• Title/Summary/Keyword: Drug misuse

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Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease (폐쇄성 폐질환 노인 환자와 성인 환자의 흡입제 사용 숙련도와 투약이행도)

  • Kim, Soo Jin;Shin, Yong Soon
    • Korean Journal of Adult Nursing
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    • v.27 no.6
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    • pp.665-672
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    • 2015
  • Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

The Effects of Voice Therapy in Vocal Process Granuloma (성대돌기 육아종의 음성치료 효과)

  • Kim, Seong-Tae;Choi, Seung-Ho;Nam, Soon-Yuhl
    • Phonetics and Speech Sciences
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    • v.2 no.4
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    • pp.165-171
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    • 2010
  • Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT$^{(R)}$, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

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Clinical Practice Guideline for Sasang Constitutional Medicine: Prevention and Risk Fators of Sasangin Disease (사상체질병증 임상진료지침: 예방 및 위험인자)

  • Bae, Na-Young;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.82-109
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline (CPG) for Prevention of Sasangin disease pattern of Sasang Constitutional Medicine (SCM) and diseases closely related with Sasang constitution. Each CPG was developed by the national-wide experts committee consisting of SCM professors. Methods At first, we searched the literatures related to SCM such as "Dongeuisusebowon", Textbook of SCM and Clinical Guidebook of SCM. Also we searched the articles related to the studies about risk factors for Sasangin disease pattern of both at home and abroad. Finally, we selected leading risk factors of Sasangin disease pattern and developed CPG for prevention of Sasangin disease pattern of SCM. And then, we searched the literatures related SCM such as "Dongeuisusebowon" and the articles on the correlation between disease and Sasang constitution using case-control studies, observational studies or cross sectional studies of both at home and abroad. Next, we selected diseases closely related with Sasang constitution on the basis of articles including prevalence rate and odds ratio between disease and Sasang constitution and finally developed CPG for these diseases. Results and Conclusions We categorized risk factors of Sasang disease pattern into 2 types: non-modifiable and potentially modifiable. 3 items (age, sex and genetic factors) were classified as non-modifiable risk factors of Sasang disease pattern. 6 items (original symptom, stress, diet and nutrition, physical activity, alcohol and drug misuse) were classified as less well-documented or potentially modifiable risk factors of Sasangin disease pattern. We found out Sasang constitution is more likely to develop some diseases. It was proven that Sasang constitution increase the risk of hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. And there is high probability of Sasang constitution being potential risk factor for obesity, hyperlipidemia, allergy and cancer. Also, we found out Taeeumin is independent risk factor for hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. Therefore we recommend that Taeeumin need to prevent these disease by regular checkups and aggressive management.

Development of a Simultaneous Detection and Quantification Method of Anorectics in Human Urine Using GC-MS and its Application to Legal Cases (GC-MS를 이용한 사람 뇨시료 중 비만치료제 분석 및 비만치료제 남용 현황의 법과학적 고찰)

  • Choi, Hyeyoung;Lee, Jaesin;Jang, Moonhee;Yang, Wonkyung;Kim, Eunmi;Choi, Hwakyung
    • YAKHAK HOEJI
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    • v.57 no.6
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    • pp.420-425
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    • 2013
  • Phentermine (PT) and phenmetrazine (PM) have been widely used as anti-obesity drugs. These drugs should be used with caution due to its close relation to amphetamine in its structure and toxicity. PT and PM, amphetamine-type anorectics, have recently been considered as alternatives for methamphetamine abuse in Korea. In addition, the misuse and abuse of PT and PM obtained by illegal sources such as the internet become a serious social problem. In the present study, a simultaneous detection and quantification method for determining PT and PM in human urine was developed and validated according to the international guidelines. The urine samples were screened using a fluorescence polarization immunooassay and analyzed by gas chromatography mass spectrometry (GC-MS) after extraction using automatic solid phase extraction (SPE) with a mixed-mode cation exchange cartridge and derivatization with pentafluoropropionic anhydride (PFPA). The validation results for selectivity, linearity, limits of detection (LOD) and quantification (LOQ), intra- and inter-assay precision and accuracy and recovery were satisfactory. The validated method was successfully applied to authentic urine samples collected from 38 drug abuse suspects. PT and/or PM were identified with or without methamphetamine in urine samples. Abuse of PT and PM have increased continuously in Korea, therefore, closer supervision of the inappropriate use of anoretics is necessary.

Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards

  • d'Ettorre, Gabriele;Pellicani, Vincenza
    • Safety and Health at Work
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    • v.8 no.4
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    • pp.337-342
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    • 2017
  • Background: Workplace violence (WPV) against healthcare workers (HCWs) employed in psychiatric inpatient wards is a serious occupational issue that involves both staff and patients; the consequences of WPV may include increased service costs and lower standards of care. The purpose of this review was to evaluate which topics have been focused on in the literature and which are new in approaching the concern of patient violence against HCWs employed in psychiatric inpatient wards, in the past 20 years. Methods: We searched for publications in PubMed and Web of Science using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management, occurrence rates, and physical/nonphysical consequences. Results: Our search resulted in a total of 64 publications that matched our inclusion criteria. The topics discussed, in order of frequency (from highest to lowest), were as follows: "risk assessment," "risk management," "occurrence rates," and "physical/nonphysical consequences." Schizophrenia, young age, alcohol use, drug misuse, a history of violence, and hostile-dominant interpersonal styles were found to be the predictors of patients' violence. Conclusion: Risk assessment of violence by patients appeared the way to effectively minimize the occurrence of WPV and, consequently, to better protect mental HCWs. We found paucity of data regarding psychologic sequelae of WPV. According to these findings, we suggest the need to better investigate the psychologic consequences of WPV, with the aim of checking the effective interventions to assist HCW victims of violence and to prevent psychologic illness.

Factors related to Suicidal Ideation in Korean High School Students (한국 고등학생의 자살생각 관련 요인)

  • Choi, Moon-Ji;Kim, Kyeng-Jin;Han, Seungwoo
    • Journal of the Korea Convergence Society
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    • v.12 no.11
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    • pp.487-499
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    • 2021
  • This study identifies factors related to suicidal ideation such as demographics, health behaviors and subjective perceptions of high school students. This study analysis using the chi-square test and multiple logistic regression to find out the factors related to suicidal ideation using the 2020 youth online health pattern survey of 25,987 Korean high school students. Sociodemographic factors that affected suicidal ideation in these subjects included grade, gender, and housing type. The health behavior characteristics were experiences with drinking, smoking, sex, and drug misuse. Finally, the subjective perception characteristics included health status, happiness status, loneliness, stress level, and depression. Therefore, it is expected that will be used as basic data for strategies to prevent suicide among high school students in Korea in the covid-19 environment.

A Comparative Study of Memory Improving Effects of Stachys Rhizome and Lycopi Rhizome on Scopolamine-induced Amensia in mice (시판 초석잠 기원식물의 기억력개선효과 비교연구)

  • Lee, Shin Woo;Jung, Tae-Hong;Shin, Yong-Wook
    • The Korea Journal of Herbology
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    • v.28 no.5
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    • pp.69-77
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    • 2013
  • Objectives : The purpose of this study was to characterize the effect of the Ethanolic extract of Stachys sieboldii and Lycopus lucidus on the learning and memory impairments induced by scopolamine. Methods : The genetic difference of Stachys sieboldii and Lycopus lucidus were observed with RAPD analysis. The cognition-enhancing effect of Stachys sieboldii and Lycopus lucidus was investigated using a passive avoidance test, Y-maze test and the Morris water maze test in mice. Drug-induced amnesia was induced by treating animals with scopolamine (1 mg/kg, i.p.). Results : As a result of RAPD analysis, Stachys sieboldii and Lycopus lucidus Radix was found to be genetically different and The results of learning memory analysis showed that Stachys sieboldii extract-treated group (500 mg/kg, p.o.) and the tacrine-treated group (10 mg/kg, p.o.) significantly ameliorated scopolamine-induced amnesia based on the Passive avoidance Y-maze test and Water maze test. And these results are same manner in DPPH radical scavenger effect and Acetylcholineseterase inhibition effect. These results suggest that Stachys sieboldii extract maybe a useful cognitive impairment treatment, and its beneficial effects are depending on the origin plants. Conclusions : Commercially available Stachys sieboldii Radix consists of two original plant, one of them people misuse. To clarify the origin of the plant Memory tests were performed. These results suggest that 80% Ethanol extract of Stachys sieboldii showed significant anti-amnestic and cognitive-enhancing activities related to the memory processes, and these activities were parallel to treatment duration and dependent of the learning models.

Proportion of Non-Medical Opioid Use of Prescription Opioids among Cancer Patients in Korea

  • Se-Il, Go;Jung Hye Kwon;Sung Woo Park;Gyeong-Won Lee;Jung Hun Kang;Eduardo, Bruera
    • Journal of Hospice and Palliative Care
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    • v.26 no.4
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    • pp.185-189
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    • 2023
  • Purpose: Limited research has been conducted on the prevalence of non-medical opioid use (NMOU) in Korean cancer patients who have received prescription opioids (PO). This study aimed to identify the potential proportion of NMOU in cancer patients who had been prescribed opioids in Korea. Methods: A retrospective cohort analysis was conducted on 14,728 patients who underwent cancer-related treatment between January 2009 and December 2019, using electronically collected data from a tertiary hospital in Korea. Information regarding the type and duration of opioid use was gathered. A detailed review of medical charts was carried out, focusing on patients who had been prescribed opioids for over 60 days beyond a 12-month period following the completion of their cancer treatment (long-term PO users). Results: Out of the 5,587 patients who were prescribed PO and followed up for at least 12 months, 13 cases of NMOU were identified, representing 0.23% of the patient population. Among the 204 long-term PO users, the rate was 6.37% (13/204). The most commonly misused opioids were oxycodone and fentanyl. For the group confirmed to have NMOU, the median duration of prescription was 1,327 days in total. Of the 13 patients diagnosed with NMOU, 9 reported withdrawal symptoms, 3 exhibited craving behavior for opioids, and 1 experienced both symptoms. Conclusion: This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.

Current status of opioid prescription in South Korea using narcotics information management system

  • Soo-Hyuk Yoon;Jeongsoo Kim;Susie Yoon;Ho-Jin Lee
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.41-50
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    • 2024
  • Background: Recognizing the seriousness of the misuse and abuse of medical narcotics, the South Korean government introduced the world's first narcotic management system, the Narcotics Information Management System (NIMS). This study aimed to explore the recent one-year opioid prescribing patterns in South Korea using the NIMS database. Methods: This study analyzed opioid prescription records in South Korea for the year 2022, utilizing the dispensing/administration dataset provided by NIMS. Public data from the Korean Statistical Information Service were also utilized to explore prescription trends over the past four years. The examination covered 16 different opioid analgesics, assessed by the total number of units prescribed based on routes of administration, type of institutions, and patients' sex and age group. Additionally, the disposal rate for each ingredient was computed. Results: In total, 206,941 records of 87,792,968 opioid analgesic units were analyzed. Recently, the overall quantity of prescribed opioid analgesic units has remained relatively stable. The most prescribed ingredient was oral oxycodone, followed by tapentadol and sublingual fentanyl. Tertiary hospitals had the highest number of dispensed units (49.4%), followed by community pharmacies (40.2%). The highest number of prescribed units was attributed to male patients in their 60s. The disposal rates of the oral and transdermal formulations were less than 0.1%. Conclusions: Opioid prescription in South Korea features a high proportion of oral formulations, tertiary hospital administration, pharmacy dispensing, and elderly patients. Sustained education and surveillance of patients and healthcare providers is required.

A Study on the Medication in an early Implementation Period of Separation System of Pharmacy and Clinic in Seoul (의약분업 초기의 서울지역 외래환자의 투약실태)

  • Cho Won Sun
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.398-411
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    • 2001
  • The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.

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