• Title/Summary/Keyword: Adverse Factors

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Factors Affecting the Adverse Drug Reactions of Mycophenolate Mofetil (Mycophenolate Mofetil 부작용 발생에 미치는 요인 분석)

  • Kim, Keum-Hi;Lee, Ju-Yeun;Park, Kyung-Ho;Son, In-Ja;Lee, Hye-Suk
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.151-158
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    • 2010
  • Therapeutic drug monitoring of Mycophenolate mofetil(MMF) has been suggested in some clinical trials, but has not been widely adopted in Korea. The purpose of this study was to analyze the withdrawal rates of MMF and determine the characteristics of the patients who experienced adverse reactions with MMF therapy and to suggest the criteria for selecting patients who need monitoring of MMF levels. We retrospectively collected data of patients who started MMF between July 2007 and June 2008. A total of 154 adult patients were included in our study. Among them, ninety seven patients discontinued MMF with 59 cases being due to adverse drug reactions. Thirty one patients required dosage reduction of MMF with twenty three cases being due to adverse reactions. Twenty six patients continued the MMF without or with mild adverse reactions. Of the 82 adverse reaction cases, hematologic adverse reactions accounted for 38 cases (46%) and gastrointestinal (GI) adverse reactions accounted for 28 cases (34%). Older age and lower serum albumin levels were significantly different characteristics between the patients who withdraw MMF due to hematological adverse reactions and those who were able to continue therapy. The group who experienced GI adverse reactions had higher MMF dosages based on body weight and lower serum albumin levels. In conclusion, the factors affecting the adverse reactions of MMF were age, serum albumin level and higher dosage, therefore therapeutic drug monitoring of MMF should be considered in these patients.

Fentanyl PCA Monotherapy and Fentanyl TTS Combination Therapy in Post-Operative Pain Management: Analyses of Spontaneous Adverse Drug Reaction Reports (자발적 약물 이상반응 보고 분석을 통한 수술 후 통증 조절에 사용된 Fentanyl의 약물사용적정성)

  • Park, Soo Jung;Jeong, Kyeong Hye;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.81-87
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    • 2018
  • Objective: There have been many cases of spontaneous adverse drug reactions to fentanyl at a regional pharmacovigilance center in the hospital. To assess the factors causing the adverse drug reactions reported in patients receiving fentanyl patient-controlled analgesia (PCA) monotherapy or in combination with fentanyl transdermal therapeutic system (TTS) for acute post-operative pain management. Methods: We conducted a retrospective cohort study with all patients prescribed fentanyl PCA for pain management after orthopedic surgery at a single university hospital from June 2012 to May 2013. We analysed the factors causing adverse drug reactions reported by a spontaneous reporting system in patients receiving fentanyl PCA monotherapy and those receiving fentanyl TTS in combination with fentanyl PCA. Results: Based on the spontaneous adverse drug reaction reporting, the risk ratio for the incidence rate of adverse drug reaction in the fentanyl TTS combination therapy group was 3.04 (95 % CI: 2.4-4.00, P < 0.0001), which was approximately 3-fold higher than that reported for fentanyl PCA monotherapy. Only 60 % of the adverse drug reactions were reported. Conclusion: It is inappropriate to add fentanyl TTS to fentanyl PCA to manage post-operative acute pain. There is a need to improve adverse drug reaction reporting. We expect that regular analysis of adverse drug reactions reported at regional pharmacovigilance centre would aid in appropriate drug utilization by patients.

Clinical Characteristics of Poor Responders to Acupotomy and Safety Pretreatment Management (침도 침술시 부작용과 예방법에 관한 연구)

  • Kim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.117-125
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    • 2008
  • Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

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Comprehensive Analysis of Exposed Adverse Factors in Disaster Response Activities - Focused on Fire - (재난 대응 활동 시 노출가능 유해인자 종합분석 -화재 현장을 중심으로-)

  • Park, Chanseok
    • Journal of the Society of Disaster Information
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    • v.10 no.3
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    • pp.420-430
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    • 2014
  • Firefighters performing disaster response activities such as Fire Suppression Rescue First Aid in fire are being exposed in various adverse factors, heat, smoke, toxic gases, emotional stress, biological toxic factors and physical overload by unnatural ergonomic posture required for firefighters. But so far, there is the study for this problem only separately. There is no study about comprehesive analysis of exposed adverse factors in fire-related disaster response activities and countermeasures. The purpose of this study is to contiribute to solving the health problems and prevention of accidents of firefighters by extracting hazardous agents in disaster such as fire and by proposing countermeasures. After analyzing circumstances such as fire-suppression, rescue first aid and life-environment, exposure factors of fire are derived and exposure status is suggested according to physical chemical biological psychological aspects. The countermeasure against the noise of the physical exposure factors are proposed. The countermeasures such as protective equipment and clean room in chemical factors, infection prevention education, vaccination and periodic check system in biological factors, PTSD alleviation booth and mentoring in psychological factors are proposed.

Analysis of Causal Factors of Internet Addiction to Resolve Adverse Effects of the Informatization (효과적인 정보화 역기능 해소를 위한 인터넷 중독 유발 요인 분석)

  • Han, Oakyoung;Kim, Jaehyoun
    • The Journal of Korean Association of Computer Education
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    • v.16 no.2
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    • pp.19-27
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    • 2013
  • Internet addiction, one of adverse effects of the informatization, has become a very serious social problem. The purpose of this study is to seek solutions for the adverse effects of the informatization by analyzing the causal factors of internet addiction to maximize prevention of the internet addiction for college students. The three causal factors of the internet addiction: personal factors, familial factors, and social environmental factors are defined as the second confirmatory factors, and the first confirmatory factors for the each second confirmatory factor are reviewed for influential factors of internet addiction. The study concluded that the personal factors are the most influential factors of internet addiction for college students; furthermore, self-control and self-efficacy are key variables of the personal factors. Therefore, it can be effective ways to prevent internet addiction if countermeasures on self-control and self-efficacy of the personal factors are presented.

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Interpregnancy Interval and Adverse Birth Outcome in Term Premature Rupture of Membrane, 2017

  • Workineh, Yinager;Ayalew, Emiru;Debalkie, Megbaru
    • The Korean Journal of Food & Health Convergence
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    • v.5 no.2
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    • pp.1-11
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    • 2019
  • The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.

Is ginseng free from adverse effects?

  • Xie, Jing-Tian;Mehendale, Sangeeta R.;Maleckar, Spring A.;Yuan, Chun-Su
    • Advances in Traditional Medicine
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    • v.2 no.2
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    • pp.80-86
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    • 2002
  • Ginseng is a perennial herb widely used in China, Japan, and Korea. It is also one of the most commonly used herbal medicines in the U.S. Although it is generally considered safe to use, adverse effects associated with ginseng use have been reported. Inappropriate ginseng use, such as high dose administration, may cause insomnia, headaches, diarrhea, as well as cardiovascular and endocrine disorders. Other factors that may contribute to adverse effects of ginseng include the variety of ginseng species, variability in commercial ginseng preparations, and potential ginseng-drug interactions. To minimize adverse effects of ginseng, consumers should be advised to use it appropriately, and the herbal industry should try to provide standardized ginseng preparations.

Rituximab Infusion-related Adverse Events and Risk Factors (Rituximab 주입관련 부작용발생 및 위험인자 분석)

  • Lee, Eun Jung;Kim, Young Joo;Rhie, Sandy J
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.3
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    • pp.223-231
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    • 2013
  • Objective: This study aimed to identify the status and risk factors of rituximab infusion-related adverse events (ADE) in rituximab-na$\ddot{i}$ve patients with cancer diseases. Method: A retrospective analysis using electronic medical records review was conducted. Inclusions were patients with a diagnosis of cancer disease with the initiation of rituximab-included treatment who were na$\ddot{i}$ve to rituximab during January 2011 to March 2013 at National Cancer Center (NCC) in Korea. Result: Total 110 patients, 582 cases of rituximab administrations, were reported in the study. About 57.2% of patients were 51-70 years old and evenly distributed between two genders and 72.7% were BMI less than $25kg/m^2$. All of study patients were diagnosed with non-Hodgkin lymphoma. Fifty patients (45.4%) and 54 cases (9.3%) were experienced rituximab infusion-related AEs even with conservative administration protocol at NCC. The most frequently occurring AEs were shivering followed by rash and itching. In single variant analysis, we found that the early stage of NHL, low exposure to rituximab administrations, high white blood cell counts, high lymphocyte counts, high absolute neutrophil count and low lactate dehydrogenase were associated with infusion-related AEs (p<0.05). The early stage of disease, high lymphocyte counts, low exposure to rituximab administrations were also related significantly with AEs in multiple variants analysis (p<0.05). Conclusion: Rituximab infusion-related AEs for patients who were na$\ddot{i}$ve to rituximab were still a concern with conservative administration protocol. The adverse drug reactions were significantly associated with early stage of NHL, higher lymphocyte counts and low exposure to rituximab administrations. The factors need to be considered with close monitoring to prevent rituximab infusion-related AE.

Clinical Determinants of Weight Loss in Patients with Esophageal Carcinoma During Radiotherapy: a Prospective Longitudinal View

  • Jiang, Nan;Zhao, Jin-Zhi;Chen, Xiao-Cen;Li, Li-Ya;Zhang, Li-Juan;Zhao, Yue
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1943-1948
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    • 2014
  • Purpose: The prevalence of weight loss in esophageal carcinoma patients is high and associated with impairment of physical function, increased psychological distress and low quality of life. It is not known which factors may contribute to weight loss in patients with esophageal carcinoma during radiotherapy in China. The objective of this study was to identify the associated demographic and clinical factors influencing weight loss. Methods: We evaluated 159 esophageal carcinoma patients between August 2010 and August 2013 in a crosssectional, descriptive study. Patient characteristics, tumor and treatment details, psychological status, adverse effects, and dietary intake were evaluated at baseline and during radiotherapy. A multivariate logistic regression analyss was performed to identify the potential factors leading to weight loss. Results: 64 (40.3%) patients had weight loss ${\geq}5%$ during radiotherapy. According to logistic regression analysis, depression, esophagitis, and loss of appetite were adverse factors linked to weight loss. Dietary counseling, early stage disease and total energy intake ${\geq}1441.3$ (kcal/d) were protective factors. Conclusions It was found that dietary counseling, TNM stage, total energy intake, depression, esophagitis, and loss of appetite were the most important factors for weight loss. The results underline the importance of maintaining energy intake and providing dietary advice in EC patients during RT. At the same time, by identifying associated factors, medical staff can provide appropriate medical care to reduce weight loss. Further studies should determine the effect of these factors on weight loss and propose a predictive model.

Progress of the 2013 Interim Guidelines for Determining Minimum Propulsion Power to Maintain the Manoeuvrability of Ships in Adverse Conditions (황천 시 최소추진출력 관련 IMO 잠정 가이드라인의 진행 현황과 적용 결과 검토)

  • Sung, Young Jae;Ock, Yu Bin
    • Journal of the Society of Naval Architects of Korea
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    • v.56 no.6
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    • pp.497-506
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    • 2019
  • Literature survey was conducted on the 2013 Interim Guidelines for determining the minimum propulsion power to maintain the manoeuvrability of ships in adverse conditions. The International Maritime Organization (IMO) Marine Environment Protection Committee (MEPC) documents related with the Guidelines were reviewed. Compatibility of the present Guidelines can be checked by two different levels: (Level 1) minimum power lines assessment and (Level 2) simplified assessment. The IHS (Information Handling Services) sea-web data on the bulk carriers and the tankers, which were built after 2000, were used to examine the Level 1 assessment. KVLCC2 was used to examine the Level 2 assessment. Regarding the Level 2 assessment, effects of the adverse weather conditions, the added resistance due to waves, the wake fractions and the thrust deduction factors were discussed.