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2. MR Ç÷°üÁ¶¿µÀ» Æ÷ÇÔÇÑ Àü½ÅÀÇ ÀÚ±â°ø¸í¿µ»ó(MRI) Á¶¿µÁ¦
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1) ±Þ¼º ¶Ç´Â ¸¸¼ºÀÇ ÁßÁõ ½ÅÀå¾Ö ȯÀÚ(GFR<30 mL/min/1.73 m2), °£-ÄáÆÏ ÁõÈıºÀ¸·Î ÀÎÇÑ ±Þ¼º½ÅºÎÀü ȯÀÚ, °£ÀÌ½Ä ¼ö¼ú ÀüÈÄÀÇ ±Þ¼º½ÅºÎÀü ȯÀÚ¿¡¼, °¡µ¹¸®´½°è Á¶¿µÁ¦ Åõ¿©´Â ½Å¿ø¼ºÀü½Å¼¶À¯Áõ(NSF : Nephrogenic Systemic Fibrosis)ÀÇ ¹ß»ý À§Ç輺À» Áõ°¡½ÃŲ´Ù. NSF´Â ÇǺÎ, ±ÙÀ°, ³»Àå±â°ü¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ¼Ò¸ð¼º ÁúȯÀÌ¸ç ¶§·Î´Â Ä¡¸íÀûÀÌ´Ù. ±×·¯¹Ç·Î ÀÌ·¯ÇÑ È¯Àڵ鿡°Ô´Â °¡µµµð¾Æ¸¶À̵带 Åõ¿©ÇÏÁö ¾Ê´Â´Ù. °¡µ¹¸®´½°è Á¶¿µÁ¦¸¦ Åõ¿©ÇÏ´Â ¸ðµç ȯÀڵ鿡 ´ëÇÏ¿© º´·Â°ú ÀÓ»óº´¸® °Ë»ç°á°ú¸¦ È®ÀÎÇÏ¿© ½ÅÀå¾Ö°¡ ÀÖ´ÂÁö È®ÀÎÇØ¾ß Çϰí, Çã°¡µÈ ¿ë·®À» ÃʰúÇÏ¿© »ç¿ëÇÏÁö ¾Êµµ·Ï ÁÖÀÇÇÑ´Ù. ¶ÇÇÑ ÀçÅõ¿©ÇØ¾ß ÇÒ °æ¿ì ÀÌÀü¿¡ Åõ¿©µÈ Á¶¿µÁ¦°¡ ¹è¼³µÇµµ·Ï ÃæºÐÇÑ ½Ã°£À» µÐ ÈÄ ÀçÅõ¿©ÇÑ´Ù.
2) ô¼ö° ³» Åõ¿© ½Ã ÁßÁõÀÇ ÀÌ»ó¹ÝÀÀÀÌ ³ªÅ¸³¯ ¼ö ÀÖÀ¸¹Ç·Î ô¼ö° ³»¿¡´Â Åõ¿©ÇÏÁö ¾Ê´Â´Ù.
3) °¡µ¹¸®´½ Á¶¿µÁ¦¸¦ ¿©·¯ ¹ø Åõ¿©ÇÑ È¯ÀÚÀÇ ºñÁ¶¿µ T1 °Á¶ MR(T1-weighted MR) ¿µ»ó¿¡¼ ¼Ò³ú Ä¡¾ÆÇÙ(cerebellar dentate nucleus)°ú â¹éÇÙ(globus pallidus)¿¡ °í½ÅÈ£(high intensity signal)°¡ °üÂûµÇ¾ú´Ù´Â º¸°í¿Í ȯÀÚÀÇ ³ú ºÎ°Ë Á¶Á÷¿¡¼ °¡µ¹¸®´½ÀÌ °ËÃâµÇ¾ú´Ù°í º¸°í°¡ ÀÖ´Ù. ÀÓ»óÀûÀÎ °á°ú´Â ¾Ë·ÁÁ® ÀÖÁö ¾Ê´Ù. °¡µ¹¸®´½ Á¶¿µÁ¦¸¦ »ç¿ëÇÑ °Ë»çÀÇ Çʿ伺À» ½ÅÁßÈ÷ ÆÇ´ÜÇØ¾ß ÇÑ´Ù.
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2) NSFÀÇ Áõ»óÀº ´ÙÀ½°ú °°´Ù:
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6) µå¹°°Ô ±¸Åä, Á¹À½, Áö°¢ÀÌ»ó, ½Ã°¢Àå¾Ö, ¼³»ç, ºÒ¾È°¨, È£Èí°ï¶õ, ÈäÅë, ºó¸Æ, ÀüÀ², °üÀýÅë¹× µÎµå·¯±â, °¡·Á¿ò ¶Ç´Â ¸ñÀÇ Àڱذ¨°ú °°Àº ¾Ë·¯Áö¼º Áõ»óÀÌ ³ªÅ¸³µ´Ù.
7) ´Ù¸¥ MRI Á¶¿µÁ¦ÀÇ °æ¿ì¿¡¼¿Í ¸¶Âù°¡Áö·Î ¸Å¿ìµå¹°°Ô ÀÌ ¾àÀÇ Åõ¿©·Î °æ·ÃÀÌ ³ªÅ¸³µÀ¸³ª ¾à¹°°úÀÇ °ü·Ã¼ºÀº È®ÀεÇÁö ¾Ê¾Ò´Ù.
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1) °¡µ¹¸®´½ Á¶¿µÁ¦ÀÇ ¹Ýº¹ Åõ¿©³ª Çã°¡µÈ ¿ë·® º¸´Ù°í¿ë·®À» »ç¿ëÇÏ´Â °ÍÀº NSF À§ÇèÀ» Áõ°¡½ÃŰ´Â ¿äÀÎÀÌ µÉ ¼ö ÀÖ´Ù.Ç÷¾×Åõ¼®ÁßÀΠȯÀÚ´Â °¡µ¹¸®´½ Á¶¿µÁ¦ÀÇ ¹è¼³À» ÃËÁøÇϱâ À§ÇØ Á¶¿µÁ¦ Åõ¿©Á÷ÈÄ Ç÷¾×Åõ¼®À» °í·ÁÇØ º¼ ¼ö ÀÖ´Ù. Ç÷¾×Åõ¼®À¸·Î °¡µ¹¸®´½ Á¶¿µÁ¦ÀÇ ¹è¼³ÀÌ ÃËÁøµÈ´Ù´Â ¹®Çå º¸°í°¡ ÀÖ´Ù. 1¢¦3ȸ Åõ¼® ÈÄ Æò±Õ °¡µ¹¸®´½ Á¶¿µÁ¦ÀÇ ¹è¼³À²Àº °¢°¢ 78%, 96%, 99% À̾ú´Ù. ±×·¯³ª Ç÷¾×Åõ¼®ÀÌ NSF¸¦ ¿¹¹æÇÏ´ÂÁö ¿©ºÎ´Â Àß ¾Ë·ÁÁ® ÀÖÁö ¾Ê´Ù. °¡µ¹¸®´½ Á¶¿µÁ¦¸¦ Åõ¿©Çϱâ Àü¿¡ º´·ÂÀ̳ª ½Å±â´É °Ë»ç¸¦ ÅëÇØ ȯÀÚÀÇ ½Å±â´ÉÀ» Á¡°ËÇÑ´Ù. °æÁõ¢¦ÁߵÀÇ ½Å±â´É Àå¾Ö ¹× Á¤»ó ½Å±â´É ȯÀÚ¿¡¼ÀÇ NSF ¹ß»ýÀ§ÇèÀº ¾Ë·ÁÁöÁö ¾Ê¾Ò´Ù. NSF À§ÇèÀÌ ³ôÀº ȯÀÚµéÀº °¡µ¹¸®´½ Á¶¿µÁ¦¸¦ Åõ¿©ÇÑ ÈÄ NSF¿Í °ü·ÃµÈ ÀÓ»ó Áõ»óÀ» Àå±â°£ ÃßÀû °üÂûÇÒ Çʿ䰡 ÀÖ´Ù.
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3) ÁßÁõÀÇ ½Å±â´É Àå¾Ö°¡ ÀÖ´Â ¸î¸î ȯÀÚ(GFR<10ml/min)¿¡¼ÀÌ ¾àÀÇ Åõ¿© ÈÄ ½Åµ¶¼ºÀÇ Áõ»óÀº ¾øÀÌ »ç±¸Ã¼¿©°úÀ²ÀÌ ¾à°£ ´õ °¨¼ÒÇÑ ¹Ù ÀÖ´Ù. À̰ÍÀÇ ÀÓ»óÀû °ü·Ã¼ºÀºÀß ¹àÇôÁ® ÀÖÁö ¾ÊÀ¸¹Ç·Î »ç¿ëÀü¿¡ ÁÖÀǸ¦ ¿äÇÑ´Ù.
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| Related FDA Approved Drug |
±âÁØ ¼ººÐ: GADODIAMIDEOMNISCAN (GADODIAMIDE)
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µå·°ÀÎÆ÷ ÀǾàǰ ¿ä¾à/»ó¼¼Á¤º¸
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»ó±â ÀÓºÎÅõ¿©¿¡ ´ëÇÑ Á¤º¸´Â Àü»êó¸® µÇ¸é¼ ÀÔ·Â ¿À·ù °¡´É¼ºÀÌ Á¸ÀçÇÕ´Ï´Ù. ¿À·ù °¡´É¼ºÀ» ÃÖ¼ÒÈÇϱâ À§ÇÏ¿© ¸¹Àº ³ë·ÂÀ» ±â¿ïÀ̰í ÀÖÀ¸³ª, ±× Á¤È®¼º¿¡ ´ëÇÏ¿© È®½ÅÀ» µå¸± ¼ö ¾ø½À´Ï´Ù. ÀÌ¿¡ ´ëÇØ ȸ»ç´Â Ã¥ÀÓÀ» ÁöÁö ¾Ê½À´Ï´Ù.
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¹Ýµå½Ã °ø½Å·Â ÀÖ´Â ¹®ÇåÀ» ´Ù½Ã Çѹø Âü°í ÇϽñ⠹ٶó¸ç ÀÇ»ç ¶Ç´Â ¾à»çÀÇ ÆÇ´Ü¿¡ µû¶ó Åõ¿©¿©ºÎ°¡ °áÁ¤µÇ¾î¾ß ÇÕ´Ï´Ù.
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| Mechanism of Action |
Gadodiamide¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Based on the behavior of protons when placed in a strong magnetic field, which is interpreted and transformed into images by magnetic resonance (MR) instruments. Paramagnetic agents have unpaired electrons that generate a magnetic field about 700 times larger than the proton's field, thus disturbing the proton's local magnetic field. When the local magnetic field around a proton is disturbed, its relaxation process is altered. MR images are based on proton density and proton relaxation dynamics. MR instruments can record 2 different relaxation processes, the T1 (spin-lattice or longitudinal relaxation time) and the T2 (spin-spin or transverse relaxation time). In magnetic resonance imaging (MRI), visualization of normal and pathological brain tissue depends in part on variations in the radiofrequency signal intensity that occur with changes in proton density, alteration of the T1, and variation in the T2. When placed in a magnetic field, gadodiamide shortens both the T1 and the T2 relaxation times in tissues where it accumulates. At clinical doses, gadodiamide primarily affects the T1 relaxation time, thus producing an increase in signal intensity. Gadodiamide does not cross the intact blood-brain barrier; therefore, it does not accumulate in normal brain tissue or in central nervous system (CNS) lesions that have not caused an abnormal blood-brain barrier (e.g., cysts, mature post-operative scars). Abnormal vascularity or disruption of the blood-brain barrier allows accumulation of gadodiamide in lesions such as neoplasms, abscesses, and subacute infarcts.
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| Pharmacology |
Gadodiamide¿¡ ´ëÇÑ Pharmacology Á¤º¸ Not Available
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| Absorption |
Gadodiamide¿¡ ´ëÇÑ Absorption Á¤º¸ Not Available
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| Pharmacokinetics |
GadodiamideÀÇ ¾à¹°µ¿·ÂÇÐÀÚ·á
- Èí¼ö
1)onset : Åõ¿©ÈÄ ¹Ù·Î ¹ÝÀÀÀÌ ³ªÅ¸³²
2)duration : 1ȸ¿ë·® ÁÖ»ç ÈÄ ¾à 4½Ã°£ À¯Áö
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1)Á¶Á÷À¸·ÎÀÇ ºÐÆ÷´Â ¸Å¿ì ³·À¸¸ç °ÅÀÇ 100% ¼¼Æ÷¿Ü¾×À¸·Î ºÐÆ÷
2)¹Ý°¨±â : 37ºÐ
3)ºÐÆ÷¿ëÀû : 200ml/kg·Î ¼¼Æ÷¿Ü¾Ö°ú °ÅÀÇ µ¿ÀÏ
- ´ë»ç : °ÅÀÇ ´ë»çµÇÁö ¾Ê°í ¼Òº¯À¸·Î ¹Ìº¯Èü ¹è¼³
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1)½Å¹è¼³ : 95%ÀÌ»ó (24½Ã°£À̳»¿¡ °ÅÀÇ ¸ðµÎ ¹è¼³, 95-99%)
2)¹Ý°¨±â : 77.8ºÐ(¸ðÈÇÕ¹°)
´Ü, ½Å±â´É ÀúÇÏȯÀÚ¿¡¼ ¹è¼³ ¹Ý°¨±â´Â 34.3½Ã°£±îÁö ¿¬ÀåµÇ¸ç ȯÀÚ¸¶´Ù ´Ù¾ç
3)feces : 0.4%
4)¸ðÀ¯ : ¾Ë·ÁÁöÁö ¾ÊÀ½
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| Toxicity |
Gadodiamide¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available
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| Drug Interactions |
Gadodiamide¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Alprazolam The protease inhibitor increases the effect of the benzodiazepineChlordiazepoxide The protease inhibitor increases the effect of the benzodiazepineClonazepam The protease inhibitor increases the effect of the benzodiazepineClorazepate The protease inhibitor increases the effect of the benzodiazepineDiazepam The protease inhibitor increases the effect of the benzodiazepineEstazolam The protease inhibitor increases the effect of the benzodiazepineFlurazepam The protease inhibitor increases the effect of the benzodiazepineHalazepam The protease inhibitor increases the effect of the benzodiazepineMidazolam The protease inhibitor increases the effect of the benzodiazepinePrazepam The protease inhibitor increases the effect of the benzodiazepineQuazepam The protease inhibitor increases the effect of the benzodiazepineTriazolam The protease inhibitor increases the effect of the benzodiazepineWarfarin The protease inhibitor increases the anticoagulant effectAcenocoumarol The protease inhibitor increases the anticoagulant effectDicumarol The protease inhibitor increases the anticoagulant effectAnisindione The protease inhibitor increases the anticoagulant effectVardenafil The protease inhibitor increases the effect and toxicity of vardenafilCyclosporine The protease inhibitor increases the effect of cyclosporineFentanyl The protease inhibitor increases the effect and toxicity of fentanylPimozide The protease inhibitor increases the effect and toxicity of pimozideSildenafil The protease inhibitor increases the effect and toxicity of sildenafilVitamin C Vitamin C decreases indinavir levelsTrazodone This strong CYP3A4 inhibitor increases the effect and toxicity of trazodoneTerfenadine Increased risk of cardiotoxicity and arrhythmiasAstemizole Increased risk of cardiotoxicity and arrhythmiasCisapride Increased risk of cardiotoxicity and arrhythmiasDelavirdine Delavirdine increases the effect of indinavirClarithromycin Clarithromycin increases the effect and toxicity of indinavirCarbamazepine Indinavir increases the effect and toxicity of carbamazepineAtorvastatin Increases the effect and toxicity of atorvastatinAmiodarone Indinavir increases the effect and toxicity of amiodaroneEfavirenz Efavirenz decreases the effect of indinavirErlotinib This CYP3A4 inhibitor increases levels/toxicity of erlotinibEsomeprazole Omeprazole decreases the absorption of indinavirOmeprazole Omeprazole decreases the absorption of indinavirLansoprazole Omeprazole decreases the absorption of indinavirPantoprazole Omeprazole decreases the absorption of indinavirRabeprazole Omeprazole decreases the absorption of indinavirFusidic Acid Increases the effect and toxicity of fusidic acidKetoconazole Ketoconazole increases the efefct of indinavirRanolazine Increased levels of ranolazine - risk of toxicity Rifabutin Rifabutin decreases the effect of indinavirRifampin Rifampin decreases the effect of indinavirSt. John's Wort St. John's Wort decreases the effect of indinavirSunitinib Possible increase in sunitinib levelsTacrolimus Increases the effect and toxicity of tacrolimusSaquinavir Possible antagonism of actionRisperidone Increased risk of extrapyramidal symptomsQuinupristin This combination presents an increased risk of toxicityAluminium The antacid decreases the absorption of indinavirAtazanavir Increased risk of hyperbilirubinemia with this associationBismuth The antacid decreases the absorption of indinavirCalcium The antacid decreases the absorption of indinavirMagnesium oxide The antacid decreases the absorption of indinavirMagnesium The antacid decreases the absorption of indinavirErgotamine Increases the effect and toxicity of the ergot derivativeDihydroergotamine Increases the effect and toxicity of the ergot derivative
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CYP450 Drug Interaction |
[CYP450 TableÁ÷Á¢Á¶È¸]
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| Description |
Gadodiamide¿¡ ´ëÇÑ Description Á¤º¸ Gadodiamide is a gadolinium based contrast agent used in MR imaging procedures to assist in the visualization of blood vessels. It is commonly marketed under the trade name Omniscan. [Wikipedia]
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| Dosage Form |
Gadodiamide¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Solution Intravenous
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| Drug Category |
Gadodiamide¿¡ ´ëÇÑ Drug_Category Á¤º¸ Contrast Media
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| Smiles String Canonical |
Gadodiamide¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ O.[Gd+3].CNC(=O)CN(CCN(CCN(CC([O-])=O)CC(=O)NC)CC([O-])=O)CC([O-])=O
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| Smiles String Isomeric |
Gadodiamide¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ O.[Gd+3].CNC(=O)CN(CCN(CCN(CC([O-])=O)CC(=O)NC)CC([O-])=O)CC([O-])=O
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| InChI Identifier |
Gadodiamide¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C16H29N5O8.Gd.H2O/c1-17-12(22)7-20(10-15(26)27)5-3-19(9-14(24)25)4-6-21(11-16(28)29)8-13(23)18-2;;/h3-11H2,1-2H3,(H,17,22)(H,18,23)(H,24,25)(H,26,27)(H,28,29);;1H2/q;+3;/p-3/fC16H26N5O8.Gd.H2O/h17-18H;;/q-3;m;
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| Chemical IUPAC Name |
Gadodiamide¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 2-[bis[2-[(2-methylamino-2-oxoethyl)-(2-oxido-2-oxoethyl)amino]ethyl]amino]acetate; gadolinium(+3) cation; hydrate
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µå·°ÀÎÆ÷ ÀǾàÇмúÁ¤º¸´Â ½ÄǰÀǾàǰ¾ÈÀüóÀÇ Á¦Ç°Çã°¡»çÇ×, Çмú¹®Çå, Á¦¾àȸ»ç Á¦°øÁ¤º¸ µîÀ» ±Ù°Å·Î ÀÛ¼ºµÈ Âü°í Á¤º¸ÀÔ´Ï´Ù.
Á¤º¸ÀÇ Á¤È®¼ºÀ» À§ÇØ ³ë·ÂÇϰí ÀÖÀ¸³ª ÆíÁý»óÀÇ ¿À·ù, Çã°¡»çÇ× º¯°æ, Ãß°¡ÀûÀÎ Çмú¿¬±¸ ¶Ç´Â Àӻ󿬱¸ ¹ßÇ¥ µîÀ¸·Î ÀÎÇØ ¹ß»ýÇÏ´Â ¹®Á¦¿¡ ´ëÇØ µå·°ÀÎÆ÷´Â
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ÀüÈ: 02-3486-1061 ¤Ó À̸ÞÀÏ: webmaster@druginfo.co.kr
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