• 제목/요약/키워드: Medication safety

검색결과 287건 처리시간 0.035초

The anti-hypertensive effect of ginseng in patients with mild hypertension

  • Kim, Young-Suk;Jung, Woo-Sang;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup
    • Advances in Traditional Medicine
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    • 제7권5호
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    • pp.494-500
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    • 2008
  • Ginseng has been traditionally used to recover vital energy from Qi deficiency in oriental countries. Recent reports suggested that ginseng could regulate blood pressure (BP), but much controversy still remain. Therefore, we intended to assess the anti-hypertensive effect of some ginseng species on Koreans and Chinese. This is a randomized, double blinded controlled clinical trial. The study subjects were recruited from the mild hypertensive patients who belonged prehypertension(120/80 to 139/89 mmHg) and stage I hypertension (140/90 to 159/99 mmHg) in Korea and China. After assigning the subjects into a Korean, a Chinese, and an American ginseng group by randomization, we prescribed ginseng with the dose of 4.5 g per a day for 4 w. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication by 24 h Ambulatory Blood Pressure Monitor (24 h ABPM). We also monitored adverse effect and laboratory findings to secure the subjects' safety. There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, and 64 treated with American ginseng. All of the ginseng species reduced subjects' BP. Especially, Korean and Chinese ginseng showed more excellent effects. The secondary analysis on the subjects' nationality revealed that all of the ginseng species showed more significant anti-hypertensive effect in Chinese than in Koreans. We suggest ginseng could be useful for mild hypertension regardless of its species. And it would be safe within the dosage of 4.5 g per a day.

충격소음으로 인한 양식어류 피해기준 제안 (Suggestion of Safety Level in Fish Farming by Impulsive Sound)

  • 최태홍;김정한;송하림;고진석
    • 터널과지하공간
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    • 제25권2호
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    • pp.125-132
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    • 2015
  • 어류 양식장 인근에서 건설공사로 인하여 발생하는 소음 진동의 경우 피해 금액과 산정방식 선정은 건설공사에 대한 공종별 전문가의 공학적, 기술적 의견이 배제된 상태에서 이루어지고 있다. 피해자 측이 일방적으로 어류 전문가들의 생물학적 자문 위주의 논리만 주장하는 반면, 어류에 대한 생물학적 전문지식이 부족한 건설사 측은 일반적인 건설소음 진동에 관한 논리를 전개하는 경우가 대부분이다. 그래서 중앙 환경 분쟁 조정위원회에서는 2009년 소음 진동으로 인한 육상 양식어류 피해 평가 및 배상액 산정기준에 관한 연구를 통해 구체적인 피해기준을 제시하였다. 국내의 경우 수중소음 피해인정 기준을 140 dB re $1{\mu}Pa$을 인정하고 있다. 이 기준은 충격음이 아닌 1초 이상의 연속음의 RMS 값이다. 또한, 기존 연구 자료들을 보면 어류는 골표류와 비골표류, 기각류와 비기각류 등 어종에 따라서 수중소음에 대한 반응이 많은 차이가 있는 것으로 보인다. 그래서 본 연구는 충격음과 연속음의 특성 차이를 고려하여 충격음의 피해기준을 제시하려 한다.

Comparative Drug Evaluation of Atorvastatin versus Rosuvastatin in Pharmacotherapy of Korean Patients with Dyslipidemia

  • Park, Seon-Young;Lee, Myung-Koo;Lim, Sung-Cil
    • Biomolecules & Therapeutics
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    • 제16권1호
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    • pp.54-60
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    • 2008
  • Dyslipidemia is the multiple lipid metabolic disorders which is one of the high risk factors for the atherosclerotic diseases. It increases the morbidity and mortality and therefore, must be treated with antilipidemic agents. HMG-Co A reductase inhibitors (statins), one of many antidyslipidemic agents, have shown to be significant improvement from the various cholesterol levels. Especially, data from many comparative trials suggest that rosuvastatin is more effective than atorvastatin among many other statins. The aims of this study were to evaluate the efficacy and safety between rosuvastatin and atorvastatin in the treatment of Korean patients with dyslipidemia. Currently the Korean Society of Lipidology and Atherosclerosis based on the Korean health screening data suggests that Korean patients with dyslipidemia should be treated by the target cholesterol levels according to the Adult Treatment Panel III guidelines of the US National Cholesterol Education Program (NCEP-ATP III). We reviewed retrospectively all medical histories of the total 392 dyslipidemic patients with atorvastatin or rosuvastatin from June 1st, 2004 to August 31st, 2006 in Chungbuk National University Medical Center. Patients were classified as total 4 groups by the NCEP-ATP III Guidelines. The numbers of enrolled patients were each 5 mg atorvastatin (n=34), 10 mg atorvastatin (n=148), 5 mg rosuvastatin (n=94) and 10 mg rosuvastatin (n=82). In comparison between groups, rosuvastatin groups in the lowering LDL-C had better efficacies, and the results were each 22% (5 mg atorvastatin), 33.3% (10 mg atorvastatin), 35% (5 mg rosuvastatin) and 41.3% (10 mg rosuvastatin) with the dose relationship (P=0.000). Rosuvastatin groups also have shown to be more significantly reducing Total Cholesterol levels compared to atorvastatin groups with the no dose relationship (P=0.000). In the lowering of non-HDL cholesteroles, rosuvastatin groups showed significantly better efficacies than atorvastatin with the dose-relationship (P=0.000). Each medication groups did not demonstrate the differences in the changing of HDL cholesterol and triglyceride levels (P=0.096, 0.309, respectively). In conclusion, rosuvastatin was better efficacious than atrovastatin in reducing LDL-C Total Chol, and Tg. Therefore, rosuvastatin is a good antilipidemic agents for Korean patients with dyslipidemia and it can use to minimize the morbidity and mortality related to the cardiovascular diseases in Korean.

개에서 케타민-자일라진 마취동안 심박변이도에 대한 아트로핀과 글리코피롤레이트의 자율신경적 특성 (Autonomic Nervous Properties of Atropine and Glycopyrrolate on Heart Rate Variability during Anesthesia with Ketamine-Xylazine in Dogs)

  • 박우영;배춘식;이수한;박우대
    • 한국임상수의학회지
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    • 제26권3호
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    • pp.212-219
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    • 2009
  • 개의 마취에서 부작용을 예방하기 위하여 전마취제로 가장 일반적으로 사용되어지는 항콜린제는 심장에 부작용을 일으킬 수 있다. 비글견에서 케타민 마취 동안 심장의 교감신경과 부교감 신경의 균형에 대한 아트로핀과 글리코피롤레이트의 효과를 검증하기 위하여, 심박변이도, 마취 기간 그리고 행동 변화가 평가 되어졌다. 아트로핀과 글리코피롤레이트에서는 어떠한 일시적인 domain 차이도 없었다. 주파수 영역과 연관되어서는, 아트로핀과 글리코피롤레이트 효과는 모두 대조군에 비해 유의하게 낮게 나타났다(P<0.05). 그러나, 아트로핀의 RMSSD와 SD1은 기준선보다 낮았으며(P<0.05), 글리코피롤레이트의 LF:HF ratio는 기준선보다 높은 유의한 변화를 보였다(P<0.05). SD1의 변화는 주파수 도메인의 HF와 일치하는 변화를 보였으며 호흡수와 $SpO_2-R$의 변화와도 일치하는 변화를 보였다. 우리의 결과는 심장의 자율신경적 특성을 이용하여 글리코피롤레이트가 안전성과 작용 시간을 고려하여 개에서 케타민 마취 시 항콜린제로 더욱 적당하다는 것을 증명한 것이다.

고혈압 환자 마취시 Transdermal Clonidine (St 155 BS)의 임상적 유용성 (Clinical Efficacy of Transdermal Clonidine (St 155 BS) for Anesthetic Management in Hypertensive Patients)

  • 이현화;김동옥;김건식;최영규;신옥영;권무일;이두익
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.231-236
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    • 1993
  • Clonidine, a centrally-acting antihypertensive agent known to reduce central sympathetic outflow and modulate presynaptic transmitter's release, has shown to suppress central noradrenergic hyperactivity induced by immobilization stress in animals, by decreasing the MAC of halothane and the dose of narcotics required to prevent reflex cardiovascular response to noxious stimuli, and to have potent analgesic properties in humans. These characteristics suggest that clonidine might be a useful adjunct to the anesthetic management of patients with preexisting hypertension. Accordingly, we determined the clinical efficacy and safety on analgesia, sedation and hemodynamic stability in the perioperative period. Thirty patients(ASA physical status II-III) with a history of arterial hypertension, scheduled for elective orthopedic surgery were randomly assigned to two groups. We applied CPA-clonidine patch($6.9\;mg/cm^2$, 0.2 mg delivered daily) or placebo patch to each groups, 48 hours prior to induction of anesthesia. Antihypertensive medication was continued until the morning of the scheduled surgery. All patients received premedication of atropine and lorazepam, and induced anesthesia with thiopental and succinylcholine, and maintained with enflurane and 50% nitrous oxide, while sustaining the BP and pulse rate at acceptable range. For the relief of pain postoperatively, diclofenac and fentanyl were administered intramuscularly on demand. The results were as follows: 1) The change of hemodynamic responses in clonidine group was less compared to the placebo group. 2) Intraoperative anesthetic requirement for enflurane in clonidine group were significantly lower than placebo group. 3) Postoperative analgetic requirement in clonidine group were significantly lower than placebo group. In clonidine group, 5 cases out of 15 cases were required no analgetics, and the incidence of administration of additional fentanyl was decreased to 5 cases, comparing with 10 cases in placebo group.

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Acupuncture in Patients with a Vertebral Compression Fracture: A Protocol for a Randomized, Controlled, Pilot Clinical Trial

  • Lee, Hyun-Jong;Seo, Jung-Chul;Park, Sung-Hoon;Kwak, Min-Ah;Shin, Im Hee;Min, Bo-Mi;Cho, Min-Su;Roh, Woon-Seok;Jung, Jin-Yong
    • 대한약침학회지
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    • 제18권1호
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    • pp.79-85
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    • 2015
  • Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.

여성 복압성 요실금에서 질전벽슬링수술의 효과 (Anterior Vaginal Wall Sling for Female Stress Urinary Incontinence)

  • 신홍석;유진욱;정희창;박동춘
    • Journal of Yeungnam Medical Science
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    • 제18권1호
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    • pp.59-66
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    • 2001
  • 본 연구에서 질전벽슬링술을 시행한 여성 복압성 요실금 환자 42명 중 술후 평균 29.4개월 후 추적 관찰시 92.9%의 성공률과 90.5%의 만족률을 보였으며, 수술에 따른 심각한 부작용은 없었다. 높은 치료성적, 비교적 간편한 술기, 해부학적 요실금과 내인성 요도괄약근 기능부전 모두에 적용할 수 있다는 장점이 있어 질전벽슬링수술은 여성 복압성 요실금의 수술치료에 효과적이고 유용한 방법으로 생각된다.

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악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용 (Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors)

  • 김진희
    • 한국콘텐츠학회논문지
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    • 제19권3호
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    • pp.365-374
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    • 2019
  • 악성종양은 양성종양과 달리 전이가 가능하고 재발이 쉬울 뿐 아니라 생존율 및 삶의 질이 떨어지는 질환이다. 국내의 경우 악성종양 치료 시 건강보험심사평가원이 제시한 항암화학요법 일반원칙에 따라 일괄적으로 치료하는 경향이 있다. 하지만 근래에는 일방적인 약물치료보다는 동반진단제를 사용을 권고하는데 이는 바이오마커를 이용한 분자진단기법으로 동반진단하여 치료 전에 환자의 약물 반응을 예측할 수 있기 때문이며, 국내외 식품의약품안전처에서는 의약품의 반응성 및 안전성을 확보하기 위하여 신약개발단계에서 동반진단제를 함께 개발하기를 권고한다. 본 종설에서는 악성 고형암을 중심으로 동반진단제의 개발방향 및 개발현황을 문헌고찰을 통해 분석하였고, 동반진단제로 사용되는 다양한 분자진단기법, 예컨대 면역조직화학염색법, 중합효소연쇄반응법, 제자리부합법, 차세대염기서열분석법 등에 따른 동반진단제 개발현황 및 미국 식품의약품안전청의 승인사례를 조사하여 최신 동반진단 개발동향을 함께 살폈다. 그리고 동반진단제 개발과정에서 기술적 사항으로 허가시점에 맞춘 분자진단기술을 선택과 진단제에 대한 명확한 기전이해와 더불어 치료와 동반진단제의 융합을 제언하였고, 사회적으로 동반진단제에 대한 공공보험의 급여책정이 필요함을 제언하였다.

근골격계 질환에 대한 양약 및 한약 병용의 간과 신장에 대한 안전성: 후향적 관찰 연구 (Hepatic and Renal Safety of Concurrent Use of Conventional and Herbal Medications for Musculoskeletal Disorders: A Retrospective Observational Study)

  • 김세윤;김형석;강도영;고준혁;김종연;김고운;김보형;조재흥;송미연;정원석
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.131-140
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    • 2022
  • Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용 (Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design)

  • 김현주;이선희;이재정;성선숙;양희;이향열
    • 대한간호학회지
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    • 제54권2호
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    • pp.237-249
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    • 2024
  • Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.