Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.
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
/
pp.27-33
/
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.
Kwon Duck Yun;Bae Young Chun;Lee Sang Min;Yoo Kwan Seok;Joo Jong Cheon;Kim Kyung Yo
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.4
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pp.1071-1077
/
2004
Mudanpi (Cortex Moutan Radicis; the root cortex of Paeonia suffruticosa Andrews) is an important Chinese crude drug used in many oriental prescriptions. 1,2,3,4,6-Penta-O-galloyl-beta-D-glucose (PGG), a major component of this crude drug, has been shown to possess potent antioxidant, anti-mutagenic and anti-proliferative effects. In this study, I examined whether PGG could protect Neuro 2A cells, a kind of neuronal cell lines, from oxidative damage through the induction of HO-1 expression and HO activity. Exposure of Neuro 2A cells to PGG (10-50μM) resulted in a concentration- and time-dependent induction of HO-1 mRNA, and protein expressions and heme oxygenase activity. PGG protected the cells from hydrogen peroxide-induced cell death. The protective effect of PGG on hydrogen peroxide-induced cell death was abrogated by zinc protoporphyrin IX (ZnPP IX), a HO inhibitor. These results indicate that PGG is a potent inducer of HO-1 and HO-1 induction is responsible for the PGG-mediated cytoprotection against oxidative damage.
To analyze scientifically the fundamental formulation theory and drug interaction on the purgative action of Chungpesagan-tang, which is one of the traditional Korean medical prescriptions that has been most frequently used for stroke, water extracts of herbal medicines with Rhei Rhizoma were administered into mice and the purgative action was measured. Water extracts of Raphani Semen or Cimicifugae Rhizoma with Rhei Rhizoma had more potent purgative activity than Rhei Rhizoma alone, although Raphani Semen alone displayed no purgative action. However, Platycodi Radix and Puerariae Radix inhibited the purgative action of Rhei Rhizoma. When Rhei Rhizoma with Raphani Semen or Cimicifugae Radix was extracted with water, sennoside A content in the water extract was increased. However, Puerariae Radix and Platycodi Radix decreased the content of sennoside A in the extracted water. The transforming rate of sennoside A of Rhei Rhizoma was inhibited by Puerariae Radix and Platycodi Radix. The transforming rate of sennoside A of Chungpesagan-tang to rheinan-throne by human intestinal microflora and its purgative activity were similar to those of Rhei Rhizoma. Finally we thought that the purgative action of Chungpesagan-tang could be controlled by the addition and subtraction of Chungpesagan-tang-composing herbal medicines.
Background : In Korea, the rational use of antibiotics are rarely controlled, and their patterns of utilization are not understood. In order to reduce the excessive use and to improve the appropriate use of antibiotics, it is necessary to accurately determine present uses of antibiotics in hospitals. Methods : Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. A stratified sampling by types of hospitals, departments, and diseases was obtained from 1994 August data. Patients with secondary diseases were excluded. In this study, 2,697 adults with URI, 6,397 children with URI, 704 adults with bronchitis, and 1,838 children with bronchitis were included. Results : Most patients were prescribed medication (95.2-99.6%). Of the patients prescribed medication, more than 85% of URI patients and more than 91% of bronchitis patients were prescribed antibiotics. Antibiotics expenses accounted for 14% of total medical expenses in adults and 9% of total medical expenses in children. In adults with URI, antibiotics expenses accounted for 52% of drug expenses. Of the patients prescribed antibiotics, average number of antibiotics used was 1.6-1.7. For patients who are prescribed antibiotics, drug expenses were 62-97% greater than patients not prescribed antibiotics. When children were prescribed antibiotics, the highest price of drugs prescribed were 3.4-fold greater. In addition, the number of drugs prescribed also increased by more than one. Elderly patients, more than 60 years, were prescribed antibiotics less frequently. Children less than 10 years and elderly patients greater than 60 years old were prescribed fewer antibiotics than other patients. And they were prescribed medications for longer days than other patients. Conclusion : This study demonstrated that the average rate of prescribing antibiotics was higher in Korea than other countries. Measures to reduce overuse of antibiotics and to improve the appropriate prescription of antibiotics must be considered for cost effective treatment and overall health of people.
Objectives : This study was conducted to investigate the research trends of herbal medicine prescriptions and herbal medicines with anti-inflammatory effects. Methods : Among the papers published in oriental medicine from 2015 to 2020(1st half), experimental papers to reveal anti-inflammatory effects were collected, and finally 198 papers were selected. The anti-inflammatory effects of each herb were summarized, and were analyzed by year, journal, experimental subjects and experimental types. Results : 1. Of the 198 papers, there were 186 papers proving anti-inflammatory drug efficacy, 6 papers comparing efficacy between drugs, and 6 papers comparing the efficacy of packaging or storage of drugs. 2. The number of anti-inflammatory drug articles published from 2015 to the first half of 2020 was 35(2015), 35(2016), 38(2017), 44(2018), 34(2019), 12(2020). 3. Papers were published in a total of 18 journals, of which 58(29.3%) were published by the Korea Journal of Herbology. 4. There were 101 papers on single herbs(51.0%) and 78(39.4%) papers on combination drugs. 71 types of single herbs were used in a total of 101 papers, of which Cheongyeol was the most common with 28. 5. Of the 198 papers, 87 in vivo papers and 125 in vitro papers were published, and 14 papers were both conducted. In vitro experiments demonstrated the efficacy of anti-inflammatory drugs in various inflammatory indicators such as NO, PGE2, and in vivo experiments demonstrated the efficacy of anti-inflammatory drugs in various inflammatory diseases such as musculoskeletal, digestive, dermal diseases.
Objectives : The root bark of Dictamnus dasycarpus has been frequently used to treat patients with skin diseases in Korea. Recently, wild root of D. dasycarpus are reported to induce liver injury. Methods : Traditional uses of D. dasycarpus for skin diseases were analysed bibliographically. In addition, reported cases were collected and analysed using pubmed and national digital library. Results : In taiwan, D. dasycarpus revealed to be one of major herbs for skin diseases and many researchers in worldwide had reported its dermatological efficacies. Reported cases related in liver injury described that hepatocellular or cholestatic liver injury were seen in patients eating wild root of D. dasycarpus. In addition, 6 cases in worldwide and 1 case in Korea showed that patients with drug induced liver injury (DILI) ingested not root bark of D. dasycarpus but prescriptions containing root bark of D. dasycarpus. These mean that wild root of D. dasycarpus (Bongsam or Bongwhangsam) was estimated to be closely related in DILI. Whereas, it was difficult to confirm direct correlation between root bark of D. dasycarpus used as herbal medicine by doctor of Korean medicine and DILI. Conclusions : these results imply that wild root of D. dasycarpus is closely related in DILI and strong recommendation not to take it without consultation by experts is needed. In addition, although there are no evidences of direct correlation between root bark of D. dasycarpus and DILI, doctor of Korean medicines should pay attention to use root bark of D. dasycarpus in their clinics.
Kim, Eun-Ji;Hwang, Eun-Jung;Yoo, Yeong-Min;Kim, Kyung-Hoon
The Korean Journal of Pain
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v.35
no.4
/
pp.361-382
/
2022
The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.
Kim, Hye Yeon;Kim, Tae Hwan;Kim, Sang Min;Lee, Sun Haeng;Lee, Jin Yong
The Journal of Pediatrics of Korean Medicine
/
v.37
no.1
/
pp.45-57
/
2023
Objectives This study aimed to provide a basis for the research on the trend and safety of Korean herbal medicines among children and adolescents. Methods Patients aged <19 years who received outpatient treatment at the Korean pediatrics department of Kyung Hee University Hospital from January 1, 2017 to October 31, 2022 were included. The current state of annual visits and herbal medicine prescriptions was analyzed. A retrospective chart review was conducted by examining the medical records of subjects who received herbal medicines, including deer antler. Adverse drug reactions in patients who received herbal medicine were also investigated. Results A total of 57,457 people visited the Korean pediatrics department, and 51,768 people (90.1%) were prescribed herbal medicine. Among these, 21,826 patients (42.2%) were prescribed with deer antler. A total of 117 adverse drug reactions were reported among the patients who received herbal medicines. Conclusions This study aimed to determine the trends and safety of herbal medicine treatment, particularly deer antlers, in children and adolescents. Well-designed, long-term, multi-institutional follow-up studies are required to expand the field of Korean pediatrics.
Kim, An-Na;Lee, Chia-Wei;Oh, Yong-Taek;Jang, Hyun-Chul;Kim, Hong-Jin
Journal of Haehwa Medicine
/
v.23
no.1
/
pp.21-55
/
2014
Objectives : This report describes the original references of 154 formulas related to the use of Rhei Rhizoma main blended from Dongeuibogam. Methods : This study analyzes the original references of 154 formulas including Rhei Rhizoma as a key component in Dongeuibogam. Results : There were five types as follows: 1.There is no exact match between 154 formulas in Dongeuibogam and the original formulas in references. 2. Case that could not found the original formula in reference: 22%. 3. Case that the citation is the similar to the original reference: 4%. 4. Case that the citation is not same to expression but contents basically: 73%. 5. Case of addition of content: 1% Conclusions : Most formulas related to the use of Rhei Rhizoma main blended from Dongeuibogam are similar to the contents in the original references. But we can find that Heo Jun, who writes Dongeuibogam, modifies the contents for his intention of editing, idea and situation in Korea.
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