• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.165-173
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• 2016

Dentists often sedate patients in order to reduce their dental phobia and stress during dental treatment. Sedatives are administered through various routes such as oral, inhalation, and intravenous routes. Intravenous administration has the advantage of rapid onset of action, predictable duration of action, and easy titration. Typically, midazolam, propofol or dexmedetomidine are used as intravenous sedatives. Administration of these sedatives via infusion by using a syringe pump is more effective and successful than infusing them as a bolus. However, during intravenous infusion of sedatives or opioids using a syringe pump, fatal accidents may occur due to the clinician's carelessness. To prevent such risks, smart syringe pumps have been introduced clinically. They allow clinicians to perform effective sedation by using a computer to control the dose of the drug being infused. To ensure patient safety, various alarm features along with a drug library, which provides drug information and prevents excessive infusion by limiting the dose, have been added to smart pumps. In addition, programmed infusion systems and target-controlled infusion systems have also been developed to enable effective administration of sedatives. Patient-controlled infusion, which allows a patient to control his/her level of sedation through self-infusion, has also been developed. Safer and more successful sedation may be achieved by fully utilizing these new features of the smart pump.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.67-76
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• 2020

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider's essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.321-325
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• 1998

Most of the patients with pain resulting from advanced cancer need opioid for adequate analgesia. Various Methods of drug administration to control the pain have been developed. One of them, continuous administration of intravenous morphine is used for more effective pain control in the patient with severe pain that cannot be satisfactorily controlled by other Methods of morphine administration. But this is not a suitable method at home because of the possibility of serious infectious complications and the difficulty in managing intravenous access by untrained personnel. Continuous subcutaneous adminstration of drugs can not only overcome such disadvantages of continuous intravenous infusion but also get almost the same effect of pain control as continuous intravenous infusion, and allows opportunity to move freely and return home, improving quality of life. We used continuous subcutaneous morphine and metoclopramide in the patients with cancer pain via a portable PCA device, and accomplished satisfactory pain relief without significant side effect.

• Biomolecules & Therapeutics
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• v.11 no.3
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• pp.163-168
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• 2003

Pharmacokinetics of eupatilin (an active components of $Stillen^{\circledR}$, a new antigastritic agent) were investigated after both intravenous and oral administration at a dose of 30mg/kg to rats. After intravenous administration, the plasma concentrations of unchanged eupatilin declined rapidly with a mean terminal half-life of 0.101 h. Eupatilin was eliminated fast in rats; the total body clearance was 121 mL/min/kg. Eupatilin was mainly metabolized in rats; the percentage of intravenous dose of eupatilin excreted in 24 h urine and feces as unchanged eupatilin was only 2.5 and 0.919％, respectively. Eupatilin was mainly metabolized to form its glucuronide conjugate; after intravenous administration, 15.9 and 51.7％ of intravenous dose was excreted in 24 h urine and feces, respectively, as eupatilin plus its glucuronide. After oral administration, the absolute bioavailability was only 3.86％ based on $AUC_{0-24h}$ of eupatilin plus its glucuronide. Approximately 68.5％ of oral dose was not absorbed from the entire gastrointestinal tract. Therefore, it could be concluded that the superior effect of eupatilin in experimental animal models of gastric ulcer and inflammatory bowel disease after oral administration could be due to the local action of eupatilin. Further pharmacokinetic studies to elucidate the local action of eupatilin are required.

• Biomolecules & Therapeutics
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• v.8 no.3
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• pp.207-212
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• 2000

The root extract of pulsatilla koreana has been used as antibacterial, antiparasitic and anti-inflam-matory analgesic agents in Traditional Medicine in Korea. Thus anti-inflammatory and analgesic actions of the methanol and water extracts of the root were investigated by administration in oral and intravenous route. From the results, it is concluded that the extracts exhibited the potent anti-inflammatory and analgesic actions in intravenous administration, but did not show the actions in oral administration in animals.

• Biomolecules & Therapeutics
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• v.19 no.2
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• pp.237-242
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• 2011

This study was designed to investigate the effects of glipizide on the pharmacokinetics of carvedilol after oral or intravenous administration of carvedilol in rats. Clinically carvedilol and glipizide can be prescribed for treatment of cardiovascular diseases as the complications of diabetes, and then, Carvedilol and glipizide are all substrates of CYP2C9 enzymes. Carvedilol was administered orally or intravenously without or with oral administration of glipizide to rats. The effects of glipizide on cytochrome P450(CYP) 2C9 activity and P-gp activity were also evaluated. Glipizide inhibited CYP2C9 activity in a concentration-dependent manner with 50% inhibition concentration ($IC_{50}$) of 18 ${\mu}M$. Compared with the control group, the area under the plasma concentration-time curve (AUC) was significantly increased by 33.0%, and the peak concentration ($C_{max}$) was significantly increased by 50.0% in the presence of glipizide after oral administration of carvedilol. Consequently, the relative bioavailability (R.B.) of carvedilol was increased by 1.13- to 1.33-fold and the absolute bioavailability (A.B.) of carvedilol in the presence of glipizide was increased by 36.8%. After intravenous administration, compared to the control, glipizide could not significantly change the pharmacokinetic parameters of carvedilol. Therefore, the enhanced oral bioavailability of carvedilol may mainly result from inhibition of CYP2C9-mediated metabolism rather than both P-gp-mediated effl ux in the intestinal or in the liver and renal elimination of carvedilol by glipizide.

• Journal of Veterinary Clinics
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• v.5 no.2
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• pp.61-71
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• 1988

This study was performed to compare the antagonistic effects of intravenous(0.125mg / kg) and subcutaneous(0.25mg /kg) administration of yohimbine on xylazine-induced immobilized(4.5mg/ kg) dog and to investigate the effectiveness of yohimbine compound(0.25mg / kg) in clinical practice. Mean arousal time(MAT), mean walk time(MWT), and time to return to normal electroencephalograms were remarkably decreased in all yohimbine-treated groups compared with the control. In electroencephalograms(A-B$\sub$I/ lead), there were no significant alteration, except RR interval. RR interval was decreased in all yohimbine-treated groups compared with the control. Second-degree heart blocks(41.7%) shown after xylazine administration disappeared within 2 min after yohimbine administration. The frequency of electroencephalograms(RO-RF trace) was recovered faster to normal in yohimbine-treated groups than that of the control. In histopathological changes of ICR mice given yohimbine compound subcutaneously, edema with inflammatory cells of hypodermis was slightly shown on the 1st day, but this findings were not observed on the 5th day. It was considered that no difference in the antagonistic effects of intravenous and subcutaneous administration of yohimbine on xylazine- induced immobilized dog were observed and yohimbine compound was usable in clinical practice for antagonistic agent to the xylazine.

• Journal of Korean Academy of Nursing
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• v.16 no.1
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• pp.67-80
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• 1986

The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.394-402
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• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

• The Journal of Internal Korean Medicine
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• v.11 no.2
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• pp.112-119
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• 1990

To evaluate effects of Sam so on Pye Tang(SSOPT) Water Extract plasma cortisol concentration and plasma $CO_2$ in the Rabbit. The results obtained were as follows. 1. Intravenous administration of SSOPT water extract at the dose of 0.5ml/kg remarkably increased plasma cortisol concentration on 1 hour. 2. Intravenous adminitration of SSOPT Water extract at the does of 1.0ml/kg significantly decreased plasma $CO_2$ on 1 hour. 3. Intravenous adminitration of SSOPT Water extract at the does of 0.5ml/kg remarkable decreased plasma $Na^+$ from 1 to 4 hour and 1.0ml/kg significantly decreased plasma $Na^+$ on 1 hour. 4. Intravenous administration of SSOPT Water extract at the does of 1.0ml/kg remarkably increased plasma $k^+$ from 1 to 3 hour. 5. Intravenous administration of SSOPT water extract at the does of 0.5ml/kg significantly decreased plasma $CI^-$ on 3, 4 hours. and 1.0ml/kg remarkably increased plasma $CI^-$ on 4 hour. These results suggest that therapeutic action of SSOPT water extract for athma may be reated with the increment of plasma cortisol concentration and the decrease plsma $CO_2.$.