• Title/Summary/Keyword: pharmacy practice

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A Systematic Review on the Certified Geriatric Pharmacist Program of the U.S.: Certification, Education and Outcomes (미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과)

  • Nam, Hye Yeon;Cho, Eun
    • YAKHAK HOEJI
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    • v.58 no.2
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    • pp.129-140
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    • 2014
  • Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

A Comparative Study the USA, Europe and Korea Guidelines of Antiplatelet Therapy for Patients with Acute Coronary Syndrome (급성관상동맥 증후군 치료를 위한 국내·외 항혈소판제 약물요법 가이드라인 비교 연구)

  • Jung, Eun-Joo;Lee, Chae-Won;Baek, In-Hwan
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.200-208
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    • 2015
  • Objective: Patients with acute coronary syndrome (ACS) are typically managed with dual antiplatelet therapy of acetylsalicylic acid (aspirin) and $P2Y_{12}$ receptor inhibitor. In this study, we discussed current and previous antiplatelet therapy guidelines and compared with guidelines of the USA (ACC/AHA), Europe (ESC) and Korea (KSC). Method: This study investigated from ACC/AHA Joint Guidelines (the USA), ESC Clinical Practice Guidelines (Europe) and Korea Society of Interventional Cardiology (Korea) web site, respectively. Results: It is significant that difference between the current and the previous guidelines was integration of terminology from clopidogrel to $P2Y_{12}$ receptor inhibitors since prasugrel and ticagrelor, new antiplatelet drugs, has been added. The other difference was all three guidelines has differences in dose of aspirin. The most notable difference was class of recommendation(COR) in $P2Y_{12}$ receptor inhibitors. ACC/AHA and Korean guidelines recommend clopidogrel, prasugrel, and ticagrelor with COR IB; whereas, ESC recommend prasugrel and ticagrelor with IB which is higher than clopidogrel with IC. Conclusion: This research addresses important movement to revise the Korean existing guideline recommendations. New Korean antiplatelet therapy guideline should be avoiding obvious differences in ACC/AHA and ESC guidelines and harmonizing international guidelines.

Experience in Using Peer-to-Peer Platforms and Immersive Technologies in the Training of Future Masters of Pharmacy in Medical Lyceum

  • Volodymyrovych, Tsekhmister Yaroslav;Tetiana, Konovalova;Yaroslavovych, Tsekhmister Bogdan
    • International Journal of Computer Science & Network Security
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    • v.22 no.2
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    • pp.23-28
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    • 2022
  • The present study has been conducted to evaluate the experience in using peer-to-peer platforms and immersive technologies in the training of future masters of pharmacy from the Pharmaceutical Faculty of Bogomolets National Medical University, Ukraine. The selected participants were given the pre- and post-test containing multiple choice questions to assess the effectiveness of immersive technologies. Further, a self-designed structured questionnaire contained 10 questions with 5 options was delivered to consented participants through email and WhatsApp. The results of test presented that students attained an average of 26% in their pre-test while the average attained score post-test was 74% that showed a significant improvement with peer-to-peer platforms and virtual reality technology. The results of survey questions also showed an overall 86.73% satisfaction for the use of peer-to-peer platforms and virtual reality technology in the training of future masters of pharmacy. These results demonstrated that 90.81% showed agreement that they gained a high level of confidence through peer-to-peer platforms and virtual reality to handle patients in clinical practice. It can be concluded that participants of this study showed a strong agreement with positive experience in using peer-to-peer platforms and virtual reality technology in the training of future masters of pharmacy in medical lyceum.

Survey on the Satisfaction of the Medication Counseling for Outpatient Prescription (원외처방환자에 대한 복약지도 현황 및 만족도 조사)

  • Kim, Hyun-Ji;Kang, Jin-Sook;Park, Jung-Yun;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.92-95
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    • 2006
  • Medication counseling improves patients' compliance, which enhances the effectiveness of treatment and reduces the medical cost consequently. Since separation of dispensary from medical practice took place, most patients have had to go to pharmacy after receiving prescription from hospital. The importance of medication counseling in pharmacy thus has been emphasized. To study the present conditions of medication counseling from the pharmacists and the patients satisfaction with them, we conducted a survey with questionnaires. The subjects were 146 outpatients and 55 pharmacies located in Yeongdeungpo-gu. The research showed that 69.9% of the outpatients had received medication counseling and only 35.5% of them were satisfied with it. The main reason for their unsatisfaction was insufficiency of explanation. A number of patients(75.3%) were thinking that medication counseling from the pharmacists is necessary for appropriate administration and optimal efficacy of the medicine. Among 55 pharmacies involved in the research, 17 of them(30.9%) answered that they have been giving patients medication counseling, which were mostly verbally done. Only 8 of them(l4.5%) were providing medication information sheets for some specific drugs. The pharmacists referred to a few problems disturbing optimal medication counseling like these: 1) Lack of time, 2) insufficient information, 3) inappropriate counseling skills. To improve these problems, they hope to get more information about prescription and specific medicines from pharmacy in hospital. If hospital decides to hold the lectures on medication counseling, about 80% of the pharmacists tend to take part in them.

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Loss of RAR-α and RXR-α and enhanced caspase-3-dependent apoptosis in N-acetyl-p-aminophenol-induced liver injury in mice is tissue factor dependent

  • Abdel-Bakky, Mohamed Sadek;Helal, Gouda Kamel;El-Sayed, El-Sayed Mohamed;Amin, Elham;Alqasoumi, Abdulmajeed;Alhowail, Ahmad;Abdelmoti, Eman Sayed Said;Saad, Ahmed Saad
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.5
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    • pp.385-393
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    • 2021
  • Tissue factor (TF) activates the coagulation system and has an important role in the pathogenesis of various diseases. Our previous study stated that retinoid receptors (RAR-α and RXR-α) are released as a lipid droplet in monocrotaline/lipopolysaccharide-induced idiosyncratic liver toxicity in mice. Herein, the interdependence between the release of retinoid receptors RAR-α and RXR-α and TF in N-acetyl-p-aminophenol (APAP)-induced mice liver toxicity, is investigated. Serum alanine transaminase (ALT) level, platelet and white blood cells (WBCs) counts, protein expression of fibrin, TF, cyclin D1 and cleaved caspase-3 in liver tissues are analyzed. In addition, histopathological evaluation and survival study are also performed. The results indicate that using of TF-antisense (TF-AS) deoxyoligonucleotide (ODN) injection (6 mg/kg), to block TF protein synthesis, significantly restores the elevated level of ALT and WBCs and corrects thrombocytopenia in mice injected with APAP. TF-AS prevents the peri-central overexpression of liver TF, fibrin, cyclin D1 and cleaved caspase-3. The release of RXR-α and RAR-α droplets, in APAP treated sections, is inhibited upon treatment with TF-AS. In conclusion, the above findings designate that the released RXR-α and RAR-α in APAP liver toxicity is TF dependent. Additionally, the enhancement of cyclin D1 to caspase-3-dependent apoptosis can be prevented by blocking of TF protein synthesis.

Identification of anti-adipogenic withanolides from the roots of Indian ginseng (Withania somnifera)

  • Lee, Seoung Rak;Lee, Bum Soo;Yu, Jae Sik;Kang, Heesun;Yoo, Min Jeong;Yi, Sang Ah;Han, Jeung-Whan;Kim, Sil;Kim, Jung Kyu;Kim, Jin-Chul;Kim, Ki Hyun
    • Journal of Ginseng Research
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    • v.46 no.3
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    • pp.357-366
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    • 2022
  • Background: Withania somnifera (Solanaceae), generally known as Indian ginseng, is a medicinal plant that is used in Ayurvedic practice for promoting health and longevity. This study aims to identify the bioactive metabolites from Indian ginseng and elucidate their structures. Methods: Withanolides were purified by chromatographic techniques, including HPLC coupled with LC/MS. Chemical structures of isolated withanolides were clarified by analyzing the spectroscopic data from 1D and 2D NMR, and HR-ESIMS experiment. Absolute configurations of the withanolides were established by the application of NMR chemical shifts and ECD calculations. Anti-adipogenic activities of isolates were evaluated using 3T3-L1 preadipocytes with Oil Red O staining and quantitative real-time PCR (qPCR). Results: Phytochemical examination of the roots of Indian ginseng afforded to the isolation of six withanolides (1-6), including three novel withanolides, withasilolides GeI (1-3). All the six compounds inhibited adipogenesis and suppressed the enlargement of lipid droplets, compared to those of the control. Additionally, the mRNA expression levels of Fabp4 and Adipsin, the adipocyte markers decreased noticeably following treatment with 25 µM of 1-6. The active compounds (1-6) also promoted lipid metabolism by upregulating the expression of the lipolytic genes HSL and ATGL and downregulating the expression of the lipogenic gene SREBP1. Conclusion: The results of our experimental studies suggest that the withasilolides identified herein have anti-adipogenic potential and can be considered for the development of therapeutic strategies against adipogenesis in obesity. Our study also provides a mechanistic rationale for using Indian ginseng as a potential therapeutic agent against obesity and related metabolic diseases.

Therapeutic Duplication as a Medication Error Risk in Fixed-Dose Combination Drugs for Dyslipidemia: A Nationwide Study

  • Wonbin Choi;Hyunji Koo;Kyeong Hye Jeong;Eunyoung Kim;Seung-Hun You;Min-Taek Lee;Sun-Young Jung
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.168-177
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    • 2023
  • Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

The antimicrobial activity of Daehwanggo against Methicillin-resistant Staphylococcus aureus (대황고(大黃膏)의 메티실린 내성 황색 포도상구균에 대한 항균활성)

  • Lee, Sun-Ae;Kong, Ryong;Kang, Ok-Hua;Seo, Yun-Soo;Zhou, Tian;Kim, Sang-A;Song, Ok-Hee;Kim, Min-Chul;Han, Hyoung-Sun;Choi, Ji-Na;Lee, Young-Seob;Kwon, Dong-Yeul
    • The Korea Journal of Herbology
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    • v.32 no.2
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    • pp.87-95
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    • 2017
  • Objectives : Infectious diseases by Methicillin-Resistant Staphylococcus aureus (MRSA) are a growing problem worldwide. Characteristic of MRSA is endlessly mutation to resist antibiotics. Daehwanggo (DHG) is one of the oriental medicine prescriptions contained in Principles and Practice of Eastern Medicine. Daehwanggo was mainly used for external preparation from old times. The purpose of this study is to confirm possibility as supplementary drug of DHG about antibiotics through observation of synergy effect between DHG and commercial antibiotics and to observe restriction on growth of MRSA on any pathway through observation of mechanism. Methods : The minimum inhibitory concentration (MIC) of DHG against MRSA is $500{\sim}2000{\mu}g/m{\ell}$ by broth dilution method. In the checkerboard method, the combinations of DHG with antibiotics has partial synergistic effect or synergy effect and DHG markedly reduced the MICs of the antibiotics oxacillin (OX), gentamicin (GT) against MRSA. In the inhibition of resistance mechanism of DHG against MRSA, the expression of resistance gene and protein about ${\beta}-lactam$ antibiotic was reduced. Also, we observed the effect of DHG about cell membrane permeability against MRSA, and confirmed that DHG suppressed growth of strains by increasing cell membrane permeability. Results : Basis on the result, we speculate that DHG increase antibacterial activity of antibiotics against MRSA by changing the structure of cell wall of MRSA. Conclusions : These data suggest that Daehwanggo possesses possibility as supplementary drug about antibiotics against MRSA.

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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Assessment of lactogenic potential of some traditional herbs

  • Raval, M.A.;Patel, H.P.;Mishra, S.H.
    • Advances in Traditional Medicine
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    • v.10 no.2
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    • pp.123-133
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    • 2010
  • The entire plant of Leptadenia reticulata (Asclepidaceae) is extensively used as lactogen, traditionally, in veterinary practice. The plants of Dregea volubilis and Pentatropis microphylla (Asclepidaceae) are now used as its substitute and sometimes replace the original drug as traditional lactogen. The lactogenic potential of these drugs was studied in rats using, pup weight, weight of mother, parenchyma percentage, secretary rating, estimation of total protein content and glycogen content of mammary glands tissues as assessment parameters. HPTLC profiles of bioactive extracts were also generated to serve the authentification needs. The results of present studies show that P.microphylla forms a better substitute over D. volubilis.