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Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.143-148
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    • 2020
  • Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

The Influence of Chlorine Application on Corrosion and Bacterial Growth in Home Plumbing Systems (급수관내 염소 주입이 미생물의 증식과 부식에 미치는 영향)

  • Kim, Tae-Hyun;Lee, Yoon-Jin;Lim, Seung-Joo
    • Journal of Environmental Health Sciences
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    • v.32 no.5 s.92
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    • pp.431-439
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    • 2006
  • This research was conducted using a model home plumbing system composed of copper, stainless steel, galvanized iron, carbon steel, and PVC (polyvinyl chloride) pipe. The number of bacteria present in stainless steel pipe and PVC was higher than other pipes. High turbidity and zinc release were found in galvanized iron pipe material and detected during the first 6 months. Conversely, there was a decrease in turbidity and zinc release after 6 months resulting in levels similar to other pipes. Copper concentration decreased as operation times increased. In this experiment, the number of bacteria detected in biofilm for a copper pipe continued to increase. Pipe material influenced bacterial numbers in biofilm and water. This showed that elevated chlorine could not control bacterial growth in biofilm for galvanized iron and stainless steel systems. It also suggested that the dosing of chlorine might not be available for all kinds of pipes. Therefore, another complementary method should be introduced to manage biofilm effectively in water distribution systems.

Zeolite Filtration for Ammonium Nitrogen Removal in Drinking Water Treatment (정수처리에서 암모니아성질소 제거를 위한 제올라이트 여과)

  • 김우항;김충환
    • Journal of Environmental Science International
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    • v.12 no.3
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    • pp.281-286
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    • 2003
  • This study was conducted to evaluate the feasibility of ammonia removal by zeolite adsorption in drinking water treatment. In generally, drinking water treatment process is conducted coagulation/flocculation, sedimentation, sand filtration and disinfection. We tested feasibility with two method, one is powdered zeolite dosing to coagulation tank and the other is to substitute granular zeolite for sand of sand filter. In powdered zeolite test, raw water is used tap water with putting of 2 mg/l of NH$_4$$\^$+/-N. Filtration of granular zeolite was conducted with 80 cm of effective column high and 120 m/d of flow rate. At above 100 mg/1 of zeolite dosage, ammonia concentration was decreased below 0.5 mg/l of NH$_4$$\^$+/-N in powdered zeolite test. But, turbidity was increased to 30 NTU by powdered zeolite dosage. That turbidity was scarcely decreased in generally coagulant using condition in drinking water treatment. In granular zeolite test, ammonia was not detected in treated water until 8 days. This result suggest that using of granular zeolite in sand filter could be removal ammonia in winter. But we need regeneration at zeolite filtration for ammonia removal. So, it is to make clear that zeolite regeneration ability was compared KCl with NaCl. The result reveal that KCl was more excellent than NaCl. Optimum regeneration concentration of KCl was revealed 100 mM. Regeneration efficient was not increased at pH range 10∼12.5.

Closed Queueing Networks and Zeros of Successive Derivatives

  • Namn, Su-Hyeon
    • Journal of the Korean Operations Research and Management Science Society
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    • v.22 no.1
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    • pp.101-121
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    • 1997
  • Consider a Jackson type closed queueing network in which each queue has a single exponential server. Assume that N customers are moving among .kappa. queues. We propose a candidata procedure which yields a lower bound of the network throughput which is sharper than those which are currently available : Let (.rho.$_{1}$, ... .rho.$_{\kappa}$) be the loading vector, let x be a real number with 0 .leq. x .leq. N, and let y(x) denote that y is a function of x and be the unique positive solution of the equation. .sum.$_{i = 1}$$^{\kappa}$y(x) .rho.$_{i}$ (N - y(x) x $p_{i}$ ) = 1 Whitt [17] has shown that y(N) is a lower bound for the throughput. In this paper, we present evidence that y(N -1) is also a lower bound. In dosing so, we are led to formulate a rather general conjecture on 'quot;Migrating Critical Points'quot; (MCP). The .MCP. conjecture asserts that zeros of successive derivatives of certain rational functions migrate at an accelerating rate. We provide a proof of MCP in the polynomial case and some other special cases, including that in which the rational function has exactly two real poles and fewer than three real zeros.tion has exactly two real poles and fewer than three real zeros.

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Predicting Feed Intake of Fallow Deer (Dama Dama) Using Alkanes as a Marker

  • Ru, Y.J.;Miao, Z.H.;Glatz, P.C.;Choct, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.2
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    • pp.209-212
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    • 2002
  • The understanding of seasonal forage intake of grazing deer is essential for the development of supplementary feeding strategies in southern Australia. The alkane technique is used in other animal species for estimating feed intake of individual animals and their diet composition. To assess the potential of using alkanes as a marker for predicting feed intake of fallow deer, the daily faecal recovery of alkanes and excretion rate of dosed artificial alkanes (C32 and C36) were measured with 6 deer fed three forage based diets. The artificial alkane capsule designed for use in sheep is suitable for fallow deer. Faecal samples need to be collected over days 7-19 after dosing. The daily excretion rate was 40 mg for C32 and 37 mg for C36. The faecal recovery of natural alkanes is incomplete and the faecal concentrations of alkanes need to be adjusted for an accurate estimation of intake. The actual feed intake of 6 experimental deer over a 5 day period was accurately estimated ($R^2$=0.52) using alkanes.

Respiratory Depression during Oral MS-Contin Administration for Pain Management of Gall Bladder Cancer (말기 담낭암 환자의 통증조절을 위해 MS Contin 투여중 발생한 호흡억제 -증례 보고-)

  • Lee, Chul-Woo;Lee, Byung-Ho;Lee, Yong-Hee
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.239-243
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    • 1996
  • MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

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Preparation of Temazepam Soft Elastic Gelatin Capsule (Softgel) and Bioavailability in Rabbits (테마제팜 연질캅셀제의 제조와 가토에 있어서 생체이용율)

  • Park, Gee-Bae;Jung, Eui-Cha;Cho, Jung-Ki;Lee, Kwang-Pyo
    • Journal of Pharmaceutical Investigation
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    • v.22 no.1
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    • pp.49-54
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    • 1992
  • This study was carried out for the purpose of developing an effective temazepam soft elastic gelatin capsule (softgel) which exhibits an excellent bioavailability and of comparing the rate and extent of absorption of temazepam from the marked elixir and prepared softgel using hydrophilic liquid such as polyethylene glycol 400 as a suspending agent by rotary die method. Both softgel and elixir containing 3 mg of temazepam were given to 7 healthy male New Zealand White rabbits in a single oral dose cross-over study. Plasma temazepam concentrations were measured by HPLC. The mean peak concentrations of temazepam following a single oral dosing as softgel and elixir dosage form were 13.84 and 13.25 ng/ml, respectively. And the mean time to peak concentration was 1.29 hr for the softgel and 1.07 hr for the elixir. There was no significant difference in the extent of drug absorption (AUC) for the two different dosage froms (p>0.05). While the softgel exhibited mean lag time of 0.63 hr, the elixir did not show any lag time. Statistical moment parameters such as the mean residence time and variance of the mean residence time did not differ significantly for the two formulations.

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Effect of Chekambohyulansin-tang, a Poly-herbal Formula, on the Obesity rats induced by Ovariectomy (체감보혈안신탕이 난소적출로 유발된 흰쥐의 비만에 미치는 영향)

  • Kwon Young Kyu;Kang Soon Byung;Kim Sang Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.380-393
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    • 2003
  • In order to evaluate the effect of Chekambohyulansin-tang (CST) which was a traditional poly-herbal formula has been used for treatment of obesity in Korea, on the obesity in ovariectomized rats, the changes of body weight, peri-kidney, abdominal and perineal subcutaneous fat weight and their histological changes were measured with the detection of number and/or size of adipocytes after an oral administration of CBT extracts (125, 250 and 500 mg/kg, respectively). CBT significantly attenuated elevations in the body weight, the absolute and relative weight of peri-kidney, abdominal and perineal fat tissues and decrease the severe hypertrophy, the number of adipocytes, and the diameter of adipocytes of peri-kidney, abdominal and perineal fat tissues in ovariectomized rats in a dose dependent manner. These results provide a story evidence that CBT can playa role in the treatment of obesity induced by ovariectomy. Determination of the specific mechanisms involred toxicological dosage of CBT on obesity will require addition study.

Single Oral Dose Toxicity Test of Choweseuncheng-tang, a Polyherbal Formula in ICR Mice (조위승청탕의 마우스 경구 단회 투여독성 평가)

  • Jung, Tae Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.1
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    • pp.53-58
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    • 2014
  • The object of this study was to evaluate the single dose toxicity of Choweseuncheng-tang (CWS), a polyherbal formula have been traditionally used as prevention or treatment agent for various diseases as Tae-eumin prescription on Korean medicinal theory, Sasang-euihak, in male and female mice. Aqueous extracts of CWS (yield = 11.00%) was administered to female and male mice as an oral dose of 2,000, 1,000 and 500 mg/kg (body weight) according to the recommendation of Korea Food and Drug Administration (KFDA) Guidelines. Animals were monitored for the mortality and changes in body weight, clinical signs and gross observation during 14 days after dosing, upon necropsy; organ weight and histopathology of 14 principle organs were also examined. As results, we could not find any CWS treatment related mortality and clinical signs, changes in the body and organ weights, gross findings and changes in histopathology of principle organs, except for some dose-independent accidental findings. The results obtained in this study suggest that the 50% lethal dose and approximate lethal dose of CWS aqueous extracts in both female and male mice were considered as over 2,000 mg/kg, the limited highest dosage recommended by KFDA Guidelines, and can be safety used in clinics.

Single Oval Dose Toxicity Study of the Extract of Aralia elata in Mice (마우스에서 두릅 추출물의 단회경구투여 독성시험)

  • Yang, Hee-Kyoung;Jin, Ju-Youn;Kim, Ji-Min;Ko, Mun-Su;Hong, Hyun-Ju;Kim, Sang-Chul;Lee, Young-Jae
    • Toxicological Research
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    • v.22 no.4
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    • pp.439-443
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    • 2006
  • This study was conducted to investigate the potential acute toxicity of Aralia elata by a single oral dose in ICR mice. Thirty mice of each sex were randomly assigned to three groups of 10 mice each. The test articles were administered once by the gavage to mice at dose levels of 0, 2,500 and 5,000 mg/kg body weight. The mortality and changes on body weight and clinical signs of gross observation were monitored for 14 days after dosing. At the end of 14-day observation period, all animals were sacrificed and complete gross postmortem examinations were performed. There were no dead animal and adverse effects on clinical signs, the body weight and the gross finding. As the results, we could not find any toxic effect at the dose levels of 2,500 or 5,000 mg/kg in mice and the minimal lethal dose was considered to be over 5,000 mg/kg body weight in mice.