• Title/Summary/Keyword: Clinical Prescription

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Medication Prescribing Status in Pediatric Patients with Migraine (소아청소년에서 편두통 치료 약물 처방 현황)

  • Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.178-184
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    • 2022
  • Background: Migraine is one of the leading causes of poor quality of life and disability, and migraine incidences in pediatrics are increasing. Proper medication is important for the preventive and acute treatment of migraine. This study aimed to identify the current status of prescribed medication in pediatric patients with migraine. Methods: We used data from a sample of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2018) and analyzed the status of prescription drugs and frequency of visits to medical institutions with migraine diagnoses in pediatric patients. Results: A total of 12,228 pediatric patients diagnosed with migraine during 2018 were analyzed. Among these patients, 7,170 (58.64%) were girls and 9,510 (77.77%) were adolescents. Additionally, 9,157 patients (74.89%) received acute treatment, and 592 patients (4.84%) received combination therapy with analgesics and triptans. Acetaminophen for acute treatment and flunarizine for preventive treatment were the most commonly prescribed. In most children and adolescents, acute treatment drugs were prescribed for less than 14 days. Conclusion: Analgesics, such as acetaminophen or non-steroidal anti-inflammatory drugs, were prescribed frequently for acute treatment in pediatric patients with migraine. The drug prescription duration was within the recommended range, indicating a low risk of overdose. For preventive treatment, clinically studied medication for pediatric patients with migraine was used.

Current Prescription Status of Contraindicated Drug Combinations Causing Serotonin Syndrome: Analysis of HIRA-NPS Data

  • Jae Gon Ryu;So Young Kim;Susin Park;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.313-320
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    • 2022
  • Background: Serotonin syndrome is a life-threatening disease if not appropriately treated. This study aimed to investigate the prescription status of contraindicated drug combinations that cause serotonin syndrome and identify the related factors. Methods: A cross-sectional study was conducted using nationwide claims data. Adult patients taking serotonergic drugs with Parkinson's disease or mental disorders were selected. Based on international medical databases (MDBs) and the Korean Drug Utilization Review (DUR), the status of prescribing contraindicated drug combinations that induce serotonin syndrome, the related factors, and the difference between international MDBs and the Korean DUR were analyzed. Results: Of the 49,773 study subjects, 163 (0.3%) were prescribed contraindicated serotonergic drug combinations based on international MDBs, and among them, only 105 (64.4%) were contraindicated by the Korean DUR. Positive influencing factors for prescribing contraindicated drug combinations include patient age between 65 and 74 and physician's specialties (neurologists, and orthopedists). Negative influencing factors were physician's specialty (internists) and medical institution (primary institutions). Conclusion: Despite the implementation of DUR, 3 out of 1,000 study subjects received contraindicated drug combinations that caused serotonin syndrome. Hence, it is necessary to comply with the DUR and improve it in accordance with international MDBs.

Evaluation of Pharmacists' Intervention Activities in Community Pharmacy (지역약국 약사의 처방중재 활동 평가)

  • Hyunji Koo;Jong-Mi Seong;Sun-Young Jung;Kyeong Hye Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.1
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    • pp.62-70
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    • 2024
  • Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.

Compilation of 104 Experimental Theses on the Antitumor and Immuno-activating therapies of Oriental Medicine (한의학의 항종양 면역치료에 관한 연구 -1990년 이후 발표된 실험논문을 중심으로-)

  • Kang Yeon Yee;Kim Tai Im;Park Jong Ho;Kim Sung Hoon;Park Jong Dai;Kim Dong Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.1
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    • pp.1-24
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    • 2003
  • This study was done to compile 104 experimental theses which are related to the antitumor and immuno-activating therapies between February 1990 through February 2002. Master's and doctoral theses were dassified by schools, degrees, materials, effects, experimental methods of antitumor and immunoactivity, and results. The following results were obtained from this study : 1. Classifying the theses by the school, 34.6% were presented by Daejeon University, 29.8% by Kyung-hee University and 11.5% by Won-kwang University. Of all theses, 51.0% were aimed for the doctoral degree and 43.3% were for the master's degree. All of three universities have their own cancer centers. 2. Classifying the theses by herb materials, complex prescription accounted for 60.3%, single herb accounted for 24.8% and herbal acupuncture accounted for 14.2%. Considering the key principles of the traditional medicine, complex prescription was much more thoroughly studied than single herb prescription. The results showed that the complex prescription had both antitumor activity and immuno-activating activity, which might reflects on multi-activation mechanisms by complex components. 3. Classifying the theses by the efficacy of herbs examined, in single herb, invigorating spleen and supplementing was 35.5%, expelling toxin and cooling was 29.0%, activating blood flow and removing blood stasis was 12.9%. In herbal acupuncture, invigorating spleen and supplementing was 52.9%, expelling toxin and cooling was 29.4%. In complex prescription, pathogen-free status was 41.9%, strengthening healthy qi to eliminate pathogen was 35.5%, strengthening healthy qi was 22.6%. It is presumed that the antitumor and immunoactivating therapy based on syndrome differentiation is the best way to develop oriental oncology. 4. Classifying the theses by antitumor experiments, cytotoxic effect was 48.1 %, survival time was 48.1 % and change of tumor size was 42.3%. Survival rate was not necessarily correlated with cytotoxicity. These data reflect the characteristic, wholistic nature of the oriental medicine which is based on BRM (biological response modifier). 5. Classifying the theses by immunoactivating experiments, hemolysin titer was 51.0%, hemagglutinin titer was 46.2% and NK cell's activity was 44.2%. In the future studies, an effort to elucidate specific molecular and cellular mechanisms of cytokine production in the body would be crucial. 6. Classifying the theses according to the data in terms of antitumor activity, 50% was evaluated good, 24.0% was excellent, and 15.5% have no effect. In an evaluation of immuno-activating activity, 35.9% was excellent and 18.0% showed a little effect. The index point, as described here, may helps to use experimental data for clinical trials. Changes in index points by varying dosage implicate the importance of oriental medical theory for prescription. 7. In 167 materials, IIP (immunoactivating index point, mean : 3.12±0.07) was significantly higher than AIP(antitumor index point, mean : 2.83±0.07). These data demonstrate that the effect of herb medicine on tumor activity depends more on immunoactivating activity than antitumor activity. This further implies that the development of herbal antitumor drugs must be preceded by the mechanistic understanding of immunoactivating effect. 8. After medline-searching tumor and herb-related articles from NCBI web site, we conclude that most of the studies are primarily focused on biomolecular mechanisms and/or pathways. Henceforth, we need to define the biomolecular mechanisms and/or pathways affected by herbs or complicated prescriptions. 9. Therefore, the most important point of oriental medical oncology is to conned between experimental results and clinical trials. For the public application of herbal therapy to cancer, it is critical to present the data to mass media. 10. To develop the relationship of experimental results and clinical trials, university's cancer clinic must have a long-range plan related to the university laboratories and, at the same time, a regular consortium for this relationship is imperative. 11. After all these efforts, a new type herbal medicine for cancer therapy which is to take care of the long-term administering and safety problem must be developed. Then, it would be expected that anti-tumor herbal acupuncture can improve clinical symptoms and quality of life (QOL) for cancer patients. 12. Finally, oriental medical cancer center must be constructed in NCC (National Cancer Center) or government agency for the development of oriental medical oncology which has international competitive power.

Analysis of Drug Use Reviews in Pediatirc Inpatients (소아입원환자에서의 약물사용 평가)

  • Shin, Eun Jeong;Ha, Hun Joo;Shin, Wan Gyoon;Park, Kwang Jun
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.1
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    • pp.27-33
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    • 2005
  • This study was intended to contribute towards the development of proper drug use system for pediatric patients by investigationg problems related to their medication and identifying drugs that need to be developed into low dosage tab-lets or syrups for pediatric use based on our analysis on the prescriptions for pediatric inpatients from 22 hospitals in South Korea on a day of Feb. 2003. The usage rates in the proportion of less than 0.5 and 1 per unit of oral solid formulation were $29.9{\%}$ and $54.3{\%}$ in hospitals with 1000 beds or more, 36.5 and $60.6{\%}$ in hospitals with 500 to less than 1000 beds, $60.8{\%}$ and $81.6{\%}$ in hospitals with less than 500 beds. Of the 63 oral solid formulation products that were used two or more times in the proportion oi less than 0.5 units, 34 products ($54.0{\%}$) were used as such despite the fact that syrups and lower dosage tablets or capsules were available in the market, and 24 products ($38.1{\%}$) so even when syrup formulations were available. Therefore, it would be desirable that pharmacist communities in charge of dispensing identify the most frequently crushed drugs or those that require special attention in choosing dispensing powders or solutions and develop dispensing guidelines that can be adopted by pharmacists in practice. Moreover government-led policies are needed to encourage development and manufacture of the formulations for pediatrics and to correct unsound prescription and dispensing practices such as using crushed forms of certain oral solid formulations although alternative formulations are available in the market.

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Retrospective Drug Utilization Review of Antibiotics for Respiratory Tract Infection(RTI) in Ambulatory Outpatient Care (외래 호흡기계 질환에서 항생제 사용에 대한 후향적 평가방안)

  • Kim, Dong-Sook;Bae, Green;Kim, Su-Kyeong;Lee, Hak-Seon;Kim, Yoon Jin;Lee, SukHyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.291-303
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    • 2012
  • As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

A Literatural Reserch for the Practical Use of the Balsaminaceae (봉선화과 식물의 활용을 위한 문헌적 조사)

  • Bang, Jeong Hwan;Chong, Myong Soo
    • Journal of Korean Medical Ki-Gong Academy
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    • v.13 no.1
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    • pp.77-104
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    • 2013
  • In this study we examined the concerned literature for clinical use of Balsaminaceae plants focusing on the latest literature "zhong hua ben cao"(chinese materia medica, 1998). The findings were summarized as follows: 1. As an original plant, 27 species have been reviewed. 2. As a result of investigating oriental drug names by medicinal using part, a survey reported that the total of 22 species of oriental drug names, including 14 species of herba, 3 species of flos, 4 species of radix and rhizoma, and 1 species of semen, are being used for clinical use. 3. When we examined oriental drugs with five flavors by calculating and arranging their nature, effect, toxicity with points for conveniences sake, pungent and bitte showed 13 points, respectively, as main flavors. In drug nature, warm property of drug indicated 10 points and cold property of drug obtained 6 points. But as for other oriental drug, it is thought that we can recognize their significance. 4. With respect to efficacy, activating blood drug reached 10 kinds and wind- damp-dispelling 7 kinds, according to the examination. 5. In the examination on components and medicinal action, we examined that components are recorded in only impatiens balsamina's whole grass, flowers, root, root stems, and seeds, and Impatiens noli-tangere's whole grass. In medical action, we found out that the components are recorded in impatiens balsamina' flowers and seeds; impatiens noli-tangere's whole grass and flowers; and Impatiens textori' whole grass. 6. As a result of examining clinical prescription, the total of 84 kinds of clinical prescriptions by disease nature were examined, of which the prescription of Impatiens balsamina showed 19 cases in total, which was remarkable.

A Study on the Safety of Bangpungtongsung-san in Rats (랫드에서 방풍통성산의 안전성 연구)

  • Jung, Ko-Eun;Lee, Kyoung-Jin;Lee, Chul-Won;Kwak, In-Seok;Lee, Jang-Cheon;An, Won-Gun
    • Herbal Formula Science
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    • v.20 no.2
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    • pp.55-63
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    • 2012
  • Objectives : This study was conducted to investigate the safety of Bangpungtongsung-san in rats. Methods : The safety of this prescription on acute toxicity was evaluated by single dose toxicity study. Rats were orally administrated in a single dose of 0 and 2,000 mg/kg(limited dose) Bangpungtongsung-san. There were 7 rats in each groups. All animals were sacrificed after 14 days of treatment. After single administration, mortality, clinical signs, and body weight changes were observed for 14 days. Three parameters(autopsy finding, clinical chemistry, and hematology) were tested on the last day. Results : In this study with rats, Bangpungtongsung-san treatment did not show any acute toxicity. No mortality was noted for 14 days of treatment. There were no adverse effects on clinical signs, body weight changes, and autopsy finding at all treatment groups. The clinical chemistry parameters attesting to liver and kidney functions as well as the hematological parameters were within the normal ranges. Conclusions : It is considered that $LD_{50}$ of Bangpungtongsung-san is over 2,000 mg/kg in oral administration by rats. This finding of the safety of Bangpungtongsung-san is expected to strengthen the position of this prescription as nontoxic medicine.

Adherence to Antidepressants in Korean Elderly Patients with Major Depressive Disorder (주요우울장애 노인 환자의 항우울제 복약이행도 연구)

  • Kyeong Ju Lee;Yu Jeung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.62-69
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    • 2023
  • Objective: Adherence is an important component in the treatment of various diseases, and poor adherence to antidepressants in patients with major depressive disorder is common. Non-adherence can be more prevalent in elderly patients with multiple morbidity and polypharmacy, resulting in negative treatment outcomes. The purpose of this study was to analyze adherence to antidepressants in Korean elderly patients with major depressive disorder. Method: A retrospective study was conducted using the Korean National Health Insurance claims database, and the subjects of this study were patients aged 65 or older who received at least one prescription of antidepressant monotherapy for the treatment of major depressive disorder between January 1, 2020 and June 30, 2020. Adherence was measured using the proportion of days covered at 6 months after the initial antidepressant prescription date. Logistic regression analysis was used to identify factors associated with adherence. Results: A total of 416,766 patients were finally included in the study. Over half of patients were non-adherent (52.67%) to antidepressants. According to the multivariate logistic regression analysis, national health insurance or medical aid, taking selective serotonin reuptake inhibitors or selective norepinephrine reuptake inhibitors, and having comorbidities were significantly associated with greater rates of adherence in the study subjects. The highest adherence rate was observed in patients taking vortioxetine. Conclusion: There was a considerable rate of non-adherence in Korean elderly patients with major depressive disorder. Health care professionals should try to improve adherence in elderly patients with major depressive disorder.

Study on the Applications of prescriptions including Platycodi Radix as a main component in Dongeuibogam (동의보감(東醫寶鑑) 중(中) 길경(桔梗)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Lee, Tae-Hyung;Lee, Sung-Jun;Huh, Jin;Shin, Dong-Gean;Lee, Jae-Cheol;Shin, Yong-Seo;Yun, Young-Gab
    • Herbal Formula Science
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    • v.18 no.1
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    • pp.23-42
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    • 2010
  • This report describes 90 prescriptions related to the use of Platycodi Radix main blended from Dongeuibogam. The following conclusions were reached through investigations on the prescriptions that use Platycodi Radix as a key component. Prescriptions that Platycodi Radix was taken as a monarch drug are utilized for 30 therapeutic purposes, for example, cough disease, throat disease, abscess and pus, and wind disease. In particular, 12.1% of prescriptions appear in the chapter of cough, and 9.9% of those appear in the chapter of throat, and each 8.8% of those appear in the chapter of abscess and of wind disease. Prescriptions that utilize Platycodi Radix as the main ingredient are used in the treatment of cough disease, throat disease and abscess, and they are also used for treating 74 different types of disease. The prescriptions are compounded with Platycodi Radix as a monarch drug are related to exogenous agents such as wind-cold pathogen, wind-heat pathogen, epidemic diseases, and endogenous agents such as seven emotions, and non-endo-exopathogenic factors like excessive labor, deficiency of Qi and blood, phlegm-mass, phlegm-fire, ect. The dosage of Platycodi Radix is 2pun(about 0.75g) to 1nyang(about 37.5g), however 1don (about 3.75g) has been taken the most for clinical application. We can find out that according to herbs or prescriptions blended with it self, Platycodi Radix makes a variety of functions to penetrate lung stagnancy and remove phlegm, relieve throat pain and get rid of pus, and regulate Qi flow. And Gamgiltang is the most useful base prescription which used the Platycodi Radix as the main component.