• The Journal of Korean Medicine
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• v.22 no.4
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• pp.101-106
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• 2001

Objectives : Zizyphus seed has long been used in hypnotics and sedatives in oriental medicine, and it is reported that the Zizyphus seed elicited a variety of pharmacological actions besides CNS depression. We did a clinical study on the effectiveness of Zizyphus seed (Ansim-san) for insomnia in stroke patients. Methods : To 41 stroke patients suffering from insomnia, we administered the extract of Zizyphus seed (Ansim-san). Outcome measures were subjective in nature and included a morning questionnaire, visual analog scales, and observation forms by study personnel. We also, to find the applicable symptom-complex of Zizyphus seed (Ansim-san), examined accompanying symptoms. Results : 1. Zizyphus seed extract use meant that sleep latency was shorter, total sleep time was longer, number of wakenings was lower, wake time during sleep was shorter, sleep quality was improved, condition upon awakening was improved, ability to concentrate was improved, and the patients fell asleep more easily (P<0.001). There were no differences in morning sleepiness. 2. Among accompanying symptoms, an oppressed feeling in the chest was significant (P=0.035) in the patients who improved sleep quality. Conclusions : The results of this clinical study suggest that in stroke patients, Zizyphus seed (Ansim-san) can be effective for insomnia, and significantly effective in patients who have an oppressed feeling in the chest.

• YAKHAK HOEJI
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• v.46 no.5
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• pp.337-342
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• 2002

Propofol(2,6-diisopropyl phenol) is a phenol derivative that is chemically distinct from other intravenous sedative hypnotics. It has been extensively used as a short term anesthetic agent, because of the rapid onset and short duration of action. Propofol microemulsion system was prepared with different concentrations of ethyl oleate, $Solutol^{(R)}$ HS 15 and $Kollidon^{(R)}$ 17 PF. Propofol microemulsions were studied by transmittance, viscosity, particle size, in vitro release and pharmacokinetics. The range of transmittance of A group with 4% ethyl oleate and that of B group with 5% ethyl oleate were 92.6~95.1 and 91.3~94.2%, respectively. Transmittance 1~2% decreased as concentration of $Kollidon^{(R)}$ 17 PF was increased and increased 0.8~3.3% when 10 times diluted with normal saline. The viscosity of A and B group were in the range of 3.9~4.1 mPaㆍsec and 4.4~5.3 mPaㆍsec, respectively. The particle sizes of A and B group increased as amount of $Kollidon^{(R)}$ 17 PF. Also, release of propofol was slowly increased as the amount of $Kollidon^{(R)}$ 17 PF was increased. Propofol plasma concentration by i.v injection showed 2-compartment model. Pharmacokinetics of A-5 was similar to that of commercial emuision(POFOL).

• Clinical Endoscopy
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• v.55 no.5
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• pp.581-587
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• 2022

Procedural sedation has become increasingly common in endoscopy. Sedatives and analgesics induce anxiolysis and amnesia. In addition, an appropriate level of sedation is necessary for safe procedures including therapeutic endoscopy. Midazolam and propofol are the most commonly used drugs in sedative endoscopy. In recent years, the need to ascertain the safety and effectiveness of sedation has increased in practice. Therefore, new sedatives and analgesic drugs for optimal sedative endoscopy, have recently emerged. This article reviews the characteristics of sedatives and analgesics, and describes their clinical use in gastrointestinal endoscopy.

• Journal of Korean Clinical Nursing Research
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• v.24 no.1
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• pp.74-84
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• 2018

Purpose: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. Methods: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 Results: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. Conclusion: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.

• Korean Journal of Clinical Pharmacy
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• v.2 no.1
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• pp.29-39
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• 1992

In a survey of drug abuse of fourteen types of drugs by employees of public house, the results are follows. $87.4\%$ of male and $82.1\%$ of female ever smoked in his/her life time. $82.2\%$ of male and $75.2\%$ of female smoked in the past month. $90.4\%$ of male and $93.9\%$ of female ever drank in his/her life time. $82.2\%$ of male and $81.6\%$ of female in the past month. $57.8\%$ of male and $54.9\%$ of female smoked daily and $27.4\%$ of male and $53.6\%$ of female drank daily. $3.9\%$ of the employees of public house ever used marijuana in his/her life time: $1.7\%$, stimulants : $5.6\%$ inhalants : $10.0\%$ tranquilizers: $14.6\%$, hypnotics : $32.9\%$ analgesics: $3.7\%$, antitussives: and $1.4\%$, antihistamines; $1.5\%$, cocaine; $0.0\%$ amphetamines; $0.6\%$ narcotics: and $4.71\%$, hallucinogens. Drug use and delinquency showed a dosed relationship: drug users committed higher degree of delinquent behaviors and delinquents used drugs more frequently.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.153-157
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• 2016

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

• The Korean Journal of Pharmacology
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• v.18 no.1
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• pp.17-22
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• 1982

Zizyphus seed(Zizyphus vulgaris Lamark var. Spinosus Bunge) has long been used as hypnotics and sedatives in oriental medicine, and it is reported that the Zizyphus seed elicited a variety of pharmacologic actions besides CNS depression. Present study was undertaken to investigate the effects of Zizyphus seed on the central nervous system and on the blood pressure. The effect of Zizyphus seed on the central nervous system was measured by the influence of thiopental sleeping time and by inhibition of chemical convulsion (strychnine and pentylenetetrazol induced). Blood pressure changes by Zizyphus extract and its mode of action were investigated. The ground Zizyphus seed was extracted with hexane and methanol, consecutively and the supernatants were discarded. The precipitate was re-extracted with distilled water and the supernatant was evaporated to a dark-brownish sticky liquid, which was used as Zizyphus seed extract in this study after dissolving in saline prior to experiment. The results are as follows. 1) Zizyphus seed extract caused marked prolongation of the thiopental sleeping time in mice. 2) The chemical convulsion by strychnine and pentylenetetrazol, and the mortality by them in chicks were not affected by pretreatment of Zizyphus seed extract. 3) Zizyphus seed extract produced transient fall of blood pressure in the cat, and this hypotentive effect was blocked partially by atropine but not affected by bilateral vagotomy and/or hexamethonium, nor propranolol and, chlorpheniramine and/or cimetidine. With the above results, it may be suggested that the water extract of Zizyphus seeds contains components producing CNS depression and hypotension. Furthermore it is felt that the cholinergic effect, but not the adrenergic or histaminergic, is partly responsible for the hypotensive effect of Zizyphus seed extract.

• Journal of Korean Public Health Nursing
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• v.10 no.1
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• pp.106-117
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• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.5-11
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• 2017

Background Conscious sedation has been widely utilized in plastic surgery. However, inadequate research has been published evaluating adequate drug dosage and depth of sedation. In clinical practice, sedation is often inadequate or accompanied by complications when sedatives are administered according to body weight alone. The purpose of this study was to identify variables influencing the depth of sedation during conscious sedation for plastic surgery. Methods This prospective study evaluated 97 patients who underwent plastic surgical procedures under conscious sedation. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and glucose levels were measured. Midazolam and ketamine were administered intravenously according to a preset protocol. Bispectral index (BIS) recordings were obtained to evaluate the depth of sedation 4, 10, 15, and 20 minutes after midazolam administration. Associations between variables and the BIS were assessed using multiple regression analysis. Results Alcohol intake and female sex were positively associated with the mean BIS (P<0.01). Age was negatively associated with the mean BIS (P<0.01). Body mass index (P=0.263), creatinine clearance (P=0.832), smoking history (P=0.398), glucose (P=0.718), AST (P=0.729), and ALT (P=0.423) were not associated with the BIS. Conclusions Older patients tended to have a greater depth of sedation, whereas females and patients with greater alcohol intake had a shallower depth of sedation. Thus, precise dose adjustments of sedatives, accounting for not only weight but also age, sex, and alcohol consumption, are required to achieve safe, effective, and predictable conscious sedation.

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.1061-1067
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• 2018

A patient had central fever following pontine hemorrhage. Central hyperthermia caused by stroke is a rare case, and it is difficult to control. There are few case reports about central hyperthermia in Korean medical treatment (KMT). The patient suffered central hyperthermia accompanied by tachycardia, dyspnea, and irritability. However, there was no evidence of infection. Thus, hypnotics, sedatives, and a minor tranquilizer (Lorazepam and Midazolam) was prescribed. Despite a temperature peak of $39.9^{\circ}C$, most of the symptoms were alleviated. The patient's average body temperature was about $37^{\circ}C$, which is higher than most people at $36.5^{\circ}C$. His symptoms were diagnosed as ascendant hyperactivity of liver Yang (肝陽上亢), and the patient was prescribed Shihogayonggolmoryo-tang. During the 44 days of KMT, there was no change in his average body temperature and no central hyperthermia over $39^{\circ}C$. This case report demonstrates the possibility of controlling central hyperthermia caused by pontine hemorrhage using KMT.