• Title/Summary/Keyword: Intravenous Therapy

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Review of Updated Guidelines and Evidence for Antithrombotic Therapy in Acute Ischemic Stroke (급성 허혈성 뇌졸중에서 항혈전제 치료의 최신 가이드라인 개정과 근거에 대한 고찰)

  • Soo-Heui Paik
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.2
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    • pp.79-99
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    • 2024
  • Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy (근거기반 중심정맥 주입요법 간호실무지침 개정)

  • Lim, Kyung Choon;Jeong, Jae Sim;Kim, Kyeong Sug;Kim, Hyun Lim;Kim, Hyun Jeong;Kim, Dong Yeon;Lee, Mi Jeong;Lee, Joohyun
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

A Study on recent tendency of anti-tumor herbal acupuncture (항암약침의 최신경향에 대한 고찰)

  • Lee, Yong-Yeon;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Gue;Cho, Chong-Kwan;Hwang, Kyu-Jeong;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.4 no.3
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    • pp.23-37
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    • 2001
  • Objective: The purpose of this study is to develop and activate anti-tumor herbal acupuncture for cancer patients in South Korea. Methods: We investigated some literatures on anti-tumor herbal acupuncture which is used in South Korea and China, and made diagrams. Results: The results are summarized as follows. Anti-tumor herbal acupuncture is one of the traditional oriental medical method which is effective for cancer patients. In domestic studies, most of herb materials are belong to action of cooling&detoxification(25.0%) and strengthening body resistance(46.4%) which are proved to have effects of anti-tumor, immune activation and preventing tumor. In China, point injection therapy are used for improving symptoms of cancer patients and hea1ing tumor. Also herbal intravenous injection is used for combination of chinese traditional and western cancer therapy and treating cancer patients variously. Conclusions: From the above results. it is expected that anti-tumor herbal acupuncture is useful to improve clinical symptoms and quality of life(QOL) of cancer patients. Also we must develop new progressive methods of point injection and herbal intravenous injection for treating cancer patients, and advance clinical studies and trials.

Arthritis in the Subacute Stage of Kawasaki Disease after Responding to Intravenous Immunoglobulin Treatment (가와사끼병에서 정맥용 면역글로불린에 반응 후 아급성기에 발생한 관절염)

  • Lee, Kyung-Yil;Oh, Jin-Hee;Koh, Dea-Kyun
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1124-1127
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    • 2003
  • We evaluated the clinical and laboratory characteristics of five children with Kawasaki disease who had showed arthritis after responding to intravenous immunoglobulin(IVIG) treatment. Age distribution was between 13 months and six years of age(mean $3.2{\pm}1.6$ years). There were two males and three females. Arthritis occurred when acute symptoms were subsiding, with the average onset on day $5.8{\pm}1.8$ after final IVIG treatment. Arthritis was pauciarticular in three, and polyarticular in two. Regarding laboratory findings, one child was positive in rhematoid factor and changed to negative after two months. Three patients were examined for HLA B27 and all showed negative results. High dose aspirin(two cases), anti-inflammatory drug(ibprofen, three cases), and corticosteroids(methyprednisolon pulse therapy, one case) were used for this type of arthritis. Symptoms and signs of arthritis in all patients were improved by these therapies. There was no relapse or complications within six months. Arthritis after responding to IVIG therapy was rarely observed in children with Kawasaki disease. This type of arthritis responded well to anti-inflammatory drugs including corticosteroids, and showed no relapses.

A 2-month-old boy with hemolytic anemia and reticulocytopenia following intravenous immunoglobulin therapy for Kawasaki disease: a case report and literature review

  • Kim, Na Yeon;Kim, Joon Hwan;Park, Jin Suk;Kim, Soo Hyun;Cho, Yeon Kyung;Cha, Dong Hyun;Kim, Ki Eun;Kang, Myung Suh;Lim, Kyung Ah;Sheen, Youn Ho
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.60-63
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    • 2016
  • Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.

The Effect of IV Infusion of Phenytoin for Glossopharyngeal Neuralgia -A case report- (설인신경통 환자에서 Phenytoin 정주의 효과 -증례 보고-)

  • Lee, Young-Bok;Yoon, Kyung-Bong;Lee, Kwang-Ho;Han, Yi-Keong
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.119-122
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    • 1999
  • Glossopharyngeal neuralgia is a rare syndrome that involves episodic bursts of pain in the sensory distributuion of the ninth cranial nerve. The nature of the pain is characterized by excruciating shock-like pain in the region of the tonsillar fossa or pharynx and can radiate to the ear or the angle of the jaw. Like trigeminal neuralgia, glossopharyngeal neuralgia typically responds to anticonvulsant agents such as carbamazepine. However, dose of carbamazepine needs to be increased gradually to avoid side effects. If the patient can not tolerate until effective carbamazepine level is reached, phenytoin can be administered intravenously at the same time that oral carbamazepine therapy is begun. We present fifty-three year old female patient suffering from glossopharyngeal neuralgia who did not respond to initial carbamazepine therapy, but responded to concomitant intravenous infusion of phenytoin.

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The Study of the Knowledge and Performance of Nursing Students for the Nosocomial Infection Control (병원감염관리에 관한 간호대학생의 지식 및 실천에 관한 연구)

  • Sung, Younghee;Nam, Hyekyung
    • Korean Journal of Occupational Health Nursing
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    • v.15 no.1
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    • pp.40-49
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    • 2006
  • Purpose: This study was designed to investigate nursing students' exposure experience to infectious diseases and their knowledge and performance for the nosocomial infection control. Method: The data was obtained from 292 nursing students having clinical experience at two university hospitals in Seoul from November 2005 to February 2006. Specific questionnaire was constructed and used for this study. The obtained data was analyzed by using the SPSS window program. Result: The results were as follow : 1. Among the evaluation scores of knowledge for the nosocomial infection control, the score of sterilization and the score of the intravenous therapy management were low(.14). 2. Among the evaluation scores of performance for the nosocomial infection control, the score of hand washing is low(1.63). 3. 86.3 percent of the nursing students had exposure experience to infectious disease. Many of them did not use the protective equipments in clinical experience nor took any treatment after the exposure to infectious diseases. Conclusion: Based on these results, we suggest that the programs for the nosocomial infection control should be developed for nursing students. It is also suggested that nursing students should be educated before their clinical experience to keep protected from the infection. In particular, the hand washing, sterilization and intravenous therapy management should be emphasized in the educational programs.

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