• Title/Summary/Keyword: Medication administration

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The effects of the direct nursing care hours with establishment of the nurse substations (Nurse Substation 운영이 직접간호시간 증가에 미치는 효과)

  • Lee, Chug-Hee;Sung, Young-Hee;Kwon, In-Gak;Lee, Soon-Kyu;Jung, Yoen-Yi;Hoe, Sung-Hee;Ryoo, Sung-Suk;Kim, Jung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.61-80
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    • 1997
  • The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

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Effects of HapKok (LI-4) , SamUmGyo (SP-6) Acupuncture on Uterine Motility and Cyclooxygenase-2 Manifestation in Rats (합곡(合谷), 삼음교(三陰交) 자침(刺鍼)이 백서(白鼠) 자궁(子宮) 운동(運動) 및 Cyclooxygenase-2 발현(發現)에 미치는 영향(影響))

  • Lee, Byung-Chul;Lee, Ho-Sub;Kim, Kyung-Sik;Lee, Geon-Mok;Na, Chang-Soo;Kim, Jung-Sang;Hwang, Woo-Jun
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.187-208
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    • 2000
  • By the activation of ovary hormone, many morphological changes occur in the epithelial cell lines and muscle cells in rat uterus. These two cells in uterus are important to the implantation of embryo, maintaining pregnancy and starting parturition. One important change associated with the morphological change of these two cells in uterus is the change on prostaglandin(PG) metabolism. Its presence and synthesis in endometriurn and myometrium in uterus affects estrous cycle and the start of embryo implantation in uterus. It also performs as an important modulator in parturition. So the abnormally weak expression of PG causes difficulty during labor and over-expression causes pre-term labor. PG biosynthesis starts from either free or liberated arachidonic acids from membrane phospholipid by phospholipase. Such arachidonic acids are converted into PG catalyzed by Cyclooxygenase. Under normal physiological condition, Cyclooxygenase-1(COX-1) having 602 units of amino acids controls the synthesis of PG. It acts as a local hormone regulating vasomodulation of blood flow, flexible muscle movement, increasing the blood permeability and contributing the protective role in preserving integrity of the stomach lining and Cyclooxygenase-2 (COX-2) is induced by the inflammation, pregnancy and increased its expression until parturition. Lipid metabolite like PG is located in uterine and expression of COX-2 increased with pregnancy. Increased expression of COX proteins in epithelial cells and myometrial cells are told to increase the muscle contractility in uterus but decreased right after the labor in rat. It is a good sign indicating that COX proteins are deeply related to the start of labor. Currently, Several studies report the use of PG and COX-2 inhibitor as medication for controlled abortion or to prevent pre-term labor but they entail various side-effects. Our study proposed to suggest use of acupuncture as an another mediator to control abortion or pre-term labor without causing unnecessary side-effects by those medicines. Two acupuncture sites, LI-4 & SP-6 were selected due to their known efficacy. From the immunohistochemical staining of COX-2, normal expression of COX-2 protein in nonpregnant SD rat's uterus revealed that COX-2 protein was primarily detected in the lumina epithelial lining and in the epithelial cell lining contacting the stromal cells. High resolution optical microscopic scanning revealed distinguishable staining in the myometrial mucosa. LI-4 acupuncture administered nonpregnant rat's uterus showed strong expression for COX-2 in endometrium contacted with lumina epithelial lining of rat uterus and in myometrial mucosa. Stromal cells showed more staining than untreated nonpregnant rat's uterus and stronger staining in stromal cells contacting myometrial layer compared to untreated nonpregnant rat's uterus. SP-6 acupuncture administered nonpregnant rat's uterus showed weak expression for COX-2 in myometrial layers and stromal cells but no staining was visible in lumina epitheliai and glandular epithelial cells. Few stromal cells and myometrial mucosa were positively stained for COX-2. Pregnant SD rat's uterus was also immunostained for COX-2 expression after 18 days of pregnancy. Unlike to untreated nonpregnant rat's uterus, luminal epithelial cells were not positively stained for COX-2 but stronger staining for COX-2 was revealed in stromal cells. LI-4 acupunctured SD rat's uterus had very strong expression of COX-2 in luminal epithelial lining. Few stromal cells showed stronger positive COX-2 staining and myometrial layers also showed more expression than untreated pregnant rat. SP-6 acupuncture administered pregnant SD rat's uterus showed positive expression of COX-2 in epithelial cells of luminal mucosa layer but weaker than that of LI-4 acupuncture treatment's case. However, strong positive staining was revealed in stromal mucosa and myometrial layers. Virgin SD rat's uterus motility index during LI-4 acupuncture was 66.52 % (Prob〉T = 0.0197) compared to its motility before the acupuncture treatment but the motility index was slighdy elevated up to 79.58 % (Prob〉T = 0.1175) after the acupuncture. During the SP-6 acupuncture treatment for 30 minutes, uterus motility index was 90.52 % (Prob〉T = 0.1832) showing lesser decrement but consequently reached similar motility index decreasal to 79.95 % (Prob〉T = 0.0215) after the acupuncture treatment as LI-4 showed. LI-4 acupuncture tend to be a quick treatment to reducing the uterus motility in a virgin rat but eventually both two acupuncture administration created very similar reduction of uterus motility seeing the index after the both acupunctures. The uterus movement monitored during the LI-4 acupuncture administered for 30 minutes, Pregnant SD rat showed decreased motility down to 77.90 % (Prob〉 T = 0.0076) compared to uterus motility before the acupuncture and it continuously decreased down to 71.81 %(Prob〉T = 0.0214) after the removal of needle. The statistical analysis using paired t-test showed significance difference for both two motility indexs at =0.05. SP-6 acupuncture administered to pregnant SD rat also had similar pattern of decreasing uterus motility index down to 74.70 % (Prob〉T = 0.1730) during the initial 30 minutes acupuncture administration and it was continuously lowered to 71.52 % (Prob〉T = 0.0155) after the acupuncture. The paired t-test resuit for SP-6 suggest prompt response of uterus motility index to the SP-6 acupuncture treatment but consequently reached same level of inducing the motility reduction as LI-4 at =0.05 level.

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Clinical Features of Sulfite-Sensitive Asthmatics (설파이트(Sulfite) 과민성 천식 환자의 임상적 특성에 관한 연구)

  • Cho, Young-Soo;Baik, Su-Hum;Park, Hae-Sim;Rhu, Nam-Soo;Cho, Dong-Ill;Kim, Jae-Won
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.2
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    • pp.159-166
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    • 1992
  • Background:Sulfiting agents are widely used as preservatives and antioxidants in foods, beverages and drugs including bronchodilators. There have been reports of sulfite-related reactions such as anaphylaxis, urticaria, angioedema, abdominal discomfortness as well as bronchospasm. Several investigators reported that sulfite-sensitive asthmatic patients comprised from 3.9% to 8.2% of all asthmatic patients and its prevalence was higher in steroid-dependent group than in steroid-independent group. Subjects and Method:We performed oral provocation test with sodium bisulfite and aspirin in 17 asthmatic patients who have experienced aggravation of their symptoms after administration of drugs or foods. All of them were steroid dependent asthmatics. We observed clinical symptoms and steroid requirements from 1 to 18 months. Result:Ten of them showed severe bronchoconstriction after the ingestion of sodium bisulfite (50 to 200 mg) within 30 minutes. Concurrent aspirin intolerance was noted by oral provocation test in four cases (40%). Three of them showed positive responses on skin prick test with sulfite (10 or 100 mg/ml). Mean total eosinophil counts was $844/mm^3$ at asthmatic attack. And there was no significant responses on skin prick test and IgE-RAST to common inhalant allergens. After complete avoidance from sulfite containing foods and drugs as well as antiasthmatic medication for 1 to 18 months, nine of them (90%) could stop or reduce the steroid requirements. ConcIusion:It was suggested that severe steroid dependent and intrinsic type of asthmatic patients should be evaluated for sulfite-sensitivity.

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Bone Mineral Density and Bone Markers in the Children with Epilepsy Taking on Chronic Anticonvulsants (장기간 항경련제를 복용하고 있는 소아 간질 환아들의 골밀도 및 골대사 지표들)

  • Lee, Soon Bum;Kang, So Young;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.527-533
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    • 2005
  • Purpose : Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants. Methods : Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[$25(OH)D_3$], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated. Results : Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01). Conclusion : This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.

Effects of Partial Cervus elaphus Linne' Extract on Antitumoral Immune Response in Melanoma-induced Mice (부위별(部位別) 녹용(鹿茸)이 흑색종(黑色腫) 유발(誘發) 생쥐의 종양억제(腫瘍抑制)와 면역기능(免疫機能)에 미치는 영향(影響))

  • Oh Ha-Souk;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.1
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    • pp.39-78
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    • 2000
  • Introduction: In order to investigate the effects of partial Cervus elaphus Linne' extract on antitumoral immunological, a group of mice are melanoma-induced and observed reponses in terms of the number of lymphocyte, CD4+ count, CD8+ count, CD4+/CD8+ ratio in blood and spleen, change in body weight, melanoma weight, spleen index, NK cell activity and productivity of IL-2 in each mouse Methodology: Male C57BL/6 mice were chosen as an experimental object and were divided into 5 groups randomly selection. The normal group did not receive any induction. The control group was treated with normal saline in melanoma-induced' mice. Sample I group induced the upper part of Cervus elaphus Linne' extract in melanoma-induced mice. Sample II group was induced the middle part of Cervus elaphus Linne' extract in melanoma-induced mice. Sample III group was induced the lower part of Cervus elaphus Linne' extract in melanoma-induced mice. The dosage of medication was 0.2cc daily for 14days. Results: 1. There was a significant difference in the number of lymphocyte in spleen in the sample I (upper part of Cervus elaphus Linne' extract induced) and the sample II (middle part of Cervus elaphus Linne' extract induced) compared to the control group and the sample III (lower part of Cervus elaphus Linne' extract induced). On the other hand, no significant difference was observed in the number of lymphocyte in blood in the control group and all sample groups. 2. In the CD4+ T cell ratio in blood, all three sample groups showed differences compared to the control group, though there was no significant difference between sample groups. In the CD4+ T cell ratio in spleen, there was a difference between the sample I and the control group, while the sample II and the sample III had significant difference to the control group. And also, it has been observed there were differences between the sample I and the other samples. 3. In the CD8+ T cell ratio in spleen, all three sample groups showed significant differences compared to the control group, while there was no difference between groups in the ratio in blood. 4. In the CD4+/CD8+ T cell ratio in blood, the sample I showed a significant difference compared to the control group, while the sample 1I and sample III showed differences compared to the control group. In the CD4+/CD8+ T cell ratio in spleen, all three samples showed a significant difference compared to the control group, when the sample I had a difference to the other sample groups. 5. The spleen index of the sample I and the sample II showed a significant difference compared to the sample III and the control group. In comparison between the sample groups, the sample I and the sample II showed a significant difference to the sample III. 6. In terms of the change in body weight and melanoma weight, all three sample groups showed a significant difference compared to the control group, while the comparison between the sample groups showed the sample and the sample II had a significant difference to the sample Ⅲ. 7. In comparison of NK cell activity, the sample I had a difference compared to the other groups when the effector to target cell ratio was 2.5:1. With the ratio of 5:1, the sample I and sample II showed significant differences compared to the control group, while the sample Ⅲ showed a difference. When the effector to target cell ratio was 10:1, there was no difference between groups. 8. In the productivity of IL-2, all three sample groups showed significant differences compared to the control group. In comparison between sample groups, there were significant differences between each sample groups in order of the sample I , the sample II and the sample Ⅲ. Conclusion: As one can witness from the above results, administration of partial Cervus elaphus Linne extract played important role in antitumoral immune response in melanoma-induced mice, and it could be suggested that sample I and sample II groups have prominent antitumoral immune effect.

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Changes in platelet counts caused by valproate in children with epilepsy (소아 간질 환자에서 valproate 투여 후 혈소판 수의 변화)

  • We, Ju Hee;Kim, Young Mi;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.75-80
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    • 2009
  • Purpose : In adults, valproate (VPA) has been reported to be associated with thrombocytopenia. However, few studies have investigated this association in children, and the factors affecting platelet counts remain controversial. This study was undertaken to investigate changes in platelet counts following VPA therapy and related factors in children with epilepsy. Methods : Our subjects comprised 75 epileptic children who had received VPA monotherapy for at least 1 year between January 2000 and December 2005. We regularly examined platelet counts at intervals of 6 to 12 months after baseline platelet counts before VPA treatment. We analyzed changes in platelet counts according to several factors such as sex, seizure type, underlying causes of epilepsy, age at the start of medication as well as at the last follow up, duration of VPA administration, VPA dose, serum VPA level, and body weight at the last follow up. Results : Overall, the platelet counts decreased significantly after VPA therapy. The average baseline platelet count was $312.5{\pm}109.1{\times}10^6/mL$. At the last follow up, the average platelet count was $261.7{\pm}72.2{\times}10^6/mL$. We observed the relationship between platelet counts and serum levels of VPA; while children with serum VPA <$75{\mu}g/mL$ showed no change in platelet counts (P=0.102), children with serum VPA >$75{\mu}g/mL$ showed a significant decrease in platelet counts. Conclusion : VPA may cause a significantly decreased platelet count in children with epilepsy. High serum VPA levels were associated with development of thrombocytopenia.

Development and Research on a Functional Hydrolyzed Whey Protein Powder Product with Sialic Acid as a Marker Compound - II. Repeated 90-day Oral Administration Toxicity Test using Rats Administered Whey Protein Powder containing Highly Concentrated Sialic Acid (23%) produced by Enzyme Separation and Solvent Enrichment Method - (Sialic Acid를 지표성분으로 하는 유청가수분해단백분말의 기능성식품 개발연구 - II. 효소분리 용매정제로 고농도 Sialic Acid가 함유된 유청가수분해단백분말(23%)의 랫드를 이용한 90일 반복경구투여 독성시험 평가 연구 -)

  • Noh, Hye-Ji;Cho, Hyang-Hyun;Kim, Hee-Kyong;Koh, Hong-Bum
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.2
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    • pp.117-135
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    • 2016
  • The present study was performed to develop a functional raw food material from hydrolyzed whey protein powder (23%-GNANA) medication containing sialic acid as a marker compound that is naturally occurring at 7% concentration in GMP (glycomacropeptide). GMP is used worldwide in foodstuffs for babies and infants and is obtained from the milk protein as safe food. While the purpose of our detailed evaluation was aimed to assess preliminary NOAEL values for and above 2,000 mg/kg/day, a clinical dose allowance for 23%-GNANA (as per characteristic of a functional health product, a highly refined test substance of 23% (v/v) sialic acid combined in GMP), at the same time we also wanted to assess the safety of GMP hydrolyzate lacking sialic acid but with identical properties as GMP. Animal safety evaluation was conducted using 23%-GNANA as the test substance, produced from hydrolyzed whey protein powder (product name: HELICOBACTROL-23; provided by Medinutrol Inc. [Korea]; composed of 23% sialic acid and GMP protein) after isolating the sialic acid using enzymes approved as food additives, with GMP as a raw material, and subsequently increasing the content of xx up to 23% through 80% (v/v) ethanol soaking and concentrating, in accordance with GLP Guideline. The animal safety evaluation mentioned above was made on the basis of toxicity in SPF Sprague-Dawley female and male rats dosed with 10 mL of the test substance diluted to 0, 1,250, 2,500, and 5,000 mg/kg directly into their stomachs for 90 d. This was determined in terms of the general symptoms and animal viability, weight and amount of feed intake, eye examination, uracrasia tests, hematological and blood biochemical disorder tests, blood coagulation test, abnormal intestine weight, abnormalities during postmortem and histopathological examinations. Statistical significance was set at P<0.05. Based on the toxicity determination, a certain minor effect associated with the test substance was observed in male rats with no major effects of the tested substance, in comparison with the control group dosed with sterilized water. Nevertheless, the NOAEL value, evaluated as per toxicity criteria, was verified as 5,000 mg/kg/day (P<0.05). Similarly, for female rats, a certain minor effect associated with the test substance was observed in 5,000 mg/kg/day dosed group, with no major effect, yet the NOAEL value (as assessed as per toxicity criteria) was determined to be 5,000 mg/kg/day (P<0.05), which was the same as for male rats. Accordingly, the NOAEL values of the test substances for all female and male rats were finally verified as 5,000 mg/kg/day (P<0.05). In conclusion, it was determined that the 23%-GNANA test substance exceeds 2,000 mg/kg/day, the clinical allowance characteristic for functional health food, and was finally evaluated to cause no safety concerns when used as a raw material in functional health food production, which was the ultimate goal of the present study.

Differences in Clinical Manifestations and Treatment Responses in Influenza Type A and B in a Single Hospital during 2013 to 2015 (단일 병원에서 2013-2015년에 유행한 인플루엔자 A형과 B형의 임상 양상 및 치료반응의 차이)

  • Lee, Sang Min;Park, Sang Kyu;Kim, Ji Hyun;Lee, Jung Ha;Na, So Young;Kim, Do Hyun;Kang, Eun Kyeong;Cho, Sung Min;Kim, Hee Sub
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.16-22
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    • 2017
  • Purpose: We suspect there is a difference in the clinical manifestations and treatment response to antiviral drugs for influenza A and B. This study was conducted to investigate this difference. Methods: We collected information on pediatric patients, infected with the influenza virus, admitted to Dongguk University Ilsan Hospital from October 2013 to May 2015. We investigated the clinical manifestations of influenza and differences in treatment response to oseltamivir treatment for the two types of influenza. Results: A total of 138 patients were included. The mean age was $3.5{\pm}4.0$ years. When comparing the diseases associated with influenza A and B, croup (19.2% vs. 1.7%, P=0.001) was more common with influenza A infection. Myositis (0% vs. 6.7%, P=0.021) and gastroenteritis (29.5% vs. 46.7%, P=0.038) were more common with influenza B infection. When comparing the total fever duration from the start of oseltamivir administration, patients treated with oseltamivir within 2 days of fever had the shortest duration. Among the patients treated with oseltamivir, the duration of fever, after the start of oseltamivir treatment, for was shorter for influenza A infection than for influenza B infection ($16.0{\pm}19.1$ hours vs. $28.9{\pm}27.9$ hours, P=0.006). Conclusions: There appear to be differences in the accompanying diseases and antiviral medication responses between the two types of influenza. It is important to administer oseltamivir within 2 days of fever.

The Effect of Sahyangsohapwon on Heart Rate Variability of Healthy Subjects (사향소합원(麝香蘇合元)이 정상인의 심박변이도에 미치는 영향)

  • Kim, Chang-Hyun;Hwang, Jae-Woong;Min, In-Kyu;Kim, Mi-Young;Byeon, Hyung-Sik;Na, Byong-Jo;Park, Sung-Wook;Park, Jung-Mi;Ko, Chang-Nam;Bae, Hyung-Sup;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Korean Medicine
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    • v.30 no.1
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    • pp.120-127
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    • 2009
  • Objectives: Sahyangsohapwon (SS) is a herbal medication that has been widely used with circulatory and neural diseases. This study was conducted to assess the effect of SS on the autonomic nervous system by using heart rate variability measurement. Methods: The eligible subjects were enrolled from the healthy male group of ages 20 to 35 years. They were divided into two groups, the SS group (n=26) and the control (n=24). We monitored the ECG of subjects from the time period 14:00 to 18:00. In the SS group, subjects were administered with a dose of SS at the time 15:00, whereas the control group had none. For each hour HRV measurement was monitored every 15 minutes for 512 seconds from the time period 14:00 to 18:00. The mean value, which was calculated using the 4 values during each hour (i.e. 14:00, 14:15, 14:30, 14:45), was used as the representative value for each individual hour. For the measurement values, RR-interval and SDNN (standard deviation of the NN intervals) were used as time domain analysis, and HF (high frequency), LF (low frequency), and LF/HF ratio were used as frequency domain analysis. Results: The LF value showed an increase after one hour of SS administration and showed gradual diminution for each and every hour. The repeated measures of ANOVA for the comparison of the LF value between the SS group and the control group showed significant differences. While, RR interval, SDNN, HF, and LF/HF ratio values showed no significant differences between the two groups. Conclusions: We suggest that the SS might be useful for stabilizing autonomic nervous system by inhibiting sympathetic nerve activation in healthy people.

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Clinical Features Affecting the Efficacy of Systemic Clonazepam for Management of Burning Mouth Syndrome (구강작열감증후군의 치료를 위한 전신적 클로나제팜의 투여 시 환자의 임상적 특징에 따른 효능의 차이에 관한 연구)

  • Min, Bo-Kyong;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.161-167
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    • 2012
  • Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.