• 제목/요약/키워드: Drug utilization

검색결과 219건 처리시간 0.024초

산초(Zanthoxylum schinifolium) 추출물의 다제내성 Acinetobacter baumannii 억제 효과 (Anitimicrobial Effects of Zanthoxylum schinifolium Extracts against Multi-drug Resistant Acinetobacter baumannii)

  • 이경호;이기형
    • 생약학회지
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    • 제42권4호
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    • pp.336-340
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    • 2011
  • The aim of this study was to investigate the possible utilization of Zanthoxylum schinifolium as a source of antimicrobial agents. The antimicrobial effects of Zanthoxylum schinifolium extracts were investigated against Acinetobacter baumannii, which is a multi-drug resistant pathogen, and 5 other pathogenic microorganisms. The hexane extract of Zanthoxylum schinifolium was more effective than the ethyl acetate, n-butanol and methanol extracts which were active against Acinetobacter baumannii 25, with minimum inhibitory concentrations(MIC) ranging from 0.8 mg/ml to 1.6 mg/ml. Tetracycline had no effect on Acinetobacter baumanniii. The hexane extract was highly active against Candida albicans IFO 6258, with an MIC of 1.5 mg/ml. In contrast, the ethyl acetate, n-butanol and methanol extracts showed no activity against the 5 pathogenic microorganisms. Furthermore, a combination of hexane extract and ethyl acetate extract was significantly more active against the 5 Acinetobacter baumannii strains than n-butanol and methanol. These results suggest that Zanthoxylum schinifolium extracts have great potential as antimicrobial compounds against multi-drug resistant pathogens, and further studies are warranted.

생강의 약물대사효소 CYP3A4 저해 성분 (The Inhibitory Constituents from the Ginger on a Drug Metabolizing Enzyme CYP3A4)

  • 차배천;이은희;권준택
    • 약학회지
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    • 제48권5호
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    • pp.266-271
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    • 2004
  • Ginger (Zingiber officinale Roscoe) is widely used as a common condiment for a variety of foods and beverages. In addition to its extensive utilization as a spice, the fresh or the processed rhizome is a useful crude drug in traditional Chinese medicine. It is considered to possess stomachic, carminative, stimulant, diuretic and antiemetic properties. Chemical studies on the pungent principles of ginger have been carried out by a number of investigators, and 6-gingerol and 6-shogaol as a major pungent substance have been isolated. In this study, the constituents inhibiting a drug metabolizing enzyme CYP3A4 from ginger were investigated. CYP3A4 is responsible for drug metabolism as heme-containing monooxygenases. As a result of experiment, 10-gingerol (lC$_{50}$ 5.75$\mu$M) isolated from EtOAc extract of ginger showed remarkable inhibitory activity compared to 6-gingerol ($IC_{50}$/ 14.56 $\mu$M) and zingerone ($IC_{50}$/ 379.63 $\mu$M). This paper describes the isolation, structure elucidation, and CYP3A4 inhibitory activity of these compounds. The structure of the compounds were identified by instrumental analysis such as LC-mass spectrometer and NMR.R.

스타틴 의약품의 약가인하 효과 및 약물 교체 관련 요인: 건강보험심사평가원 환자표본자료를 이용한 분석 (Impact of Price Control on Drug Expenditure and Factors Associated with the Drug Switch among Statins: Analysis of HIRA-NPS Data)

  • 이혜재;이태진
    • 보건행정학회지
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    • 제23권2호
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    • pp.112-123
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    • 2013
  • Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

강직성 척추염 환자에 대한 약물사용 현황 분석 (Analysis of Drug Utilization for Patients with Ankylosing Spondylitis)

  • 강한빈;제남경
    • 한국임상약학회지
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    • 제25권4호
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    • pp.246-253
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    • 2015
  • Background & Object: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes ankylosis and deformation of axial joints. Since current medicine cannot cure the disease yet, alleviating pain and preventing deformation with medications are the main therapy for patients with AS. The key medications for these purposes include nonsteroidal anti-inflammatory drugs (NSAIDs), and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) inhibitors. This study aims to analyze prescribing patterns of AS patients in South Korea. Method: National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 was analyzed. Patients with AS were identified with Korean Standard Classification of Diseases code-6, which was M45. The rates of prescription, discontinuation, and switching ingredients were calculated for each medication during 2013. Results: Total number of patients was 655, and most of them were male (n = 514, 78.5%). Of all age groups, the proportion of 30-40 year old patients was the greatest (35.1%). The most utilized drug class was NSAIDs (82.4%). Less than half of patients were prescribed $TNF-{\alpha}$ inhibitors (n = 212, 32.4%). Meloxicam, aceclofenac, and celecoxib were the most frequently prescribed NSAIDs. In case of $TNF-{\alpha}$ inhibitors, adalimumab, etanercept and infliximab were the top three most prescribed drugs. Although not recommended by the current practice guideline, significant proportions of patients were identified using disease modifying anti-rheumatic drugs (DMARDs). Conclusion: Considering the current practice guideline and previous studies about the efficacy, the use of DMARDs should be reduced and medical insurance term in South Korea should be re-examined.

Basic concepts, recent advances, and future perspectives in the diagnosis of bovine mastitis

  • Samah Attia Algharib;Ali Sobhy Dawood;Lingli Huang;Aizhen Guo;Gang Zhao;Kaixiang Zhou;Chao Li;Jinhuan Liu;Xin Gao;Wanhe Luo;Shuyu Xie
    • Journal of Veterinary Science
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    • 제25권1호
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    • pp.18.1-18.27
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    • 2024
  • Mastitis is one of the most widespread infectious diseases that adversely affects the profitability of the dairy industry worldwide. Accurate diagnosis and identification of pathogens early to cull infected animals and minimize the spread of infection in herds is critical for improving treatment effects and dairy farm welfare. The major pathogens causing mastitis and pathogenesis are assessed first. The most recent and advanced strategies for detecting mastitis, including genomics and proteomics approaches, are then evaluated. Finally, the advantages and disadvantages of each technique, potential research directions, and future perspectives are reported. This review provides a theoretical basis to help veterinarians select the most sensitive, specific, and cost-effective approach for detecting bovine mastitis early.

마황 3종 판별을 위한 KASP 마커 개발과 활용 (Development and Utilization of KASP Markers for the Identification of Three Types of Ephedra Herbs)

  • 박보름;이선희;한경문;황진우;김형일;백선영
    • 생약학회지
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    • 제53권4호
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    • pp.226-233
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    • 2022
  • Ephedra herbs are defined as stem of Ephedra sinica , Ephedra intermedia and Ephedra equisetina in the Korean Pharmacopoeia. It is important to use pure herbs to derive the safety and efficacy of herbal medicine. However, the identification of these herbs by conventional taxonomic methods is difficult. Recently, many studies have applied these DNA barcoding for the identification of herbal medicinal species using standard DNA markers. In this study, we report a case study in which the identification of Ephedra species was done by DNA barcoding. For identification of Ephedra species, 17 samples were collected, and a reference DNA barcode library was developed using 6 markers (rbcL, matK, ITS2, ycf1, ycf3, and rpoC2). To develop KASP-SNP markers, we selected 4 markers (ycf1, ycf3, rpl2, and rbcL), which were able to distinguish three Ephedra species. In the result, the specific markers for each of the three Ephedra were clustered into FAM-positive section, whereas non-targeted plants were clustered either HEX-positive or negative section. Therefore, we have developed KASP assay that allow rapid and easy Ephedra species identification using three KASP markers.

Drug Use Evaluation of Letrozole in Breast Cancer Patients at Regional Cancer Hospitals in Thailand

  • Ketkaew, Chaninun;Kiatying-Angsulee, Niyada
    • 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.

전국 한방의료기관 한의사 대상 한의 변증활용 현황 조사 (A National Survey on Utilization of Pattern Identification among Korean Medicine Doctors)

  • 여민경;박기현;장은수;이영섭
    • 대한예방한의학회지
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    • 제19권3호
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    • pp.45-55
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    • 2015
  • Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.

일부(一部) 농촌주민(農村住民)의 상병(傷病) 및 의료실태(醫療實態)에 관(關)한 조사연구(調査硏究) (A Study on Sickness and the Status of Medical Care in a Rural Area)

  • 박정선
    • Journal of Preventive Medicine and Public Health
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    • 제14권1호
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    • pp.65-74
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    • 1981
  • This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

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Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging

  • Jung, Sung Mee
    • Journal of Yeungnam Medical Science
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    • 제37권3호
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    • pp.159-168
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    • 2020
  • The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. The traditional drugs, such as chloral hydrate, pentobarbital, midazolam, and ketamine, are still used due to the ease of administration despite low sedation success rate, prolonged recovery, and significant adverse events. Currently, dexmedetomidine, with respiratory drive preservation, and propofol, with high effectiveness and rapid recovery, are preferred for children undergoing ambulatory MRI. General anesthesia using propofol or sevoflurane can also provide predictable rapid time to readiness and scan times in infants or children with comorbidities. The selection of appropriate drugs as well as sufficient monitoring equipment are vital for effective and safe sedation and anesthesia for ambulatory pediatric MRI.