• Proceedings of the PSK Conference
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• 2000.04a
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• pp.61-63
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• 2000

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.108-112
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• 2007

Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms ; and the constellation of symptoms has been called laryngopharyngeal reflux (LPR). In the absence of definite diagnostic criteria, LPR disease remains a subjective entity. A diagnosis of LPR is usually based on response of symptoms to empirical treatment. Investigative modalities such as pH monitoring and, more recently, impedance studies are generally reserved for treatment failures. LPR usually requires more aggressive and prolonged treatment to achieve regression of both symptoms and laryngeal findings. The suppression of gastric acid and secretion with anti-secretary agents has been the mainstay of medical treatment for patients with acid-related disorders. The suppression of gastric acid secretion achieved with Hz-receptor antagonist $(H_2RA)$ has proved suboptimal for relief of reflux symptoms. The rapid development of tolerance and rebound acid hypersecretion after the with-drawal of $H_2RA$ limit their clinical use. Proton pump inhibitors (PPI) have been proved to be very effective for suppressing intragastric acidity, but the optimal dose and duration is unknown. Current evidence indicates that pharmacologic intervention should include, at a minimum, a 3 month trial of twice daily PPI. Symptoms of LPR improve over 2 months of therapy. The physical findings of LPR resolve more slowly than the symptoms and this continues through out at least 6 months of treatment. For most patients with LPR, twice daily dosing with a PPI is usually recommended for an initial treatment for a period of no less than 6 months treatment, and lifetime treatment may be required.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.264-272
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• 2015

Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.