• 제목/요약/키워드: (-)-ephedrine

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진도종 개에서 아트로핀에 의해 발생한 역설적 방실 전도 차단 (Atropine Induced Paradoxical Atrioventricular Conduction Block in a Jindo Dog)

  • 이무현;이승곤;문형선;이준석;이용훈;현창백
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.422-425
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    • 2007
  • 6개월령 수컷 진도종 개가 교통사고에 의한 골반 골절 교정술을 위하여 내원하였다. 일반적인 수술 전 검사에서 마취와 관련해 위험성 있는 이상은 발견되지 않았다. 이 개는 아트로핀으로 전처치하고, 유도마취로 thiopental을 주사하였으며 유지 마취 약물로 isoflurane을 사용하였다. 수술 시작 40분 후 갑자기 서맥이 발생하여 아트로핀(18ug/kg)을 천천히 정맥주사 하였으나 즉시 맥박이 증가하지 않고 오히려 heart rate가 감소하며 방실 전도 차단($2^{nd}$ degree type I)이 발생하였다. 따라서 ephedrin을 즉각적으로 주사하였으며, 투여 7분 후 정상 심박으로 회복되었다. 본 증례는 개에서 고용량 atropine 투여로 드물게 발생하는 역설적 방실전도 차단 임상예이다.

약물 유발성폐부종 (Drug induced Pulmonary Edema)

  • 성시한;장혜영;임훈
    • 대한임상독성학회지
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    • 제8권2호
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    • pp.113-121
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    • 2010
  • Purpose: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. Methods: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. Results: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. Conclusion: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.

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Quantitative Analysis and Enantiomeric Separation of Ephedra Alkaloids in Ma Huang Related Products by HPLC-DAD and UPLC-MS/MS

  • Kyoung-Moon Han;Jinwoo Hwang;Sun Hee Lee;Boreum Park;Hyungil Kim;Sun Young Baek
    • Natural Product Sciences
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    • 제28권4호
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    • pp.168-180
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    • 2022
  • Ephedra is a genus of the Ephedraceae family and is found in temperate regions, such as Central Asia and Europe. Among the various ephedra species, Ma Huang (Ephedra herb) is derived from the aerial parts of Ephedra sinica S tapf, Ephedra equisetina Bunge, and Ephedra intermedia Schrenk & C.A. Mey. Ma Huang contains various ephedra alkaloids, including (-)-ephedrine, (+)-pseudoephedrine, (-)-norephedrine, (+)-norpseudoephedrine, (-)-methylephedrine, and (+)-methylpseudoephedrine, which are found naturally as single enantiomers, although they can be prepared as racemates. Although the use of Ma Huang in foods is prohibited in Korea, products containing Ma Huang can be imported, and so it is necessary to develop a suitable analytical technique for the detection of Ma Huang in foods. Herein, we report the development of analytical methods for the detection of ephedra alkaloids in products containing Ma Huang. Following sample purification by solid phase extraction, quantitative analysis was performed using ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-MS/MS). Additionally, the enantiomers were successfully separated using HPLC-DAD. We successfully analyzed various food samples, where the ephedra alkaloids were qualitatively and quantitatively determined, and the enantiomers were separated. It is expected that these methods may contribute toward preventing the distribution of illegal products containing Ma Huang.

가미태음조위탕 2주 복용이 과체중 또는 비만 환자의 혈압, 맥박수 및 체중에 미치는 영향: 후향적 차트리뷰 (The Effect of Taking Gamitaeeumjowee-tang for 2 Weeks on Blood Pressure, Pulse Rate and Body Weight in Overweight or Obese Patients: A Retrospective Chart Review)

  • 박소영;박민정;김은주;김은서;임영우
    • 한방비만학회지
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    • 제24권1호
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    • pp.68-75
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    • 2024
  • Objectives: This study was aimed to evaluate changes in blood pressure, pulse rate and body weight of overweight or obese patients after two weeks of taking Gamitaeeumjowee-tang. Methods: A retrospective chart review was conducted for patients with auscultatory blood pressure records who visited the clinic after two weeks from the first visit between July 8, 2019 and August 30, 2019. Results: A total of seventy-two patients were included. There were significant differences in systolic blood pressure (121.69±14.3 mmHg to 117.37±12.3 mmHg, P=0.002) and pulse rate (78.56±9.3 bpm to 82.99±9.0 bpm, P<0.001). There was no significant difference in diastolic blood pressure. There were significant differences in body weight (76.28±13.5 kg to 73.41±13.1 kg, P<0.001) and body mass index (28.82±4.4 kg/m2 to 27.75±4.3 kg/m2, P<0.001). Conclusions: In this study, blood pressure tended to decrease and pulse rate slightly increased after two weeks of taking Gamitaeeumjowee-tang. It is necessary to notice the possibility of pulse rate increase and the plan of action when using Gamitaeeumjowee-tang. Additional well-designed investigations are needed.

영남대학교 의과대학 부속병원 외래환자에 대한 약물처방 동향의 분석 (Drugs Most Frequently Used in OPD of Yeungnam University Hospital: March to August, 1985)

  • 이광윤;김원준;김승훈
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.95-102
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    • 1985
  • 대구 및 그 인접지역의 질병 발생 경향을 추정하고, 영남대학교 의과대학 부속병원의 약제수급 계획을 위한 참고자료를 얻기 위하여, 1985년 3월부터 동년 8월까지 당 병원 외래에 내원한 환자들을 위하여 내려진 약물 처방을 전산 집계하여 다음과 같은 결과를 얻었다. 가장 빈번히 처방된 약물로 부터 100종의 약물을 처방빈도 순으로 나열하였던 바, diazepam, aluminum compound, acetaminophen, isoniazid, metoclopramide, $polaranine^{(R)}$, carboxymethylcystein, ephedrine, codeine, caroverine (이하생략) 등의 순으로 나타났으며, 이와 같이 선정된 100종의 약물을 임상용도별로 분류하여 총 처방회수 521,855회에 대한 백분율을 조사한 결과는 다음과 같다. 중추신경계약물 (20.57%)이 가장 많았고, 다음은 위장관 및 평활근에 작용하는 약물 (18.64%), 호흡기계약물 (16.11%), 항균제 (15.12%), 심혈관 계약물 (5.64%)의 순으로 많았으며, 그 다음은 소염제 (4.33%), 단독비타민제 (3.76%), 호르몬 및 항호르몬제 (3.29%), 감기치료제 (3.12%), 이뇨제 (2.81%), 간기능이상치료제 (2.02%), 자율신경계약물 (1.89%), 항히스타민제 (1.02%) 및 소독약 (0.74%) 등의 순으로 나타났다.

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감기 임상연구의 최신 동향 및 평가도구에 관한 연구 (Study of Instruments for Assessment and Clinical Research Trends in Common Cold)

  • 양수영;변준섭;황지호;안정조;홍권의;강위창;이용구;박양춘
    • 대한한의학회지
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    • 제29권2호
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    • pp.165-181
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    • 2008
  • Objectives: This study was conducted to help clinical studies for treating the common cold with Oriental medicine. We inspected tendencies of clinical studies of the common cold in western medicine and analyzed the assessing instruments for it by scrutinizing PubMed publications for the last five years. Materials and Methods: We inspected 32 theses and scrutinized their objectives, periods, participants, materials and methods, the instrument of assessment for the studies, and validity, reliability, criteria and symptom score for questionnaires, results and JADAD score. Results: 1. The median for total period of study was 7 months, the median for days of treatment was 7.5, and most studies were carried out during the winter/spring period, because of the enhanced risk of cold infections. 2. The studies focused on unorthodox medicines or new drug products, such as antipyretic analgesics (e.g. paracetamol), decongestant and bronchodilator (e.g. ephedrine), echinacea, antioxidants (e.g. zinc), probiotic bacteria and so on. 3. All theses except one had subjectscomposed of cold patients who were infected naturally. The median number of subjects for final analysis was 187. 4. 27 studies used survey as the instrument of assessment. Among these, only one thesis was verified for validity. 5. The mean of JADAD score was 4.41, suggesting most of theses of worth. 7 studies were assessed as ineffective. Conclusion: Recent studies of the common cold are focused on unorthodox medicines or new drug products, and it is necessary to provide an objective instrument for assessing common cold treatments.

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구충증(鉤蟲症)에 관(關)한 연구(硏究) 제2편(第2編) 감염경중(感染輕重)에 따른 구충증(鉤蟲症)의 임상증상(臨床症狀), 빈혈상(貧血像) 및 약물(藥物) 특(特)히 철제제(鐵製劑)의 효과(效果) (Studies on Ancylostomiasis II. Clinical Symptomatology, Effects of Drugs, especially of Iron Compounds, with Relation to the Severity of Artificial Infection)

  • 이문호;김동집;이장규;서병설
    • 대한핵의학회지
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    • 제1권2호
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    • pp.41-59
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    • 1967
  • This study was aimed; firstly to observe various clinical symptomatology with reiation to the number of Ancylostoma duodenale larvae orally given to the human beings, secondly to evaluate the effects of some drugs like steroid hormones, antihistaminic3 and antitussives, and, thirdly to study the influences of some iron compounds in prevention and treatment of anemia of such origin. Ten healthy volunteers free from the previous history of hookworm infection were divided into 4 groups, to whom various numbers of actively moving filariform Ancylostoma duodenale larvae were orally given; 500 to 4 cases, 250 to 3 cases and 100 to 3 cases. Following were the results: 1. Clinical symptomatology 1. The most frequently encountered symptoms and signs were general malaise, cough and hoar seness. The tracheal itching and pain low back pain, arthralgia, sputum and salivation, acid belching, loss of appetite, abdominal pain and vomiting were also noted. 2. If the larger number of the larvae was given, the clinical symtomatology was more severe. 3. Prednisolone medication caused some improvement of such symptomatology, while the antihistaminics and antitussives like codeine or ephedrine were ineffective. 4. In volunteers whose nutritional conditions were rather poor appeared to show more severe symptomatology. 2. Effects of iron compounds 1. The oral administration of ferrous fumarate induced a slight increase of serum iron levels in the initial stage of the infection, then a decrease from $15{\sim}20$ days later and a recovery after 2 months. 2. The intravenous administration of saccharated ferric oxide induced a steady upkeep of the serum iron levels. 3. The hemoglobin contents also showed the upkeeps after either the oral or intravenous administration of the iron compounds. 4. The iron compounds, therefore, are considered to have the preventive as well as the therapeutic effects on hookworm anemia, which may strongly suggest that hookworm anemia is essentially the iron deficiency type. 3. Hematological changes 1. The severity of hookworm anemia generally correlated with the number of larvae given. 2. The moderate leucocytosis was observed in all cases regardless of the number of larvae given, which reached to a peak in $25{\sim}35$ days. 3. Eosinophilia was observed in all cases, but was more severe in cases given larger number of larvae, which was slightly less evident after the medication of prednisolone. 4. Red cell survival time The red cell survival time determined by $^{51}Cr$ was generally in the normal ranges except for the severe anemia patients.

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마황 단기복용이 사상체질인의 불안에 미치는 영향 : 이중맹검 임상시험 (Short-Term Effects of Mahuang on State-Trait Anxiety According to Sasang Constitution Classification : A Double-Blind Randomized Controlled Trial)

  • 형례창;양창섭;이태호;김락형;곽민정;서의석;장인수
    • 대한한방내과학회지
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    • 제28권1호
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    • pp.106-114
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    • 2007
  • Background : Mahuang (Ephedrae Herba, Ephedra sinica $S_{TAPE}$) has been widely used to treat respiratory disease in Asian over the past thousand years. The main ingredient of Mahuang is ephedrine, whose affects on the autonomic nervous system induce some adverse effects like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, etc. Although there were lots of reports about adverse effects of Mahuang, there were no clinical studies which evaluated the adverse effects of Mahuang on the autonomic nervous system by objective numerical value in the past decade. Objectives : The purpose of this report was to provide an objective assessment of state-trait anxiety that is caused by Mahuang, and to identify anxiety of Mahuang according to different Sasang constitution classifications. Methods : The study design was a double-blind randomized placebo-controlled trial. The subjects of this study were 79 adults aged between 20 to 40 who agreed to participate. Because 8 adults dropped out, a total of 71 subjects entered the study. They were allocated through randomization to a Mahuang group (N=50) and placebo group (N=21). Each group took three opaque capsules (every opaque capsule containing 2g of Mahuang or none) twice a day. To compare the state and trait anxiety before and after taking Mahuang, we checked the anxiety by using STAI-KYZ. Results : The following results were obtained. Short-term administration of Mahuang significantly increased state-anxiety, but in the placebo group, there were no significant changes in state-anxiety. In the Mahuang group except females, there was more significant increase in state-anxiety of Soeumin than Soyangin and Taeumin in the 2nd measurement. Conclusion : It is suggested that the ingestion of Mahuang can increase sympathetic activity and induce anxiety. There was a significant difference among Sasang constitution classification. Especially, the response is stronger in Soeumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only minimize the anxiety but maximize the potential curative value.

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오수유와 마황이 저열량식이요법을 병행한 비만여성환자의 체구성성분 및 휴식대사량에 미치는 영향 (The Effects of Evodia Rutaecarpa and Ephedra Sinica on the Resting Metabolic Rate and Body Composition of Obese Women on a Low-Calorie Diet: A Double-blinded Randomized Controlled Clinical Trial)

  • 박정미;김호준;김진아;김수진;고병표
    • 대한한의학회지
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    • 제26권3호
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    • pp.249-262
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    • 2005
  • Backgrounds : As obesity prevails as an epidemic. diet programs including low-calorie diets are developed continuously. It is generally believed that a low-calorie diet is commonly followed by resting metabolic rate decrease and ultimate weight regain. Ephedra and Evodia are known to have sympathomimetic and anti-obesity effect. Objectives : This study was a prospective, double-blinded, randomized md placebo-controlled clinical trial to evaluate the effects of Ephedra sinica and Evodia rutaecarpa on resting metabolic rate (RMR), weight, body composition, and short-term safety in obese women on low-calorie diet. Methods : 125 otherwise healthy obese women (body mass Index ${\geq}\;25kg/m^2$) were recruited and randomly assigned to three groups: Ephedra group (n=41), Evodia group (n =45), and placebo group (n=39). Subjects were administered Ephedra extract in capsules (pseudo-ephedrine 31.52mg) or Evodia extract in capsules (evodiamine 6.75mg, rutaecarpine 0.66mg) or placebo capsules as well as participating in a low-calorie diet for 8 weeks, Resting metabolic rate and body composition were measured at baseline,4 and 8 weeks. Basic serum exams were performed to evaluate the short-term safety of the herbs and changes of lipid variables. Results : All three groups showed significant BMI decreases probably due to low-calorie diet. Among them, the Ephedra group manifested most prominent BMI-reducing effect and towered total cholesterol and triglycerides significantly. The RMR was not changed during the 8-week diet in all groups. No significant difference among the groups was found in RMR, either. Stbject with higher RMR than the mean at the baseline showed a tendency to keep their RMR more stable during the diet program. Conclusions : Ephedra with a low-calorie diet was effective in reducing BMI. RMR change was not compensated by herbal medicines. RMR change seemed to be affected rather by constitution and body composition than medicine. Ephedra and Evodia were proven to be safe for sort-term use in herbal form. Especially, Ephedra was effective in lowering total cholesterol and triglycerides during the 8 weeks.

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마황 복용이 정산인의 심박변이도에 미치는 영향에 대한 무작위배정 이중맹검 임상연구 (Effect of Mahuang on Heart Rate Variability in Adults : a Double-Blind, Placebo-Controlled, Randomized Trial)

  • 손동혁;형례창;김락형;정승일;서의석;장인수
    • 대한한의학회지
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    • 제28권1호통권69호
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    • pp.105-116
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    • 2007
  • Objectives : Mahuang (Ephedra sinica), well known as an herbal medicine in the East and West, contains a relatively high percentage of ephedrine known as sympathomimetic alkaloid. We investigated the effects of Mahuang on sympathetic nervous system with heart rate variety (HRV). Time and frequency domain analysis of HRV is a noninvasive technique capable of providing information on autonomic modulation of the sinus node. Methods : We investigated 57 healthy volunteers consisting of 37 subjects in the Mahuang group and 20 subjects in the placebo group. Study form was a randomized, placebo-controlled, double-blind clinical trial. The 37 subjects in the Mahuang group took 3 Mahuang capsules (1 capsule equivalent to 2g herb Mahuang) twice a day at 10 a.m. and 2 p.,., while the 20 subjects in the placebo group took 3 placebo-capsules filled with glutinous rice powder at the same times. Mahuang medicine and placebo medicine were made into opaque capsules. We measured HRV at 3 p.m. 1 or 2 days before medication and at 3 p.m. after medication. Results : Mean-RR and SDNN of the Mahuang group significantly decreased compared with that of the placebo group, but the heart rate of the Mahuang group significantly increased compared with the placebo. HRV-Index, RMSSD and SDSD of the Mahuang group significantly decreased compared with that of the placebo group, but PNN50 of the Mahuang group significantly increased compared with placebo. Ln(TP), Ln(VLF), Ln(LF) and Ln(HF) of the Mahuang group significantly decreased compared with those of the placebo group. There were no significant differences in normalized LF, normalized HF and LF/HF ratio between the Mahuang and placebo groups. Conclusion : The results suggest that Mahuang in healthy adults tends to reduce the autonomic nervous system within the normal range.

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