• Title/Summary/Keyword: Pharmacologic therapy

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Issues on Safety of Long-Acting Muscarinic Antagonist (지속성 무스카린 대항제(LAMA)의 안전성)

  • Lee, Yang-Deok;Cho, Yong-Seon;Han, Min-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.5
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    • pp.384-389
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    • 2011
  • The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled ${\beta}_2$ agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.

Sogeunjung-tang improves depressive-like behavior decreased by forced-swimming test

  • Jeong, Hyun-Ja;Moon, A Rim;Kim, Na-Hyung;Chung, Cha-kwon
    • CELLMED
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    • v.7 no.1
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    • pp.4.1-4.4
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    • 2017
  • Sogeunjung-tang (S-tang) is a traditional Korean medicine that has been used for the therapy of anxiety disorder in a variety of clinical situations. However, no study has investigated this effect. The aim of this study was to investigate the effectiveness of S-tang for reducing depression in animal model. The anti-depressant effect of S-tang was investigated in ICR mice by using forced swimming test (FST). After FST, we analyzed the blood biochemical parameters from blood. The immobility time was significantly decreased in the S-tang oral administration or pharmaceutical acupuncture group compared with the control group at 14 days (p < 0.05). The anti-depressant effect of S-tang was higher than that of fluoxetine (a classical anti-depressant). S-tang or fluoxetine significantly decreased the creatine kinase and lactate dehydrogenase level compared with the control group (p < 0.05) but not glucose, protein, and blood urea nitrogen level. Further investigation of S-tang as a potential pharmacologic agent in the management of depression related anxiety is warranted.

A proposal for management of migraine in dental clinic (치과임상에서 편두통 치료에 대한 제안)

  • Park, YounJung;Lee, Hye-Jin;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.199-205
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    • 2019
  • Management of migraine, one of common primary headache disorders, involves the diverse strategies non-pharmacological treatment, such as headache diary, lifestyle modification, regular exercise and relaxation, cognitive behavioral therapy and neurostimulation, and pharmacological treatment. Among the treatments, this review described a pharmacologic treatment of migraine, classified into acute and preventive treatment based on the severity and the frequency of headache. It introduced the way to optimize pharmacological treatment and updated the latest treatment for migraine.

Effect of nitroglycerin on isolated rabbit cardiac muscle and coronary strip (적출심근 및 관상동맥에 대한 Nitroglycerin 의 작용)

  • Hong, Jang-Su;Seo, Gyeong-Pil;Kim, Gi-Hwan
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.272-280
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    • 1983
  • With respect to controversial opinions concerning the nitroglycerin effects on cardiac muscle the direct nitroglycerin actions were thoroughly studied in isolated papillary muscles, atrial preparations and coronary strips of rabbits. Isometric active tension of papillary muscles developed at $35^{\circ}C$ upon electric stimulation at a rate of 60/min, was not affected by nitroglycerin up to a concentration of 10mg/L Higher concentrations of nitroglycerin, however, reduced action tension progressively. This depression of mechanical activity is accompanied by a decrease in oxygen consumption as measured by means of a flow respirometer. Resting oxygen uptake, on the other hand, remained unchanged. Similarly active tension of spontaneously beating atrial preparations also declined at a nitroglycerin concentration of more than 10 mg/L, whereas the sinus frequency did not change up to 40 mg/L. In contrast, rabbit coronary strips are much more sensitive to nitroglycerin and relax in a range of 10-100 ug/L of nitroglycerin concentration. The results indicate that the pharmacologic effects of nitroglycerin in coronary disease are due to vascular actions, because the plasma levels of nitroglycerin attainable in human therapy are not sufficiently high to directly influence the myocardium.

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Review of Herbs Used as Treatment for Menopausal Patients in Alternative Medicine (대체의학에서 갱년기 증후군에 사용되는 약물에 대한 고찰)

  • Kim, Seung-Hyun;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.3
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    • pp.90-98
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    • 2008
  • Purpose: Menopausal syndrome is caused by urgent changes of sex hormone in women. The hormonal therapy can soothe the problems of menopausal patients, but it can increase the probability of another disease, such as breast cancer, heart attack, etc. So the demand of alternative herb therapy is increasing in Western countries. In Korea, herbal medicine is imported and used by Western doctors. To know and use the alternative herbal medicine, Korean Medical doctors should know their efficacy and safety. Methods: We researched the Medline(Pubmed) with the key word such as 'CAM', 'herb' and 'menopause'. We selected the herbs known as treating the menopausal syndrome and researched the similar or same herbs that are used in Korean medicine by the scientific name and efficient ingredients. To evaluate the efficacy of the herbs, we compared the herbs that were differently defined in alternative and Korean medicine Results: Balm, black cohosh, chaste berry, dong quai. evening primrose oil. ginkgo, St. John's wort, valerian root, and sarsaparilla were chosen as prevalent herbs used in alternative medicine. The pharmacologic effect of Black cohosh, licorice root, St. John's wort were recognized. But these three herbs are not usually prescripted for menopausal patients in Korean medicine. So we could apply these three herbs as one of Korean medical treatments. The efficacy of other herbs cannot be surely prescripted for menopausal patients. Conclusion: The efficacy and safety of alternative medicine is not proved yet. But to diversify the treatmental methods of Korean medicine, we need to prove and use these medicine as one of Korean medical treatment.

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Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Utilization Behaviour and Influencing Factors of Complementary and Alternative Medicine Therapies Among the Elderly (일부 노인의 보완대체요법 이용행태와 영향요인)

  • Moon, Gi-Won;Kim, Jun-Ho;Kim, Chun-Bae
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.25-38
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    • 2013
  • Objectives: The aim of this study is to analyze the utilization behaviour and influencing factors of complementary and alternative medicine (CAM) therapies among elderly people with chronic diseases. Methods: The study population was selected among 9 welfare facilities for the aged in 2 cities among Daegu Metropolitan City & Gyeongsangnam Province by two-stage cluster sampling. 250 senior citizens participated in a face-to-face interview using a structured questionnaire. Logistic regression analysis was performed to examine the association between the utilization of CAM therapies and various characteristics of the elderly. All statistics were analyzed using the PASW (ver 18.0). Results: Among 233 elderly peoples, 70.4% (164 persons) had used various kinds of CAM therapies (including nutritional methods, pharmacologic and biologic treatments, etc.) more than once during the last year. 48.8% (64 persons) ~ 60.7% (88 persons) of the elderly used CAM therapies without health and medical experts' counsel. The elderly with perceptions of CAM therapy used it 2 times more than those without knowledge of CAM therapies. The number of chronic diseases was more likely to increase the usage of nutritional methods (OR=2.92, 95% CI: 1.07-7.97), manipulative and body-based practices (OR=5.85, 95% CI: 1.97-17.34), pharmacologic and biologic treatments (OR=2.92, 95% CI: 1.49-8.17). Elderly with diabetes used nutritional methods 3.76 (95% CI: 1.49-9.47) more than elderly without diabetes. Conclusions: CAM therapies use in the aged with chronic diseases appears common. The findings suggest that the clinical efficacy and safety of CAM therapies on medical management of chronic disease may be investigated and that patient-physician communication need to be strengthened.

Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report (급성 비정복성 관절원판 변위에 따른 급성 교합변화의 증례)

  • Jung, Jae-Kwang;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.205-211
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    • 2012
  • A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.

An Aerodynamic study used aerophone II for snoring patients (코콜이 환자의 sleep splint 착용 전후의 음향학적 및 공기역학적 연구)

  • Jung, Se-Jin;Kim, Hyun-Gi;Shin, Hyo-Keun
    • The Journal of the Korean dental association
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    • v.49 no.4
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    • pp.219-226
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    • 2011
  • Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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