• Title/Summary/Keyword: Period of Prescription

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Clinical Course according to Antipsychotics Prescription Pattern in Delirium (섬망 환자에서 항정신병약물 처방 유형에 따른 임상 경과의 차이)

  • Park, Jaesub;Kim, Jae-Jin;Park, Sungjong;Kim, Sungmin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.120-128
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    • 2017
  • Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

Patterns of Antibiotic Usage in Clinics and Pharmacy after Separation of Dispensary from Medical Practice (의약분업 이후 의원 및 약국에서의 항생제 사용 실태)

  • Song, Yun-Kyoung;Lee, Hyun-Kyung;Ji, Eun-Hee;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.332-338
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    • 2011
  • This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.

A Study on Role Conflict and Job Satisfaction of Neurosurgery Clinical Nurse Specialist (신경외과 임상전문간호사의 역할갈등과 직무만족에 관한 연구)

  • Lee, Hae Jin;Kang, Young Sil;Choi, Eun Sook
    • Korean Journal of Adult Nursing
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    • v.18 no.2
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    • pp.304-313
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    • 2006
  • Purpose: The purpose of this study was to describe role conflict and job satisfaction of Neurosurgery Clinical Nurse Specialist(NCNS) and to identify associated factors. Method: The target populations was 77 NCNSs from 30 general hospitals. Data were collected with self-administered questionnaires and analyzed using t-test and ANOVA. Results: The overall mean scores of role conflict and job satisfaction were $3.60({\pm}0.54)$ and $3.04({\pm}0.46)$ respectively. Significant variables affecting role conflict were the working period as NCNS, the number of colleague NCNSs in working hospital, and assignment of prescription rights. The significant variable affecting job satisfaction was assignment of prescription rights. There was no statistically significant correlation between job and role conflict. Conclusion: The variable effecting both role conflict and job satisfaction was the extent of prescription rights. In order to improve the quality of patient care and to protect Neurosurgery Nurse Clinical Specialist, the enactment of law on prescription practice is needed.

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Antidepressant Prescription Patterns in Bipolar Disorder: a Nationwide, Register-based Study in Korea

  • Yoon, Woon;Shon, Seung-Hyun;Hong, Youjin;Joo, Yeon Ho;Lee, Jung Sun
    • Journal of Korean Medical Science
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    • v.33 no.46
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    • pp.290.1-290.11
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    • 2018
  • Background: The role of antidepressants (ADs) in bipolar disorder is long-standing controversial issue in psychiatry. Many clinicians have used ADs as a treatment for bipolar depression, and the selection of therapeutic agents is very diverse and inconsistent. This study aimed to examine recent AD prescription patterns for patients with bipolar disorder in Korea, using the nationwide, population-based data. Methods: This study utilized the Korean nationwide, whole population-based registry data of the year 2010, 2011, and 2013. All prescription data of the ADs, antipsychotics, and mood stabilizers of the sampled patients diagnosed with bipolar disorder (n = 2,022 [in 2010]; 2,038 [in 2011]; 2,626 [in 2013]) were analyzed for each year. Results: Annual prescription rate of ADs was 27.3%-33.6% in bipolar disorder, which was gradually increasing over the 3-year period. The combination pattern of ADs and antipsychotic drugs tended to increase over 3 years. The proportion of females and the prevalence of comorbid anxiety disorder were significantly higher in AD user group in all three years. Among individual ADs, escitalopram was prescribed most frequently, and fluoxetine and bupropion were prescribed to the next many patients. The mean duration of bipolar depressive episodes was 135.90-152.53 days, of which ADs were prescribed for 115.60-121.98 days. Conclusion: Our results show prescription rate of ADs in bipolar disorder was maintained at substantial level and increased in recent 3 years. More empirical data and evidence are needed to establish practical treatment consensuses.

A Study on Cold Damage(傷寒) in the Compendium of Prescription from the Countryside(鄕藥集成方) - Focusing on citation, medical theory, prescription, medicinal herbs - (조선 의서 『향약집성방』 중에 실린 상한(傷寒) 논의 연구 - 인용 문헌, 의론(醫論), 처방, 본초 등을 중심으로 -)

  • Oh, Chae-Kun
    • The Journal of Korean Medical History
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    • v.25 no.2
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    • pp.121-136
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    • 2012
  • The purpose of this paper is to derive the features of cold damage clinical medicine during the early days of the Chosun(朝鮮) period by analyzing discussions on cold damage published in the official medical book of the Chosun period, Compendium of Prescription from the Countryside(鄕藥集成方, CPC). Cold damage was one of the typical diseases in East Asia where there was constant seeking of the utilization of prescriptions, ways of preparations, and awareness regarding cold damage as shown in Zhang, Zhongjing(張仲景)'s Treatise on Cold Damage Disease(傷寒論, TCDD) below. Traditional Korean medicine which possessed the medical universality of East Asia also was no exception and through an analysis of the part on cold damage in CPC, it is expected that medical features of cold damage in Korea passed down from the Koryo(高麗) Dynasty to the early Chosun period will be revealed. For this, first there needs to be an organization of past discussions on cold damage surrounding the existence of infection and after checking the issues, exploring which of the writings related to TCDD and editions are being utilized through an analysis on citing literature of Cold Damage Disease Literature(傷寒門) and Heat Pathogen Disease Literature(熱病門) which have developed discussions on cold damage in CPC. In addition, by comparing Peaceful Holy Benevolent Prescription(太平聖惠方, PHBP) and Complete Record of Sacred Benevolence(聖濟總錄, CRSB), known to have greatly influenced CPC and Cold Damage Literature and Heat Pathogen Disease Literature, features of form and content used by CPC were analyzed. Features of form were examined through pattern of organization and number of citing literature were examined and for features of content, cold damage infection, classification, syndrome differentiation method, and utilization of materia medica among prescriptions were examined. Discussions on cold damage as being uninfectious as stated in Treatise on the Pathogenesis and Manifestations of All Diseases(諸病源候論) unlike pestilence, epidemic pathogen(時氣), warm pathogen disease(溫病), and heat pathogen disease were excluded in PHBP. PHBP opened the possibility of cold damage infection and later writings, CRSB and CPC also follow this. As a result of analyzing citing literature of the part on cold damage in CPC, it is uncertain which edition of TCDD is being utilized; however, the most distinctive feature was that Classified Emergency Materia Medica(證類本草) and not writings specializing in cold damage are in use. In general, although CPC in terms of form is similar to CRSB, content creation predominantly depended on PHBP. More specifically; first, in terms of the existence of cold damage infection, arguments of PHBP and CRSB are maintained. Second, in terms of cold damage classification, although CRSB is followed, heat pathogen disease is classified separately developing PHBP as is. Third, in terms of method, as Book of Keep Healthy(南陽活人書) and CRSB compiled in later times are cited, it is deemed that arguments were raised to a certain extent regarding six-meridian syndrome differentiation(六經辨證). Fourth, although the majority of utilized materia medica among cold damage prescriptions utilize Materia Medica from the Countryside(鄕藥本草) in CPC and materia medica from Korean Peninsula, this is due to the desire for the compilation performance of CPC to be propagated to ordinary citizens and not the ruling class. CPC as the official medical book compiled in the early days of the Chosun period was greatly influenced by the Song(宋) Dynasty's medical books, PHBP and CRSB shows that cold damage medicine in the early Chosun Period indeed possesses the medical universality of East Asia. Furthermore, the features of published medical theory and prescriptions reveal the existence of the cold damage medical tradition of the Chosun period serving as clues for cold damage research tradition among Korea's medical history.

A Study on Clinical Korean Medicine Book 『JeSeBoGam』 during the Period of Japanese Occupation - with Focus on the Comparison with 『BangYakHapPyeon』 - (일제강점기 임상한의서 『제세보감』 연구 - 『방약합편』과의 비교를 중심으로 -)

  • Ku, Hyun-Hee
    • The Journal of Korean Medical History
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    • v.29 no.2
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    • pp.35-47
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    • 2016
  • "JeSeBoGam (濟世寶鑑)" was a medical document authored by Moon Gi-hong during the Japanese colonial rule in 1933, and the author acted as a Korean medicine doctor, an acupuncturist, a medicine practitioner and an apothecary. Since its first publication in 1933, it has been published three times in 1966 and 1975, from the Japanese colonial period to the liberation period. "JeSeBoGam" is largely divided into Preface part, "List of drugs according to symptoms [隨症用藥目錄]", "JeSeBoGam-Gap (濟世寶鑑甲)", and the Appendix includes "Key points for diagnosing the disease [察病要訣]" "Key points of acupuncture and pulse [脈訣]" "Key points of acupuncture and moxibustion treatment [針灸訣]" in the back of the book. In 1933, there are attached exam books and license application forms related to Korean medicine doctor and pharmacist, so strict regulations on them during the Japanese occupation period can be confirmed. "JeSeBoGam-Gap" contains 208 prescriptions from 143 prescriptions taken from "BangYakHapPyeon" and 65 prescriptions from other books. It divided into Gap (甲) Eul (乙) Byung (丙) Jung (丁). These prescriptions were placed in "List of drugs according to symptoms [隨症用藥目錄]" according to a symptom 1,286 times. Considerable parts of organization and prescription drug composition of "JeSeBoGam" are closely related with "BangYakHapPyeon", but there were adjustments in all medicinal ingredients and capacity for the rest of them except 23 prescription drugs. Compared to "BangYakHapPyeon", there was a tendency to substitute the basic prescription in "JeSeBoGam" for prescriptions used for the same disease. Though only 65 prescriptions were taken from books other than "BangYakHapPyeon", 575 times were reflected in "List of drugs according to symptoms [隨症用藥目錄]", and the rate of utilization is high compared with the number of prescriptions of "BangYakHapPyeon". It is thought that the circumstances of the Japanese occupation period, limits in medicinal ingredients composition due to regional characteristics, and changes in a patient's condition and the treatment method might have an influence on the author's drug use tendency. "JeSeBoGam" is similar to "BangYakHapPyeon" in composition, but it is a new practical medical book in which the author's clinical records are concentrated.

The study on utilization of Hyangyak in 「Single-medicine prescription treatment of domestic herbs」 of 『Kwangjebikeup』 : Focusing on Ginseng (『광제비급』의 「향약단방치험」에 나타난 향약활용법에 대한 연구 - 인삼을 중심으로)

  • Kang, Yun Mi;Kim, Yun Kyung;Ahn, Sang Woo
    • The Korea Journal of Herbology
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    • v.29 no.3
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    • pp.1-10
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    • 2014
  • Objectives : In this study, we investigated Hyangyak in "Single-medicine prescription treatment of domestic herbs" of "Kwangjebikeup" and then conducted further studies focusing on ginseng as it is written in "Single-medicine prescription treatment of domestic herbs". Methods : Through a study of classical literature on Hyangyak and ginseng, information regarding the two was gathered and analyzed, with respect to both time and region. Results : All of the herbs in "Single-medicine prescription treatment of domestic herbs", the 4th volume of "Kwangjebikeup", are domestic herbs. Ginseng was a part of the flora of the Korean Peninsula from long ago and ginseng was cultivated from most of the peninsula. We confirmed cultivation of ginseng in Sungcheon, Pyungan-do and most areas of Hamgyeong-do through geography books such as "Geography Monograph of King Sejong". Because the natural environmental condition of the Korean Peninsula was conducive to growing wild ginseng, it was possible to cultivate ginseng. In the late Chosun period, cultivated ginseng was so prevalent that people would have been able to collect and use ginseng without great difficulty. In "Kwangjebikeup", ginseng shows superior efficacy in terms of first-aid. "Kwangjebikeup" contains practical herbal medicines that were based on obtainable ingredients. Conclusions : The purpose of publication of this book was to make medical knowledge available to general public in an easy-to-understand form. And through added clinical experiences of the author, we know that "Kwangjebikeup" played a role in settlement and spreading of foreign knowledge to civilians.

An Analysis of Prescription Patterns and Incidence of Dyslipidemia in a Korean Tertiary Hospital HIV Patients Receiving High Active Antiretroviral Therapy (3차 병원에서 HAART 치료를 받은 HIV 환자의 처방패턴 및 이상지질혈증 발생 빈도 분석)

  • Park, Sun Hee;Yang, Young-Mo;Choe, In;Yoon, Hyonok;Choi, Eun Joo
    • YAKHAK HOEJI
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    • v.59 no.3
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    • pp.85-91
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    • 2015
  • Highly active antiretroviral therapy (HAART) has reduced AIDS-related morbidity and mortality; however, it has been associated with metabolic abnormalities including dyslipidemia and dysglycemia depending on the regimens used. The aims of this study were to analyze the prescription patterns of antiretroviral agents and to examine the prevalence of lipid abnormalities among the prescriptions of HAART. The electronic medical records (EMR) of HIV patients were retrospectively reviewed from January 2007 to September 2012 based on our inclusion criteria. The patients who had taken HAART for at least 3 months were included in this study. The lipid profiles of patients on antiretrovirals (ARTs) were collected from his or her laboratory data, and dyslipidemia was defined as total cholesterol (TC) ${\geq}240mg/dL$ and triglycerides (TG) >200 mg/dL. Eighty-four prescriptions were discovered during the study period. Twenty-three prescriptions were the combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Fifty-three prescriptions were the combination of two NRTIs and one protease inhibitor (PI) and thirty-nine prescriptions of them included a PI booster. Eight prescriptions were the combination of two NRTIs and one integrase inhibitor. The Incidence of hypertriglyceridemia among the patients receiving HAART was totally about 41.7% (2NRTIs+PI regimen vs. 2NRTIs+NNRTI regimen vs. 2 NRTIs+integrase inhibitor regimen, 52% vs. 12.5% vs. 25%), but there was no incidence of hypercholesterolemia. This study investigated that the prescription medication patterns and dyslipidemia associated with lipid abnormalities among HIV patients receiving HAART. The types of HAART prescription regimens had an effect on the occurrence of hypertriglycemia. Further studies related to metabolic abnormalities and adverse effects of HIV patients on ARTs are needed in the near future.

Study on Prescription and Formation of SoAEuiBang and DongEuiBoGam (소아의방(小兒醫方)과 동의보감(東醫寶鑑)의 편제와 처방에 대한 연구)

  • Kim, Cho-Young;Chang, Gyu-Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.1
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    • pp.65-76
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    • 2010
  • Objectives In the later period of Choseon dynasty, korean pediatrics became a pivot part of medicine. SoAUiBang was the most important book in that era. DongEuiBoGam was the most widely read of all oriental medicine books and published in early days of the Choseon dynasty. Therefore, this comparative study on the prescription and formation of SoAUiBang and DongEuiBoGam could be a useful way to understand SoAUiBang's characteristics. Methods This study was based on SoAUiBang and DongEuiBoGam, two literatures of oriental medicine. Results 1. Formation of SoAUiBang had a similar aspect with that of DongEuiBoGam's and enlarged the area of pediatrics by featuring general medical books. However, its formation did not follow the DongEuiBoGam's, but had its unique formation. It tried to include all diseases of pediatrics in the system of DongEuiBoGam. Plus, smallpox and measles belonged to the epidemic diseases were excluded from the area of pediatrics. 2. Comparing SoAUiBang's prescription of some important diseases with DongEuiBoGam's, it was almost a prescription based on DongEuiBoGam's prescription. However, adjustment of herbs and dosages could not be found in any oriental medicine books including DongEuiBoGam. Conclusions SoAUiBang maintained the traditional Oriental medicine based on author's scholarly creativeness. In addition, it also inherited the lineage of medicine in Korea along with the pedigree of DongEuiBoGam. Therefore, SoAUiBang should be re-evaluated as a medicine book that opened a new field of pediatric and had great academic values.

Decipherment of the Wooden Tablet Prescription Excavated at Anapji (안압지 출토 목간(木簡) 처방전의 석독(釋讀)에 대한 연구)

  • Lee, Deok-Ho;Lee, Sun-A;Kim, Nam-Il
    • Korean Journal of Oriental Medicine
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    • v.15 no.2
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    • pp.85-91
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    • 2009
  • The manufacture date of the number 198 wooden tablet excavated at Anapji is estimated to be between year 751 and 774. As medical artifacts around this period of time is scarce, the discovery of an artifact with distinct medical information such as names of medicinal drugs recorded in hand writing holds great value in the history of medicine. This wooden tablet was presumably a prescription for a medicinal formula. That the '灸' character which is a method of processing drugs is found after '甘草' indicates the possibility of this wooden tablet to be a practical form of prescription. On this slip, a certain sign can be found at the upper right corner of the names of drugs. This is thought to be an additional sign added to the original text. It seems to have been originated from the letter '了', based on the composition and finishing touches of the strokes, presumably to confirm the end of a work by adding the letter '了' which means 'to finish'. The base material of 靑黛 and 藍淀 are the same, and the two often took each other's place in a prescription. It is difficult to find an example of a formula where both drugs are included. Therefore, the prescription on the front with 靑黛, and the one on the back with 藍淀 of tablet 198 can be understood as separate formulas.

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