• Title/Summary/Keyword: Antihistamines

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Analysis of Prescriptions for Oral Solid Dosage Forms Split at Primary Health Care Using National Health Insurance Database (의원의 건강보험청구자료를 이용한 고형경구제 분할 처방 분석)

  • Park, Se-Jung;Lee, Suk-Hyang;Lee, Eui-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.37 no.2
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    • pp.119-126
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    • 2007
  • Tablet splitting is used in pharmacy practice to adjust the dose to be administered. However, it also causes several problems such as undesirable effect for sustained release or enteric-coated dosage form, inaccuracy of dose, and pharmacist's safety by splitting hazardous drugs. This study investigated the current status of oral dosage form splitting for patients older than 19 years by analyzing Korea National Health Insurance Claims Database. Out of oral solid drugs prescribed (N=1,486,584) 9.8% of them included tablets (or capsules) split. There were some splitting cases even in sustained release (4.9%), enteric-coated forms (1.3%) and hazardous drugs (2.7%) that were selected by NIOSH (The National Institute for Occupational Safety and Health). The most frequently split drugs were antihistamines, neuropsychotics and steroids. In case of digoxin and warfarin, unit doses in a domestic market were not diverse compared to foreign markets. Guidelines for splitting oral solid dosage forms, approval of diverse doses and conducting dose-response studies for the commonly splitting ingredients on Korean people are needed for the saff and effective use of oral solid drugs.

Analysis of Frequent Therapeutic Duplication Drug Classes Based on National Health Insurance Claimed Data in Korea (국내 건강보험심사청구자료에 근거한 다빈도 치료중복 의약품 약효군 분석)

  • Sohn, Hyun-Soon;Lee, Young-Sook;Choi, Kyung-Eob;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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    • pp.262-267
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    • 2010
  • Therapeutic duplication of prescriptions is the most frequently reported inappropriate drug use in Korea. To prevent significant problems during drug prescribing and dispensing, prospectively, development of standard including drug lists considered as therapeutic duplications for the prioritized drug classes first would be necessary. This study was aimed to analyze frequent drug classes of therapeutic duplications by healthcare providers in clinical practice settings. National health claims data for drug review and reimbursement (1,426,065 prescriptions dated March 19, 2008) were analyzed. Therapeutic duplication was defined as the prescription including more than 2 ingredients belonging to the same KFDA drug classification numbers that considered to have therapeutic similarities. The following 3 drug classes were mostly frequent therapeutic duplication classes: 114 anti-pyretics, analgesics and anti-inflammatory drugs; 117 drugs for psycho-nervous system; 141 Antihistamines. About 3.5% of overall prescriptions analyzed showed therapeutic duplications. This result might be starting step to develop DUR therapeutic duplication standard.

A Case of Non-traumatic Rhabdomyolysis after Doxylamine Overdose (Doxylamine 중독 후 합병한 비 외상성 횡문근융해증 1례)

  • Hwang, Sung Woog;No, Hyeung Kyeung;Kim, Kee Hyuck
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1033-1037
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    • 2002
  • Doxylamine is an antihistamine of the ethanolamine class. It is used primarily as a sleep-inducing agent. Clinicians should be aware of the complications in rhabdomyolysis patients who ingest doxylamine succinate and over-the-counter antihistamines. The easy availability of these substances increases the potential not only of intentional overdose by adults but also of inadvertent ingestion by children. Prompt intervention and careful assessment of renal function, urinary output, and serum creatine kinase levels may represent the difference between an uncomplicated and acute renal failure. Recognition of the potential for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug. A 14-year-old male was found to have hematuria and oliguria. Evaluation of the patient revealed myoglobinuria, and a creatine kinase(CK) level of 117,563 IU/L. He was recovered by massive fluid administration, urine alkalization and mannitol infusion. We report a case of a suicide attempt in a child where ingestion of the doxylamine complicated by non-traumatic rhabdomyolysis with brief review related literatures.

Differential diagnosis of peripheral vertigo (말초성 현기증의 감별진단)

  • Bae, Chang Hoon
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.1-8
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    • 2014
  • Dizziness can be classified mainly into 4 types: vertigo, disequilibrium, presyncope, and lightheadedness. Among these types, vertigo is a sensation of movement or motion due to various causes. The main causes of peripheral vertigo are benign paroxysmal positional vertigo (BPPV), acute vestibular neuritis (AVN), and Meniere's disease. BPPV is one of the most common causes of peripheral vertigo. It is characterized by brief episodes of mild to intense vertigo, which are triggered by specific changes in the position of the head. BPPV is diagnosed from the characteristic symptoms and by observing the nystagmus such as in the Dix-Hallpike test. BPPV is treated with several canalith repositioning procedures. AVN is the second most common cause of peripheral vertigo. Its key symptom is the acute onset of sustained rotatory vertigo without hearing loss. It is treated with symptomatic therapy with antihistamines, anticholinergic agents, anti-dopaminergic agents, and gamma-aminobutyric acid-enhancing agents that are used for symptoms of acute vertigo. Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, and tinnitus. It is traditionally relieved with life-style modification, a low-salt diet, and prescription of diuretics. However, diagnosis and treatment of the peripheral vertigo can be difficult without knowledge of BPPV, AVN, and Meniere's disease. This article provides information on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere's disease.

Approaches to the diagnosis and management of chronic urticaria in children

  • Choi, Sun Hee;Baek, Hey Sung
    • Clinical and Experimental Pediatrics
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    • v.58 no.5
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    • pp.159-164
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    • 2015
  • Most guidelines for chronic urticaria (CU) in infants and children are based on limited pediatric evidence. Current evidence used to guide treatment in children is extrapolated from data focusing on older age groups. CU in children is a different and complex condition than that in adults. Furthermore, there is little published information regarding urticaria in Korean children. The aim of the present article is to review recent research on chronic childhood urticaria and improve the current understanding of its pathogenesis and management. The classification and definition of urticaria in adults also applies to children. CU is defined as a daily occurrence of spontaneous wheals, angioedema, or both for >6 weeks. The precise pathophysiology of CU is unknown and the rates of successful identification of a cause in children with CU vary from 20%-50%. There is no established laboratory test to evaluate the presence of urticaria. The natural course of childhood CU is undetermined, with limited reports discussing long-term outcomes. Second-generation H1 antihistamines are the cornerstone of management, while limited therapeutic drugs are available for adults.

Two cases of dermatitis patients during pregnancy (임신 중 피부질환에 대한 치험 2례)

  • Jung, A-Rong;Jung, Eun-A;Park, Soo-Eun;Kim, Kyeong-Hye
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.1
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    • pp.258-267
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    • 2007
  • Purpose : Generally dermatitis is treated by corticosteroids, antihistamines ect, but the use of these drugs may affect pregnant women adversely. In this case Oriental medical therapy can be very useful. The purpose of this study is to report clinical management of dermatitis patients during pregnancy by oriental medicine including Hwa-acupuncture and herbal-combined extraction. Methods : We experienced two cases of dermatitis patient during pregnancy. In the beginning of treatment, they had severe itching, burning sensation, bulls, papule. We teated them with Hwa-acupuncture, herbal-combined extraction. Results : After quite short oriental treatment including Hwa-acupuncture and herbal-combined extraction, the symptoms of patients are remarkable alleviated. Conclusion : We think that many case of dermatitis during pregnancy can be managed effectively by Hwa-acupuncture and herbal-combined extraction. If we make more studies about disease under pregnancy condition, it will bring the high satisfaction of patient and the elevation of treatment rate.

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Pathophysiology and new treatment of itch (가려움증의 병태생리 및 최신치료)

  • Jung, Min Je;Choi, Yong Won;Chung, Bo Young;Park, Chun Wook;Kim, Hye One
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.670-677
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    • 2018
  • Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.

Scombroid Fish Poisoning and Histamine Food Poisoning (스콤브로이드 생선 중독과 히스타민 식중독)

  • Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.1-6
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    • 2019
  • Scombroid fish poisoning (SFP) is a form of histamine food poisoning caused by the ingestion of improperly stored fish. The term "scombroid" derives from the family name of the fish family first implicated, such as tuna and mackerel. On the other hand, non-scombroid fish species, such as sardine and herring, can also cause histamine poisoning. The histamine is converted from histidine by a bacterial enzyme in the causative fish. Because the symptoms of SFP can easily be confused with food allergies, it is believed to have been significantly under-reported. In 2016, an outbreak of SFP occurred among primary school students who had eaten yellowtail steak in Korea. The most common findings consisted of a rapid onset of flushing of the face and trunk, erythematous and urticarial rash, diarrhea, and headache occurring soon after consuming the spoiled fish. Usually, the course is self-limiting and antihistamines can be used successfully to relieve symptoms, but several life-threatening SFP cases have been reported. Clinical toxicologists should be familiar with SFP and have competency to make a differential diagnosis between fish allergy and histamine poisoning. SFP is a histamine-induced reaction caused by the ingestion of histamine-contaminated fish, whereas a fish allergy is an IgE-mediated reaction. This review discusses the epidemiology, pathophysiology, diagnosis, treatment, and preventive measures of SFP.

The Application of Auriculotherapy to the Treatment of Chronic Spontaneous Urticaria: A Systematic Review and Meta-analysis

  • Zhu, Libing;Kim, Yunjin;Yang, Zongbao
    • Journal of Acupuncture & Meridian Studies
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    • v.11 no.6
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    • pp.343-354
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    • 2018
  • Auriculotherapy has been extensively used for chronic spontaneous urticaria in China. However, the evidence of its effectiveness and safety for the treatment of chronic spontaneous urticaria is insufficient. Hence, we conducted this study to compare auriculotherapy or auriculotherapy joint treatment with Western medicine for the cure of chronic spontaneous urticaria. This meta-analysis of seven randomized controlled trials showed that auriculotherapy or auriculotherapy joint treatment was significantly superior to Western medicine in curing clinical signs and symptoms of chronic spontaneous urticaria [odds ration (OR), 2.61; 95% confidence interval (CI), 1.54-4.43; p = 0.0004) and also better in total effect rate (OR, 3.81; 95% CI, 2.07-7.01; p<0.0001). But, auriculotherapy or auriculotherapy joint treatment was similar to Western medicine in improving clinical signs and symptoms of chronic spontaneous urticaria (OR, 0.74; 95% CI, 0.35-1.56; p = 0.42). Auriculotherapy or auriculotherapy joint treatment was safer than Western medicine for curing chronic spontaneous urticaria (OR, 0.26; 95% CI, 0.09-0.80; p = 0.02). Auriculotherapy alone or auriculotherapy joint treatment appears to be more effective and safer than Western medicine that contains antihistamines in the treatment of chronic spontaneous urticaria. However, these findings should be interpreted with caution due to the unclear risk bias of methodological quality, and further studies with large-scale, better, and more rigorously designed protocol are necessary to prove these findings.

The Study on the Pityriasis Rosea in Oriental-Western Medicine (장미색비강진에 대한 동서의학적 고찰)

  • Lee, Kyou-Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.4
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    • pp.106-122
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    • 2022
  • Objectives : In this study, we aimed to analyze the latest knowledge of pityriasis rosea(PR) through oriental-western medical review on PR. Methods : We searched Pubmed, CNKI, and OASIS to select papers related to the cause, mechanism, diagnosis, classification, treatment, and herbal treatment of PR. Results : The results are as follows. 1. Although the exact cause of PR is not known, it has recently been found that reactivation of latent human herpesvirus-6 and human herpesvirus-7 infection is a possible etiology. Most patients require emollients, antihistamines, topical steroids, and macrolides. Acyclovir, and narrow-band UVB therapy are also used. 2. The cause and mechanism of PR in Chinese and Korean medicine can be mainly summarized as wind-heat, blood heat, and blood deficiency and wind-dryness. Most of the herbal medicine used have the effects of clearing heat, cooling the blood, detoxifying, dispelling wind, relieving itching, nourishing blood, and moistening dryness. Conclusions : In Chinese and Korean medicine, it is necessary to organize the representative prescriptions according to pattern identification, and it is also necessary to study the atypical types of PR and its treatment methods. It is thought that research on oriental and western combination therapy should be continuously conducted, and efforts to develop Korean medicine formulations are needed to revitalize clinical research in Korea.