• Korean Journal of Clinical Pharmacy
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• v.17 no.1
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• pp.13-18
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• 2007

The purpose of the present study was to investigate the effect of cimetidine on theophylline pharmacokinetics in Korean healthy normal subjects. Eight subjects were enrolled and open label, two period cross-over study was conducted without significant drug related adverse reactions. Cimetidine seemed that significantly inhibited the metabolism of theophylline, oral clearance decreased significantly when cimetidine was coadministered. Coadministered cimetidine increased $AUC_t$ and $C_{max}$ of theophylline. All subjects were genotyped using PCR-RFLP methods to evaluate the differences in metabolic capacity in accordance with CYP1A2 genotypes, but no mutant genotype was found. This suggests that metabolic capacities were not significantly affected by CYP1A2 genotypes among subjects. In conclusion, disposition of theophylline was significantly affected by coadministered cimetidine. Further evaluation with well-designed drug interaction study in accordance with various genotype of CYP1A2 is needed.

• The Korean Society of Law and Medicine
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• v.12 no.2
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• pp.265-291
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• 2011

Changes in a drug's availability from prescription only to over-the-counter (OTC) status is of concern to physicians from both public health and individual patient perspectives. Government has generally been supportive of changes in medications from prescription(Rx) to over-the-counter (OTC) status in Korea, however, recognizing that there are both benefits and risks to any health care intervention, health care professionals are conservative in implementing changes to either the process or structure of health care. Changes in status of a drug from Rx to OTC can represent a change in both structure and process. Cost and convenience seem to be major factors in determining whether, given the choice, patients purchase a medicine over the counter or obtain it on prescription. With current arrangements, exemption from prescription charges provides an incentive to continue to obtain products on NHS prescription even when they are available over the counter. There is therefore no simple relation between the availability of over the counter medicines and the level of prescribing of deregulated products. The appropriate use of over the counter medicines-particularly those that have only recently been deregulated-places a burden of care on community pharmacists and calls for closer working relationships with general practitioners. In particular, systems for referral and for recording details of both prescribed and over the counter medicines need to be developed, and a direct route needs to be established for community pharmacists to report adverse drug reactions to over the counter products. Reclassification of prescription medicines-by making them available through pharmacies without a prescription-provides the opportunity for consumers to purchase a wider range of medicinal products without making a demand on NHS resources. There is, however, no simple relation between availability of over the counter medicines and demand for NHS prescriptions. In the late 1980s the UK government fuelled the over the counter market by making it easier to reclassify certain medicines from prescription only status to allow over the counter sale in pharmacies. To explore the influence of deregulation of medicines on NHS prescribing, this article presents analyses of consumer behaviour in using medicines and prescribers' attitudes to over the counter medication and collates findings from research. Policy makers should be aware that patients' expectations in relation to OTC medicines may be in conflict with evidence-based practice.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.403-407
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• 2017

Purpose: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. Methods: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, $10.9{\pm}5.76years$), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5-1.0 mg/kg/day, 2 consecutive days) every 3-4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. Results: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was $4.49{\pm}2.22mg/kg/yr$, and the mean treatment period was $10.8{\pm}3.32months$. The BMD z score of the lumbar spine showed a significant increase from $-4.22{\pm}1.24$ before treatment to $-2.61{\pm}1.69$ during treatment (P=0.008). Alkaline phosphatase decreased during treatment (P=0.037). Significant adverse drug reactions and new fractures were not reported. Conclusion: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.1
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• pp.85-94
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• 2017

Objectives: To explore experiences of treatment-related side effects and supportive care among Korean breast cancer survivors (BCS). Methods: Focus group interview was conducted with six Korean women with breast cancer. Participants were recruited through snow-balling. Interview was audio-recorded and transcribed verbatim. NVivo-11 was used to code the data into themes. Results: Two major themes were identified: (1) experiences of Western medicine, including treatment, side effects, needs and costs; (2) experiences of supportive care with Korean medicine, including the same as above. All participants experienced Western medicine in treatment phase and reported impairment of physical, emotional, and social functioning during and after Western medicine treatment. Only three participants used Korean medicine after treatments end. The negative responses from Western medicine doctors were the most important factor keeping participants from accessing Korean medicine when treatment-related side effects occurred. For this reason, some participants used Korean medicine without disclosure. Participants usually acquired information about Korean medicine from online community or other BCS, which was another important factor because it raised concerns about side effects and credibility of Korean medicine. High cost was also reported as barrier in using Korean medicine. During the cancer treatment, participants tended to endure their treatment-related side effects. Conclusions: Korean BCS may be at high risk of physical or emotional distress during treatment period. Findings suggest that there is a high need for supportive care to relieve treatment-related side effects and improve patients' quality-of-life. Furthermore, developing a systematic guidance or credible information sources should be warranted to help patients find the best supportive care options including Korean medicine.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.207-212
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• 2016

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

• Journal of East-West Nursing Research
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• v.17 no.2
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• pp.96-102
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• 2011

Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.17-23
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• 2018

Objective: Opioid analgesics, for postoperative pain management, are an indispensable group of medication; however, they also have a variety of adverse drug reactions (ADR). Multimodal methods, combining non-opioid analgesics with opioid analgesics, have been investigated to increase the effects of analgesics and reduce ADR with opioid-sparing effects. The purpose of this study was to compare the effects of patient-controlled analgesia (PCA) with fentanyl alone, and PCA with fentanyl and intravenous (i.v.) propacetamol to determine the effects of pain control, cumulative opioid usage, and opioid ADR. Methods: The subjects were patients who underwent total knee arthroplasty at the Seoul Veterans hospital from January 1, 2015 to December 31, 2016. The study period was from postoperative day 0 (POD0) to day 3 (POD3), and the retrospective study was conducted using electronic medical records. Results: Pain severity was significantly low at POD1 (p = 0.017), POD2 (p = 0.003), and POD3 (p = 0.002) in the multimodal group. The fentanyl only group frequently reported both moderate and severe pain at a statistically significant level. This was consistent with the analysis of the pro re nata (PRN) intramuscular analgesia usage at the time of numerical rating scale (NRS) 4 and above. The opioid-sparing effect confirmed that the average opioid dose equivalent to i.v. morphine dose was 9.4 mg more than that used for the multimodal group in the fentanyl only group. The ADRs and length of stay between the two groups were not statistically different. Conclusion: The results of this study suggest that the combination therapy of fentanyl and i.v. propacetamol is superior to fentanyl monotherapy.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.223-233
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• 2018

Topical anesthetics are commonly used in oral & maxillofacial surgery to control pain in the oral cavity mucosa before local anesthetic injection. These anesthetic agents come in many forms, developed for different usages, to minimize adverse reactions, and for optimal anesthetic efficiency. Earlier studies have revealed that these agents may also limit the growth of microorganisms in the area of anesthetic application. Many topical anesthetic agents show different levels of antimicrobial activity against various bacterial strains and Candida. The dosage of local anesthetic agent used in some clinical preparations is too low to show a significant effect on microbial activity. Efficiency of antimicrobial activity depends on the local anesthetic agent's properties of diffusion within the bloodstream and binding efficiency with cytoplasmic membrane, which is followed by disruption of the bacterial cell membrane. The antimicrobial properties of these agents may extend their usage in patients to both control pain and infection. To develop the topical local anesthetic optimal usage and antimicrobial effect, a collaborating antiseptic agent may be used to benefit the local anesthetic. However, more research is required regarding minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of topical local anesthetic agents with drug interaction between anesthetics and antiseptic agents.

• Molecular & Cellular Toxicology
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• v.3 no.2
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• pp.127-131
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• 2007

Chronic treatment with olanzapine (OLZ), an atypical antipsychotic drug, is associated with the adverse effects of weight gain, hyperglycemia and/or hypertriglyceridemia. Green tea or epigallocatechin gallate (EGCG), one of the most abundant green tea polyphenols, significantly reduces or prevents an increase in glucose levels, lipid markers and/or body weight. We hypothesized that combined treatment with OLZ and green tea extract (GTE) or EGCG may prevent body weight gain and increase of the lipid markers. ICR male mice weighing an average of 30.51 g (n=32) at the beginning of the experiment were used. OLZ, OLZ+GTE and OLZ+EGCG were administered for 27 d in the drinking water, and then the levels of fasting glucose, nitric oxide (NO), and a typical lipid marker triglyceride (TG) were determined in plasma. The body weight and food intake were also compared. The chronic treatment of OLZ increased the average body weight compared with that of controls. In the presence of GTE or EGCG, the OLZ-induced increase in body weight was significantly prevented. Furthermore, in the OLZ group, the plasma levels of glucose, NO and TG were significantly increased, whereas GTE or EGCG prevented these increases. These results implicate that OLZ may induce systematic inflammatory reaction, and suggest that GTE or EGCG can protect against OLZinduced weight gain, hyperglycemia and hypertriglyceridemia.

• Tuberculosis and Respiratory Diseases
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• v.56 no.4
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• pp.411-414
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• 2004

Isoniazid is a first-line drug in the treatment of tuberculosis. A variety of adverse reactions of isoniazid have been reported. These include hepatitis, peripheral neuropathy, skin rashes, neurologic disturbances and hematologic alterations. Among these, acute pancreatitis due to isoniazid is very rare. We report a case of acute pancreatitis due to isoniazid confirmed by rechallenge test with review of some literatures.