• Title/Summary/Keyword: Drug monitoring system

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Status of Polypharmacy and Inappropriate Medication Use of the Elderly in Nursing Homes (노인요양시설 노인의 다약제 복용(Polypharmacy)과 부적절한 약물사용 실태)

  • Kim, Jeong-Sun;Kang, Sook
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.237-249
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    • 2013
  • This study was done to investigate status of polypharmacy and inappropriate medications use of the elderly of in nursing homes. The subjects of this study were 270 elderly people in the nursing homes of G city and K city, In this study, the medications were classified by Anatomical Therapeutic Chemical (ATC) code, polypharmacy was defined as taking medications more than five, and inappropriate medications use were identified by Beers criteria. Data was analyzed by using descriptive statistics, t-test and one-way ANOVA. Total number of drug types in this study was the average $6.1{\pm}2.6$. The subjects with polypharmacy were 193(71.5%), and with inappropriate medications use were 138(51.1%). There was a significant difference in the polypharmacy according to the number of diseases(p<.001) and in the inappropriate medications use according to age(p=.018). Baesd on this study, polypharmacy and inappropriate medications use of elderly people were main problems that need to carefully assess for safe and correct medication usage in nursing home. Therefore, an ongoing medication monitoring system is necessary to minimize the adverse drug reactions of elderly.

Autonomy Level of Nurse according to Nursing Delivery System (간호 분담체계에 따른 간호사의 자율성 정도)

  • Oh, Eun Sil
    • Korean Journal of Occupational Health Nursing
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    • v.9 no.2
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    • pp.155-165
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    • 2000
  • This study is to grope for a plan to increase nurse's autonomy by grasping autonomy degree according to nursing delivery system. The subject of this study are 265 nurses who work for 4 general hospitals in Seoul, and 73 of them work in primary nursing delivery system, 99 of them in team nursing delivery system and 93 of them in functional nursing delivery system. Data collection was done through questionaires from Sep. 1, 1997 to Sep. 30, 1997, and autonomy was measured by Professional Nursing Autonomy Scale developed by Schutzonhofer. Data analysis as inspected with $X^2$ test, ANOVA, and t-test, using SPSS program. The results are as follows : 1. When it comes to the autonomy of all the nurses, mean score was 161.99. Which is medium level, and autonomy degree according to nursing delivery system had no significant differences. 2. There was a significant difference in autonomy degree according to inservice education among the subject's work-related characteristics, and there was no significant difference in autonomy distribution in each grade according to general characteristics although older group, married group, and junior college graduates group showed rather higher trends. 3. Considering each item, questions related to direct nursing such as "Vital sign monitoring", "Nursing rounding", "Withhold contraindicated drug", showed high score in autonomy scores, and long-term and indirect nursing behaviors such as "Nursing administration", "Nursing research", "Follow-up care" and "Educational planning".

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Preliminary Evaluation of Levocetirizine and Cetirizine Induced Liver Injury (임상 자료를 활용한 레보세티리진과 세티리진이 유도한 간손상 평가)

  • Sung, Eun Ji;Moon, Mira;Cho, Yoon Sook;Lee, Hye Suk;Kim, Hyang Sook;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.3
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    • pp.213-218
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    • 2014
  • Objectives: The aim of this study was to identify the causal relationship between use of levocetrizine or cetrizine, and liver injury, by comparing frequency and pattern of hepatotoxicity in levocetrizine or cetrizine prescribed patients. Methods: This is a retrospective observational study, using data retrieved from electronic medical record system. Among 1164 patients prescribed levocetrizine or cetrizine during study period (Jul, 2009 - Jun, 2010) at Seoul National University Hospital, 543 patients with more than 4- time liver function test (LFT) results were included in final analysis. Liver injury was defined as greater than 3 times elevated level of alanine aminotransferase or 2 times elevated level of alkaline phosphatase or total bilirubin, compared to upper limit of normal, in patient with normal liver function at baseline. The frequency and pattern of liver injury were assessed. Results: Incidence of liver injury in patients prescribed with levotcetrizine or cetrizine were 1.48% and 2.94%, respectively. With few exceptions, most injuries were shown to be hepatocellular type. Rapid recovery was observed after drug cessation and long term use tends to be associated with incidence of liver injury. In patient with digestive system disorder, rate of liver injury was significantly higher (p=0.011). Conclusion: The result of this study implies potential need of liver toxicity monitoring, especially in patients taking long term levecetrizine or cetrizine or in patient with digestive system disorder. However, prospective large scale observational study is needed to confirm liver injury associated with the use of levocetirizine or cetirizine.

In vitro and In vivo Activities Studies of Chois Mastic Using Self-microemulsifying Drug Delivery System (SMEDDS) against Helicobactor pylori (자가미세유화시스템을 이용한 매스틱의 헬리코박터파일로리 대한 In vitro 및 In vivo 활성 연구)

  • Kim, Su-Ji;Jeong, Sang-Young;Gil, Young-Sig;Shin, Byung-Cheol;Hwang, Sung-Joo;Cho, Sun-Hang
    • YAKHAK HOEJI
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    • v.55 no.1
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    • pp.1-10
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    • 2011
  • Mastic is a bleed resin formed in pistacia lentiscus tree extract form the anacatdiaceae family. Mastic is used as a food ingredient in the Mediteraanean resin, and has been used by local inhabitants as a traditional medicine for relief of upper abdominal discomfort, dyspepsiaand peptic ulcer. Clinically, mastic has been effective in the treatment of benign gastric and duodenal, ulcers, giving symptomatic relief and endoscopically proven healing. In this study, to enhance activiteies of poorly water soluble Mastic with oils, surfactants and cosurfactants and then the mixure was microemulsified in aqueous media under condition of gentle agitation and digestive motility that would be encountered in the gastrointestinal tract. Formulation development and screening were based on phase diagrams and characteristics of resultant microemulsion. For optimum mastic formulation, microemulsions with various ratio (w/w%) of mastics, oils, surfactants and cosurfactants were prepared and their solubility was evaluated by monitoring particles size in their buffer through visual asessment and electrophoretic light scattering spectrophotomerter (ELS). In vitro activity of self microemulsified mastic (SME mastic) was determined by minimum ingibition concentration (MIC) test against a panel of Helicobacter pylori (H. pylori) clinical strains. Additionally, in vivo activity of SME masitc was investigated us mouse infected by CH275 of H. pylori. The mean diameter of SME mastic was less then 100 nm in water and SME mastic was showed similar antiboisis effect compared to tometronidazole, clarithromycin and omeproazole. Consequently, SME mastic would be effective system to exterminate H. pylori. If mastic were dose with combined treatment, mastic might augur well for effect of H. pylori eradication as good remedy.

Ultra-fast Generic LC-MS/MS Method for High-Throughput Quantification in Drug Discovery

  • Kim, So-Hee;Yoo, Hye Hyun;Cha, Eun-Ju;Jeong, Eun Sook;Kim, Ho Jun;Kim, Dong Hyun;Lee, Jaeick
    • Mass Spectrometry Letters
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    • v.4 no.3
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    • pp.47-50
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    • 2013
  • An ultra-fast generic LC-MS/MS method was developed for high-throughput quantification of discovery pharmacokinetic (PK) samples and its reliability was verified. The method involves a simple protein precipitation for sample preparation and the analysis by ultra-fast generic LC-MS/MS with the ballistic gradient program and selected reaction monitoring (SRM) mode. Approximately 290 new chemical entities (NCEs) (over 10,000 samples) from 5 therapeutic programs were analyzed. The calibration curves showed good linearity in the concentration range of 1, 2 or 5 to 2000 ng/mL. No significant ion suppression was observed in the elution region of all the NCEs. When approximately 300 plasma samples were continuously analyzed, the peak area of internal standard was constant and reproducible. In the repeated analysis of samples, the plasma concentrations and the area under the curve (AUC) were consistent with the results from the first analysis. These results showed that the present ultra-fast generic LC-MS/MS method is reliable in terms of selectivity, sensitivity, and reproducibility and could be useful for high-throughput quantification and other bioanalysis in drug discovery.

Monitoring Bacillus cereus and Aerobic Bacteria in Raw Infant Formula and Microbial Quality Control during Manufacturing (영.유아용 식품원료의 Bacillus cereus와 일반세균 모니터링 및 제조공정 중 미생물 품질제어)

  • Jung, Woo-Young;Eom, Joon-Ho;Kim, Byeong-Jo;Ju, In-Sun;Kim, Chang-Soo;Kim, Mi-Ra;Byun, Jung-A;Park, You-Gyoung;Son, Sang-Hyuck;Lee, Eun-Mi;Jung, Rae-Seok;Na, Mi-Ae;Yuk, Dong-Yeon;Gang, Ji-Yeon;Heo, Ok-Sun;Yoon, Min-Ho
    • Korean Journal of Food Science and Technology
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    • v.42 no.4
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    • pp.494-501
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    • 2010
  • The purpose of this study was to examine the presence of Bacillus cereus, aerobic bacteria and coliforms in the raw material of infant formulas and investigate the manufacturing process in terms of microbial safety. Among ten kinds of raw infant formula material samples (n=20), Bacillus cereus appeared in two (n=4). Aerobic bacteria were not detected in raw infant formula material or maximum 4.15 log CFU/g. Eleven species of aerobic bacteria were isolated and 76% of them were Sphingomonas paucimobilis, Pseudomonas fluorescens, Rhizobium radiobactor, or Stenotrophomonas maltophilia. A Pearson's correlation analysis revealed that the most influential factors for detecting Bacillus cereus were aerobic bacteria and coliforms. In other words, when the measured values of aerobic bacteria and coliforms were higher, the possibility that Bacillus cereus would appear increased. In a regression model to predict Bacillus cereus, the rate of appearance was correlated with aerobic bacteria and coliforms, and its contribution rate for effectiveness was 86%. Improving microbial quality control by pasteurization, spray dry, popping and extrusion resulted in a decrease in the numbers of Bacillus cereus, aerobic bacteria and coliforms in the raw materials. The results suggest that a hazard analysis and critical control point system might be effective for reducing microbiological contamination.

A Study of Adverse Events that Occurred after Taking Herbal Medicine - Focused on Children and Adolescents (한약 복용 후 발생한 유해사례에 대한 연구 - 소아·청소년을 중심으로)

  • Lee, Ji Hong;Yu, Sun Ae;Lee, Seung Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.28 no.3
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    • pp.1-16
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    • 2014
  • Objectives The purpose of this study is to investigate the incidence and clinical features of adverse events associated with herbal medicine, and to analyze their causality and severity. Methods This study was carried out from 159 children and adolescents who took herbal medicine in the Department of Pediatrics, ${\bigcirc}{\bigcirc}$ Korean Medical Hospital from december, 2013 to april, 2014. The data was collected by survey in person or telephone. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to analyze causality for each adverse events. Results 1. 207 cases were surveyed from 159 children and adolescents who took one or more kinds of herbal medicine. 2. A total of 12 general adverse events (5.8%) were reported from the study. Among these adverse events, 8 cases (3.9%) were associated with herbal medicine. 3. Gastro-intestinal system disorders were most frequently reported (70%) as adverse events, which is followed by psychiatric disorders (15%), skin and appendages disorders (10%), urinary system disorders (5%). 4. The most common clinical symptom was abdominal pain (20%), followed by diarrhea (15%), loose stools (10%), vomiting (10%) and borborygmus (10%). 5. The severity of adverse drug reactions was mostly mild (87.5%), and moderate (12.5%). There was no severe case. Conclusions The adverse events from herbal medicine on children and adolescents were mostly minor, most of them could continue herbal medicines.

Understanding the Mechanism of Indomethacin-Saccharin Co-crystal Formation Using In-line Monitoring System based on PVM and FBRM (PVM 및 FBRM 기반 인라인 모니터링을 통한 indomethacin-saccharin 공결정의 생성 메커니즘이해)

  • Kim, Paul;Cho, Min-Yong;Choi, Guang J.
    • Korean Chemical Engineering Research
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    • v.55 no.2
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    • pp.180-189
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    • 2017
  • Pharmaceutical co-crystals primarily to improve the solubility as well as stability of insoluble drug are to be investigated more intensively for IMDs as US FDA has reclassified co-crystal as a special case of solvates in August this year. In this study, we proposed a mechanism of indomethacin-saccharin co-crystal formation and the creation of transient indomethacin meta-stable form using in-line monitoring tools with the addition rate of anti-solvent as a critical process parameter. Among various instruments, we combined PVM (particle vision measurement) and FBRM (focused beam reflectance measurement) for the in-line monitoring of anti-solvent co-crystallization process. The off-line characterization of resulting powders was carried out employing the PXRD (powder x-ray diffraction) and DSC (differential scanning calorimeter). It was observed that the pathway to the final IMC-SAC co-crystal was significantly dependent upon the anti-solvent addition rate. The process conditions to obtain high quality co-crystal powder effectively were established. Consequently, we concluded that in-line monitoring combing the PVM and FBRM should be useful for the in-line monitoring of pharmaceutical co-crystallization processes.

Recent Advancements of Treatment for Leptomeningeal Carcinomatosis

  • Gwak, Ho-Shin;Lee, Sang Hyun;Park, Weon Seo;Shin, Sang Hoon;Yoo, Heon;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.1-8
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    • 2015
  • Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

Issues in 2-year Long-term in vivo Carcinogenicity Assay (2년 장기 발암성 검색법의 이슈)

  • Son, Woo-Chan;Kim, Bae-Hwan;Jang, Dong-Deuk;Han, Beom-Seok;Kim, Jong-Choon;Lee, Je-Bong;Shin, Jin-Sup;Kim, Hyoung-Chin
    • The Korean Journal of Pesticide Science
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    • v.8 no.4
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    • pp.239-254
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    • 2004
  • It has been debating about conducting and interpretating of 2-year rodent carcinogenicity bioassay. Although some criticisms arising in usefulness, it has been still known that long-term carcinogenicity studies using rodents would be the only assay system to predict any possible human risks, which would not be replaced. Both regulatory agencies and academies have developed some assay models, however, there have been controversy whether those study designs and interpretations are based on sound scientific rationale and validated data. Such kinds of issues including choice of species/strain, dose level selection, duration of study, number of animals per group, historical control data, monitoring parameters, terminal investigations, peer review, statistics, alternative assay models, interpretation of neoplastic lesions, and risk assessments, were reviewed.