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Medication Errors in Chemotherapy Preparation and Administration: a Survey Conducted among Oncology Nurses in Turkey

  • Ulas, Arife;Silay, Kamile;Akinci, Sema;Dede, Didem Sener;Akinci, Muhammed Bulent;Sendur, Mehmet Ali Nahit;Cubukcu, Erdem;Coskun, Hasan Senol;Degirmenci, Mustafa;Utkan, Gungor;Ozdemir, Nuriye;Isikdogan, Abdurrahman;Buyukcelik, Abdullah;Inanc, Mevlude;Bilici, Ahmet;Odabasi, Hatice;Cihan, Sener;Avci, Nilufer;Yalcin, Bulent
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1699-1705
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    • 2015
  • Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

Protein Arginine Methyltransferase 5 (PRMT5) Regulates Adipogenesis of 3T3L-1 Cells (단백질 아르기닌 메틸전이효소 5(PRMT5)에 의한 3T3L-1 세포의 지방세포 분화 조절)

  • Jang, Min Jung;Yang, Ji Hye;Kim, Eun-Joo
    • Journal of Life Science
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    • v.28 no.7
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    • pp.765-771
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    • 2018
  • Peroxisome proliferator-activated receptor gamma ($PPAR{\gamma}$) is a key transcription factor that regulates adipogenesis, and epigenetic control of $PPAR{\gamma}$ is of great interest in obesity-inhibition research. Our previous study showed that CACUL1 (CDK2-associated cullin domain 1) acts as a corepressor that inhibits $PPAR{\gamma}$ transcriptional activity and adipocyte differentiation. Here, we investigated the roles of protein arginine methyltransferase 5 (PRMT5), a novel binding partner of CACUL1, in regulating $PPAR{\gamma}$. The interaction between PRMT5 and CACUL1 was shown by immunoprecipitation assay in vivo and GST pulldown assay in vitro. As shown by luciferase reporter assay, PRMT5 and CACUL1 cooperated to inhibit the transcriptional activity of $PPAR{\gamma}$. The suppressive role of PRMT5 in adipogenesis was examined by Oil Red O staining using 3T3-L1 cells, which stably overexpress or deplete PRMT5. Overexpression of PRMT5 suppresses $PPAR{\gamma}$-mediated adipogenesis, whereas PRMT5 knockdown increases lipid accumulation in 3T3-L1 cells. Consistently, PRMT5 attenuates the expression of Lpl and aP2, the target genes of $PPAR{\gamma}$, as demonstrated by RT-qPCR analysis. Overall, these results suggest that PRMT5 interacts with CACUL1 to impair the transcriptional activity of $PPAR{\gamma}$, leading to the inhibition of adipocyte differentiation. Therefore, the regulation of PRMT5 enzymatic activity may provide a clue to develop an anti-obesity drug.

Anti-Inflammatory Effect of Chondrus nipponicus Yendo Ethanol Extract on Lipopolysaccharide-Induced Inflammatory Responses in RAW 264.7 Cells (LPS로 유도된 RAW 264.7 세포에 대한 가락진두발 에탄올 추출물의 항염증 효과)

  • Kim, Min-Ji;Bae, Nan-Yong;Kim, Koth-Bong-Woo-Ri;Park, Ji-Hye;Park, Sun-Hee;Jang, Mi-Ran;Ahn, Dong-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.2
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    • pp.194-201
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    • 2016
  • The anti-inflammatory activity of ethanol extract from Chondrus nipponicus Yendo (CNYEE) was investigated by measuring production of a lipopolysaccharide-induced inflammatory response mediator. CNYEE had no cytotoxic effects on proliferation of macrophages compared to the control. CNYEE significantly inhibited (over 50%) NO production at $50{\mu}g/mL$, with inhibitory effects on expression levels of cytokines such as interleukin (IL)-6, tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), and IL-$1{\beta}$. In particular, IL-6 inhibitory activity of CNYEE was higher than 70% at $100{\mu}g/mL$. CNYEE also reduced protein expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and nuclear factor (NF)-${\kappa}B$ in a dose-dependent manner. CNYEE also significantly reduced phosphorylation of p38, extracellular signal-regulated kinase, and c-Jun N-terminal kinase. Therefore, these results suggest that CNYEE may have anti-inflammatory effects by modulating the NF-${\kappa}B$ and mitogen-activated protein kinases signaling pathways and may be used as an anti-inflammatory therapeutic material.

Poly(DL-Lactide-co-Glycolide) Nanoparticles Used PEG-PPG Diblock Copolymer by Surfactant: Preparation and Loading of Water Insoluble Drug (유화제로서 PEG-PPG 블록 공중합체를 이용한 Poly(DL-Lactide-co-Glycolide) 나노입자: 제조 및 지용성 약물의 로딩)

  • Taek Kyu Jung;Sung Soo Kim;Byung Cheol Shin
    • Journal of the Korean Chemical Society
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    • v.47 no.5
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    • pp.479-486
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    • 2003
  • In this study, poly(DL-lactide-co-glycolide) nanoparticles loaded with water-insoluble vitamins such as vitamin A (Retinol) and vitamin E acetate were prepared by the emulsification diffusion method. Polymer solution was prepared by the two water-miscible organic solvent, such as ethanol and acetone. Because of its biocompatible property, polyethyleneglycol-polypropyleneglycol diblock copolymer was used as surfactant and stabilizer. The influence of some preparative variables on the nanoparticle formation and on the loading efficiency of active agents, such as the type and concentration of stabilizing agent, the stirring methods, the water/oil phase ratio and the polymer concentration were investigated in order to control and optimize the process. After preparation of nanoparticles loaded with active agent, particle size and distribution were evaluated by the light scattering particle analyzer. The loading efficiency of active agents was evaluated by the UV-visible spectroscopy. As the results, particle size were 50-200 nm and dispersibility was monodisperse. The optimum loading efficiency of active agents was observed 50-60%. It was found that the appropriate of selections of binary solvent mixtures and polymeric concentrations in both organic and aqueous phases could provide good yield and favorable physical properties of PLGA nanoparticles.

Experimental Studies on Antitumor Activity of Herb Drugs (I)-Effectiveness on Rat Natural Killer Cell Activity- (수종(數種)의 생약(生藥)에 대(對)한 항암효과(抗癌效果)의 실험적(實驗的) 연구(硏究)(I) -백서(白鼠)의 자연살해세포활성(自然殺害細胞活性)에 미치는 영향(影響)-)

  • Kang, Yun-Ho;Kim, Byung-Woon;Ha, Youn-Mun;Park, Jai-Kyung;Nam, Sang-Yun;Choi, Kyu-Chul;Choi, Yong-Mook
    • Korean Journal of Pharmacognosy
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    • v.18 no.2
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    • pp.118-126
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    • 1987
  • Natural Killer cells are considerd to play an important role in antitumor immune surveilance mechanism. In this study, 21 putative anticancer drugs selected from reference were assessed by evaluating the effect on rat Natural Killer cell activity (NKCA). All 21 herb drugs were extracted in boiling water, lyophilized, autoclaved, and then used for experiment. Culture supernatant of concanavalin-A (Con-A)-stimulated rat spleen cells as a source of lymphokine was also used as a control of comparison. Rat spleen cells were used as effector and NKCA was measured in 4hr $^{51}Cr-release$ assay against Yac-1 mouse lymphoma cell line. In order to determine the optimal conditions for NKCA augmentation, effector cells were treated with 3 different concentrations of each drug for 24, or 48 hrs before testing of NKCA, In optimal conditions determined from previous results, the effect of herb drugs on NKCA were assessed in 3 to 5experiments. NKCA was significantly enhanced by treatment with 4 herb drugs(Ponciri Fructus, Houttuyniae Herba, Aurantii Pericarpium, Nepetae Herba). Culture supernatant of Con-A-stimulated spleen cells also augmented the rat NKCA more significantly. The results show that 4 of the herb medicines supposed to display anticancer effect may have activity as a biological response modifier through augmentation of NKCA.

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The Efficacy of Saururus chinensis on Cervical Cancer Cells : The Inhibitory Effect on the Function of E6 and E7 Oncogenes of HPV Type 16 (삼백초 추출물의 자궁경부암세포 억제 효능)

  • Chung, Yeon-Gu;Lee, Hae-Sook;Lee, Kyung-Ae;Joung, Ok;Oh, Won-Keun;Kim, Kwang-Dong;Lim, Jong-Seok;Moon, Ja-Young;Cho, Yong-Kweon;Park, Sue-Nie;Yoon, Do-Young
    • YAKHAK HOEJI
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    • v.46 no.6
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    • pp.426-432
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    • 2002
  • Cervical cancer is one of the leading causes of female death from cancer worldwide with about 500,000 deaths per year. A strong association between certain human papilloma viruses (HPV type 16 and 18) and cervical cancer has been well known. An extract of Saururus chinensis, named as PE-46, has been used to investigate whether this agent has the ability of inhibiting the oncogenes E6 and E7 of HPV type 16. PE-46 inhibited the proliferation of human cervical cancer cell lines in a dose response manner. PE-46 also inhibited the in vitro binding of E6 and E6AP which are essential for the binding and degradation of the tumor suppressor p53. In addition, PE-46 inhibited the in vitro binding of E7 and Rb which is essential tumor suppressor for the control of cell cycle. The levels of mRNA for E6 and E7 were also decreased by PE-46. SiHa cells treated with PE-46 induced G0/G1 arrest, resulting in inhibition of growth. Our study showed that the PE-46 can inhibit the cervical carcinomas via both inhibition of bindings between oncogenes and tumor suppressors, and inhibition of G1longrightarrowS transition. PE-46 inhibited the oncogenecity of E6 and E7 of HPV 16 type, thus could be used as a putative modulating agent for the treatment of cervical carcinomas caused by HPV.

A Study on the Reflection of Rabbit Nervous Tissue After Electromagnetic Irradiation and the Effect of Nimodipine Injection (전자파에 노출된 토끼의 뇌신경조직의 반응과 Nimodipine 투여효과에 관한 연구)

  • 이근호;김영태
    • Journal of Biomedical Engineering Research
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    • v.19 no.1
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    • pp.81-90
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    • 1998
  • Electromagnetic waves may induce various effects on nervous tissues either by thermal or non-thermal mechanisms. This paper intoduces a method to evalute the non-thermal effect to central nervous system by measuring the EEGs of the rabbits treated by nimodipine before exposed to weak microwave field. 20 rabbits were divided into 2 groups and their EEGs were measured after their head section were exposed to 2,450 MHz microwave with the power density of 10 dBm and 20 dBm respectively for 10 minutes and compared with those of the 3rd group of 10 rabbits which were not exposed. The 4th group of 10 rabbits were intravenously given with nimodipine before exposed to 20 dBm field to determine whether this drug would reverse the EEGs changes induced by weak microwave irradiation. As field poser exceeded 20 dBm although no significant physiological changes were observed, total induced EEGs power was remarkably decreased suggesting the presence of CNS activation. Using Fourier analysis on the EEGs signal it was found that remarkable decrease in delta band and increase in the alpha and beta bands in a significant manner(P<0.05) compared to control group. The changes were, however, not reversed by nimodipine-treatment. The effects may be pure thermal in nature because no significant change has been observed in nimodipine treated rabbits.

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Effectiveness of Intravenous Isoniazid and Ethambutol Administration in Patients with Tuberculosis Meningoencephalitis and HIV Infection

  • Butov, Dmytro;Feshchenko, Yurii;Kuzhko, Mykhailo;Gumenuik, Mykola;Yurko, Kateryna;Grygorova, Alina;Tkachenko, Anton;Nekrasova, Natalia;Tlustova, Tetiana;Kikinchuk, Vasyl;Peshenko, Alexandr;Butova, Tetiana
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.96-103
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    • 2020
  • Background: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. Methods: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. Results: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). Conclusion: In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

Validation of an analytical method of oxyresveratrol for standardization of Mulberry (Morus alba L.) branch extract as a functional ingredient (상지추출물의 기능성원료 표준화를 위한 지표성분 옥시레스베라트롤 분석법 검증)

  • Jeon, Young-Hee;Choi, Sang-Won
    • Korean Journal of Food Science and Technology
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    • v.50 no.4
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    • pp.377-382
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    • 2018
  • An HPLC method was developed to quantitate a marker, oxyresveratrol (ORT), for the standardization of mulberry branch extracts (MBE) as a functional ingredient. HPLC was performed on a $C_{18}$ column with a gradient elution using 0.05% $H_3PO_4$ and acetonitrile at a flow rate of 0.8 mL/min, and detected at 320 nm. The HPLC method was validated according to Korea Food and Drug Administration (KFDA) guideline of analytical procedures with respect to specificity, linearity, accuracy and precision. Calibration curve of ORT showed high linearity ($R^2=1$), and limits of detection and quantification were 0.3 and $1.0{\mu}g/mL$, respectively. Relative standard deviation values from intra-and inter-day precision were less than 3.52 and 4.70%, respectively. Recovery rate ranged from 97.64% to 103.69%, and ORT content in MBE was approximately 3.78%. These results suggest that the HPLC method developed for the analysis of ORT in MBE is simple, efficient, and could contribute to the quality control of MBE.

Efficacy of Disinfectants and Sanitizers of Chlorine Oxide Bubbling Tablets (기포 발생형 타정제의 살균세정 효과)

  • Ji, Won Dae;Kang, Sang Gu;Lee, Kyung Eun
    • Journal of Life Science
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    • v.25 no.9
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    • pp.1036-1042
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    • 2015
  • By using effective sanitizers, early block for transmission of pathogens is the effective way to prevent epidermic outbreaks. Here we developed a chlorine oxide bubbling type of sanitizing tablets and evaluated the disinfectant and sanitization effects. The sanitizers showed 99.999% of sanitization effect for Escherichia coli ATCC 10536 and Staphylococcus aureus ATCC 6538 strains for 5 min±10 sec on 20±1℃ in clean condition by dilution-neutralization method. It reduced more than 5 log10 cfu/ml of a legal permission standard of colony reduction. When a few used socks and underwear soaked for one hour in the 0.1% of the sanitizing tablets, no microorganisms were grown on CHROMagar plates. However, on CHROMagar plates of the no sanitizing tablets treated control, about 6.5×104 cfu/ml of Staphylococcus sp., Klebsiella sp. and Enterococus sp. were grown. Furthermore, the sanitizing tablets killed approximately 1.5x108 cfu/ml of E. coli BL21 in 5 minutes. Therefore, we concluded that the chlorine based bubbling type of sanitizing tablets satisfied the legal standard for the regulation of food and drug safety for disinfectants and sanitizers to pathogens and daily supplies.