• Title/Summary/Keyword: Effect of drugs

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Factors Affecting Patient Waiting Times at the Outpatient Pharmacy Department in a Tertiary Care Hospital (3차진료기관 외래약국 투약대기시간에 영향을 주는 요인)

  • Park, Hayoung;Han, Ok-Youn;La, Hyun-Oh
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.60-72
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    • 1994
  • Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

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Local Drug Delivery System Using Biodegradable Polymers

  • Khang, Gil-Son;Rhee, John M.;Jeong, Je-Kyo;Lee, Jeong-Sik;Kim, Moon-Suk;Cho, Sun-Hang;Lee, Hai-Bang
    • Macromolecular Research
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    • v.11 no.4
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    • pp.207-223
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    • 2003
  • For last five years, we are developing the novel local drug delivery devices using biodegradable polymers, especially polylactide (PLA) and poly(D,L-lactide-co-glycolide) (PLGA) due to its relatively good biocompatibility, easily controlled biodegradability, good processability and only FDA approved synthetic degradable polymers. The relationship between various kinds of drug [water soluble small molecule drugs: gentamicin sulfate (GS), fentanyl citrate (FC), BCNU, azidothymidine (AZT), pamidronate (ADP), $1,25(OH)_2$ vitamin $D_3$, water insoluble small molecule drugs: fentanyl, ipriflavone (IP) and nifedipine, and water soluble large peptide molecule drug: nerve growth factor (NGF), and Japanese encephalitis virus (JEV)], different types of geometrical devices [microspheres (MSs), microcapsule, nanoparticle, wafers, pellet, beads, multiple-layered beads, implants, fiber, scaffolds, and films], and pharmacological activity are proposed and discussed for the application of pharmaceutics and tissue engineering. Also, local drug delivery devices proposed in this work are introduced in view of preparation method, drug release behavior, biocompatibility, pharmacological effect, and animal studies. In conclusion, we can control the drug release profiles varying with the preparation, formulation and geometrical parameters. Moreover, any types of drug were successfully applicable to achieve linear sustained release from short period ($1{\sim}3$ days) to long period (over 2 months). It is very important to design a suitable formulation for the wanting period of bioactive molecules loaded in biodegradable polymers for the local delivery of drug. The drug release is affected by many factors such as hydrophilicity of drug, electric charge of drug, drug loading amount, polymer molecular weight, the monomer composition, the size of implants, the applied fabrication techniques, and so on. It is well known that the commercialization of new drug needs a lot of cost of money (average: over 10 million US dollar per one drug) and time (average: above 9 years) whereas the development of DDS and high effective generic drug might be need relatively low investment with a short time period. Also, one core technology of DDS can be applicable to many drugs for the market needs. From these reasons, the DDS research on potent generic drugs might be suitable for less risk and high return.

QTc Prolongation due to Psychotropic Drugs Intoxication and Its Risk Assessment (향정신성 약물 중독에 의한 QTc 연장과 그 위험성에 대한 고찰)

  • Park, Kwan Ho;Hong, Hoon Pyo;Lee, Jong Seok;Jeong, Ki Young;Ko, Seok Hun;Kim, Sung Kyu;Choi, Han Sung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.66-77
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    • 2020
  • Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual's risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.

Effects of aquatic drugs and immune response in color carp, Cyprinus carpio, to Aeromonas hydrophila (Aeromonas hydrophila에 대한 비단잉어의 면역반응과 수산약제의 영향)

  • Ji, Bo-Young;Park, Soo-Il
    • Journal of fish pathology
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    • v.5 no.2
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    • pp.77-85
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    • 1992
  • This study was carried out in order to investigate the immunosuppressive factor and immune response of color carp. The protection and serum antibody production of juvenile color carp aganist Aeromonas hydrophila were investigated on the effect of temperature differences and injected several aquatic drugs, i.e. Hydrocortisone, Oxytetracycline, Chloramphenicol and Ascorbic acid. The fish were injected intraperitoneally with 1mg/fish of HKC and FKC at three different temperature conditions as $16^{\circ}C$, $24^{\circ}C$, and $32^{\circ}C$ respectively. There were induced better protection and serum antibody production in the fish which had been kept at $24^{\circ}C$ than in the fish which had been kept at $16^{\circ}C$ and $32^{\circ}C$. The FKC immunized fish were followed 24 hrs later with intraperitoneal injection of 40mg/kg body weight of Hydrocortisone, 60mg/kg body weight of Oxytetracycline. 60mg/kg body weight of Chloramphenicol and 30mg/kg body weight of Ascorbic acid, respectively. The control fish were injected PBS only. The fish given the above aquatic drugs reduced serum antibody production level and protection rate when compared to control fish. As the results, immune response of juvenile color carp immunized FKC at $24^{\circ}C$ was more effective than $16^{\circ}C$ or $32^{\circ}C$ and immune response of juvenile color carp injected several aquatic drugs which was seemed to be immunosuppressive factor.

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Prediction of Drug Side Effects Based on Drug-Related Information (약물 관련 정보를 이용한 약물 부작용 예측)

  • Seo, Sukyung;Lee, Taekeon;Yoon, Youngmi
    • The Journal of Korean Institute of Information Technology
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    • v.17 no.12
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    • pp.21-28
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    • 2019
  • Side effects of drugs mean harmful and unintended effects resulting from drugs used to prevent, diagnose, or treat diseases. These side effects can lead to patients' death and are the main causes of drug developmental failures. Thus, various methods have been tried to identify side effects. These can be divided into biological and systems biology approaches. In this study, we use systems biology approach and focus on using various phenotypic information in addition to the chemical structure and target proteins. First, we collect datasets that are used in this study, and calculate similarities individually. Second, we generate a set of features using the similarities for each drug-side effect pair. Finally, we confirm the results by AUC(Area Under the ROC Curve), and showed the significance of this study through a comparison experiment.

The Combined Antiallodynic Effect of Gabapentin and Milnacipran in a Rat Neuropathic Pain Model (흰 쥐의 신경병증성 통증 모델에서 Gabapentin과 Milnacipran의 병용 효과)

  • Lee, Hyeon Jeong;Shin, Sang-Wook;Jang, Hee Jeong
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.8-14
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    • 2007
  • Background: Anticonvulsants and antidepressants are adjuvant analgesic drugs that are used widely for treating chronic neuropathic pain syndromes. The combined analgesic effect of gabapentin and milnacipran was investigated with a rat neuropathic pain model. Methods: The rat neuropathic pain model was made by ligating the spinal nerves (L5 and L6). An intrathecal catheter was inserted into the subarachnoid space. Tactile allodynia was tested with the up-down method using von Frey hair. We determined the antiallodynic effect of intraperitoneal (I.P.) and intrathecal (I.T.) gabapentin. The combined effect of I.P. gabapentin (50 mg/kg) and milnacipran (0, 10 and 30 mg/kg) was investigated. Results: Intraperitoneal and intrathecal administration of gabapentin increased the threshold for tactile allodynia (the ED50 was 60.6 mg/kg and $45.5{\mu}g$, respectively). Co-administration of I.P. milnacipran increased the antiallodynic effect of I.P. gabapentin in a dose-dependent fashion. Conclusion: The combined administration of milnacipran and gabapentin may increase the total analgesic effect during treatment of neuropathic pain.

Sensitivity of Plasmodium falciparum to Antimalarial Drugs in Hainan Island, China

  • Wang, Shan-Qing;Wang, Guang-Ze;Li, Yu-Chun;Meng, Feng;Lin, Shi-Gan;Zhu, Zhen-Hu;Sun, Ding-Wei;He, Chang-Hua;Hu, Xi-Min;Du, Jian-Wei
    • Parasites, Hosts and Diseases
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    • v.53 no.1
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    • pp.35-41
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    • 2015
  • Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time ($22.5{\pm}10.6hr$) and the mean parasite clearance time ($27.3{\pm}12.2hr$) showed no statistical significance with different genders, ages, temperatures, or parasite density (P>0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P<0.0001). The resistance intensities decreased as follows: chloroquine>piperaquine>pyronarididine>artesunate. The inhibitory dose 50 ($IC_{50}$) was $3.77{\times}10^{-6}mol/L$, $2.09{\times}10^{-6}mol/L$, $0.09{\times}10^{-6}mol/L$, and $0.05{\times}10^{-6}mol/L$, and the mean concentrations for complete inhibition (CIMC) of schizont formation were $5.60{\times}10^{-6}mol/L$, $9.26{\times}10^{-6}mol/L$, $0.55{\times}10^{-6}mol/L$, and $0.07{\times}10^{-6}mol/L$, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.

Human Neutrophil Cathepsin G: In Vivo Synthesis of Anti-HNCG Antibody, Inhibition of the Activity of HNCGs and Mechanism of the Inhibitions (사람 호중구 Cathepsin G: Anti-HNCG Ab의 In Vivo 합성, HNCG의 활성도 억제와 그 기전에 관한 연구)

  • Bae, Sung-Jun;Kim, Woo-Mi;Kim, Ki-Chan;Chang, Myung-Woong;Kang, Koo-Il
    • The Korean Journal of Pharmacology
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    • v.27 no.2
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    • pp.145-153
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    • 1991
  • Human neutrophil cathepsin-G, which has been known as one of the active enzymes causing inflammatory diseases, was purified by two steps procedure involving one size exclusion (Ultorogel AcA54) and one ion exchange (CM-Sephadex) chromatography. Purified HNCGs were cross-reacted with Anti-HNCathepsin-G antibodies which were radised in rabbits and purified by cathepsin-G labeled Sepharose 4B affinity chromatography. HNCGs were effectively inhibited by NSAIDs including phenylbutazone, sulindac, oxyphenbutazone, salicylic acid and salicyluric acid. $IC_{50}_s$ of these drugs for inhibition of Cathepsin G were 0.3-0.8 mM. Other NSAIDs including aspirin showed little or no inhibition effect on the activity of Cathepsin G. These results strongly indicated that NSAIDs which showed inhibition effect on the activity of HNCGs possibly be at least a part of mechanism of action which might be related to direct inhibition of cathepsin G at the tissue destruction sites beside of their known mechanism of action as an anticyclo-oxygenase in treatment of inflammatory diseases. Lipid soluble component of Korean Red Ginseng which was known as an anti-inflammatory agent inhibited HNCGs strongly, but no other fractions did inhibited HNCGs. Antibiotics including novobiosin and rifamycin showed some inhibition effect on HNCGs, i. e.., $IC_{50}$ of these drugs were 2.6 mM and 1.5 mM respectively, and other antibiotics including penicillin G showed no or negligible inhibition effect on the activity of HNCGs. However. tetracyclines inhibited HNCGs very effectively at the concentration of therapeutic range. The inhibition effect of the activity of HNCGs by tetracycline are not related to the N-dimethyl radical on the 4 position of the tetracycline molecule. Furthermore, N-dedimethylated tetracyclines may have beneficial effect for long term treatment of chronic inflammatory diseases without developing any drug resistance to microorganisms.

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Effect of Geijibokryunghwan and each constituent herb on inhibition of platelet aggregation (계지복령환(桂枝茯笭丸) 및 그 구성약물(構成藥物)의 혈소판응집억제(血小板凝集抑制)에 관(關)한 연구(硏究))

  • Kim, Jong-Goo;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.115-129
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    • 2000
  • The cause that the increase of animality fat intakes, under exercise, fatness, adding the stress, advanced age etc., the occurrence rate of the circulation system disease has been increased. And the thrombosis importantly came to the front as the risk factor of these circulation system's disease. Nowadays, the ischemic disease has especially discussed, for example the angina or myocardial infarction, originated in thrombosis that came from the platelet aggregation. In the western medicine, as the cure and prevention, using the aspirin or ticlopidine for platelet aggregation suppressant. But in the , the curing method must be used properly according to the pectoralgia or heartache's kind, state, grade. The platelet do not attache to the normal hemangioendothelial cell. But when it stimulated by endothelium peronia and so on, it attache to the injury endothelium or rise aggregation between the platelet. On this time, it secrete the platelet aggregation inducer as like ADP, thromboxane A2 from the inside of platelet. So it has first defensive function through the aggregation augment that prevent the celerity consumption of blood. But the activation of abnormal platelet occur the platelet grume and thrombogenesis. So it bring up the occlusive angiosis, so to speak, cardiovascular disease, cerebrovascular disease, arterial sclerosis. In oriental medicine, the thrombosis in the category of blood stasis and this blood stasis present the generalise or local blood circulation disturbance that generated by all kinds of pathological fact or blood stream retention accompanying with a series of syndrome. As the syndrome, stabbing pain fixed at certain region, squamous and dry skin, fullness and pain of the chest and hypochondrium, firmness and fullness of the lower abdomen, black stool, dark purple tongue or with ecchymoses and petechiae etc.. has been created. And it becomes the pathopoiesis cause that the convulsion and palpitation, severe palpitatiion, tympanites, the symtom complex with a mass or swelling in the abdomen, insanity, stricken by wind etc.. Moreover, it used the drugs for invigorating blood circulation and eliminating blood stasis or drugs for removing blood stasis for all kinds of syndrome through the blood stasis. And the drugs for activating the blood circulation, such as Salviae Radix, Angelicae Sinensis Radix, Persicae Semen, Achyranthis Radix, Cnidii Rhizoma, Carthami Flos are used for that. And it is used to the herbs of insects that has strong effect about the disintergrating blood stasis such as Hirudo, Scolopendrae Corpus, Buthus, Lumbricus etc.. On this study, It used Geijibokryunghwan(GBH) and the consisting herbs to investigate the influence of platelet aggregation about drugs that used to improvement various symptoms created by the thrombosis in oriental medicine. GBH formula has as formula recorded in the , action of 'eleminating the evil and not impairment of healthy energy' and 'promoting the flow of QI and cold and heat, so used for the expel blood stasis herbs from the ancient. Therefore we investigated the restraint effect of GBH and the consisting herbs about the platelet agregation induced to the ADP, AA or collagen. The conclusion is following. 1. When it added the aggregation inducer after that it added GBH and individual consisting herbs in the PRP, GBH showed the (+) inhibition effect on the platelet aggregation and it showed the (+) inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis. 2. It showed the (+), (+,++) inhibition effect on the platelet aggregation in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc. 3. In the aggregation inhibition activating on the difference of density, GBH showed strong inhibition effect to the aggregation state induced to collagen, and it showed the inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis about the aggregation induced by the collagen. 4. It showed the strong inhibition effect about the aggregation induced by the collagen in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc Like this, as confirm GBH and the individual consisting herb's inhibition effect of platelet aggregation, We considerated that GBH and the individual consisting herbs have practical applicational value of clinical trial in the thrombosis caused by platelet aggregation.

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Effect of First-Aid Drugs on Internal Contamination of Radiostrontium (방사성(放射性) 스트론듐의 체내오염(體內汚染)에 대한 응급처치제(應急處置劑)의 효과(效果))

  • Chung, In-Yong;Kim, Tae-Whan;Chin, Soo-Yil
    • Journal of Radiation Protection and Research
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    • v.14 no.1
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    • pp.16-23
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    • 1989
  • To obtain the basic data for protective roles and first-aid of radiation hazard, the present studies were carried out to evaluate the decontamination of radiostrontium by the First-Aid drugs. Each mouse was administered intraperitoneally dose of sodium alginate 5mg, $CaNa_3DTPA$ 8.4mg and saline 5ml following the internal contamination with 1 $\mu$Ci of strontium as $^{85}SrCl_2$. $^{85}Sr$ was determined by the radioactivity of body burden, urinary excretion, fecal excretion and organ distribution by Ge-detector and MCA. The results are summarized as follows. 1. Effective half life on whole body retention $^{85}Sr$ was determined at 33 hours. 2. The decontamination effect of First-Aid durgs on the body $^{85}Sr$ burden were increased $CaNa_3DTPA$ (4.7 times), sodium alginate (1.7 times) and saline (2.4 times) respectively. 3. Strontium were excreted through urine (35.4%), feces (64.4%) and other (0.2%). But on the $^{85}Sr$ excretion routes following First-Aid drugs treatment, strontium-85 mainly were excreted through urine after $CaNa_3DTPA$ and saline treatment, and was excreted through feces after sodium alginate treatment. 4. The organ distribution of strontium-85 is vertebra, femur, sternum and liver in order Finally, the extrapolations from these data to victims were suggested that the rapid administration of $CaNa_3DTPA$, sodium alginate and saline simultaneously were markedly increased the decontamination effects on the internal contamination of radiostrontium.

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