• Title/Summary/Keyword: drug-related side effects

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Difficult Clinical Problems of Treatment in Depression (우울증 치료에서의 어려운 문제들)

  • Min, Kyung-Joon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.37-46
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    • 2001
  • Whenever a clinician manages the patients with depression, he may meet various problems that make it difficult to treat them. Even though he has good skills and knowledge about depression, some barriers will be appear during his practice. In general, the difficulties in treating depression are treatment-resistance, adverse effects of antidepressants, pregnancy in female patients, comorbid medical conditions, poor compliance, drug-drug interactions, and so on, which are related with pharmacological treatments. Here, only the two of them, the treatment-resistant depression and difficult problems concerned with pregnancy, were discussed. Some level of treatment resistance is the norm rather than the exception. As the treatment failure stems from inadequate treatment, it is important that the clinician should prescribe medications with sufficient doseage and adequate duration. And to overcome the treatment resistant depression the polypharmacy is necessary, in that case, the side effects and toxicities should be explored and managed immediately. So the clinician have to learn more about the pharmacokinetic and pharmacodynamic mechanisms of each drugs used in treatment of depression. When the risk of the fetus by the exposure is higher than the risk of untreated maternal psychiatric disorder, psychotropic medications should be used during pregnancy. Women who are maintained on psychotropics and become pregnant, as well as women with the new onset of psychiatric symptoms during pregnancy, should be carefully reassessed. However, data concerning the potential risk of long-term behavioral changes following prenatal exposure to psychotropics is rare, so further longitudinal follow-up studies are needed.

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Herbal-drug-associated Adverse Events Reported in the Internet Newspaper Articles (인터넷 신문기사에 보도된 한약 유해사례 분석)

  • Kim, Mikyung;Han, Chang-Ho
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.33-44
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    • 2015
  • Objectives: The aim of this study was to understand the characteristics of herbal-drug-associated adverse events (AEs) reported in the internet newspaper articles and to take a countermeasure against the safety issue of herbal drugs. Methods: We searched the internet newspaper articles published from 2010 to 2014 in the 3 major portal sites in Korea, NAVER, DAUM, and GOOGLE. Search terms were the Korean words equivalent of 'herbal drug' and 'side effects'. Informations on the type and characteristics of suspected herbal drugs, AEs, and the patient records were extracted from the articles reporting the herbal-drug-associated AE occurred in Korea. Results: From 8,806 articles, a total of 36 AEs were found. The most frequently reported age group was 20s, and women outnumbered men. Obesity was the most common cause of administration. Doctors of Korean medicine clinic were the most commonly referred prescribers and purchasing route (11 cases). The most frequently mentioned medicinal herb was Ephedra sinica (7 cases) and the most commonly reported AEs were abdominal pain (8 cases), dizziness (6 cases), diarrhea (5 cases), and vomiting (5 cases) were followed in order. Ten cases were judged as serious AEs, and the others were not. Conclusions: Current customers demand health care providers to offer them sufficient information on the safety of herbal drugs. To satisfy their requirements, physicians of Korean medicine should be able to explain, predict, prepare, recognize, and deal with the herbal-drug-associated AEs. We propose an establishment of pharmacovigilance system for herbal medicine, in which doctors of Korean medicine are participated as important personnel, to collect and analyze the related AEs and offer credible information on the safety of herbal drug.

Factors influencing repeated suicide attempts among suicide attempters who visited the emergency room due to acute drug intoxication: a retrospective study (급성약물중독으로 응급의료센터를 내원한 자살시도자의 자살 재시도 영향요인: 후향적 연구)

  • In Ah Yun;Mi Yang Jeon
    • Journal of Korean Biological Nursing Science
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    • v.26 no.3
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    • pp.228-239
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    • 2024
  • Purpose: This retrospective study was conducted to identify factors associated with repeated suicide attempts by analyzing the electronic medical records of suicide attempters who visited emergency medical centers due to drug intoxication. Methods: Data from January 1, 2020 to December 31, 2021 were collected for this study and analyzed using SPSS/WIN 25.0. Results: In this study, the factors affecting repeated suicide attempts among individuals who visited the emergency medical center due to acute drug intoxication were the presence or absence of psychiatric diseases, the season of drug intoxication, and age. In order to identify the factors affecting repeated suicide attempts in those who presented with acute drug intoxication, logistic regression analysis was performed by inputting psychiatric diseases, season of drug intoxication, and age, all of which exhibited significant differences between those who did and did not attempt suicide again. The presence of psychiatric diseases (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.04~3.80), intoxication occurring in the fall (vs. spring; OR = 3.35, 95% CI = 1.28~8.75), and age ≥ 65 (vs. those under the age of 18; OR = 12.96, 95% CI = 2.02~83.17). The regression model was found to be statistically significant (F = 30.01, p < .001), and the coefficient of determination of Cox and Snell, which represents the explanatory power of the model, was 12.0%. Conclusion: This study suggests that to prevent repeated suicide attempts, it is necessary to develop a tool to evaluate the risk of suicide, use it to evaluate the risk of suicide, and then manage individuals accordingly.

Lumbosacral polyradiculoneuropathy associated with combination therapy of nivolumab and ipilimumab

  • Cho, Eun Bin;Kim, Seung Joo;Yang, Tae-Won;Jung, Seunguk;Jeong, Heejeong;Park, Ki-Jong
    • Annals of Clinical Neurophysiology
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    • v.24 no.1
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    • pp.26-29
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    • 2022
  • Immune checkpoint inhibitors (ICIs) have emerged as one of the most promising therapeutic options for advanced cancers. While ICIs have improved survival in multiple cancers, their increased use is restricted by various immune-related adverse events. In this report we describe a patient with renal cell carcinoma who received a combination of ICIs, nivolumab plus ipilimumab, and who developed lumbosacral polyradiculoneuropathy. Corticosteroid use was an effective treatment for this patient.

Systemic effects of fluoroscopically guided epidural steroid injection with dexamethasone

  • Kang, Woo Young;Lee, Joon Woo;Lee, Eugene;Kang, Yusuhn;Ahn, Joong Mo;Kang, Heung Sik
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.178-186
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    • 2019
  • Background: Epidural steroid injections (ESIs) have been widely used in managing spinal pain. Dexamethasone has recently emerged as a useful drug in this setting, relative to particulate steroids, although the associated systemic effects have not been fully elucidated. This study aimed to investigate the incidences and types of systemic effects after fluoroscopically guided ESI with dexamethasone. Methods: This retrospective study included 888 ESIs with dexamethasone (fluoroscopically guided at the cervical and lumbosacral levels) performed on 825 patients during January to June 2017. Data regarding systemic effects were collected via telephone interviews using a standardized questionnaire at 2 weeks after the procedure. Data on patient demographic, clinical, and procedural characteristics were collected and analyzed to identify factors that were associated with systemic effects. All statistical analyses were performed using the chi-squared test. Results: Among the 825 patients, 40 patients (4.8%) experienced systemic effects during the 2-week follow-up period. The most common systemic effect was facial flushing (12 patients, 1.5%), which was followed by urticaria (7 patients, 0.8%) and insomnia (7 patients, 0.8%). A history of spine surgery was significantly associated with the occurrence of systemic effects (P = 0.036). Systemic effects were significantly more common for injections at the cervical level than at the lumbar level (P = 0.019). Conclusions: Approximately 4.8% of the patients who underwent ESI with dexamethasone experienced minor and transient systemic effects. These effects were more common in patients who had undergone a previous spine surgery or received a cervical ESI.

A Randomized trial to investigate the effect of Asparagus racemosus root tablet in Relieving Postmenopausal Hot Flashes

  • K.M. Hina Fatima;Mariyam Roqaiya;Nawazisha
    • CELLMED
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    • v.14 no.10
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    • pp.10.1-10.6
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    • 2024
  • Background and Objectives: As per the available data, 75% peri and postmenopausal women experience hot flashes having negative effect on their quality of life. Using herbal medicines are stepping forward to alleviate hot flashes as the available hormonal medications have been reported the presence of side effects. This study was planned with the intention to investigate the effect of Asparagus racemosus root in the treatment of postmenopausal hot flashes in comparison to the placebo. Methods: This prospective patient blinded clinical trial randomly assigned 40 postmenopausal women with symptoms of hot flashes to receive either test drug (n=20) comprising Asparagus racemosus tablet of 1g in the dosage of 2 tablet thrice in a day for the duration of 60 days continuously or to receive placebo tablet prepared from roasted wheat flour in the same dosage and duration as test drug. The efficacy was determined by reduction in the frequency and intensity of hot flashes assessed by daily diary along with the improvement in quality of life assessed through Hot Flash-Related Daily Interference Scale. Statistical analysis was accomplished by student t test and Chi-square/Fisher Exact test. Results: Test drug significantly (p <0.001) reduced the intensity and frequency of hot flashes as well as improved the quality of life without showing any side effect. Discussion & Conclusion: According to Unani scriptures, the treatment is to treat the underlying cause, such as aberrant temperament and psychological and environmental issues. Unani drugs have emmenagogue, anti-inflammatory, analgesic, and neuroprotective qualities that can help alleviate premenstrual symptoms. Unani herbs such as C. sativus, Vitex, agnus castus, P. vulgare, N. Jatamansi, M. officinalis, and Z. officinalis have been clinically demonstrated to be effective in PMS. Thus, traditional knowledge authentication and conservation are vital for future research and appreciated for application in the modern day. Furthermore, randomised controlled trials, comprehensive reviews, and meta-analyses are suggested.

Rheumatiod Arthritis: An Updated Overview of Latest Therapy and Drug Delivery

  • Kesharwani, Disha;Paliwal, Rishi;Satapathy, Trilochan;Paul, Swarnali Das
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.210-224
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    • 2019
  • Rheumatoid arthritis is a severe autoimmune disorder, related to joints. It is associated with serious cartilage destruction. This causes disability and reduces the excellence of life. Numerous treatments are existed to combat this disease, however, they are not very efficient and possess severe side effects, higher doses, and frequent administration. Therefore, newer therapies are developed to overcome all these limitations. These include different monoclonal antibodies, immunoglobulins, small molecules used for immunotherapy and transgenes for gene therapy. One of the main goals of these new generation therapeutics is to address the underlying distressing biological processes by specifically targeting the causative agents with fewer systemic side effects and greater patient console. It is very fortuitous that loads of progressive investigations are going on in this field and many of them have entered into the successful clinical trial. But till date, a limited molecule has got FDA clearance and entered the market for treating this devastating disease. This review highlights the overview of conventional therapy and advancements in newer therapeutics including immunotherapy and gene therapy for rheumatoid arthritis. Further, different novel techniques for the delivery of these therapeutics of active and passive targeting are also described.

Treatment Outcomes of Venlafaxine and Duloxetine in Refractory Burning Mouth Syndrome Patients

  • Kim, Moon-Jong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.83-91
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    • 2019
  • Purpose: Venlafaxine and duloxetine have been shown to be effective in the treatment of neuropathic pain disorders. However, knowledge about the efficacy of venlafaxine and duloxetine on burning mouth syndrome (BMS) is still insufficient. The purpose of this study was to investigate the efficacy of venlafaxine and duloxetine on refractory BMS patients. Methods: Twelve refractory BMS patients who were prescribed venlafaxine or duloxetine were included in this study. These patients did not respond to previous administration of clonazepam, alpha-lipoic acid, gabapentin, and nortriptyline. All participants were the primary type of BMS patients who had no local and systemic factors related to the oral burning sensation. The intensities of oral symptoms following venlafaxine or duloxetine administration were compared with those before administration and at baseline. Results: Venlafaxine and duloxetine were prescribed to four and nine patients, respectively. One patient was prescribed both medications in turn. Among them, only two patients showed improvement of oral symptoms without side effects. In the other ten patients, symptoms failed to improve. Six of them reported that the drug was ineffective, and four of them stopped taking the medications on their own due to intolerable side effects, such as insomnia, constipation, drowsiness, dizziness, and xerostomia. Conclusions: Venlafaxine and duloxetine may only relieve oral symptoms in a minority of refractory BMS patients. Further large-scale studies are needed to determine the potential clinical factors that could predict the efficacy of venlafaxine and duloxetine.

Nanoparticles Promise New Methods to Boost Oncology Outcomes in Breast Cancer

  • Islamian, Jalil Pirayesh;Hatamian, Milad;Rashidi, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1683-1686
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    • 2015
  • Different types of treatment are available for patients with breast cancer, the most being radiotherapy, chemotherapy, hormonal therapy and combination therapy. Recently, nanoparticles have been emerging as promising agents for cancer therapy and are being investigated as contrast agents, drug carriers, radiosensitizers and also for hyperthermia effects. In this review the focus is on approaches for targeted treatment of breast cancer by combining nanoparticles, chemodrugs and radiation. The availble data suggest the possibility of increased roles for combined therapy, particularly by reducing the dose of each treatment modality, and consequently minimizing related side effects.

Inhibitory Effects of Corni Fructus Extract on Angiogenesis and Adipogenesis

  • Hwang, Jae-Ho;Kim, Jong-Deog
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.1
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    • pp.43-51
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    • 2011
  • Natural products in Chonnam, Korea were screened via anti-angiogenesis experiments, and 1 candidate product was identified, Corni fructus, which exerted dose-dependent inhibitory effects against angiogenesis, adipogenesis, and cell adhesion. C. fructus extract (CFE) exhibits an angiogenesis inhibitory effect superior to that of the EGCG from green tea leaves. The expression level of angiogenesis and adipogenesis-related signal molecules in the western blotting was reduced by increasing the amount of added CFE. Moreover, a diet supplemented with CFE was deemed more effective in inducing weight loss in LB mice than a representative synthetic diet drug, orlistat, which incidently caused the side effect of denuding the mice of their hair. These results indicate that C. fructus may prove to be a useful anti-adipogenic compound, and these in vitro results may be reflected later under in vivo conditions.