• 셀메드
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• 제2권1호
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• pp.9.1-9.13
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• 2012

Jeechool-Whan (JW) is a prescription of Ponciri Fructus Immaturus and Atractylodis Rhizoma Alba and improves the functions of the stomach and the spleen. Although it is said in Korean Medicine that the spleen and the stomach are the roots of the body's resistance, the meaning of 'improving the spleen and the stomach' is very comprehensive. Moreover, there are lots of drugs that are said to improve the spleen and the stomach, and the number of prescriptions using these drugs is huge. In this study, we focused on the new effect and mechanism of the JW on the ovalbumin (OVA)-induced allergic rhinitis (AR) model. The increased number of rubs and the increased levels of IgE and histamine in the OVA-sensitized mice were inhibited by JW administration. The balance of Th1/Th2 cytokine level was regulated by JW administration. The levels inflammatory proteins were decreased by JW administration in the nasal mucosa of the OVA-sensitized mice. Eosinophils and mast cells infiltration increased by OVA-sensitization was also decreased in the JW-administered mice. In addition, JW inhibited caspase-1 activity in the same nasal mucosa tissue. In activated human mast cells, JW inhibited the receptor interacting protein-2, I${\kappa}$B kinase-${\beta}$, nuclear factor-${\kappa}$B/Rel A, and caspase-1 activation. In conclusion, this study will be support the clear understanding of the concept of the spleen and the stomach in traditional Korean medicine as well as for a possibility of finding a cure for this AR in traditional medical treatments.

• 보건행정학회지
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• 제22권1호
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• 약학회지
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• 제55권2호
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• pp.121-126
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• 2011

Sipjundaebo-tang was a well-known restorative traditional herbal prescription that used to treat anemia, anorexia, fatigue and inflammation. In this study, we examined the bioconversion of compounds in the Sipjundaebo-tang (SJ) and fermented Sipjundaebo-tang with Lactobacillus fermentum KFRI 164 (FSJ) using established HPLC-DAD method. The chromatogram of FSJ has shown that the contents of six bioactive compounds 5-HMF, paeoniflorin, ferulic acid, cinnam aldehyde, decursin, glycyrrhizin in SJ has decreased. And the contents of unknown compounds (1), (2), (3), (4) and (5) in FSJ were higher than each contents of SJ. The antioxidant activities of SJ and FSJ were conducted by DPPH free radical and Hydrogen peroxide ($H_2O_2$) scavenging assay. Electron donating activity (EDA, %) value of FSJ has shown higher than 21.9% and 14.5% at a concentration of 0.5 mg/ml for DPPH radical scavenging activity and $H_2O_2$ scavenging activity, respectively. Also, the neuroprotective activities of SJ and FSJ against glutamate-induced oxidative stress in a mouse hippocampal cell line (HT22) were evaluated by MTT assay. As a result, FSJ has shown higher neuroprotective activity than 56.5% comparing with SJ. In conclusion, the fermented SJ using microorganism could convert compounds in SJ and enhance antioxidant activity and neuroprotective activity.

• Archives of Pharmacal Research
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• 제28권2호
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• pp.203-208
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• 2005

Scoparone is a major component of the shoot of Artemisia capillaris (Compositae), which has been used for the treatment of hepatitis and biliary tract infection in oriental countries. In the present study we observed that, scorparone exhibited no cytotoxic effect in unstimulated macrophages, but reduced the release of nitric oxide (NO) and prostaglandin $E_2\;(PGE_2)$ upon stimulation by IFN-${\gamma}$/LPS or LPS. The inhibitory effects were found to be in conjuction with the suppression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in IFN-${\gamma}$/LPS stimulated RAW 264.7 cells. Moreover, scoparone also attenuated the production of tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-$1{\beta}$ and IL-6 in LPS-stimulated RAW264.7 cells. These results suggest that scoparone decreases the production of the inflammatory mediators such as NO and $PGE_2$ in macrophages by inhibiting iNOS and COX-2 expression.

• 한국병원경영학회지
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• 제7권1호
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• pp.19-40
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• 2002

The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

• 약학회지
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• 제59권5호
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• pp.235-244
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• 2015

The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.

• 약학회지
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• 제52권6호
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• pp.471-479
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• 2008

The purpose of this study is to investigate the best way that Oriental medicine contributes for activation of pharmacy management after the separation of prescribing and dispensing practice since July 2000. In order to investigate current pharmacy conditions for handling of Oriental medicine and many problems for administering the Oriental medicine to patients, a questionnaire was written with a list of questions related to pharmacy management with Oriental medicine, and given to 58 subjects via fax or personal visit during the period of April 21 to 30, 2003. The research results was as follows; In th 58 subjects, 45 subjects (77.6%) were pharmacists with a licence for dispensing Oriental medicine. 70.7% of subjects most likely preferred to extract granule as administering type of oriental medicine. About the motivation using Oriental medicine, the reason for activation of pharmacy management was 39.7%, second, the reason for resolving the limitation of treatment over western medicine was 25.9%. Oriental medicine for patients was mainly administered by recommendation with pharmacist (65.5%). In comparison with after and before the separation of prescribing and dispensing, 51.7% of subjects answered that sale volume was decreased after the separation. Concerning the ratio of total sales volume to Oriental medicine within 5 years, 50% of subjects expected that sales volume will increase positively. About treating Oriental medcine, 34.5% of subjects thought the problem is the regulation by limiting 100 kinds of formulary. The most important factor for increasing Oriental medicine selling amount was continueous education for various information of oriental medicine in case of 44.8% of sujects. The best pharmacy to handle oriental medicine was community pharmacy (36.2%). It was expressed the reason why many pharmacists have not been treated oriental medicine because lots of time needs for dispensing prescription from clinics in these 4 years after the separation of prescribing and dispensing. These results lead to the conclusion that the Oriental medicine at pharmacy will greatly increase within 5 years and will be very important portion for pharmacy management.

• 약학회지
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• 제58권1호
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• pp.40-46
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• 2014

Drugs with a narrow therapeutic index (NTI) require very precise dosing. Warfarin and digoxin are the examples of NTI-drugs and dosing of them varies widely for different patients. However, in South Korea, only two strengths of warfarin and one of digoxin are commercially available. This is a big barrier for the precise dispensing and has potential safety risks to patients, particularly to elderly patients. To find a potential solution to the problem, an analysis of the prescribed doses and dispensing patterns of those drugs was performed. Data were collected by computer-facilitated prescription review in a university hospital. The period screened was from May 1st, 2012 to April 30th, 2013. All the prescriptions with either warfarin or digoxin tablets were selected for this study and dispensing patterns were analyzed according to the prescribed doses. A total of 17,017 warfarin prescriptions were analyzed; 8,148 for inpatient prescriptions, 8,869 for outpatient prescriptions, respectively. Of the 23 kinds of prescribed doses, 2 mg (19.9%) was most frequent, followed by 3 mg (13.2%) and 2.5 mg (11.7%). By analyzing the dispensing patterns, 60.3% (10,253) of the prescriptions required pill splitting and 72.0% of them were for the patients 65 years old and over. On the other hand, 4,350 digoxin prescriptions were included in this study. Of the 6 kinds of prescribed doses, 0.125 mg (71.2%) was most frequent, followed by 0.0625 mg (20.2%). Among the prescriptions for digoxin, 92.0% (3,998) should be split and 65.7% of them were for the patients aged 65 years and over. Despite limitations of strengths, various doses of warfarin and digoxin were prescribed. Furthermore, more than half of the prescriptions that required pill splitting were for elderly patients. The results from this study suggest that different strengths of warfarin and digoxin should be provided for accuracy of dispensing and safety for patients receiving them.

• 약학회지
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• 제58권2호
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• pp.91-98
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• 2014

Pharmacists must be aware of veterinary drugs to prevent abuse and misuse of the drugs, and to ensure the safety of livestock under the veterinarian prescription system. In this study, the awareness of animal pharmacies was surveyed in order to find out the role of animal pharmacies and the necessity of veterinary drug education for pharmacists. Surveys were conducted by 187 animal owners and 115 community pharmacists. 80% of the animal owners had purchased drugs for their animals. 63% of respondents were not aware of the existence of animal pharmacies. The best selling drug class for animals was antiparasitic. The most common drug that respondents wanted to buy in animal pharmacies was also antiparasitic. About 80% of respondents answered affirmatively on the question of whether they would buy the drugs from animal pharmacies regardless of the location of the pharmacies. Most community pharmacists were aware of the existence of animal pharmacies. 70% of pharmacists had considered trading in veterinary drugs. 41% of respondents answered that they did not trade in them because they were not familiar with veterinary drugs. 80% of respondents answered that what they needed most was education in order to increase the number of animal pharmacies. Pharmacies for animal will expand the choice of animal owners, and enable pharmacists to improve their specialty as well as to diversify the pharmacy services. To achieve this, promotion of animal pharmacies and education about veterinary drugs for pharmacists would be needed in regular education system.

• 약학회지
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• 제57권2호
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• pp.101-109
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• 2013

Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.