• Title/Summary/Keyword: Glimepiride

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The Effect of Biological Equivalence Examination on Prescribing Practice of Doctors (글리메피라이드 제제의 생물학적동등성 시험이 의사의 처방전발행에 미치는 영향)

  • Jang, Mal-Sook;Choi, Byung-Chul;Yong, Chul-Soon;Choi, Han-Gon;Rhee, Jong-Dal;Yoo, Bong-Kyu
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.96-100
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    • 2006
  • Korea Food and Drug Administration (KFDA) has been expediting the Biological Equivalence Examination (BEE) project to encourage generic substitution without expense of inappropriate therapeutic outcome. However, little is known about which considerations are most important in making the decision to prescribe a drug among many generic drugs. The purpose of this survey was to identify how strongly the KFDA certification of BEE influenced doctors when they make a choice between brand and generics of glimepiride preparations. Telephone survey was performed towards doctors working at local clinics by using a questionnaire. Most influential factor to doctors' decision was drug cost followed by pharmaceutical representatives, therapeutic efficacy, and review guideline for reimbursement. Advertisement of the drug was the least influential followed by KFDA certification of BEE. The meaning of BEE was best understood by relatively young doctors with specialty in surgical parts. This survey result further indicated that the doctors considered the therapeutic equivalence examination a preferred measure to expedite generic substitution.

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Cost-Effectiveness Analysis of Glimepiride or Pioglitazone in Combination with Metformin in Type-2 Diabetic Patients (제2형 당뇨병 환자에 대한 메트포르민-글리메피리드 병합요법과 메트포르민-피오글리타존 병합요법의 비용-효과분석)

  • Lim, Kyung-Hwa;Shin, Hyun-Taek;Sohn, Hyun-Soon;Oh, Jung-Mi;Lee, Young-Sook
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.96-104
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    • 2009
  • 배경: 당뇨병 환자에게 관상동맥심질환은 생존률, 건강 상태 유지 및 삶의 질에 주요한 영향을 미치는 합병증이며 적극적인 당뇨병 치료는 이러한 심혈관 합병증을 예방할 수 있으나 당뇨병의 적극적 치료와 관리에는 많은 비용이 소요된다. 목적: 제2형 당뇨병 환자를 대상으로 메트포르민과 글리메피리드 병합요법과 메트포르민과 피오글리타존 병합요법의 비용-효과성을 비교하고자 하였다. 연구방법: 마르코프 코호트 프로세스(Markov Cohort Process Model) 모형을 이용하여 비용-효과분석을 실시하였다. 연장된 수명 (life years gained, LYG)과 삶의 질(quality)을 보정하여 증가된 QALYs를 주요 효과 지표로 측정하였고, 총비용으로는 직접의료비용과, 환자와 가족의 교통비를 직접비의료비용으로 고려하였고 환자와 가족의 시간비용을 간접비용으로 포함하였다. 연구결과: 비용-효과분석 결과, 메트포르민과 글리메피리드 병합요법의 경우 총 비용은 5,962,288원, 효과는 7.94LYG, 6.43QALY이었다. 반면 메트포르민과 피오글리타존 병합요법은 총 비용 10,982,243원, 효과 8.62LYG, 6.99QALY으로, 점증적 비용-효과비(ICER)는 7,402,663원/LYG과 8,934,546원/QALY 이었다. 결론: 우리 사회의 연장된 수명(LYG)에 따른 지불의사가 700만원 이하인 경우는 메트포르민과 글리메피리드 병합요법이 비용-효과적인 대안이며 700만원 이상인 경우에는 메트포르민과 피오글리타존 병합요법이 비용-효과적인 대안이 될 수 있다.

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Protective Effect of White-Skinned Sweet Potato (Ipomoea batatas L.) from Indonesia on Streptozotocin-Induced Oxidative Stress in Rats (흰 쥐에서 streptozotocin으로 유발된 산화적 스트레스에 대한 인도네시아산 white-skinned sweet potato (WSSP, Ipomoea batatas L.)의 보호효과)

  • Bachri, Moch. Saiful;Jang, Hye-Won;Choi, Jong-Won;Park, Jong-Ok
    • Journal of Life Science
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    • v.20 no.11
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    • pp.1569-1576
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    • 2010
  • Sweet potato (Ipomoea batatas L.) is widely used in Indonesia and other countries as a traditional medicine for the treatment of diabetes mellitus (DM). The MeOH extract of white skinned sweet potatoes (WSSP) was administered orally in doses of 100 and 200 mg/kg body weight in streptozotocin (STZ)-induced diabetic rats. Experimental diabetes was induced by a single dose of STZ (45 mg/kg, i.p.) injection. Oxidative stress was measured by tissue lipid peroxide (LPO) levels, serum aspartate transaminase (AST), alanine transaminase (ALT), total triglyceride (TG), total cholesterol (TC) and by antioxidative enzymatic activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione S-transferase in the liver. An increase in blood glucose, LPO level, AST, ALT, TG and TC levels was observed in the STZ-induced diabetic rats. Administration of MeOH extract of WSSP at a dose of 200 mg/kg for two weeks caused a significant reduction in blood glucose, LPO levels, AST, ALT, TG and TC levels in the STZ-induced diabetic rats. Furthermore, oral administration of MeOH extract showed significant improvement in the activities of antioxidant enzymes (SOD, GPx, and CAT) compared to STZ-induced diabetic rats. In conclusion, the obtained results clearly indicate the role of oxidative stress in the induction of diabetes, and that the protective effects of MeOH extracts of WSSP could be used to benefit diabetic patients.

Comparison of Estimation Methods in NONMEM 7.2: Application to a Real Clinical Trial Dataset (실제 임상 데이터를 이용한 NONMEM 7.2에 도입된 추정법 비교 연구)

  • Yun, Hwi-Yeol;Chae, Jung-Woo;Kwon, Kwang-Il
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.137-141
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    • 2013
  • Purpose: This study compared the performance of new NONMEM estimation methods using a population analysis dataset collected from a clinical study that consisted of 40 individuals and 567 observations after a single oral dose of glimepiride. Method: The NONMEM 7.2 estimation methods tested were first-order conditional estimation with interaction (FOCEI), importance sampling (IMP), importance sampling assisted by mode a posteriori (IMPMAP), iterative two stage (ITS), stochastic approximation expectation-maximization (SAEM), and Markov chain Monte Carlo Bayesian (BAYES) using a two-compartment open model. Results: The parameters estimated by IMP, IMPMAP, ITS, SAEM, and BAYES were similar to those estimated using FOCEI, and the objective function value (OFV) for diagnosing the model criteria was significantly decreased in FOCEI, IMPMAP, SAEM, and BAYES in comparison with IMP. Parameter precision in terms of the estimated standard error was estimated precisely with FOCEI, IMP, IMPMAP, and BAYES. The run time for the model analysis was shortest with BAYES. Conclusion: In conclusion, the new estimation methods in NONMEM 7.2 performed similarly in terms of parameter estimation, but the results in terms of parameter precision and model run times using BAYES were most suitable for analyzing this dataset.

Antidiabetic Drugs and Their Nanoconjugates Repurposed as Novel Antimicrobial Agents against Acanthamoeba castellanii

  • Anwar, Ayaz;Siddiqui, Ruqaiyyah;Shah, Muhammad Raza;Khan, Naveed Ahmed
    • Journal of Microbiology and Biotechnology
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    • v.29 no.5
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    • pp.713-720
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    • 2019
  • Acanthamoeba castellanii belonging to the T4 genotype may cause a fatal brain infection known as granulomatous amoebic encephalitis, and the vision-threatening eye infection Acanthamoeba keratitis. The aim of this study was to evaluate the antiamoebic effects of three clinically available antidiabetic drugs, Glimepiride, Vildagliptin and Repaglinide, against A. castellanii belonging to the T4 genotype. Furthermore, we attempted to conjugate these drugs with silver nanoparticles (AgNPs) to enhance their antiamoebic effects. Amoebicidal, encystation, excystation, and host cell cytotoxicity assays were performed to unravel any antiacanthamoebic effects. Vildagliptin conjugated silver nanoparticles (Vgt-AgNPs) characterized by spectroscopic techniques and atomic force microscopy were synthesized. All three drugs showed antiamoebic effects against A. castellanii and significantly blocked the encystation. These drugs also showed significant cysticidal effects and reduced host cell cytotoxicity caused by A. castellanii. Moreover, Vildagliptin-coated silver nanoparticles were successfully synthesized and are shown to enhance its antiacanthamoebic potency at significantly reduced concentration. The repurposed application of the tested antidiabetic drugs and their nanoparticles against free-living amoeba such as Acanthamoeba castellanii described here is a novel outcome that holds tremendous potential for future applications against devastating infection.

Concurrent Use of Sulfonylureas and Antimicrobials of the Elderly in Korea: A Potential Risk of Hypoglycemia (고령자에서 Sulfonylureas와 항균제의 병용투여 현황)

  • Lee, Sera;Ock, Miyoung;Kim, Hyunah
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.188-193
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    • 2018
  • Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution (저용량 polyethylene glycol 용액에 아스코르빈산을 첨가한 장정결제로 대장내시경 전처치 후 발생한 발작을 동반한 저나트륨혈증)

  • Lee, Jae Young;Jang, Byung Ik;Nam, Yoon Jeong;Song, Jay;Kim, Min Cheol;Chung, Seung Min;Jang, Jong Geol;Cho, Jae Ho
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.55-59
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    • 2015
  • The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.

Antidiabetic and Beta Cell-Protection Activities of Purple Corn Anthocyanins

  • Hong, Su Hee;Heo, Jee-In;Kim, Jeong-Hyeon;Kwon, Sang-Oh;Yeo, Kyung-Mok;Bakowska-Barczak, Anna M.;Kolodziejczyk, Paul;Ryu, Ok-Hyun;Choi, Moon-Ki;Kang, Young-Hee;Lim, Soon Sung;Suh, Hong-Won;Huh, Sung-Oh;Lee, Jae-Yong
    • Biomolecules & Therapeutics
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    • v.21 no.4
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    • pp.284-289
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    • 2013
  • Antidiabetic and beta cell-protection activities of purple corn anthocyanins (PCA) were examined in pancreatic beta cell culture and db/db mice. Only PCA among several plant anthocyanins and polyphenols showed insulin secretion activity in culture of HIT-T15 cells. PCA had excellent antihyperglycemic activity (in terms of blood glucose level and OGTT) and HbA1c-decreasing activity when compared with glimepiride, a sulfonylurea in db/db mice. In addition, PCA showed efficient protection activity of pancreatic beta cell from cell death in HIT-T15 cell culture and db/db mice. The result showed that PCA had antidiabetic and beta cell-protection activities in pancreatic beta cell culture and db/db mice.

Anti-diabetic Effect of Fermented Milk Containing Conjugated Linoleic Acid on Type II Diabetes Mellitus

  • Song, Kibbeum;Song, In-Bong;Gu, Hye-Jung;Na, Ji-Young;Kim, Sokho;Yang, Hee-Sun;Lee, Sang-Cheon;Huh, Chang-Ki;Kwon, Jungkee
    • Food Science of Animal Resources
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    • v.36 no.2
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    • pp.170-177
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    • 2016
  • Conjugated linoleic acid (CLA) is a group of positional and geometric isomers of conjugated dienoic derivatives of linoleic acid. CLA has been reported to be able to reduce body fat. In this study, we investigated the antidiabetic effect of fermented milk (FM) containing CLA on type II diabetes db/db mice. Mice were treated with 0.2% low FM, 0.6% high FM, or Glimepiride (GLM) for 6 wk. Our results revealed that the body weight and the levels of fasting blood glucose, serum insulin, and leptin were significantly decreased in FM fed mice compared to db/db mice. Oral glucose tolerance and insulin tolerance were significantly ameliorated in FM fed mice compared to db/db mice. Consistent with these results, the concentrations of serum total cholesterol, triglycerides, and LDL cholesterol were also significantly decreased in FM fed mice compared to db/db mice. However, the concentration of HDL cholesterol was significantly higher in FM fed mice compared to db/db mice. These results were similar to those of GLM, a commercial anti-diabetic drug. Therefore, our results suggest that FM has anti-diabetic effect as a functional food to treat type II diabetes mellitus.