• Title/Summary/Keyword: drug-related

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Awareness of Adverse Drug Reaction Reporting System in General Population (일반인에서의 의약품 부작용보고제도 인식도)

  • Ahn, So Hyeon;Chung, Sooyoun;Jung, Sun-Young;Shin, Ju-Young;Park, Byung-Joo
    • Health Policy and Management
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    • v.24 no.2
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    • pp.164-171
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    • 2014
  • Background: Safety of drugs has become a major issue in public healthcare. Spontaneous reporting of adverse drug reaction (ADR) is the cornerstone in management of drug safety. We aimed to investigate the awareness and knowledge of spontaneous ADR reporting in general public of Korea. Methods: A total of 1,500 study subjects aged 19-69 years were interviewed with a questionnaire for their awareness and knowledge related to spontaneous ADR reporting. Computer assisted telephone interview was performed from 27th February 2013 to 4th March 2013. Target population was selected with quota sampling, using age, sex, and residence area. Healthcare professionals such as physicians, pharmacists, and nurses were excluded. The survey questions included awareness of spontaneous ADR reporting, opinions on ways to activate ADR reporting, and sociodemographic characteristics. Results: Overall awareness of spontaneous ADR reporting system was 8.3% (${\pm}2.53%$) among general population of Korea. Major source from which people got the information regarding ADR reporting was television/radio (69.9%), followed by internet (19.3%), and poster/brochure (6.1%). Awareness level differed between age groups (p<0.0001) and education levels (p<0.0001). Upon learning about the ADR reporting system, 88.5% of study subjects agreed on the necessity of ADR reporting system, while 46.6% thought promotion through internet and mass media as an effective way to activate ADR reporting. Conclusion: The overall awareness of spontaneous ADR reporting should be enhanced in order to establish a firm national system for drug safety. Adequate promotions should be performed targeting lower awareness groups, as well as various publicity activities via effective channels for the general population.

Immunological Mechanisms in Cutaneous Adverse Drug Reactions

  • Ai-Young Lee
    • Biomolecules & Therapeutics
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    • v.32 no.1
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    • pp.1-12
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    • 2024
  • Adverse drug reactions (ADRs) are an inherent aspect of drug use. While approximately 80% of ADRs are predictable, immune system-mediated ADRs, often unpredictable, are a noteworthy subset. Skin-related ADRs, in particular, are frequently unpredictable. However, the wide spectrum of skin manifestations poses a formidable diagnostic challenge. Comprehending the pathomechanisms underlying ADRs is essential for accurate diagnosis and effective management. The skin, being an active immune organ, plays a pivotal role in ADRs, although the precise cutaneous immunological mechanisms remain elusive. Fortunately, clinical manifestations of skin-related ADRs, irrespective of their severity, are frequently rooted in immunological processes. A comprehensive grasp of ADR morphology can aid in diagnosis. With the continuous development of new pharmaceuticals, it is noteworthy that certain drugs including immune checkpoint inhibitors have gained notoriety for their association with ADRs. This paper offers an overview of immunological mechanisms involved in cutaneous ADRs with a focus on clinical features and frequently implicated drugs.

P-Glycoprotein-Based Drug-Drug Interactions: Preclinical Methods and Relevance to Clinical Observations

  • Aszalos, Adorjan
    • Archives of Pharmacal Research
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    • v.27 no.2
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    • pp.127-135
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    • 2004
  • Multiple drug administration is common in elderly, HIV, and cancer patients. Such treatments may result in drug-drug interactions due to interference at the metabolic enzyme level, and due to modulation of transporter protein functions. Both kinds of interference may result in altered drug distribution and toxicity in the human body. In this review, we have dealt with drug-drug interactions related to the most studied human transporter, P-glycoprotein. This transporter is constitutively expressed in several sites in the human body. Its function can be studied in vitro with different cell lines expressing P-glycoprotein in experiments using methods and equipment such as flow cytometry, cell proliferation, cell-free ATP as activity determination and Transwell culture equipment. In vivo experiments can be carried out by mdr1a(-/-) animals and by noninvasive methods such as NMR spectrometry. Some examples are also given for determination of possible drug-drug interactions using the above-mentioned cell lines and methods. Such preclinical studies may influence decisions concerning the fate of new drug candidates and their possible dosages. Some examples of toxicities obtained in clinics and summarized in this review indicate careful consideration in cases of polypharmacy and the requirement of preclinical studies in drug development activities.

Delamanid, Bedaquiline, and Linezolid Minimum Inhibitory Concentration Distributions and Resistance-related Gene Mutations in Multidrug-resistant and Extensively Drug-resistant Tuberculosis in Korea

  • Yang, Jeong Seong;Kim, Kyung Jong;Choi, Hongjo;Lee, Seung Heon
    • Annals of Laboratory Medicine
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    • v.38 no.6
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    • pp.563-568
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    • 2018
  • Background: Delamanid, bedaquiline, and linezolid have recently been approved for the treatment of multidrug- and extensively drug-resistant (MDR and XDR, respectively) tuberculosis (TB). To use these drugs effectively, drug susceptibility tests, including rapid molecular techniques, are required for accurate diagnosis and treatment. Furthermore, mutation analyses are needed to assess the potential for resistance. We evaluated the minimum inhibitory concentrations (MICs) of these three anti-TB drugs for Korean MDR and XDR clinical strains and mutations in genes related to resistance to these drugs. Methods: MICs were determined for delamanid, bedaquiline, and linezolid using a microdilution method. The PCR products of drug resistance-related genes from 420 clinical Mycobacterium tuberculosis strains were sequenced and aligned to those of M. tuberculosis H37Rv. Results: The overall MICs for delamanid, bedaquiline, and linezolid ranged from ${\leq}0.025$ to >1.6 mg/L, ${\leq}0.0312$ to >4 mg/L, and ${\leq}0.125$ to 1 mg/L, respectively. Numerous mutations were found in drug-susceptible and -resistant strains. We did not detect specific mutations associated with resistance to bedaquiline and linezolid. However, the Gly81Ser and Gly81Asp mutations were associated with resistance to delamanid. Conclusions: We determined the MICs of three anti-TB drugs for Korean MDR and XDR strains and identified various mutations in resistance-related genes. Further studies are needed to determine the genetic mechanisms underlying resistance to these drugs.

Canonical Correlation between Drug Dosage Calculation Error Prevention Competence of Nurses and Medication Safety Organizational Climate (약물계산 오류예방을 위한 간호사의 역량과 투약안전과 관련된 병원조직풍토간의 정준상관관계)

  • Kim, Myoung Soo
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.569-579
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    • 2012
  • Purpose: The purpose of this study was to investigate the relationship between drug dosage calculation error prevention competence and medication safety organizational climate. Methods: We surveyed 207 nurses from 15 hospitals. An assessment survey was designed to assess the medication safety organizational climate which consisted of four subcategories including medication safety cultures, medication safety initiatives, medication error communication, and medication error management competence. The drug dosage calculation error prevention competence contains two subcategories; Dosage calculation habits and ability. The data were collected from July to August 2011. Descriptive statistics, t-test, ANOVA, partial Pearson correlation coefficient, canonical correlation were used. Results: Organizational climate was related to dosage calculation error prevention competence with two significant canonical variables. The first canonical correlation coefficient was .53 (Wilks' ${\lambda}$=0.71, df=8, p<.001) and that of the second was .21 (Wilks' ${\lambda}$=0.96, df=3, p=.027). The first variate indicated higher perception of medication safety cultures, safety initiatives, error communication and error management competence were related to better dosage calculation habits. The second variate showed higher perception of medication safety cultures and lower medication error management competence were related to higher calculation ability. Conclusion: Continuous supporting strategies for medication safety organizational climate should be implemented to improve drug dosage calculation habits.

Patient compliance with drug treatment - new perspectives on an old problem

  • Kruse W.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.332-335
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    • 1994
  • Compared to other variables being considered in therapeutics, patient compliance has long been given minor attention although it affects every aspect of medical care; Limited methodology of compliance measurement, in particular, has hampered major progress in research, and pre-conceptions have been reiterated. However, there is a recent surge in interest derived from new data revealed by reliable methods, i.g. continuous medication (compliance) monitoring. The visualization of dynamics in drug regimen compliance over time offers unique opportunities, both to scientific drug evaluation and therapeutics in medical practice. New perspectives related to the descriptive and explanatory side of the problem are outlined by giving examples from various therapeutic fields.

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Effects of Ginseng on the Drug Metabolizing Enzymes (인삼이 간의 약물 대사 효소에 미치는 영향)

  • 김낙두
    • YAKHAK HOEJI
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    • v.28 no.1
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    • pp.29-33
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    • 1984
  • The paper aimed to review the influences of ginseng on the metabolism of foreign substances and on the activity of hepatic drug metabolizing enzyme system in mouse or rat liver. It has been known that ginseng components reduces the motality rates and the toxic effects induced by foreign materials. Chronic pretreatment of mouse or rat with ginseng extract fractions or saponin caused the increase in the metabolism of foreign materials and the activity of drug metabolizing enzymes, such as cytochrome $P_{450}$, NADPH cytochrome C reductase and glucuronyl S-transferase in liver. Thus, it may be concluded that decrease in toxic effect of foreign substances by ginseng pretreatment may be partly related to the induction of drug metabolizing enzymes in liver.

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Drug-drug Interactions between Psychotropic Agents and Other Drugs in Physically Ill Patients - Experience of Consultation-liason in Korea University Hospital - (내외과계 환자의 정신과 약물치료에서 약물-약물 상호작용 - 고려대학교 부속병원의 자문조정의 경험을 통하여 -)

  • Lee, Min Soo;Lee, Heon-Jeong
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.49-66
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    • 1999
  • Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

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Genetic Polymorphisms in Drug Transporters and Regulatory Xenobiotic Receptors in Korean Population

  • Lee, Sang-Seop;Shin, Jae-Gook
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2004.05a
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    • pp.27-29
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    • 2004
  • Drug transporters play an essential role in the absorption, distribution and elimination of clinical drugs, nutrients and toxicants. The importance of the transporters is exampled by therapeutic failure in cancer chemotherapy that is mainly caused by the overexpression of multidrug resistance (MDR)-related transporters. In addition, the transporters may involve in drug-drug interactions that lead to serious adverse drug responses and some transporters also contribute to inter-individual variation in drug responses. As an effort to understand the mechanism underlying the inter-individual variation of transporters activity, genetic and environmental factors influencing the expression or function of the transporters have extensively explored through last decade. Among them, genetic polymorphism of drug transporter encoding genes has generated much interest since the discovery of functional single nucleotide polymorphisms (SNP) of MDR1 gene. Besides drug transporters, xenobiotic receptors also modulate drug disposition by regulating the transcription of drug metabolizing enzymes and drug transporters. Among many xenobiotic receptors, pregnane X receptor (PXR) and constitutive androstane receptor (CAR) are two most well characterized since these receptors show wide substrate specificities and regulate the expression of various enzymes involved in drug disposition. Recently, several functional genetic polymorphisms were reported in PXR coding gene. In the present study, genetic polymorphisms of two drug transporters, MDR1 and BCRP, and two xenobiotic receptors, PXR and CAR, were investigated in Korean population.

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Genetic Polymorphisms in Drug Transporters and Regulatory Xenobiotic Receptors in Korean Population

  • Lee, Sang-Seop;Shin, Jae-Gook
    • Proceedings of the Korean Society of Toxicology Conference
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    • 2004.05a
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    • pp.27-29
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    • 2004
  • Drug transporters play an essential role in the absorption, distribution and elimination of clinical drugs, nutrients and toxicants. The importance of the transporters is exampled by therapeutic failure in cancer chemotherapy that is mainly caused by the overexpression of multidrug resistance (MDR)-related transporters. In addition, the transporters may involve in drug-drug interactions that lead to serious adverse drug responses and some transporters also contribute to inter-individual variation in drug responses. As an effort to understand the mechanism underlying the inter-individual variation of transporters activity, genetic and environmental factors influencing the expression or function of the transporters have extensively explored through last decade. Among them, genetic polymorphism of drug transporter encoding genes has generated much interest since the discovery of functional single nucleotide polymorphisms (SNP) of MDRl gene. Besides drug transporters, xenobiotic receptors also modulate drug disposition by regulating the transcription of drug metabolizing enzymes and drug transporters. Among many xenobiotic receptors, pregnane X receptor (PXR) and constitutive androstane receptor (CAR) are two most well characterized since these receptors show wide substrate specificities and regulate the expression of various enzymes involved in drug disposition. Recently, several functional genetic polymorphisms were reported in PXR coding gene. In the present study, genetic polymorph isms of two drug transporters, MDR1 and BCRP, and two xenobiotic receptors, PXR and CAR, were investigated in Korean population.

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