태백중앙병원 인공신장실

<P style="MARGIN: 0cm 0cm 0pt 14.4pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -14.4pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 14.4pt" align=left>1.   정의 수두-대상포진바이러스(varicella-zoster virus, VZV)가 소아기에 수두를 일으킨 뒤 잠복상태로 존재하고 있다가 재활성화되면서 발생하는 임상질환   <P style="MARGIN: 0cm 0cm 0pt 14.4pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -14.4pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 14.4pt" align=left>2.   발병기전 및 병리 (1) 일차감염 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    대개 호흡기를 통해 전파된 바이러스는 복제되어 그물내피계통으로 퍼지며 바이러스 혈증 유발, 이로 인해 광범위하고 산발적인 피부병변 유발 (2) 재발감염 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    VZV가 재활성화되어 대상포진을 일으키는 기전은 밝혀지지 않음. 수두를 앓는 동안 후근반사신경절을 침범하고 재활성화될 때까지 잠복된 상태로 남아있는 것으로 추정됨. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    급성 대상포진을 앓고 있는 시기의 후근반사신경절의 병리학적 소견은 출혈, 부종, 림프구 침윤 등임. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    드물게 재활성화된 VZV가 폐를 침범한 경우 간질성 폐렴, 다핵거대세포 형성, 핵내 봉입체, 폐출혈 등이 나타나고, 중추신경계에 침범한 경우 홍역 및 바이러스성 뇌염과 비슷한 혈관주위세포 침윤이 나타남. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>  <P style="MARGIN: 0cm 0cm 0pt 14.4pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -14.4pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 14.4pt" align=left>3.   증상 (1) 일반적인 특징 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    단일 피부분절(dermatome)내에 편측 수포발진 발생 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    피부병변이 나타나기 48-72시간 전에 통증이 먼저 나타나고 그 후 홍반성 반구진성 발진이 생기고 빠르게 수포성 병변으로 진행 (정상적인 환자의 경우, 병변은 3-5일 동안 진행) <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    총 이환기간은 일반적으로 7-10일이지만 피부가 정상으로 돌아오는 데는 2-4주도 걸릴 수 있음. (2) 합병증 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    대상포진후 신경통(PHN) : 50세 이상 환자의 50%가 피부병변이 사라진 수개월 후에도 어느 정도의 통증을 느낌.   <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    국소화된 대상포진 후에 중추신경계로 침범할 수 있는데, 수막뇌염의 경우 두통, 발열, 눈부심, 수막염, 구토 등의 증상을 나타냄, 이 때, 드물게 반대쪽 반마비를 동반한 육아종 혈관염의 증상을 나타내기도 함. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>  <P style="MARGIN: 0cm 0cm 0pt 14.4pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -14.4pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 14.4pt" align=left>4.   치료 (1) Antiviral therapy <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    빠른 상처 치유, 급성 신경염으로 인한 통증의 심각도와 기간 감소, PHN의 발생률과 심각도 감소 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    50세 이상의 환자에게 추천됨. 임상적 증상이 나타난 후 72시간 이내에 치료해야 함. (Table 참조) (2) 통증관리 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    경증의 통증: NSAIDs나 acetaminophen 단독 투여 또는 약한 마약성 진통제(codeine 등), tramadol을 병용 투여 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    중등도/중증의 통증: 강한 마약성 진통제(oxyconone, morphine 등) 투여 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>•    통증지속 시 glucocorticoids 요법 고려 (3) Glucocorticoids 사용 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shapetype id=_x0000_t75 stroked="f" filled="f" path="m@4@5l@4@11@9@11@9@5xe" o:preferrelative="t" o:spt="75" coordsize="21600,21600"><v:stroke joinstyle="miter"></v:stroke><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"></v:f><v:f eqn="sum @0 1 0"></v:f><v:f eqn="sum 0 0 @1"></v:f><v:f eqn="prod @2 1 2"></v:f><v:f eqn="prod @3 21600 pixelWidth"></v:f><v:f eqn="prod @3 21600 pixelHeight"></v:f><v:f eqn="sum @0 0 1"></v:f><v:f eqn="prod @6 1 2"></v:f><v:f eqn="prod @7 21600 pixelWidth"></v:f><v:f eqn="sum @8 21600 0"></v:f><v:f eqn="prod @7 21600 pixelHeight"></v:f><v:f eqn="sum @10 21600 0"></v:f></v:formulas><v:path o:connecttype="rect" gradientshapeok="t" o:extrusionok="f"></v:path><o:lock aspectratio="t" v:ext="edit"></o:lock></v:shapetype><v:shape id=그림_x0020_1 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1025"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     삶의 질을 개선, 치유시간 단축, PHN의 발생률 감소 위해 항바이러스제와 병용 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shape id=그림_x0020_2 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1026"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     Prednisolone 경구투여 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>   <v:shape id=그림_x0020_3 style="VISIBILITY: visible; WIDTH: 3.75pt; HEIGHT: 3.75pt" alt="http://www.amc.seoul.kr/upload/20100408/15/20100408031333715.gif" type="#_x0000_t75" o:spid="_x0000_i1027"><v:imagedata o:title="20100408031333715" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.gif"></v:imagedata></v:shape> 1-7일 : 60mg/day <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>   <v:shape id=그림_x0020_4 style="VISIBILITY: visible; WIDTH: 3.75pt; HEIGHT: 3.75pt" alt="http://www.amc.seoul.kr/upload/20100408/15/20100408031333715.gif" type="#_x0000_t75" o:spid="_x0000_i1028"><v:imagedata o:title="20100408031333715" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.gif"></v:imagedata></v:shape> 8-14일 : 30mg/day <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left>   <v:shape id=그림_x0020_5 style="VISIBILITY: visible; WIDTH: 3.75pt; HEIGHT: 3.75pt" alt="http://www.amc.seoul.kr/upload/20100408/15/20100408031333715.gif" type="#_x0000_t75" o:spid="_x0000_i1029"><v:imagedata o:title="20100408031333715" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.gif"></v:imagedata></v:shape> 15-21일 : 15mg/day <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shape id=그림_x0020_6 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1030"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     일반적인 병용은 추천되지 않으나(2차 세균 감염 유발 가능) 급성 신경염 환자에서 보조요법으로 사용 <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shape id=그림_x0020_7 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1031"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     이 요법은 내원 당시 중등도 혹은 중증의 통증이 있는 비교적 건강한 성인에서만 적절함. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shape id=그림_x0020_8 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1032"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     골다공증, 당뇨병, 당뇨, 고혈압이 있는 환자에게는 적합하지 않음. <P style="MARGIN: 0cm 0cm 0pt 18pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -13pt; LINE-HEIGHT: 13.5pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; tab-stops: list 0cm" align=left><v:shape id=그림_x0020_9 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt" alt="http://contents.amc.seoul.kr/manager/images/sub_img/icon01.gif" type="#_x0000_t75" o:spid="_x0000_i1033"><v:imagedata o:title="icon01" src="file:///C:\DOCUME~1\Owner\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.gif"></v:imagedata></v:shape>     항바이러스제를 같이 투여하지 않는 한 단독으로 사용해서는 안됨. <v:shape id=그림_x0020_11 style="VISIBILITY: visible; WIDTH: 7.5pt; HEIGHT: 8.25pt; mso-position-horizontal-relative: char; mso-position-vertical-relative: line" alt="dept_icon_01.gif" type="#_x0000_t75" o:spid="_x0000_s1026"><v:textbox style="mso-rotate-with-shape: t"></v:textbox><w:wrap type="none"></w:wrap><w:anchorlock></w:anchorlock></v:shape> Table. Antiviral therapy <TABLE Table style="BORDER-RIGHT: medium none; BORDER-TOP: medium none; BORDER-LEFT: medium none; WIDTH: 100%; BORDER-BOTTOM: medium none; BORDER-COLLAPSE: collapse; mso-border-top-alt: solid teal 1.5pt; mso-border-bottom-alt: solid teal 1.5pt; mso-yfti-tbllook: 480; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-insideh: .5pt solid #61A0A4; mso-border-insidev: .5pt solid #61A0A4" cellSpacing=0 cellPadding=0 width="100%" border=1> <TBODY> <TR style="HEIGHT: 16.15pt"> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #61a0a4 1.5pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #61a0a4; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 16.15pt; mso-border-top-alt: solid #61A0A4 1.5pt; mso-border-bottom-alt: solid #61A0A4 .5pt" vAlign=top width="9%">  </TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #61a0a4 1.5pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #61a0a4; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 34.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 16.15pt; mso-border-top-alt: solid #61A0A4 1.5pt; mso-border-bottom-alt: solid #61A0A4 .5pt" vAlign=top width="34%" colSpan=2> Acyclovir</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #61a0a4 1.5pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #61a0a4; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 29.58%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 16.15pt; mso-border-top-alt: solid #61A0A4 1.5pt; mso-border-bottom-alt: solid #61A0A4 .5pt" vAlign=top width="29%" colSpan=2> Famciclovir</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #61a0a4 1.5pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #61a0a4; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 26.64%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 16.15pt; mso-border-top-alt: solid #61A0A4 1.5pt; mso-border-bottom-alt: solid #61A0A4 .5pt" vAlign=top width="26%" colSpan=2> Valacyclovir</TD></TR> <TR style="HEIGHT: 25.8pt; page-break-inside: avoid"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-right-alt: solid #61A0A4 .5pt" width="9%" rowSpan=2> 원내코드</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 16.8%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="16%"> ZOVI</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 17.4%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="17%"> 조비락스 정 200mg, </TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 15.12%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="15%" rowSpan=2> FAMVIC(원외)</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 14.46%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="14%" rowSpan=2> 팜빅스 정 , 750mg</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 13.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="13%" rowSpan=2> VALT(원외)</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 13.44%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 25.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt" width="13%" rowSpan=2> 발트렉스 정 500mg</TD></TR> <TR style="HEIGHT: 22.8pt; page-break-inside: avoid"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 16.8%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 22.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="16%"> 7ZOY</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 17.4%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 22.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" width="17%"> 조이렉스 주 250mg</TD></TR> <TR style="HEIGHT: 48.8pt"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 48.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-right-alt: solid #61A0A4 .5pt" width="9%"> 적응증</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 34.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 48.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="34%" colSpan=2> 단순포진, 구순포진, 대상포진, 단순포진성 뇌염, 피부점막 단순포진, 신생아 단순포진, 수두 </TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 29.58%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 48.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="29%" colSpan=2> 급성 대상포진, 면역기능이 정상적인 환자에서의 재발성 생식기포진, HIV감염 환자의 재발성 피부점막/생식기 단순포진</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 26.64%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 48.8pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt" vAlign=top width="26%" colSpan=2> 면역기능이 정상적인 환자에서의 대상포진, 생식기포진, 구순포진</TD></TR> <TR style="HEIGHT: 94.9pt"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 94.9pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-right-alt: solid #61A0A4 .5pt" width="9%"> 작용기전</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 34.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 94.9pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="34%" colSpan=2> 바이러스 효소에 의해 acyclovir가 monophoaphate를 거쳐 triphosphate로 전환됨. 이는 viral DNA polymerase에 대해 deoxyguanosine triphosphate와 경쟁적으로 작용하고, viral DNA에 결합하여 DNA 합성과 바이러스 복제를 억제함.</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 29.58%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 94.9pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="29%" colSpan=2> 활성형태인 peniciclovir로 빠르게 생체전환됨: peniciclovir는 acyclovir와 동일한 과정으로 peniciclovir triphosphate로 전환되어 acyclovir triphosphate와 동일한 기전으로 항바이러스 작용을 함 .</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 26.64%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 94.9pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt" vAlign=top width="26%" colSpan=2> 장, 간대사에 의해 빠르고 거의 완전하게 acyclovir로 전환되어 acyclovir와 동일한 기전으로 항바이러스 작용을 함.</TD></TR> <TR style="HEIGHT: 122.6pt"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 122.6pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-right-alt: solid #61A0A4 .5pt" width="9%"> <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: center; mso-pagination: widow-orphan; tab-stops: 45.8pt 91.6pt 137.4pt 183.2pt 229.0pt 274.8pt 320.6pt 366.4pt 412.2pt 458.0pt 503.8pt 549.6pt 595.4pt 641.2pt 687.0pt 732.8pt" align=center>용법·용량 <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: center; mso-pagination: widow-orphan; tab-stops: 45.8pt 91.6pt 137.4pt 183.2pt 229.0pt 274.8pt 320.6pt 366.4pt 412.2pt 458.0pt 503.8pt 549.6pt 595.4pt 641.2pt 687.0pt 732.8pt" align=center>(대상포진 치료시)</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 34.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 122.6pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="34%" colSpan=2> <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none" align=left>경구투여 <P style="MARGIN: 0cm 0cm 0pt 5pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none; mso-para-margin-left: .5gd" align=left>: 성인 1회 800mg 1일 5회(Q4hr), 7일간 <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none" align=left>정맥투여 <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none" align=left>- 면역이 저하된 12세 미만의 환자 <P style="MARGIN: 0cm 0cm 0pt 13pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; TEXT-INDENT: -8pt; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none; mso-para-margin-left: .5gd; mso-char-indent-count: -1.0" align=left>: 1회 20mg/kg, Q8hr, 7일간 <P style="MARGIN: 0cm 0cm 0pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none" align=left>- 면역이 저하된 12세 이상의 환자 <P style="MARGIN: 0cm 0cm 0pt 5pt; LAYOUT-GRID-MODE: char; WORD-BREAK: keep-all; LINE-HEIGHT: 12pt; TEXT-AUTOSPACE: ideograph-numeric; TEXT-ALIGN: left; mso-pagination: widow-orphan; mso-layout-grid-align: none; mso-para-margin-left: .5gd" align=left>: 1회 10mg/kg 또는 500mg/m2, Q8hr, 7일간</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 29.58%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 122.6pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="29%" colSpan=2> 500mg, Q8hr, 7일간</TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 26.64%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 122.6pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt" vAlign=top width="26%" colSpan=2> 1g, 1일 3회, 7일간 </TD></TR> <TR style="HEIGHT: 49.4pt; mso-yfti-lastrow: yes"> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 9.56%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 49.4pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-right-alt: solid #61A0A4 .5pt" width="9%"> 부작용</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 34.2%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 49.4pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="34%" colSpan=2> >10%: 권태감 1-10%: 두드러기, 가려움, 발진, 오심, 구토, 간수치 상승, 정맥염, BUN/Cr상승</TD> <TD style="BORDER-RIGHT: #61a0a4 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 29.58%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 49.4pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt; mso-border-alt: solid #61A0A4 .5pt" vAlign=top width="29%" colSpan=2> >10%: 두통, 오심 1-10%: 피로, 편두통, 가려움, 발진, 월경통, 설사, 구토, 호중구감소증 </TD> <TD style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #ece9d8; WIDTH: 26.64%; PADDING-TOP: 0cm; BORDER-BOTTOM: #61a0a4 1pt solid; HEIGHT: 49.4pt; BACKGROUND-COLOR: transparent; mso-border-top-alt: solid #61A0A4 .5pt; mso-border-bottom-alt: solid #61A0A4 .5pt; mso-border-left-alt: solid #61A0A4 .5pt" vAlign=top width="26%" colSpan=2> >10%: 두통 1-10%: 현기, 월경통, 오심, 구토, 백혈구/혈소판감소증, AST증가</TD></TR></TBODY></TABLE>