• Journal of The Korean Society of Clinical Toxicology
• /
• v.16 no.1
• /
• pp.42-48
• /
• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Health Communication
• /
• v.13 no.2
• /
• pp.185-193
• /
• 2018

Background: Nursing college students are exposed to information about diseases or drugs, and are likely to have a distorted perception of drug knowledge or behavior. The study aimed to identify knowledge and attitude about drugs and current status of self-medication among nursing students. Methods: The subjects were 172 nursing students from a university in Busan. Data were collected with structured questionnaires and analyzed using descriptive analysis, t-test, and one-way ANOVA using SPSS 23.0. Results: Nursing students had a high level of knowledge about drugs, but attitudes toward drugs were relatively low. 83.7% of patients had experience of self-medication. The methods to acquire information for self-administration were 29.9% by smart phone and 27.1% by internet. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) among self-medication drugs was the highest. The most common reason for self-medication was 'I thought it to be a mild disease', and the pharmacists were the most affected by choice of self-medication. The knowledge about drugs was statistically significant according to grade, school life satisfaction and subjective health status. The attitudes about medication were statistically significant according to grade and self-medication experience. Conclusion: Nursing college students need drug safety education to improve awareness and practice of correct drug use.

• Journal of Life Science
• /
• v.31 no.10
• /
• pp.873-884
• /
• 2021

The purpose of present study is to investigate the role of artesunate (ART) in enhancing anticancer effect of nonsteroidal anti-inflammatory drug (NSAID) on human cancer cells, and we elucidate a possible molecular mechanism of this combination effect. We showed that the combined effect of ART with NSAID such as celecoxib (CCB) or dimethyl-CCB (DMC) in various type of human cancer cells. After ART treatment, the expression of p62, nuclear factor erythroid 2-like 2 (NRF2) and cancer stemness (CS)-related proteins including CD44, CD133, aldehyde dehydrogenase 1 (ALDH1), octamer-binding transcription factor 4 (Oct4), mutated p53 (mutp53) and c-Myc was down-regulated. ART induced autophagy as reduction of the autophagy receptor p62, which was associated with up-regulation of activating transcription factor 4 (ATF4) and C/EBP homologous protein (CHOP), and simultaneous down-regulation of NRF2 and CS-related proteins was occurred in the human cancer cells. These results indicate a possibility that ART activates autophagy through ATF4-CHOP cascade leading to down-regulation of CS-related proteins and subsequently eradicated cancer stem cells. In addition, co-treatment with ART and imatinib was more effective than either drug alone on growth inhibition and apoptosis induction of cancer cells. In conclusion, induction of autophagy-dependent cell death by ART might play a critical role in mediating the synergistic effect of drug combination (ART/NSAID and ART/imatinib). Therefore, ART could be a promising candidate as a chemosensitizer to enhance the anticancer effects of NSAID and imatinib.

• Journal of the Korean Magnetic Resonance Society
• /
• v.15 no.1
• /
• pp.54-68
• /
• 2011

$^1H$ nuclear magnetic resonance (NMR) spectroscopy of biological samples has been proven to be an effective and nondestructive approach to probe drug toxicity within an organism. In this study, ketoprofen toxicity was investigated using $^1H$-NMR spectroscopy coupled with multivariate statistical analysis. Histopathologic test of ketoprofen-induced acute gastrointestinal damage in rats demonstrated a significant dose-dependent effect. Furthermore, principal component analysis (PCA) derived from $^1H$-NMR spectra of urinary samples showed clear separation between the vehicle-treated control and ketoprofen-treated groups. Moreover, PCA derived from endogenous metabolite concentrations through targeted profiling revealed a dose-dependent metabolic shift between the vehicle-treated control, low-dose ketoprofen-treated (10 mg/kg body weight), and high-dose ketoprofen-treated (50 mg/kg) groups coinciding with their gastric damage scores after ketoprofen administration. The resultant metabolic profiles demonstrated that the ketoprofen-induced gastric damage exhibited energy metabolism perturbations that increased urinary levels of citrate, cis-aconitate, succinate, and phosphocreatine. In addition, ketoprofen administration induced an enhancement of xenobiotic activity in fatty oxidation, which caused increase levels of N-isovalerylglycine, adipate, phenylacetylglycine, dimethylamine, betaine, hippurate, 3-indoxylsulfate, N,N-dimethylglycine, trimethyl-N-oxide, and glycine. These findings demonstrate that $^1H$-NMR-based urinary metabolic profiling can be used for noninvasive and rapid way to diagnose adverse drug effects and is suitable for explaining the possible biological pathways perturbed by nonsteroidal anti-inflammatory drug toxicity.

• KSBB Journal
• /
• v.25 no.3
• /
• pp.297-302
• /
• 2010

Ketoprofen is one of the propionic acid class of nonsteroidal anti-inflammatory drug with analgesic and antipyretic effects. The most common side effects from ketoprofen after oral administration are gastrointestinal irritation, diarrhea, abdominal pain and retention of fluid. Ketoprofen was formulated as water-soluble gels to reduce these side effects. To increase the skin permeability of ketoprofen, microsphere containing ketoprofen was prepared with chitosan and ploy-$\varepsilon$-caprolactone. And then prepared microsphere was manufactured as an adhesive hydrogel with polyvinylpyrrolidone K-25, polyethylene glycol 4000, and various permeation enhancers. The flux and permeability of ketoprofen were evaluated. As the concentration of tween 80 and enhancers increased, the flux of ketroprofen was accelerated. Also the permeation rate was facilitated by enhancers, but did not affect the lag time. From these results, the adhesive hydrogel using microsphere could be a good delivery system for ketoprofen to improve the skin permeation.

• The Korean Journal of Pain
• /
• v.19 no.2
• /
• pp.285-287
• /
• 2006

Hundreds of drugs have been implicated as the causes of antibody-mediated thrombocytopenia. Naproxen is a commonly used nonsteroidal anti-inflammatory drug, and it is generally considered to be safe with few hematological side effects such as thrombocytopenia. In this case, severe thrombocytopenia associated with petechia and epistaxis appeared after initiation of naproxen therapy in the 59-year-old man. We report here on a case of severe thrombocytopenia that was recognized at 10 days after the use of naproxen, and the patient rapidly recovered to a normal platelet count without bleeding symptoms or any complications, although immunoglobulin or steroid was not used.

• Journal of Veterinary Clinics
• /
• v.19 no.1
• /
• pp.100-102
• /
• 2002

Nonsteroidal anti-inflammatory drugs are widely used for treatment of animals. Their use is limited by frequent side effects commonly involving the gastrointestinal tract, most important of which is development of ulcerating lesions principally In the stomach. Unfortunately, presence of such lesions is often unsuspected because clinical signs may be overlooked until a complication develops. A 5-year-old, female mongrel dog was referred to Veterinary Teaching Hospital in Chungbuk National University. She was showed vomiting, anorexia and lethargy after administration of ibuprofen (400 mg/body, qid, oral) for 5 days. General examination and plain radiography were performed in the patient. Physical examination, hematologic values, chemical profiles, urinalysis and radiographs were normal. Therefore, endoscopic examination was performed in this patient and confirmed to show the gastric ulcer in pyloric region of the stomach. Drug therapy was performed successfully in this case. This article reports the development of a gastric ulcer associated with orthopedic disease treated by ibuprofen.

• Bulletin of the Korean Chemical Society
• /
• v.8 no.4
• /
• pp.261-264
• /
• 1987

Benoxaprofen (2-(4-chlorophenyl)-${\alpha}$ -methyl-5-benzoxazole acetic acid) is a nonsteroidal anti-inflammatory drug that causes acute cutaneous phototoxicity. The ability of benoxaprofen (BXP) and its photoproduct, decarboxybenoxaprofen (DBXP) to photosensitize the decomposition of tryptophan was evaluated in various media such as water, ethanol and aqueous micellar dispersions of surfactants. The weak photosensitization of BXP in water was found to be enhanced in cationic CTAB micelle system, but yielded little difference in anionic SDS micelles. In ethanol solution, BXP was determined to photosensitize the decomposition of tryptophan, but no photosensitization was observed with DBXP. All of these results implicate that the anion radical of BXP may play a major role in the photosensitization in hydrophobic micellar phase, forming superoxide through interaction with oxygen as demonstrated by observation that the photosensitization was inhibited by superoxide dismutase.

• Journal of Hospice and Palliative Care
• /
• v.19 no.4
• /
• pp.331-334
• /
• 2016

Purpose: Advanced cancer may accompany cold sweat as paraneoplastic symptom. Few studies have been performed on the efficacy of non-steroid anti-inflammatory drug (NSAID) in advanced cancer patients who sweated without fever. Methods: To select study participants, medical records were retrospectively reviewed for patients who satisfied the following criteria: 1) incurable, advanced solid cancer; 2) Cold sweating of 4 or higher on the numeric rating scale (NRS) 4; 3) No evidence of infection or hypoglycemia; 4) No newly started opioid or anti-hormonal agents within one month; 5) NSAID prescription for the management of cold sweating and 6) Documented NRS information before and after NSAID administration. Results: A total of 13 patients were selected after excluding four patients due to lack of NRS information or fever. The mean age was 59 years old (range: 50~71), and nine patients (69%) were male. Bile duct cancer was the most common primary tumor followed by pancreatic cancer, gastric cancer and prostate cancer. The mean NRS of cold sweating dropped from baseline 6.5 (min-max: 4~10) to 1.9 at the follow-up assessment (min-max: 0~5). The mean follow-up period was 9.1 days (range: 2~30 days) from NSAID treatment to assessment. Conclusion: NSAID was effective medication for management of sweating without fever in patients with advanced cancer.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.28 no.1
• /
• pp.13-28
• /
• 2015

Objectives: To observe the in vitro anti-inflammatory effects of Hyunbulikyung-tang aqueous extracts (HBLKT) and the possible synergic combination effects with a nonsteroidal anti-inflammatory drug, piroxicam. Methods: Anti-inflammatory effects of HBLKT (yield=16.17%) were observed on LPS activated raw 264.7 cells based on $ED_{50}$ to cell viability, NO, $PGE_2$, $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 productions as compared with piroxicam, in the present study. In addition, the combination effects of HBLKT with piroxicam were observed after treatment of HBLKT 1/4 $ED_{50}$ + piroxicam 1/4 $ED_{50}$, 1/8 $ED_{50}$, 1/16 $ED_{50}$, 1/32 $ED_{50}$ and 1/64 $ED_{50}$ concentrations, respectively. Results: Significant (p<0.01 or p<0.05) increases of cell viabilities and decreases of NO, $PGE_2$, $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 cytokine releases were detected in HBLKT 1/4 $ED_{50}$ + piroxicam 1/4 $ED_{50}$, 1/8 $ED_{50}$, 1/16 $ED_{50}$ and 1/32 $ED_{50}$ concentration co-treatment as compared with each of single 1/4 $ED_{50}$ concentration of piroxicam and HBLKT treatments, respectively. Although significant (p<0.01 or p<0.05) increases of cell viabilities and decreases of NO, $PGE_2$, $TNF-{\alpha}$, $IL-1{\beta}$ and IL-6 cytokine releases were also demonstrated in piroxicam 1/64 $ED_{50}$ + HBLKT 1/4 $ED_{50}$ co-treatment as compared with LPS control, no significant changes were detected as compared with each of single 1/4 $ED_{50}$ concentration of piroxicam and HBLKT treatments, in this experiment. Conclusions: Hyunbulikyung-tang showed cell protective and anti-inflammatory effects against LPS activated raw 264.7 cells. It, therefore, expected that HBLKT will be showed favorable effects to relieve dysmenorrhea related to over expressed inflammatory cytokines, and it also expected that the clinical dosages of piroxicam can be reduced as 1/8 levels as combination with HBLKT.