• The Korea Journal of Herbology
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• v.28 no.1
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• pp.51-58
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• 2013

Objectives : As Daily Dose of Zizyphi Fructus was designated by the numbers in Treatise on Cold Damage Disease, estimation of Daily Dose was all different among researchers. The purpose of this study was to estimate exact Daily Dose of Zizyphi Fructus. Methods : We fixed the errors in various copy of Treatise on Cold Damage Disease and considered the meaning of the Bee Zizyphi Fructus(肥大棗) and general rules of Daily Dose in Treatise on Cold Damage Disease. So we reduced Daily Dose of Zizyphi Fructus, and compared this with the standard of Zizyphy Fructus in Pharmacopoeia of several Nation and Korean Forest Service. Results : Daily Dose of Zizyphi Fructus was generally 12 pieces; less was for prescriptions which scaled down the amount of ingredients prescribed in the originals; 15, 25, and 30 pieces were used when more was required. The medicinal part was the pulp of fructus, and the dosage of 12 pieces was respectively equivalent to 3 Ryang(兩), and 19.5 g. As defined in the Korean Pharmacopoeia Ninth Edition and standards of forest products by Korea Forest Service, Zizyphi Fructus was medium-sized, and weighs about 1.625 g if properly dehydrated. Conclusions : In short, the proper Daily Dose of Zizyphi Fructus in Treatise on Cold damage Disease was 12 pieces of Zizyphi Fructus and 19.5 g of its pulp, weighing three Ryang(兩). The pulp was estimated to be 1.625 g; it was medium-sized according to the present standard.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.653-659
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• 2016

The purpose of the study is to investigate the correlation between the amount of antimicrobial agent (Defined Daily Dose, DDD) and antimicrobial resistance rate (%). The treatment of infectious diseases is becoming increasingly difficult, due to the increase in the number of multi-drug resistant bacteria, making it a clinically significant problem. Among the various factors, antimicrobial abuse is a major cause of antimicrobial resistance. The study was conducted on inpatients in a secondary university hospital in the central region utilizing the hospital's computerized statistical data and microbiological program of laboratory medicine from January 2010 to December 2014 pertaining to the dose of antimicrobial drugs for Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli strains isolated from blood culture. We analyzed the antimicrobial resistance rate per dose with the Pearson correlation coefficient. A significant (positive?) correlation was detected between the cefepime dose and the resistance of E. coli (P<0.033; r=0.907), while a significant negative correlation was found between the tobramycin dose and the resistance of E.coli. (P<0.028; r=-0.917). The aminoglycoside resistance of A. baumannii showed a significant negative correlation (P<0.048; r=-0.881), and the aminoglycoside resistance of E. coli showed a significant negative correlation as well (P<0.001; r=-0.992). In conclusion, the amount of antimicrobial agent (Defined Daily Dose, DDD) (is partly related to) the bacterial strain and its antimicrobial resistance rate (%).

• Korean Journal of Clinical Pharmacy
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• v.17 no.1
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• pp.19-32
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• 2007

Objectives : It is necessary to monitor consumption of drugs in order to enhance promote appropriate use of drugs. Defined Daily Dose(DDD) of World Health Organization(WHO) has been used for evaluating the amount of medicine use. However, DDD of some drugs must be determined for drugs in Korea which are not listed by WHO. Our formulary follows ourself classification and DDD of some drugs must be determined since they exist only in Korea. This study was aimed to determine DDD value using RAND Appropriateness Methods and evaluate the amount of antibiotics use using DDD value. Methods : J01 antibiotics of WHO anatomical therapeutic chemical(ATC) classification were extracted from drug formulary. Antibiotics list without DDD was identified to determine their DDD with comprehensive review of references and recommendation of experts. defined. Review of reference was executed. of Expert panels were comprised of clinical pharmacist and clinical doctors. Modified Delphi Method was applied by survey and consensus meeting. Amount of antibiotic use was calculated by DDD/1000 inhabitants/day in the national level using health insurance claim data. Results : The result of 1 round, DDD values of 28 ingredients were determined from the first round of consensus meeting. With 2nd round meeting, 3 ingredients were deleted and DDD of 17 ingredients were decided. Analysis of antibiotic use in health insurance claim data showed 22.97 DDD/1000 inhabitants/day in 2003 year. Conclusion : This study can contribute to the establishment of DDD assignment and thus quantifying drug uses.

• Journal of the Korean Medical Association
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• v.61 no.11
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• YAKHAK HOEJI
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• v.58 no.4
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• pp.268-276
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• 2014

Background: World Health Organization considers opioid analgesic use as an important measure in the treatment of pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals in Korea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to 2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over 18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearly prescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000${\bullet}$HS). Results: Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalized patients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancer patient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increased by 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, the use of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone has increased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiary hospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital can be cautiously inferred based on this results.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.35-43
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• 2021

Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.134-139
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• 2021

Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion: Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

• Journal of Gastric Cancer
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• v.21 no.4
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• pp.418-425
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• 2021

Purpose: We designed a new regimen by combining intraperitoneal (IP) paclitaxel (PTX) with systemic S-1 plus oxaliplatin (SOX) for the treatment of advanced gastric cancer with peritoneal metastasis. This dose-escalation study aimed to determine the maximum tolerated dose (MTD) and recommended dose (RD) of IP PTX administered weekly to patients. Materials and Methods: Eight cycles of IP PTX plus SOX regimen were administered to the patients. S-1 was administered orally twice daily at a dose of 80 mg/m²/day for 14 consecutive days, followed by 7 days of rest. Intravenous oxaliplatin was administered at a fixed dose of 100 mg/m² on day 1, while IP PTX was administered on days 1 and 8. The initial dose of IP PTX was 40 mg/m², and the dose escalation was set in units of 20 mg/m² up to 80 mg/m². Dose-limiting toxicities (DLTs) were defined as grade 3 non-hematologic toxicities, grade 4 leukopenia, grade 3 febrile neutropenia, and grade 3 thrombocytopenia. Results: Nine patients were included in the study. No DLTs were observed in any of the enrolled patients. Therefore, the MTD was not reached, and the RD of IP PTX was determined to be 80 mg/m². Four patients (44%) showed a decreased peritoneal cancer index score on second-look laparoscopic examination. Conclusions: The present study determined the dose for further clinical trials of IP PTX to be 80 mg/m², when combined with a systemic SOX regimen.

• Journal of Nutrition and Health
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• v.44 no.1
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• pp.82-91
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• 2011

The present study reviewed the effects of excess iodine intake on thyroid function and the incidence of thyroid disease and discussed the scientific basis for establishing a tolerable upper intake level (UL) of iodine for Koreans. ULs are defined as "the highest level of daily nutrient intake that is likely to pose no risk of adverse effects to almost all individuals in the general population." Koreans consume excess iodine from seaweed, and iodine intake is strongly influenced by seaweed consumption. However, no dose-response data derived from subjects consuming excess iodine frequently but not continuously during a lifetime are available. Therefore, the Korean DRI committee set the iodine UL to reduce the risk of adverse health effects by excess iodine intake for Koreans with distinctive seaweed-eating habits.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.102-108
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• 1996

This was an open trial to evaluate the efficacy and safety of moclobemide twice daily for treatment of Korean patients with major depressive disorder(DSM-III-R). The duration of the trial was 6 weeks with the initial dose of moclobemide being fixed lor the first two weeks at 300mg/day(150mg twice daily, each token after morning and evening meals). Thereafter, when necessary, the dose was allowed to increase to 600mg/day or decrease to 150mg/day according to the seventy of the depression and/or the tolerability of the drug. Hypnotics and/or sedatives from a benzodiazepine group could be concomitantly administered at usual dosage. Patients were assessed at baseline and at days 14, 28 and 42. Efficacy was primarily judged on the Hamilton Rating Scale for Depression(HAM-D) and Beck Depression Inventory(BDI). Patients had to score at least 17 respectively an both scales to enter the trial. Secondary efficacy parameters included Clinical Global Impression(CGI) for severity of illness and improvement. Safety and tolerability were judged on reported adverse events, vital signs and laboratory parameters. In addition, there was a series of questions and assessments for the psychiatrists and patients to complete at the end of the trial Twenty nine patients completing trial were included in the analysis of efficacy : of thirty one patients participating in the safety and tolerability analysis, those who withdraw voluntarily without particular reasons or violated the treatment schedule were not included. The efficacies as determined by HAM-D, BDI or CGI were found to be significant compared to baseline. The number of responders defined as patients with a total score of 10 or less or with a total score of 50% or less of the baseline score on HAM-D and BDI were 17(59%) and 18(62%) respectively. Regarding safety and tolerability, nine patients(29%) reported mild adverse events probably related to moclobemide : of these one patient dropped out because of poor tolerability : however, there were no appreciable changes in blood pressure, pulse rate, body weight or laboratory parameters for all patients over the trial period. Furthermore, the physicians' and patients' opinions at final evaluation showed that moclabemide has a good antidepressant effect as well as a favorable tolerability. In conclusion, a twice-daily dosage schedule with maclobemide is recommendable for the treatment of Korean patients with major depressive disorder since its efficacy and safety were demonstrated in this study.