• Title/Summary/Keyword: Medication review

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Pharmacological Treatments for Dysthymic Disorder and Atypical Depression (기분부전장애와 비전형우울증의 약물치료)

  • Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.14-20
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    • 2007
  • Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

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Using Intervention Mapping to Develop a Community-based Disease Self-management Support Program for Patients with Osteoarthritis (Intervention Mapping을 적용한 지역사회기반의 골관절염 자기관리지지 프로그램 개발)

  • Ahn, Yang Heui
    • Journal of muscle and joint health
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    • v.22 no.3
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    • pp.245-257
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    • 2015
  • Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.

The Role of Functional Imaging Techniques in the Dementia (치매 환자에서 기능 영상법의 역할)

  • Ryu, Young-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.209-217
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    • 2004
  • Evaluation of dementia in patients with early symptoms of cognitive decline is clinically challenging, but the need for early, accurate diagnosis has become more crucial, since several medication for the treatment of mild to moderate Alzheimer' disease are available. Many neurodegenerative diseases produce significant brain function alteration even when structural imaging (CT or MRI) reveal no specific abnormalities. The role of PET and SPECT brain imaging in the initial assessment and differential diagnosis of dementia is beginning to evolve vapidly and growing evidence indicates that appropriate incorporation of PET into the clinical work up can improve diagnostic and prognostic accuracy with respect to Alzheimer's disease, the most common cause of dementia in the geriatric population. in the fast few years, studios comparing neuropathologic examination with PET have established reliable and consistent accuracy for diagnostic evaluations using PET - accuracies substantially exceeding those of comparable studies of diagnostic value of SPECT or of both modalities assessed side by side, or of clinical evaluations done without nuclear imaging. This review deals the role of functional brain imaging techniques in the evaluation of dementias and the role of nuclear neuroimaging in the early detection and diagnosis of Alzheimer's disease.

Factors Influencing Adherence to Self Care in Patients with Chronic Heart Failure (만성 심부전 환자의 자가간호 이행 관련요인)

  • Son, Youn-Jung;Kim, Sun-Hee;Kim, Gi-Yon
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.244-254
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    • 2011
  • Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

A Case of Disseminated Cutaneous Cryptococcosis Accompanied by Pulmonary Tuberculosis (폐 결핵과 동반된 파종성 피부 크립토콕쿠스증 1예)

  • Choi, Hae Jin;Lee, Sang Hwa;Lee, Tae Hoon;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.527-531
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    • 2008
  • Although disseminated cryptococcosis occurs most commonly in immunocompromised patients, particularly those with a human immunodeficiency virus (HIV) infection, it can occur in immune competent persons. There are no case reports of disseminated cutaneous crytpcoccosis associated with pulmonary tuberculosis in Korea. A 71-year-old female presented with fever and multiple cutaneous nodules. She was finally diagnosed with disseminated cutaneous cryptococcosis accompanied by pulmonary tuberculosis, and was treated successfully with anti-tuberculous medication and fluconazole. She had no apparent predisposing conditions for systemic cryptococcosis. We report this case with a review of the relevant literature.

OTC Drug Regulatory System of Korea Comparing to Other Countries (일반의약품 허가제도의 국가간 비교 및 발전 방향)

  • Sohn, Hyun-Soon;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.127-138
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    • 2005
  • This is to examine the OTC regulatory system of Korea in comparison with those of Japan, UK and US, and suggest the possible regulatory actions to harmonize it to international standards. Individual countries have their own regulatory requirements and processes far OTC application based on established drug monographs and safety profiles from clinical experiences. Categories of OTC drug monographs are being expanded with transparent establishment procedure according to detailed guidelines, and public opinions as well as professional experts for assessing appropriateness of wide usage without physician's prescription. In line with trend of self-medication worldwide, the number of OTC drugs is increasing and more efficient and professional drug review is underway in the separate OTC division in regulatory agency. For improving OTC regulatory system in Korea, settlement of optimal drug classification policy and management for encouraging OTC drug use, development of more detailed and specific guidelines for OTC drug application, expansion of OTC drug monographs, transparent process for OTC monographs establishment, and establishment of OTC division in health authority, are suggested.

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Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report (하악 과두하 골절시 후하악 접근법에 의한 수술 후 발생한 이하선 누공 형성과 이에 대한 치료 증례)

  • Ro, Jae-Chan;Kim, Ju-Won;Yang, Byoung-Eun
    • The Journal of the Korean dental association
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    • v.55 no.10
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    • pp.696-705
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    • 2017
  • Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

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A Study of Side Effects from Korean Herb Medicine on Children (한약을 복용한 소아에게 발생한 부작용에 대한 연구)

  • Jung, Sun-Kyung;Gok, Su-Yeong;Yu, Sun-Ae;Lee, Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.3
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    • pp.33-42
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    • 2010
  • Objectives: The purpose of this study is to investigate the frequency of side effects, and the range of the side effects from Korean herb medicine on children. Methods: The study has been carried out from 212 children who took Korean herb medicine in Department of Pediatrics, $\bigcirc\;\bigcirc$ Oriental Medical Hospital from September 2009 to February 2010. The study was completed through patients chart review and telephone survey. Results: 1. There were 6 side effect cases on male, and 3 side effect cases on female out of 212 children. The incidence of side effect was 4.2%. 2. The most common side effect was abdominal pain. The most common related organ was digestive organ. 3. The side effect occurred within one to three days after taking Korean herb medicine, and the symptoms were mostly disappeared after taking the Korean herb medicine into divided dose or less dose. Conclusions: The symptom of side effects on children was not as severe as other adverse drug reactions often seen in Western medication. The most common symptom was abdominal pain. Further studies are needed.

A Review of Attention Deficit Hyperactivity Disorder in Traditional Chinese Medicine (주의력결핍${\cdot}$과잉행동장애의 한의학 치료동향 (2005-2006년 중국 임상 논문 중심으로))

  • Park, Hyun-Chul;Kang, Mun-Su;Kim, Lak-Hyung
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.2
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    • pp.35-44
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    • 2007
  • Objective : The purpose of this study is to take around the oriental medical treatment about Attention Deficit Hyperactivity Disorder in China. Method : We reviewed the 22 studies about ADHD which were published from 2005 to 2006. We selected those studies from CNKI (中國知識基礎設施工程 http://www.cnki.net). Result : We could find 22 studies about ADHD in CNKI from 2005 to 2006. DSM (III-R of IV) was used frequently in the diagnosis of ADHD. Herbal medicines, acupuncture, auricular therapy, moxibustion, chuna treatment, cupping therapy were used in the tre atments of ADHD. Differentiation of syndromes-Eum deficiency, heart and spleen deficiency, Damwha- was important in the diagnosis and treatments of ADHD in TCM. Jang and Bu(the internal organs; 臟腑) concerned in differentiation of syndromes about ADHD were Liver 肝, Kidney 賢, Heart 心, Spleen 脾. Most of studies reported very good results compared with western medicine treatment- Ritalin medication. Conclusion :There have been reported many ADHD clinical studies in China and these studies can be applied to the clinical practices in Korea.

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Pharmacological Treatment of Anxiety Disorders in Medical Illness (내과질환에 동반된 불안증상에 대한 약물치료)

  • Woo, Jong-Min;Lee, Chang-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.3-6
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    • 2007
  • Anxiety disorders are common illness to general physician. The comorbidity between anxiety disorders and medical illness is not only a diagnostic issue, but also has implications of the course of the disease and its outcome. The comorbid condition requires consideration of each individual illness, their psychological and physiological condition. This article aims to review the literature on the prevalence of anxiety disorders in patients prescribing to psychiatrists and to discuss pharmacological treatment options for patients with a comorbid anxiety disorder and medical illness.

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