']j'U1:5 'VI3JlrJmtn 1 mg ~Ela'l"i~::~lrJ 5 mL
o ThilHtn~Ell"i::U'lJm~W1L,j'U mcg/kg/min .
•
'VI~Ela~"ilm"ilitn (rate) L,j'UmLlhr
o Lnuli~'ULLa'I
rlml>1-HtJ1
o ~"il"iJa'Elua'rnl::~,jlrJ i.~LLri
'IJ
- septic shock or anaphylactic shock
- central venous pressure> 12 cm.H20 or
pulmonary capillary wedge pressure> 15 mmHg
- systolic BP < 90 mmHg .JI~i.~futn doPAmine
LL~::M~EldoBUtamine lWlJ'Ul~rJ1a'la'~LLil
'IJ •
- ~~m"i~"iT;rr~ 12-lead ECG i.3-iY-lUrnl:: acute
myocardial ischemia, infarction or injury
- f1ihifY-l"iJ"i~,jlrJ~~hLL'VIUIdorsalis pedis or
'IJ
posterior tibia pulse i.~
o "i::ar~"i::l1m"iThmrn"lJ'Ul~rJlffi'1i LiiEll"iJlm,j'U
potent drugs
o ~Ell dilute rJlriEl'UliLa'3JElLL~::Th'Ulrnm"i~a'3Jtnl'U
'VIUlrJmg/mL t~rJlia'l"i~::~lrJ 0-5-W 'VI~El0-5-S
o i.3-i~a'3J113Jnua'1"i~::~lrJ~L,j'U~11LL~::i.3-ili~a'3J113J
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1Jm:::l-HtI1
o GllLL'VItl.-lffiir.nTl1"iLiht'VIGlEl~L~El'il~hffi'VIq)'VI~m~rJI
msli'Yl11'V1~El'ilL~El'il~1'yj~lLL'VUI"lJ1LL~::'VIilii ElL,:4El
,JElln'Um"iLn'ilgangrene
o ~EllTl1Uf13JamlL11"lJEllm"ilitn t~m.,h'ULf1~Ell
i
infusion pump LL~::ml"iJa'Elutl13Jlrntnffiimjl1
a'3JlLa'3JEl
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2. Clonidine nu Tricyclic antidepressants l~llri Amitriptyline, Clomipramine, Doxepin,
Imipramine, Nortriptyline
3. Nitrates nu Phosphodiesterase Inhibitors (Sildenafil, Tadalafil, Vardenafil)
4. Propranolol nu Thioridazine
5. Amiodarone nu Immunosuppressants (Cyclosporine, Tacrolimus)