• 제목/요약/키워드: Antiplatelets

검색결과 23건 처리시간 0.024초

한방병원 입원 허혈성 뇌경색 환자에서 한방 의료보험용 엑스산제와 항혈소판제 및 항응고제의 병용투여 현황 (The current status of the combination therapy of frequently used herbal extracts and anti-platelet drug, anti-coagulant drug in ischemic stroke patients hospitalized in oriental medical hospital)

  • 한수련;박성환;안영민;안세영;이병철
    • 대한한의학회지
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    • 제32권2호
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    • pp.14-22
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    • 2011
  • Objective: Nowadays the combined use of herbal extracts and western medicines has been prevalent, but concern about its risk is also increasing. Even though the importance of clinical trials is well recognized, there have been only a few studies on the combined use of herbal extracts and western medicines. This study was aimed to examine which herbal extracts and antiplatelets or anticoagulants are most commonly prescribed together to inpatient ischemicstroke patients and investigate the combined prescription rate. Methods: We investigated the most frequently prescribed herbal extracts from two different sources. First, we chose herbal medicine extracts from 2008 Traditional Korean Medicine Utilization Status. Then, among patients who were admitted to Kyung-Hee Oriental Medical Center diagnosed with ischemic stroke, we found patients who were administered with these herbal medicine extracts and among these patients, we investigated how many were concomitantly administered with antiplatelets or anticoagulants. Second, we chose other herbal medicine extracts that were most often prescribed within Kyung-Hee Oriental Medical Center and found patients who were administered with these herbal medicine extracts, then investigated how many of them were concomitantly administered with specific antiplatelets or anticoagulants. Results: The most commonly prescribed herbal medicine extracts among ischemic stroke patients were Ojeok-san, Bojungikgi-tang, Sochungryong-tang and Samsoeum. About 46 to 69 percent were concomitantly administered with either specific antiplatelets or anticoagulants. Conclusions: The most often prescribed herbal medicine extracts in inpatient ischemic stroke patients are Ojeok-san, Bojungikgi-tang, Sochungryong-tang, and Samsoeum. Among patients who were prescribed with Ojeok-san, Bojungikgi-tang, Sochungryong-tang, Samsoeum, patients who were concomitantly administered with either antiplatelets or anticoagulants were about 46% to 69%.

항혈소판제제를 복용 중인 출혈성 방광염 환자의 저령탕합사물탕 치험 1례 (Case of a Hemorrhagic Cystitis Patient Taking Antiplatelets Treated with Jeoryeong-tang-hap-Samul-tang)

  • 이다빈;김근영;전선욱;이한결;조기호;문상관;정우상;권승원
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.178-186
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    • 2023
  • Hemorrhagic cystitis refers to massive inflammation and the diffuse vesical bleeding of the bladder. In patients with hematuria complaining of dysuria and pain, it is necessary to differentiate various causes, including cystitis, nephritis, and prostatitis. After the diagnosis of hemorrhagic cystitis, antibiotics usually treat and prevent further urinary tract infections. In the present case, a 78-year-old female patient with hemorrhagic cystitis presenting with hematuria underwent Korean medical treatment with Jeoryeong-tang-hap-Samul-tang for 29 days. The effect of the treatment was assessed with the hematuria grading scale (HGS) per week, urinalysis per two weeks, and the NRS (numeric rating scale) of dysuria per day. After treatment, both HGS and NRS scores decreased, and protein, blood, and red blood cells (RBCs) in urinalysis improved. This case report suggests that Jeoryeong-tang-hap-Samul-tang might be an effective option for hemorrhagic cystitis patients who continuously take antiplatelets.

Drug-herb interactions: Mechanisms involved and clinical implications of five commonly and traditionally used herbs

  • Ong, Chin Eng;Pan, Yan
    • 셀메드
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    • 제4권3호
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    • pp.17.1-17.8
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    • 2014
  • Herbal remedies are commonly used by patients worldwide. Because these herbal preparations share the same metabolic and transport proteins with prescribed medicines, the potential for a drug-herb interaction is substantial and is an issue of significant concern. This review paper summarizes drug-herb interactions involving inhibition or induction of cytochrome P450 enzymes, drug transporters as well as modulation of drug pharmacodynamics. An increasing number of in vitro and animal studies, case reports and clinical trials evaluating such interactions have been reported, and implications of these studies are discussed in this review. The most commonly implicated drugs in the interaction include anticoagulants, antiplatelets, immunosuppressants, anti-neoplastics, protease inhibitors, and some antidepressants. Pharmacokinetic and/or pharmacodynamic interactions of five commonly used herbal remedies (danshen, garlic, Ginkgo biloba, ginseng, and St John's wort) with these drugs are presented, with focus of discussion being the potentials for interaction, their mechanisms and clinical implications. There is a necessity for adequate pharmacovigilance to be carried out in minimizing unanticipated but often preventable drug-herb interactions.

한방병원에 입원한 뇌경색 환자의 기능회복과 관련된 특성에 대한 연구 (The Study about Characteristics Affecting Functional Recovery of Stroke Patients Treated in an Oriental Medical Center)

  • 김영지;김미영;이승엽;최원우;박주영;권승원;정우상;문상관;조기호;김영석;박성욱;박정미;고창남;배형섭;나병조
    • 대한한방내과학회지
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    • 제30권4호
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    • pp.719-731
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    • 2009
  • Objectives : Stroke is the most common disabling neurological disease of adult life. The treatment and rehabilitation of stroke patients is an important and challenging area in the field of medicine. In Korea, a lot of stroke patients are treated using oriental medicine and there have been reports on their functional recovery. The aim of this study was to prove the therapeutic effect of oriental medicine on ischemic stroke. We also tried to identify characteristics of patients whose functional recovery was prominent and studied whether or not the use of fluids, anticoagulants, antiplatelets and neuroprotective agents increased the functional recovery of patients. Methods : We studied 794 patients within 2 weeks after first attack of ischemic stroke who were admitted to Kyung-Hee Oriental Medical Center from 1999 to 2000. Their maximum admission period was 60 days. Results : Motor power grade, NIHSS and MBI scores of patients improved during hospitalization significantly. Factors affecting functional recovery were admission period, motor power grade, NIHSS and MBI at admission. Age, waist-hip ratio and HDL cholesterol also affected functional recovery of patients. Whether or not fluids, anticoagulants, antiplatelets and neuroprotective agents were administered had nothing to do with functional recovery. Conclusion : Oriental medicine is effective for treatment and rehabilitation of ischemic stroke patients. When we manage stroke, we have to consider some important factors.

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당뇨병성 말초혈관병증에서 항혈소판제의 효과: 발목상완지수 및 맥파전달속도를 통한 비교 (Effect of Antiplatelets in Diabetic Peripheral Vasculopathy: Comparison by Ankle-Brachial Index and Peak Wave Velocity)

  • 박세진
    • 대한족부족관절학회지
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    • 제18권4호
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    • pp.159-164
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    • 2014
  • Purpose: The purpose of this study is to confirm the effect of antiplatelet drugs in diabetic peripheral vasculopathy in diabetic foot patients. Materials and Methods: We designed a retrospective study in diabetic foot patients with diabetic peripheral vasculopathy. From October 2007 to December 2013, 278 cases in 139 patients who took antiplatelet drugs over at least a six-month period were included in this study. We categorized these patients according to the type of drug used. The efficacy of antiplatelet drugs was evaluated using anklebrachial index (ABI) and pulse wave velocity (PWV). Results: Only the aspirin group showed a statistically significant increase of ABI after antiplatelet therapy ($1.10{\pm}0.12$ to $1.12{\pm}0.11$). In addition, only the cilostazol group showed a statistically significant decrease of PWV after antiplatelet therapy ($1,701.20{\pm}396.56$ to $1,627.42{\pm}324.98$). Conclusion: Aspirin and cilostazol may be used in treatment of diabetic peripheral vasculopathy, whereas dual antiplatelet therapy with aspirin and clopidogrel has no specific benefits in diabetic peripheral vasculopathy.

A study on the current status and perioperative management of antithrombotic in a general hospital

  • You, Seoung-Hee;Park, Sungwon
    • International Journal of Advanced Culture Technology
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    • 제10권1호
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    • pp.108-115
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    • 2022
  • The purpose of this study is to investigate the actual status of antithrombotic management before and after the procedure or surgery, the difference between the duration of medication suspension by clinical and demographic characteristics, and the patient's understanding and satisfaction after medication management by a dedicated nurse. The results were as follows. The most commonly used antithrombotic agents were aspirin and flavitol. The drug discontinuation period according to antithrombotic, procedures, and underlying diseases, there was a significant difference in duration for each variables(p<.000). In the case of antiplatelet drugs, 5-day suspension was the most frequent, and anticoagulants 2-day suspension was the most frequent. Depending on the procedure,colonoscope,nucleoplasty,rotator cuff repair,and total knee arthroplasty commonly showed more than 80% of 5-day discontinuation. The differences according to underlying diseases are as follows. 64.7% of all diseases discontinued on the 5th. The patient's understanding of the nurse's medication management performed before and after the procedure was found to be lower in Angina patients than those with other diseases. In terms of age, those in their 50s showed higher understanding than other age groups. There were no differences in understanding and satisfaction with the remaining characteristics.

급성 허혈성 뇌졸중에서 항혈전제 치료의 최신 가이드라인 개정과 근거에 대한 고찰 (Review of Updated Guidelines and Evidence for Antithrombotic Therapy in Acute Ischemic Stroke)

  • 백수희
    • 한국임상약학회지
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    • 제34권2호
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    • pp.79-99
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    • 2024
  • Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

술 전 항혈소판제 복합투여가 무심폐기하 관상동맥우회술 후 출혈에 미치는 영향 (Effects of Combined Antiplatelets on Bleeding in Off-Pump Coronary-Artery Bypass Surgery)

  • 이수경;김태진;송윤석;정선호;양경호;최강주;김용복
    • Journal of Yeungnam Medical Science
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    • 제28권2호
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    • pp.124-132
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    • 2011
  • Background: Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). Methods: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. Results: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. Conclusion: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.

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Effect of Allium sativum on cytochrome P450 and possible drug interactions

  • Janil, Ashutosh;Mehta, Anita A
    • Advances in Traditional Medicine
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    • 제6권4호
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    • pp.274-285
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    • 2006
  • Allium sativum (Family Amaryllidaceae or Liliaceae) is used worldwide for various clinical uses like hypertension, cholesterol lowering effect, antiplatelets and fibrinolytic activity etc. Due to these common house hold uses of Allium sativum, as a herbal supplements, and failure of patients to inform their physician of the over-the-counter supplements they consume leads to drugnutrient interactions with components in herbal supplements. Today these types of interactions between a herbal supplement and clinically prescribed drugs are an increasing concern. In vitro studies indicated that garlic constituents modulated various CYP (cytochrome P450) enzymes. CYP 3A4 is abundantly present in human liver and small intestine and contributes to the metabolism of more than 50% of commonly used drugs including nifedipine, cyclosporine, erythromycin, midazolam, alprazolam, and triazolam. Extracts from fresh and aged garlic inhibited CYP 3A4 in human liver microsomes. The in vivo effects of garlic constituents are found to be species depended and the dosing regimen of garlic constituents appeared to influence the modulation of various CYP isoforms. Studies have indicated that the inhibition of various CYPs by organosulfur compounds from garlic was related to their structure also. Studies using in vitro, in vivo, animal and human models have indicated that various garlic constituents can be the substrates, inhibitors and or inducers of various CYP enzymes. The modulation of CYP enzyme activity and expression are dependent on the type and chemical structure of garlic constituents, dose regime, animal species and tissue, and source of garlic thus this review throws light on the possible herb drug interaction with the use of garlic.

한양방결합치료로 장기간 생존하고 있는 교모세포종 증례 보고 (Case Report on Long Term Survival of Glioblastoma Patient Treated with Integrative Medicine)

  • 양주노;윤영주;홍진우;한창우;권정남;이인;박성하;김소연;최준용;이혜윤
    • 대한한의학회지
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    • 제39권1호
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    • pp.75-85
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    • 2018
  • 교모세포종 진단을 받고 항암치료와 수술을 시행한 30대 남자에게 서양의학, 한의학적인 치료를 결합하여 시행한 결과, 현재 비록 치료 후유증인 편마비가 남아 있으나 이미 14년간 재발없이 장기간 생존함으로써 한방치료의 가능성을 보여 주었기에, 이에 증례를 보고한다.