• 한국임상약학회지
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• 제24권1호
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• pp.1-8
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• 2014

Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

• 한국임상약학회지
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• 제28권1호
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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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• 제18권4호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4843-4846
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• 2013

Background: The infusion rate is considered to affect incidence and severity of infusion reactions (IRs) caused by protein formulations. Trastuzumab (TRS) is approved for 90-minute infusion as the initial dose followed by 30-minute infusion with 250 ml saline. In the study, we evaluated the safety of TRS intravenously administered over 30 minutes with 100 ml saline to reduce burden of patients, safety of infusion with 250 ml saline already being established. Materials and Methods: Women with HER2 positive breast cancer, ${\geq}18$ years and ${\geq}55%$ left ventricular ejection fraction (LVEF), were registered in the study. Patients received 8mg/kg of TRS 250 ml over 90 minutes followed by 6mg/kg of TRS 100ml over 30 minutes in a three-week cycle. Results: A total of 31 patients were recruited, 24 for adjuvant therapy and seven with metastases. The median age was 59 years (range 39 to 82). The total number of TRS doses ranged from 5 to 17 with the median of 15. Mild IR occurred in two patients at the first dose. However, no IR was observed after reducing to 100 ml saline. No decrease of LVEF, increase of serum brain natriuretic peptide or any other adverse events were reported. Conclusions: Intravenous infusion of TRS with 100 ml saline over 30 minutes in breast cancer patients can be considered safe based on results from the study. It can be given on an outpatient basis as with the currently recommended dilution in 250 ml saline.

• The Korean Journal of Physiology and Pharmacology
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• 제5권5호
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• pp.407-412
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• 2001

Many drugs are primarily metabolized by the cytochrome P450s (CYPs). Drug metabolites would be important allergens for adverse drug reactions such as drug eruptions. Skin tests with a suspected drug have conducted to identify causative drugs of drug eruptions, with vehicles such as white petrolatum, DMSO, ethanol. This study will compare the expression of rat CYP isozyme mRNAs between the skin and the liver, with examining an effect of the vehicles on the cutaneous CYPs using semi-quantitative RT-PCR. Thirty-two Sprague-Dawley rats between the ages of six and eight weeks were divided as four groups. One group was used to compare the constitutive mRNA expression between skin and liver, while the others were to examine the effects of three vehicles. The ratios of expression of CYP1A2, CYP2B1/2, CYP2E1, CYP3A1, and CYP4A1 were significantly higher in the liver than the skin. However, CYP1A1 and CYP2C11 were higher in the skin than liver. The effects of vehicles were quite different; white petrolatum significantly induced CYP1A1 (p=0.012) and CYP2C11 mRNAs, while ethanol inhibited CY P1A1 and CYP2B1/2. DMSO did not make any changes. The results suggest that rat skin can participate in drug metabolism with their own CYP isozymes. The effects of vehicles on the cutaneous CYP expression should not be ignored and may be applied for determination of an appropriate vehicle for certain drug(s).

• 대한한방내과학회지
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• 제25권4호
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• pp.373-382
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• 2004

Cystitis and acute pyelonephritis(APN) are usually caused by ascending infection. Two cases of urinary tract infection(UTI) were encountered. Because antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting, so Korean Traditional Medicine has been applied to UTI, and several reports can be found in the literature. This study was performed on two patients with UTI who were treated with herbal medicine, acupuncture and moxibustion. Noteworthy results were obtained in hematology and urinalysis. UTI symptoms, signs and laboratory findings are indicative of successful treatment. Results suggests that Korean Traditional Medicine applied to UTI is effective. These findings are reported with a brief review of related literature.

• Molecular & Cellular Toxicology
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• 제3권2호
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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.

• 한국환경생물학회:학술대회논문집
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• 한국환경생물학회 2002년도 학술대회
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• pp.123-126
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• 2002

Pollutants that are persistent, bioaccurnulative, and toxic have been linked to numerous adverse effects in human and animals, PBTs include heavy metals, polychlorinated biphenyls (PCBs), dioxins, polycyclic aromatic compounds (PACs) in addition to pesticides. This study focuses on toxic effects of the PBTs except pesticides on insects. Eight PBTs were selected from subgroups: three heavy metals (Pb, Hg, and Cd), two PCB mixtures (Aroclor mixtures 1 and 2), 2,3,7,8-tetrachlorodibenzo-p-dioxin, two monophenols (4-octylphenol and 4-nonylphenol), and tetrabutyltin, Beet armyworm, Spodoptera exigua, was used as test target insect species. Three physiological markers (metamorphosis, immune reaction, and follicle patency) were assessed in each exposure to different doses of the PCBs. Heat-shock proteins as molecular markers were also analyzed in response to the PCBs. All tested PBTs were toxic to metamorphosis from larvae to pupae when they were applied with diet. Two PCB mixtures were the most toxic compounds in this assay by giving significant toxicity at 0.005 ppm, while others had from 10 to 1000 ppm. Dioxin (0.1 ppb), tetrabutyltin (0.1 ppb), Pb (10 ppb), and Hg (0,01 ppb) were potent to inhibit immune reactions analyzed by inducing phenoloxidase activity and blocked phospholipase $A_2$ enzyme, Tetrabutyltin and dioxin significantly induced follicle cell patency, but their effects were lower than that of endogenous juvenile hormone, Dioxin, Pb, Hg, and Cd could induce the expression of heat shock proteins that were detected by immunoblotting against human HSP70 monoclonal antibody. HSP78 and HSP80 were upregulated in response to the PBTs. This expression was detected from the fat body and epidermis at as fast as 4h after injection. All these results clearly suggest that PBTs give significant ecotoxicity to insects that are valuable organisms in our environment.

• 대한유전성대사질환학회지
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• 제2권1호
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• pp.89-94
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• 2002

목 적 : 한국에서 처음 개발된 페닐케톤뇨증 소아를 위한 특수분유를 1년간 섭취시켜 발달양상 및 치료결과를 관찰하여 효율성과 안정성을 확인하고자 하였다. 방 법 : 순천향대학병원에서 페닐케톤뇨증으로 진찰된 소아 14명을 대상으로 1년간 수유하면서 식이 일기 평가, 혈장 아미노산 분석, 일반혈액검사, ferritin, 간기능검사, 소변검사를 시행하였다. 결 과 : 14명 모두 잘 먹었으며 신장, 체중, 두위는 모두 정상발육을 보였다. 혈색소는 모두 정상범위였다. 14례중 4례에서 ferritin 치가 12 ng/mL 이하여서 철분체제를 투여하였다. 알부민 치, S-GOT, S-GPT 소변검사는 모두 정상이었다. 페닐알라닌 치는 0.7-15.6 mg/dL로 대부분 정상 범위로 잘 유지되었다. 발진, 설사, 변비 등의 부작용은 관찰되지 않았다. 결 론 : 국내에서 처음 개발된 PKU-1과 PKU-2 Formula의 발육양상과 치료 결과가 좋은 것으로 확인되어 환자에게 안심하고 사용할 수 있는 우수한 제품으로 사료된다.

• 대한화장품학회지
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• 제32권4호
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• pp.263-267
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• 2006

태양광선과 산소는 피부세포에 자유라디칼(free radical)과 활성산소종(reactive oxygen species, ROS)을 생성시켜 세포막 지질의 과산화와 염증을 유발한다. 본 연구는 자외선에 의한 피부손상에 대한 머위추물물의 피부 보호효과에 대한 것으로 UVB가 조사된 각질형성세포에서이 항산화 및 염증관련 사이토카인의 억제효과를 측정하였다. 라디칼에 의한 지질과산화에 대한 억제효과는 $100{\mu}g/mL$에서 70.1%로 우수하게 나타났으며, 세포내에서 ROS에 의해 형광을 띠는 물질로 전환되는 $CM-H_2DCFDA$를 이용하여 ROS의 양을 측정한 결과 자외선에 의해 증가된 세포내 ROS의 양이 머위추출물을 처리함으로써 $500{\mu}g/mL$ 농도에서 45% 이상의 우수한 소거효과를 나타냈다. 또한 각질형성세포에서 UVB에 의해 생합성이 증가되는 $IL-1{\alpha}$ 및 $PGE_2$의 생합성 억제효과는 $100{\mu}g/mL$에서 각각 25.7%, 59.3%를 저해하는 것으로 우수한 효과를 나타내었다. 따라서 머위추출물은 각질형성세포에서 자외선 조사에 의한 피부손상에 대한 보호효과를 가진 화장품에서 우수한 소재로 적용될 수 있다.