• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.322-327
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• 2002

The effect of GnRH alone and concomitant with PMSG on the prevention of implantation. termination of pregnancy, and concentration of plasma progesterone were studied in pregnant rats. GnRH 50, 100 or 200 ug alone and concomitant with PMSG 25 or 50 IU were administered once on day 2 or 9 of gestation, respectively. Rats were autopsied on days 7 or 20. Administration of GnRH on day 2 did not result in the prevention of implantation and termination of pregnancy but resulted in termination of pregnancy administering on day 9. Administration of GnRM concomitant with PMSG on day 2 or 9 resulted in prevention of implantation and termination of pregnancy, but injection of GnRH 50 ug concomitant with PMSG 25 IU on day 9 had only one live fetus. Administration of GnRH alone and concomitant with PMSG on day 2 had no effect on the concentration of plasma progesterone determining on day 7. Administration of GnRH concomitant with PMSG on day 2 resulted in decrease of progesterone level determining on day 20 but GnRH alone was normal level. Administration of GnRH alone and concomitant with PMSG on day 9 resulted in decrease of the concentration of progesterone but was normal concentration administering GnRH 50 ug concomitant with PMSG 25 IU.

• Korean Journal of Clinical Pharmacy
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• v.24 no.3
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• pp.193-198
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• 2014

Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.234-238
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• 2012

Background: Valproic acid is widely used in the treatment of generalized tonic-clonic and partial seizures. The carbapenem class is the most potent and widest spectrum of antimicrobial activity. Concomitant administration of carbapenems and valproic acid has been reported to decrease the serum concentration of valproic acid, which is sometimes associated with seizures. The purpose of this study is to evaluate the changes in valproic acid concentration and half life and the frequency of seizure during concomitant administration of valproic acid and carbapenems. Method: This study was performed retrospectively on total 40 cases with identified valproic acid concentration during concomitant administration of valproic acid and carbapenems at Kangbuk Samsung Hospital from February 1st, 2006 to October 31st, 2011. Patients were classified into 3 groups: ertapenem group (n=14), imipenem group (n=12), meropenem group (n=14). Results: The mean serum concentrations in each group during combined treatment were $9.50{\pm}8.84$, $21.88{\pm}8.17$ and $10.62{\pm}8.67$ mg/L, respectively (p < 0.001). The mean half-lives in each group during concurrent use of valproic acid and carbapenems were $3.18{\pm}0.81$, $4.63{\pm}1.97$ and $2.67{\pm}1.69$ hr, respectively (p < 0.001). The valproic acid serum concentration decreased by 75.5%, 54.1% and 84.1% and the half-life of valporoic acid decreased by 65.6%, 35.7% and 73.5%, respectively. Total cases with seizure were 12(30%) with 5(35.7%) in the ertapenem group, 3 (25.0%) in the imipenem group and 4(28.6%) in the meropenem group (p=0.911). There were no specific factors to influence on seizure development during combined treatment. Conclusion: Concurrent use of carbapenems and valproic acid should be avoided. If concomitant administration is essential, very close serum concentration monitoring and clinical observation are necessary.

• Journal of Oriental Neuropsychiatry
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• v.35 no.3
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• pp.217-229
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• 2024

Objectives: To develop guidelines for concomitant use of four herbal medicines (Gamisoyosan, Banhasasimtang, Ojeoksan, and Bojungikgitang) with escitalopram. Methods: A guideline development team was assembled and relevant prior research was systematically reviewed to gather evidence. The potential for drug interactions was evaluated by analyzing changes in pharmacokinetic parameters. Safety was assessed through the analysis of adverse drug reactions associated with combined use. Recommendations and concomitant administration guidelines were formulated through a consensus process. Results: No significant drug interactions were identified between the four herbal medicines and escitalopram, indicating no need for dosage adjustment of escitalopram. However, it is recommended to monitor potential adverse reactions during concurrent use. Conclusions: This study provides recommendations for combined use of four herbal medicines covered by domestic insurance combined with escitalopram. Further research on interactions between antidepressants and herbal medicine is necessary to refine and enhance concomitant administration guidelines.

• Journal of Veterinary Clinics
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• v.18 no.1
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• pp.48-54
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• 2001

The effects of PMSG and/or prostaglandin analogue, cloprostenol, on the prevention of implantation, termination of pregnancy, concentration of plasma progesterone, and Na and K contents of the plasma and uterine fluid were studied in pregnant rats. PMSG 50 or 100 IU concomitant with cloprostenol 90 or 180 mg were administered once on day 3 or 9 of gestation. Rats were autopsied on days 8, 10 or 21 gestation. A single administration of PMSG resulted in increasing the number of corpora lutea, preventing implantation and terminating pregnancy. A single administration of cloprostenol had no effect on the prevention of implantation and termination of pregnancy but was able to induce the termination of pregnancy administering at large doses on day 9. A single administration of PMSG concomitant with cloprostenol ws found to be very increased the number of corpora lutea and to be 100% effective in preventing implantation and to be nearly 100% effective in terminating pregnancy. It is uncommon that a single dose of PMSG 50 IU concomitant with cloprostenol 90 or 180 mg on day 9 was able to maintain the pregnancy at very low rates of 0.3∼5.3%. Concentration of plasma progesterone and Na and K contents of the plasma and uterine fluid were increased or decreased administering PMSG and/or cloprostenol, but had no effect on preventing implantation and terminating pregnancy.

• Journal of Veterinary Clinics
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• v.20 no.2
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• pp.212-219
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• 2003

The effect of GnRH and/or hCG on the implantation, pregnancy, and the concentration of plasma estradiol and progesterone were studied in pregnant rats. GnRH 50, or 100ug and/or hCG 50 or 100 IU were administered once on day 2 or 9 of gestation, respectively. Rats were autopsied on days 8 or 16. Administration of GnRH on day 2 did not induce the prevention of implantation and termination of pregnancy but was able to induce termination of pregnancy administering on day 9. Administration of hCG induced delayed implantation on day 2 and termination of pregnancy on day 2 and 9. Administration of GnRH concomitant with hCG had no effect on prevention of implantation on day 2 but induced termination of pregnancy with a very increased fetal resorption on day 2 and with a moderate increased fetal resorption on day 9. Administration of GnRH concomitant with hCG on day 2 induced more increased termination of pregnancy compared to injection of GnRH or HCG and opposite result was observed on day 9. Plasma estradiol and progesterone concentrations by administering GnRH and/or hCG had no effect on the termination of pregnancy the pregnant rats.

• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.204-214
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• 2022

Objective: This study aimed to investigate the occurrence and types of the adverse events (AEs) associated with oral fluconazole and itraconazole and factors associated with specific types of AEs. Methods: We analyzed AEs reported by community pharmacies nationwide over 10 years using the Korea Adverse Event Reporting System database. Various AE terms were categorized into 18 types, and concomitant medications were classified by drug-drug interaction (DDI) severity. The relationship between the specific type of AE and age, sex, and number of concomitant medications was investigated using multiple logistic regression analysis. Results: A total of 879 AE reports of fluconazole and 401 reports of itraconazole were analyzed; of these reports, 321 and 83 reports of fluconazole and itraconazole, respectively, described concomitant drug administration categorized as DDI severity of contraindicated or major. Women had a higher risk of psychiatric AEs associated with fluconazole use (OR, 1.587; p=0.042). Polypharmacy increased the risk for psychiatric AEs (OR, 3.598; p<0.001 for fluconazole and OR, 2.308; p=0.046 for itraconazole). In dermatologic AEs, the mean age of patients who received itraconazole was lower than that of patients who received fluconazole (46.3±16.8 vs. 54.9±15.4; p<0.001). Co-administration of fluconazole with 1-3 drugs increased the risk of neurological AEs (OR, 1.764; p=0.028). Conclusion: When using fluconazole and itraconazole, psychiatric AEs should be noted, particularly in women and in case of polypharmacy; moreover, when fluconazole is co-administered with other drugs, attention should be paid to the occurrence of neurological AEs.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.77-85
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• 2024

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.110-118
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• 2016

Background: Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient controlled analgesia (PCA). Methods: Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl $1,000{\mu}g$; Group B, fentanyl $500{\mu}g$ + nefopam 200 mg; and Group C, fentanyl $500{\mu}g$ + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. Results: Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. Conclusions: The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.

• The Journal of the Korean Society for Microbiology
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• v.34 no.6
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• pp.543-554
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• 1999

The purpose of this study was to evaluate the existence of amoxicillin, clarithromycin, and metronidazole resistance Helicobacter pylori and to determine the in-vitro MIC of two and three kinds of antibiotic concominant administration in the isolates. The antimicrobial agents tested against 169 H. pylori included metronidazole, amoxicillin, ciprofloxacin, clarithromycin, omeprazole, josamycin, erythromycin, and tetracycline. MIC of each antimicrobial agents was determined by broth microdilution method. The 169 strains of H. pylori were isolated from biopsy specimens of patients with gastric cancer. $MIC_{50}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 2.0, 1.0, 4.0, 8.0, 0.5, 0.5, and $0.5\;{\mu}g/ml$, respectively. $MIC_{90}$ of clarithromycin, amoxicillin, metronidazole, omeprazole, erythromycin, josamycin, tetracycline, and ciprofloxacin was 64.0, 64.0, 32.0, 16.0, 8.0, 2.0, and $1.0\;{\mu}g/ml$, respectively. H. pylori isolates were detected in the following resistaince rates: 34.3% to clarithromycin, 31.9% to metronidazole, 20.7% to amoxicillin, 12.4% to erythromycin, and 10.1% to josamycin. The prevalence of the antibiotic resistant strains of H. pylori were detected 18.1% for two kind of antibiotics and 9.6% for three kind of antibiotics, and 3.9% for four kind of antibiotics. The $MIC_{90}$ of clarithromycin-, metronidazole-, and amoxicillin-resistant H. pylori was decreased under the $1\;{\mu}g/ml$ by the two or three kind of antibiotic concomitant administration in-vitro. These results suggest that two or three antibiotics concomitant administration could be more effective for the treatment of clarithromycin-, amoxicillin-, metronidazole-, and josamycin-resistant H. pylori strains.