• Title/Summary/Keyword: Rational drug use

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Pharmacoeconomics Evaluation of Morphine, MS Contin and Oxycodone in the Treatment of Cancer Pain

  • Zhang, Wen-Zhou;Yu, Wei-Jiang;Zhao, Xiu-Li;He, Bao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8797-8800
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    • 2014
  • Objective: To analyze cost-effectiveness of morphine, MS contin and oxycodone in the treatment of cancer pain, providing guidance for rational drug use in the clinic. Methods: Confirmed by histology, a total of 171 patients with various cancers who required analgesic treatment were selected and divided into 3 groups, 57 cases for each group, given morphine, MS contin and oxycodone, respectively. If there appeared a poor short-term effect or aggravated sudden pain during the treatment, a short-acting morphine injection was given and adverse reactions were processed by symptomatic treatment. The pain relief rate and adverse reactions of groups were observed and pharmacoeconomics evaluation was undertaken. Results: The pain relief rates with morphine, MS contin and oxycodone were 89.5%(51/57), 91.2%(52/57) and 93.0%(53/57), respectively, with no difference samong groups (${\chi}^2=4.4489$, P=0.6162). The occurrence rates of adverse reactions were 59.7%(34/57), 54.4%(31/57) and 43.9%(25/57), again with no significant variation (P>0.05). The ratios of cost-effectiveness (C/E) for the 3 groups were $14.6{\pm}7.21$, $15.0{\pm}7.44$ and $16.1{\pm}8.10$. When the price of 3 kinds of analgesics was reduced by 10%, the ratios of cost-effectiveness were $12.2{\pm}6.53$, ($13.4{\pm}6.08$ and $14.5{\pm}6.74$ but there was no differences when compared with before the price adjustment (t=1.86, P=0.0651; t=1.30, P=0.1948; t=1.17, P=0.2453). Conclusion: Morphine, MS contin and oxycodone give similar pain relief and adverse reaction rates but of all, morphine is the preferred drug for the treatment of cancer pain from the perspective of pharmacoeconomics.

Knowledge, attitudes and practices toward antimicrobial usage: a cross-sectional study of layer and pig farm owners/managers in Chiang Mai, Lamphun, and Chonburi provinces, Thailand, May 2014 to February 2016

  • Nuangmek, Aniroot;Rojanasthien, Suvichai;Patchanee, Prapas;Yano, Terdsak;Yamsakul, Panuwat;Chotinun, Suwit;Tadee, Pakpoom
    • Korean Journal of Veterinary Research
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    • v.58 no.1
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    • pp.17-25
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    • 2018
  • This study aimed at determining the current knowledge, attitude, and practices (KAP) of layer and pig farmers to antimicrobial usage and its consequences. Description of such KAP could provide insights useful for promoting the rational use of antimicrobials in livestock. From May 2014 to February 2016, a survey involving 251 respondents in Chiang Mai, Lamphun, and Chonburi provinces, Thailand, was conducted by using a validated questionnaire. More than half (51.0%) of the respondents incorrectly believed that antimicrobial drug efficacy could not be reduced by using sub-recommended dosages, 61.2% had misconceptions about non-therapeutic antimicrobial use, and 66.9% inaccurately felt that antimicrobials were also effective for virus and fungi. Over half (50.6-55.2%) did not see the need to follow instructions or advice of veterinarians. Moreover, only 10.4% regularly relied on responses to drugs sensitivity tests when evaluating the effectiveness of antimicrobials. Overall, assessment of KAP regarding antimicrobial usage indicated that the majority of respondents had low levels of knowledge of antimicrobials, neutral rather than positive attitudes, and employed poor practices in the use of antimicrobials. The results indicate improvements in KAP could be helpful in developing more effective interventions by farmers, reduce antibiotic usage, and slow the growth of antimicrobial resistance.

Scientific review of the aesthetic uses of botulinum toxin type A

  • Park, Mee Young;Ahn, Ki Young
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.1-10
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    • 2021
  • Botulinum toxin type A (BoNT-A), onabotulinumtoxinA (Botox) was approved by the United States Food and Drug Administration for temporary improvement of glabellar lines in patients 65 years and younger in 2002, and has also been used widely for aesthetic purposes such as hyperhidrosis, body shape contouring, and other noninvasive facial procedures. BoNT-A inhibits presynaptic exocytosis of acetylcholine (ACh)-containing vesicles into the neuromuscular junction at cholinergic nerve endings of the peripheral nervous system, thereby paralyzing skeletal muscles. ACh is the most broadly used neurotransmitter in the somatic nervous system, preganglionic and postganglionic fibers of parasympathetic nerves, and preganglionic fibers or postganglionic sudomotor nerves of sympathetic nerves. The scientific basis for using BoNT-A in various cosmetic procedures is that its function goes beyond the dual role of muscle paralysis and neuromodulation by inhibiting the secretion of ACh. Although the major target organs for aesthetic procedures are facial expression muscles, skeletal body muscles, salivary glands, and sweat glands, which are innervated by the somatic or autonomic nerves of the peripheral cholinergic nerve system, few studies have attempted to directly explain the anatomy of the areas targeted for injection by addressing the neural physiology and rationale for specific aesthetic applications of BoNT-A therapy. In this article, we classify the various cosmetic uses of BoNT-A according to the relevant component of the peripheral nervous system, and describe scientific theories regarding the anatomy and physiology of the cholinergic nervous system. We also review critical physiological factors and conditions influencing the efficacy of BoNT-A for the rational aesthetic use of BoNT-A. We hope that this comprehensive review helps promote management policies to support long-term, safe, successful practice. Furthermore, based on this, we look forward to developing and expanding new advanced indications for the aesthetic use of BoNT-A in the future.

Molecular Application in Psychiatry (정신과의 분자생물학 적용)

  • Choi, Ihn-Geun
    • Korean Journal of Biological Psychiatry
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    • v.7 no.2
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    • pp.115-122
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    • 2000
  • The development of molecular biology has brought many changes in psychiatry. Molecular biology makes us possible to know the cause of mental disorders that provide the way to prevent the disorders, and to develop various accurate diagnostic and treatment methods for mental disorders. The author discusses the concept, cause, and treatment of mental disorders in the aspect of molecular biology. Importing the methods of molecular biology into psychiatry, we can anticipate to get a number of the goals of psychiatric genetics, including identification of specific susceptibility genes, clarification of the pathophysiological processes whereby these genes lead to symptoms, establishment of epigenetic factors that interact with these genes to produce disease, validation of nosological boundaries that more closely reflect the actions of these genes, and development of effective preventive and therapeutic interventions based on genetic counseling, gene therapy, and modification of permissive or protective environmental influences. In addition to their capacity to accelerate the discovery of new molecules participating in the nervous system's response to disease or to self-administered drugs, molecular biological strategies can also be used to determine how critical a particular gene product may be in mediating a cellular event with behavioral importance. Molecular biology probably enables us discover the environmental factors of mental disorders and allow rational drug design and gene therapies for mental disorders, by isolation of gene products that facilitate a basic understanding of the pathogenesis of these disorders. A specific genetic linkage may suggest a novel class of drugs that has not yet been tried. With respect to gene therapy, the hypothetical method would use a gene delivery system, most likely a modified virus, to insert a functional copy of a mutant gene into those brain cells that require the gene for normal function.

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A Study on the Improvement of Domestic Medical Device Classification System through the Analysis of Major Foreign Countries (주요국의 의료기기 품목 분류체계 조사분석을 통한 국내 의료기기 품목 신설 및 세분화 연구)

  • Ji Min, Son;Kang Hyeon, You;You Rim, Kim; Gyeong Min, Kwon;Hui Sung, Lee;Won Seuk, Jang
    • Journal of Biomedical Engineering Research
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    • v.44 no.1
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    • pp.41-52
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    • 2023
  • With the international change in the medical device market owing to the development of innovative medical engineering and the use of various raw materials, a systematic and rational medical device classification system is needed to safely manage newly developed medical devices. This study aims to improve the domestic medical device classification system by proposing product establishment and segmentation. It is based on medical device products from the United States and Europe that are only available in foreign systems and are more subdivided than domestic products. This study analyzes and compares the domestic and foreign medical device classification systems by examining laws, guidelines, and analysis reports in Korea, the United States, and Europe. In accordance with product establishment and segmentation criteria, products subject to improvement are presented. This study contributes to safely managing medical devices that do not fit with the current classification system and to solving the confusion caused by the lack of international harmony in product classification systems.