• Title/Summary/Keyword: Drug combination

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Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision

  • Woo, Young Sup;Bahk, Won-Myong;Lee, Jung Goo;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, InKi;Shim, Se-Hoon;Jon, Duk-In;Seo, Jeong Seok;Min, Kyung Joon;Kim, Won;Song, Hoo-Rim;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.434-448
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    • 2018
  • Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

In vivo Anti-fungal Activity of the Essential Oil Fraction from Thymus Species and in vitro Synergism with Clotrimazole

  • Kim, Ji-Hyun;Shin, Seung-Won
    • Natural Product Sciences
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    • v.13 no.3
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    • pp.258-262
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    • 2007
  • The antifungal activity of the essential oil fraction from Thymus magus, and its major component thymol, against Candida albicans was investigated in vitro and in vivo. The combined effects of the oils and clotrimazole, a commonly used antifungal drug for treatment of external candidiasis, were evaluated in this study. In experimental vaginal candidiasis the essential oil fraction of T. magnus resulted in relatively milder inhibition of fungal growth following the inoculation of test mice compared to clotrimazole. However, new fungal growth was not detected up to 12 days after cessation of treatment. In contrast, in a similar experiment using clotrimazole, C. albicans was detected in the $12^{th}$ day post-treatment with the sample. This result indicates that T. magnus oil could be a promising drug to control vaginal candidiasis. In checkerboard titer tests, the combination of clotrimazole with the essential oil fraction of T. magus or T. quinquecostatus resulted in significant synergism, with FIC indices between 0.14 and 0.27 against C. albicans, while clotrimazole combined with thymol, the major component of these oils, produced only an additive effect, with FIC indices ranging between 0.50 and 1.00. Thus, the prominent synergistic effects of clotrimazole combined with T. magus essential oil indicate that these compounds may be an effective treatment for C. albicans infections.

Detection of Norovirus in Contaminated Ham by Reverse Transcriptase-PCR and Nested PCR

  • Kim, Seok-Ryel;Kim, Du-Woon;Kwon, Ki-Sung;Hwang, In-Gyun;Oh, Myung-Joo
    • Food Science and Biotechnology
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    • v.17 no.3
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    • pp.651-654
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    • 2008
  • In order to enhance the efficacy of norovirus detection by reverse transcriptase-polymerase chain reaction (RT-PCR) and nested PCR, this study developed a norovirus mRNA concentration method using poly oligo dT-conjugated magnetic beads. An efficient norovirus detection protocol was performed on commercial ham using 2 viral elution buffers (glycine buffer and Tris beef extract buffer) and 2 concentration solutions [polyethylene glycol (PEG) and zirconium hydroxide]. The different approaches were verified by RT-PCR and nested PCR. This method was performed on ham in less than 8 hr by artificial inoculation of serial dilutions of the virus ranging from 1,000 to 1 RT-PCR unit/mL. The viral extraction and concentration method had 10-fold higher sensitivity using the combination of Tris beef extract buffer and PEG as compared to glycine buffer and zirconium hydroxide. This method proved that RT-PCR and nested PCR have the sensitive ability to detect norovirus in commercial ham, in that norovirus was successfully detected in artificially contaminated samples at a detection level as low as 1-10 RT-PCR unit/mL. Overall, such a detection limit suggests this protocol is both quick and efficient in terms of its potential use for detecting norovirus in meat products.

Drug Interaction between Ketoconazole and Paclitaxel in Rats (케토코나졸과 파크리탁셀과의 약물상호작용)

  • Choi, Jun-Shik;Park, Bok-Soon
    • Journal of Pharmaceutical Investigation
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    • v.33 no.3
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    • pp.223-227
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    • 2003
  • The purpose of this study was to investigate the effect of ketoconazole (20 mg/kg) on the pharmacokinetic parameters and the bioavailability of paclitaxel (40 mg/kg) orally coadministered in rats. The plasma concentration of paclitaxel in combination with ketoconazole was significantly (p<0.05) increased from 8 hr to 24 hr compared to that of control. Area under the plasma concentration-time curve (AUC) of paclitaxel with ketoconazole was significantly (coadministration p<0.05, pretreatment p<0.0l) higher than that of control. Peak concentration $(C_{max})$ of paclitaxel pretreated with ketoconazole were significantly (p<0.05) increased compared to that of control. Time to peak concentation $(T_{max})$ of paclitaxel pretreated with ketoconazole were significantly (p<0.05) shorter than that of control. Half-life at elimination phase $(t_{1/2{\beta}})$ of paclitaxel pretreated with ketoconazole was significantly (p<0.05) prolonged compared to that of control. Based on these results, it might be due to both inhibition of the enzyme cytochrome P450 and p-glycoprotein, which engaged in paclitaxel absorption and metabolism in liver and gastrointestinal mucosa.

Control of Avian Coccidiosis : Past, Present, and Future (닭 콕시듐병 방제의 과거, 현재, 그리고 미래)

  • Ruff, M.D.
    • Korean Journal of Poultry Science
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    • v.19 no.3
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    • pp.151-160
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    • 1992
  • Control of coccidiosis depends on medication, management, immunity, or some combination of these methods. Prophylactic medication with anticoccidials remains the primary method of control, although the development of drug resistance is a major problem. Shuttle and rotation programs are increasingly used to delay the onset of drug resistance. Sensitivity testing has become an important tool in the identification of what specific medications will be effective in specific poultry operations. Management techniques for the control of coccidiosis have not been totally effective because most disinfectants do not kill the coccidial oocysts. Present methods for vaccination are currently limited to the use of controlled doses of live coccidia. New vaccination methods under investigation include vaccination with attenuated strains or parasite antigens produced either by fractionating the parasites or genetically engineered sub unit vaccines.

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Combination of Curcumin and Paclitaxel-loaded Solid Lipid Nanoparticles to Overcome Multidrug Resistance

  • Li, Rihua;Xu, Wenting;Eun, Jae-Soon;Lee, Mi-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.41 no.6
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    • pp.381-386
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    • 2011
  • Multi-drug resistance (MDR) has been known as a major hurdle in cancer chemotherapy. One of the most clinically significant causes of MDR was the efflux of anticancer agents mediated by p-glycoprotein (p-gp) over-expressed in MDR cancer cells. To overcome MDR, there have been several strategies such as co-administration with p-gp inhibitors and encapsulation of anticancer drugs into drug delivery systems. In the present study, curcumin was evaluated for its potential as p-gp inhibitor and MDR reversal activity when combined with paclitaxel incorporated into lipid nanoparticles (PTX/LN). Western blot assay showed curcumin did not modulate the level of p-gp expression in MCF-7/ADR which is a MDR variant of human breast cancer cell line, MCF-7, and over-expresses p-gp. However, curcumin inhibited p-gp-mediated efflux of calcein in a dose-dependent manner even though it showed lower activity compared to verapamil, a well-known p-gp inhibitor. Incorporation of paclitaxel into lipid nanoparticles partially recovered the anticancer activity of paclitaxel in MCF-7/ADR. The combined use of curcumin and PTX/LN exhibited further full reversal of MDR, suggesting susceptibility of PTX/LN to the efflux system. In conclusion, combined approach of using p-gp inhibitors and incorporation of the anticancer agents into nano-delivery systems would be an efficient strategy to overcome MDR.

A Comparison of Butorphanol and Fentanyl Administered in Conjunction with Ketorojac in Intravenous Patient Controlled Analgesia after Total Abdominal Hysterectomy (복식 전자궁 절제술 후 통증 자가 조절 장치를 통하여 Ketorolac과 함께 투여한 Butorphanol과 Fentanyl의 비교)

  • Kim, Dong-Hee;Min, Hye-Ra
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.60-64
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    • 1998
  • Background: We compared butorphanol and fentanyl for opioids use in patient-controlled analgesia(PCA) with ketorolac to determine a suitable drug combination for postoperative pain control. Methods: Sixty patients were equally divided into 2 Groups. Group 1 (n=30) butorphanol 10 mg with ketorolac 180 mg; Group 2 (n=30) fentanyl 1 mg with ketorolac 180 mg, diluting 100 ml solutions intravenously via PCA pump after total abdominal hysterectomy under general anesthesia. Total infusion dosage of PCA drug, VAS pain scores, and side effects of both group were manitored. Results: Total infusion dosages were as follows: (Group 1) butorphanol 8.3 mg with ketorolac 149.7 mg; (Group 2) fentanyl $646.6\;{\mu}g$ with ketorolac 116.2 mg. The two groups showed similar pain scores auld side effects. Conclusions : Both butorphanol and fentanyl were effective for postoperative pain control using PCA pump, but butorphanol was more economical. The putative potency ratio of butorphanol to fantanyl was 12.8 : 1.

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Cardiac Transplantation; 1 Case Report (심장이식 1례보고)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.224-227
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    • 1993
  • We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

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Contents Analysis of Addiction Prevention in Middle School Textbooks (중독예방에 대한 중학교 교과서 내용 분석)

  • Park, Hyang Jin;Cho, Haeryun
    • Child Health Nursing Research
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    • v.23 no.1
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    • pp.19-27
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    • 2017
  • Purpose: The purpose of this study was to analyze addiction prevention related content shown in middle school text books. Methods: Using a combination of the terms "addiction", "drug", "medicine", "personal preference", "smoking", "drinking", "sex", "misuse" or "abuse" as key words, the researchers screened the table of contents of 23 randomly selected middle school textbooks from the 2009 curriculum. Finally 13 textbooks (physical education=10, health=3) were selected for this study, and analyzed using Krippendorff's contents analysis. Results: Through indepth discussion and investigation of the relevant textbooks, content related to addiction prevention included material addiction (77.8%) and behavioral addiction (22.2%). The construction of addiction prevention in middle school textbooks included understanding addiction, rejection of peer temptation, and empowerment of self-control. Conclusion: When developing an intervention for addiction prevention that targets middle school students, education with accurate addiction information must be considered so that the students have the correct knowledge about addiction and addiction prevention. Additionally, the ability to reject peer temptation when invited to act upon related addiction behaviors should be treated seriously. The empowerment of self-control is also important, and can be promoted through strengthening self-regulation competence.

Application of Metabolomics to Quality Control of Natural Product Derived Medicines

  • Lee, Kyung-Min;Jeon, Jun-Yeong;Lee, Byeong-Ju;Lee, Hwanhui;Choi, Hyung-Kyoon
    • Biomolecules & Therapeutics
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    • v.25 no.6
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    • pp.559-568
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    • 2017
  • Metabolomics has been used as a powerful tool for the analysis and quality assessment of the natural product (NP)-derived medicines. It is increasingly being used in the quality control and standardization of NP-derived medicines because they are composed of hundreds of natural compounds. The most common techniques that are used in metabolomics consist of NMR, GC-MS, and LC-MS in combination with multivariate statistical analyses including principal components analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Currently, the quality control of the NP-derived medicines is usually conducted using HPLC and is specified by one or two indicators. To create a superior quality control framework and avoid adulterated drugs, it is necessary to be able to determine and establish standards based on multiple ingredients using metabolic profiling and fingerprinting. Therefore, the application of various analytical tools in the quality control of NP-derived medicines forms the major part of this review. $Veregen^{(R)}$ (Medigene AG, Planegg/Martinsried, Germany), which is the first botanical prescription drug approved by US Food and Drug Administration, is reviewed as an example that will hopefully provide future directions and perspectives on metabolomics technologies available for the quality control of NP-derived medicines.