• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.280-285
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• 2015

Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.131-145
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• 2009

Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.

• Korean Journal of Clinical Pharmacy
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• v.25 no.1
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• pp.56-58
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• 2015

Summary: We report the first hepatic adverse effect of tosufloxacin tosylate in a muscle invasive bladder cancer patient with normal liver functions and with scheduling to undergo a surgical operation for a neobladder. Tosufloxacin tosylate 150 mg was administered to a 57-year-old man who maintained transurethral resection of bladder tumor (TUR-BT) postoperative multiple medications. His labs presented significant increases in alanine amino transferase (ALT) and aspartate amino transferase (AST) levels with 2-week compliance of 150 mg tablet three times a day. After discontinuing tosufloxacin tosylate, the levels slowly decreased and completely returned to normal ranges without any intervention in a few weeks. The Naranjo Causality Algorithm indicates a probable relationship between increased ALT and tosufloxacin. The patient was to have the second surgical operation as scheduled after getting normal range of ATL level. Therefore, tosufloxacin should be avoided in patients at risk for having liver dysfunctions or diseases if the patients have a schedule for any operation. Background: Tosufloxacin tosylate has been shown to have favorable benefits as an antibiotic. Tosufloxacin tosylate may be considered to have the adverse effects such as nauseas, vomiting, diarrhea, abdominal pain, stomatitis, tendonitis, tendon rupture, headache, dizziness, drowsiness, insomnia, weakness, agitation including hemolysis in the event of glucose-6-phosphate dehydrogenase deficiency as other fluoroquinolones. More severe adverse reactions of tosufloxacin tosylate over the above common adverse effects of fluoroquinolones were thrombocytopenia and nephritis. It also is not well known that tosufloxacin can cause hepatic problem. Here the study reports the first hepatic reaction from tosufloxacin and might arouse heath care providers' attention to appropriate drug choice for patients.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.230-237
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• 2016

Background: Since the use of opioid analgesics is frequent in operation rooms (OR), the risk of medication error is high; however the use of medication in the OR has been operating independently with the hospital pharmacy. Therefore, the assessment on management of medication use in operation and the pharmacist's role is needed. Methods: We conducted the literature review and survey from anesthesiologists, operating nurses at Chung-Ang Hospital on management of medication for operation use, awareness on need for medication management efficiency, need for satellite pharmacy in the operating room and its effect. Results: 56% of medical staffs responded that management of medication in the operating room is efficient; however, 82.6% responded that they felt the inconvenience in medication delivery to the OR when additional prescription was ordered. 51.5% also responded that extra time was required for management of narcotics and inventory/record keeping. 80% agreed that there could be lost costs due to prescription missed. Medical staffs responded improving the drug management system could increase the OR efficiency (87%), and eventually bring the increase in hospital revenue (80.4%). Those who responded that implementation of OR satellite pharmacy was needed include physicians (84.6%), nurses (63.6%), and also responded that it'd bring more profit to the hospital by increasing the efficiency in OR (60.9%). Conclusion: For efficient management of medications, implementation of OR satellite pharmacy would lead to improved drug management and increased efficiency in OR and reduced cost and improved patient care.

• Journal of Microbiology and Biotechnology
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• v.32 no.8
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• pp.1017-1025
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• 2022

Bone homeostasis is regulated by constant remodeling through osteogenesis by osteoblasts and osteolysis by osteoclasts and osteoporosis can be provoked when this balance is broken. Present pharmaceutical treatments for osteoporosis have harmful side effects and thus, our goal was to develop therapeutics from intrisincally safe natural products. Fucoidan is a polysaccharide extracted from many species of brown seaweed, with valuable pharmaceutical activities. To intensify the effect of fucoidan on bone homeostasis, we hydrolyzed fucoidan using AMG, Pectinex and Viscozyme. Of these, fucoidan biotransformed by Pectinex (Fu/Pec) powerfully inhibited the induction of tartrate-resistant acid phosphatase (TRAP) activity in osteoclasts differentiated from bone marrow macrophages (BMMs) by the receptor for activation of nuclear factor-κB ligand (RANKL). To investigate potential of lower molecular weight fucoidan it was separated into >300 kDa, 50-300 kDa, and <50 kDa Fu/Pec fractions by ultrafiltration system. The effects of these fractions on TRAP and alkaline phosphatase (ALP) activities were then examined in differentiated osteoclasts and MC3T3-E1 osteoblasts, respectively. Interestingly, 50-300 kDa Fu/Pec suppressed RANKL-induced osteoclasts differentiation from BMMs but did not synergistically enhance osteoblasts differentiation induced by osteogenic agents. In addition, this fraction inhibited the expressions of NFATc1, TRAP, OSCAR, and RANK, which are all key transcriptional factors involved in osteoclast differentiation, and those of Src, c-Fos and Mitf, as determined by RT-PCR. In conclusion, enzymatically low-molecularized 50-300 kDa Fu/Pec suppressed TRAP by downregulating RANKL-related signaling, contributing to the inhibition of osteoclasts differentiation, and represented a potential means of inducing bone remodeling in the background of osteoporosis.

• Journal of the Korean Applied Science and Technology
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• v.36 no.2
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• pp.592-599
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• 2019

This study is to stabilize insoluble and unstable active ingredient which is Idebenone (INCI name: hydroxydecyl ubiquinone) in a multi-lamellar vesicle (MLV) and to stabilize it in the skin care cosmetics. Idebenone is good effective raw material in the treatment of Alzheimer's disease in the medical field and a powerful antioxidant in dermatology. It is well known as a substance that inhibits the formation of melanin and cleans the skin pigment. However, it did not dissolve in any solvent and it was difficult to apply in cosmetic applications. Niosome vesicle was able to develop a nano-particle by making a multi-layer of idebenone encapsulated with a nonionic surfactant, hydrogenated lecithin and glycine soja (soybean) sterols and passing it through a high pressure microfluidizer. Idebenone niosome vesicle (INV) has been developed to have the ability to dissolve transparently in water and to promote transdermal penetration. The appearance of the INV was a yellowish liquid having specific odor, and the particle size distribution of INV was about 10~80 nm. The pH was 5~8 (mean=6.8). This capsulation with idebenone was stored in a $45^{\circ}C$ incubator for 3 months and its stability was observed and quantitatively measured by HPLC. As a result, the stability of the sample encapsulated in the niosome vesicle (97.5%) was about 66.3% higher than that of the non-capsule sample of 32.5%. Idebenone 1% INV was used for the efficacy test and clinical trial evaluation as follows. The anti-oxidative activity of INV was 38.2%, which was superior to that of 12.8% tocopherol (control). The melanin-reducing effect of B16 melanoma cells was better than INV (17.4%) and Albutin (control) (9.6%). Pro-collagen synthesis rate was 128.2% for INV and 89.3% for tocopherol (control). The skin moisturizing effect was 15.5% better than the placebo sample. The elasticity effect was 9.7% better than the placebo sample. As an application field, INV containing 1% of idebenone is expected to be able to develop various functional cosmetic formulations such as skin toner, ampoule essence, cream, eye cream and sunblock cream. In addition, it is expected that this encapsulated material will be widely applicable to emulsifying agents for skin use in the pharmaceutical industry as well as the cosmetics industry.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2915-2921
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• 2015

Background: Some recent clinical trials have been conducted to evaluate a combination of EGFR- TKI with chemotherapy for advanced NSCLC patients as second-line therapy, but the results on the efficacy of such trials are inconsistent. The aim of this meta-analysis was to evaluate the efficacy and safety of combination of EGFR-TKI and chemotherapy for patients with advanced NSCLC who failed first-line treatment. Materials and Methods: We searched relative trials from PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, Cochrane Library and Clinical Trials.gov. Outcomes analyzed were overall response rate (ORR), progression- free survival (PFS), overall survival (OS) and major toxicity. Results: Seven trails eventually were included in this meta-analysis, covering 1,168 patients. The results showed that the combined regimen arm had a significant higher ORR (RR 1.76 [1.16, 2.66], p=0.007) and longer PFS (HR 0.75 [0.66-0.85], p<0.00001), but failed to show effects on OS (HR 0.88 [0.68-1.15], p=0.36). In terms of subgroup results, continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance confered no improvement in ORR (RR 0.95 [0.68, 1.33], p=0.75) and PFS (HR 0.89[0.69, 1.15], p=0.38), and OS was even shorter (HR1.52 [1.05-2.21], p=0.03). However, combination therapy with EGFR-TKI and chemotherapy after failure of first-line chemotherapy significantly improved the ORR (RR 2.06 [1.42, 2.99], p=0.0002), PFS (HR 0.71 [0.61, 0.82], p<0.00001) and OS (HR 0.74 [0.62-0.88], p=0.0008), clinical benefit being restricted to combining EGFR-TKI with pemetrexed, but not docetaxel. Grade 3-4 toxicity was found at significantly higher incidence in the combined regimen arm. Conclusions: Continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance should be avoided. Combination therapy of EGFR-TKI and pemetrexed for advanced NSCLC should be further investigated for prognostic and predictive factors to find the group with the highest benefit of the combination strategy.

• YAKHAK HOEJI
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• v.57 no.1
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• pp.55-62
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• 2013

Objective: This study aims to assess the following issues - acquisition level in terms of the information on frequently used drugs of youth, access paths for the information, actual status of the use of drugs frequently used by youth, types of the used drugs, drug abuse among youth, and the consequent drawbacks. This study also takes aims at suggestion of correct role of pharmacists in consideration of drug abuse among youth. Methods: During the period from August 1, 2011 to October 31, 2012, a research design and a question development have been conducted. To the students of the schools that were randomly selected (elementary school's N=99, middle school's N=106, high school's N=115 and university's N=115), it was asked to complete given questionnaire from August 1, 2012 to August 31, 2012. During the period from September 1, 2012 to October 30, 2012, the questionnaires were collected back and the analysis and evaluation of them were carried out. Results: Drugs known to the respondents were a total of 115 different medicines and most of the drugs belonged to over-the-counter drugs. The most well known drug was pain reliever and the second most familiar drug was wound ointment. Most of the respondents found the drugs through direct use and advertisement. In everyday life, more than half of the respondents were using over-the-counter drugs as well as health supplements. The most commonly used drug was analgesic drug. It was showed that the respondents also frequently used the drugs for improving their grades and appearances. It was shown that among the cases of drug use, there were also the cases of misuse and abuse of drugs for the respondents or people around them. Reliability of pharmacists was shown to be high and many students were also satisfied with the pharmacists' guidance for medication. Conclusion: Currently many students are using different kinds of drug in daily life, and there is a possibility that the risk of misuse and abuse of drugs will be increased. Those age groups can easily engage in bad habit of drug use. Thus, promotion on accurate drug information has to be strengthened, and pharmacists are required to conduct correct guidance for drug user's medication in terms of use amount, usage, interactions among different drugs, and potential risks.

• Safety and Health at Work
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• v.4 no.1
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• pp.37-45
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• 2013

Objectives: As quality of work-life (QWL) among nurses affects both patient care and institutional standards, assessment regarding QWL for the profession is important. Work-related Quality of Life Scale (WRQOLS) is a reliable QWL assessment tool for the nursing profession. To develop a Chinese version of the WRQOLS-2 and to examine its psychometric properties as an instrument to assess QWL for the nursing profession in China. Methods: Forward and back translating procedures were used to develop the Chinese version of WRQOLS-2. Six nursing experts participated in content validity evaluation and 352 registered nurses (RNs) participated in the tests. After a two-week interval, 70 of the RNs were retested. Structural validity was examined by principal components analysis and the Cronbach's alphas calculated. The respective independent sample t-test and intra-class correlation coefficient were used to analyze known-group validity and test-retest reliability. Results: One item was rephrased for adaptation to Chinese organizational cultures. The content validity index of the scale was 0.98. Principal components analysis resulted in a seven-factor model, accounting for 62% of total variance, with Cronbach's alphas for subscales ranging from 0.71 to 0.88. Known-group validity was established in the assessment results of the participants in permanent employment vs. contract employment (t = 2.895, p < 0.01). Good test-retest reliability was observed (r = 0.88, p < 0.01). Conclusion: The translated Chinese version of the WRQOLS-2 has sufficient validity and reliability so that it can be used to evaluate the QWL among nurses in mainland China.

• Research in Community and Public Health Nursing
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• v.26 no.2
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• pp.61-68
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• 2015

Purpose: In this study, we performed a comparative analysis on the quality of life (QoL) in male and female chronic obstructive pulmonary disease (COPD) patients based on the 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) from 2007 to 2010. Methods: We extracted the socio-demographic and clinical data of 1,218 COPD patients including 874 men and 344 women from the KNHANES IV database. Descriptive statistics and correlation test were used to analyze the data. In order to find factors associated with QoL of COPD patients, we conducted multivariate linear regression analysis. Results: Infrequency analysis, the educational level and income were lower in the female COPD patients than in the male ones. The QoL indexes including mobility, self-care, activities of daily living, discomfort, anxiety, and depression were significantly worse in the female of COPD patients than in the male ones (p<.01).Conclusion: Our study indicates that QoL of female COPD patients should be improved on the educational, economic, and healthcare aspects.