• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• Korean Journal of Clinical Pharmacy
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• v.29 no.4
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• pp.267-277
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• 2019

Backgrounds: With the globalization of drug development, multi-regional clinical trials (MRCTs) have emerged to facilitate rapid availability of medicines to patients worldwide. The present study aimed to has explored attitudes and perceptions towards adopting the Korean MRCT guideline. Methods: An online survey, consisting of 16 questions, classified into two subjects, was administered to stakeholders in Korea. Most quantitative components were measured using the Likert scales. A content analysis of the qualitative components was carried out to identify the keywords in open-ended responses. Results: A total of 94 survey responses were analyzed: 51 participants from pharmaceutical companies, 11 from clinical research organizations, and 21 from clinical trial centers. The content of the guideline was rated as appropriate for clarity, acceptability, and applicability (96.8, 96.8, and 93.6%, respectively). The local environmental impact of the systemic/political, academic/technical, and industrial/economical aspects of the guideline was rated as appropriate at 95.7, 97.9, and 91.5%, respectively. The suggested adoption period was 1~2 years (40, 42.6%). The concept and individuals' domestic circumstances were the key problems affecting the clarity, applicability, and local environmental impact of the guideline. Conclusion: The Korean MRCT guideline was well-developed. Their overall impact on the local environmental impact of MRCTs in Korea was expected to be beneficial, but methods are needed to minimize the negative impacts. The findings of this study can inform the priorities for the future adoption of the guideline in Korea.

• Korean Journal of Pharmacognosy
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• v.52 no.1
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• pp.1-12
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• 2021

Platycodon (Platycodon grandiflorum) is used as a food and medicinal ingredient worldwide, particularly in Northeast Asia. Although a large number of studies have been conducted to determine its medicinal efficacy, there is still a paucity of literature summarizing the clinical activity of Platycodon. In this systematic review, we aimed to summarize the clinical efficacy of Platycodon. All literature describing the clinical efficacy of Platycodon was collected from international databases, and relevant papers were carefully evaluated for eligibility. Data were extracted from the selected papers and quality evaluation was conducted in accordance with the standards provided by the National Institutes of Health (NIH), with all procedures being conducted in accordance with PRISMA 2009 checklist guidelines. After the removal of 342 papers, 644 studies were fully screened for their titles and abstracts, among which, 19 studies were finally selected for full summarization. Extraction of data indicated evidence of the effectiveness of Platycodon in the treatment of respiratory system-related diseases and cancer, and in the provision of immunity. However, we found that the quality and objectivity of evaluation, management of variable factors, sample size, and reproducibility were generally poor. Although Platycodon has shown potential antiviral, antibacterial, anticancer, and antidepressant effects, and promotion of immunity in clinical settings, it was not possible to integrate objective indicators to conduct a meta-analysis due to the lack of literature and insufficient studies. More investigations in the clinical setting should be conducted to confirm the functional effects of Platycodon.

• Korean Journal of Clinical Pharmacy
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• v.30 no.4
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• pp.270-278
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• 2020

Background: Although the identification of clinical and laboratory features in pediatric COVID-19 patients is essential in establishing an appropriate treatment plan, a systematic review and meta-analysis on the topic has yet to be reported. Methods: We searched MEDLINE, Embase, and Web of Science to access clinical and laboratory characteristics as well as clinical outcomes of children with COVID-19 infection. A meta-analysis using random-effect model was performed to estimate pooled prevalence and 95% confidence intervals. Results: Among the 532 studies initially collected, 12 articles were finally included in the meta-analysis. Among the investigated 320 pediatric patients with COVID-19, fever (48.2%) and cough (39.3%) were the most common symptoms. Almost one third of patients (30.4%) were asymptomatic. In laboratory findings, only 11.4% of pediatric patients experienced lymphocytopenia. Increased inflammatory markers including c-reactive protein (18.6%) and procalcitonin (32.4%) were observed. Only a few patients needed mechanical ventilation and intensive care support, and only one death was reported. Conclusion: Pediatric patients with COVID-19 infection exhibited milder symptoms and more favorable outcomes compared to adults. However, considering the high rate of asymptomatic pediatric patients, close monitoring is required to prevent community infection in asymptomatic conditions and hidden disease progression.

• Korean Journal of Clinical Pharmacy
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• v.22 no.1
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• pp.1-8
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• 2012

항혈소판제인 티크로피딘과 항고혈압제인 니칼디핀과의 약동학적 상호작용 연구를 위하여 티크로피딘 (3 또는 10 mg/kg)과 니칼디핀의 경구 (4 mg/kg) 및 정맥 (12 mg/kg) 투여하여 본 연구를 시행하였다. 연구방법: 티크로피딘이 cytochrome P450 (CYP) 3A4 활성과 P-glycoprotein (P-gp)의 활성에 미치는 영향도 평가하였다. 결 과: 티크로피딘과 니칼디핀의 병용투여 시 티크로피딘이 니칼디핀의 약물동태 파라미터에 미치는 결과는 다음과 같다. 티크로피딘은 CYP3A4 효소의 활성을 저해 하였으나 P-gp활성에는 영향을 미치지 못하였다. 니칼디핀의 혈중농도곡선하면적 (AUC)는 대조군에 비해 티크로피딘 10 mg/kg 병용투여군에서 유의성 (p < 0.05)있게 증가되었다. 상대적 생체이용률 (RB)은 티크로피딘 병용투여군에서 115-143%로 증가하였다. 결 론: 본 논문에서 흰쥐에 티크로피딘과 니칼디핀을 병용경구투여 시 니칼디핀의 생체이용률 (bioavailability)이 유의성 (p < 0.05)있게 증가된 것은 티크로피딘이 대사효소인 CYP3A4를 억제하여 소장과 간장에서 초회통과효과 (first-pass metabolism)를 감소 시켰기 때문인 것으로 사료된다. 본 실험결과를 토대로 인체에서 티크로피딘과 니칼디핀의 상호작용을 검토한 후 투여용량을 조절하는 것이 바람직하다고 사료된다.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.159-165
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• 2015

Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.

• Korean Journal of Clinical Pharmacy
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• v.6 no.2
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• pp.1-6
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• 1996

Carcadian rhythm dependence of vancomycin pharmacokinetics was evaluated in 5 normal volunteers receiving a single intravenous 1.0 g dose of vancomycin at 8 o'clock in the morning and another occasion at 8 o'clock in the evening in a crossover manner. The serum data were subjected to simultaneous computer nonlinear least squares regression analysis using a two-compartment pbarmacokinetic model. The mean half-life of vancomycin was $4.78\pm0.81$ hr in the morning and $4.25\pm0.51$ hr in the evening. The mean total body clearance of vancomycin was $1.29\pm0.58$ hr in the morning and $5.58\pm0.48$ hr in the evening. No circadian rhythm was found to be apparent in normal volunteers. The mean in intrasubject difference in the half-life between 8 A.M. and 8 P.M. was $15.4\%$ with fluctuations ranging from $10.4\sim33.8\%$, It is reasonable to consider individual circadian rhythm for effective dosage regimen of vancomycin in clinical chronotherapeutics.

• Korean Journal of Clinical Pharmacy
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• v.7 no.2
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• pp.91-95
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• 1997

• Korean Journal of Clinical Pharmacy
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• v.11 no.1
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• pp.42-44
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• 2001

• Korean Journal of Clinical Pharmacy
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• v.11 no.1
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• pp.45-47
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• 2001