• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.23-27
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• 2013

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.

• Clinical and Experimental Reproductive Medicine
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• v.50 no.1
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• pp.26-33
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• 2023

Objective: Human exposure to multiple xenobiotics, over various developmental windows, results in adverse health effects arising from these concomitant exposures. Humans are widely exposed to bisphenol A, and acetaminophen is the most commonly used over-the-counter drug worldwide. Bisphenol A is a well-recognized male reproductive toxicant, and increasing evidence suggests that acetaminophen is also detrimental to the male reproductive system. The recent recognition of male reproductive system dysfunction in conditions of suboptimal reproductive outcomes makes it crucial to investigate the contributions of toxicant exposures to infertility and sub-fertility. We aimed to identify toxicity in the male reproductive system at the mitochondrial level in response to co-exposure to bisphenol A and acetaminophen, and we investigated whether melatonin ameliorated this toxicity. Methods: Male Wistar rats were divided into six groups (n=10 each): a control group and groups that received melatonin, bisphenol A, acetaminophen, bisphenol A and acetaminophen, and bisphenol A and acetaminophen with melatonin treatment. Results: Significantly higher lipid peroxidation was observed in the testicular mitochondria and sperm in the treatment groups than in the control group. Levels of glutathione and the activities of catalase, glutathione peroxidase, glutathione reductase, and manganese superoxide dismutase decreased significantly in response to the toxicant treatments. Likewise, the toxicant treatments significantly decreased the sperm count and motility, while significantly increasing sperm mortality. Melatonin mitigated the adverse effects of bisphenol A and acetaminophen. Conclusion: Co-exposure to bisphenol A and acetaminophen elevated oxidative stress in the testicular mitochondria, and this effect was alleviated by melatonin.

• Korean Journal of Food Science and Technology
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• v.42 no.2
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• pp.217-222
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• 2010

Resveratrol is a natural polyphenolic compound frequently found in grapes. The biological actions of resveratrol have been extensively investigated both in vitro and in vivo. The interactions of resveratrol with commonly-consumed drugs, however, have rarely been studied. In this study, the cytotoxic properties of resveratrol on the hepatic and intestinal cells in the presence of over-the-counter (OTC) drugs, including acetaminophen (AAP), aspirin (Asp), and ibuprofen (Ibu), were evaluated. The cytotoxic effects of resveratrol on hepatic HepG2 and colonic HCT 116 cells were not markdely changed in the presence of AAP, Asp, or Ibu. Conversely, the cytotoxicity of OTC drugs was not affected by resveratrol either. Concentrations of resveratrol below 10 mM significantly increased HepG2 cell growth after 48 or 72 hr incubation; however, the growth-stimulating effect was not observed in the presence of AAP. When HCT 116 cells were treated with OTC drugs before or after resveratrol, the cytotoxic effects were not significantly altered. The present study provides basic information for the potential health effects of the interactions between resveratrol and commonly-consumed OTC drugs.

• Herbal Formula Science
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• v.16 no.2
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• pp.183-191
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• 2008

Acetaminophen (N-acety1-p-aminophenol, paracetamol) is widely used as an over-the-counter analgesic and antipyretic drug. Intake of a over dose of acetaminophen may result in severe hepatic necrosis. In this study, we investigated the liver damage in mice using single dose (300 mg/kg) of acetaminophen and the possible protective effects of administration (50-200 mg/kg body weight) of SB-Ex on acetaminophen-induced liver damage in mice. The alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activities were determined in the plasma of mice. The effect of SB-Ex on lipid peroxidation product thiobarbituric reacting substances (TBARS) and some antioxidant enzymes superoxide dismutase (SOD), catalase, d-aminolevulinate dehydratase (${\sigma}$-ALA-D) activities, and gluthathione peroxidase (GPx), were also evaluated in the mouse liver homogenate. Acetaminophen caused liver damage as evident by statistically significant increased in plasma activities of AST and ALT. There were general statistically significant losses in the activities of SOD, catalase, ${\sigma}$-ALA-D, and GPx and an increase in TBARS in the liver of acetaminophen-treated group compared with the control group. However, SB-Ex was able to counteract these effects. These results suggest that SB-Ex can act as hepatoprotectives against acetaminophen toxicity and is a good candidate for further evaluation as an effective chemotherapeutic agent.

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.119-145
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• 2023

The Pharmaceutical Affairs Act stipulates medication counseling as an obligatory requirement in the case of preparation of medicine. In fact, there are many cases where pharmacists only tell patients the dose and time and do not properly guide them on taking medications. However, in light of the current situation where non-face-to-face treatment is being attempted, there is a high possibility of drug-taking accidents due to insufficient medication guidance. In addition, as an aging society progresses, the need for explanations on pharmaceuticals is increasing. If a pharmacist causes damage to a patient by failing to give appropriate medication guidance, the patient can claim compensation for damages. In addition, if a drug accident occurs due to a conflict between the pharmacist's duty to guide medication and the doctor's duty to explain, a joint tort is established between the pharmacist and the doctor. Nevertheless, there are cases in which only doctors are judged to bear the tort liability. However, the Pharmaceutical Affairs Act includes providing information for the selection of over-the-counter drugs in the medication guidance as part of the medication guidance obligation. Therefore, in order to reconsider the importance of the medication-taking guidance duty, it is necessary to define the medicationaking information provision method and the medication-taking guidance duty as separate concepts. In addition, it is necessary to amend related regulations centered on patients so that medication guidance, such as side effects of medicines and interactions with concomitant medications, can be made in detail.

• Journal of International Area Studies (JIAS)
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• v.14 no.4
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• pp.27-52
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• 2011

The regions of Central Asia have each acquired an elevated strategic importance in the new security paradigm of post-September 1lth. Comprised of five states, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, Central Asia's newly enhanced strategic importance stems from several other factors, ranging from trans-national threats posed by Islamic extremism, drug production and trafficking, to the geopolitical threats inherent in the region's location as a crossroads between Russia, Southwest Asia and China. Although the U.S. military presence in the region began before September 11th, the region became an important platform for the projection of U.S. military power against the Taliban in neighboring Afghanistan. The analysis goes on to warn that 'with US troops already in place to varying extents in Central Asian states, it becomes particularly important to understand the faultlines, geography, and other challenges this part of the world presents'. The Kyrgyz military remains an embryonic force with a weak chain of command, the ground force built to Cold War standards, and an almost total lack of air capabilities. Training, discipline and desertion - at over 10 per cent, the highest among the Central Asian republics - continue to present major problems for the creation of combat-effective armed forces. Kyrgyzstan has a declared policy of national defence and independence without the use of non-conventional weapons. Kyrgyzstan participates in the regional security structures, such as the Collective Security Treaty Organisation (CSTO) and the Shanghai Co-operation Organisation (SCO) but, in security matters at least, it is dependent upon Russian support. The armed forces are poorly trained and ill-equipped to fulfil an effective counter-insurgency or counter-terrorist role. The task of rebuilding is much bigger, and so are the stakes - the integrity and sovereignty of the Kyrgyz state. Only democratization, the fight against corruption, reforms in the military and educational sectors and strategic initiatives promoting internal economic integration and national cohesion hold the key to Kyrgyzstan's lasting future

• The Journal of Internal Korean Medicine
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• v.45 no.1
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• pp.55-74
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• 2024

Objectives: This study reviewed the status of adverse event (AE) reporting in VigiAccess using anti-obesity agents as examples and explored the possibility of its use and future challenges. Methods: AE reports related to some representative drugs among herbal medicines (HMs), complex HM prescriptions, ingredients of supplements, and over-the-counter and prescription medicines were investigated using VigiAccess on February 1, 2024. Results: AE reports on prescription drugs were overwhelmingly higher than those on HMs or supplements. Although most reports were submitted from North America, reports on Ephedra sinica and green tea extract (GTE) were more from Asia and Europe, respectively. The female population reported more, and the difference in the sex ratio was the smallest for Ephedra spp. The age group was concentrated on young adults, but many older patients reported GLP-1 receptor agonist-related AEs. Symptoms related to the gastrointestinal and nervous systems were most commonly reported, but mental and cardiac disorders were common in Ephedra-type HMs. Hepatobiliary disorders are also commonly found in GTE-related reports. Conclusions: VigiAccess was useful for easily checking the global status of AE reporting for prescription drugs. However, several limitations were observed in using VigiAccess for HMs because of the few reports. Thus, it is necessary to increase the number of reports by education and to promote AE reporting among HM prescribers and users. The full range of HMs should be included in the pharmacovigilance system, and the coding and classification of HMs should be revised.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.102-110
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• 2015

Objective: This study was to investigate the perception gap between preceptors and pharmacy students on community pharmacy experiential education. Methods: The online survey was performed for 55 preceptors and 215 pharmacy students separately from April 1 to April 30, 2014. The preceptors were who completed community pharmacy practice experience at least a session and the students were who involved in community pharmacy practice for more than 21 days. The questionnaires were prepared based on the lesson contents guideline of Introductory Pharmacy Practice Education of Community Pharmacy by Korea Association of Pharmacy Education. The survey questions were consisted with demographic characteristics, evaluation of student and preceptors, benefits and disadvantages of pharmacy practice for both groups. Results: A total of 27 (49.1%) preceptors and 103 (47.9%) pharmacy students responded to the survey questionnaires. Preceptors indicated that students lacked face-to-face communication ability with patients, caregivers, and physicians. One of the Benefits of participating in pharmacy practice education as a preceptor included the improvement of self-esteem (70.37%). Disadvantages were identified as workload burden due to teaching and preceptor responsibilities at the same time. All students responded that benefits of experiencing pharmacy practice education were helping them determine their career, and they would consider working in community pharmacies (68.93%). However, handling over-the-counter drugs and communicating with doctors or nurses were identified as barriers. In addition, preceptors and pharmacy students expressed necessity of the standard text books and curriculums. Conclusion: This study identified the perception gap on community pharmacy experiential education between preceptors and pharmacy students. For the successful implementation of pharmacy practice experience, the effective and appropriate methods should be developed.

• Journal of Applied Biological Chemistry
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• v.66
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• pp.29-38
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• 2023

Recent studies have highlighted the link between diseases and inflammation across our lifespan. Our sedentary lifestyle, high-calorie diet, chronic stress, chronic infections, and exposure to pollutants and xenobiotics, collectively intensify the course and recurrence of infections and inflammation in our bodies, promoting the prevalence of chronic diseases and aging. Given such phenomena and considering additional factors such as the frequency of prescription, and easy access to over-the-counter drugs, the need for anti-inflammatory therapeutics is ever-increasing. However, the readily available anti-inflammatory treatment option comes with a greater risk of side effects or high cost (biologics). Therefore in this growing competition of discovering and developing new potent anti-inflammatory drugs, we focused on utilizing the established knowledge of traditional medicine to find lead compounds. Since lead optimization is an indispensable step toward drug development, we applied this concept for the production of potent anti-inflammatory compounds achieved by structural modification of flavonoids. The derivative obtained through acetylation of myricetin, 3,3',4',5,5',7-hexaacetate myricetin, showed a greater inhibitory effect in the production of pro-inflammatory mediators such as nitric oxide, Prostaglandin E₂, and pro-inflammatory cytokines like interleukin-6, interleukin1β, in lipopolysaccharide-stimulated RAW264.7 mouse macrophage cells compared to myricetin. The increased potency of inhibition was in conjunction with an increased inhibitory effect on inducible nitric oxide synthase and cyclooxygenase-2 proteins. Through such measures, this study supports lead optimization for well-established lead compounds from traditional medicine using a simpler and greener chemistry approach for the purpose of designing and developing potent anti-inflammatory therapeutics with possibly fewer side effects and increased bioavailability.

• Herbal Formula Science
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• v.17 no.2
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• pp.123-132
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• 2009

Acetaminophen (AP) is widely used as an over-the-counter analgesic and antipyretic drug. AP-induced hepatotoxicity is a common consequence of AP overdose and may lead to acute liver failure. In this study, we investigated the liver damage in mice using single dose (300 mg/kg) of AP and the possible protective effects of administration (50-200 mg/kg body weight) of Joo-Juk on acetaminophen-induced liver damage in mice. The alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activities were determined in the plasma of mice. The effect of Joo-Juk on lipid peroxidation product thiobarbituric reacting substances (TBARS) and some antioxidant enzymes superoxide dismutase (SOD), catalase, d-aminolevulinate dehydratase ($\sigma$-ALA-D) activities, and gluthathione peroxidase (GPx), were also evaluated in the mouse liver homogenate. AP caused liver damage as evident by statistically significant increased in plasma activities of AST and ALT. There were statistically significant losses in the activities of SOD, catalase, $\sigma$-ALA-D, and GPx and an increase in TBARS in the liver of AP-treated group compared with the control group. However, Joo-Juk was able to counteract these effects. These results suggest that Joo-juk can act as hepato-protectant against AP toxicity and is a good candidate for further evaluation as an effective chemotherapeutic agent.