드러그인포 약품요약정보

허가정보

항목

내용

청구코드(KD코드)
비급여점검코드
상한금액

비급여
[상병코드조회]
[질병코드조회]

빠른조회


요약정보	[효능] [용법] [금기] [신중투여] [이상반응]

상세정보	[효능] [용법] [경고] [금기] [신중투여] [이상반응] [일반주의] [상호작용] [임산부] [수유부] [소아] [고령자] [신장애환자] [간장애환자] [적용주의] [과량투여] [임상검사치] [보관] [기타]

제품성상

연한 청색의 타원형 장용 필름코팅정 [제형정보 확인]

포장·유통단위

자사포장단위에 따름

효능효과

[적응증 별 검색]

효능.효과
감기의제증상 (기침, 가래, 오한, 발열, 두통, 관절통, 근육통, 인후통)의 완화

약물음식간 상호작용

[조회]

용법용량

* 절대 임의복용하지 마시고 반드시 의사 또는 약사와 상담하시기 바랍니다.

[처방약어]

용법.용량
성인 1회 1정, 1일 3회 식후 30분에 복용

[BMI지수 계산] [Body Surface Area 계산] [Cockcroft-Gault GFR 계산] [MDRD GFR 계산]

주요약물 상호작용

[조회]

신중투여

1) 본인, 양친 또는 형제 등이 두드러기, 접촉성피부염, 기관지천식, 알레르기성 비염, 편두통, 음식물알레르기 등을 일으키기 쉬운 체질을 갖고 있는 사람
2) 지금까지 약에의해 알레르기 증상 (예 : 발열, 발진, 관절통, 천식, 가려움증 등)을 일으킨 적이 있는 사람
3) 수두 또는 인플루엔자에감염되어 있거나 또는 의심되는 영유아 및 14세 이하의 어린이
4) 간장, 신장, 갑상선질환, 당뇨병, 고혈압 등이 있는 사람, 몸이 약한 사람 또는 고열이 있는 사람
5) 심장에 장애가있는 사람 또는 고령자 (메칠에페드린 및 그 염류, 마황을함유하는 제제)
6) 녹내장 (예 : 눈의 통증, 눈이침침함 등) 이 있는 사람, 배뇨곤란이 있는 사람
(항히스타민을 함유하는 제제)
7) 임부 또는 임신하고 있을가능성이 있는 부인, 수유부
8) 의사 또는 치과의사의 치료를받고 있는 사람

이상반응

1) 복용하는 동안발진, 발적, 구역, 구토, 변비, 식욕부진, 배뇨곤란, 현기증 등의 증상이 나타나면 복용을 중지하고 의사, 약사와 상의할것. (다만, 배뇨곤란은 항히스타민을 함유하는 제제)
2) 복용하는 동안졸음이 오는 경우가 있으므로 자동차 운전 또는 기계류의 운전 조작을 피할 것. (항히스타민을 함유하는제제)
3) 여러 차례 복용하여도증상의 개선이 없을 경우는 복용을 중지하고 의사, 약사와 상의할 것.
4) 장기연용하지 말 것.

[주요 이상반응정보]

Off-label Usage

[조회]

Related FDA Approved Drug

기준 성분:EPHEDRINE HYDROCHLORIDE
ACTAHIST (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
ACTIFED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
ACTIFED W/ CODEINE (CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
ADVIL ALLERGY SINUS (CHLORPHENIRAMINE MALEATE; IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
ADVIL COLD AND SINUS (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
ALEVE-D SINUS & COLD (NAPROXEN SODIUM; PSEUDOEPHEDRINE HYDROCHLORIDE)
ALLEGRA D 24 HOUR (FEXOFENADINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
ALLEGRA-D 12 HOUR (FEXOFENADINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
ALLERFED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
BENYLIN (DIPHENHYDRAMINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
BROMANATE DM (BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
BROMFED-DM (BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
CETIRIZINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE (CETIRIZINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
CHILDREN'S ADVIL ALLERGY SINUS (CHLORPHENIRAMINE MALEATE; IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
CHILDREN'S ADVIL COLD (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
CHILDREN'S MOTRIN COLD (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
CODIMAL-L.A. 12 (CHLORPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE)
CORPHED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
DIMETANE-DX (BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
EFIDAC 24 PSEUDOEPHEDRINE HYDROCHLORIDE/BROMPHENIRAMINE MALEATE (BROMPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE)
FEXOFENADINE HCL; PSEUDOEPHEDRINE HCL (FEXOFENADINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE (FEXOFENADINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
HISTAFED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
IBUPROHM COLD AND SINUS (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
ISOCLOR (CHLORPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE)
MUCINEX D (GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE)
MYFED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
NAPROXEN SODIUM AND PSEUDOEPHEDRINE HYDROCHLORIDE (NAPROXEN SODIUM; PSEUDOEPHEDRINE HYDROCHLORIDE)
NOVAFED (PSEUDOEPHEDRINE HYDROCHLORIDE)
PSEUDOEPHEDRINE HYDROCHLORIDE (PSEUDOEPHEDRINE HYDROCHLORIDE)
PSEUDOEPHEDRINE HYDROCHLORIDE AND CHLORPHENIRAMINE MALEATE (CHLORPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE)
PSEUDOEPHEDRINE HYDROCHLORIDE AND TRIPROLIDINE HYDROCHLORIDE (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
SEMPREX-D (ACRIVASTINE; PSEUDOEPHEDRINE HYDROCHLORIDE)
SINE-AID IB (IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE)
SUDAFED 12 HOUR (PSEUDOEPHEDRINE HYDROCHLORIDE)
SUDAFED 24 HOUR (PSEUDOEPHEDRINE HYDROCHLORIDE)
TAVIST ALLERGY/SINUS/HEADACHE (ACETAMINOPHEN; CLEMASTINE FUMARATE; PSEUDOEPHEDRINE HYDROCHLORIDE)
TRIACIN-C (CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRILITRON (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPHED (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPROLIDINE AND PSEUDOEPHEDRINE (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPROLIDINE AND PSEUDOEPHEDRINE HYDROCHLORIDES (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPROLIDINE AND PSEUDOEPHEDRINE HYDROCHLORIDES W/ CODEINE (CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPROLIDINE HCL, PSEUDOEPHEDRINE HCL AND CODEINE PHOSPHATE (CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
TRIPROLIDINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE (PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE)
ZYRTEC-D 12 HOUR (CETIRIZINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE)
기준 성분:CAFFEINE ANHYDROUS
기준 성분:ASPIRIN
ACETAMINOPHEN, ASPIRIN AND CAFFEINE (ACETAMINOPHEN; ASPIRIN; CAFFEINE)
ACETAMINOPHEN, ASPIRIN, AND CODEINE PHOSPHATE (ACETAMINOPHEN; ASPIRIN; CODEINE PHOSPHATE)
AGGRENOX (ASPIRIN; DIPYRIDAMOLE)
ASPIRIN AND DIPYRIDAMOLE (ASPIRIN; DIPYRIDAMOLE)
AXOTAL (ASPIRIN; BUTALBITAL)
AZDONE (ASPIRIN; HYDROCODONE BITARTRATE)
BAYER EXTRA STRENGTH ASPIRIN FOR MIGRAINE PAIN (ASPIRIN)
BUTALBITAL, ASPIRIN AND CAFFEINE (ASPIRIN; BUTALBITAL; CAFFEINE)
BUTALBITAL, ASPIRIN, CAFFEINE, AND CODEINE PHOSPHATE (ASPIRIN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATE)
CARISOPRODOL AND ASPIRIN (ASPIRIN; CARISOPRODOL)
CARISOPRODOL COMPOUND (ASPIRIN; CARISOPRODOL)
CARISOPRODOL, ASPIRIN AND CODEINE PHOSPHATE (ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE)
CODEINE, ASPIRIN, APAP FORMULA NO. 2 (ACETAMINOPHEN; ASPIRIN; CODEINE PHOSPHATE)
CODEINE, ASPIRIN, APAP FORMULA NO. 3 (ACETAMINOPHEN; ASPIRIN; CODEINE PHOSPHATE)
CODEINE, ASPIRIN, APAP FORMULA NO. 4 (ACETAMINOPHEN; ASPIRIN; CODEINE PHOSPHATE)
CODOXY (ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE)
COMPOUND 65 (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
DARVON COMPOUND (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
DARVON COMPOUND-65 (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
DARVON W/ ASA (ASPIRIN; PROPOXYPHENE HYDROCHLORIDE)
DARVON-N W/ ASA (ASPIRIN; PROPOXYPHENE NAPSYLATE)
EQUAGESIC (ASPIRIN; MEPROBAMATE)
EXCEDRIN (MIGRAINE) (ACETAMINOPHEN; ASPIRIN; CAFFEINE)
FIORINAL (ASPIRIN; BUTALBITAL; CAFFEINE)
FIORINAL W/CODEINE (ASPIRIN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATE)
INVAGESIC (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
INVAGESIC FORTE (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
LANORINAL (ASPIRIN; BUTALBITAL; CAFFEINE)
MEASURIN (ASPIRIN)
MEPRO-ASPIRIN (ASPIRIN; MEPROBAMATE)
MEPROBAMATE AND ASPIRIN (ASPIRIN; MEPROBAMATE)
METHOCARBAMOL AND ASPIRIN (ASPIRIN; METHOCARBAMOL)
MICRAININ (ASPIRIN; MEPROBAMATE)
NORGESIC (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
NORGESIC FORTE (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
ORPHENADRINE CITRATE, ASPIRIN, AND CAFFEINE (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
ORPHENGESIC (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
ORPHENGESIC FORTE (ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE)
OXYCODONE AND ASPIRIN (ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE)
OXYCODONE AND ASPIRIN (HALF-STRENGTH) (ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE)
PERCODAN (ASPIRIN; OXYCODONE HYDROCHLORIDE)
PERCODAN-DEMI (ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE)
PRAVIGARD PAC (COPACKAGED) (ASPIRIN; PRAVASTATIN SODIUM)
PROPOXYPHENE COMPOUND 65 (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
PROPOXYPHENE COMPOUND-65 (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
PROPOXYPHENE HYDROCHLORIDE W/ ASPIRIN AND CAFFEINE (ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE)
Q-GESIC (ASPIRIN; MEPROBAMATE)
ROBAXISAL (ASPIRIN; METHOCARBAMOL)
ROXIPRIN (ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE)
SOMA COMPOUND (ASPIRIN; CARISOPRODOL)
SOMA COMPOUND W/ CODEINE (ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE)
SYNALGOS-DC (ASPIRIN; CAFFEINE; DIHYDROCODEINE BITARTRATE)
TALWIN COMPOUND (ASPIRIN; PENTAZOCINE HYDROCHLORIDE)
VICOPRIN (ASPIRIN; HYDROCODONE BITARTRATE)

정보요약

드럭인포 의약품 요약/상세정보

코드 및 분류정보

항목	내용
성분코드	M223155/에페드린염산염 25.0밀리그램 / M223183/카페인무수물 25.0밀리그램 / M040355/아스피린 100.0밀리그램 /
BIT 약효분류	기타제제(Miscellaneous)
ATC 코드	OTHER COLD PREPARATIONS / R05X [코드분류상세설명] [ATC코드예측]
복지부분류코드	114 (해열·진통·소염제 )
Drugs By Indication	[전체보기]
Drugs By Classification	[전체보기]

제품정보

항목	내용
청구코드(KD코드) 비급여점검코드 상한금액	비급여 [상병코드조회] [질병코드집 다운로드]
제품성상	연한 청색의 타원형 장용 필름코팅정 [제형정보 확인]
포장·유통단위	자사포장단위에 따름
보관방법	기밀용기, 실온(1～30℃)보관

복약정보

항목

내용

LACTmed 바로가기

[바로가기]

약리작용

유료정보입니다.

축약복약지도

유료정보입니다.

복약지도

유료정보입니다.

임부에대한투여

*	전체임신 기간별로 여러등급이 존재할 수 있으며 가장 위험도가 높은 정보만 보여집니다. 단, 복합제의 경우 모든 복합제성분에 대한 임부투여등급이 표시된것은 절대 아니며 표시된것중에 가장 위험도가 높은 정보만 나타납니다.

FDA : D등급
(aspirin;ephedrine; )

*	상기 임부투여에 대한 정보는 전산처리 되면서 입력 오류 가능성이 존재합니다. 오류 가능성을 최소화하기 위하여 많은 노력을 기울이고 있으나, 그 정확성에 대하여 확신을 드릴 수 없습니다. 이에 대해 회사는 책임을 지지 않습니다.
*	반드시 공신력 있는 문헌을 다시 한번 참고 하시기 바라며 의사 또는 약사의 판단에 따라 투여여부가 결정되어야 합니다.

Pharmacokinetics

유료정보입니다.

보관상 주의

조제시 주의

심사정보

항목

내용

심사사례

4. 진료내역 참조, 불안정성 협심증 등 상병에 Coronary stent시술 하지 않은 상태로 장기간 병용 투여한 플라빅스정 및 아스피린제제에 대하여
■ 청구 및 진료내역

사례1 (여/59세)

청
구
내
역

▶ 상병명 : 불안정성 협심증, 본태성 고혈압, 심근경색을 유발하지 않는 심장동맥혈전증 등
▶ 주요청구내역 [처방전]
플라빅스 1x90, 아스트릭스 100mg 1x90, 딜테란180mg 1x90, 엘로톤 50mg 2x90
리피토 10mg 1x90, 코디오반 12.5mg 1x90

진 료 내 역

0 전년.12.9 CC : rest시 흉통, 호흡이 힘들다. BP 145/90mmHg
        12.16 CC : Chest pain (recent : 내원일 새벽, remote : 내원 20일전)
              DX : Unstable angina
              PI : 20년전 HTN 진단받고 med하던 중 내원 20일전부터 chest pain으로 본원 OPD에서 W/U 예정이었으나 pain aggravation(내원일 새벽0시, 5시, 아침8시)되어 ER 통해 내원
              PHx : smoking (+), alcohol(-)
              2D-echo : mild LA enlargement, global function 55-60%
                         => concentric LVH, mild LA enlargement
        12.17 CAG) LAD : atherosclerotic
                    Ramus : mild diffuse severe
                    LCX : mid severe subtotal eccentric, distal severe diffuse stenosis,
                          small calibered
                => Medication Tx 유지하기로 함. (Astrix 100mg, Plavix 75mg 투여)
        12.24 퇴원약 : Astrix 100mg, Plavix 75mg, herben, isomack, tritace, lipitor
※ 약제처방내역
                                                                         ↓현청구분

약제 일자	전년.12/17	12/30	동년.1/27	3/2	4/27	6/24	투약일수
Astrix 100mg	1x15	1x30	1x40	1x60	1x60	1x90	295일
clopidogrel 75mg	1x15	1x30	1x40	1x60	1x60	1x90	295일

소
견
서

LCX mid severe sub-total severe stenosis로 PCI 필요하나 비교적 small caliber이며 PCI 거부하여 PLAVIX 투여가 필요하다고 사료됨.

사례2 (남/64세)

청
구
내
역

▶ 상병명 : 급성 심내막하 심근경색증, 울혈성 심장기능상실(심부전), 당뇨병, 순수 고콜레스테롤혈증, 불안정성 협심증, 심근경색증을 유발하지 않는 심장동맥혈전증
▶ 주요청구내역 [처방전]
플라빅스 1x90, 아스트릭스캅셀100mg 1x90, 디고신 1x90, 레니프릴 10mg 1x90,
콩코르 50mg 0.5x90, 아마릴정 2mg 2x90, 라식스정 0.5x90

진
료
내
역

0 2년전.6.7   CC : abd distension, chr cough, dyspnea
               PI : local에서 시행한 Sono상 ascites 있어 evaluation위해 내원
                    constipation(±), epigastric soreness(-)
         6.8   AF, RVR로 순환기내과 Consult, Sono상 R/O Rt heart decompensation
               PX : depas 0.5g, lasix 4mg, aldactone 25mg
         6.10 2D-echo : enlarged LV and LA, RA, mild LVH
                         valve structure(normal), regional wall motion (diffuse hypokinesia)
                         global function 10-15%, pericardium (minimal effusion)
               => severe LV dysfunction, moderate pulmonary HTN, mild LVH, LVE, LAE, and RAE,
                  Hepatic congestion, minimal pericardia effusion
         6.12   PX : digoxin 0.25mg, enalapril 5mg, alsactone 12.5mg, lasix 40mg
         8.24   BP 140/70mmHg, irregilar heart beat
                PX : digoxin 0.25mg, enalapril 5mg, alsactone 12.5mg, lasix 20mg, Astrix
                안과 : cataract-수술 효과기대 못함.
         10.19 Plan : Β-blocker
         12.18 PX : digoxin 0.25mg, enalapril 5mg, alsactone 12.5mg, lasix 20mg, Astrix, Concor
0 전년. 4.12 갈증, BP : 110/60mmHg
                PX : 12/18일 PX + Plavix
         6.2    holter :underlying atrial fibrillation, tachy-brady syndrome was observed
                         (Max HR 114회/분, pause 3secs)
                        tachy-brady syndrome with Af
         6.7 FBS 327, PP2h 586
         6.11 PX : 아마릴, Glucoban
0 동년.3.22 BP 138/69mmHg, BST 150/180 PX : repeat
※ 약제처방내역
                                                                              ↓현청구분

약제 일자	2년전.8/24 전년.4/12 동년.6/21
Astrix 100mg	<--------------------------------------------------------->
clopidogrel 75mg	<------------------------------------->

소
견
서

전형적 흉통으로 인해 CAG 필요하나 echo에서 EF 10%로 매우 저하되어 있고 CAG거부한 상태로
환자상태 고려시 plavix 투여가 불가하다고 사료됨

사례3 (여/64세)

청
구
내
역

▶ 상병명 : 인슐린비의존성 당뇨병, 심부전을 동반한 고혈압성심장질환, 불안정성 협심증, 뇌경색증, 고글리세라이드혈증
▶ 주요청구내역 [처방전교부]
플라빅스 1x60, 아스피린프로텍트 100mg 1x60, 엘로톤 50mg 1x60, 미카르디스40mg 1x60
아반디아 4mg 1x60, 아마릴정 2mg 2x60

진 료 내 역

0 타병원 진료의뢰서(2년전.12월)
   : HT와 DM으로 내과 local에서 치료 중 내원 10일전부터 운동시 dyspnea & chest discomfort가 develop 되어 further evaluation 위해 전원함.
0 전년.6.23   CC : effort시 dyspnea -> admission recommend 했으나 refuse
        6.27-7.3 입원-DM, Angina
        1    CAG : LAD-sever diffuse sclerotic change beaded appearance : 70% stenosis
                     LCX-chronic total occlusion in prox portion bridge collateral flow(GⅠ-Ⅱ)
                     RCA-severe diffuse sclerotic change beaded appearance
                    => Con) OM1 with remodeling process -> Plan) 2nd prevention
        7.2    Chest PA : mild cardiomegaly
        7.16   FBS 150-230/280-330, 2D-echo : EF 30%, 75.9/59.3, 10.8/7.7, 26.1/56.4
                Px : aspirin, plavix, lipitor, tritace, lasix, aldacton, isoket, 아마릴4mg
         8.27 식전 150-200/165-300 => 아마릴 6mg 증량
   동년. 1.28 식전 130-170/180-200, 안과치료 중-retinopathy
         3.30   CAG : LAD-diffuse stenosis, LCX-total occlusion
         4.12   CAG : LAD-severe diffuse sclerotic change beased appearance
                      LCX-chronic total occlusion in prox. portion bridge collateral flow(G1-2)
                      RCA-severe diffuse sclerotic change beaded appearance
                      => previous CAG와 비교시 no interval change => Plan) medication
※ 약제처방내역
                                                                            ↓현청구분

약제 일자	전년.7/16 동년.6/17
Aspirin 100mg	<--------------------------------------------------------->
clopidogrel 75mg	<--------------------------------------------------------->

소
견
서

당뇨, 협심증환자로 Coronary angio상 3vessel로 CABG수술 받아야 하나 수술 불가능 상태로 plavix 투여가 필요하다고 사료됨.

사례4 (여/47세)

청 구 내 역

▶ 상병명 : 불안정성 협심증, 순수고콜레스테롤혈증, 대뇌경색증의 후유증, 급성심근경색에 의한 합병증으로서 심방, 심이 또는 심실의 혈전증
▶ 주요청구내역 [처방전교부]
플라빅스 1x90, 아스트릭스100mg 1x90, 헤르벤정 4x90, 니트로글리세린 0.6mg 1x60,
이소켓서방정 40mg 0.5x90, 셀벡스 2x90

진 료 내 역

0 동년.2.23(입원) CC : chest pain
                    DX : unstable angina, HTN
                    PI : 2년전부터 HTN으로 medication 중으로 3년전부터 새벽이나 빨리 걸을때 chest pain 있어 타병원에서 herben medication 중 최근 증상 aggravation 됨. 내원일 새벽 1시간가량 pain 지속되어 내원
                    Medication : astrix, plavix, lipitor, isoket, herben, tylenol, curon
         2.24      CAG : LAD : diffuse sclerosis-esp. diffuse narrowing from mid segment
                                D1 OS-concentric mild stenosis(50%)
                          LCX : mild diffuse sclerosis, dominent vessel
                          RCA : OS-concentric mild to moderate stenosis(70%)
                                 -> IC-NTG & sublingual : no response
                      → Dx : R/O angina pectoris(mixed angina)
         2.25   RCA OS에 stenosis 관찰 -> 보호자에 PTCA or OP or medical Tx 필요에 대해 설명
         2.26   환자 및 보호자 medication 하기로 결정 -> Medication만 유지시 problem에 대해 설명
         2.28   chest discomfort-mild, intermittent
         3.3    퇴원약 : Astrix 100mg, Plavix 75mg, isoket 40mg, herben, tylenol, lipitor
※ 약제처방내역
                                                                        ↓현청구분

약제 일자	동년.2/23 동년.6/8
Astrix 100mg	<------------------------------------------------->
clopidogrel 75mg	<------------------------------------------------->

소
견
서

Right coronary artery OS significant stenosis로 PCI 필요한 상태이나 PCI 거부로 Plavix 투여가 필요하다고 사료됨.

사례5 (남/67세)

청 구 내 역

▶ 상병명 : 본태성 고혈압, 협심증, 순수 고글리세라이드혈증, 기타 뇌경색증
▶ 주요청구내역 [처방전교부]
플라빅스 1x60, 아스트릭스100mg 1x60, 트리파몰정 1x60, 딜라트렌정 12.5mg 1x60, 아프로벨정150mg 1x60, 리피토 10mg 1x60

진 료 내 역

0 진료의뢰서(전년.3.8) : 최근 걸을 때 chest pain 호소하며 안정하면 증세가 사라져 further evaluation위해 전원함
0 전년.3.10   Dx : unstable angina
                    underlying Hypertension, 최근 effort시 발생하는 흉통악화
                    treadmil test시 흉통 있었고 nitrate 설하 투여로 호전
        3.12   2D-echo : normal systolic LV function, hypokinetic wall motion이 basel inferior wall에서 관찰, LVID 43.3/23.1, septum/PW 10.7/10.7, Aorta/LA 33.8/38.0
               Astrix, Plavix, Herben
        3.13   CAG : critical stenosis가 Lt main distal/LAD .Os/LCX.Os에서 관찰
                      plaque rupture가 Lt main distal에서 의심됨.
               Emergency OP : CABG
        3.19   2D-echo : ef 45-50%, normal regional wall motion
        3.21   CAG : LITA to D1-patent, LITA to OM1-patent, RGEA to LAD distal -None
        4.18   퇴원약 : plavix 75mg, allfgra 180mg, tritace 5mg, aminophylline 100mg, spara 100mg

※ 약제처방내역
                                                                                ↓현청구분

약제 일자	전년.3.12 동년.6/26
Astrix 100mg	<----------------------------------------------------------------->
clopidogrel 75mg	<----------------------------------------------------------------->

소
견
서

CAG상 Lt main and LAD OS의 critical stenosis로 CABG 시행받은 환자로 병변의 심각성을 감안시 Plavix 투여가 불가피하다고 사료됨.

■ 참고사항
○ CECILTextbook of Meicine, goldman/ausiello, 22nd Edition p396, 406-407, 418, 1423
○ PDR,2004, p.3032-3036
○ The TaskForce on the Management of Acute Coronary Syndromes of theESC(European Society of Cardiology): European heart journal(2002) 23,1809-1840
○ ACC/AHA 2002 Guideline Update for theManagement of Patients With Unstable Angina and Non-ST-Segment ElevationMyocardial InfarctionSummary Article. A Report of theAmerican College of Cardiology/American Heart Association Task Force onPractice Guidelines (Committee on the Management of Patients With UnstableAngina), circulation 2002;106:1893.등.
■ 심의내용
   - 플라빅스정(성분명 : Clopidogrel)은 “뇌졸중, 심근경색 또는말초동맥성질환이 있는 환자나 급성관상동맥증후군이 있는 환자에서 죽상동맥경화성 증상의 개선”에 투여토록 허가받은 약제로 식약청 허가사항에 아스피린의효과를 상승시켰고 아스피린과 1년까지 병용투여 하였다.“고명시되어 있음.
     또한, ACS(Acute Coronary Syndrome)환자의 경우에 플라빅스정은 ESC(europeansociety of cardiology) guideline(2002)에서는 최소 9-12개월까지, ACC/AHA(american college of cardiology/american heart association)guidelines(2002)에서는 9개월까지 투여기간을 언급하고 있는 점 등을 참조하여플라빅스정과 아스피린을 병용투여 시 12개월 범위 내에서 사례별로 인정토록 함.
   - 불안정성 협심증 상병에 Coronary stent 시술하지 않은 상태로 약 3개월에서 15개월 정도 아스피린과
     플라빅스정 병용 투여한 동 건(사례1-5)은 12개월정도 플라빅스정 투여를 인정함.
   [2005.3.4 진료심사평가위원회]

학술정보

항목	내용
DUR (의약품사용평가)	병용금기 : 고시된 병용금기 내용은 없습니다. [상호작용/병용금기검색] 연령대금기 : 고시된 연령금기 내용은 없습니다. [연령대금기상세검색]
독성정보	Ephedrine에 대한 독성정보 : 정보보기 출처: 국립독성과학원 독성물질정보DB : http://www.nitr.go.kr/nitr/contents/m134200/view.do
Mechanism of Action	Aspirin에 대한 Mechanism_Of_Action 정보 The analgesic, antipyretic, and anti-inflammatory effects of aspirin are due to actions by both the acetyl and the salicylate portions of the intact molecule as well as by the active salicylate metabolite. Aspirin directly and irreversibly inhibits the activity of both types of cyclo-oxygenase (COX-1 and COX-2) to decrease the formation of precursors of prostaglandins and thromboxanes from arachidonic acid. This makes aspirin different from other NSAIDS (such as diclofenac and ibuprofen) which are reversible inhibitors. Salicylate may competitively inhibit prostaglandin formation. Aspirin's antirheumatic (nonsteroidal anti-inflammatory) actions are a result of its analgesic and anti-inflammatory mechanisms; the therapeutic effects are not due to pituitary-adrenal stimulation. The platelet aggregation–inhibiting effect of aspirin specifically involves the compound's ability to act as an acetyl donor to the platelet membrane; the nonacetylated salicylates have no clinically significant effect on platelet aggregation. Aspirin affects platelet function by inhibiting the enzyme prostaglandin cyclooxygenase in platelets, thereby preventing the formation of the aggregating agent thromboxane A2. This action is irreversible; the effects persist for the life of the platelets exposed. Aspirin may also inhibit formation of the platelet aggregation inhibitor prostacyclin (prostaglandin I2) in blood vessels; however, this action is reversible. Caffeine에 대한 Mechanism_Of_Action 정보 Caffeine stimulates medullary, vagal, vasomotor, and respiratory centers, promoting bradycardia, vasoconstriction, and increased respiratory rate. This action was previously believed to be due primarily to increased intracellular cyclic 3′,5′-adenosine monophosphate (cyclic AMP) following inhibition of phosphodiesterase, the enzyme that degrades cyclic AMP. It is now thought that xanthines such as caffeine act as agonists at adenosine-receptors within the plasma membrane of virtually every cell. As adenosine acts as an autocoid, inhibiting the release of neurotransmitters from presynaptic sites but augmenting the actions of norepinephrine or angiotensin, antagonism of adenosine receptors promotes neurotransmitter release. This explains the stimulatory effects of caffeine. Blockade of the adenosine A1 receptor in the heart leads to the accelerated, pronounced "pounding" of the heart upon caffeine intake. Ephedrine에 대한 Mechanism_Of_Action 정보 Ephedrine is a sympathomimetic amine - that is, its principal mechanism of action relies on its direct and indirect actions on the adrenergic receptor system, which is part of the sympathetic nervous system. Ephedrine increases post-synaptic noradrenergic receptor activity by (weakly) directly activating post-synaptic 慣-receptors and 棺-receptors, but the bulk of its effect comes from the pre-synaptic neuron being unable to distinguish between real adrenaline or noradrenaline from ephedrine. The ephedrine, mixed with noradrenaline, is transported through the noradrenaline reuptake complex and packaged (along with real noradrenaline) into vesicles that reside at the terminal button of a nerve cell. Ephedrine's action as an agonist at most major noradrenaline receptors and its ability to increase the release of both dopamine and to a lesser extent, serotonin by the same mechanism is presumed to have a major role in its mechanism of action.
Pharmacology	Aspirin에 대한 Pharmacology 정보 Aspirin (acetylsalicylic acid) is an analgesic, antipyretic, antirheumatic, and anti-inflammatory agent. Aspirin's mode of action as an antiinflammatory and antirheumatic agent may be due to inhibition of synthesis and release of prostaglandins. Aspirin appears to produce analgesia by virtue of both a peripheral and CNS effect. Peripherally, Aspirin acts by inhibiting the synthesis and release of prostaglandins. Acting centrally, it would appear to produce analgesia at a hypothalamic site in the brain, although the mode of action is not known. Aspirin also acts on the hypothalamus to produce antipyresis; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. Aspirin's antipyretic activity may also be related to inhibition of synthesis and release of prostaglandins. Caffeine에 대한 Pharmacology 정보 Caffeine, a naturally occurring xanthine derivative like theobromine and the bronchodilator theophylline, is used as a CNS stimulant, mild diuretic, and respiratory stimulant (in neonates with apnea of prematurity). Often combined with analgesics or with ergot alkaloids, caffeine is used to treat migraine and other headache types. Over the counter, caffeine is available to treat drowsiness or mild water-weight gain.
Protein Binding	Aspirin에 대한 단백결합 정보 High (99.5%) to albumin. Decreases as plasma salicylate concentration increases, with reduced plasma albumin concentration or renal dysfunction, and during pregnancy. Caffeine에 대한 단백결합 정보 Low (25 to 36%).
Half-life	Aspirin에 대한 반감기 정보 The plasma half-life is approximately 15 minutes; that for salicylate lengthens as the dose increases: doses of 300 to 650 mg have a half-life of 3.1 to 3.2 hours; with doses of 1 gram, the half-life is increased to 5 hours and with 2 grams it is increased to about 9 hours. Caffeine에 대한 반감기 정보 3 to 7 hours in adults, 65 to 130 hours in neonates
Absorption	Aspirin에 대한 Absorption 정보 Absorption is generally rapid and complete following oral administration but may vary according to specific salicylate used, dosage form, and other factors such as tablet dissolution rate and gastric or intraluminal pH. Caffeine에 대한 Absorption 정보 Readily absorbed after oral or parenteral administration. The peak plasma level for caffeine range from 6-10mg/L and the mean time to reach peak concentration ranged from 30 minutes to 2 hours.
Pharmacokinetics	Caffeine anhydrous의 약물동력학자료 흡수 : 경구 : 신속하게, 완전히 흡수됨 (99%) 분포 : 모든 체액에 분포하며, 뇌혈관장벽, 태반을 통과하고, 유즙으로도 분비됨 분포용적 : 신생아 : 0.92 L/kg 성인 : 0.58 L/kg 단백결합 : 15-35% 대사 : 성인 : 거의 대부분이 간에서 대사되며, 탈메틸화되어 paraxanthine (72%), theobromine (20%), theophylline (8%)으로 대사됨 반감기 : 미숙아 : 65-103 시간 완숙아 : 82시간 3-4개월 영아 : 14.4 시간 5-6개월 영아 : 2.6 시간 성인 : 3-7.5 시간 (평균 4.9 시간) 임신부 : 18시간까지 혈중최고농도 도달시간 : 15-45분 소실 : 성인 : 미변화체로 신배설되는 양은 0.5-3.5% 신생아 : 거의 대부분 미변화체로 신배설됨 Aspirin의 약물동력학자료 혈중최고농도 도달시간 : 약 1-2 시간 흡수 : 위, 소장으로부터 흡수됨. 분포 : 대부분의 체액 및 조직으로 분포됨. 대사 : 위장관 점막, 적혈구, 활액, 혈액 등에 존재하는 esterases에 의해 활성형인 salicylate로 가수분해된다. Salicylate는 주로 간의 microsome 효소에 의해 대사되며 대사에 포화가 나타난다. 반감기 Aspirin : 15-20분 Salicylates : 용량의존적. 저용량 (300-600 mg)에서 3시간, 고용량 (1g)에서 5-6 시간, 더 고용량에서는 10시간 Ephedrine HCl의 약물동력학자료 경구투여시 작용발현시간 : 0.25-1시간 이내 작용지속시간 : 3-6 시간 분포 : 태반 통과, 유즙 분비 대사 : 간대사를 거의 받지 않음 반감기 : 2.5-3.6 시간 소실 : 24시간내에 투여량의 60-77%가 미변화체로 뇨를 통해 배설됨
Biotransformation	Aspirin에 대한 Biotransformation 정보 Aspirin is rapidly hydrolyzed primarily in the liver to salicylic acid, which is conjugated with glycine (forming salicyluric acid) and glucuronic acid and excreted largely in the urine. Caffeine에 대한 Biotransformation 정보 Hepatic cytochrome P450 1A2 (CYP 1A2) is involved in caffeine biotransformation. About 80% of a dose of caffeine is metabolized to paraxanthine (1,7-dimethylxanthine), 10% to theobromine (3,7-dimethylxanthine), and 4% to theophylline (1,3-dimethylxanthine).
Toxicity	Aspirin에 대한 Toxicity 정보 Oral, mouse: LD₅₀ = 250 mg/kg; Oral, rabbit: LD₅₀ = 1010 mg/kg; Oral, rat: LD₅₀ = 200 mg/kg. Effects of overdose include: tinnitus, abdominal pain, hypokalemia, hypoglycemia, pyrexia, hyperventilation, dysrhythmia, hypotension, hallucination, renal failure, confusion, seizure, coma, and death. Caffeine에 대한 Toxicity 정보 LD₅₀=127 mg/kg (orally in mice)
Drug Interactions	Aspirin에 대한 Drug_Interactions 정보 Acetazolamide The salicylate at high dose increases the effect of the carbonic anyhydraseAcetohexamide The salicylate increases the effect of sulfonylureaMethotrexate The salicylate increases the effect and toxicity of methotrexateAnisindione The salicylate increases effect of anticoagulantBetamethasone The corticosteroid decreases the effect of salicylatesChlorpropamide The salicylate increases the effect of sulfonylureaDexamethasone The corticosteroid decreases the effect of salicylatesDichlorphenamide The salicylate at high dose increases the effect of the carbonic anyhydrase inhibitorsDicumarol The salicylate increases effect of anticoagulantValproic Acid The salicylate increases the effect of valproic acidFludrocortisone The corticosteroid decreases the effect of salicylatesGliclazide The salicylate increases the effect of sulfonylureaGlipizide The salicylate increases the effect of sulfonylureaGlisoxepide The salicylate increases the effect of sulfonylureaGlibenclamide The salicylate increases the effect of sulfonylureaTolazamide The salicylate increases the effect of sulfonylureaTolbutamide The salicylate increases the effect of sulfonylureaGriseofulvin Anticipate decrease of ASA efficiency in presence of griseofulvinHeparin Association of ASA/heparin increases risk of bleedingHydrocortisone The corticosteroid decreases the effect of salicylatesPrednisolone The corticosteroid decreases the effect of salicylatesPrednisone The corticosteroid decreases the effect of salicylatesTriamcinolone The corticosteroid decreases the effect of salicylatesWarfarin The salicylate increases the effect of anticoagulantAcenocoumarol The salicylate increases the effect of anticoagulantMethylprednisolone The corticosteroid decreases the effect of salicylatesIbuprofen Ibuprofen reduces ASA cardioprotective effectsInsulin-aspart The salicylate increases the effect of insulinInsulin-detemir The salicylate increases the effect of insulinInsulin-glargine The salicylate increases the effect of insulinInsulin-glulisine The salicylate increases the effect of insulinInsulin-lispro The salicylate increases the effect of insulinKetorolac ASA increases toxicity of ketorolacMethazolamide The salicylate at high dose increases the effect of the carbonic anhydrase inhibitorsProbenecid The salicylate decreases the uricosuric effect of probenecidSulfinpyrazone The salicylate antagonizes the uricosuric effect of sulfinpyrazoneTiclopidine Increased effect of ticlopidineCortisone acetate The corticosteroid decreases the effect of salicylatesGinkgo biloba Association of ASA/ginkgo increases risk of bleedingGlycodiazine The salicylate increases the effect of sulfonylureaInsulin The salicylate increases the effect of insulinParamethasone The corticosteroid decreases the effect of salicylates Caffeine에 대한 Drug_Interactions 정보 Not Available
CYP450 Drug Interaction	[CYP450 Table직접조회]
Drug Target	[Drug Target]
SNP 정보	Name:Caffeine (DB00201) Interacting Gene/Enzyme:Cytochrome P450 1A2 (Gene symbol = CYP1A2) Swissprot P05177 SNP(s):rs762551 (C allele) Effect:Myocardial infarction Reference(s):Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H: Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA. 2006 Mar 8;295(10):1135-41. [PubMed]
Description	Aspirin에 대한 Description 정보 The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5) Caffeine에 대한 Description 정보 A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine& Ephedrine에 대한 Description 정보 An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [PubChem]
Dosage Form	Aspirin에 대한 Dosage_Form 정보 Gum OralLiquid OralPowder OralSolution / drops OralSuppository RectalTablet OralTablet, chewable OralTablet, coated OralTablet, delayed release Oral Caffeine에 대한 Dosage_Form 정보 Capsule OralElixir OralLiquid OralPill OralSolution OralSolution / drops OralSuppository RectalSuspension OralSyrup OralTablet OralTablet, extended release Oral Ephedrine에 대한 Dosage_Form 정보 Capsule OralLiquid IntramuscularLiquid IntravenousPowder OralSolution IntramuscularTablet Oral
Drug Category	Aspirin에 대한 Drug_Category 정보 Anti-Inflammatory Agents, Non-SteroidalAnticoagulantsCyclooxygenase InhibitorsFibrinolytic AgentsPlatelet Aggregation InhibitorsSalicylates Caffeine에 대한 Drug_Category 정보 Anorexigenic AgentsCentral Nervous System StimulantsPhosphodiesterase Inhibitors Ephedrine에 대한 Drug_Category 정보 Adrenergic AgentsCentral Nervous System StimulantsSympathomimeticsVasoconstrictor Agents
Smiles String Canonical	Aspirin에 대한 Smiles_String_canonical 정보 CC(=O)OC1=CC=CC=C1C(O)=O Caffeine에 대한 Smiles_String_canonical 정보 CN1C=NC2=C1C(=O)N(C)C(=O)N2C Ephedrine에 대한 Smiles_String_canonical 정보 CNC(C)C(O)C1=CC=CC=C1
Smiles String Isomeric	Aspirin에 대한 Smiles_String_isomeric 정보 CC(=O)OC1=CC=CC=C1C(O)=O Caffeine에 대한 Smiles_String_isomeric 정보 CN1C=NC2=C1C(=O)N(C)C(=O)N2C Ephedrine에 대한 Smiles_String_isomeric 정보 CN[C@@H](C)[C@H](O)C1=CC=CC=C1
InChI Identifier	Aspirin에 대한 InChI_Identifier 정보 InChI=1/C9H8O4/c1-6(10)13-8-5-3-2-4-7(8)9(11)12/h2-5H,1H3,(H,11,12)/f/h11H Caffeine에 대한 InChI_Identifier 정보 InChI=1/C8H10N4O2/c1-10-4-9-6-5(10)7(13)12(3)8(14)11(6)2/h4H,1-3H3 Ephedrine에 대한 InChI_Identifier 정보 InChI=1/C10H15NO/c1-8(11-2)10(12)9-6-4-3-5-7-9/h3-8,10-12H,1-2H3/t8-,10-/m0/s1
Chemical IUPAC Name	Aspirin에 대한 Chemical_IUPAC_Name 정보 2-acetyloxybenzoic acid Caffeine에 대한 Chemical_IUPAC_Name 정보 1,3,7-trimethylpurine-2,6-dione Ephedrine에 대한 Chemical_IUPAC_Name 정보 (1R,2S)-2-methylamino-1-phenylpropan-1-ol
Drug-Induced Toxicity Related Proteins	ASPIRIN 의 Drug-Induced Toxicity Related Protein정보 Replated Protein:Vimentin Drug:aspirin Toxicity:aspirin-induced gastric mucosal microvessels injury . [바로가기] Replated Protein:Angiopoietin-related protein Drug:aspirin Toxicity:damage to microvessels. rupture of capillary walls. necrosis of endothelial cells. damage to endothelial organelles. deposition of fibrin. adherence of platelets to damaged endothelium. [바로가기] Replated Protein:Myeloperoxidase Drug:aspirin Toxicity:haemorrhagic erosions. [바로가기] Replated Protein:Thromboxane A2 receptor Drug:aspirin Toxicity:thrombotic complications. [바로가기] Replated Protein:Integrin beta-3 Drug:Aspirin Toxicity:Antiplatelet effect. [바로가기] Replated Protein:Integrin alpha-Iib Drug:Aspirin Toxicity:Antiplatelet effect. [바로가기] Replated Protein:Nuclear factor NF-kappa-B p105 subunit Drug:aspirin Toxicity:apoptosis in human colon cancer cells. [바로가기] CAFFEINE 의 Drug-Induced Toxicity Related Protein정보 Replated Protein:Metallothionein Drug:caffeine Toxicity:hepatotoxicity. [바로가기]

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