• Title/Summary/Keyword: GI drugs

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Use of Gastrointestinal Drugs in Patients without Digestive Symptoms (소화기계 무증상환자에 대한 소화기계 약제 투약현황)

  • Ko, Hee Kyung;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.2
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    • pp.57-61
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    • 2000
  • Gastrointestinal (GI) medications have been administered to many patients without any gastrointestinal diseases. The objectives of this study were to evaluate use of GI drugs and assess related factors. Medical records of 600 outpatients were reviewed from January 1997 to December 1997 at A Hospital, Kyunggi-do, Korea. Fifty patients every month among all outpatients were randomly selected up to total 600 patients. Surgical patients, visitors for regular health examination and inpatients were excluded. GI symptoms included nausea, vomiting, diarrhea, dyspepsia, constipation, heartburn, dysphagia and abdominal pain. The prescribed gastrointestinal drugs were antacids. $H_2$-antagonist, sucralfate, cisapride, omeprazole, laxatives, digestive enzymes and antidiarrheal agents. Patients without GI symptoms were 348 out of 600 outpatients who were screened. Two hundred and eighty two of 348 patients $(81\%)$ were given GI drugs though they did not have any GI symptoms. There were no differences in regard to sex and age of patients. Most of medical departments prescribed gastrointestinal drugs for these patients. The most frequently prescribed drugs were in order of digestive enzyme, antacids and $H_2$-antagonists. In view of economic aspects, patients paid 12.28 percents of total cost per prescription for unnecessary medicines. The medical practice of prescribing GI drugs should be assessed to define appropriate subgroups to have benefits with prophylactic administration and to reduce adverse effects caused by drug interactions. Pharmacists would have a significant role to promote rational drug therapy.

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Analysis of Frequently Diagnosed Gastrointestinal Disorders and Therapeutic Regimens in the Outpatients (외래환자의 위장관계 다빈도 질환과 처방 분석)

  • Kim, Min Jeong;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.22-32
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    • 1997
  • The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

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Potentially Unnecessary Gastrointestinal Drug Use in Patients with Acute Cystitis (외래 급성 방광염 환자에서 잠재적으로 불필요한 위장약 사용)

  • Taeyeon Kim;Song Hyeon Jeon;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.8-21
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    • 2023
  • Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

Autophagy and Digestive Disorders: Advances in Understanding and Therapeutic Approaches

  • Thein, Wynn;Po, Wah Wah;Choi, Won Seok;Sohn, Uy Dong
    • Biomolecules & Therapeutics
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    • v.29 no.4
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    • pp.353-364
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    • 2021
  • The gastrointestinal (GI) tract is a series of hollow organs that is responsible for the digestion and absorption of ingested foods and the excretion of waste. Any changes in the GI tract can lead to GI disorders. GI disorders are highly prevalent in the population and account for substantial morbidity, mortality, and healthcare utilization. GI disorders can be functional, or organic with structural changes. Functional GI disorders include functional dyspepsia and irritable bowel syndrome. Organic GI disorders include inflammation of the GI tract due to chronic infection, drugs, trauma, and other causes. Recent studies have highlighted a new explanatory mechanism for GI disorders. It has been suggested that autophagy, an intracellular homeostatic mechanism, also plays an important role in the pathogenesis of GI disorders. Autophagy has three primary forms: macroautophagy, microautophagy, and chaperone-mediated autophagy. It may affect intestinal homeostasis, host defense against intestinal pathogens, regulation of the gut microbiota, and innate and adaptive immunity. Drugs targeting autophagy could, therefore, have therapeutic potential for treating GI disorders. In this review, we provide an overview of current understanding regarding the evidence for autophagy in GI diseases and updates on potential treatments, including drugs and complementary and alternative medicines.

A Sasang Constitutional Study on the Myunghyun Symptom (명현현상(瞑眩現狀)에 대한 사상의학적(四象醫學的) 고찰(考察))

  • Jeong, Yong-Jae;Lee, Jun-Hee;Lee, Soo-Kyung;Kim, Dal-Rae;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.1
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    • pp.20-27
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    • 2009
  • 1. Objects Myunghyun Symptom(瞑眩現狀) is widely regarded as 'symptoms of discharge the accumulated poison in body', 'symptoms in the process of healing' apart from any other side effects of drugs. Recently, Natural Medicine of Europe and the U.S.A named it 'healing crisis'. However, this tends to be used indiscriminately. I took a look at the meaning of the Myunghyun Symptom correctly, and the meaning at a point of Sasang Constitutional view 2. Methods It was researched on the literal study about the meaning of the Myunghyun Symptom on the book "Seokyung"(書經), "Dongeuibogam(東醫寶鍵)", "Dongyi Suse Bowon(東醫壽世保元)", "Yakjing(藥徵)", and the meaninig at a point of Sasang Constitutional view through the "Dongyi Suse Bowon(東醫壽世保元)", "Dongyi Suse Bowon Sasang Chobonguen(東醫壽世保元 四象草本卷)". 3. Results and Conclusions 1. The original meaning of the Myunghyun symptom is 'dizziness by the use of massive effective drugs'. 2. Yoshimasu Todo interprεtated broadly the Myunghyun symptoms as the discharge of the accumulated poison in body, the symptoms in the process of healing. 3. Dongmu recognized the Myunghyun symptom as dizziness by massive effective drugs and shun the use of massive effective drugs. 4. Dongmu established the concept of 'Jang-gi(臟氣) and 'Yak-gi(藥氣)' and esteemed Jang-gi more than Yak-gi. So he contended that When there is no disease does not use drugs, even if the illness prioritized the use of mild drug, use the massive effective drugs a little while when there is an acute disease. 5. When the Sasnag Constututional Drugs help the Bomyungjiju(보명지주), Sometimes the Myunghyun Symptom is appeared. it is the process of Tongoi by Taeum Drugs, Chungjang by Soyang Drugs, Gojung by Tayang Drugs, Onri by Soeum Durgs. 6. Myunghyun symptoms which used indiscriminately in present is stopped and needs a clear observation and description about the drug reactions to the patient's condition.

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Relationship of Emotions and Several Diseases from the Viewpoint of Gi(氣) Movements (기기(氣機) 운행(運行)을 중심으로 본 감정(感情)과 병증(病症)의 상관성(相關性))

  • Ahn, Jae-Young;Jo, Hak-Jun
    • Journal of Korean Medical classics
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    • v.23 no.2
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    • pp.1-13
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    • 2010
  • We get following conclusion in relationship of emotions and several diseases from the viewpoint of Gi(氣) movements. "Naegyeong(內經)" state mainly relationship of emotions and five organs, relationships of emotion and Gi(氣) movements in detail, but refer about symptoms of diseases that happen by anger, fear, and astonishment. "Yumunsachin(儒門事親)" supplement the relationships of emotions and five organs in "Naegyeong(內經)", and "Uihak-ipmun(醫學入門)" present medical treatments for each symptom of diseases that is led by emotion. According to "Naegyeong", as well as emotions can lead to various symptoms of diseases by affecting Gi(氣) movements, particular symptoms of diseases can affect in emotions by affecting Gi (氣) movements. Because emotions can affect to symptoms of diseases through Gi(氣) movements, we can treat with drugs that control Gi(氣) as well as with methods that control emotions in case of emotions leading to particular symptoms of diseases. Because particular symptoms of diseases can affect to emotions through Gi(氣) movements, we can treat with methods that control emotions as well as with drugs that control Gi(氣) movements in case of particular symptoms of diseases leading to emotions. We think the theory of Gi(氣) movements can be used as a principle of acupuncture as well as of drugs by examining the relationship of emotions and symptom of diseases from the viewpont of Gi(氣) movements.

적취(積聚) 처방(處方)에 대(對)한 문헌적(文獻的) 고찰(考察)

  • Mun, Gu;Jo, Seong-Gak
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.2 no.1
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    • pp.113-160
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    • 1996
  • Cancer is one of the most important cause of death. So recently, investigation of cancer progress prosperously all over the world. Cancer in the present medicine correspond to You-Am, Sin-Am, Young-Soon, Sel-Gyun, Sil-Young, Young-Lyoo, Seg-Je, Seg-Young, Seg-Ha, Jerk-Chui(積聚), Jing-Ha, Oel-Gyek, Ban-Oui, Bi-Gi, Bok-Lyang, Jang-Dan, Hyen-Bek in the oriental medicine. Among these, generally Jerk-Chui(積聚) is expressed to cancer. So to develop of new drugs of cancer in the present medicine, bibliographic investigation of mass-prescriptions was studied in the oriental medicine-books. According to the bibliographic study of Jerk-Chui-prescriptions, the results run as follows. 1. According to the analyses of three hundred sixty eight Jerk-Chui-prescriptions in the twenty-seven kinds of literature, the frequency number of the used drugs were Pericarpium Citri Nobilis Viride 140 times, Pericarpium Citri Reticulatae 135 times, Rhizoma Scirpi 124 times, Radix Aucklandie 115 times, Rhizoma Zedoariae 114 times, Cortex Magnoliae Officinalis 111 times, Radix Glycyrrhizae 106 times, Rhizoma Zingiberis 100 times, Rhizoma Coptidis 94 times, Radix Ginseng 93 times, Poria 86 times, Rhizoma Pinelliae 85 times, Semen Arecae 83 times, Rhizoma Cyperi 82 times, Radix Angelicae Sinensis 80 times, Rhizoma Atractylodis 74 times, Massa Fermentata Medisinalis 67 times, Radix Et Rhizoma Rhei 66 times, Fructus Aurantii 62 times, Fructus Hordei Genninatus 55 times, Conex Cinnamomi 54 times, Fructus Evodiae 51 times, Fructus Aurantii Immaturus 49 times, Fructus Crataegi 49 times, Rhizoma Cnidii 46 times, Radix Platycodi 44 times, Semen Tiglii 44 times, Radix Aconiti 43 times, Fructus Amoni 38 times, Semen Raphani 37 times, Radix Aconiti Praeparata 36 times, Radix Scutellariae 35 times, Pericarpium Zanthoxyli 35 times, Rhizoma Corydalis 33 times, Rhizoma Acori Graminei 31 times, Carapax Amydae 31 times, Fructus Foeniculi 31 times, Semen Persicae 30 times, Radix Bupleuri 30 times. 2. The frequency number of the most imponant used drugs in the Jerk-Chui-prescriptions were Rhizoma Coplidis 41 times, Rhizoma Scirpi 35 times, Radix Et Rhizoma Rhei 31 times, Pericarpium Citri Reticuiatae 30 times, Rhizoma Zedoariae 27 times, Rhizoma Cyperi 22 times, Cortex Magnoliae Officinalis 22 times, Rhizoma Atraclylodis 22 times, Pericarpium Citri Nobilis Viride 21 times, Rhizoma Pinelliae 20 times, Semen Arecae 20 times, Fructus Crataegi 18 times, Rhizoma Zingiberis 17 times, Carapax Amydae 16 times, Semen Pharbitidis 13 times, Poria 12 times, Radix Angelicae Sinensis 10 times, Semen Persicae 10 times, Fructus Evodiae 10 times, Radix Aeoniti 10 times, Radix Glycyrrhizae 9 times, Massa Fennenlata Medisinalis 9 times, Fructus Aurantii 9 times, Fructus Hordei Genninatus 8 times, Radix Aueklandie 8 times, Rhizoma Atractylodis 8 times, Radix Bupleuri 8 times, Radix Ginseng 7 times, Semen Raphani 7 times, Radix Astragali 7 times, Cortex Cinnamomi 6 times, Fructus Aurantii Immaturus 6 times, Rhizoma Cnidii 6 times, Radix Aconiti Praeparata 5 times, Fructus Foeniculi 5 times, Lacca Sinica Exsiccata 5 times, Radix Aconiti 5 times, Rhizoma Zingiberis 5 times. 3. The clinical-botanic classifications of the used drugs in the Jerk-Chui-prescriptions were regulating the flow of Qi drugs, warm-heating drugs, promoting blood circulation drugs, killing mass drugs, resolving drugs, purgative drugs, Qi and blood tonics drugs, heat clearing drugs, removing dampness by promoting diures is drugs, phlegm eliminating drugs, allaying pain drugs. 4. According to the nature and taste in the drugs, warm and heating recipes were used most, heatclearing recipes were used a few times assistantly. 5. The Jerk-Chui-prescription used frequently was Bun-Don-Tang, which was used 13 times ; Bok-Oyang-Hoan 12 times, Bi-Gi-Hoan(肥氣丸) 12 times, Sik-Boon-Hoan 12 times, A-Uie-Hoan 12 times, Bi-Gi-Hoan 12 times, Dai-Cil-Gi-Tang 8 times, San-Cuie-Tang 8 times, Guye-Gyen-Tang 6 times, On-Baig-Won 5 times, So-Jek-Jeng-Ouen-San 5 times, Jin-In-Hoa-Cel-Tang 5 times, Byel-Gab-San 5 times, Sng-Hong-Hoan 5 times, Ji-Sil-San 4 times, So-A-Oie-Hoan 4 times, Hyang-Rng-Hoan 4 times.

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Evaluation of Proper Use of NSAIDs to Prevent Gastrointestinal and Cardiovascular Problems in Elderly Patients (노인환자에서 위장관계 및 심혈관계 부작용 발생 예방을 위한 NSAIDs 사용의 적절성 평가)

  • Joo, Sung-Lak;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.15-25
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    • 2014
  • Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

Evaluation of Drug Use Causing Delirium and Drowsiness in Elderly Patients of Korea (한국의 노인환자에 대한 섬망 및 졸음 유발 약물의 사용평가)

  • Cho, Ha-Na;Lee, Ok-Sang;Lim, Sung-Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.30-40
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    • 2012
  • In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially, neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60% of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist, analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.

The bibliographical study on the treatment and drugs of Hu-Ro(虛勞) (허로(虛勞)의 치법(治法) 및 치방(治方)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Ryu, Gi-Won;Baek, Tae-Hyun
    • The Journal of Internal Korean Medicine
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    • v.13 no.1
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    • pp.117-123
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    • 1992
  • This study has been carried out to investigate the treatment and drugs of Hu-Ro(虛勞) by referring to 35 literatures. The results were as follows; 1. The treatment of Hu-Ro(虛勞) is as follows. basic treatment : hujeokboji (虛卽補之) nojaonji sonjaonji (勞者溫之 損者溫之) general treatment : onbo (溫補) - bojungikgiseongyang (補中益氣升陽) chungbo (淸補) - jaeomganghwa (滋陰降火) 2. The drugs of Gi-Su(氣嗽) is as follows. gihu (氣虛) : bojungikgitang (補中益氣湯), sagunjatang (四君子湯) hulhu (血虛) : samultang (四物湯), daebojineum (大補眞飮) yanghu (陽虛) : oogwieum (右歸嗽), jwagihwna (左歸丸) eumhu (陰虛) : yukmihwan (六味丸), jwagihwna (左歸丸) eumyangguhu (陰陽俱虛) : gojineumja (固眞飮子), palmultang (八物湯)

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