200

Quetia Tablets 200mg

Quetiapine(fumarate)..................................................................................................................................................................................................200mg

Quetiapine 50mg 100mg 200mg 300mg 300~450mg 150~750mg 100mg 200mg 300mg 400mg 200~800mg 400~800mg Quetiapine Quetiapine 25mg 25~50mg quetiapine quetiapine 25% quetiapine quetiapine quetiapine 25mg 25~50mg

quetiapine

( ) quetiapine (ketoacidosis) (Hyperglycemic Hyperosmolar Nonketotic Coma) ( ) ( ) ( ) (Randomized controlled trial RCT) (Retrospective cohort study) (Conventional) (Atypical) (dementia-related psychosis)

9 quetiapine ( 0.5x10 /L)

quetiapine9 1.0X10 /L quetiapine

9 ( 1.5X10 /L)( " ") quetiapine ( " ") quetiapine Quetiapine quetiapine QTc quetiapine QTc quetiapine quetiapine ( " ") (Tardive dyskinesia) quetiapine quetiapine (Neuroleptic malignant syndrome) quetiapine( " ") creatine phosphokinase quetiapine

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( )

Quetiapine (dementia-related psychosis) (n=710 83 56-99 ) 10 quetiapine quetiapine 5.5% 3.2% quetiapine " " Quetiapine ( carbamazepine) quetiapine Quetiapine CYP3A4 ( azole ) quetiapine ( " ") quetiapine

quetiapine quetiapine Quetiapine Quetiapine(quetiapine fumarate) valproate semisodium( divalproex sodium[USAN]) valproic acid quetiapine Valproate semisodium sodium valproate valproic acid risperidone haloperidol quetiapine quetiapine thioridazine quetiapine Quetiapine antipyrine quetiapine carbamazepine( ) quetiapine carbamazepine quetiapine quetiapine ( AUC ) quetiapine 13% quetiapine quetiapine quetiapine 750mg 800mg Quetiapine (phenytoin) quetiapine quetiapine phenytoin ( barbiturates rifampicin) quetiapine phenytoin carbamazepine ( sodium valproate) quetiapine Quetiapine P450 CYP3A4 cimetidine P450 quetiapine imipramine( CYP2D6 ) fluoxetine( CYP3A4 CYP2D6 ) quetiapine quetiapine CYP3A4 ( azole ) ( " " " ")

quetiapine ( " " " " ) quetiapine Quetiapine quetiapine

quetiapine

Quetiapine quetiapine (CIOMS III 1995) quetiapine

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( 10%)

( 1% 10%)

1.5

2

1.5

3

4(ALT,AST)8level 7

1.5

" "

1. " " 2. quetiapine 3. 4. quetiapine (ALT AST) -GT quetiapine 5. 1 quetiapine 6.

9 7. 1.5X10 /L quetiapine9 1.5X10 /L 1.72% 0.73%

9 9 1.0X10 /L 1.5X10 /L9 quetiapine 0.5X10 /L 0.21% 0% 0.5

9 1.0X10 /L 0.75% 0.11% 8. 126mg/dL 200mg/dL quetiapine T4 T4 quetiapine T4 T4 T4 T4 quetiapine quetiapine T4 T4 T3 T3 TBG TSH quetiapine quetiapine quetiapine quetiapine QTc quetiapine QTc ( " ") ( " ")

quetiapine 30g quetiapine13.6g quetiapine ( " ") Quetiapine (oxygenation)

N05A H04 1. Quetiapine quetiapine N-desalkyl quetiapine (receptor) quetiapine N-desalkyl quetiapine serotonin(5HT ) dopamine D D2 1 2

5HT D quetiapine2 2

(EPS) N-desalkyl quetiapine norepinephrine (NET) quetiapine N-desalkyl quetiapine histaminergic -adrenergic -adrenergic serotonin 5HT cholinergic 1 2 1A

muscarinic benzodiazepine (conditioned avoidance) quetiapine dopamine dopamine (dopamine D2 ) (EPS) quetiapine dopamine D2 quetiapine mesolimbic A10 dopaminergic A9 quetiapine (dystonic) N-desalkyl quetiapine quetiapine

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( quetiapine 75~750mg) quetiapine EPS 800mg quetiapine quetiapine quetiapine lithium valproate semisodium quetiapine EPS quetiapine (prolactin) quetiapine quetiapine chlorpromazine haloperidol quetiapine quetiapine quetiapine quetiapine 600mg 85% 400~800mg 2. quetiapine quetiapine 83% quetiapine N-desalkyl quetiapine quetiapine 35% Quetiapine N-desalkyl quetiapine 7 12 quetiapine (PET) quetiapine 5HT D2 2

12 Quetiapine N-desalkyl quetiapine quetiapine quetiapine 30~50%

2 (creatinine 30ml/min/1.73m ) ( ) quetiapine 25% quetiapine N-desalkyl quetiapine 5% Quetiapine quetiapine 5% 73% 21% quetiapine ( ) 25% quetiapine ( " ") In vitro quetiapine P450 CYP3A4 N-desalkyl quetiapine CYP3A4 quetiapine ketoconazole ketoconazole quetiapine Cmax AUC 235% 522% quetiapine 84% 2.6 6.8 tmax

Quetiapine ( N-desalkyl quetiapine) P450 1A2 2C9 2C19 2D6 3A4 CYP (300~800mg/day)50 in vitro quetiapine P450

1. Quetiapine quetiapine(500mg/kg) (100mg/kg) (ptosis) 2. quetiapine ( ) quetiapine dopamine D2 quetiapine 100mg/kg 225mg/kg 3. ( 0 20 75 250 mg/kg) ( 250 mg/kg) ( 250 750mg/kg) 4. ( ) Quetiapine 5. Quetiapine quetiapine (clastogen)

2~1000

25

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GMP

cGMP 17-1 2008.12

4-GT

(0.01% 0.1%)

( 0.01%)

( LDL )1

(Restless legs syndrome)1

6

( 0.1 1%)

1.5