• 제목/요약/키워드: Drug utilization

검색결과 220건 처리시간 0.024초

사망 전 노인들의 보완대체요법 이용수준 및 관련 요인 (Utilization Level and Associated Factors of Complementary and Alternative Medicine in the Older Population before Death)

  • 조남홍;우은경;이지전;이상욱;조항석;김선현
    • Journal of Hospice and Palliative Care
    • /
    • 제7권1호
    • /
    • pp.37-48
    • /
    • 2004
  • 목적: 보완대체요법을 이용하는 인구 및 비용이 전 세계적으로 꾸준히 늘고 있다. 젊은 인구에 비해 노인인구에서 이용량이 높을 것으로 생각된다. 본 연구에서는 노인사망자를 대상으로 사망전 6개월간의 보완대체요법 이용실태를 조사하고자 했다. 방법: 2001년 하반기동안 사망한 후 건강보험에서 장제비를 지급 받은 서울지역 65세 이상 노인 4210명을 선정하였다. 이들을 성별 연령별로 배열하여 14명씩 총 301군으로 구분하였고, 각 군에서 1명씩 선택하여(총 301명) 사망시 연령, 성별, 사망 원인질환, 보완대체요법에 대한 설문조사를 시행하였다. 보완대체요법은 심신조정요법, 한의학 관련요법, 한방민간요법, 식이 영양 요법, 수기신체 치료 요법, 약물요법, 에너지 요법으로 총 7가지 영역으로 구분하였다. 결과: 사망 전 6개월간 보완대체요법을 이용한 사망자는 247명으로 전체 대상자의 83.1%였다. 보완대체요법중 특히 식이 영양 요법의 이용률(65.5%)이 가장 높았고 약물요법(29.9%)도 많이 이용하였다. 성별과 사망원인에 따라 이용률에 유의한 차이를 보였는데 여성(60%)이 남성(40%)보다 높았고, 노인성 질환군(30.8%)이 가장 높고, 암인 군(16.8%)이 가장 낮았다. 보완대체요법의 전체 만족도와 부작용 점수를 보면 6점 만점에 평균 4.25점, 부작용은 평균 5.55점으로 부작용이 거의 없었다. 식이 영양요법의 만족도(평균4.41점)가 가장 높았고 수기신체치료요법(평균 3.38점)이 가장 낮았다. 수기신체치료요법에서 부작용이 가장 없었고(평균 5.88점), 한의학 관련요법의 부작용 점수가 가장 낮았다(평균 5.35점). 또한 연령과 사망원인 질병에 따라 만족도와 부작용 수준에 유의한 차이를 보였다. 결론: 65세 이상 노인의 대다수가 사망전 6개월간 보완대체요법을 이용하였으며 전체 만족도도 상당히 높고 부작용도 거의 없었다. 현실적인 대안을 마련하는 것이 필요하다.0.04{\pm}0.20$ P=0.1519), 우울 정도, 불안 정도, 스트레스 정도는 자가치료 순응도가 좋을수록 감소하는 경향을 보였으나, 통계적으로 유의하지는 않았다. 아로마 자가 치료군에서 수축기 혈압은 약간 증가하였으나 통계학적 의의는 없었다($4.53{\pm}14.43mmHg\;vs\;0.0{\pm}7.22mmHg$, P=0.152). 자가 치료군에서 환자들은 두통(20%), 감각이상(6.7%), 오심(6.7%) 등의 부작용을 호소했으나, 이들 모두 일시적인 것으로 자가치료를 중단할 정도는 아니었다. 결론: 유방암 환자들에게 아로마 손 마사지 교육을 시킨 후 자기 스스로 2주간 시행한 결과, 통증강도, 우울 및 불안 정도가 의미 있게 감소하였다.임의 유무와 이유에 대해서는, '망설이지 않았다'(34명)가 '망설였다'(6명)보다 높게 나타났다. 사별가족모임에 참석한 후의 소감, 개선사항, 아쉬운 점에 대한 질문에는, 대부분의 응답자들이 '의미 있는 시간이었다', '사별가족에 대한 배려와 관심에 대해 감사한다.'라는 긍정적인 응답이 있었고, '고인에 대한 회상을 할 수 있는 자리여서 좋았다.' '사별가족모임이 일년에 한 번이 아니라 계속적으로 있었으면 한다.', '한편은 슬프고 한편은 기쁘다.' 등의 의견이 있었다. 사별 후 느끼는 가장 큰 어려움에 대해 참석가족은, '우울감'(10명), '외로움'(7명)의 빈도가 높았고, '그리움'(1명), '경제적/역할상 어려움'(4명), 무응답(6명)으로, '우울감'이 가장 큰 어려움으로 나타났다. 반면에, 비참석 가족에서는, 가장 큰 어려움은 '경제적/역할상 어려움'(6명), '외로움'(5명), '우울감'(3명), '후회감'(1명), '고인에 대한 원망감'(1명), '특별히 어려움이 없다'(1명)라고 답하였다. 결론: 호스피스 서비스를

  • PDF

Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
    • /
    • 제45권5호
    • /
    • pp.283-290
    • /
    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

Effect of different diets on growth and development of the two-spotted cricket, Gryllus bimaculatus (Orthoptera: Gryllidae)

  • Song, Myung-Ha;Han, Moon-Hee;Kwak, Kyu-Won;Lee, Seokhyun;Kim, Eun-Sun;Park, Kwan-Ho;Kim, Won-Tae;Choi, Ji-Young
    • International Journal of Industrial Entomology and Biomaterials
    • /
    • 제33권2호
    • /
    • pp.59-62
    • /
    • 2016
  • Many insects have gained increasing attention as an alternative protein for humans. Among those, the two-spotted cricket, Gryllus bimaculatus (Orthoptera: Gryllidae), was recently approved as a general food ingredient by the Korean Ministry of Food and Drug Safety. For industrial utilization of G. bimaculatus, mass rearing techniques and production system should be standardized first. In this study, we investigated the effects of five different feeds on the growth and development of G. bimaculatus. Feed is the one of the key factors that has considerable effects on rearing insects. With five different kinds of feed on $1^{st}$, $3^{rd}$, and $5^{th}$ instar nymphs, the change of survival rate, body weight were monitored up to eight wk after hatching. We concluded that 50% of soybean flour, 20% of corn powder, 10% of rice bran, 9% of milk serum, 10% of rice flour, 0.5% of microorganisms, and 0.5% of multivitamins and minerals (diet C) was the best mix for promoting growth and development of $3^{rd}$ instar nymphs compared to the control diet.

말기 암환자에 투여한 Heptaplatin의 신독성에 대한 후향적 평가 (Retrospective Evaluation of Heptaplatin Toxicities in Patients with Advanced Gastric Cancer)

  • 박미숙;강민희;임성실;최순옥;;이명구
    • 한국임상약학회지
    • /
    • 제16권2호
    • /
    • pp.131-138
    • /
    • 2006
  • Heptaplatin, a new platinum derivative, has several contradicting reports on the nephrotoxicity. Therefore, the aim of this study is to compare the toxicities of heptaplatin-containing regimens in the chemotherapy. This study was performed retrospectively on seventy-seven patients with advanced gastric cancer who did not receive chemotherapy within the last 1 months before taking of heptaplatin- or cisplatin-containing chemotherapy. The 38 patients among total patients was received heptaplatin-containing regimens (26 with SEF regimens: heptaplatin/epirubicin/5-FU, 12 with SF regimens: heptaplatin/5-FU) and the rest 39 patients was received cisplatin-containg regimens (11 with CEF regimens: cisplatin/epirubicin/5-FU, 28 with ELF regimens: epirubicin/leucovorin/5-FU). Before and after the chemotherapy serum creatinine (Scr) and proteinuria were measured by urine stick test in all patient groups. Also Scr was measured a day before the second cycle and did not vary significantly between groups. However Scr on cycle 3 were significantly higher in SEF and SF groups. In case of proteinuria, it was more frequent on cycle 1 in heptaplatin/5-FU group. Proteinuria before and after on cycle 2 was not different between the two cisplatin -containing groups, but was more frequent in heptaplatin-containing groups. The reason why the Scr measured was not so different could be because we excluded the patients who received only one cycle of heptaplatin and changed the regimen due to signs of nephrotoxcity. As the results nephrotoxicity such as protienuria was appeared to be more frequent with heptaplatin-treated patients. It suggests that the clinical consequences of the toxicity need to further evaluation and also the modalities to prevent or minimize nephrotoxicity of heptaplatin should be studied for future utilization of the drug.

  • PDF

Naesohwangryeon-tang Induced Apoptosis and Autophagy in A549 Human Lung Cancer Cells

  • Kim, Hong Jae;Jeong, Jin-Woo;Park, Cheol;Choi, Yung Hyun;Hong, Su Hyun
    • 대한약침학회지
    • /
    • 제22권4호
    • /
    • pp.269-278
    • /
    • 2019
  • Objectives: Naesohwangryeon-tang (NHT) is a type of traditional herbal formula, however, little is known about its antitumor activity. In this study, the antitumor properties of NHT was evaluated in human lung adenocarcinoma cells. Methods: To check the inhibitory effect of NHT, MTT assay was performed. Cell cycle analysis and detection of ROS production were conducted by flow cytometry. To evaluate the signaling pathway, Western blotting was conducted. Results: Our results showed that the decrease of cell proliferation by NHT stimulation occurred more significantly in A549 cells than in NCI-H460 cells. In addition, NHT-induced apoptosis was associated with the activation of caspases and production of reactive oxygen species (ROS). NHT-induced apoptosis was attenuated after pretreatments with z-VAD-fmk or N-acetylcysteine, suggesting that NHT-induced apoptosis was caspaseand ROS-dependent. Interestingly, NHT treatment led to the development of autophagic vesicular organelles and upregulation of several autophagy-related genes. The pretreatment of bafilomycin A1 decreased apoptosis slightly but increased cell viability in the presence of NHT. Conclusion: These findings indicated that NHT induces both apoptosis and cell-protective autophagy in human lung cancer cells. This data suggests that NHT might be a novel herbal drug for lung cancer.

국내 2018년 의약품 소비량 및 판매액 통계 산출 및 국제 비교 (A Critical Evaluation and International Comparison of Pharmaceutical Consumption and Sales Statistics)

  • 김지혜;이다희;김수연;김동숙
    • 보건행정학회지
    • /
    • 제30권3호
    • /
    • pp.311-325
    • /
    • 2020
  • Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

Barbigerone Inhibits Tumor Angiogenesis, Growth and Metastasis in Melanoma

  • Yang, Jian-Hong;Hu, Jia;Wan, Li;Chen, Li-Juan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권1호
    • /
    • pp.167-174
    • /
    • 2014
  • Tumor angiogenesis, growth and metastasis are three closely related processes. We therefore investigated the effects of barbigerone on all three in the B16F10 tumor model established in both zebrafish and mouse models, and explored underlying molecular mechanisms. In vitro, barbigerone inhibited B16F10 cell proliferation, survival, migration and invasion and suppressed human umbilical vascular endothelial cell migration, invasion and tube formation in concentration-dependent manners. In the transgenic zebrafish model, treatment with $10{\mu}M$ barbigerone remarkably inhibited angiogenesis and tumor-associated angiogenesis by reducing blood vessel development more than 90%. In vivo, barbigerone significantly suppressed angiogenesis as measured by H and E staining of matrigel plugs and CD31 staining of B16F10 melanoma tumors in C57BL/6 mice. Furthermore, it exhibited highly potent activity at inhibiting tumor growth and metastasis to the lung of B16F10 melanoma cells injected into C57BL/6 mice. Western blotting revealed that barbigerone inhibited phosphorylation of AKT, FAK and MAPK family members, including ERK, JNK, and p38 MAPKs, in B16F10 cells mainly through the MEK3/6/p38 MAPK signaling pathway. These findings suggested for the first time that barbigerone could inhibit tumor-angiogenesis, tumor growth and lung metastasis via downregulation of the MEK3/6/p38 MAPK signaling pathway. The findings support further investigation of barbigerone as a potential anti-cancer drug.

우리나라의 다제약제 현황과 적정관리 방안에 대한 고찰 (Reviews on the Current Status and Appropriate Management of Polypharmacy in South Korea)

  • 박혜영;손현순;권진원
    • 한국임상약학회지
    • /
    • 제28권1호
    • /
    • pp.1-9
    • /
    • 2018
  • Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가 (Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation)

  • 서예진;금민정;이경아;김재송;손은선;유윤미
    • 한국임상약학회지
    • /
    • 제30권3호
    • /
    • pp.149-160
    • /
    • 2020
  • Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

The Flavin-Containing Reductase Domain of Cytochrome P450 BM3 Acts as a Surrogate for Mammalian NADPH-P450 Reductase

  • Park, Seon-Ha;Kang, Ji-Yeon;Kim, Dong-Hyun;Ahn, Taeho;Yun, Chul-Ho
    • Biomolecules & Therapeutics
    • /
    • 제20권6호
    • /
    • pp.562-568
    • /
    • 2012
  • Cytochrome P450 BM3 (CYP102A1) from Bacillus megaterium is a self-sufficient monooxygenase that consists of a heme domain and FAD/FMN-containing reductase domain (BMR). In this report, the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and 5-cyano-2,3-ditolyl tetrazolium chloride (CTC) by BMR was evaluated as a method for monitoring BMR activity. The electron transfer proceeds from NADPH to BMR and then to BMR substrates, MTT and CTC. MTT and CTC are monotetrazolium salts that form formazans upon reduction. The reduction of MTT and CTC followed classical Michaelis-Menten kinetics ($k_{cat}=4120\;min^{-1}$, $K_m=77{\mu}M$ for MTT and $k_{cat}=6580\;min^{-1}$, $K_m=51{\mu}M$ for CTC). Our continuous assay using MTT and CTC allows the simple, rapid measurement of BMR activity. The BMR was able to metabolize mitomycin C and doxorubicin, which are anticancer drug substrates for CPR, producing the same metabolites as those produced by CPR. Moreover, the BMR was able to interact with CYP1A2 and transfer electrons to promote the oxidation reactions of substrates by CYP1A2 and CYP2E1 in humans. The results of this study suggest the possibility of the utilization of BMR as a surrogate for mammalian CPR.