• Title/Summary/Keyword: clinical pharmaceutical care

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Continuous Control of Acetaminophen Poisoning after Implementation of Regulation for Ease Access of Acetaminophen: Cohort Study from Emergency Department Based in-depth Injury Surveillance (아세트아미노펜 사용 편의성 증가 후 중독발생 위험의 지속적 관리 필요성)

  • Jo, Seung Jik;Gang, Hyun Young;Lee, Si Jin;Bae, Gyu Hyun;Lee, Eui Jung;Han, Kap Su;Kim, Su Jin;Lee, Sung Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.57-65
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    • 2020
  • Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

Effect of Hwanggumgung, a Natural Product, on Hair Growth Promotion in C57BL6 Mice (C57BL6 마우스에서 복합생약제인 황금궁의 육모 효과)

  • Hue Jin-Joo;Li Lan;Lyu Sul-Hye;Baek In-Jeoung;Yon Jung-Min;Nam Sang-Yoon;Yun Young Won;Hwang Seock-Yeon;Hong Jin Tae;Lee Beom Jun
    • YAKHAK HOEJI
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    • v.49 no.6
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    • pp.518-526
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    • 2005
  • Hwanggumgung (HGG) is a hair-care product which is composed of several plant extracts used in oriental medicine. This study was carried out to investigate effect of HGG on hair regrowth in a shaving model of C57BL6 mice. Five-week-old mice were acclimated for 1 week under 23$\pm$3$^{\circ}C$, 50$\pm10\%$ relative humidity and 12 h of a light/dark cycle before beginning experiment. There were four experimental groups including distilled water (D.W., control), 10$\%$ ethanol (EtOH, vehicle control), a positive control of 3$\%$ minoxidil (MXD), and HGG for female and male mice, respectively; Six-weeks old mice were trimmed by electric clippers so as not to damage the skin. The next day; mice without visible scraches were selected, randomized and separated in groups of 11 mice. The test compounds were topically treated with 0.15ml per mouse per day for 21 days. The hair regrowth was photographically and histologically determined during the experimental period of 21 days. Enzyme activities of $\gamma$-glutamyl transpeptidase and alkaline phosphatase were also determined using a rate assay method. There were no clinical signs in all experimental groups. The topical application of 3$\%$ MXD and HGG in female mice promoted hair regrowth earlier and faster than the control groups. In male mice, the topical application of 3$\%$ MXD and HGG also accelerated hair growth compared with the controls. Ten percent ethanol also promoted hair growth faster than D.W group. The histology of hair growth in experimental groups was strongly associated with the hair regrowth. 3$\%$ MXD and HGG promoted elongation of hair follicles compared with the controls in both female and male mice. Activities of alkaline phosphatase and $\gamma$-glutamyl transpeptidase, enzymes related to hair growth, significantly increased after treatments of 3$\%$ MXD and HGG for 2 weeks in both female and male mice (p < 0.05). These results suggest that HGG has hair growth promoting activities and it can be for treatment for alopecia.