• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6055-6059
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• 2015

Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

• 대한한의학회지
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• 제34권2호
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• pp.20-28
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• 2013

Objectives: This study examined the effects of 8 types of herbal prescriptions prescribed to alleviate dementia symptoms in a rat model of arterial thrombosis induced by ferric chloride ($FeCl_3$). Methods: Thirty minutes before 35% $FeCl_3$ treatment, SD rats were intraperitoneally injected with the 8 types of herbal prescriptions, respectively. We tested the effects of the herbal prescriptions on time to occlusion (TTO) in an arterial thrombosis model using a laser Doppler flow meter. In addition, thrombus weight (TW) and collagen fiber damages were evaluated in the same condition. Results: Herbal prescriptions showed the following rank-order based on their TTO: Chong-myung-tang (CMT) > modified Jangwonhan 02 (LMK02) > Toki-shakuyaku-san (TSS) ${\geq}$ Oren-gedoku-to (OGT) ${\geq}$ Yokukansan (YKS). In particular, CMT (100 mg/kg, i.p.) and LMK02 (100 mg/kg, i.p.) delayed the TTO the most ($14.83{\pm}0.98$ and $13.67{\pm}1.03$ min, respectively) compared with the vehicle group ($7.95{\pm}0.78$ min, P<0.001). In addition, CMT, LMK02, and OGT treatment ($0.63{\pm}0.01$, $0.66{\pm}0.02$ and $0.67{\pm}0.01$ mg/mm, respectively) significantly reduced thrombus weight compared with the vehicle treatment ($0.78{\pm}0.03$, P<0.001) and also alleviated collagen fiber damage (CMT; $28.40{\pm}2.22$%, LMK02; $30.79 {\pm} 4.07$%, OGT; $26.20{\pm}1.48$%) in the vessels injured by $FeCl_3$. Therefore, CMT and LMK02 showed the greatest preventive activity in rat model of arterial thrombosis induced by $FeCl_3$. Conclusions: These results provide experimental evidence for traditional use of herbal prescriptions, suggesting that CMT and LMK02 extracts could be used to prevent vascular injury and thrombosis in the early stages of dementia.

• 한국임상약학회지
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• 제21권2호
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• pp.106-114
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• 2011

1) 제주도 사업의 경우에 고양시보다 의료기관의 참여도가 높았는데 이것은 처방내에서 혹은 동일 의사의 처방내에서 병용금기나 중복의 발생을 줄이는 노력을 기울인 사실을 의미하였다. 빈도수에 있어서 병용금기는 고양시에서 처방전 1만 건당 0.45건 발생에서 제주도는 0건으로, 중복의 경우는 고양시에서 1만 건당 197건에서 제주도는 23건으로 감소하였다. 2) 하지만 제주도의 의료기관 참여도가 높음에도 불구하고 다른 의사 처방과의 점검에서는 병용금기 및 중복이 뚜렷이 감소하지 않았다. 병용금기의 발생은 고양시에서 1만 건당 4.95건에서 제주도의 경우 4.16건으로, 중복의 경우에 고양시의 경우 1만 건당 426건에서 제주도는 381건으로 감소하였지만 그 차이는 동일 의사 점검에서와 같은 뚜렷한 감소가 아닌 미세한 것이었다. 3) 두 지역을 통합하여 계산하였을 때 병용금기 발생의 동일 의사 점검: 다른 의사 점검의 비(比)(ratio)는 1:23으로 계산되었다. 4) 고양시 지역에서 중복의 발생은 동일 의사 점검: 다른 의사 점검의 비(比)(ratio)는 1: 2.12이었으며 제주도의 경우 그 비(比)(ratio)는 1:16.5이다. 5) 병용금기나 중복의 발생 문제 대부분이 다른 의사가 발행한 복수 처방에 의한 의약품의 병용에서 비롯하는 문제이며 이것은 의도하거나 인지하지 못한다는 점에서 단순 다제병용보다 심각한 문제를 포함할 수 있다. 6) 연구의 발견점은 의료 및 약사용 측면에서 통합성을 높이는 정책대안의 시급성을 시사하고 있으며 DUR제도의 확대강화와 단골약국 이용을 통하여 이러한 목표를 향한 정책을 지지해주는 결과라고 볼 수 있다.

• 사상체질의학회지
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• 제20권3호
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• pp.107-117
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• 2008

1. Objective The aim of this study was to survey the adverse reactions by the prescriptions of Soeumin.Soyangin and to compare the tendency of their symptoms according to Sasang constitutional type. 2. Methods The clinical data for this study were based on the medical records of total 91 cases collected from an oriental clinic during 1996-2004. Their constitutional types were diagnosed by a specialist and then confirmed by drug reactions. To evaluate reliability of the analysis, we only analysed the cases above grade C. The target prescriptions were Palmulgunja-tang, Bojungikgi-tang, Hyangsayangwi-tang, Ijung-tang, Hyeongbangsabaek-san, Jeoryeongchajeonja-tang, Yanggyeoksanhwa-tang, Yangdokbaekho-tang and the sorts of Jihwang-tang. 3. Results and Conclusion The prescriptions which were not suitable for their Sasang constitutional type induced indigestion, stomachache and evacuation troubles basically. Besides, the prescriptions of Soeumin caused some fever of the upper body and skin on Taeeumin and Soyangin. And the prescriptions of Soyangin lead to more severe digestive and evacuation troubles on Taeeumin and Soeumin. 4. Conclusion: This study need to be compensated by additional clinical studies which are more systematic and continuous. This way we can make the firm evidence for approving the difference of drug susceptibility according to the Sasang constitutional type.

• 한국의사학회지
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• 제27권2호
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• pp.11-37
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• 2014

Objectives : The purpose of this study was to analyze and identify the problems of the changes in regulations that are relevant to approval, notification, and review of herbal medicinal preparations and crude drug preparations. Methods : I collected the regulations of approval, notification, and review of medicinal products mostly from official gazettes, analyzed enactment and amendments regarding herbal medicinal preparations and crude drug preparations, and studied it from the view point of Korean medicine field. Results : Regulations in regards to approval, notification, and review of herbal medicinal preparations and crude drug preparations were first established in 1978. Herbal drugs started to be categorized as crude drug preparations in 1981 and the regulatory outlines were completed in 1999. From 2008 to 2012, the regulatory standards that let crude drug preparations be new drugs from natural products were established. Through those procedures, the followings became crude drug preparations: 1) wholly new prescriptions that are not recorded in Korean Medical Classics, 2) prescriptions that are recorded in Korean Medical classics but prepared with new standard, composition and efficacy, 3) prescriptions that are recorded in Korean Medical classics but prepared with new formulation, and 4) herbal drugs. In case of herbal medicinal preparations, however, only regulations that are related to 1) drugs prepared with new compositions that are not recorded in Korean Medical Classics, 2) drugs with same prescription and same formulation, and 3) drugs with new formulation were arranged. Conclusions : Actual circumstances on crude drug-oriented regulations regarding approval, notification and review and future forms of prescription and drug administration in Korean Medical Institutions can be expected due to expansion in range of herbal medicinal preparations and shrink in that of on-site preparations. Reasonable improvement in efficient usage of modernized herbal medicinal preparations in Korean medical institutions and prospective cooperation from related pharmaceutical industry are needed.

• 대한한의학방제학회지
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• 제13권1호
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• pp.161-178
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• 2005

This report describes 47 studies related to the use of Fructus Schisandra main blended prescriptions from Donguibogam. The following conclusions were reached through investigations on the prescriptions that use Fructus Schisandra as a key ingredient. 1.34% of a cough, 10.6% of a consumptive disease, recorded the largest number of clinical frequency of the prescriptions in therapeutic use when Fructus Schisandra was taken as a monarch drug in prescriptions 2. Prescriptions that utilize Fructus Schisandra as the main ingredient are used in the treatmeant of a cough, a consumptive disease, an exogenous febrile disease, a carbuncle, and cellulitis, and they are also used for treating 11 different types of diseases. 3. The prescriptions are compounded with Fructus Schisandra as a monarch drug can apply to a deficiency syndrome of the lung a deficiency syndrome of both the lung and the stomach, a deficiency syndrome both the spleen and the lung a deficiency syn-drome of the kidney, a hypofunction of the bladder with cold syndrome, a cold of insufficiency type, a deficiency syndrome of the heart, a heat syndrome of the stomach, an affective by cold, an invasion by wind, a consumptive disease. 4. The dosage of Fructus Schisandra is 5pun(about 1.88g) to 5jeon(about 18.75g), however 1jeon(about 3.75g) has been taken the most for clinical application. 5. When Fructus Schisandra is combined with base prescriptions such as Ijintang Chungliongsan, Saengmaksan, it applies symtoms of cough. In addition, when Fructus Schisandra is combined with base prescriptions such as Liukmizihwangtang, Ssangbohwan, Sipjeondaebotang, it utilizes a consumtive disease.

• 한국의료질향상학회지
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• 제14권2호
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• 약학회지
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• 제47권6호
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• pp.390-397
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• 2003

It is common that geriatric patients are on several medications at the same time. With this situation on hand, this study has collected prescriptions of individual geriatric patient and investigated possible drug interactions. In order to minimize the drug interactions and protect those patients from adverse reactions of medication, the gradual implementation and management of the medication history of each individual patient, the establishment of medication counseling system on medicines particularly in need of obligatory advice, the use of an inspection system on drug interactions at the time of prescription, and the implementation of a patient monitoring system on the drugs with narrow margin of safety at hospitals.

• 대한한의학방제학회지
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• 제15권2호
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• pp.47-64
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• 2007

This report describes 94 prescriptions related to the use of Radix Angelicae Dahuricae main bl ended from Donguibogam. The following conclusions were reached through investigations on the prescriptions that use Radix Angelicae Dahuricae as a key component. 11.7% of wind. 10.6% of carbuncle and deep-rooted carbuncle. recorded the largest number of clinical frequency of the prescriptions in therapeutic use when Radix Angelicae Dahuricae was ta ken as a monarch drug in prescriptions, Prescriptions that utilize Radix Angelicae Dahuricae as t he main component are used in the treatment of apoplexy and carbuncle and deep-rooted carbuncle. headache. wound and they are also used for treating 26 different types of diseases. The prescriptions are compounded with Radix Angelicae Dahuricae as a monarch drug can ap ply to apoplexy, exogenous febrile disease, invasion by wind. wind-cold pathogen, wind-heat path ogen. epidemic disease, pestilence. bruise, bites, deficiency of liver and kidney, deficiency, phlegm-fire, phlegm-heat. The dosage of Radix Angelicae Dahuricae is 0.37g to 7.5g, however 3.75g has be en taken the most for clinical application. The function of Radix Angelicae Dahuricae is to expelling Wind and relieving pain, to expelling wound and forming muscle. to astrict and neutralizing poison. to expelling wind and to getting through body hole. to emit and relieving pain from the combination of drugs and prescriptions.

• 한국임상약학회지
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• 제34권1호
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• pp.62-70
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• 2024

Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.