huang lian 黃連/ xuan hu lian 宣胡連

Pharmaceutical name:
Rhizoma Coptidis (huang lian)
Rhizoma Picrorhizae (xuan hu lian)
Biological name拉丁學名﹕
huang lian:
1. Coptis chinensis Franch.
2. Coptis deltodea C.Y Cheng et Hsiao
3. Coptis teeta Wall.
4. Coptis quiquefolia Mig. (台灣黃連)
xuan hu lian:
1. Picrorhiza scrophularfifolia Pennell (胡黃連)
2. Picrorhiza kurrooa Royle ex Benth.(印度胡黃連)
Other names別名：
chuan lian,川蓮，wei lian 味蓮  (Coptis chinensis Franch.),
ya lian 雅蓮 (Coptis deltodea C.Y Cheng et Hsiao) ,
yun lian雲蓮  (Cotis teeta Wall.)
Common Name英文名：
coptis rhizome (huang lian)
Figwortflower, Picrorhiza Rhizome (xuan hu lian)
Distribution分佈﹕
huang lian: Sichuan四川, Xizang 西藏, Hubei 湖北, Jiangxi 江西, Shanxi 陝西 , Shanxi 江西
xuan hu lian: Yunnan, Xizang, Nepal, India,
Properties (characteristics)性味:
bitter in taste; cool
苦 ， 寒 。
Channels (meridians) entered歸經：
heart, large intestine, liver, and stomach channels.
心﹐大腸﹐肝﹐胃。
Actions & Indications主治：
Relief heat toxicity, indigestion, diabetes, inflammation of intestine,  diarrhea caused by bacterial infection, high fever, restlessness and insomnia, spitting blood, nose bleeding due to heat in blood, red eyes and excess stomach acid, tooth ache, boils.
External uses: inflammation of the cornea,  middle ear infection, ulceration of tongue and mouth, external ear infection and eczema.
Jiu huang lian: for heat in the upper part of the body like red eyes, sores in the mouth.
Jiang huang lian: for clearing the stomach, stop vomiting; for coldness and heat intertwined in the abdomen area.
Yu huang lian: for relieving the liver, stop vomiting; for liver and stomach not in harmony, vomiting and excess stomach acid.
用於濕熱肝脾腫脹，黃疸，消化不良﹐糖尿病﹐嘔吐瀉痢，高熱神昏﹐心火亢盛﹐心煩不寐 ，
血熱吐衄，目赤吞酸，牙痛，癱腫疔瘡。
外治: 濕疹，濕瘡，耳道流膿。
酒黃連﹕清上焦火熱。用於目赤，口瘡 。
薑黃連﹕清胃和胃止嘔。用於寒熱互結，瀛熱中阻，痞滿嘔吐。
萸黃連﹕舒肝和胃止嘔。用於肝胃不和，嘔吐吞酸。
Medical function药理：
1. antibiotic and anti-amoeba
2. effect on heart and blood vessels
(1) small amount improves coronary blood vessel circulation while large amount suppresses it.
(2) protects heart muscles in case of lack of blood circulation and anti arrhythmia.
(3) relaxes blood vessels
(4) anti palette coagulation
(5) shrinks red blood cells
(6) lowers blood sugar
3. small amount improves function of acetylcholine while large amount suppresses it.
4. decoction of huang lian 5mg/ml/1 hr, kills 99.8% of H. pylori in vitro.[1]
Huang lian possesses calcium channel blocker and it can prolong purkinje′s fibre
黃連具有鈣離子通道阻滯作用，可以延長蒲肯野纖維和心
室肌細胞的動作電位時間和有效不應期[2]
黃連屬第三類抗心律失常藥，且沒有發現其致心律失
常和明顯副作用[3]
Samples of formulae處方舉例：
huang lian e jiao tang 黃連阿膠湯
san huang xie xin tang 三黄瀉心湯
Chemical ingredients化學成份：
erberine C20H17NO3 小檗碱
colchicine  C21H25NO5 秋水仙胺
coptisine C19H15NO5 黃連鹹
worenine C21H15NO4 甲基川連鹼
palmatine C22HC24 H24O5 N.OHO5NOH 棕鹼
jatrorrhizine 藥根碱
magnoflorine 木蘭鹼
See:Chemical ingredients of  xian hu lian
Dosage用量：
1.5 to 20 g. Concentrated extract: 0.5 g to 2 g.
1.5～20克；濃縮中藥：0.5～2 克
Toxicity不良反應：
It is being used in wind heat type of cold or flu. Not to to be used  in cases of wind cold type type of cold or flu and deficient type of syndromes.
Normal dosage is relatively safe with few side effects and no adverse effects from long term use. Large dosage can be toxic.
Not to use in patients with glucose-6-phosphate dehydrogenase deficiency.
Clinical experiences and laboratory studies show that the toxic reactions include:
1. acute deprivation of oxygen of the brain due to cardiac function
2. shock due to allergenic reaction
3. rash
4. dizziness, tinnitus, nausea, vomiting, anxiety and fright, short of breath, joint pain
5. diarrhea, flatulence, rumbling noise in the intestines, frequent urination
6. decrease of heme and blood cells
7. report of sudden stoppage of circulation and breathing due to venous feeding of injectiones of huang lian
患有葡萄糖-六-磷酸鹽去氫酵素缺乏症(蠶豆 症)之病人忌用。
只適用於風熱感冒和實熱性病証。不可用於風 寒感冒和虛寒証。
臨床和實驗研究表明，本品有以下毒副反應：[1]
1. 急性心源性腦缺氧综合征；
2. 過敏性休克；
3. 麻疹样药疹和荨麻疹型药疹；
4. 頭晕,耳鳴,惡心,嘔吐,心慌,氣短,關節痛等；
5. 腹瀉,腹脹,腸鳴,多尿；
6. 血色素及血细胞减少。
7. 静滴黄連素曾引致三例循環呼吸骤停。


[1]四 川省农业信息工程技术研究中心
Chemical ingredients of hu huang liang (Picrorhiza scrophularfifolia Pennell)胡黃連化學成份﹕
Roots of  Picrorhiza scrophularfifolia Pennell contain:
胡黄連根含:
Kutkin 3.4%*
胡黄連素 3.4%*
D—Mannitol 0．5%
D—甘露醇 0．5%
Vanillic acid 0．1%
香 荚藍酸  0．1%
Kutkiol
胡黄連醇
Kutkisterol 0.18％
黄連甾醇 0.18％
Apocynin
香荚藍乙酮
Kutkin is not a simple chemical compound, it is:
胡黄連素并不是一个的 簡單化合物, 它是﹕
a stable crystalized mixture of Picroside  I and Kutkoside and contains Picroside  II
胡黄連苦甙I和胡黄連甙的稳定混晶, 並含﹕胡黄連苦甙Ⅱ
Fruits contain:
果實含:
vitamin C
抗壞血酸
sugar
糖类
starch
澱粉
protein
蛋白質
Roots and stems contain:
根茎含:
iridoid glycoside. The ingredients are: picroside  I﹐II﹐III
環烯醚萜甙成分為胡黄連甙I﹐II﹐III
free organic acid: Vanillic Acid, Cinnamic acid and  ferulic acid.
游离有机酸，主要為香草酸﹐桂皮酸﹐阿魏酸。


Hu huang lian belongs to controlled material of CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora),  under append. II (permit required for import and export trade):  
胡黃連屬於《華約》附錄二品種 管 制的藥材種類。  須 按 預先申請的許可証進行貿易 。
[1] 劉波 李雪駝 等. 中國科學院大連化學 物理研究所生物技術部,大連116023
[2] 馬英，朱飛奇．黃連素的藥理研究進展及在心血管、神經系
統疾病的應用前景[J]．鄖陽醫學院學報，2006，25(6)：377
[3] Zong XH， Zeng XJ， LiYY， et a1． Efficacy and safety of berberine for congestive hean failure secondary to ischemic or idiopathic dilated cardiomyopathy [J ]． Am J Cardiol，2003，92 (2)：173—176

Formula 14 for Benign Neoplasm of Brain

Formula 14 for Benign Neoplasm of Brain/ Chinese Herbs Therapy


Syndrome:
弦脈 tight pulse


Composition:
大柴胡湯乙4g
吳茱萸湯 wu zhu yu tang 2g
天麻粉 tian ma powder 2g
肉桂粉 rou gui powder 0.5g
丹參 dan shen 1g
厚朴 hou po 3.5g
細辛 xi xin 2g
黃連 huang lian 1g
乾薑 gan jiang 1g

TAKEPRON OD TAB 30MG 泰克胃通口溶錠

醫令碼          20767
健保碼          B024273100
商品名          TAKEPRON OD 30MG (高劑量)
藥品許可證      衛署藥輸字第024273號
中文名          泰克胃通口溶錠
健保局藥理類別  560900 氫離子幫浦抑制劑
學名            Lansoprazole
類別            PHR
劑量            TAB
仿單            TAKEPRON OD-說明書
孕婦用藥分級    B 級：在對照的動物生殖研究試驗中未顯示該藥物有胚胎毒性，但尚無完整的人體懷孕婦女研究試驗資料；或者在動物生殖對照研究試驗中發現該藥物有不良反應（大於降低生育力之反應），但在對照的人體懷孕婦女研究試驗中，未顯示該藥物有胚胎毒性。
結構式        2-[(3-methyl-4-(2,2,2-trifluoroethoxy) pyridin-2-yl) methylsulfinyl] -1H-benzoimidazole
藥理作用 本製劑主要是藉著抑制存在於胃黏膜上壁細胞的質子幫浦(Protopump)，亦即抑制(H+K)-ATPase的活性，故能強力且持續地抑制胃酸分泌。其藥效藥理包括：(1)(H+ K+)-ATpase活性抑制作用(2)壁細胞酸生成抑制作用(3)胃酸分泌抑制作用(4)慢性潰瘍的治癒促進作用(5)潰瘍形成的抑制作用。
適應症        胃潰瘍、十二指腸潰瘍、逆流性食道炎、ZOLLINGER-ELLISON症侯群，合併抗生素治療與幽門螺旋桿菌(HELICOBACTER PYLORI)相關的消化性潰瘍。
用法用量 通常，成人每天1次，口服lansoprazole 30mg。治療胃潰瘍和逆流性食炎通常須連續服用8週，治療十二指腸潰瘍須連續服用6週。
藥動力學 >>>>>
Absorption：Absorption is rapid. T max is approximately 1.7 h. C max and AUC are approximately proportional in doses from 15 to 60 mg single dose administration. Absolute bioavailability is over 80%. C max and AUC decrease 50% if given 30 min after food.
Distribution：Protein binding (97%) is constant over the concentration range of 0.05 to 5 mcg/mL.
Metabolism：Extensively metabolized in the liver. Metabolites are hydroxylated sulfonyl and sulfone derivatives (very little activity).
Elimination：Significant biliary excretion of the metabolites. Mean t ½ is 1.9 to 2.9 h.
Special Populations：
Hepatic Function Impairment：
Mean t ½ prolonged to 3.2 to 7.2 h and AUC increased up to 500%; dose reduction is recommended in severe hepatic disease.
Elderly：Cl is decreased with t ½ increasing approximately 50% to 100%. Because mean t ½ remains between 1.9 to 2.9 h, repeated once daily dosing does not accumulate; no adjustment needed.
副作用        >>>>>
1. 過敏症：偶有發疹，瘙癢等症狀，如出現上述症狀時，請中止投與
2. 肝臟：偶有GOT、GPT、ALP、LDH、γ-GTP上昇等現象，所以須細心觀察，如有異常現象出現應採取停藥等適當的處置。
3. 血液：偶有貧血，白血液減少，嗜酸球增多等症狀、血小板減少之症狀極少發生。
4. 消化器：偶有便秘、下痢、口渴、腹脹等症狀。
5. 精神神經系：偶有頭痛、嗜睡等症狀、失眠、頭暈等症狀極少發生。
6. 其他：偶有發熱，總膽固醇上昇，尿酸上昇等症狀。
交互作用 >>>>>
Digoxin 
Increased digoxin absorption, leading to elevated levels and increased risk of toxicity may occur.
Ketoconazole 
Effects may be decreased by lansoprazole.
Sucralfate 
May delay and reduce absorption; give lansoprazole at least 30 min before sucralfate.
禁忌        對本品過敏者。
給付規定 >>>>>
7.1消化性潰瘍用藥：
1.藥品種類：
(1)制酸懸浮劑：
各廠牌瓶裝、袋裝制酸懸浮劑及袋裝顆粒制酸劑。
(2)乙型組織胺受體阻斷劑：
各廠牌乙型組織胺受體阻斷劑之口服製劑與針劑。
(3)氫離子幫浦阻斷劑：
各廠牌氫離子幫浦阻斷劑。
(4)細胞保護劑：如gefarnate、cetraxate、carbenoxolone等。
(5)其他消化性潰瘍用藥：
dibismuth trioxide, sucralfate, pirenzepine HCl, Gaspin, Caved-S, misoprostol, proglumide及其他未列入之同類藥品，價格與其相當者比照辦理。
2.使用規定：
(1) 使用於治療活動性（active）或癒合中（healing）之消化性潰瘍及逆流性食道炎。(92/10/1)
(2) 瘢痕期（scar stage）之消化性潰瘍復發預防，其劑量依照醫理減量使用。
(3) 消化性潰瘍及逆流性食道炎符合洛杉磯食道炎分級表（The Los Angeles Classification of Esophagitis※備註）Grade A或Grade B者，欲使用消化性潰瘍用藥，其使用期間以四個月為限，申報費用時需檢附四個月內有效之上消化道內視鏡檢查或上消化道Ｘ光攝影報告，其針劑限使用於消化道出血不能口服之病人急性期替代療法。(92/10/1)
(4)經上消化道內視鏡檢查，診斷為重度逆流性食道炎，且符合洛杉磯食道炎分級表（The Los Angeles Classification of Esophagitis※備註）Grade C或Grade D者，得經消化系專科醫師之確認後可長期使用消化性潰瘍用藥一年。另外，下列病患得比照辦理：(92/10/1)
Ⅰ胃切除手術縫接處產生之潰瘍。
Ⅱ經消化系專科醫師重覆多次（三次以上）上消化道內視鏡檢查確認屬難治癒性之潰瘍。經診斷確定為Zollinger-Ellision症候群之病患，得長期使用氫離子幫浦阻斷劑而不受一年之限制。
(5)需使用NSAIDs而曾經上消化道內視鏡或Ｘ光攝影證實有過潰瘍，得於使用NSAIDs期間內，經消化系專科醫師之確認後可使用消化性潰瘍用藥。(92/10/1)
(6)對於症狀擬似逆流性食道炎之患者，但其上消化道內視鏡檢查無異常，若欲使用消化性潰瘍用藥，則需檢附其他相關檢查（如24小時pH監測）的結果。(92/10/1)
(7)消化性潰瘍穿孔病人經手術證實者，且所施手術僅為單純縫合，未作胃酸抑制相關手術者，可檢附手術記錄或病理檢驗報告，申請使用消化性潰瘍用藥，但以四個月內為限，如需繼續使用，仍請檢附胃鏡檢查或上腸胃道Ｘ光檢查四個月內有效報告影本。(92/10/1)
(8)嚴重外傷、大手術、腦手術、嚴重燙傷、休克、嚴重胰臟炎及急性腦中風者為預防壓力性潰瘍，得使用消化性潰瘍藥品。此類藥物之針劑限使用於不能口服之前述病患短期替代療法。
(9)消化性潰瘍病患得進行初次幽門螺旋桿菌消除治療，使用時需檢附上消化道內視鏡檢查或上消化道Ｘ光攝影報告並註明初次治療。(92/10/1)
(10)幽門螺旋桿菌之消除治療療程以二週為原則，特殊病例需延長治療或再次治療，需檢附相關檢驗報告說明理由。
(11)下列病患若因長期服用NSAIDs而需使用前列腺素劑(如misoprostol)，得免附胃鏡報告，惟需事前報准後使用（刪除）：(99/7/1)
Ⅰ紅斑性狼瘡。
Ⅱ五十歲以上罹患類風濕性關節炎或僵直性脊椎炎之病患。
注意事項 >>>>>
1. 對孕婦或有可能懷孕之婦女，須事先判斷治療上之有益性勝過危險性，始可投與。
2. 本藥品不適合用於正在哺乳中的婦女，如不得已需服藥時，應避免哺乳。
3. 對孕婦及哺乳婦的投與：(1)對孕婦或有可懷孕之婦女，須事先判決治療上之有益勝過危險性，始可投與。(2)本藥品不適合用於正在哺乳的婦女，如不得已需服藥時，應避免哺乳。
4. 服用時，因為本藥會隱蔽由胃癌所引起之症狀，所以須先確認非惡性胃癌始可給藥。
藥品保存方式 藥品應置於攝氏 15 ~ 25 度乾燥處所；如發生變質或過期，不可再食用。

Lexapro tab 10mg 立普能膜衣錠

製造商 H Lundbeck
代理/經銷商 Hoan Pharmaceuticals
成份 Escitalopram (oxalate)
適應症 Treatment of major depressive episodes. Treatment of social anxiety disorder (social phobia). Treatment of generalised anxiety disorder. Treatment of obsessive-compulsive disorder (OCD).
用量 Social anxiety disorder 10 mg once daily for 2-4 weeks. Dose may be adjusted to 5 mg or max 20 mg daily. Treatment for 3 months is recommended. Generalised anxiety disorder 10 mg once daily; may be increased to max 20 mg daily. OCD 10 mg once daily; may be increased to max 20 mg daily. Duration may be several months or longer.
過量 View Lexapro[立普能] overdosage for action to be taken in the event of an overdose.
用法 May be taken with or without food
美國食品藥物管理局之懷孕等級
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
禁忌 Concomitant treatment with non-selective, irreversible MAOIs.
注意事項 Paradoxical anxiety, unstable epilepsy, history of mania/hypomania, suicide, patients at risk of developing hyponatraemia, concurrent administration with electroconvulsive therapy, patients with bleeding tendencies, coronary heart disease, pregnancy & lactation. Concomitant administration with oral anticoagulants, drugs affecting platelet function, drugs with serotonergic effects or St John's Wort. May alter glycaemic control in patients with diabetes. Careful monitoring of patients with controlled epilepsy advised. Avoid abrupt withdrawal. Use in children & adolescents < 18 yr is not recommended.
不良反應 Appetite decreased, libido decreased, anorgasmia (female), insomnia, somnolence, dizziness, sinusitis, yawning, nausea, diarrhoea, constipation, sweating increased, ejaculation disorder, impotence, fatigue, pyrexia. Rarely, hyponatraemia, seizures, ecchymoses.
View ADR Monitoring Website[參閱藥物不良反應監測表格]
交互作用 MAOIs, selegiline, serotonergic drugs (e.g. tramadol, sumatriptan & other triptans), drugs which lower the seizure threshold, lithium, tryptophan, St John's Wort, oral anticoagulants, alcohol.
View more drug interactions with Lexapro[立普能]
儲存 View Lexapro[立普能] storage conditions for details to ensure optimal shelf-life.
描述 View Lexapro[立普能] description for details of the chemical structure and excipients (inactive components).
作用 View Lexapro[立普能] mechanism of action for pharmacodynamics and pharmacokinetics details.
MIMS 藥理分類 抗憂鬱藥 (Antidepressants)
ATC 分類 N06AB10 - escitalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.