• Title/Summary/Keyword: Clinical Prescription

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A Study on Applications of Prescriptions including Semen Arecae as a Main Component in Dongeuibogam ("동의보감(東醫寶鑑)" 중(中) 빈랑(檳榔)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Lim, Dai-Hwan;Jeon, Young-Kyun;Lee, Ju-Hee
    • Herbal Formula Science
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    • v.17 no.1
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    • pp.61-74
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    • 2009
  • This report describes 46 studies related to prescriptions which are mainly used Semen Arecae from Dongeuibogam. The following conclusions were reached through investigations on the prescriptions that use Semen Arecae as a main component. 19.6% of a malaria, 17.4% of an evacuation problem, recorded the largest number of clinical frequency of the prescriptions in therapeutic use when Semen Arecae was taken as a main component in prescriptions Prescriptions that utilize Semen Arecae as the main ingredient are used in the treatment of a malaria, an evacuation problem and a malignant dermatosis. they are also used for treating 11 different types of diseases. The prescriptions are compounded with Semen Arecae as a main component which can be applied to an affection by wind-cold, a heat(fire) syndrome, a cold-stroke, a phlegm-retention syndrome, a constipation induced by apoplexy, a stagnation of vital energy, an asthenia of the spleen and the stomach, a convulsion caused by improper diet, a parasitic infestation and a traumatic disease. The dosage of Semen Arecae is 2.5pun(nearly 0.94g) to 3don(nearly 11.25g), however 1don(nearly 3.75g) has been taken the most for clinical application. When Semen Arecae is combined with basic prescriptions such as Ijintang and Bulium, it applies symptoms of malaria. In addition, when Semen Arecae is combined with basic prescriptions such as Daemainhwan, Soseungkitang and Samatang, it utilizes an evacuation problem.

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Pattern of Medications Usage and Potentially Inappropriate Medication Usage among Korean Ambulatory Elderly Patients Based on an Explicit Criterion (한국의 외래노인환자에서 약물사용의 경향 및 explicit criteria에 의한 적절성 평가)

  • Nam, Jin-Sun;Shin, Wan-Gyoon;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.149-159
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    • 2005
  • Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

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Comparison of Herbs in Prescription Composition of Consumptive Disease and Internal Injury in Donguibogam Through Network Analysis (네트워크 분석을 통한 동의보감(東醫寶鑑) 내상(內傷)문과 허로(虛勞)문의 처방 구성 본초 비교)

  • Chien-hsin Kuo;Heung Ko;Seon-mi Shin
    • The Journal of Internal Korean Medicine
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    • v.44 no.1
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    • pp.35-52
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    • 2023
  • Objective: Internal injuries and consumptive disease have different causes, yet they can affect each other. The relationship and combination of prescription drugs in the clinical practice of internal injuries and consumptive disease were analyzed for various diseases of "Donguibogam" through network analysis. Methods: The prescriptions used in consumptive disease and internal injury were established by conducting a full survey on the papers extracted from Donguibogam. The R version 4.0.3 (2020-10-10) and the igraph and arules package were used to perform network analysis and association rule relationship mining analysis in the first and second prescription compositions. Results: The herb frequently used for internal injury was Glycyrrhizae Radix, while the herb combination frequently used was Citri Pericarpium-Glycyrrhizae Radix. For centrality, the main factor was generally Glycyrrhizae Radix. In the case of consumptive disease, the herb most frequently used was Angelicae Gigantis Radix, and the combination most frequently used was Rehmanniae Radix Preparata-Angelicae Gigantis Radix. In terms of centrality, it was Angelicae Gigantis Radix. As a result of the network analysis of herbal prescription frequency, each group was divided into three. Conclusion: The interrelationship between internal injury and consumptive disease prescription drugs may reveal the differences and similarities between internal injury and consumptive disease and may serve as a basis for the development of new drugs or materials that can enhance mutual effectiveness in the treatment of internal injury and consumptive diseases.

Case Development on Nurses' Ethical Dilemmas with Physicians' and Nurses' Decision Making (간호사와 의사 간의 윤리적 딜레마 사례개발과 간호사의 의사결정 양상)

  • Jeong, Jeong-Mee;Park, Jung-Hyun;Jeong, Seok Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.5
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    • pp.668-678
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    • 2013
  • Purpose: This study was done to develop a realistic clinical case and investigate nurses' decision-making about nurses' ethical dilemmas with physicians in the fields of nursing practice. Methods: Case development and a hypothetical case study were used. Participants were 52 nurses. Data were collected in 2012 and 2013 using an open-ended questionnaire and interviews and analyzed using content analysis and descriptive statistics. Results: Various dilemma situations between nurses and physicians, such as violence, deathbed, medication prescription, and physicians' incapacity unfairness, were suggested. A clinical dilemma case about medication prescription was developed based on nurses' experiences. Nurses' responses to the developed case situation and responses were classified into five types. Various reasons were given for making the decisions and about 56% of the nurses decided to notify their supervisor without deleting nursing records. Conclusion: In this study, a realistic clinical dilemma case was developed, and nurses' ethical decision making was identified. These findings can be used in developing effective strategies for nurses to solve ethical dilemmas and to improve ethical decision-making abilities.

Drug Interaction Review of Prescriptions for Outpatients at General Hospital (종합병원의 외래환자 처방전에 대한 약물상호작용 검토)

  • Cho, Jin Hoan;Choi, Byung Chul;Sohn, Uy Dong
    • YAKHAK HOEJI
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    • v.49 no.5
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    • pp.399-404
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    • 2005
  • To investigate drug interaction, 23,536 prescriptions published for 1 year were investigated with 'Drug Inter­action Fact 2002'. Dispensing records and a database file written in a local general hospital in South Korea were used as a sample. The number of total cases of drug interaction was 3,238 ($13.76\%$) out of 23,536 prescriptions. The incidence of drug interaction in each prescription the children, the adults, and the elderly were $1.33\%,\;10.97\%,\;25.50\%$, respectively. The incidences of drug interaction per each prescription were $22.03\%,\;20.52\%,\;0.51\%,\;and\;0.36\%$ in neurosurgery, internal med­icine, pediatrics, and orthopedics, respectively. In neurosurgery and internal medicine, risk-high drugs of drug interaction such as antihypertensive drugs, diuretics, and cimetidine were used very often in elderly. In this paper, several suggestions to reduce drug interaction were postulated with regard to the usage of analgesics, non-steroidal antiinflammatory drugs, and antibiotics.

A Review of Clinical Studies with Herbal Medicine for Depression - Based on Randomized Controlled Clinical Trial - (우울증에 대한 한약물 치료 문헌적 고찰 - 무작위 대조군 임상연구를 중심으로 -)

  • Lee, Jae-Eun;Kwon, Yong-Ju;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.31-39
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    • 2011
  • Objectives : This study aimed to investigate frequently used herbal materials among herbal prescription for depression focusing on randomized controlled trial. Methods : Every article relevant to depression was initially obtained from China National Infrastructure(CNKI), Korean database and book hand-searching. Searching keywords were 'depression', 'herbal medicine' and 'randomized controllled trial(RCT)'. Results : Among comorbidity with depression, the most accompanied disease was that of circulatory system. Among sixty-five articles, depression with cerebral vascular disease was twenty-eight. Article about mood disorder was twenty-four. High frequently used herbal materials were Bupleuri Radix(41times), Curcumae Radix(34 times), Acori Graminei Rhizoma and Cnidii Rhizoma(24 times). Conclusions : According to this study, we could know select frequent-used herbal medicine. In a clinical treatment, herbal materials can be added herbal prescription related to depression. As these results, it can be helpful to develop new drugs.

Comparison of Prescription Patterns and Clinical Features according to Clinical Departments in Sedative-hypnotic Intoxication (진정수면제 중독 환자의 처방과에 따른 처방 및 임상양상 비교)

  • Kim, Do Min;Park, Won Bin;Lim, Yong Su;Kim, Jin Joo;Jang, Jae Ho;Jang, Jee Yong;Yang, Hyuk Jun;Lee, Geun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.54-62
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    • 2014
  • Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

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The Analysis on Trend of Clinical Studies about Dizziness in Journal of Korean Medicine (국내 한의학 학술지에 게재된 현훈 임상논문의 경향 분석)

  • YI, Gil-Hee;Jung, Chan-Yung;Hong, Seung-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.88-102
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    • 2017
  • Objectives : The aim of this study is to review domestic clinical studies about dizziness in Korean medicine. Methods : Population key words "현훈(Hyeonhoon), 현기증(Hyeongijeung), 어지럼(Eojireom), 어지러움(Eojireoum), 실신(Silsin), 眩暈(Hyeonhoon), 眩氣症(Hyeongijeung), 失神(Silsin)" were searched on five database systems(DBpia, KISS, KMbase, NDSL, RISS) from September, 13th to September, 15th, 2016. 60 clinical studies were collected and classified by published journal, year, etiologic disease, study design, dizziness assessment tools of studies, study results, evaluation of disease pattern and process, interventions(herbal medicine and acupuncture treatment points), and number of studies which chose that prescription. Results & Conclusions : Dizziness was researched constantly since 1998 and 7 clinical stuides were issued 2007, the most. The journal which the most studies were presented was Journal of korean oriental internal medicine(12 studies over 60, 20%). Original article were 12(20.0%) and case reports were 48(80.0%) among 60 studies. BPPV was reported as a etiologic disease on 9 studies(20.45%) among 44 studies. VAS was used mainly as dizziness assessment tools of studies(26 studies over 38, 68.42%). 9 studies(15.0%) got evaluation of disease pattern and process among 60. Banhabaekchulcheonma-tang was reported as a herbal medicine prescription on 9 over 44 studies(20.45%) and ST36 was chosen acupuncture point most(24 over 45 studies, 53.33%). It doesn't have enough representativenes but has meaning to apprehend present tendency to treat dizziness in Korean medicine clinical studies.

Comparative Analysis of Korean, Chinese and Japanese Articles about Oncheongeum Used for Curing Atopic Dermatitis (아토피성 피부염에 활용되는 온청음(溫淸飮)에 대한 한중일의 논문 비교)

  • Kang, Hwi-Jung;Lee, Hyang-Im;Cho, Young-Joo;Joo, Myung-Soo;Kwon, Young-Kyu
    • Korean Journal of Oriental Medicine
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    • v.15 no.3
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    • pp.63-74
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    • 2009
  • Background and Purpose : Oncheongeum(溫淸飮) composed of Samultang(四物湯) and Hwangryunhaedoktang(黃連解毒湯) was mainly used for healing metrorrhagia in the Qing dynasty of China. At present, Oncheongeum is used for treating a broad spectrum of diseases such as skin disease, stomatitis, behcets disease, diabetes mellitus and, especially in Japan, atopic dermatitis. To our knowledge, however, neither the precise constituents and their effects of Oncheongeum nor the criteria for the prescription of Oncheongeum were defined. To address this issue, we searched and performed analysis of Korean, Chinese and Japanese articles reporting the clinical and experimental studies of Oncheongeum. Methods : We searched articles in the national assembly library of Korea by using keyword 'Oncheongeum' korean. Similarly, we did chinese articles in the CNKI and japanese ones in the CiNii, respectively. Results : We found 13 korean articles about Oncheongeum in the national assembly library, 34 chinese articles in the CNKI, and 23 japanese in the CiNii. The papers were divided into clinical and experimental articles. The clinical articles were mainly published from China and Japan, and their subjects were predominantly on skin diseases. Conclusions : There were a lot of case reports about Oncheongeum used in the clinical studies. In order to better understand the effects of Oncheongeum, systematic review of the studies seems essential. The efficacy of Oncheongeum reported in the clinical studies should be supported by experimental data. Not much were clinical reports in Korea, although we are expecting more to come. It is possible to not only analyse but compare Oncheongeum with other prescriptions used for atopic dermatitis. More comprehensive and comparative analysis of three countries' prescriptions might provide a way of how to standardize prescriptions, which leads oriental medicine to an evidence based medicine.

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Beta Blockers or Calcium Channel Blockers as Primary Antianginal Drug after Percutaneous Coronary Intervention: Prescription Pattern and its association with Clinical Outcome (관상동맥중재술 전후 주요 항협심증 약제로서의 베타차단제와 칼슘채널차단제: 처방패턴 및 임상결과에 미치는 영향)

  • Noh, Sun Young;Jo, Yun Hee;Cho, Yoon Sook;Hahn, Hyeon Joo;Lee, Hae-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.213-219
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    • 2016
  • Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.