• Title/Summary/Keyword: dosage regimen

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Evaluation of the Current Regimen of Tacrolimus in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포 이식환자에서의 현행 tacrolimus 치료방법 평가)

  • Yeo, Mi-Jin;Park, Soo-Jin;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.193-199
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    • 2010
  • Tacrolimus, an immunosuppressant prescribed against graft-versus-host disease (GVHD) in patients with allogeneichematopoietic stem cell transplantation (HSCT), is affected to change its pharmacokinetic properties by various factors. For this reason, it is needed a close monitoring to adjust dosage amount in order to optimize the blood concentration of tacrolimus is located within the effective range. According to our in-house study, 62% of HSCT-patients were needed dosage-adjustment and it is necessary to optimize the current immunosuppressive regimen in clinical settings. A retrospective study was designed to evaluate the dosing regimen (converting ratio of IV:PO=1:4) of tacrolimus in HSCT patients (n=62). After collecting data from patient's profile and medical record, pharmacokinetic parameters were calculate and compared between the estimated and the actual values in the selected subjects (n=58). It was found that the bioavailabilty (BA) of oral tacrolimus was 40.5% very much different from that is known as 25%. It implies that the current protocol has a potent risk causes dose-related toxicities to the patients. Furthermore, analyses among factors demonstrated that there was no statistical significance between BA of tacrolimus and the variable factors. In the clinical perspectives, the current converting ratio of tacrolimus in patients with HSCT to be re-considered and an appropriate and optimal alternative regimen should be adopted to prevent GVHD and to increase the quality of life of patients.

Chronopharmacokinetics of Vancomycin in Normal Volunteers (반코마이신의 시간 약물동태학)

  • Choi, Jun Shik;You, Jae Sin;Choi, Byung Cheol;Kim, Jin;Bum, Jin Pil;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.6 no.2
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    • pp.1-6
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    • 1996
  • Carcadian rhythm dependence of vancomycin pharmacokinetics was evaluated in 5 normal volunteers receiving a single intravenous 1.0 g dose of vancomycin at 8 o'clock in the morning and another occasion at 8 o'clock in the evening in a crossover manner. The serum data were subjected to simultaneous computer nonlinear least squares regression analysis using a two-compartment pbarmacokinetic model. The mean half-life of vancomycin was $4.78\pm0.81$ hr in the morning and $4.25\pm0.51$ hr in the evening. The mean total body clearance of vancomycin was $1.29\pm0.58$ hr in the morning and $5.58\pm0.48$ hr in the evening. No circadian rhythm was found to be apparent in normal volunteers. The mean in intrasubject difference in the half-life between 8 A.M. and 8 P.M. was $15.4\%$ with fluctuations ranging from $10.4\sim33.8\%$, It is reasonable to consider individual circadian rhythm for effective dosage regimen of vancomycin in clinical chronotherapeutics.

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The Effect of Circadian Rhythm on the Gentamicin Pharmacokinetics in Rabbits (가토에서 생체리듬이 겐타마이신의 약물동태에 미치는 영향)

  • Ko, Jae Won;Baek, Chae Sun;Choi, Jun Shik
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.3
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    • pp.125-129
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    • 2000
  • The effect of circadian rhythm on gentamicin pharmacokinetics was studied in rabbits who took a single intravenous 2 mg/kg dose of gentamicin at 09:00 in the morning (a.m.) and 22:00 in the evening (p.m.). A significant circadian rhythm of pharmacokinetic parameters as a function of time of day was noted in rabbits, showing lower total body clearance $CL_t$ and higher serum area under the curve (AUC) when given in the evening. The half-life $t_{1/2}$ was shorter in the morning $(3.88\pm0.62h)$ when compared to the evening $(4.76\pm0.75\;h)$. The AUC was greater in the evening $(25.92\pm3.49\;{\mu}g/ml{\cdot}hr)$ than that in the morning $(22.42\pm3.42\;{\mu}g/ml{\cdot}hr)$, most likely because the CLt was significantly higher when gentamicin was given in the morning $(0.18\pm0.28\;ml/hr)$ versus in the evening $(0.15\pm0.26\;ml/hr)$. The $t_{1/2}$ of gentamicin in the evening was increased significantly(p<0.05) compared to those of gentamicin in the morning. It is reasonable to consider individual circadian rhythm for effective dosage regimen of gentamicin in clinical chronotherapeutics.

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Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy (대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시)

  • Lim, Hyun-Soo;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.158-166
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    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

Studies on N-Ethyl-N-nitrosourea Mutagenesis in BALB/c Mice

  • Cho, Kyu-Hyuk;Cho, Jae-Woo;Song, Chang-Woo
    • Toxicological Research
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    • v.24 no.1
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    • pp.59-68
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    • 2008
  • N-ethyl-N-nitrosoures (ENU) is effective in inducing hypermorphic mutation as well as hypomorphic and antimorphic mutations. Therefore, this mutagen is used to the production of mutant in the mice. In order to perform an effective ENU mutagenesis using BALB/cAnN mice, determination of optimal dosage and dosage regimen of ENU is necessary. And this study tried to develop a suitable screening method and searched for novel and various mutants as model animals in phenotypedriven ENU mutagenesis. We have carried out dosage regimen for mutagenizing dose of 200 mg/kg ENU in the BALB/c mice. Total screened mice were 30,133. As the results of Esaki and Cho's Phenotype Screening, we got 2,516 phenotypic and behavior abnormalities in $G_1,\;G_2\;and\;G_3$ mice. One hundred thirty five $G_1$ phenodeviants were tested for inheritance and 16 dominant mutants were discovered. Forty two recessive mutants were also found in tested 201 micropedigrees. Early-onset mutant mice included the dysmorphology of face, eye, tail, limb, skin, and foot and abnormal behavior like circling, swimming, head tossing, stiff-walking, high cholesterol level, and tremor etc. In this study we could effectively screen $G_3$ recessive mutants. The frequent and concise early-onset screening before weaning will be available for ENU mutagenesis.

Formulation of a rational dosage regimen of ceftiofur hydrochloride oily suspension by pharmacokinetic-pharmacodynamic (PK-PD) model for treatment of swine Streptococcus suis infection

  • Luo, Wanhe;Wang, Dehai;Qin, Hua;Chen, Dongmei;Pan, Yuanhu;Qu, Wei;Huang, Lingli;Xie, Shuyu
    • Journal of Veterinary Science
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    • v.22 no.6
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    • pp.41.1-41.14
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    • 2021
  • Background: Our previously prepared ceftiofur (CEF) hydrochloride oily suspension shows potential wide applications for controlling swine Streptococcus suis infections, while the irrational dose has not been formulated. Objectives: The rational dose regimens of CEF oily suspension against S. suis were systematically studied using a pharmacokinetic-pharmacodynamic model method. Methods: The healthy and infected pigs were intramuscularly administered CEF hydrochloride oily suspension at a single dose of 5 mg/kg, and then the plasma and pulmonary epithelial lining fluid (PELF) were collected at different times. The minimum inhibitory concentration (MIC), minimal bactericidal concentration, mutant prevention concentration (MPC), post-antibiotic effect (PAE), and time-killing curves were determined. Subsequently, the area under the curve by the MIC (AUC0-24h/MIC) values of desfuroylceftiofur (DFC) in the PELF was obtained by integrating in vivo pharmacokinetic data of the infected pigs and ex vivo pharmacodynamic data using the sigmoid Emax (Hill) equation. The dose was calculated based on the AUC0-24h/MIC values for bacteriostatic action, bactericidal action, and bacterial elimination. Results: The peak concentration, the area under the concentration-time curve, and the time to peak for PELF's DFC were 24.76 ± 0.92 ㎍/mL, 811.99 ± 54.70 ㎍·h/mL, and 8.00 h in healthy pigs, and 33.04 ± 0.99 ㎍/mL, 735.85 ± 26.20 ㎍·h/mL, and 8.00 h in infected pigs, respectively. The MIC of PELF's DFC against S. suis strain was 0.25 ㎍/mL. There was strong concentration-dependent activity as determined by MPC, PAE, and the time-killing curves. The AUC0-24h/MIC values of PELF's DFC for bacteriostatic activity, bactericidal activity, and virtual eradication of bacteria were 6.54 h, 9.69 h, and 11.49 h, respectively. Thus, a dosage regimen of 1.94 mg/kg every 72 h could be sufficient to reach bactericidal activity. Conclusions: A rational dosage regimen was recommended, and it could assist in increasing the treatment effectiveness of CEF hydrochloride oily suspension against S. Suis infections.

Pharmacokinetic Interaction of Vancomycin and Probenecid in Rabbits (반코마이신과 프로베네시드의 약물동태학적 상호작용)

  • Lee, Do-Nil;You, Jae-Sin;Burm, Jin-Pil;Choi, Jun-Shik
    • Journal of Pharmaceutical Investigation
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    • v.27 no.1
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    • pp.51-56
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    • 1997
  • This study was attempted to investigate the pharmacokinetic interaction of vancomycin (10 mg/kg, i.v.) and probenecid (7.5. 15, and 30 mg/kg, oral) in rabbits. The area under curve (AUC) of plasma vancomycin concentration was significantly increased (p<0.01) in rabbits when the probenecid was coadministrated. Volume of distribution (Vd) was significantly decreased (p<0.05) in rabbits coadministrated with probenecid (15 and 30 mg/kg) and total body clearance (CLt) was decreased significantly (p<0.05. p<0.01) in rabbits coadministrated with probenecid (7.5, 15 and 30 mg/kg). There was significant correlation between AUC and probenecid dose. From the results of this experiment, it is desirable to adjust dosage regimen of vancomycin for reduction of side or toxic effect when the probenecid is coadministered in clinical practice.

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Pharmacokinetics of Theophylline in Rabbits with Hepatic Failure (간장장해에서 Theophylline의 체내동태)

  • Moon, Hong-Sub;Lee, Chong-Ki;Choi, Jun-Shik
    • Korean Journal of Clinical Pharmacy
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    • v.2 no.1
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    • pp.23-28
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    • 1992
  • This study was attempted to investigate the pharmacokinetics of theophylline(4mg/kg) in the rabbits of carbon tetrachloride induced hepatic Cailure, The plasma concentration and relative bioavailability of theophylline were increased significantly in hepatic railure rabbits compared with those of normal rabbits. There was significant relationship between SGOT value and bioavailability parameters of theophylline. From the results of this experiments, dosage regimen of theophylline is considered to be adjusted in dose size and dosing interval using SGOT values.

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Pharmacokinetics of Sulfamethoxazole in Rabbits with Experimental Renal Failure (실험적 신장장해 가토에서 설파메톡사졸의 약물동태학적 연구)

  • Choi, Jun-Shik;Lee, Chong-Ki
    • Journal of Pharmaceutical Investigation
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    • v.16 no.4
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    • pp.152-157
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    • 1986
  • The pharmacokinetics of sulfamethoxazole were investigated in rabbits with folate-induced renal failure. The blood level, area under the blood concentration curve (AUC) and biological half-life were increased significantly, and the urinary excretion was decreased significantly compared with those of normal rabbits. Correlation of serum creatinine concentration and AUC, biological half-life, and correlation of creatinine clearance and renal clearance have linear relationship respectively. From these results, dosage regimen of sulfamethoxazole is considered to be adjusted for effective and safe therapy in renal failure.

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Drug Interaction of Probenecid and Lithium Carbonate (프로베네시드와 탄산리튬의 약물상호작용)

  • Lee, Jin-Hwan;Lee, Chong-Ki
    • Journal of Pharmaceutical Investigation
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    • v.17 no.2
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    • pp.95-98
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    • 1987
  • The drug interaction between probenecid and lithium carbonate was studied pharmacokinetically in rabbits. The blood level and the area under the concentration curve (AUC) of lithium carbonate administered orally were elevated by coadministration of probenecid. Probenecid inhibited the urinary excretion of lithium carbonate in rabbits. Biological half-life and $t_{max}$ of lithium carbonate were prolonged by coadministration of probenecid. From these results, dosage regimen of lithium carbonate is considered to be adjusted for effective and safe therapy in the coadministration of probenecid.

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