• 제목/요약/키워드: Pharmacological therapy

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Exacerbation Prevention and Management of Bronchiectasis

  • Joon Young Choi
    • Tuberculosis and Respiratory Diseases
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    • 제86권3호
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    • pp.183-195
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    • 2023
  • Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

뇌혈관 내 수술 후 운동요법이 불편감, 요통, 출혈 및 혈종에 미치는 효과 (The Effect of Exercise Therapy after Cerebral Endovascular Surgery on the Level of Discomfort, Low Back Pain, Hemorrhage, and Hematoma)

  • 장경혜;이은자
    • 임상간호연구
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    • 제19권1호
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    • pp.69-80
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    • 2013
  • Purpose: This study aimed to prove the effect of exercise therapy on discomfort and low back pain after cerebral endovascular surgery through femoral artery. Methods: The study employed a non-equivalent control group pretest-posttest design. Data were collected from 74 participants and were divided equally into two groups as experimental and control groups. In the experimental group, exercise therapy was applied in 2 hours, 4 hours, and 6 hours after cerebroendovascular surgery. The level of discomfort, back pain, hemorrhage, and hematoma was observed and recorded as a pretest. In the posttest, low back pain, hemorrhage, and hematoma were measured in 2.5 hours, 4.5 hours, and 6.5 hours, and discomfort was measured in 6.5 hours. The study was conducted from April to September, 2012. Data were analyzed with descriptive study, Chi-square test, t-test, repeated measure ANOVA and Bonferroni using SPSS/WIN 18.0 version. Results: The exercise therapy after cerebral endovascular surgery helps in reducing the level of discomfort (t=-2.37, p=.020) and low back pain (F=5.15, p=.005) without the side effects of hemorrhage or hematoma. Conclusion: Therefore, the exercise therapy was an efficient intervention for patients after cerebral endovascular surgery with discomfort and low back pain. Nurses could apply non-pharmacological interventions such as exercise therapy to avoid pharmacological side-effects.

수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석 (The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis)

  • 김현영;신선화
    • 동서간호학연구지
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    • 제27권1호
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

경도인지장애 노인의 우울증상을 위한 비약물적 중재 효과: 무작위 대조군 실험연구의 체계적 문헌고찰 (The Effect of Non-Pharmacological Intervention on Depressive Symptom in Elderly with Mild Cognitive Impairment : A Systematic Review of Randomized Controlled Trials)

  • 정재훈
    • 산업융합연구
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    • 제20권10호
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    • pp.39-49
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    • 2022
  • 본 연구는 국외 경도인지장애 노인의 우울증상을 위한 비약물적 중재에 대한 특성과 효과를 분석하기 위해 무작위 대조군 실험연구에 대한 체계적 고찰을 시행하였다. 3개의 검색 데이터베이스를 사용하여 2011년 1월부터 2021년 7월까지 출간된 문헌을 분석하였다. 총 1,455편의 문헌이 검색되어 총 11편의 문헌을 최종 분석하였다. 문헌의 질 평가는 Risk of bias(RoB)를 사용하였다. 우울증상 평가도구는 Geriatric Depression Scale(GDS)이 가장 많이 사용되었다. 분석된 문헌에서 사용된 중재는 요가, 심리사회적 중재, 인지훈련, 건강교육, 다중요소 중재, 게임훈련, 유산소/심폐물리치료, 미술치료, 음악회상 활동, 기억특이성 훈련, 인지자극, 수면교육이 적용되었다. 그 중 요가, 다중요소 중재, 게임훈련이 우울증상 개선에 효과적이었다. 본 연구는 경도인지장애 노인의 우울증상에 대한 중재계획 및 실행에서 임상적 근거를 제시하였다.

Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review

  • Eduarda Cristina Santos;Daniela Huller;Sabrina Brigola;Marceli Dias Ferreira;Marcia Thais Pochapski;Fabio Andre dos Santos
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권5호
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    • pp.245-256
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    • 2023
  • Background: Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective: This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods: We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results: A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions: Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.

Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review

  • Shim, In Hee;Bahk, Won-Myong;Woo, Young Sup;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • 제16권4호
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    • pp.376-382
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    • 2018
  • We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

Current and Future Molecular Mechanism in Inflammation and Arthritis

  • Sharma, Vikash;Tiwari, Raj Kumar;Shukla, Shiv Shankar;Pandey, Ravindra Kumar
    • 대한약침학회지
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    • 제23권2호
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    • pp.54-61
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    • 2020
  • Inflammation is an immune response of the human body but excessive inflammation is taken as a major factor in the development of many diseases including autoimmune disorders, cancer and nerve disorders etc. In this regards the need is to suppress the inflammatory response. Suppression of extra or imperfect inflammatory response is not a big deal provided there is an exact knowledge of particular target in the body. Recent advancements in Pharmacological aspect made the therapy with improved outcomes in number of patients. Anticytokine therapy might be one of the important and novel approaches for inflammation and Arthritis. This can be achieved only when we go through the pathophysiology of expression and identification of mediators. Let's take an example of cytokine like interleukins (IL), chemokines, interferons (INF), tumor necrosis factors (TNF-α), growth factors, and colony stimulating factors) release pathway which is a major signalling protein in inflammatory response. In the present study we have reviewed the recent pharmacological therapeutic advancement, inflammatory mediators, receptors, and major signalling pathways. Such information will not only provide the idea about the mechanism of action of Pharmaceuticals and molecular targets but also it provides a new aspect for drug designing and new corrective approaches in existing clinical medicines. This study will be a source of good information for the researchers working in the area of drug designing and molecular Pharmacology especially in anti-inflammatory and anti arthritic medicines for target based therapy.

여드름의 약물치료요법 (Pharmacological treatment options for acne)

  • 박귀영
    • 대한의사협회지
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    • 제61권11호
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    • pp.680-686
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    • 2018
  • Acne vulgaris is a very common condition affecting up of about 80% to 90% of adolescents. The patients with acne have been shown to be adversely impacted by the effect of acne on their quality of life. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, the target for acne therapy is these well-known pathogenic factors responsible for this disease state. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Fixed combination topical products with retinoids, benzoyl peroxide and antibiotics have been introduced. Use of systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the main pathogenic features of acne but is contraindicated in pregnant women and has been associated with cheilitis and dry skin. Hormonal therapy has been found to improve acne in some selective patients and should be considered for appropriate candidates. This review will present the general aspects of the pharmacological treatments for acne.

Phenotype of Chronic Obstructive Pulmonary Disease Based on Computed Tomography-Defined Underlying Pathology

  • Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • 제85권4호
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    • pp.302-312
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    • 2022
  • Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease. Not all patients with COPD respond to available drugs. Identifying respondents to therapy is critical to delivering the most appropriate treatment and avoiding unnecessary medication. Recognition of individual patients' dominant characteristics by phenotype is a useful tool to better understand their disease and tailor treatment accordingly. To look for a suitable phenotype, it is important to understand what makes COPD complex and heterogeneous. The pathology of COPD includes small airway disease and/or emphysema. Thus, COPD is not a single disease entity. In addition, there are two types (panlobular and centrilobular) of emphysema in COPD. The coexistence of different pathological subtypes could be the reason for the complexity and heterogeneity of COPD. Thus, it is necessary to look for the phenotype based on the difference in the underlying pathology. Review of the literature has shown that clinical manifestation and therapeutic response to pharmacological therapy are different depending on the presence of computed tomography-defined airway wall thickening in COPD patients. Defining the phenotype of COPD based on the underlying pathology is encouraging as most clinical manifestations can be distinguished by the presence of increased airway wall thickness. Pharmacological therapy has shown significant effect on COPD with airway wall thickening. However, it has limited use in COPD without an airway disease. The phenotype of COPD based on the underlying pathology can be a useful tool to better understand the disease and adjust treatment accordingly.

비약물적 분만통증 중재법에 대한 고찰 (Non-Pharmacological Interventions to Relieve Labor Pain: A Literature Review)

  • 김정수
    • 부모자녀건강학회지
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    • 제14권1호
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    • pp.28-35
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    • 2011
  • Purpose: The aim of this study is to suggest a direction for the development of effective methods for relieving labor pain, by analyzing non-pharmacological interventions through a literature review. Methods: Collection of literature data in this study has been accomplished through theses, reports, and academic data searched on databases of the Research Information Sharing Services (Riss), PubMed, ProQuest, and the National Discovery for Science Leaders (NDSL). Results: Non-pharmacological interventions analyzed as effective in relieving labor pain, in literature published both within and outside of Korea, included: pre-delivery education, Yoga, Doula delivery care, Massage, Music therapy, Aromatherapy, Hypnosis, TENS, Sterilized water injection, and Acupuncture. Conclusion: Several different interventions have been attempted for the relief of labor pain. Since even the same intervention shows different results depending on the research method utilized, critical factors must be acknowledged that compromise the effectiveness of these methods. In addition, study of potential synergy effects of interventions that combine these various methods might also prove to be significant.

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