• Title/Summary/Keyword: Therapeutic Drug Monitoring

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Simultaneous Liquid Chromatography Tandem Mass Spectrometric Determination of 35 Prohibited Substances in Equine Plasma for Doping Control

  • Kwak, Young Beom;Yu, Jundong;Yoo, Hye Hyun
    • Mass Spectrometry Letters
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    • v.13 no.4
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    • pp.158-165
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    • 2022
  • Many therapeutic class drugs such as beta-blocker, corticosteroids, NSAIDs, etc are prohibited substances in the horse racing industry. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology makes it possible to isolate drugs from interference, enables various drug analyses in complex biological samples due to its sensitive sensitivity, and has been successfully applied to doping control. In this paper, we describe a rapid and sensitive method based on solid-phase extraction (SPE) using solid phase cartridge and LC-MS/MS to screen for different class's 35 drug targets in equine plasma. Plasma samples were pretreated by SPE with the NEXUS cartridge consisted non-polar carbon resin and minimum buffer solvent. Chromatographic separation of the analytes was performed on ACQUITY HSS C18 column (2.1 × 150 mm, 1.8 ㎛). The elution gradient was conducted with 5 mM ammonium formate (pH 3.0) in distilled water and 0.1% formic acid in acetonitrile at a flow rate of 0.25 mL/min. The selected reaction monitoring (SRM) mode was used for drug screening with multiple transitions in the positive ionization mode. The specificity, limit of detection, recovery, and stability was evaluated for validation. The method was found to be sensitive and reproducible for drug screening. The method was applied to plasma sample analysis for the proficiency test from the Association of Racing Chemist.

Cell Surface Antigen Display for Neuronal Differentiation-Specific Tracking

  • Kim, Sang Chul;Lee, Eun-Hye;Yu, Ji Hea;Kim, Sang-Mi;Nam, Bae-Geun;Chung, Hee Yong;Kim, Yeon-Soo;Cho, Sung-Rae;Park, Chang-Hwan
    • Biomolecules & Therapeutics
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    • v.27 no.1
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    • pp.78-84
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    • 2019
  • Cell therapeutic agents for treating degenerative brain diseases using neural stem cells are actively being developed. However, few systems have been developed to monitor in real time whether the transplanted neural stem cells are actually differentiated into neurons. Therefore, it is necessary to develop a technology capable of specifically monitoring neuronal differentiation in vivo. In this study, we established a system that expresses cell membrane-targeting red fluorescent protein under control of the Synapsin promoter in order to specifically monitor differentiation from neural stem cells into neurons. In order to overcome the weak expression level of the tissue-specific promoter system, the partial 5' UTR sequence of Creb was added for efficient expression of the cell surface-specific antigen. This system was able to track functional neuronal differentiation of neural stem cells transplanted in vivo, which will help improve stem cell therapies.

A Practical Guide for Clinical Use of Antidepressants with Particular Reference to Major Depression (항우울제의 임상사용을 위한 실제적 지침 : 주요 우울증을 중심으로)

  • Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.1 no.1
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    • pp.17-30
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    • 1994
  • Several different classes of antidepressants(ADs) with newer drugs becoming available have been used for the phamacological management of a broad spectrum of mental disorders, among which depressive disorder is most commonly indicated. Successful clinical use of ADs requires a complete understanding of the psychopharmacological properties of ADs and on accurate knowledge of patients, characteristics based on clinical experience and theoretical framework. This paper aims at providing some practical information on the clinical use of ADs to assist clinicians in treating patients with major depression. The author describes (1) different classes of ADs and their presumed mechanisms of action, (2) clinical characteristics of ADs focusing on side-effect profiles, (3) some issues arising during the treatment course such as : a) pretreatment tasks, b) choice of ADs, c) therapeutic drug dose and monitoring of drug concentration, d) three stages of treatment and e) strategies in refractory depression and (4) ADs in special patient groups.

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Drug Interaction between Sodium Valproate and Phenytoin in Rabbits (발프로산나트륨과 페니토인과의 약물상호작용)

  • Choi, Jun-Shik;You, Jae-Sin;Park, Yong-Chae;Lee, Jin-Hwan
    • Journal of Pharmaceutical Investigation
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    • v.26 no.2
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    • pp.113-117
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    • 1996
  • This study was attempted to investigate the pharmacokinetic interaction between sodium valproate (4, 8, 16 mg/kg, i.v.) and phenytoin (4 mg/kg, i.v.) in rabbits. The plasma concentration and area under the curve (AUC) of phenytoin were increased significantly (p<0.05, p<0.01) when coadministered with sodium valproate (4, 8, 16 mg/kg) in rabbits. The volume or distribution and total body clearance of phenytoin were decreased significantly (p<0.05, p<0.01) when coadministered with sodium valproate (8, 16 mg/kg) in rabbit. From the results of this experiment, it is desirable that dosage regimen of phenytoin should be adjusted and therapeutic drug monitoring should be performed for reduction of side or toxic effect when phenytoin will be coadministered with sodium valproate in clinical use.

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Recent Trends of Sedation in Pediatric Dentistry (임상가를 위한 특집 3 - 소아치과에서 진정치료의 신경향)

  • Lee, Gi-Seop
    • The Journal of the Korean dental association
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    • v.47 no.11
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    • pp.736-749
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    • 2009
  • 근래 환자의 불안을 조절하는 것이 성공적인 치료에 매우 중요하다는 인식이 확산되면서 의과, 치과, 영상의학과, 응급실 및 외래 수술센터 등에서 진정요법에 대한 필요가 현저하게 늘어났다. 응급상황이거나 아니거나 진정요법의 필요성은 점차 증가하고 있고 대한 소아치과학회는 이러한 진정요법에 대한 지침을 출간한 바 있다. 이번 개정은 진정요법에 필요한 적절한 환자감시(monitoring)의 필요에 관한 최신지견을 반영한 것이나 그럼에도 불구하고 이 지침에 충실하였다고 해서 특정환자의 결과를 보장하지는 못한다. 그러 나 이번에 소개하는 진정요법 protocol은 널리 받아들여지는 것으로 부작용 역시 최소화한 것이다. 소아 환자의 진정요법은 원하는 수준의 진정이나 투여 방법과는 상관없이 호흡기능 저하와 환자의 방어 반응이 소실될 수도 있다는 인식하에 작성되었다. 이번 호에서는 최근 2006년에 미국소아과학회와 미국소아치과학회가 공동으로 개정된 지침(Guideline for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures developed and endorsed by AAP a and AAPD)이 어떻게 변경되는지에 중점적으로 알아보며 새로 변경된 지침에 따라 소아치과의의 진정요 법의 진료와 교육도 영향을 미칠 것이다. 이러한 영향으로 다양한 약 투여방법(Alternative routes of d drug administration)과 다양한 약물의 선택에 대해 알아 보기로 한다.

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Therapeutic monitoring of vancomycin according to initial dosing regimen in pediatric patients

  • Kim, Dae-Il;Im, Mi-Sun;Choi, Jin-Hyoung;Lee, Jin-A;Choi, Eun Hwa;Lee, Hoan-Jong
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.1000-1005
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    • 2010
  • Purpose: This study aimed to determine the optimal initial vancomycin dose to achieve appropriate trough levels in pediatric patients. Methods: We analyzed clinical data for 309 children treated with intravenous vancomycin between 2004 and 2009 at 2 different hospitals in South Korea. The patients were 1-16 years old and exhibited normal renal function. Patient data, including reason for treatment and initial dosing regimen, were reviewed. Two subgroups were identified and compared according to initial vancomycin dose: 40 (35-45) mg/kg/day and 60 (55-65) mg/kg/day. Trough levels were obtained at steady state after at least 4 doses of vancomycin. Results: Patients who received vancomycin had post-operation or wound-related infections (37.2%), localized infection (12.9%), catheter-related infections (9.4%), meningitis (8.7%), or endocarditis (6.8%). Pathogens were confirmed in 79 cases: 28 cases of methicillin-resistant $Staphylococcus$ $epidermidis$ (35.4%) and 25 of methicillin-resistant $Staphylococcus$ $aureus$ (31.6%). Out of the 309 patients, 201 (65%) received vancomycin at 40 mg/kg/day and 108 (35%) at 60 mg/kg/day. Average trough concentrations were significantly different between the groups ($P$<0.001). Trough levels over 10 mg/L were less likely to be achieved in the 40 mg/kg/day group (14%) than in the 60 mg/kg/day group (49%) ($P$<0.001). There were no differences in renal function deterioration between the groups. Conclusion: A common vancomycin dosing regimen, 40 mg/kg/day, was not high enough to achieve trough levels of over 10 mg/L in pediatric patients. Careful drug monitoring must be performed, and increasing initial dose of vancomycin should be considered in pediatric patients.

The Effects of Intrapatient Variability in Tacrolimus Concentration on Clinical Outcomes Immediately After Liver Transplantation (Tacrolimus의 혈중농도 변동성이 간이식 예후에 미치는 영향)

  • Kim, Eunji;Kim, Boram;Cho, Jungwon;Lee, Jung Hwa;Lee, Eunsook;Yu, Yun Mi;Cho, Jai Young;Lee, Euni;Choi, YoungRok
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.36-43
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    • 2020
  • Background: Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. Methods: Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value: high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, post-transplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. Results: Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or post-transplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). Conclusion: High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.

A Study on the Realities and Preventive Countermeasures of Child Abuse Committed by Biological Parents by information analysis.

  • Ryu, Chae-Hyoung;Yoon, Hyun-Seok
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.5
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    • pp.171-177
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    • 2019
  • In this paper, we analyze the current phenomenon of child abuse crimes based on the information gathered by the National Child Protection Agency. The purpose of this paper is to diagnose the seriousness of child abuse by biological parents based on the analyzed information and propose measures against it. Comprehensive and integrated measures are needed for child abuse committed by biological parents due to abuse concealment, continuity of damage, and inactive national intervention by considering punishment on attackers through national intervention, fundamental in-depth psychological counseling, therapeutic care, promoting recovery of victims, and ultimately continuous and regular management and monitoring as a long-terms measure. To do so, developing customized and individual educational programs and make them obligations can be first presented to identify child abuse in advance and build up preventive systems based on the principle of family preservation. In addition, problems should be addressed at a fundamental level by performing various and active therapeutic treatments such as psychological treatment, mental treatment, or drug treatment gradually and through phases for biological parents who commit child abuse and contributing to recovering the relationship. Furthermore, proper protection and treatment service should be provided to children victimized by abuse by extending professional children care facilities and adopting the professional family commission system as measures by separating family.

Overview of the Interaction between Warfarin and Korean Herbal Medicine (와파린과 상호작용하는 한약재에 대한 고찰)

  • Lee, In;Park, Sang-Moo;Park, Seung-Chan;Kim, Do-Hyung;Cho, Min-Kyoung;Han, Chang-Woo;Kwon, Jeong-Nam;Hong, Jin-Woo
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.160-171
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    • 2012
  • Background and Objective : Warfarin is the standard anticoagulation treatment for atrial fibrillation, venous thromboembolism (VTE), and mechanical heart valves. Close monitoring of the International Normalized Ratio (INR) is required due to the drug's very narrow therapeutic window. Many factors can affect INR levels. Drug and food interactions are frequently cited as causes of adverse events with warfarin. We discussed interactions between herbs and warfarin studied in this research. Methods : In this review, PubMed was used to search medical journals. Keywords "warfarin AND interaction" were applied. Results : 55 articles were included. The possibility of correlation between warfarin and single herbal medicines such as Salviae Miltiorrhizae Radix, Angelicae Gigantis Radix, Ginseng Radix Alba, Lycii Fructus, Ginkgo Folium, Menthae Herba, Trigonellae semen was suggested. Furthermore, some herbal compounds interacting with warfarin were reported. The conclusion of studies reporting the effect of herbal medicine on warfarin were controversial due to small size or quality of research. Conculsions : We suggest that we should prescribe therapeutic herbal medicines to patients using warfarin more carefully and do INR follow-up regularly.

Status of Polypharmacy and Inappropriate Medication Use of the Elderly in Nursing Homes (노인요양시설 노인의 다약제 복용(Polypharmacy)과 부적절한 약물사용 실태)

  • Kim, Jeong-Sun;Kang, Sook
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.237-249
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    • 2013
  • This study was done to investigate status of polypharmacy and inappropriate medications use of the elderly of in nursing homes. The subjects of this study were 270 elderly people in the nursing homes of G city and K city, In this study, the medications were classified by Anatomical Therapeutic Chemical (ATC) code, polypharmacy was defined as taking medications more than five, and inappropriate medications use were identified by Beers criteria. Data was analyzed by using descriptive statistics, t-test and one-way ANOVA. Total number of drug types in this study was the average $6.1{\pm}2.6$. The subjects with polypharmacy were 193(71.5%), and with inappropriate medications use were 138(51.1%). There was a significant difference in the polypharmacy according to the number of diseases(p<.001) and in the inappropriate medications use according to age(p=.018). Baesd on this study, polypharmacy and inappropriate medications use of elderly people were main problems that need to carefully assess for safe and correct medication usage in nursing home. Therefore, an ongoing medication monitoring system is necessary to minimize the adverse drug reactions of elderly.