• Title/Summary/Keyword: Drug regimen

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A Phenomenological Study for the Inquiry into Long Life Factors in Persons of One Hundred and Above on Cheju Island (제주도 100세이상 노인의 장수요인 규명을 위한 현상학적 연구)

  • Kim, Seong-Hyuk
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.40-63
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    • 1998
  • A long life is the desire of many people. The purpose of this study was to describe long life factors for people aged one hundred and above on Chju island. The research was conducted using a phenomenological method to add understanding to this subject. The field work for this study was done from July, 1997 to February, 1998 on Cheju island. The sample consisted of 10 persons of one hundred or above and 12 families. They were audio-recorded and analyzed using Colaizzi's (1978) method. The results of the present study shows the following: The thoughts of the persons one hundred and above showed ten important concepts; 'dietary regimen', 'mental regimen', 'sleep regimen', 'residence regimen', 'health regimen', 'labor regimen', 'exercise regimen', 'being born', 'filial piety and posterity', 'attachment to life'. Concerning 'Dietary Regimen': Dietary regulation, Preferential food intake, Living on vegetables, Light eating, and concern for longevity in food intake were important. Concerning 'Mental Regimen' : Harmony, Clearheadedness, Mildness, Abstinence, Generosity, Relaxation, Gaiety, Inspiration and Strength were important. Concerning 'Sleep Regimen'; Enough sleeping hours, Sound sleep, Curved sleeping posture, and Comfortable bedding were important. Concerning 'Residence Regimen' ; Clean dwelling, Pleasant surroundings, Thatched house life, Living in the village with good-hearted people, and Regular life were important. Concerning 'Health Regimen'; Temperance of drug, use Proper temperature, Proper humidity, and a Clean body were important. Concerning 'Labor Regimen'; Agricultural labor, Diligence, and Domestic labor were important. Concerning Exercise Regimen': Proper exercise, and Sunbathing were important. Concerning 'Being Born' ; Strong physical constitution, Longevity lineage, and Destiny were important. Concerning 'Filial Piety and Posterity' : Showing respect to a long-lived elder and Reducing anxiety were important. Concerning 'Attachment to Life' ; The desire to live long was important. The following conclusion was made from the above results. Human beings cannot avoid death, but the span of life can be prolonged to the maximum span of human life by wisdom, health care, and proper environmental conditions. As a result, a health regimen must be imposed for longevity such as controling food intake, having positive thoughts, being relaxed, sleeping enough, clean dwelling, taking care of oneself which can improve immunity and resistance to decrease, as well as proper labor and exercise. In addition, when filial piety is served, the desire of longevity and retaining one's youthfulness for a long time can be achieved. These should be done to live long and lead a qualitative life. By the results of this research, the following is suggesed for nursing. To satisfy the basic nursing principle that nursing must be practiced to help people live long, education must be spread to people who are nursed and their family so that they can lead a healthy life. And in nursing elders, nurses must recognize that elders have a strong desire for life, even though they may have negative thoughts about life at times. Therefore nurses have to respect the elders' value of life, and help them improve their self-esteem and self -fulfilment.

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Serum miR-19a Predicts Resistance to FOLFOX Chemotherapy in Advanced Colorectal Cancer Cases

  • Chen, Qi;Xia, Hong-Wei;Ge, Xiao-Jun;Zhang, Yu-Chen;Tang, Qiu-Lin;Bi, Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7421-7426
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    • 2013
  • Background: Colorectal cancer is the fourth most common cancer worldwide and the second leading cause of cancer-related death. FOLFOX is the most common regimen used in the first-line chemotherapy in advanced colorectal cancer, but only half of the patients respond to this regimen and we have almost no clue in predicting resistance in such first-line application. Methods: To explore the potential molecular biomarkers predicting the resistance of FOLFOX regimen as the first-line treatment in advanced colorectal cancer, we screened microRNAs in serum samples from drug-responsive and drug-resistant patients by microarrays. Then differential microRNA expression was further validated in an independent population by reverse transcription and quantitative real-time PCR. Results: 62 microRNAs expressing differentially with fold-change >2 were screened out by microarray analysis. Among them, 5 (miR-221, miR-222, miR-122, miR-19a, miR-144) were chosen for further validation in an independent population (N=72). Our results indicated serum miR-19a to be significantly up-regulated in resistance-phase serum (p=0.009). The ROC curve analysis showed that the sensitivity of serum miR-19a to discriminate the resistant patients from the response ones was 66.7%, and the specificity was 63.9% when the AUC was 0.679. We additionally observed serum miR-19a had a complementary value for cancer embryonic antigen (CEA). Stratified analysis further revealed that serum miR-19a predicted both intrinsic and acquired drug resistance. Conclusions: Our findings confirmed aberrant expression of serum miR-19a in FOLFOX chemotherapy resistance patients, suggesting serum miR-19a could be a potential molecular biomarker for predicting and monitoring resistance to first-line FOLFOX chemotherapy regimens in advanced colorectal cancer patients.

Potentially Inappropriate Medications and Regimen Complexity on Readmission of Elderly Patients with Polypharmacy: A Retrospective Study

  • Sunmin Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.1-7
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    • 2023
  • Background: Along with the increase in the elderly population, concerns about polypharmacy, which can cause medication-related problems, are increasing. This study aimed to find out the association between drug-related factors and readmission in elderly patients within 30 days after discharge. Methods: Data of patients aged ≥65 years who were discharged from the respiratory medicine ward of a tertiary hospital between January and March 2016 were retrospectively obtained. The medication regimen complexity at discharge was calculated using the medication regimen complexity index (MRCI) score, comorbidity status was assessed using the Charlson comorbidity index (CCI), potentially inappropriate medications (PIMs) were evaluated based on the Beer 2019 criteria, and adverse drug events (ADEs) were examined using the ADE reporting system. Multivariable logistic regression analysis was used to evaluate the effect of medication-related problems on hospital readmission after controlling for other variables. Results: Of the 206 patients included, 84 (40.8%) used PIMs, 31 (15%) had ADEs, and 32 (15.5%) were readmitted. The mean age, total medications, MRCI, CCI, and PIMs in the readmission group were significantly higher than those in the non-readmission group. Age significantly decreased the risk of readmission (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.96) after adjusting for sex, length of hospital stay, and ADEs. The use of PIMs (OR, 2.38; 95% CI, 1.10-5.16) and increased CCI (OR, 1.50; 95% CI, 1.16-1.93) and MRCI (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased occurrence of readmission. Conclusion: PIMs were associated with a significantly greater risk for readmission than MRCI.

The Prevalence of Initial Drug Resistance among Pulmonary Tuberculosis Patients (초치료 폐결핵 환자들에 있어서 초회 약제내성률)

  • Kong, Jae Hwan;Lee, Sang Seok;Kang, Ha Yan;Park, Jae Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.95-101
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    • 2008
  • Background: Drug resistant tuberculosis (TB) in patients who have not received previous TB treatment (initial drug resistance) is a serious problem for the control of TB. However, prevalence of initial drug resistance among pulmonary TB patients has not been well characterized in Korea, especially in the private sector. We assessed the prevalence of initial drug resistance and evaluated the risk factors for drug resistance in pulmonary TB patients, at a regional tertiary hospital in Cheonan. Methods: We performed a drug susceptibility test for both first and second line anti-TB drugs in all culture-confirmed pulmonary TB patients who had not received a previous TB treatment at Dankook University Hospital from September 2005 to September 2007. In addition, we evaluated the initial drug resistance pattern and clinical characteristics of patients to evaluate the risk factors for initial drug resistance. We also assessed the influence of the drug susceptibility test results on the treatment regimen. Results: Of the total 156 cases where the drug susceptibility test was performed, resistance to at least one anti-TB drug was found in 21 cases (15.6%) and multidrug resistance, where TB was resistant to at least isoniazid and rifampin, was found in one case (0.6%). Multivariate logistic regression showed no clinical characteristics were independently associated with initial drug resistance. Of the total 156 patients who underwent the drug susceptibility test, the treatment regimen was changed for 15 patients (9.6%) according to the results of the drug susceptibility test. Conclusion: Initial drug resistance is common and the drug susceptibility test is informative for pulmonary TB patients who have not received previous TB treatment.

Drug Interaction of Probenecid and Lithium Carbonate (프로베네시드와 탄산리튬의 약물상호작용)

  • Lee, Jin-Hwan;Lee, Chong-Ki
    • Journal of Pharmaceutical Investigation
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    • v.17 no.2
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    • pp.95-98
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    • 1987
  • The drug interaction between probenecid and lithium carbonate was studied pharmacokinetically in rabbits. The blood level and the area under the concentration curve (AUC) of lithium carbonate administered orally were elevated by coadministration of probenecid. Probenecid inhibited the urinary excretion of lithium carbonate in rabbits. Biological half-life and $t_{max}$ of lithium carbonate were prolonged by coadministration of probenecid. From these results, dosage regimen of lithium carbonate is considered to be adjusted for effective and safe therapy in the coadministration of probenecid.

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Pediatric tuberculosis and drug resistance (소아 결핵과 약제 내성)

  • Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.529-537
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    • 2009
  • Drug-resistant tuberculosis in children has important implications for both the patients and tuberculosis control programs. In Korea, among all new patients, the isoniazid resistance rate was 9.9% and multidrug-resistant tuberculosis rate was 2.7% in 2004 (in patients aged 10-19 yr, the multidrug-resistant tuberculosis rate reached 2.1%). Tuberculosis in pediatric patients is difficult to diagnose because many children have nonspecific clinical signs and the detection rates of acid-fast bacilli smears and cultures are low. Therefore, every effort should be made to identify adult sources and obtain information on drug susceptibility because symptomatic adult patients have a higher chance of culture positivity and drug-susceptibility patterns are the same in most adult-child pair patients. Korean children are at significant risk of drug-resistant tuberculosis. As the isoniazid resistance rate is greater than 4% among the new cases in Korea, a four-drug regimen should be considered for initial treatment of children with active tuberculosis, unless drug-susceptibility test results are available. Treatment of drug-resistant tuberculosis in children is challenging and there are only few available data. Tuberculosis control programs should be continuous with specific focus on pediatric populations because they can serve as reservoirs for future active cases. Further studies are needed regarding treatment of drug-resistant tuberculosis in children.

Treatment of Drug Susceptible Pulmonary Tuberculosis

  • Shin, Hong-Joon;Kwon, Yong-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.161-167
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    • 2015
  • Tuberculosis (TB) remains a major global health problem, and the incidence of TB cases has not significantly decreased over the past decade in Korea. The standard short course regimen is highly effective against TB, but requires multiple TB-specific drugs and a long treatment duration. Recent studies using late-generation fluoroquinolones and/or high-dose rifapentine-containing regimens to shorten the duration of TB treatment showed negative results. Extending the treatment duration may be considered in patients with cavitation on the initial chest radiograph and positivity in sputum culture at 2 months of treatment for preventing TB relapse. Current evidence does not support the use of fixed-dose combinations compared to separate drugs for the purpose of improving treatment outcomes. All patients receiving TB treatment should be monitored regularly for response to therapy, facilitation of treatment completion, and management of adverse drug reactions. Mild adverse effects can be managed with symptomatic therapy and changing the timing of the drug administration, but severe adverse effects require a discontinuation of the offending drugs.

Therapeutic monitoring of vancomycin according to initial dosing regimen in pediatric patients

  • Kim, Dae-Il;Im, Mi-Sun;Choi, Jin-Hyoung;Lee, Jin-A;Choi, Eun Hwa;Lee, Hoan-Jong
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.1000-1005
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    • 2010
  • Purpose: This study aimed to determine the optimal initial vancomycin dose to achieve appropriate trough levels in pediatric patients. Methods: We analyzed clinical data for 309 children treated with intravenous vancomycin between 2004 and 2009 at 2 different hospitals in South Korea. The patients were 1-16 years old and exhibited normal renal function. Patient data, including reason for treatment and initial dosing regimen, were reviewed. Two subgroups were identified and compared according to initial vancomycin dose: 40 (35-45) mg/kg/day and 60 (55-65) mg/kg/day. Trough levels were obtained at steady state after at least 4 doses of vancomycin. Results: Patients who received vancomycin had post-operation or wound-related infections (37.2%), localized infection (12.9%), catheter-related infections (9.4%), meningitis (8.7%), or endocarditis (6.8%). Pathogens were confirmed in 79 cases: 28 cases of methicillin-resistant $Staphylococcus$ $epidermidis$ (35.4%) and 25 of methicillin-resistant $Staphylococcus$ $aureus$ (31.6%). Out of the 309 patients, 201 (65%) received vancomycin at 40 mg/kg/day and 108 (35%) at 60 mg/kg/day. Average trough concentrations were significantly different between the groups ($P$<0.001). Trough levels over 10 mg/L were less likely to be achieved in the 40 mg/kg/day group (14%) than in the 60 mg/kg/day group (49%) ($P$<0.001). There were no differences in renal function deterioration between the groups. Conclusion: A common vancomycin dosing regimen, 40 mg/kg/day, was not high enough to achieve trough levels of over 10 mg/L in pediatric patients. Careful drug monitoring must be performed, and increasing initial dose of vancomycin should be considered in pediatric patients.

HIV/AIDS Management: Dolutegravir Based Antiretroviral Drug Therapy

  • John, Ikpeama Osita;Emmanuel, Okoh Emeka;Anthonia, Ikpeama Chizoba;Joy, Ikpeama Chinwe;Adimabua, Okafor Patrick;Osazuwa, Igbineweka Osa;Andrew, Ikpeama Emeka;Mariam, Onuzulike Nonye;Gami, Hilary Tumba
    • The Korean Journal of Food & Health Convergence
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    • v.6 no.4
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    • pp.17-19
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    • 2020
  • HIV/AIDS disease still remain a global pandemic and it's management has undergone series of treatment changes and improvement although there is still no permanent cure.Dolutegravir belongs to a group of HIV drugs called integrase inhibitors. Integrase inhibitors block an HIV enzyme called integrase. By blocking integrase, integrase inhibitors prevent HIV from multiplying and can reduce the amount of HIV in the body.Dolutegravir combination based regimen has turned out to be very effective (antiviral) with negligible rare side effects on clients. This drug (Dolutegravir based regimen) combination has successfully increased the appetite for food of all the clients, unlike others and has shown to reduce viral load in the most shortest period ever. It can be deduced that development of resistant mutant virus will be reduced if not eliminated with dolutogravir based regimen.The role of Continuous adherence counseling has shown to improve clients treatment management. It is important to note that the availability of food has direct effect on the economic status or financial weight on the client. Hence the progress that is increase in body mass index (BMI) is a direct impact of the availability of food for the clients.

Analysis of Factors Affecting Medication Compliance of Outpatients (의료기관 외래 이용자의 복약순응 관련 요인분석)

  • Lee, Eui-Kyung;Park, Jeong-Young
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.164-175
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    • 2002
  • Background : The purpose of this study was to investigate the current status of medication compliance of outpatients and to analyze the factors contributing to medication non-compliance Methods : Telephone survey was conducted to the 1,000 outpatients who visited medical institutions during the period from January 2002 to April 2002. Subjects were randomly selected from the telephone directories of the nation, and the socio-demographic characteristics of the respondents such as age, gender and region were matched based on those of outpatients in 2001. Results : The results of survey revealed that those who complied with doctors' regimen in the right way accounted for 82.4%. The compliance increased with the strong belief in the medication, less unwanted side effects and inconvenience, more severity of disease, and lower perceived health status. Compliance rate was also higher in the patients group who experienced the drug education by the pharmacists than those who did not. Conclusion : In order to improve drug compliance, drug information on efficacy, adverse reaction, drug interactions, and basic disease information are to be provided to the patients. Drug education needs to be focused not only on providing knowledge of drugs and diseases but also changing attitude on drug use of the patients.

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