• Urogenital Tract Infection
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• v.13 no.3
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• pp.79-83
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• 2018

Purpose: The 5 alpha reductase inhibitor (5ARI) reduces the size of the prostate and alleviates lower urinary tract symptoms. After stopping 5ARI, the prostate quickly recovers to its pre-medication size. The purpose of this study was to investigate the factors affecting the restoration of prostate size after 5ARI discontinuation. Materials and Methods: Between March 2009 and May 2017, patients who visited an outpatient clinic and were diagnosed with benign prostatic hyperplasia were selected and start 5ARI medication. After 6 months of medication, the patients stopped medication for 1 year. Meanwhile, we measured the prostate volumes of patients 3 times (before and after medication, after discontinuation) and divide the patients into 3 groups (maintained, intermediate, and restored) with recovered prostate volume ratio. After classification, we investigated the relationship between the variable factors (age, serum prostate-specific antigen, initial volume, reduced volume after medication) between groups. Results: Among the 147 selected patients, the mean age and plasma PSA level were $61.6{\pm}7.9$ and $0.8{\pm}0.6$, respectively. The mean initial prostate volume was $32.3{\pm}4.2ml$, which reduced to $23.2{\pm}3.2ml$ after medication. After one year of discontinuation, the mean volume was $31.4{\pm}6.4ml$, with restoration to 101.5% of the reduced size. We noticed a tendency that patients with faster prostate volume recovery were generally older than those with slower recovery; however, this was not statistically significant. Other factors showed no relationship with prostate recovery. Conclusions: When using 5ARI in elderly patients, continuous treatment seems better than intermittent treatment. If discontinuation is needed, short term follow-up is recommended.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.236-243
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• 2018

Purpose: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. Methods: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients' Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. Results: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR= 1.75; confidence interval, CI= 1.09-2.82), nausea (OR= 105.27; CI= 61.03-181.58), total intravenous anesthesia (TIVA) of the thyroidectomy (OR= 10.43; CI= 5.01-21.70). Conclusion: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom associated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing interventions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.78-83
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• 2020

Objectives: The discontinuation of bisphosphonate (BP) treatment before tooth extraction may induce medication-related osteonecrosis of the jaw (MRONJ). Whether the long-term discontinuation of BP treatment before tooth extraction affects the risk of developing MRONJ after tooth extraction or whether extended drug holidays induce systemic side effects remains unclear. The present study assessed the incidence of MRONJ among patients who underwent tooth extraction and did not discontinue BP therapy prior to the procedure. Materials and Methods: Patients were classified according to whether or not they discontinued BP therapy before tooth extraction. Differences in the incidence of MRONJ after tooth extraction were compared between the two groups using the chi-squared test. Results: The BP-continuation (BPC) and BP-discontinuation (BPDC) groups included 179 and 286 patients, respectively. One patient in the BPC group and no patients in the BPDC group developed MRONJ (P=0.385). The patients in the BPDC group stopped receiving BP therapy at a mean of 39.0±35.5 months prior to tooth extraction. Conclusion: The possibility of pre-existing MRONJ in the extraction area must be considered during the extraction procedure. Routine discontinuation of BP medications for several months before the extraction procedure should be carefully considered, as evidence of its efficacy in reducing the development of post-extraction MRONJ is limited.

• Korean Journal of Biological Psychiatry
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• v.7 no.2
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• pp.186-190
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• 2000

Objective : The authors experienced that cognitive behavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. Method : A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(PCT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment aassessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spielberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire (BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FQ), Toronto Alexithymia Scale(TAS). Results : At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). Conclusion : Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.

• International Journal of Advanced Culture Technology
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• v.10 no.1
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• pp.108-115
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• 2022

The purpose of this study is to investigate the actual status of antithrombotic management before and after the procedure or surgery, the difference between the duration of medication suspension by clinical and demographic characteristics, and the patient's understanding and satisfaction after medication management by a dedicated nurse. The results were as follows. The most commonly used antithrombotic agents were aspirin and flavitol. The drug discontinuation period according to antithrombotic, procedures, and underlying diseases, there was a significant difference in duration for each variables(p<.000). In the case of antiplatelet drugs, 5-day suspension was the most frequent, and anticoagulants 2-day suspension was the most frequent. Depending on the procedure,colonoscope,nucleoplasty,rotator cuff repair,and total knee arthroplasty commonly showed more than 80% of 5-day discontinuation. The differences according to underlying diseases are as follows. 64.7% of all diseases discontinued on the 5th. The patient's understanding of the nurse's medication management performed before and after the procedure was found to be lower in Angina patients than those with other diseases. In terms of age, those in their 50s showed higher understanding than other age groups. There were no differences in understanding and satisfaction with the remaining characteristics.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.127-132
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• 2019

Purpose: The aim of this study was to determine if preoperative temporary discontinuation of antiplatelet medication (aspirin, clopidogrel, or cilostazol) is a safe procedure that does not increase early postoperative bleeding and allogenic blood transfusion after a total knee arthroplasty. Materials and Methods: A retrospective analysis was conducted among consecutive patients who underwent navigation assisted primary total knee arthroplasty performed by a single surgeon, from January 2013 to December 2016. A total of 369 patients enrolled in this study were divided into two groups, 271 patients with no history of antiplatelet therapy and 98 patients who underwent 7 days of temporary withdrawal of antiplatelet therapy. Comparative analysis between the two groups, on the variation of hemoglobin and hematocrit during the first and second postoperative days, was conducted to determine the amount of early postoperative bleeding and the frequency of allogenic blood transfusion during hospitalization. Results: The variation of hemoglobin, hematocrit during the first and second postoperative days and the frequency of allogenic blood transfusion between no history of antiplatelet medication and discontinuation antiplatelet medication before 7 days from surgery were similar in both groups. Of the 369 patients, 149 patients received a blood transfusion during their hospitalization. Compared to patients who did not receive a blood transfusion, those who did received blood transfusion were significantly older in age, smaller in height, lighter in weight, and showed significantly lower preoperative hemoglobin and hematocrit values. No statistically significant differences in sex, preoperative American Society of Anesthesiologists scores, and the history of antiplatelet medication until 7 days prior to surgery were observed between the two groups according to blood transfusion. Conclusion: Compared to patients with no history of antiplatelet medication, the temporary discontinuation of antiplatelet medication 7 days prior to surgery in patients undergoing antiplatelet medication did not increase the amount of postoperative bleeding or the need for allogenic blood transfusion.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.244-247
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• 1996

A 67 year old male with postherpetic neuralgia complained of right anterior chest throbbing pain and also allodynia. We performed thoracic epidural block with 0.25% bupivacaine and 1% lidocaine. Oral carbamazepine and imipramine were also administred concomitantly. One month later, patient complained of fatigue, anorexia, pruritis, jaundice, and dark urine. Liver function test values were significantly elevated then. Therefore we removed the epidural catheter and ceased all medication. Liver function test values decreased rapidly after discontinuation of medication. Hepatitis might have developed as result of drugs administered and could have been prevented if the patient had been monitored with regular clinical laboratory follow up. The purpose of this case report is emphasize the importance of early regular laboratory test to detect any possible side effect that may occur by administration of drugs during treatment of chronic pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.4
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• pp.219-224
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• 2022

Objectives: There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods: This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T₀), 12 months after (T₁), and 18 months after (T₂) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton's method. Paired t-tests were used to analyze differences over time. Results: The difference in indices (mental index and panoramic mandibular index) between T₀ and T₁ was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T₁ and T₂ was statistically significant (paired t-test, P<0.05). Conclusion: The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.168-178
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• 1997

The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disroders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs) may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs). Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.

• International journal of thyroidology
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• v.11 no.2
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• pp.82-87
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• 2018

Skin-related toxicity is one of the most important adverse events from multi-target tyrosine kinase inhibitor (MTKI) to treat radioiodine refractory thyroid cancer. As hand foot skin reaction can limit quality of life and therapeutic effectiveness, it is essential to cope with a variety of severity of skin-related toxicity induced by MTKI. Herein, we will discuss two representative cases of skin-related toxicities which were managed by discontinuation/reduction of therapeutic doses of MTKI and were treated by proper medication in thyroid cancer patients with distant metastasis.