• Title/Summary/Keyword: Dosing

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COMPARISON OF TRAMADOL/ACETAMINOPHEN AND CODEINE/ACETAMINOPHEN/IBUPROFEN IN ONSET OF ANALGESIA AND ANALGESIC EFFICACY FOR POSTOPERATIVE ACUTE PAIN (수술후 급성 동통에 대한 Tramadol/Acetaminophen과 Codeine/Acetaminophen/Ibuprofen의 효과 발현시점과 진통효과의 비교)

  • Jung, Young-Soo;Kim, Dong-Kee;Kim, Moon-Key;Kim, Hyung-Jun;Cha, In-Ho;Han, Moo-Young;Lee, Eui-Wung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.143-149
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    • 2004
  • Background: Some clinical trials have reported that a new analgesic combination of tramadol and acetaminophen provides good efficacy in various pain models. For the more clinical uses of this agent, comparisons about the onset of analgesia and analgesic efficacy in the acute state of pain with the other drugs known as strong analgesics were needed. Purpose: The goal of this study was to compare the times to onset of analgesia and the other analgesic efficacy of 75 mg tramadol/650 mg acetaminophen and 20 mg codeine/500 mg acetaminophen/400 mg ibuprofen in the treatment of acute pain after oral surgery. Patients and Methods: Using a randomized, single-dose, parallel-group, single-center, and active-controlled test design, this clinical study compared the times to onset of analgesia using a two-stopwatch technique and the other analgesic efficacy of the single-dose tramadol/acetaminophen and codeine/acetaminophen/ibuprofen. These were assessed in 128 healthy subjects with pain from oral surgical procedures involving extraction of one or more impacted third molars requiring bone removal. From the time of pain development, the times to onset of perceptible and meaningful pain relief, pain intensity, pain relief, an overall assessment, and adverse events of the study medications were recorded for 6 hours. Results: The demographic distribution and baseline pain data in the two groups were statistically similar. The median times to onset of perceptible pain relief were 21.0 and 24.4 minutes in the tramadol/acetaminophen and codeine/acetaminophen/ibuprofen groups respectively and those to onset of meaningful pain relief were 56.4 and 57.3 minutes, which were statistically similar. The other efficacy variables such as mean total pain relief (TOTPAR) and the sum of pain intensity differences (SPID) were also similar in the early period after pain development and drug dosing. The safety of tramadol/acetaminophen was well tolerated and very comparable to that of codeine/acetaminophen/ibuprofen. Conclusions: In this acute dental pain model, the onset of analgesia and analgesic efficacy of tramadol/acetaminophen was comparable to that of codeine/acetaminophen/ibuprofen. These results showed that tramadol/acetaminophen was recommendable for fast and effective treatment in the management of postoperative acute pain.

Preference of Herbal Medicine Packagings for Caregivers (환아 보호자 대상으로 실시한 한약 용기 선호도 조사)

  • Jeong, A Ram;Lee, Hye Yoon;Cheon, Jin Hong;Kim, Ki Bong
    • The Journal of Pediatrics of Korean Medicine
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    • v.28 no.4
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    • pp.71-84
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    • 2014
  • Objectives The aim of this study is to investigate preferred herbal medicine packaging. Methods The study used questionnaires for the caregivers, who have administered their children herbal and western medicine. 106 of them were visited the Department of Pediatrics, the Oriental Medicine Hospital of ${\bigcirc}{\bigcirc}$ University, during the period between in 2014. We used PASW Stastics 18.0 to analyze different dosing methods, and preferred packaging and drug formulations. Results 1. 77.4% answered that they use cups to administer medications, 9.4% transferred it to other plastic bottles, 8.5% used straw to drink from the pouch, 4.7% drank as it is inside the pouch. Method of taking it was not very significant depending on the age. 2. Compare to pills and capsules, 48 responders answered that pills and capsules are easier to take, 11 answered herbal medication is easier to take. 32 answered that there were no significant difference. 3. 45.3% reported vinyl pouch was preferable, 44.3% answered spout pouch was preferred, 5.7% answered bottles are convenient, and another 5.7% responders thought cup was fine. Others include syrup bottles had 1 person. These varying preferences were not depending on the age variations. 4. 56.3% answered that price was the main reason why they prefer one over the other. Others 29.2% stated convenience, 12.5% reported safety, and 10.4% people answered ease of administration as their main reason for their preferences. Conclusions Based on this study, numbers of parents felt inconvenient administering herbal medicine as a vinyl pouch, and felt necessary to improve this. However, price and other reasons made vinyl pouch still more preferable option. Vinyl pouch that we are using today didn't show any safety issues. Therefore, it is recommended to still use vinyl pouch, but with caps on top to improve administration and distinguishing issues.

Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study (조현병 환자에서 장기지속형 항정신병 주사제 팔리페리돈 팔미테이트의 효능과 안전 : 24주 개방형 연구)

  • Kang, Hyun-Ku;Hahm, Woong;Shon, In-Ki;Paik, In-Ho
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.111-117
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    • 2013
  • Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

Metallothionein Induction and Its Protective Effect in Liver and Kidney of Rats Exposed to Cadmium Chloride (Cadmium에 의한 흰쥐의 간장 및 신장의 Metallothionein 변화와 방어효과)

  • Kim, Nam-Song;Lee, Jae-Hyung;Koh, Dai-Ha;Ki, No-Suk;Hwang, In-Dam
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.287-304
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    • 1991
  • Tolerance to several toxic effects of cadmium, including lethality has been shown following pretreatment with cadmium and zinc. This study was designed to determine if tolerance also develops to Cd-induced hepatotoxicityandrenaltoxicity. Three groups of rats (A, B, C), each consisting of 16 rats, were studied and each group was divided into four subgroups (1, 2, 3, 4), 4 rats for each subgroup. Rats were subcutaneously pretreated with saline (A), $CdCl_2$ (0.5 mg/kg, B), and $ZnCl_2$ (13.0 mg/kg, C) during time periods of $1{\sim}6$ weeks. At the end of the period, rats were challenged with $CdCl_2$ (3.0, 6.0 and 9.0 mg/kg, ip). After giving the challenge dose, cadmium and metallothionein (MT) concentrations were determined and also observed the histologic change in liver and kidney. The concentration of cadmium in liver and kidney increased dose-dependently to the challenge dosage. These da indicate the kidney is a major target organ of chronic cadmium poisoning, and suggest that cadmium induced hepatic injury, via release of Cd-MT, may play an important role in the nephrotoxicity observed in response to long-term exposure to cadmium. In addition, histologic examination of group $A_2,\;A_3\;and\;A_4$ revealed moderate to severe cadmium toxicity, evidenced by infiltration of inflammatory cells, cell swelling, pyknosis, enlarged sinusoids and necrosis in liver, and tubule cell necrosis and degeneration in kidney. However, MT concentrations in liver and kidney were increased by the pretreatment of $CdCl_2$ and $ZnCl_2$, and their morphological findings were not significantly changed, comparing with control group. Higher MT concentration in liver and kidney observed in the pretreated groups constitutes a plausible explanation of the protective effects of pretreatment against the cadmium toxicity after challenge dosing.

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Comparison of the Measurement of the Injection Rate of Radioactive Drugs Using 99mTc in Nuclear Medicine (핵의학과에서 99mTc를 이용한 방사성의약품의 투여율 측정 비교)

  • Son, Sang-Joon;Park, Jeong-Kyu;Jung, Dong-Kyung;Park, Myeong-Hwan
    • Journal of radiological science and technology
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    • v.43 no.2
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    • pp.97-103
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    • 2020
  • This study was conducted by SPECT test at the Department of Nuclear Medicine at Daegu P Hospital from June 1 to October 31, 2019. A 3-way injection material was mounted among inpatients, and a syringe that was administered with radiopharmaceuticals using a 99mTc labeled compound was secured. We tried to find a way to calculate the dose rate of each radiopharmaceutical and increase the dose rate. As a result of measuring the radioactivity of radio-pharmaceuticals using 99mTc, the average dose rate of 60 syringes of all 6 radiopharmaceuticals was 93.26±7.34%, and the average dose rate of 99mTc-DMSA was 77.72%, 15.54% lower than the total. As a way to increase the dosing rate, the average dose rate diluted twice with the remaining amount of syringe after administration using normal saline increased to 95.37±6.99%, and the average dose rate diluted three times increased to 96.32±6.86%. The corresponding sample t-test to compare the pre- and post-dose rates at 1 dilution and 2 and 3 dilutions. As a result of the dilution and 2 dilutions, the probability of significance was 0.013, which was significantly higher than the dilution(p<0.05). The probability of significance for dilution 1 and dilution 3 was 0.016, which was significantly higher than in one dilution(p<0.05). The sum of the average dose rate using the experimental 3-way line was the highest with 98.85±1.42% of 99mTc, 99mTc-ECD 98.82±1.26%, 99mTc-Mebrofenin 98.82 ± 1.16%, 99mTc-HDP 98.74 ± 1.91%, 99mTc -MIBI was 98.69 ± 1.48%, and 99mTc-DMSA was the lowest with 86.47 ± 4.74%. When the number of dilutions was 5 times using 0.5 cc of normal saline and when the number of dilutions was 5 times using 1 cc of normal saline, when the number of dilutions was 5 times using 0.5 cc of normal saline and 1 cc of nomal saline When the number of dilutions was 5 times and the syringe volume was 0.5 cc, there was a statistically significant difference (p<0.05). There was a statistically significant difference when the number of dilutions was 5 times using 1 cc of nomal saline and the number of dilutions was 5 times using 1 cc of normal saline, and the syringe volume was 0.5 cc (p<0.05).

Reduce the Energy Loss in Ruminant; Using Raphanus Sativus Extracts to Mitigate Methane Emission (반추동물의 에너지 손실을 줄이기 위한 연구; 무 추출물을 이용한 메탄 손실 억제)

  • Lee, Shin-Ja;Choi, You-Young;Lee, Su-Kyung;Lee, Il-Dong;Eom, Jun-Sik;Kim, Hyun-Sang;Kim, Do-Hyung;Lee, Sung-Sil
    • Korean Journal of Organic Agriculture
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    • v.25 no.4
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    • pp.917-930
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    • 2017
  • This study was conducted to evaluate Raphanus sativus extracts to methane reduction in rumen. Five different levels of R. sativus extracts were used to investigate the most effective dosing level for the decrease of methane production in the rumen. The rumen fluid was collected from a cannulated one Hanwoo cow ($BW=450{\pm}30kg$) consuming 600 g/kg timothy and 400 g/kg concentrate. On fermentation day, rumen fluid was collected at 2 hr postfeeding R. sativus extracts was dosed to achieve final concentration of 0, 1, 3, 5, 7, and 9% respectively, to fermentation bottles containing the mixture of rumen fluid and McDougall's buffer and 300 mg of timothy was added as a substrate. The fermentation was conducted for 3, 6, 9, 12, 24, 48 and 72 hr incubation time at $39^{\circ}C$ with shaking. In vitro ruminal pH values were measured normal range for ruminal fermentation. Dry matter disappearance was significantly higher (p<0.05) at 3 hr incubation time 1, 3 and 5% doses than that of control. The highest methane reduction was observed in 12 hr incubation time 5, 7 and 9%. The carbon dioxide emission was also significantly (p<0.05) lower than that of control at 12 hr incubation time 5, 7 and 9%. The total volatile fatty acid was no significant difference between control and all doses level at 12 and 24 hr incubation time. At 24 hr incubation time, the result of real-time PCR were indicated that M. archea was significantly lower (p<0.05) at all doses level comparing to that of control. In conclusion, R. sativus extracts were significantly decreased methane emission. R. sativus extracts were significantly lower (p<0.05) than that of control at 12 hr incubation time 5, 7 and 9% and no adversely effect in rumen pH, dry matter disappearance and total VFA.

Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.746-760
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Comparison of Piperacillin/Tazobactam Dosing (13.5 g/day vs. 18 g/day) for the Treatment of Hospital-Acquired Pneumonia and Ventilator-associated Pneumonia in Intensive Care Unit (중환자실 내 병원성 폐렴 치료를 위한 Piperacillin/Tazobactam의 용량에 따른 효과와 안전성 비교)

  • Kang, Jeung Yun;Lee, Kyung A;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.167-173
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    • 2018
  • Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.

DENIAL TREATMENT OF THE CHILD WITH CONGENITAL HEART DISEASE (선천성 심장질환 환아의 치과치료)

  • Kim, Jae-Gon;Lee, Yong-Hee;Kim, Mi-Ra;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.208-215
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    • 2000
  • Patient with congenital heart disease are susceptible to infective endocarditis, and bacteremia following dental procedures may lead to infective endocarditis is these patients. Therefore prophylactic antibiotics are recommended for patients with congenital heart disease who are undergoing dental procedures that are associated with infective endocarditis. In 1997 American Heart Association revised guidelines for a prophylaxis against infective endocarditis. The new American Heart Association recommendations for the prevention of infective endocarditis represent a substantial departure from past guidelines. Major change involve the indications for prophylaxis, antibiotic choice and dosing that may reduce bacteremic risk. Previously, antibiotic prophylaxis was suggested for dental procedures associated with any amount of bleeding. Now only those that are associated with significant bleeding are recommended for prophylaxis as dictated by clinical judgement. Recommended antibiotic prophylaxis regimens now consist of a single preprocedural dose, no second dose is recommended. This report presents three cases of dental treatment of patients with congenital heart disease under the most recent American Heart Association recommendations for antibiotic prophylaxis.

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Removal of Ca2+ and Fe3+ in Acid Mine Drainage by Tripolyphosphates (트리폴리인산염을 이용한 산성광산배수 내 칼슘 및 철이온 제거)

  • Hyun, Jaehyuk;Jeon, Hyungjoong;Kim, Jihoon
    • Journal of the Korean GEO-environmental Society
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    • v.10 no.5
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    • pp.27-32
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    • 2009
  • This study evaluates tripolyphosphate's ability to treat AMD (Acid Mine Drainage). Based on the batch test results for reaction between tripolyphosphate and AMD obtained from Munkyung coal mine, $4.7{\times}10^{-3}$ mole is the optimum dosage of tripolyphosphate for AMD treatment. $Ca^{2+}$ concentration is decreased from $16.4mg/{\ell}$ to $5.6mg/{\ell}$, in other words, the removal rate of $Ca^{2+}$ is 65.9%. $Fe^{3+}$ concentration is decreased from $3.7mg/{\ell}$ to $0.02mg/{\ell}$, that is, the removal rate of $Fe^{3+}$ is 99.5%. $SO{_4}^{2-}$ concentration ranges from $526.8mg/{\ell}$ to $566.5mg/{\ell}$, which shows no obvious decrease. After dosing up tripolyphosphate, $Na^+$ concentration in AMD ranges from $549.8mg/{\ell}$ to $599.3mg/{\ell}$ and orthophosphate concentration in AMD ranges from $6.82mg/{\ell}$ to $7.60mg/{\ell}$. It was found that the precipitate in the order of amount is Apatite${\gg}{\beta}$-tricalcium phosphate > $Fe(OH)_3$ from SEM, XRF, XRD analyses. Consequently, the treatment by tripolyphosphate is effective in pH buffering and in the removal of $Ca^{2+}$ and $Fe^{3+}$.

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