2009年5月24日 星期日
十大育種公司
杜邦（Dupout美国）、孟山都（Momsanto美国）、先正达（Syngenta瑞士）、 利马格兰（Limagrain法国）、圣尼斯（Seminis墨西哥）、 埃德瓦塔（Advanta荷兰）、 道化工（Dow美国）、 KWS AG公司（德国）、 Delta & Pine Land 公司（美国）、 Aventis 公司（德国），美国占十分之四，且第一、第二的是美国公司。杜邦公司在世界500强公司里排第47位， 1999年以77亿美元兼并了世界排名第一的种子公司--美国先锋种子公司，开始涉足种业， 2000年种子销售额为19.38亿美元，主要种子业务是玉米，约占全球杂交玉米种子市场的43%。2005年，杜邦先锋的销售收入大约是20亿美元。这个数字差不多是整个中国种子产业一年销售总额的3倍。
2009年4月16日 星期四
捷運上的愛情劇場
多年前的一個晚上,我正獨自搭著捷運回家
那時我特地坐在最後車廂
到了後面的站比較容易有位置
終於車箱裡只剩我和一對情侶了
他們倆站在離我一小段距離的空間
但車廂內的寧靜還是讓他們的對話變得很清楚
兩人不時勾勾手,聊聊天
此時女生問
[你喜不喜歡我啊~~?]
此時我內心苦悶的OS:真是另人害羞的小情人啊~~
男:[嗯~~]
女:[到底是喜不喜歡嗎?]
男:[喜歡啊~~]
此時女生突然把手鬆開,低下頭說:[可是我不喜歡你了...]
什麼!?他們該不會要在這邊說分手吧!?
我感覺到有一股視線看過來我這邊
於是我趕緊裝睡避免尷尬
你們要分手要合好自便吧~~
此時我聽到女生甜甜的說
[因為我現在是很愛很愛你喔!]
我的身體不慎滑落了一下
...很晚了,乖孩子該睡了 不要再開這種肉麻又無聊的玩笑了好嗎?
我內心有些許不悅
兩人繼續打情罵俏著,我則盡量想其他的事
女:[XX站快要到了,你快要下車了吧?]
我內心os:哼哼,原來這男的跟我住很近呢...
男:[嗯,那你回家後還會一直想著我嗎?]
女:[會啊,你呢?]
OS:XX站怎麼還不快到啊!?
男:[嗯,有時候也會想著別人啦...]
女:[什麼? 是誰!!]
OS:哼哼,這男的看來也是條漢子,說話倒是挺誠實的
男:[我在想我們以後的孩子會長什麼樣子啊.]
天啊!! 我按捺著自己心中的怒意輕輕咳了一聲...
怎麼可以這麼閃
車上還有我耶!
終於,XX站到了
我內心的惡魔讓我想看看他們道別時的樣子
奇怪? 沒人下車
車門又再度關上了...
女:[你怎麼不下車...?] 但兩人的手還是勾著
男:[我想多陪你一下,我待會再自己坐回去就好了.]
真是太感人了...連我都覺得自己之前的嫉妒和惡意感到汗顏
願天下有情人終成眷屬啊~~
我內心響起了美妙的樂章
但突然一個想法打斷了演奏
我站起來驚呼了一聲
兩人都不解的望向我
不知是太入戲了還是內心起了反抗意識
我自顧自的回答
[你要陪她我不用啊.我為什麼沒下車?]
那時我特地坐在最後車廂
到了後面的站比較容易有位置
終於車箱裡只剩我和一對情侶了
他們倆站在離我一小段距離的空間
但車廂內的寧靜還是讓他們的對話變得很清楚
兩人不時勾勾手,聊聊天
此時女生問
[你喜不喜歡我啊~~?]
此時我內心苦悶的OS:真是另人害羞的小情人啊~~
男:[嗯~~]
女:[到底是喜不喜歡嗎?]
男:[喜歡啊~~]
此時女生突然把手鬆開,低下頭說:[可是我不喜歡你了...]
什麼!?他們該不會要在這邊說分手吧!?
我感覺到有一股視線看過來我這邊
於是我趕緊裝睡避免尷尬
你們要分手要合好自便吧~~
此時我聽到女生甜甜的說
[因為我現在是很愛很愛你喔!]
我的身體不慎滑落了一下
...很晚了,乖孩子該睡了 不要再開這種肉麻又無聊的玩笑了好嗎?
我內心有些許不悅
兩人繼續打情罵俏著,我則盡量想其他的事
女:[XX站快要到了,你快要下車了吧?]
我內心os:哼哼,原來這男的跟我住很近呢...
男:[嗯,那你回家後還會一直想著我嗎?]
女:[會啊,你呢?]
OS:XX站怎麼還不快到啊!?
男:[嗯,有時候也會想著別人啦...]
女:[什麼? 是誰!!]
OS:哼哼,這男的看來也是條漢子,說話倒是挺誠實的
男:[我在想我們以後的孩子會長什麼樣子啊.]
天啊!! 我按捺著自己心中的怒意輕輕咳了一聲...
怎麼可以這麼閃
車上還有我耶!
終於,XX站到了
我內心的惡魔讓我想看看他們道別時的樣子
奇怪? 沒人下車
車門又再度關上了...
女:[你怎麼不下車...?] 但兩人的手還是勾著
男:[我想多陪你一下,我待會再自己坐回去就好了.]
真是太感人了...連我都覺得自己之前的嫉妒和惡意感到汗顏
願天下有情人終成眷屬啊~~
我內心響起了美妙的樂章
但突然一個想法打斷了演奏
我站起來驚呼了一聲
兩人都不解的望向我
不知是太入戲了還是內心起了反抗意識
我自顧自的回答
[你要陪她我不用啊.我為什麼沒下車?]
2009年4月3日 星期五
Alprazolam
Alprazolam
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Alprazolam
Systematic (IUPAC) name
8-chloro-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepine
Identifiers
CAS number
28981-97-7
ATC code
N05BA12
PubChem
2118
DrugBank
APRD00280
ChemSpider
2034
Chemical data
Formula
C17H13ClN4
Mol. mass
308.765
Pharmacokinetic data
Bioavailability
80-90%
Metabolism
Hepatic, via Cytochrome P450 3A4
Half life
Immediate release: 11.2 hours;[1] Extended release: 10.7-15.8 hours[2]
Excretion
Renal
Therapeutic considerations
Pregnancy cat.
D(US)
Legal status
Schedule IV(US)
Routes
Oral
Alprazolam, also known under the trade names Xanax, Xanor and Niravam, is a short-acting drug of the benzodiazepine class used to treat moderate to severe anxiety disorders, panic attacks, and as an adjunctive treatment for anxiety associated with moderate depression. It is also available in an extended release form, Xanax XR. Both forms are now available generically. Alprazolam possesses anxiolytic, sedative, hypnotic, anticonvulsant and muscle relaxant properties.[3]
Alprazolam may be habit-forming and long term use and/or abuse may cause a physical dependence to develop along with withdrawal reactions during abrupt or rapid discontinuation. In the USA, alprazolam is a schedule IV controlled substance under the Controlled Substances Act.[4]
Contents[hide]
1 History
2 Pharmacology
3 Pharmacokinetics
4 Indications
5 Side effects
6 Contraindications
7 Food and drug interactions
8 Physical dependence and withdrawal
9 Recreational use
9.1 Patients at a high risk for abuse and addiction
10 Overdose
11 Availability
12 Legal status
13 See also
14 References
//
[edit] History
Alprazolam was first synthesized by Upjohn (now a part of Pfizer). It is covered under U.S. Patent 3,987,052 , which was filed on October 29, 1969, granted on October 19, 1976 and expired in September 1993. Alprazolam was released in 1981.[5][6] The first approved indication was panic disorder. Upjohn took this direction at the behest of a young psychiatrist David Sheehan. Sheehan's suggestion was to use the new distinction the DSM-III created in the classification of anxiety disorders between generalized anxiety disorder (GAD) and panic disorder in order to market alprazolam specifically for the latter. Panic disorder was, at that point, perceived to be rare and treatable only with tricyclic antidepressants; benzodiazepines were thought to be ineffective. However, from his clinical experience, Sheehan knew panic disorder to be both widespread among the populace and responsive to benzodiazepines. He suggested to Upjohn that marketing alprazolam for panic disorder would both cover new diagnostic territory and emphasize the unique potency of this drug. Sheehan describes that the first group of patients treated by alprazolam was so impressed by its action that they knew outright—this drug was going to be a hit. A few of those patients actually pooled their money and purchased stock in Upjohn. Several months later, when alprazolam was approved by the FDA, they sold out and made a profit.[7]
Alprazolam has an exceptional history insofar as soon after its introduction a large number of case reports were published in the medical literature of severe withdrawal symptom-related case reports of psychoses, seizures and intense rebound anxiety upon discontinuation of alprazolam.[8]
[edit] Pharmacology
Alprazolam is classed as a high potency benzodiazepine and is a triazolobenzodiazepine,[9][10] that is, a benzodiazepine with a triazole ring attached to its structure. Benzodiazepines produce a variety of therapeutic and adverse effects by binding to the benzodiazepine site on the GABAA receptor and modulating the function of the GABA receptor, the most prolific inhibitory receptor within the brain. The GABA chemical and receptor system produces inhibitory or calming effects of alprazolam on the nervous system. The GABAA receptor is made up from 5 subunits out of a possible 19, and GABAA receptors made up of different combinations of subunits have different properties, different locations within the brain and importantly, different activities in regards to benzodiazepines.[11][12]
[edit] Pharmacokinetics
Alprazolam is readily absorbed from the gastrointestinal tract with a bioavailability of 80–100%. The peak plasma concentration is achieved in 1–2 hours. Most of the drug is bound to plasma protein, mainly serum albumin. Alprazolam is hydroxylated in the liver to α-hydroxyalprazolam, which is also pharmacologically active but much less so than the parent compound. This and other metabolites are later excreted in urine as glucuronides. Some of the drug is also excreted in unchanged form. The elderly clear alprazolam more slowly than younger adults.[13]
[edit] Indications
The main medical uses for alprazolam include:
Panic disorder
Alprazolam is FDA-approved for the short term treatment (up to 8 weeks) of panic disorder, with or without agoraphobia. Alprazolam is very effective in treating moderate to severe anxiety, essential tremor and panic attacks. Physicians who elect to prescribe alprazolam for longer than 8 weeks should be aware that continued efficacy has not been systematically demonstrated beyond 8 weeks use as tolerance to alprazolam's effects may occur after 8 weeks and necessitate discontinuation or physician-directed dose escalation.[14] However, patients with panic disorder have been treated on an open basis for up to 8 months without apparent loss of benefit. The physician should periodically reassess the usefulness of the drug for the individual patient.[15]
Anxiety disorder
Alprazolam is indicated for the management of anxiety disorder (a condition corresponding most closely to the APA Diagnostic and Statistical Manual DSM-III-R diagnosis of generalized anxiety disorder) or the short-term relief of symptoms of anxiety.[15] Alprazolam is recommended for the short-term treatment (2–4 weeks) of severe acute anxiety. Alprazolam should only very rarely be used for longer periods of time – the body becomes rapidly tolerant to the drug's effects, which may translate to decreased efficacy.[16][17]
Alprazolam is sometimes prescribed for anxiety with associated depression. There is some evidence for antidepressant treatment of clinical depression in outpatient settings, evidence for inpatients is lacking.[18] The antidepressant effects of alprazolam may be due to its effects on beta-adrenergic receptors.[19] Other benzodiazepines are not known to have antidepressant activity.[20][21] Studies show that any antidepressant action of alprazolam is questionable and generally weak in comparison to antidepressant medications.[22][23][24][25] Conversely, whilst alprazolam in acute or short term treatment may have some antidepressant properties there is evidence that up to a third of long term users of alprazolam may develop depression.[26]
[edit] Side effects
Although the side effect profile of alprazolam is generally benign, side effects may occur in some patients and are more likely the higher the dosage taken. Some side effects may disappear with continued treatment. If signs of an allergic reaction occur such as hives, difficulty breathing, swelling of face, lips, tongue or throat occur, medical attention should be sought immediately. Medical attention should also be sought immediately if signs of jaundice appear such as yellowing of the skin or eyes. Other side effects which may occur are as follows:
euphoria (infrequent)[27]
drowsiness (common), dizziness (common), lightheadedness (common), fatigue, unsteadiness and impaired coordination, vertigo[28][29]
skin rash (rare), respiratory depression, constipation (common)[28][29]
disinhibition (infrequent)[30]
suicidal ideation (rare)[31][32]
urinary retention (infrequent)[33]
hallucinations (rare)[34]
ataxia, slurred speech[35]
short-term memory loss and impairment of memory functions[36]
anterograde amnesia[37] and concentration problems
decreased or increased libido[38]
dry mouth (infrequent) [39]
increase in appetite[40]
jaundice (very rare)[41]
Paradoxical Reactions
Although unusual, if the following paradoxical reactions occur, the prescribing physician or other healthcare profressional should be alerted and the medication gradually discontinued:
muscle twitching and tremor[42]
aggression [43]
rage, hostility[44]
mania, agitation, hyperactivity and restlessness[45][46][47]
[edit] Contraindications
Use of alprazolam should be avoided,carefully monitored by medical professionals, in individuals with the following conditions: Myasthenia gravis, acute narrow-angle glaucoma, severe liver deficiencies (e.g., cirrhosis), severe sleep apnea, pre-existing respiratory depression, marked neuromuscular respiratory weakness including unstable myasthenia gravis, acute pulmonary insufficiency, chronic psychosis, hypersensitivity or allergy to alprazolam or other drugs in the benzodiazepine class, borderline personality disorder (may induce suicidality and dyscontrol).[48][49][50][51]
Women who are pregnant or are planning on becoming pregnant should avoid starting alprazolam.[52] It should be considered that the child born of a mother who is receiving benzodiazepines may be at risk of developing withdrawal reactions during the postnatal period. Also, neonatal flaccidity and respiratory problems have been reported in children born of mothers who have been receiving benzodiazepines.[53]
Benzodiazepines, including alprazolam are known to be excreted in human milk.[54] Chronic administration of diazepam to nursing mothers has been reported to cause their infants to become lethargic and to lose weight.[55][56] As a general rule, nursing should not be undertaken by mothers who use alprazolam.
Elderly individuals should be cautious in the use of alprazolam due to the possibility of increased susceptibility to side effects, especially loss of coordination and drowsiness.[56]
Like all central nervous system depressants, including alcohol, alprazolam in larger than normal doses can cause significant deterioration in alertness, combined with increased feelings of drowsiness, especially in those unaccustomed to the drug's effects.[57] People driving or conducting activities which require vigilance should exercise caution in using alprazolam or any other depressant.
[edit] Food and drug interactions
Cimetidine, erythromycin, fluoxetine, fluvoxamine, itraconazole, ketoconazole, nefazodone, propoxyphene and ritonavir all interact with alprazolam leading to a delayed clearance of alprazolam which may result in excessive accumulation of alprazolam. This may result in excessive sedation and other adverse effects associated with excessive intake of alprazolam.[13][58]
Imipramine and desipramine have been reported to be increased an average of 31% and 20%, respectively, by the concomitant administration of alprazolam tablets in doses up to 4 mg/day.[59] Oral contraceptive pills reduce the clearance of alprazolam, which may lead to increased plasma levels of alprazolam and accumulation.[60]
Alcohol is one of the most important and common interactions. Alcohol and benzodiazepines such as alprazolam taken in combination have a synergistic effect on one another which can cause severe sedation, behavioral changes and intoxication. The more alcohol and alprazolam taken the worse the interaction.[61]
[edit] Physical dependence and withdrawal
See also: Benzodiazepine withdrawal syndrome
Alprazolam, like other benzodiazepines, binds to specific sites on the GABAA gamma-amino-butyric acid receptor. When bound to these sites, which are referred to as benzodiazepine receptors, it modulates the effect of GABA A receptors and thus GABAnergic neurons. Long-term use causes adaptive changes in the benzodiazepine receptors, making them less sensitive to stimulation and less powerful in their effects.[62]
Not all withdrawal effects are evidence of true dependence or withdrawal. Recurrence of symptoms such as anxiety may simply indicate that the drug was having its expected anti-anxiety effect and that, in the absence of the drug, the symptom has returned to pretreatment levels. If the symptoms are more severe or frequent, the patient may be experiencing a rebound effect due to the removal of the drug. Either of these can occur without the patient actually being drug-dependent.[62]
Alprazolam and other benzodiazepines may also cause the development of physical dependence, tolerance and benzodiazepine withdrawal symptoms during rapid dose reduction or cessation of therapy after long-term treatment.[63][64] There is a higher chance of withdrawal reactions if the drug is administered in a higher dosage than recommended, or if a patient stops taking the medication altogether without slowly allowing the body to adjust to a lower dosage regimen.[65][66][67]
In 1992 Romach and colleagues reported that dose escalation was not a characteristic of long-term alprazolam users, and the majority of patients indicated that alprazolam continued to be effective, suggesting that tolerance to the anti-anxiety effect is limited.[68]
If a patient feels the need to end treatment with alprazolam, they should consult their physician before discontinuing the medication. Some common symptoms of alprazolam discontinuation include: tachycardia, dysphoria, dry mouth, loss of appetite, insomnia, anxiety, dizziness, tremors, nausea, cramps, vomiting, diarrhea, panic attacks, mood swings, heart palpitations, memory loss. Less common and more severe reactions can occur including hallucinations, seizures or fever[69]
Patients taking a dosing regimen larger than 4 mg per day have an increased potential for dependence. This medication may cause withdrawal symptoms upon abrupt withdrawal or rapid tapering, which in some cases have been known to cause seizures. The discontinuation of this medication may also cause a reaction called rebound anxiety. Other withdrawal effects reported from discontinuing alprazolam therapy include homicidal ideation (very rare), rage reactions, hyperalertness, vivid dreams and intrusive thoughts.[70] Grand mal seizures have occurred after abrupt withdrawal after only short term use. Therefore even short term users of alprazolam should taper off of their medication slowly to avoid serious withdrawal reactions including seizures.[71][72]
Alprazolam should never be abruptly stopped if taken regularly for any length of time because severe withdrawal symptoms may occur. Severe psychosis and seizures have been reported in the medical literature from abrupt alprazolam discontinuation,[73][74] and one death occurred from withdrawal-related seizures after gradual dose reduction.[74]
In a 1983 study of patients who had taken long acting benzodiazepines ie clorazepate for extended periods, the medications were stopped abruptly under double-blind conditions (that is, patients were receiving either placebo or the same drug they had been taking). Only 5% of patients who had been taking the drug for less than 8 months demonstrated withdrawal symptoms, but 43% of those who had been taking them for more than 8 months did, whereas with alprazolam a short acting benzodiazepine taken for 8 weeks 35% of patients experienced significant rebound anxiety. To some degree these older benzodiazepines are self-tapering.[75]
The benzodiazepines diazepam (Valium) and oxazepam (Serepax) have been found to produce less withdrawal reactions than alprazolam (Xanax) or lorazepam (Temesta/Ativan). Factors which determine the risk of psychological dependence or physical dependence and the severity of the benzodiazepine withdrawal symptoms experienced during dose reduction of alprazolam include: dosage used, length of use, frequency of dosing, personality characteristics of the individual, previous use of cross dependent/cross tolerant drugs (alcohol or other sedative-hypnotic drugs), current use of cross dependent/cross tolerant drugs (alcohol or other sedative-hypnotic drugs), use of other short-acting, high potency benzodiazepines[8][76] and method of discontinuation.[77]
[edit] Recreational use
Sandoz generic 2mg alprazolam tablets.
Alprazolam has a relatively high potential for abuse.[78] Injection of alprazolam, though extremely rare, is considered especially dangerous by medical professionals[79] because, when crushed in water it will not fully dissolve (40 µg/ml of H2O at pH 7, and 12 mg/mL at pH 1.2 per 1 mg of alprazolam[80]), potentially causing severe damage to arteries if not filtered properly. While it is somewhat soluble in alcohol, the combination of the two, particularly when injected, has the potential to cause a serious, and potentially fatal overdose. Alprazolam may also be insufflated.[81] However, long-term use of benzodiazepines does not usually result in notable dose escalation and most prescribed alprazolam users do not abuse their medication.[82]
Alprazolam is sometimes used with other recreational drugs to relieve the panic or distress of dysphoric reactions to psychedelics such as LSD and also to promote sleep in the "come-down" period following use of recreational drugs with stimulant or insomniac properties (such as LSD, cocaine, amphetamines, DXM, and MDMA along with the related amphetamines). It is also often used in conjunction with marijuana or heroin to potentiate the relaxing effect.[83][84][85][86][87]
A large scale nation wide USA government study conducted by SAMHSA found that benzodiazepines in the USA are the most frequently abused pharmaceutical with 35% of drug related visits to the Emergency Department involving benzodiazepines. Benzodiazepines are more commonly abused than opiate pharmaceuticals which accounted for 32% of visits to the emergency department. No other pharmaceutical is more commonly abused than benzodiazepines, however, benzodiazepines remain in Schedule IV of the Controlled Substances Act, whereas opiates are much more strictly scheduled. Men abuse benzodiazepines as commonly as women. The report found that alprazolam is the most commonly abused benzodiazepine followed by clonazepam, lorazepam and then diazepam.[4]
[edit] Patients at a high risk for abuse and addiction
At a particularly high risk for misuse, abuse, and dependence are polydrug abusers (someone who already uses at least one substance in a recreational context). Patients with a history of alcoholism (including a family history of alcoholism) or drug abuse and/or dependence[88][89][90][91][92] and patients with borderline personality disorder are at increased risk of misusing alprazolam.[93]
[edit] Overdose
See also: Benzodiazepine overdose
Overdoses of alprazolam can be mild to severe depending on how much of the drug is taken and if any other depressants have been taken. Alprazolam is significantly more toxic in overdose than other benzodiazepines with higher rates of fatalities. A study in New Zealand found that alprazolam was almost 8 times more likely to result in death in overdose than other sedative hypnotics as a group, with higher rates of ICU admissions and mechanical ventilation. Combined overdose with tricyclic antidepressants, alcohol or opiates or overdoses of alprazolam in the elderly significantly increases the likelihood for severe toxicity and possible fatality.[94] Alprazolam (Xanax) overdose reflect the central nervous system depression of the brain and may include one or more of the following symptoms:[33]
Somnolence (difficulty staying awake)
Mental confusion
Hypotension
Impaired motor functions
Impaired or absent reflexes
Muscle weakness
Impaired balance
Dizziness
Fainting
Hypoventilation (Respiratory Depression)
Coma
Death
About 50% of the cases of death involving alprazolam were attributed to combined drug toxicity of alprazolam and another drug, most often cocaine and methadone. Only 1% of such deaths was attributed to alprazolam alone.[95][96]
[edit] Availability
Alprazolam is available in 0.25 mg, 0.5 mg, 1 mg and 2 mg strength oral, extended release or orally disintegrating tablets.[97]
Alprazolam is available in English-speaking countries under the following brand names:
Brand Names[98]
Alprax, Alprox, Alzam, Anxirid, Apo-Alpraz, Alzolam, Azor, Calmax, Gerax, Kalma, Niravam, Novo-Alprazol, Nu-Alpraz, Texidep, Xanax, Xanor, Zopax
[edit] Legal status
In the United States, alprazolam is a prescription drug and is assigned to Schedule IV of the Controlled Substances Act by the Drug Enforcement Administration.[99] Under the UK drug misuse classification system benzodiazepines are class C drugs.[100] Internationally, alprazolam is included under the United Nations Convention on Psychotropic Substances as Schedule IV.[101]
[edit] See also
Benzodiazepine
Benzodiazepine dependence
Benzodiazepine withdrawal syndrome
Long term effects of benzodiazepines
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Alprazolam
Systematic (IUPAC) name
8-chloro-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepine
Identifiers
CAS number
28981-97-7
ATC code
N05BA12
PubChem
2118
DrugBank
APRD00280
ChemSpider
2034
Chemical data
Formula
C17H13ClN4
Mol. mass
308.765
Pharmacokinetic data
Bioavailability
80-90%
Metabolism
Hepatic, via Cytochrome P450 3A4
Half life
Immediate release: 11.2 hours;[1] Extended release: 10.7-15.8 hours[2]
Excretion
Renal
Therapeutic considerations
Pregnancy cat.
D(US)
Legal status
Schedule IV(US)
Routes
Oral
Alprazolam, also known under the trade names Xanax, Xanor and Niravam, is a short-acting drug of the benzodiazepine class used to treat moderate to severe anxiety disorders, panic attacks, and as an adjunctive treatment for anxiety associated with moderate depression. It is also available in an extended release form, Xanax XR. Both forms are now available generically. Alprazolam possesses anxiolytic, sedative, hypnotic, anticonvulsant and muscle relaxant properties.[3]
Alprazolam may be habit-forming and long term use and/or abuse may cause a physical dependence to develop along with withdrawal reactions during abrupt or rapid discontinuation. In the USA, alprazolam is a schedule IV controlled substance under the Controlled Substances Act.[4]
Contents[hide]
1 History
2 Pharmacology
3 Pharmacokinetics
4 Indications
5 Side effects
6 Contraindications
7 Food and drug interactions
8 Physical dependence and withdrawal
9 Recreational use
9.1 Patients at a high risk for abuse and addiction
10 Overdose
11 Availability
12 Legal status
13 See also
14 References
//
[edit] History
Alprazolam was first synthesized by Upjohn (now a part of Pfizer). It is covered under U.S. Patent 3,987,052 , which was filed on October 29, 1969, granted on October 19, 1976 and expired in September 1993. Alprazolam was released in 1981.[5][6] The first approved indication was panic disorder. Upjohn took this direction at the behest of a young psychiatrist David Sheehan. Sheehan's suggestion was to use the new distinction the DSM-III created in the classification of anxiety disorders between generalized anxiety disorder (GAD) and panic disorder in order to market alprazolam specifically for the latter. Panic disorder was, at that point, perceived to be rare and treatable only with tricyclic antidepressants; benzodiazepines were thought to be ineffective. However, from his clinical experience, Sheehan knew panic disorder to be both widespread among the populace and responsive to benzodiazepines. He suggested to Upjohn that marketing alprazolam for panic disorder would both cover new diagnostic territory and emphasize the unique potency of this drug. Sheehan describes that the first group of patients treated by alprazolam was so impressed by its action that they knew outright—this drug was going to be a hit. A few of those patients actually pooled their money and purchased stock in Upjohn. Several months later, when alprazolam was approved by the FDA, they sold out and made a profit.[7]
Alprazolam has an exceptional history insofar as soon after its introduction a large number of case reports were published in the medical literature of severe withdrawal symptom-related case reports of psychoses, seizures and intense rebound anxiety upon discontinuation of alprazolam.[8]
[edit] Pharmacology
Alprazolam is classed as a high potency benzodiazepine and is a triazolobenzodiazepine,[9][10] that is, a benzodiazepine with a triazole ring attached to its structure. Benzodiazepines produce a variety of therapeutic and adverse effects by binding to the benzodiazepine site on the GABAA receptor and modulating the function of the GABA receptor, the most prolific inhibitory receptor within the brain. The GABA chemical and receptor system produces inhibitory or calming effects of alprazolam on the nervous system. The GABAA receptor is made up from 5 subunits out of a possible 19, and GABAA receptors made up of different combinations of subunits have different properties, different locations within the brain and importantly, different activities in regards to benzodiazepines.[11][12]
[edit] Pharmacokinetics
Alprazolam is readily absorbed from the gastrointestinal tract with a bioavailability of 80–100%. The peak plasma concentration is achieved in 1–2 hours. Most of the drug is bound to plasma protein, mainly serum albumin. Alprazolam is hydroxylated in the liver to α-hydroxyalprazolam, which is also pharmacologically active but much less so than the parent compound. This and other metabolites are later excreted in urine as glucuronides. Some of the drug is also excreted in unchanged form. The elderly clear alprazolam more slowly than younger adults.[13]
[edit] Indications
The main medical uses for alprazolam include:
Panic disorder
Alprazolam is FDA-approved for the short term treatment (up to 8 weeks) of panic disorder, with or without agoraphobia. Alprazolam is very effective in treating moderate to severe anxiety, essential tremor and panic attacks. Physicians who elect to prescribe alprazolam for longer than 8 weeks should be aware that continued efficacy has not been systematically demonstrated beyond 8 weeks use as tolerance to alprazolam's effects may occur after 8 weeks and necessitate discontinuation or physician-directed dose escalation.[14] However, patients with panic disorder have been treated on an open basis for up to 8 months without apparent loss of benefit. The physician should periodically reassess the usefulness of the drug for the individual patient.[15]
Anxiety disorder
Alprazolam is indicated for the management of anxiety disorder (a condition corresponding most closely to the APA Diagnostic and Statistical Manual DSM-III-R diagnosis of generalized anxiety disorder) or the short-term relief of symptoms of anxiety.[15] Alprazolam is recommended for the short-term treatment (2–4 weeks) of severe acute anxiety. Alprazolam should only very rarely be used for longer periods of time – the body becomes rapidly tolerant to the drug's effects, which may translate to decreased efficacy.[16][17]
Alprazolam is sometimes prescribed for anxiety with associated depression. There is some evidence for antidepressant treatment of clinical depression in outpatient settings, evidence for inpatients is lacking.[18] The antidepressant effects of alprazolam may be due to its effects on beta-adrenergic receptors.[19] Other benzodiazepines are not known to have antidepressant activity.[20][21] Studies show that any antidepressant action of alprazolam is questionable and generally weak in comparison to antidepressant medications.[22][23][24][25] Conversely, whilst alprazolam in acute or short term treatment may have some antidepressant properties there is evidence that up to a third of long term users of alprazolam may develop depression.[26]
[edit] Side effects
Although the side effect profile of alprazolam is generally benign, side effects may occur in some patients and are more likely the higher the dosage taken. Some side effects may disappear with continued treatment. If signs of an allergic reaction occur such as hives, difficulty breathing, swelling of face, lips, tongue or throat occur, medical attention should be sought immediately. Medical attention should also be sought immediately if signs of jaundice appear such as yellowing of the skin or eyes. Other side effects which may occur are as follows:
euphoria (infrequent)[27]
drowsiness (common), dizziness (common), lightheadedness (common), fatigue, unsteadiness and impaired coordination, vertigo[28][29]
skin rash (rare), respiratory depression, constipation (common)[28][29]
disinhibition (infrequent)[30]
suicidal ideation (rare)[31][32]
urinary retention (infrequent)[33]
hallucinations (rare)[34]
ataxia, slurred speech[35]
short-term memory loss and impairment of memory functions[36]
anterograde amnesia[37] and concentration problems
decreased or increased libido[38]
dry mouth (infrequent) [39]
increase in appetite[40]
jaundice (very rare)[41]
Paradoxical Reactions
Although unusual, if the following paradoxical reactions occur, the prescribing physician or other healthcare profressional should be alerted and the medication gradually discontinued:
muscle twitching and tremor[42]
aggression [43]
rage, hostility[44]
mania, agitation, hyperactivity and restlessness[45][46][47]
[edit] Contraindications
Use of alprazolam should be avoided,carefully monitored by medical professionals, in individuals with the following conditions: Myasthenia gravis, acute narrow-angle glaucoma, severe liver deficiencies (e.g., cirrhosis), severe sleep apnea, pre-existing respiratory depression, marked neuromuscular respiratory weakness including unstable myasthenia gravis, acute pulmonary insufficiency, chronic psychosis, hypersensitivity or allergy to alprazolam or other drugs in the benzodiazepine class, borderline personality disorder (may induce suicidality and dyscontrol).[48][49][50][51]
Women who are pregnant or are planning on becoming pregnant should avoid starting alprazolam.[52] It should be considered that the child born of a mother who is receiving benzodiazepines may be at risk of developing withdrawal reactions during the postnatal period. Also, neonatal flaccidity and respiratory problems have been reported in children born of mothers who have been receiving benzodiazepines.[53]
Benzodiazepines, including alprazolam are known to be excreted in human milk.[54] Chronic administration of diazepam to nursing mothers has been reported to cause their infants to become lethargic and to lose weight.[55][56] As a general rule, nursing should not be undertaken by mothers who use alprazolam.
Elderly individuals should be cautious in the use of alprazolam due to the possibility of increased susceptibility to side effects, especially loss of coordination and drowsiness.[56]
Like all central nervous system depressants, including alcohol, alprazolam in larger than normal doses can cause significant deterioration in alertness, combined with increased feelings of drowsiness, especially in those unaccustomed to the drug's effects.[57] People driving or conducting activities which require vigilance should exercise caution in using alprazolam or any other depressant.
[edit] Food and drug interactions
Cimetidine, erythromycin, fluoxetine, fluvoxamine, itraconazole, ketoconazole, nefazodone, propoxyphene and ritonavir all interact with alprazolam leading to a delayed clearance of alprazolam which may result in excessive accumulation of alprazolam. This may result in excessive sedation and other adverse effects associated with excessive intake of alprazolam.[13][58]
Imipramine and desipramine have been reported to be increased an average of 31% and 20%, respectively, by the concomitant administration of alprazolam tablets in doses up to 4 mg/day.[59] Oral contraceptive pills reduce the clearance of alprazolam, which may lead to increased plasma levels of alprazolam and accumulation.[60]
Alcohol is one of the most important and common interactions. Alcohol and benzodiazepines such as alprazolam taken in combination have a synergistic effect on one another which can cause severe sedation, behavioral changes and intoxication. The more alcohol and alprazolam taken the worse the interaction.[61]
[edit] Physical dependence and withdrawal
See also: Benzodiazepine withdrawal syndrome
Alprazolam, like other benzodiazepines, binds to specific sites on the GABAA gamma-amino-butyric acid receptor. When bound to these sites, which are referred to as benzodiazepine receptors, it modulates the effect of GABA A receptors and thus GABAnergic neurons. Long-term use causes adaptive changes in the benzodiazepine receptors, making them less sensitive to stimulation and less powerful in their effects.[62]
Not all withdrawal effects are evidence of true dependence or withdrawal. Recurrence of symptoms such as anxiety may simply indicate that the drug was having its expected anti-anxiety effect and that, in the absence of the drug, the symptom has returned to pretreatment levels. If the symptoms are more severe or frequent, the patient may be experiencing a rebound effect due to the removal of the drug. Either of these can occur without the patient actually being drug-dependent.[62]
Alprazolam and other benzodiazepines may also cause the development of physical dependence, tolerance and benzodiazepine withdrawal symptoms during rapid dose reduction or cessation of therapy after long-term treatment.[63][64] There is a higher chance of withdrawal reactions if the drug is administered in a higher dosage than recommended, or if a patient stops taking the medication altogether without slowly allowing the body to adjust to a lower dosage regimen.[65][66][67]
In 1992 Romach and colleagues reported that dose escalation was not a characteristic of long-term alprazolam users, and the majority of patients indicated that alprazolam continued to be effective, suggesting that tolerance to the anti-anxiety effect is limited.[68]
If a patient feels the need to end treatment with alprazolam, they should consult their physician before discontinuing the medication. Some common symptoms of alprazolam discontinuation include: tachycardia, dysphoria, dry mouth, loss of appetite, insomnia, anxiety, dizziness, tremors, nausea, cramps, vomiting, diarrhea, panic attacks, mood swings, heart palpitations, memory loss. Less common and more severe reactions can occur including hallucinations, seizures or fever[69]
Patients taking a dosing regimen larger than 4 mg per day have an increased potential for dependence. This medication may cause withdrawal symptoms upon abrupt withdrawal or rapid tapering, which in some cases have been known to cause seizures. The discontinuation of this medication may also cause a reaction called rebound anxiety. Other withdrawal effects reported from discontinuing alprazolam therapy include homicidal ideation (very rare), rage reactions, hyperalertness, vivid dreams and intrusive thoughts.[70] Grand mal seizures have occurred after abrupt withdrawal after only short term use. Therefore even short term users of alprazolam should taper off of their medication slowly to avoid serious withdrawal reactions including seizures.[71][72]
Alprazolam should never be abruptly stopped if taken regularly for any length of time because severe withdrawal symptoms may occur. Severe psychosis and seizures have been reported in the medical literature from abrupt alprazolam discontinuation,[73][74] and one death occurred from withdrawal-related seizures after gradual dose reduction.[74]
In a 1983 study of patients who had taken long acting benzodiazepines ie clorazepate for extended periods, the medications were stopped abruptly under double-blind conditions (that is, patients were receiving either placebo or the same drug they had been taking). Only 5% of patients who had been taking the drug for less than 8 months demonstrated withdrawal symptoms, but 43% of those who had been taking them for more than 8 months did, whereas with alprazolam a short acting benzodiazepine taken for 8 weeks 35% of patients experienced significant rebound anxiety. To some degree these older benzodiazepines are self-tapering.[75]
The benzodiazepines diazepam (Valium) and oxazepam (Serepax) have been found to produce less withdrawal reactions than alprazolam (Xanax) or lorazepam (Temesta/Ativan). Factors which determine the risk of psychological dependence or physical dependence and the severity of the benzodiazepine withdrawal symptoms experienced during dose reduction of alprazolam include: dosage used, length of use, frequency of dosing, personality characteristics of the individual, previous use of cross dependent/cross tolerant drugs (alcohol or other sedative-hypnotic drugs), current use of cross dependent/cross tolerant drugs (alcohol or other sedative-hypnotic drugs), use of other short-acting, high potency benzodiazepines[8][76] and method of discontinuation.[77]
[edit] Recreational use
Sandoz generic 2mg alprazolam tablets.
Alprazolam has a relatively high potential for abuse.[78] Injection of alprazolam, though extremely rare, is considered especially dangerous by medical professionals[79] because, when crushed in water it will not fully dissolve (40 µg/ml of H2O at pH 7, and 12 mg/mL at pH 1.2 per 1 mg of alprazolam[80]), potentially causing severe damage to arteries if not filtered properly. While it is somewhat soluble in alcohol, the combination of the two, particularly when injected, has the potential to cause a serious, and potentially fatal overdose. Alprazolam may also be insufflated.[81] However, long-term use of benzodiazepines does not usually result in notable dose escalation and most prescribed alprazolam users do not abuse their medication.[82]
Alprazolam is sometimes used with other recreational drugs to relieve the panic or distress of dysphoric reactions to psychedelics such as LSD and also to promote sleep in the "come-down" period following use of recreational drugs with stimulant or insomniac properties (such as LSD, cocaine, amphetamines, DXM, and MDMA along with the related amphetamines). It is also often used in conjunction with marijuana or heroin to potentiate the relaxing effect.[83][84][85][86][87]
A large scale nation wide USA government study conducted by SAMHSA found that benzodiazepines in the USA are the most frequently abused pharmaceutical with 35% of drug related visits to the Emergency Department involving benzodiazepines. Benzodiazepines are more commonly abused than opiate pharmaceuticals which accounted for 32% of visits to the emergency department. No other pharmaceutical is more commonly abused than benzodiazepines, however, benzodiazepines remain in Schedule IV of the Controlled Substances Act, whereas opiates are much more strictly scheduled. Men abuse benzodiazepines as commonly as women. The report found that alprazolam is the most commonly abused benzodiazepine followed by clonazepam, lorazepam and then diazepam.[4]
[edit] Patients at a high risk for abuse and addiction
At a particularly high risk for misuse, abuse, and dependence are polydrug abusers (someone who already uses at least one substance in a recreational context). Patients with a history of alcoholism (including a family history of alcoholism) or drug abuse and/or dependence[88][89][90][91][92] and patients with borderline personality disorder are at increased risk of misusing alprazolam.[93]
[edit] Overdose
See also: Benzodiazepine overdose
Overdoses of alprazolam can be mild to severe depending on how much of the drug is taken and if any other depressants have been taken. Alprazolam is significantly more toxic in overdose than other benzodiazepines with higher rates of fatalities. A study in New Zealand found that alprazolam was almost 8 times more likely to result in death in overdose than other sedative hypnotics as a group, with higher rates of ICU admissions and mechanical ventilation. Combined overdose with tricyclic antidepressants, alcohol or opiates or overdoses of alprazolam in the elderly significantly increases the likelihood for severe toxicity and possible fatality.[94] Alprazolam (Xanax) overdose reflect the central nervous system depression of the brain and may include one or more of the following symptoms:[33]
Somnolence (difficulty staying awake)
Mental confusion
Hypotension
Impaired motor functions
Impaired or absent reflexes
Muscle weakness
Impaired balance
Dizziness
Fainting
Hypoventilation (Respiratory Depression)
Coma
Death
About 50% of the cases of death involving alprazolam were attributed to combined drug toxicity of alprazolam and another drug, most often cocaine and methadone. Only 1% of such deaths was attributed to alprazolam alone.[95][96]
[edit] Availability
Alprazolam is available in 0.25 mg, 0.5 mg, 1 mg and 2 mg strength oral, extended release or orally disintegrating tablets.[97]
Alprazolam is available in English-speaking countries under the following brand names:
Brand Names[98]
Alprax, Alprox, Alzam, Anxirid, Apo-Alpraz, Alzolam, Azor, Calmax, Gerax, Kalma, Niravam, Novo-Alprazol, Nu-Alpraz, Texidep, Xanax, Xanor, Zopax
[edit] Legal status
In the United States, alprazolam is a prescription drug and is assigned to Schedule IV of the Controlled Substances Act by the Drug Enforcement Administration.[99] Under the UK drug misuse classification system benzodiazepines are class C drugs.[100] Internationally, alprazolam is included under the United Nations Convention on Psychotropic Substances as Schedule IV.[101]
[edit] See also
Benzodiazepine
Benzodiazepine dependence
Benzodiazepine withdrawal syndrome
Long term effects of benzodiazepines
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懷孕及授乳注意事項：有造成胎兒缺損的可能、而且孕婦會有禁斷症狀，除非醫師認為必要，否則不建議使用。
使用禁忌：已知對Benzodiazepine過敏的病人，禁用本品。本品可仗用在正接受 適當療法之廣角性青光眼患者，但對狹角性青光眼是禁忌。對18歲以 下兒童之安全性和有效性尚未建立。
交互作用：Benzodiazepine類藥物（包括本品）當併用其他影響神志、抗痙攣或 抗組織胺、乙醇等抑制CNS的製劑時，會加成抑制CNS的效果。
懷孕及授乳注意事項：有造成胎兒缺損的可能、而且孕婦會有禁斷症狀，除非醫師認為必要，否則不建議使用。
使用禁忌：已知對Benzodiazepine過敏的病人，禁用本品。本品可仗用在正接受 適當療法之廣角性青光眼患者，但對狹角性青光眼是禁忌。對18歲以 下兒童之安全性和有效性尚未建立。
交互作用：Benzodiazepine類藥物（包括本品）當併用其他影響神志、抗痙攣或 抗組織胺、乙醇等抑制CNS的製劑時，會加成抑制CNS的效果。
2009年1月29日 星期四
心窩
心窩～MP3完整版～超好聽～尊樺合唱喔！(附歌詞)
（rap:東）感受不易形容 就算會有一點唐突也要說 請搬進我心窩 如果你不幸福再離家出走 我心窩做你的新窩 也許坪數不太夠 甚至會擁擠到 只裝得下你我 （尊）請快準備行李 丟掉用不到的傷心舊回憶 腦海中 相本日記 從此更新 只有彼此專署甜蜜 （樺）抱枕就丟掉 有肩膀就夠 最後用關心問候 捆綁我們的手完工 （飛&she) 只要在你身邊 我就省掉思念 時間只用來眷戀 我要在你身邊 盡情浪費喜悅 也許一待就永遠 (rap:樺）管它金窩銀窩 怎樣都比不過彼此的心窩 打包一箱溫柔 今後多多指教就相互寬容 你心窩做我的新窩 暖氣不需要使用 我已經溫暖到 融化所有冷漠 （尊）請快準備行李 丟掉用不到的傷心舊回憶 腦海中 相本日記 從此更新 只有彼此專署甜蜜 （樺）抱枕就丟掉 有肩膀就夠 最後用關心問候 捆綁我們的手完工 （飛&she) 只要在你身邊 我就省掉思念 時間只用來眷戀 我要在你身邊 盡情浪費喜悅 也許一待就永遠
（rap:東）感受不易形容 就算會有一點唐突也要說 請搬進我心窩 如果你不幸福再離家出走 我心窩做你的新窩 也許坪數不太夠 甚至會擁擠到 只裝得下你我 （尊）請快準備行李 丟掉用不到的傷心舊回憶 腦海中 相本日記 從此更新 只有彼此專署甜蜜 （樺）抱枕就丟掉 有肩膀就夠 最後用關心問候 捆綁我們的手完工 （飛&she) 只要在你身邊 我就省掉思念 時間只用來眷戀 我要在你身邊 盡情浪費喜悅 也許一待就永遠 (rap:樺）管它金窩銀窩 怎樣都比不過彼此的心窩 打包一箱溫柔 今後多多指教就相互寬容 你心窩做我的新窩 暖氣不需要使用 我已經溫暖到 融化所有冷漠 （尊）請快準備行李 丟掉用不到的傷心舊回憶 腦海中 相本日記 從此更新 只有彼此專署甜蜜 （樺）抱枕就丟掉 有肩膀就夠 最後用關心問候 捆綁我們的手完工 （飛&she) 只要在你身邊 我就省掉思念 時間只用來眷戀 我要在你身邊 盡情浪費喜悅 也許一待就永遠
2008年12月28日 星期日
哪一種人會被最後炒魷魚呢？
精闢，可是少了一個就不是海賊團了
: 經濟不景氣
: 很多人都縮編裁員自保
: 可是哪一種人比較不會被砍呢
: 哪一種人幾乎是最後一群考慮的
: 能力很強 跟老闆有關係的
: 這些都不用說了 @@
: 還有其他的答案嗎
: 擁有能力特殊的有沒有算呢
: 漫畫或卡通都這樣演的
^^^^^^^^^^^^^^^^^^^^^
: 一個組織要保都先保那些擁有特殊能力
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
: 很難或是不可替代(不是指能力強)的?
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
很讚同你上面這三句話..對一個組織的營運
的確是有能者居之..存續應該以能力為考量..
你提到動漫..我便以海賊王為例...
如果有一天..魯夫上甲板宣布 :
『因為金融海嘯..草帽海賊團最近開始進行一波裁員...?』
那裁員的順序應該是 :
【1】妮可.羅賓 : 歷史學家對於海賊團的營運並沒有太大的幫助
在平時的確可以發揮一些顧問的效用..並為組織開發新方向
但一旦市場萎縮獲利出現問題..妮可便成一個冗員..
【2】騙人布 : 如大家所知.騙人布在海賊團並沒有特殊的能力,比妮可的優勢在於他可
以做些雜役,木工之類..但在佛朗基加入之後..騙人布的角色定位
便顯得多餘..因此當妮可走之後..騙人布應該是第二順位
【3】索隆 : 大家一定驚訝為啥索隆會在這麼前面..ok...索隆在海賊團的主要擔任
打手類的角色..而與人戰鬥一向也是海賊的獲利主因..但除他之外..
肉搏系的角色尚有魯夫 香吉士 佛朗基等人..而其它人都具有第二專長
相對於索隆只專注在戰鬥這一塊..便吃虧許多...因此第三順位
以上是第一波名單 ...
如果還有第二波的話.. 那接下來應該是:
【4】喬巴 : 說真的..船醫在船上的角色並不太重要..原因主要兩個..
(1) 在這船上的人都不是正常人..所以很少生病吧
(2) 他主要CASE都在治療戰鬥所受的傷..可是業務量(戰鬥量)一但小
他能發揮的發揮的機會其實有限...
【5】佛朗基 : 留得青山在..不怕沒材燒..為了保存船的存續..因此他才能撐這麼後面
不過其實..佛朗基也很晚才加入..在那之前"黃金梅莉號".飛天下海..
操成這樣也都壞不了..證明有沒有一個專業船匠 並不是那麼的需要
【6】娜美 : 一直以來..娜美所扮演的航海士的角色..在公司來說就是CEO
制定公司整體的走向..每次有什麼賭博 比賽呀 這種撈錢的機會
她從來不放過..為組織積極的開源..裁到她已經是萬不得已的了..
【7】香吉士 : 民以食為天..相信沒有一個人可以一天不吃飯吧.尤其是老闆又是特別
住重飲食的人..裁到香吉士整個團可以說是瓦解..
【8】魯夫 : 雖然很多人都一定覺得..他應該是第一個被裁掉的人..但畢竟是老闆呀..
以上是小弟的拙見....
: 經濟不景氣
: 很多人都縮編裁員自保
: 可是哪一種人比較不會被砍呢
: 哪一種人幾乎是最後一群考慮的
: 能力很強 跟老闆有關係的
: 這些都不用說了 @@
: 還有其他的答案嗎
: 擁有能力特殊的有沒有算呢
: 漫畫或卡通都這樣演的
^^^^^^^^^^^^^^^^^^^^^
: 一個組織要保都先保那些擁有特殊能力
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
: 很難或是不可替代(不是指能力強)的?
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
很讚同你上面這三句話..對一個組織的營運
的確是有能者居之..存續應該以能力為考量..
你提到動漫..我便以海賊王為例...
如果有一天..魯夫上甲板宣布 :
『因為金融海嘯..草帽海賊團最近開始進行一波裁員...?』
那裁員的順序應該是 :
【1】妮可.羅賓 : 歷史學家對於海賊團的營運並沒有太大的幫助
在平時的確可以發揮一些顧問的效用..並為組織開發新方向
但一旦市場萎縮獲利出現問題..妮可便成一個冗員..
【2】騙人布 : 如大家所知.騙人布在海賊團並沒有特殊的能力,比妮可的優勢在於他可
以做些雜役,木工之類..但在佛朗基加入之後..騙人布的角色定位
便顯得多餘..因此當妮可走之後..騙人布應該是第二順位
【3】索隆 : 大家一定驚訝為啥索隆會在這麼前面..ok...索隆在海賊團的主要擔任
打手類的角色..而與人戰鬥一向也是海賊的獲利主因..但除他之外..
肉搏系的角色尚有魯夫 香吉士 佛朗基等人..而其它人都具有第二專長
相對於索隆只專注在戰鬥這一塊..便吃虧許多...因此第三順位
以上是第一波名單 ...
如果還有第二波的話.. 那接下來應該是:
【4】喬巴 : 說真的..船醫在船上的角色並不太重要..原因主要兩個..
(1) 在這船上的人都不是正常人..所以很少生病吧
(2) 他主要CASE都在治療戰鬥所受的傷..可是業務量(戰鬥量)一但小
他能發揮的發揮的機會其實有限...
【5】佛朗基 : 留得青山在..不怕沒材燒..為了保存船的存續..因此他才能撐這麼後面
不過其實..佛朗基也很晚才加入..在那之前"黃金梅莉號".飛天下海..
操成這樣也都壞不了..證明有沒有一個專業船匠 並不是那麼的需要
【6】娜美 : 一直以來..娜美所扮演的航海士的角色..在公司來說就是CEO
制定公司整體的走向..每次有什麼賭博 比賽呀 這種撈錢的機會
她從來不放過..為組織積極的開源..裁到她已經是萬不得已的了..
【7】香吉士 : 民以食為天..相信沒有一個人可以一天不吃飯吧.尤其是老闆又是特別
住重飲食的人..裁到香吉士整個團可以說是瓦解..
【8】魯夫 : 雖然很多人都一定覺得..他應該是第一個被裁掉的人..但畢竟是老闆呀..
以上是小弟的拙見....
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