• Title/Summary/Keyword: clinical pharmaceutical sciences

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Meta-analysis of Inline Filtration Effects on Post-infusion Phlebitis Caused by Particulate Contamination of Intravenous Administration

  • Ku, Hye-Min;Kim, Ji-Yeon;Kang, Suk-Hyun;Lee, Eui-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.40 no.4
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    • pp.225-230
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    • 2010
  • The particulate contamination of intravenously administered fluid has been of major concern. One of the most common complications associated with long term i.v. therapy is post-infusion phlebitis (PIP). We undertook a systematic review and meta-analysis of the effect of inline filters on PIP. An electronic search of Medline, KoreaMed, and KRIST was conducted to identify randomized controlled trials evaluating the effect of inline filters. Meta-analysis was undertaken using STATA 10. A total of 62 literatures were retrieved, of which 7 were included in meta-analysis. Inline filtration for intravenous infusion significantly reduced by 39% of the incidence of phlebitis, with a relative risk of 0.61 (95% CI 0.41-0.90, p=0.012). Therefore, inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a part of intravenous therapy.

Novel Oral Anticoagulants for the Treatment of Venous Thromboembolism in Cancer Patients (암환자의 정맥혈전색전증 치료를 위한 새로운 경구용 항응고제)

  • Kim, Joo Hee;Gwak, Hye Sun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.269-282
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    • 2016
  • Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, has increased in cancer patients and adversely affects their prognosis. Low-molecular-weight heparins are recommended as efficacious and safe anticoagulation treatment in cancer patients. However, in practice, oral anticoagulation is preferred, especially if longterm or extended treatment is necessary. Novel oral anticoagulants have recently emerged as an alternative to the standard therapy owing to the ease of administration, predictable anticoagulation effect without the need of laboratory monitoring, and fewer drug interactions. These new agents have been shown as effective and safe for the management of cancer-associated thrombosis in ongoing head-to-head comparative trials. Here we review the advances and limitation of current anticoagulant therapies.

Conjugation of Protein and Peptide Drugs with Hydrophilic Polymers and Their Applications (수용성 고분자물질-단백질 접합체의 합성 및 응용)

  • Yong, Chul-Soon;Sohn, Young-Taek
    • Journal of Pharmaceutical Investigation
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    • v.23 no.4
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    • pp.187-206
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    • 1993
  • Since the advent of recombinant DNA technology coupled with other biotechnology a variety of therapeutically effective proteins and peptides have been extensively invesitigated and many of them are now on clinical trial. They, however, suffer from some problems such as immunogenicity, antigenicity, instability and short half-life in circulation due to their proteinous natures. These drawbacks can be overcome successfully by conjugating proteins and peptides with hydrophilic polymers such as polyethylene glycol (PEG), albumin or dextran. The resulting soluble conjugates showed reduced antigenicity and immunogenicity, increased circulatory half-life, enhanced stability against proteolytic degradation. Comparing with the unmodified proteins and peptides, the therapeutic potential of conjugates is greatly enhanced. Clinical applications of these conjugates have shown promising results for the future use.

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Development of a UPLC-MS/MS method for the therapeutic monitoring of L-asparaginase

  • Jeong, Hyeon-Cheol;Kim, Therasa;Yang, Deok-Hwan;Shin, Kwang-Hee
    • Translational and Clinical Pharmacology
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    • v.26 no.3
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    • pp.134-140
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    • 2018
  • This study aimed to develop a UPLC-MS/MS method for determining plasma levels of L-aspartic acid and L-asparagine and the activity of L-asparaginase. L-aspartic acid, L-asparagine, and L-aspartic acid-2,3,3-$d_3$ were extracted from human plasma by protein precipitation with sulfosalicylic acid (30%, v/v). The plasma samples were analyzed using an Imtakt Intrada amino acid analysis column with 25 mM ammonium formate and 0.5% formic acid in acetonitrile as the mobile phase with step gradient method at a flow rate of 0.5 mL/min. The injection volume was $5{\mu}L$, and the total run time was 15 min. Inter- and intra-batch accuracies (%) ranged from 96.62-106.0% for L-aspartic acid and 89.85-104.8%, for L-asparagine, and the coefficient of variation (CV%) did not exceed 7%. The validation results for L-aspartic acid and L-asparagine satisfied the specified criterion, however, the results for L-asparaginase activity assay showed a borderline validity. This study could be a foundation for further development of therapeutic drug monitoring systems using UPLC-MS/MS.

Development of mRNA Vaccines/Therapeutics and Their Delivery System

  • Sora Son;Kyuri Lee
    • Molecules and Cells
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    • v.46 no.1
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    • pp.41-47
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    • 2023
  • The rapid development of mRNA vaccines has contributed to the management of the current coronavirus disease 2019 (COVID-19) pandemic, suggesting that this technology may be used to manage future outbreaks of infectious diseases. Because the antigens targeted by mRNA vaccines can be easily altered by simply changing the sequence present in the coding region of mRNA structures, it is more appropriate to develop vaccines, especially during rapidly developing outbreaks of infectious diseases. In addition to allowing rapid development, mRNA vaccines have great potential in inducing successful antigen-specific immunity by expressing target antigens in cells and simultaneously triggering immune responses. Indeed, the two COVID-19 mRNA vaccines approved by the U.S. Food and Drug Administration have shown significant efficacy in preventing infections. The ability of mRNAs to produce target proteins that are defective in specific diseases has enabled the development of options to treat intractable diseases. Clinical applications of mRNA vaccines/therapeutics require strategies to safely deliver the RNA molecules into targeted cells. The present review summarizes current knowledge about mRNA vaccines/ therapeutics, their clinical applications, and their delivery strategies.

Efficacy and safety of low dose oral ketamine for controlling pain and distress during intravenous cannulation in children: a double-blind, randomized, placebo-controlled trial

  • Bagheri, Mahdi;Soltani, Alireza Ebrahim;Qorbani, Mostafa;Sureda, Antoni;Faghihi, Toktam
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.311-318
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    • 2022
  • Background: Ketamine is widely used in infants and young children for procedural sedation and anesthesia. The aim of this study was to evaluate the efficacy and safety of low dose oral ketamine to control pain and distress in children during intravenous (IV) cannulation. Methods: This is a prospective, randomized, double-blind study, including children aged between 3 and 6 years requiring a non-emergent IV-line placement. Children were randomly assigned to two groups, treated either with oral ketamine or a placebo. All patients were monitored for vital signs. Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker Faces Pain Rating Scale (WBFS) scales and sedation using a 5-point sedation score. The facility of IV-line placement was measured by a 3-point scale. Adverse effects were recorded after 1 and 24 hours. Results: A total of 79 and 81 children were entered in the ketamine and placebo groups, respectively. The heart and respiratory rates increased significantly in the placebo group. The median CHEOPS 4 (95% confidence interval [CI]: 3, 4, P < 0.001) and WBFS 6 (95% CI: 4, 6, P < 0.001) scores decreased statistically in the ketamine group. IV-line placement was 50% easier in the ketamine group (95% CI: 37%, 63%, P < 0.001). No serious adverse effects were observed in all cases. Conclusions: Low dose oral ketamine effectively decreased the pain and distress during IV cannulation in children without any significant adverse reactions.

Arsenic Exposure and Haematological Derangement in Cervical Cancer Cases in India

  • Kumar, Rahul;Trivedi, Vinita;Murti, Krishna;Dey, Akalanka;Singh, Jitendra Kumar;Nath, A;Das, P
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6397-6400
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    • 2015
  • Cervical cancer is the second most common gynecological malignancy worldwide. According to HPV Information Centre, Spain (Aug'2014), in India approximately 1,22,844 women are diagnosed with the disease every year and of them 67,477 die due to the disease. CaCx is said to be mediated by HPV but recent data published reveal the role of Oxidative Stress in different Cancers. Arsenic is also one of the agents for causing Oxidative Stress. Arsenic has been linked with different types of cancer. Arsenic is considered responsible for generation of free radicals and eventually for apoptosis. Early diagnosis of CaCx is presently a matter of concern and clinical presentation in advanced stages become difficult for complete clinical response. For determination of oxidative stress, Malondialdehyde (MDA) was taken as an identifier and arsenic estimation was performed with the help of Atomic Absorption Spectrometer (AAS). RBC count and Haemoglobin levels were performed according to standard protocol. MDA was in direct proportion with arsenic concentration and inversely proportional to RBC and Haemoglobin in CaCx patients. Arsenic is one of the major causative agents for oxidative stress and hence may be a risk factor leading to cancer including CaCx.

Impact of Cassia acutifolia Infusion on Glucose Levels in Obesity and Diabetes Rat Model

  • Raffoul-Orozco, Abdel Kerim;Avila-Gonzalez, Ana Elisa;Barajas-Vega, Jessica Lucia;Rodriguez-Razon, Christian Martin;Garcia-Cobian, Teresa Arcelia;Ramirez-Lizardo, Ernesto Javier;Rubio Arellano, Edy David
    • Journal of Pharmacopuncture
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    • v.20 no.3
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    • pp.201-206
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    • 2017
  • Objectives: The aim of this study was to investigate the effects of Cassia acutifolia on the obesity and the glucose levels in a rat model of obesity and diabetes. Methods: By random selection, 36 Wistar male rats were divided in two control groups, the positive and the negative control groups, and into four experimental groups receiving different infusions of Cassia acutifolia in water ad libitum. Results: The results revealed a statistically significant anti-obesogenic effect (P = 0.02), although this was not considered clinically significant. Additionally, Cassia acutifolia lowered the glucose levels by 30 mg/dL to 90 mg/dL (P = 0.05). However, we observed adverse effects in the liver, a two-fold increase in transaminase levels (P = 0.002), and in the kidneys, decreased creatinine levels (P = 0.001), and these adverse effects had no viable explanation. Conclusion: Cassia acutifolia has anti-hyperglycemic effects in obese diabetic rats. However, Cassia acutifolia also has adverse effects, so it should not be administered to patients.

A critique: The good and bad of a review

  • McMullen, Debbie;McClean, Rhett;Pak, Sok Cheon
    • CELLMED
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    • v.5 no.3
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    • pp.16.1-16.3
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    • 2015
  • Evidence based medicine involves using both the individual clinician's expertise and the current best available external clinical evidence from systematic research in deciding on the appropriate care for individual patients. The current approach to evidence based practice in healthcare adds a third component which is patient values. Evidence based practice is thus a triad, in which the practitioner's expertise, research evidence and the patient's values are all given consideration. The balance to be struck between them depends on the individual case. The literature indicates that complementary medicine practitioners are moving away from traditional knowledge and towards the use of evidence based practice in their clinical discussions. In the context of the daily practice of complementary medicine practitioners and their continuing development of their knowledge base of evidence based practice, this short review discusses the good and bad of a review journal article.

Tumor Imaging by Monoclonal Antibodies Labeled with Radioactive Metal Ions

  • Endo, K.;Sakahara, H.;Nakashima, T.;Koizumi, M.;Kunimatsu, M.;Ohta, H.;Furukawa, T.;Ohmomo, Y.;Arano, Y.;Yokoyama, A.;Okada, K.;Yoshida, O.;Hosoi, S.
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.2
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    • pp.77-85
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    • 1984
  • Monoclonal antibodies have become widely investigated in the Nuclear Oncology, especially in the radioimmunosassay of tumor markers and in vivo radioimmunoimaging of cancer. However, there are numerous factors as to whether radioimmunoimaging will ultimately successful. For imaging of tumors, metallic radionuclides such as In-111, Ga-67, Tc-99m have favorable nuclear properties than widely used I-131. These radioistopes have characteristics of the useful radiation for imaging, convenient short half-lives and the simple and rapid radiolabeling of monoclonal antibodies by using bifunctional chelaing agents. The obtained chelate-tagged antibodies are quite stable both in vitro and in vivo, without interfering antibody activities and animal experiments provided a good basis for its clinical applicability for the radioimmunoimaging of cancer. Much attention has also been given to the possibility, only beginning to be exploited, of the specific treatment of malignant neoplasms with these agents. Although specific antibody has not been developed that is uniquely specific for cancer alone and there are still many questions to be answered and problems to be overcome before radioimmunoimaging can be successfully used in ptients with cancer, these methods can be applied to the coupling of monoclonal antibodies with anti-neoplastic drugs or radionuclides suitable for internal radiation therapy of cancer.

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