• Journal of Pharmaceutical Investigation
• /
• 제37권2호
• /
• pp.119-126
• /
• 2007

Tablet splitting is used in pharmacy practice to adjust the dose to be administered. However, it also causes several problems such as undesirable effect for sustained release or enteric-coated dosage form, inaccuracy of dose, and pharmacist's safety by splitting hazardous drugs. This study investigated the current status of oral dosage form splitting for patients older than 19 years by analyzing Korea National Health Insurance Claims Database. Out of oral solid drugs prescribed (N=1,486,584) 9.8% of them included tablets (or capsules) split. There were some splitting cases even in sustained release (4.9%), enteric-coated forms (1.3%) and hazardous drugs (2.7%) that were selected by NIOSH (The National Institute for Occupational Safety and Health). The most frequently split drugs were antihistamines, neuropsychotics and steroids. In case of digoxin and warfarin, unit doses in a domestic market were not diverse compared to foreign markets. Guidelines for splitting oral solid dosage forms, approval of diverse doses and conducting dose-response studies for the commonly splitting ingredients on Korean people are needed for the saff and effective use of oral solid drugs.

• 대한한의학회지
• /
• 제24권2호
• /
• pp.213-218
• /
• 2003

폐동맥고혈압으로 진단받은 객혈환자 1예에 대하여 청상보하탕 가미방을 투여하여 객혈량, 전신소력감 및 ABGA의 변화를 고찰해 본 결과 위와 같이 객혈량의 약 90％ 감소, 전신소력감의 약 40％ 감소 및 ABGA의 호전을 보였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
• /
• 제25권1호
• /
• pp.50-57
• /
• 2008

Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

• 약학회지
• /
• 제54권3호
• /
• pp.205-214
• /
• 2010

This study aimed to evaluate the patterns of inappropriate medication use and inappropriate dosage in elderly patients in Korea. A retrospective study was performed for the elderly 65 years or older admitted from January 2007 to December 2007 in a medical center, Seoul, Korea. Potentially inappropriate medication (PIM) use in the elderly was evaluated using Beers criteria. Eighteen drugs out of Beers criteria were included in the formulary of the institute. Inappropriate dosage was set using Beers criteria, CMS (the Centers for Medicare& Medicaid Services) guideline, Geriatric Dosage Handbook. As results, the patients with PIM were 2,172 during the study period. The commonly used inappropriate medications were drugs for the nervous system (n=1237, 44.78%), the alimentary System (n=663, 24.54%) and the cardiovascular system (n=494, 18.28%). The elderly patients with prescription of inappropriate dosage were 10% out of patients with PIMs. The commonly inappropriate dosage drugs were digoxin (n=75, 27.27%), diazepam (n=70, 22.55%) and ferrous sulfate (n=66, 24.00%). Logistic regression analysis showed the number of PIM, days of hospital stay as predictors related to inappropriate dosage use. In conclusion, CNS drugs were frequently prescribed as PIM and inappropriate dosages were identified. It is needed to develop a means of decreasing adverse drug events in elderly.

• Archives of Pharmacal Research
• /
• 제18권6호
• /
• pp.427-433
• /
• 1995

A microscopic mass balance approach has hsown that the initial saturation (Is), absorption number (An), dose number (Do), and dissolution number (Dn) are four fundamental dimensionless parameters that can be used to estimate the fraction dose absorbed (F)l of suspensions of poorly soluble drugs in humans. The dissolution number of a drug increases with decreasing its particle size. The effect of micronization on F for suspensions was investigated in terms of Dn. About 90% of maximal F can be achieved at $Dn{\approx}2$. Increasing the solubility of a drug results in better oral absorption through increasing Dn and decreasing the solubility of a drug results in better oral absorption through increasing Dn and decreasing Do. The fractions dose absorbed of digoxin, griseofulvin, and benoxaprofen agree with predicted F values sorbed by reducing particle size, while absorption of drugs with high Do and low Dn is limited by solubility and requires higher solubility to enhance the fraction dose absorbed in addition to micronization. Solubility at the physiological pH should be used for the estimation of the fraction dose absorbed.

• Clinical and Experimental Pediatrics
• /
• 제45권6호
• /
• pp.790-795
• /
• 2002

모유 수유아에 발생하는 고나트륨혈성 탈수는 드물기는 하나 지난 30년 동안 꾸준히 보고되어 왔다. 저자들은 모유 수유 부족에 의한 고나트륨혈성 탈수를 보인 생후 14일된 여아를 경험하였다. 내원시 환아는 17%의 체중 감소가 있었고, 혈청 나트륨농도는 179 mEq/L였으며, 전신성 요독증, 고혈당증, 범발성 혈관내 응고증, 심부전 소견있었으나 치료 후 교정되었으며, 탈수 교정 중 경련을 보였으나 두부 초음파 및 뇌자기공명영상 검사에 뇌부종, 출혈 등 이상 소견은 없었고, 환아 현재 정상적인 발달을 하고 있기에 문헌 고찰상 이 증례는 모유 수유 중 발생한 고나트륨혈성 탈수의 첫 증례로 생각되어 보고하는 바이다.

• 대한한의학회지
• /
• 제22권2호
• /
• pp.94-101
• /
• 2001

Background and Purpose : Relationship between 17-KS.17-OHCS in 24hrs urine and Deficiency Syndrome of the Kidneys had been examined, but the study about 17-KS.17-OHCS in stroke patients was rare6'. In this study, we aimed to investigate the usefulness of 24hrs urine 17-KS.17-OHCS in stroke patients as an index for the Differentiation of Deficiency Syndrome of the Kidneys. Subjects : 66 stroke patients(male : female =2 9 : 37) were selected, they were admitted in the hospital of oriental medicine, Kyunghee university(from November 1 st, 1998 to May 30th, 2000). Their age was over 65 years. The patients who had renal malfunction, hyperthyroidism, hypothyroidism were excluded and who took chlorpromazine, spironolactone, digoxin, reserpine, hormonal agent were also excluded. Methods : After we selected the patients, we investigated the Differentiation of Syndrome by use of Diagnostic Paper and examined the level of 17-KS.17-OHCS in 24hrs urine. We compared Deficiency Syndrome with non-Deficiency Syndrome of the Kidneys using of 17-KS.17-OHCS in 24hrs urine. Results : 1. Stroke did not affect 17-KS.17-OHCS excretion in 24hrs urine. 2. In 24hrs urine, 17-KS of male stroke patients and 17-OHCS of female stroke patients were lower in patients diagnosed as a Deficiency Syndrome than non-Deficiency Syndrome of the Kidneys(p<0.05). 3. Among Deficiency Syndrome of Yin, Yang, Yang and Yin of the Kidneys group, there was no differentiation of 17-KS.17-OHCS in 24hrs urine(p>0.05).

• Journal of Yeungnam Medical Science
• /
• 제1권1호
• /
• pp.13-23
• /
• 1984

Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

• 동의생리병리학회지
• /
• 제22권1호
• /
• pp.256-261
• /
• 2008

Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.

• 대한임상독성학회지
• /
• 제5권2호
• /
• pp.106-111
• /
• 2007

Purpose: Inadequate hospital stocking and unavailability of essential antidotes is a worldwide problem. The purpose of this study was to determine the adequacy of antidote stocks in Korean hospitals based on a modified version of US antidote stocking guidelines. Methods: Both written and telephone surveys to collect information on hospital demographics and antidote stocking were given to the emergency departments or hospital pharmacies of 117 hospitals with emergency medical centers. The twenty antidotes included in the survey were taken from year 2000 US antidote stocking guidelines, except for activated charcoal and black widow spider antivenin. Antidote stocks were compared by hospital size, geographic location, and type of emergency medical center. Results: Complete responses were received from all hospitals. A mean of $12.4{\pm}2.9$ antidotes were adequately stocked per hospital. All hospitals stocked atropine, $CaCl_2$ naloxone, and sodium bicarbonate. However, digoxin Fab fragment (16%), cyanide kits (15%), EDTA (10%), BAL (9%), and fomepizole (1%) were not uniformly stocked. Large and teaching hospitals were significantly more likely to stock greater numbers of antidotes. Conclusions: Korean hospitals as a group do not have adequate antidote stocks. Korean stocking guidelines and an antidote management system are recommended in order to correct these deficiencies.