• Title/Summary/Keyword: 비스테로이드성 항염제

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Frequency of Clostridium difficile-associated Diarrhea and Relevant Medical Treatment in a Tertiary Care Hospital in Korea (3차 의료기관에서 Clostridium difficile-associated Diarrhea의 발생빈도 및 치료에 관한 연구)

  • Kang, Hye-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.228-236
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    • 2011
  • 배경: 약물로 인한 Clostridium difficile-associated diarrhea (CDAD)는 널리 알려져 있으며 우리나라에서 항생제와 프로톤 펌프 억제제 소모량을 고려할 때 질환 치료과정에서의 CDAD 발생빈도 및 CDAD 유발 이전에 투여한 약물의 사용빈도와 CDAD의 치료방법을 조사할 필요성이 있다. 방법: 경상대학교 병원에서 2011년 1월부터 6월까지의 입원환자를 대상으로 대변 독소 검사에 의해 CDAD로 판명된 환자의 성별, 연령분포, 질환명, 입원병동, 재발률을 조사하였으며 CDAD 판명이전에 투여한 약제 및 CDAD 판명후 치료약제를 조사하였다. 결과: 연구기간 동안 CDAD 대변 독소 검사 의뢰된 환자수는 1,500명이었으며 CDAD 양성은 111명(9.3%)이었고, 재발은 29명(26.1%)이었다. CDAD를 주소로 입원한 환자는 17명 (15.3%)이었고, 나머지는 입원기간 중에 발생하였다. CDAD 양성인 환자의 연령대는 60대에서 32.4% (36/111명) 이었고, 내과병동에서 34.2%를 나타내었고, 재발률은 외과계 병동에서 41.4%로 가장 높게 나타났다. CDAD 환자의 17% (19/111명)은 항암제 투여 동안 발생하였으며 CDAD 발생 전 사용약물로는 세팔로스포린계 항생제가 162회로 가장 빈번하게 사용 되었으며, 히스타민2 수용체길항제 107회, 스테로이드 82회, 비 스테로이드 항염제 79회, 프로톤 펌프 억제제 77회, 하제 59회, 항암제가 33회 처방되었다. CDAD 치료약제로는 8종의 약제가 241회 처방 되었으며 metronidazole이 99회로 가장 빈번하게 사용되었고, vancomycin이 37회로 나타났다. 결론: 입원환자에 있어서 CDAD양성은 특히 고령의 암환자가 많아 항암제 투여 시에는 CDAD 발생에 주의해야 할것으로 보인다. CDAD의 치료약제로는 metronidazole이 vancomycin 보다 많이 사용되는 것으로 나타났다.

New screening method for anti-inflammatory agent (Cyclooxygenase 억제제 검색을 통한 항염증제 개발 연구)

  • Lee, Su-Hwan;Jeong, Seong-Won;Lee, U-Yeong
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.20 no.1
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    • pp.25-36
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    • 1994
  • It is weal known that bacterial lipopolysaccharide (LPS) stimulates prostaglandin synthesis in various experimental system via enhancing the expression of cylooxygenase-2 (COX-2). This study was designed to characterize U)5-induced prostaglandin synthesis in mouse peritoneal macrophages LPS-stimulated prostaglandin synthesis in macrophages with short term exposure was not so much prominent, but there was a burst in prostaglandin synthesis 8 hours after the LPS treatment and this u·as accompanied with the increase of cyclooxygenase activity, Dexamethasone markedly inhibited prostaglandin synthesis in this system. Metabolic label ins data supported above observations and thus, it could be concluded that LPS induces the do novo synthesis of COX-2 by which it stimulates the prostaglandin synthesis in mouse peritoneal macrophages, These data suggested that this experimental model system could be used for the screening procedure of COX-2 selective inhibitors. Ketoprofen, a non steroidal anti inflammatory agent, appeared to inhibit COX-1 relatively more selectively than COX-2.

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Arthritis in the Subacute Stage of Kawasaki Disease after Responding to Intravenous Immunoglobulin Treatment (가와사끼병에서 정맥용 면역글로불린에 반응 후 아급성기에 발생한 관절염)

  • Lee, Kyung-Yil;Oh, Jin-Hee;Koh, Dea-Kyun
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1124-1127
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    • 2003
  • We evaluated the clinical and laboratory characteristics of five children with Kawasaki disease who had showed arthritis after responding to intravenous immunoglobulin(IVIG) treatment. Age distribution was between 13 months and six years of age(mean $3.2{\pm}1.6$ years). There were two males and three females. Arthritis occurred when acute symptoms were subsiding, with the average onset on day $5.8{\pm}1.8$ after final IVIG treatment. Arthritis was pauciarticular in three, and polyarticular in two. Regarding laboratory findings, one child was positive in rhematoid factor and changed to negative after two months. Three patients were examined for HLA B27 and all showed negative results. High dose aspirin(two cases), anti-inflammatory drug(ibprofen, three cases), and corticosteroids(methyprednisolon pulse therapy, one case) were used for this type of arthritis. Symptoms and signs of arthritis in all patients were improved by these therapies. There was no relapse or complications within six months. Arthritis after responding to IVIG therapy was rarely observed in children with Kawasaki disease. This type of arthritis responded well to anti-inflammatory drugs including corticosteroids, and showed no relapses.

Opioids and Antidepressants for Pain Control in Musculoskeletal Disease (근골격계 질환에서 통증 조절을 위한 마약성 진통제 및 항우울제)

  • Park, Se-Jin;Kim, Woo Sub;Jang, Taedong
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.1-8
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    • 2020
  • The progression of aging and the increase in musculoskeletal diseases have led to an increase in invasive treatment methods, including various surgical methods, but conservative treatment should be attempted before surgical treatment in musculoskeletal diseases. Medication for pain control, such as acetaminophen, non-steroidal anti-inflammatory drugs, steroid, opioids, antidepressants, etc., is one of the most popular methods for pain control. If the pain receptors on peripheral organ are stimulated, pain is transmitted to the brain by the ascending pathway, and the brain then secretes endogenous opioids, such as endorphin, by the descending pathway for pain control. Opioids are substances that act on the opioid receptors, and there are three receptors for opioids. The affinity for each receptor varies according to the tissue and the patient's systemic status. Antidepressants work on the synapses in the central nervous system and its main mechanism is regulation of the ascending pathway. This is mainly effective in chronic pain and neuropathic pain, which is similar in effectiveness to opioids. This review focuses on the effectiveness, method of use, and side effects of opioids and antidepressants.

A Methocarbamol Combination to Prevent Toxicity of Non-steroidal Anti Inflammatory Drugs (비스테로이드성 항염증제의 약물독성 예방을 위한 Methocarbamol의 약물조합)

  • Yeom, Seung-Min;Kim, Min-Seok;Lingenfelter, Eric;Broadwell, Jonathan
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.88-98
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    • 2017
  • To prevent toxicity from both robax platinum (methocarbamol, ibuprofen) and robaxacet (methocarbomol, acetaminophen), separately, we used stretches and naproxen as a non-steroidal anti-inflammatory drug (NSAID) to compare each effectiveness. This study used the United States Forces Korea Prescription form (Annex A-Over-The-Counter Prescription) and Alice Rich's Pain scale with robax platinum, robaxacet including narproxen. The IBM SPSS statics version 24 was used to calculate the data. The combined methocarbamol 500 mg, acetaminophen 325 mg tablet, and ibuprofen 200 mg (or naproxen) tablet can work as well as the combined methocarbamol 500 mg tablet with acetaminophen 325 mg tablet with stretches. Both methods were successful in managing pain. The drug combination of methocarbamol 500 mg, acetaminophen 325 mg and ibuprofen 200 mg tablets yielded similar benefits as the methocarbamol 500 mg and acetaminophen 325 mg tablets paired with physical stretching exercises regarding managing overall pain.

Pimecrolimus ($Elidel^{(R)}$, SDZ ASM1981) (엘리델$^{(R)}$(피메크로리무스)크림 $1\%$ 전임상 약리학 성상 및 피부 선택성)

  • 한국임상약학회
    • Korean Journal of Clinical Pharmacy
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    • v.13 no.2
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    • pp.97-105
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    • 2003
  • 아스코마이신(ascomycin)의 macrolactam 유도체인 피메크로리무스(pimecrolimus; 엘리델 [Elidel], SDZ ASM 981; Novartis Pharma AG, 바젤, 스위스)는 세포선택성을 지닌 염증성 사이토카인(cytokines) 억제제로서 아토피피부염, 알레르기성 접촉피부염, 자극성 접촉피부염 및 판형 건선 등 염증성 피부질환의 치료제로 개발되었다. T세포와 비만세포의 염증성 사이토카인 생산 분비를 억제하고 사전 형성된 염증성 매개물질의 비만 세포 분비를 저해한다. 국소 투여된 피메크로리무스는 알레르기성 접촉피부염(allergic contact dermatitis [ACD]) 돼지 모델에서 고역가 코르티코스테로이드 클로베타졸-17-propionate(corticosteroid clobetasol-17-propionate)와 동등한 효과를 나타낸다. 하지만 피메크로리무스는 클로베타졸과는 달리 피부 위축을 일으키지 않는다. 경구 투여시 피메크로리무스는 마우스와 랫트 ACD 치료에 있어서 타크로림무스(tacrolimus [FK 506])와 동등한 혹은 더 우수한 효과를 나타낸다. 또한 피메크로리무스는 아토피피부염 급성 징후 유사 모델인 저마그네슘 혈증 탈모 랫트(hypomagnesemic hairless rat)의 피부 염증과 소양증을 효과적으로 감소시킨다. 피메크로리무스는 랫트에서 다음과 같은 측면의 전신 면역반응 손상 효과가 타크로리무스 와 비교하여 낮게 평가된다: (1)국소 이식편대 숙주 반응, (2)양(sheep) 적혈구에 대한 항체 형성, (3)신장이식. 시험관내 평가시 돼지 피부를 통한 피메크로리무스 투과 속도가 타크로리무스보다 10배 낮게 측정되므로 생체에서 경피 흡수가 더 적게 될 것으로 판단된다. 상기 자료로 판단컨대 피메크로 리무스는 피부에 대한 항염증 활성이 높을 뿐 아니라 전신 면역반응 손상 부작용이 낮은것으로 사료된다.

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Inhibition of Human Neutrophil Elastase by NSAIDs and Inhibitors, and Molecular Pharmacological Mechanism of the Inhibition (비스테로이드성 항염증제와 효소 억제제에 의한 사람 중성구 Elastase의 활성도 억제 및 분자약리학적 기전)

  • Kang, Koo-Il;Kim, Woo-Mi;Hong, In-Sik;Lee, Moo-Sang
    • The Korean Journal of Pharmacology
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    • v.32 no.3
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    • pp.425-431
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    • 1996
  • Human neutrophil elastases (HNElastase, EC 3.4.21.37), a causative factor of inflammatory diseases, are regulated by plasma proteinase inhibitors, alpha-proteinase inhibitor and ${\alpha}_2-macroglobulin$. Under certain pathological conditions, however, released enzymes or abnormal function of inhibitors may cause various inflammatory disease. NSAIDs have been clinically applied for treatment of inflammatory diseases. Inhibition of cyclooxygenase is a known mechanism of action of NSAIDs in the treatment of inflammatory disease. In in vitro experiments, HNElastase was inhibited by naproxen, phenylbutazone, and oxyphenbutazone, but ibuprofen, ketoprofen, aspirin, salicylic acid, and tolmetin did not inhibit elastase. HNElastase was also inhibited by chelating agents, EDTA & EGTA, and tetracyclines. Removal of divalent metal ions by EDTA caused inhibition of elastase, and reconstitution of the metal ions recovered the enzyme activity to a certain level. Frequencies and contours in the Raman spectra of various conditions of human neutrophil elastase undergo drastic changes upon partial removal and/or reconstitution of calcium and zinc ions. The metal ion content dependent activities and change of the contour of the Raman spectrogram suggest us that the mechanism of action of a chelator or chelator-like agents on neutrophil elastase may be related to the conformational change at/or near the active site, especially -C=O radical or -COOH radical.

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Non-Steroid Anti-Inflammatory Agents for Management of Cold Sweating in Advanced Cancer Patients (식은 땀을 호소하는 진행성 암 환자에서 비스테로이드성 항염증 제제를 이용한 치료)

  • Choi, Hye Jung;Song, Haa-Na;Kang, Jung Hun
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.331-334
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    • 2016
  • Purpose: Advanced cancer may accompany cold sweat as paraneoplastic symptom. Few studies have been performed on the efficacy of non-steroid anti-inflammatory drug (NSAID) in advanced cancer patients who sweated without fever. Methods: To select study participants, medical records were retrospectively reviewed for patients who satisfied the following criteria: 1) incurable, advanced solid cancer; 2) Cold sweating of 4 or higher on the numeric rating scale (NRS) 4; 3) No evidence of infection or hypoglycemia; 4) No newly started opioid or anti-hormonal agents within one month; 5) NSAID prescription for the management of cold sweating and 6) Documented NRS information before and after NSAID administration. Results: A total of 13 patients were selected after excluding four patients due to lack of NRS information or fever. The mean age was 59 years old (range: 50~71), and nine patients (69%) were male. Bile duct cancer was the most common primary tumor followed by pancreatic cancer, gastric cancer and prostate cancer. The mean NRS of cold sweating dropped from baseline 6.5 (min-max: 4~10) to 1.9 at the follow-up assessment (min-max: 0~5). The mean follow-up period was 9.1 days (range: 2~30 days) from NSAID treatment to assessment. Conclusion: NSAID was effective medication for management of sweating without fever in patients with advanced cancer.

Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation (요양급여심사기준 완화에 따른 비스테로이드성 항염제 및 위장관 보호제 처방 변화 및 안정성 분석)

  • Han, Mi Hye;Noh, Eunsun;Nam, Jin Hyun;Lee, Sang Won;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.250-257
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    • 2017
  • Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

Effect of Celecoxib on Lung Injury Improvement by Controlling Epithelial-Mesenchymal Transition(EMT) in Chronic Obstructive Pulmonary Disease(COPD) (만성폐쇄성폐질환에서 상피중간엽이행 조절을 통한 Celecoxib의 폐 손상 개선효과)

  • Lee, Sun-Kyung
    • Journal of Convergence for Information Technology
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    • v.11 no.11
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    • pp.248-255
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    • 2021
  • This study confirmed the effects of improving lung damage of celecoxib using an animal model of chronic obstructive pulmonary disease(COPD). It was induced in models LPS + CSE and performed in vitro and in vivo. MTT assay and real-time PCR were performed in MRC5 cells as in vitro, and mRNA expression, BALF, collagen content, and protein expression were confirmed as in vivo. Celecoxib reduced the number of inflammatory cells, cytokine and soluble protein accumulation in BALF, decreased body weight and lung weight in animal models, and improved lung collagen deposition. In addition, the reduction of EMT markers was confirmed through Western blotting and real-time PCR. Consequently, celecoxib is thought to improve lung damage of COPD induced to LPS+CSE by regulating EMT.