• 제목/요약/키워드: Dosing guideline

검색결과 18건 처리시간 0.018초

인진(茵蔯)의 생식.발생 독성 시험 -배자(胚子)및 태자(胎子)발생을 중심으로- (Terato Genicity Test of Oral Administration of Artemisiae capillaris herba Extracts on New Zealand White Rabbit)

  • 노희목;김승모
    • 한국한의학연구원논문집
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    • 제16권2호
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    • pp.143-157
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    • 2010
  • Objectives : The objective of this study was to access the effect of Artemisiae capillaris herba Extracts on the organogenetic reproductive toxicity of New Zealand White rabbits when administered by oral gavage. Methods : Gestational New Zealand White rabbits were dosed from 6 days of gestation to 18 days of gestation. It was conducted in accordance with the recommendations of the KFDA Guideline for Detection of Toxicity to Reproduction for Medicinal Products. In addition, serum AST, ALT, LDH and ALP levels were detected with their necropsy and histopathological observation Results: No significant changes of body weights, gains and food consumption were demonstrated in all dosed groups compared to those of vehicle control group except for 2,000mg/kg-dosing group, which showed significantly increase of body weight compared to that of vehicle control group. Normal gross findings were demonstrated in all tested groups. No significant changes of number of corpora lutea, implantation, implantation rate, number of fetal death, loss rate of post-implantation, number of live youngs at C-section, survival rate of post-implantation, number of male live youngs at C-section, number of female live youngs, sex ratio of live young, external anomalies of live youngs and body weight of live youngs were demonstrated in all dosed groups compared to those of vehicle control group. Although some visceral variations such as thymic reminant in the neck, dilation of renal pelvis, dilated ureter and malpositioned left common carotid artery, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. Some malformations and variation were demonstrated with retardations. However, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. In addition, similar ossification numbers were detected in sternebrae, metacarpals, metatarsals, phalanges, cervical vertebrae, and sacral and caudal vertebrae. No Artemisiae capillaris herba Extracts treatment-related changes of serum AST, ALT, LDH and ALP levels were demonstrated in all dosed levels in this study. Conclusions : We could conclude that oral administration of Artemisiae capillaris herba Extracts hasn't an influence on the organogenetic reproductive toxicity.

보중익기합대칠기탕(補中益氣合大七氣湯) 추출물의 ICR마우스에서 경구 단회투여독성 평가 (Single Dose Toxicity Test of Bojungikkeehapdaechilkitang water extract in Male and Female ICR Mice)

  • 배영철;최빈혜;김동우;허진일;김대준;변준석
    • 대한한방내과학회지
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    • 제26권2호
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    • pp.369-378
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    • 2005
  • An herbal water extract of Bojungikkeehapdaechilkitang(BDT) was prepared to test it for single-dose and repeated-dose toxicity, genotoxicity and reproductive toxicity, and to obtain a 50% lethal dose$(LD_{50})$, approximated lethal dose(ALD), and approximated target organs for BDT. The extract was tested on female and male ICR mice according to KFDA Guideline 1999-61 at doasge level of 2000, 1000, 500, 250 and 125mg/kg/10mL In this study, clinical signs, mortalities and gross findings of principal organs were observed for 14 days of single dosing, and afterwards in some cases. The ALD and $LD_{50}$ of BDT extract obtained in this study was>2000mg/kg for both male and female ICR mice. Also, any possible digestive toxicity of BDT extract was found to be above 1000mg/kg in both male and female ICR mice. The results of this study strongly suggest that BDT extract has no toxic effect at dosage level below 500mg/kg.

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조혈모세포 이식 환자의 돌발성 구역·구토에 대한 항구토제 사용 현황 (Evaluation of Antiemetic Therapy for Breakthrough Nausea and Vomiting in Patients with Hematopoietic Stem Cell Transplantation)

  • 김지윤;홍소연;전수정;남궁형욱;이은숙;김은경;방수미
    • 한국임상약학회지
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    • 제28권3호
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    • pp.224-229
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    • 2018
  • Background: The patients receiving hematopoietic stem cell transplantation (HSCT) are known to have a high incidence of breakthrough nausea and vomiting due to the conditioning regimen. The purpose of this study was to evaluate the adequacy of antiemetic therapy for breakthrough nausea and vomiting in patients receiving HSCT and to propose an effective treatment regimen. Methods: We retrospectively reviewed the electronic medical records of 109 adult patients. The collected data were used to identify (1) antiemetic and dosing regimens prescribed for controlling breakthrough nausea and vomiting, (2) the rate of patients who developed breakthrough nausea and vomiting, and (3) the percent of antiemetics prescribed on the day of symptom onset. Based on the National Comprehensive Cancer Network guideline, we assessed the suitability of antiemetics for breakthrough nausea and vomiting, and prescription timing. Results: All patients were prescribed pro re nata antiemetics. About 40.0%, 41.4%, and 18.6% of patients were using one, two, and three or more additional drugs for breakthrough nausea and vomiting, respectively. The most frequently administered drugs were intravenous metoclopramide (43.8%) and granisetron patch (36.2%). Breakthrough nausea and vomiting occurred in 87 patients (79.1%) and they developed symptoms 320 cases. About 220 cases (68.8%) were treated with additional antiemetics on the day of symptom onset and the rate of symptom resolution was only 10.3% (9 patients). Conclusion: The breakthrough nausea and vomiting in patients receiving HSCT occurred very frequently and was hard to control, thus requiring more rapid and aggressive treatments.

중환자실 내 병원성 폐렴 치료를 위한 Piperacillin/Tazobactam의 용량에 따른 효과와 안전성 비교 (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)

  • 강정은;이경아;김재송;김수현;손은선
    • 한국임상약학회지
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    • 제28권3호
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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.

심방세동 환자의 고주파 도자절제술 전.후의 항응고약물요법 사용실태 분석 (Evaluation of Peri-procedural Anticoagulation Drug Therapy undergoing Radiofrequency Ablation in Patients with Atrial Fibrillation)

  • 김수현;안성심;김순주;방준석;나현오
    • 한국임상약학회지
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    • 제20권2호
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    • pp.159-164
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    • 2010
  • Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

국내 지반특성에 적합한 지반분류 방법 및 설계응답스펙트럼 개선에 대한 연구 (I) - 국내 내진설계기준의 문제점 분석 (Development of Site Classification System and Modification of Design Response Spectra considering Geotechnical Site Characteristics in Korea (I) - Problem Statements of the Current Seismic Design Code)

  • 윤종구;김동수;방은석
    • 한국지진공학회논문집
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    • 제10권2호
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    • pp.39-50
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    • 2006
  • 본 논문에서는 국내 162개 지반에 대한 전단파속도 주상도, 기반암 깊이 및 지반의 동적변형특성을 획득하여 등가선형해석을 수행한 후 미국 서부해안지역의 지반 특성과 비교 검토하였다. 검토 결과 국내의 일반적인 특성을 가지는 지반과 미국 서부해안지역의 지반은 기반암 깊이와 고유주기가 매우 다름을 확인하였다. 지진응답 해석 결과 단주기 증폭계수 $F_a$의 경우 1997 UBC 기준의 값보다 크게 산정되었고, 장주기 증폭계수 $F_v$는 작게 나타나 국내 지반특성에 적합한 증폭계수는 현재 국내 내진설계기준 값과는 매우 다른 경향을 보였다. 따라서, 증폭계수를 재산정하고 설계응답스펙트럼을 개선해야 할 필요성을 확인하였다. 본 논문에서는 현재 이용되고 있는 내진설계기준과 국내 지반특성과의 차이점 파악에 중점을 두었고, 개선방법에 대한 내용은 동반논문(II 지반분류 개선방법, III 설계응답스펙트럼 개선방법)에서 심도있게 논의하였다.

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea

  • Jun, Jin-Su;Seo, Ji-Hyun;Park, Ji-Sook;Rhee, Kwang-Ho;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권5호
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    • pp.417-430
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    • 2019
  • The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

식품첨가물의 독성자료 고찰과 ADI 평가지침 - 소포제 Polydimethylsiloxane를 사례로 - (Evaluation of Toxicological Data on Food Additives and Guideline for ADI establishment - Polydimethylsiloxane as emulsifier -)

  • 최찬웅;정지윤;박형수;문진현;이광호;이효민
    • 한국식품위생안전성학회지
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    • 제24권4호
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    • pp.352-356
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    • 2009
  • 본 연구는 최근 JECFA에서 이슈화된 식품첨가물의 평가 정보를 파악하여 국내에서 선제적 위해관리에 활용할 수있도록 하기 위하여, 제 69차 JECFA 회의에 의제로 선정된 PDMS의 독성자료 검토 및 monograph 작성 내용에 대하여 소개하고자 수행되었다. PDMS의 독성자료 검토는 'Guidelines for the preparation of toxicological working papers for the Joint FAO/WHO Expert Committee on Food Additives'에 근거하였고, 평가 의뢰 시 제공된 자료 및 추가적으로 검색된 자료를 활용하였다. PDMS는 거품제거와 뭉침 방지를 위하여 간장, 제당, 당밀, 유제품, 쨈, 과즙제품, 두부 등의 제조 시 첨가물로 사용된다. 15,000-20,000 Da 이하의 분자량을 가지는 PDMS가 혈관을 통해 좀 더 쉽게 흡수될 수 있다는 문제가 제기되어, 기존에 설정된 ADI 0-1.5 mg/kg bw/day의 검토가 요구되었다. 이에 따라 흡수, 분포, 배설에 대한 자료와 독성시험자료의 검토가 수행되었다. 검토 결과 PDMS는 체내로 흡수가 거의 이루어지지 않고 대부분 배설되었으며, 급성독성, 아만성독성, 만성독성시험에서 특이적인 전신증상이 관찰되지 않았다. 그러나 급성독성, 아만성독성 및 만성독성시험에서 안구독성이 일관되게 관찰되었으며 이 안구독성의 기전이 확실하게 밝혀지지 않았다. 따라서 이전에 설정된 ADI 0-1.5mg/kg bw/day 값에 안구독성에 대한 추가적인 safety factor 2를 적용하여 temporary ADI 0-0.8 mg/kg bw/day로 재설정하였다. 또한 독성시험에서 관찰된 안구독성의 타당성을 설명하기 위한 추가적인 연구결과를 2010년까지 제공하도록 요청하였다.