• 대한불안의학회지
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• 제12권1호
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• pp.47-55
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• 2016

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제14권1호
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• pp.53-63
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• 2003

자폐장애는 Leo Kanner가 처음 기술한 이래, 독립된 임상적 실체로 인식되어 왔다. 자폐장애의 원인은 불분명하며, 여러 가지 뇌구조와 기능 이상을 보인다. 자해는 저기능 자폐증 환자에서 나타나며, 만성화되지 않도록 조기 치료가 필요하다. 본 논문은 자폐증의 여러 증상에 사용되는 약물을 고찰하였으며, 특히 자해와 공격성에 대한 약물을 중점으로 고찰하였다. 세로토닌 재흡수차단제는 일차적 항공격 효과가 불분명하다. 도파민 차단약물은 공격성과 자기 손상을 감소시키는데 상당한 효과를 보이는데 부작용의 측면에서 리스페리돈이 가장 유효하다. 날트렉손은 아직까지 일관된 연구결과가 나오지 않았다. 클로니딘은 공격성 감소의 효과가 있다. 또한 리튬이 공격적 자기손상적 행동의 치료에 효과적이었다. 그리고 카바마제핀 등의 항경련제가 공격적 폭발적 행동에 효과적이었다. 앞으로 단일한 진단과 치료반응 측정을 통해 자해에 대한 약물치료가 보다 진보할 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제27권1호
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• pp.31-38
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• 2016

Pharmacotherapy is considered the first line therapy in attention-deficit hyperactivity disorder (ADHD). Many patients also choose complementary medicine such as dietary supplements. Omega-3 has shown some efficacy for improving ADHD symptoms in several studies. The goal of this review is to integrate the previous research findings on omega-3 and understand the issues worth considering in the treatment of ADHD. The terms "attention deficit disorder with hyperactivity", "omega-3", and "dietary supplements" were searched on PubMed, Cochrane, and Google scholar. The search was further limited to clinical trials, reviews, and meta-analyses. Trials that examined treatments for ADHD, used randomized design, and placebo-controlled trials were included. Eighteen clinical trials with a total of 1,141 participants were included in this review. Fifteen trials had parallel designs, comparing an omega-3/6 polyunsaturated fatty acid (PUFAs) or a combination of both to a placebo and three compared omega-3/6 PUFAs to a placebo and psycho-stimulants. Seven of the included trials showed significant improvements in groups receiving omega-3/6 PUFAs compared to placebo groups, however, 11 trials showed no significant differences. Evidence that PUFAs supplementation provides benefits for ADHD was yet limited. Mixed results were due to selection variability criteria, variability of supplementation, and short follow-up intervals.

• 한국임상약학회지
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• 제24권4호
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• pp.304-310
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• 2014

Objective: The objective of this study was to evaluate the 6-year clinical pharmacy curriculum in Korea among 35 schools of pharmacy and to compare the pharmacy practice experience curriculum with the U.S. Methods: Data on the 6-year clinical pharmacy curriculum was collected and analyzed from 35 schools of pharmacy in Korea. Data were collected from each school's website, or through professors in clinical pharmacy or the administrative office, when not available online. Guidance for U.S. clinical pharmacy curriculum was referenced from the Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines. Results: Pharmacotherapy was the only course that was offered in every school of pharmacy with average of $11.5{\pm}2.8$ credit hours offered. Only six subjects were offered in more than half of the schools. Average pharmacy practice experience credit hours in Korea were $1.8{\pm}0.6$, $7.8{\pm}1.5$, $4.9{\pm}1.2$, $3.5{\pm}1.1$, $11.8{\pm}1.2$ in introductory, hospital, community, pharmaceutical industry and administration, and intensified pharmacy practice experience, respectively. While the U.S. required introductory pharmacy practice experience (IPPE) to be conducted in the real pharmacy setting, the IPPE in Korea was conducted as an in-class simulation. The total required hours of IPPEs and APPEs were 1400 hours in Korea and 1740 (300+1440) hours in the U.S. Conclusion: Clinical pharmacy curriculum in Korea is offered through a variety of courses and the pharmacy practice experience curriculum has been adopted by every school of pharmacy. A guidance outlining the major required contents of clinical pharmacy curriculum could help standardize and advance the clinical pharmacy education in Korea.

• 한국임상약학회지
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• 제24권4호
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• pp.255-264
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• 2014

Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

• Journal of Preventive Medicine and Public Health
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• 제44권2호
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• pp.84-92
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• 2011

Objectives: This study aimed to investigate smoking relapse and the related factors within 1 year after discharge from the smoking cessation clinics (SCCs) of public health centers (PHCs). Methods: Data were collected with a structured questionnaire from 395 people who success fully stopped smoking at 4 SCCs in Busan between May and June 2009, and this data were analyzed by Kaplan-Meier survival curves and the Cox proportional hazard model. Results: The rate of smoking relapse within 1 year after discharge from SCCs was 39.2% and this decreased rapidly over 6 months after discharge. The factors related to smoking relapse within 1 year after discharge from SCCs were being female (HR, 2.11; 95% CI, 1.17 to 3.82), a trial of smoking cessation with any assistants (HR, 1.95; 95% CI, 1.19 to 3.19), more than 7 ppm of exhaled CO2 on the SCCs' registration (HR, 1.81; 95% CI, 1.24 to 2.64), use of pharmacotherapy after discharge from SCCs (HR, 2.00; 95% CI, 1.36 to 2.93), alcohol drinking more than once a week after discharge from SCCs (HR, 3.32; 95% CI, 2.15 to 6.78), and a perceived barrier (HR, 1.21; 95% CI, 1.14 to 1.30) after discharge from the SCCs. Conclusions: According to the results, at least 6 months follow-up after discharge from SCCs of public health centers is recommended to reduce the rate smoking relapse. It is also recommended to strengthen the education on how to overcome barriers such as drinking in the course of smoking cessation clinics.

• 대한임상독성학회지
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• 제6권2호
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• pp.130-133
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• 2008

In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1 g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.1-27
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

• Clinical and Experimental Pediatrics
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• 제62권1호
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• pp.3-21
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

• 비만대사연구학술지
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• 제1권1호
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• pp.4-13
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• 2022

Currently, pharmacotherapy is becoming essential for obesity, owing to its expanding and increasing epidemiology. In this review, novel peptide-based drugs of four classes are covered: GLP-1 receptor agonist, GIP/GLP-1 receptor dual agonist, glucagon/GLP-1 receptor dual agonist, and a combination of amylin receptor agonist/GLP-1 receptor agonist. Semaglutide is a next-generation GLP-1 receptor agonist with a longer duration and stronger weight and glucose reduction effects than liraglutide and dulaglutide. In the STEP1 trial, semaglutide 2.4 mg reduced body weight by approximately 15% in people with obesity with similar or milder adverse events than liraglutide 3.0 mg. Tirzepatide, a GIP/GLP-1 receptor dual agonist, also has a long duration and strong weight- and glucose-lowering effect. According to SURPASS-2, 3, and 4, in patients with BMI≥25 kg/m² and type 2 diabetes mellitus (T2DM), tirzepatide 15 mg reduced the initial body weight by >13%. Cotadutide, a glucagon/GLP-1 receptor dual agonist, showed weaker weight-lowering effects than semaglutide and tirzepatide, while it was comparable to that of liraglutide in a phase 2 clinical trial for non-alcoholic fatty liver disease in patients with BMI≥25 kg/m² and T2DM. Additionally, its effect on the liver was noticeable. The long-acting amylin receptor agonist cargrilintide combined with semaglutide can be another effective option for obesity treatment. Even in a small phase 1 trial with a short study period of 20 weeks, cargrilintide 2.4 mg/semaglutide 2.4 mg reduced by 17% of initial body weight in people with BMI 27-39.9 kg/m². In coming several years, semaglutide, tirzepatide, and cargrilintide/semaglutide will become available for obesity treatment in Korea.