• Title/Summary/Keyword: adverse drug reaction

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Usefulness of drug provocation tests in children with a history of adverse drug reaction

  • Na, Hye-Ran;Lee, Jeong-Min;Jung, Jo-Won;Lee, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.54 no.7
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    • pp.304-309
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    • 2011
  • Purpose: There are very few reports of adverse drug reactions (ADR) and almost no study of drug provocation test (DPT) in Korean children. We aimed to assess the role of DPT in children with unpredictable ADRs, and compare the causative drugs and clinical characteristics between detailed history of ADRs and result of DPTs. Methods: We included 16 children who were experienced ADRs referred to pediatric allergy clinic at Ajou University Hospital (January 2006 to December 2009). With various suspected drugs, 71 DPTs were done in 16 patients using our own protocol, and skin tests to antibiotics were combined in ADRs to antibiotics in medical history. Results: There were 17 (23.9%) positive DPTs results out of 71 individual DPTs, and 11 patients (68.8%) from 16 patients were positive to at least one drug. Drugs causing positive reactions were acetaminophen in 5 (31%), Non-steroidal anti-inflammatory drugs in 4 (25%), penicillin in 3 (19%), cephalosporin in 2 (13%), and cotrimoxazole, macrolide and lactose in 1 each. Conclusion: DPT seems a safe and useful procedure to confirm causative drug and identify safely administering alternative drugs in children with ADR.

Comparison of WHO-ART Versus MedDRA, Internationally Standardized Terminology of Adverse Drug Reaction Classification (의약품 부작용에 관한 국제 분류체계인 WHO-ART와 MedDRA의 비교분석)

  • Lim, Kyung-Hwa;Shin, Hyun-Taek;Sohn, Hyun-Soon;Jun, Hyo-Jung;Lee, Joo-Hyun;Lee, Yoo-Jung;Lee, Young-Sook;Song, In-Sook
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.46-51
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    • 2007
  • This study was aimed to provide the controlled terminology for adverse drug reactions by selecting an appropriate internationally standardized classifications (WHO-ART or MedDRA). We collected the relevant information on ADR terminology systems including WHO-ART and MedDRA by online searching and visiting pharmaceutical companies and WHO UMC (Uppsala Monitoring Centre, Uppsala, Sweden). For MedDRA, project leader directly communicated with the officer of MSSO (Maintenance and Support Services Organization). Collecting all the pertinent information, two possible terminology classifications or systems (WHO-ART and MedDRA) were compared in the views of acceptability, cost-effectiveness and international feasibility and reviewed by the consultation committee and finally WHO-ART was selected.

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Investigating attitudes and knowledge of paramedic students regarding adverse drug reactions (약물이상반응에 대한 응급구조학과 학생의 지식과 태도 조사)

  • Kim, Sa-Rah;Kim, Chul-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.93-109
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    • 2021
  • Purpose: This study aims to investigate the knowledge and attitudes regarding adverse drug reactions (ADR) of emergency medical services (EMS) students, so that suggestions for further education on ADR can be made. Methods: A survey on knowledge and attitude was created and modified according to Lee's and Kim's test tool. In total, 149 students' data were collected and compared with previous studies. Results: Knowledge of ADR was relatively low (54%) but attitude was relatively high (75%). Clinical experience was important in knowledge and attitude. Knowledge and attitude showed a positive correlation. Conclusion: Increased knowledge of ADR leads to a more active attitude towards it. Hence, modification of the education system to provide a more personalized education is required.

Adverse Drug Reaction Surveillance System in Korea (우리나라 약물유해반응 감시체계)

  • Choi, Nam-Kyong;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.278-284
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    • 2007
  • Despite extensive researches and pre-market clinical trials, only limited information on the adverse drug reactions (ADRs) of a drug can be collected at the time of market approval from regulatory agency. ADRs constitute a major public health problem. Post-marketing surveillance of drugs is important to detect signals for ADR. In Korea, one of the main methods for monitoring the safety of marketed drugs is spontaneous reporting system of suspected ADRs. Re-examination and re-evaluation system are in force for monitoring safety of new market approval drugs and currently under marketing drugs, respectively. Recently, regional pharmacovigilance centers were designated from Korean Food and Drug Administration for facilitating ADR surveillance. Over recent years, with the development of information technology, there has been an increased interest in establishing data mining system for detecting signals from Health Insurance Review Agency database. The purpose of this paper is to review the current status of Korean ADR surveillance system and suggest the possible solutions for developing active pharmacovigilance system in Korea.

Awareness of Adverse Drug Reaction Reporting System in General Population (일반인에서의 의약품 부작용보고제도 인식도)

  • Ahn, So Hyeon;Chung, Sooyoun;Jung, Sun-Young;Shin, Ju-Young;Park, Byung-Joo
    • Health Policy and Management
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    • v.24 no.2
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    • pp.164-171
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    • 2014
  • Background: Safety of drugs has become a major issue in public healthcare. Spontaneous reporting of adverse drug reaction (ADR) is the cornerstone in management of drug safety. We aimed to investigate the awareness and knowledge of spontaneous ADR reporting in general public of Korea. Methods: A total of 1,500 study subjects aged 19-69 years were interviewed with a questionnaire for their awareness and knowledge related to spontaneous ADR reporting. Computer assisted telephone interview was performed from 27th February 2013 to 4th March 2013. Target population was selected with quota sampling, using age, sex, and residence area. Healthcare professionals such as physicians, pharmacists, and nurses were excluded. The survey questions included awareness of spontaneous ADR reporting, opinions on ways to activate ADR reporting, and sociodemographic characteristics. Results: Overall awareness of spontaneous ADR reporting system was 8.3% (${\pm}2.53%$) among general population of Korea. Major source from which people got the information regarding ADR reporting was television/radio (69.9%), followed by internet (19.3%), and poster/brochure (6.1%). Awareness level differed between age groups (p<0.0001) and education levels (p<0.0001). Upon learning about the ADR reporting system, 88.5% of study subjects agreed on the necessity of ADR reporting system, while 46.6% thought promotion through internet and mass media as an effective way to activate ADR reporting. Conclusion: The overall awareness of spontaneous ADR reporting should be enhanced in order to establish a firm national system for drug safety. Adequate promotions should be performed targeting lower awareness groups, as well as various publicity activities via effective channels for the general population.

Drug eruption by antihistamine mistaken for chronic urticaria in a child

  • Lee, Gun Moo;Chu, Shou-Yu;Kang, Sung Yeon;Kim, Hyo-Bin;Park, Jin-Sung;Kim, Ja Kyoung
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.75-78
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    • 2019
  • Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

A Clinical Case Report of Contrast-induced drug eruption patient Treated with Traditional Oriental Medicine (조영제로 유발된 약진(藥疹)환자 치험 1례)

  • Jerng, Ui-Min;Jeong, Jong-Soo;Yoon, Seong-Woo;Park, Jae-Woo
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.75-82
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    • 2007
  • Drug eruption is a cutaneous reaction caused by various drugs. It is a very common drug induced adverse reaction. Contrast media induced drug eruption is rare. But approximately 10% of people injected with contrast media experience adverse reaction, and drug eruption accounts for more than 40% of all adverse reactions. We report a case of mild drug eruption and its treatment process based on korean traditional medicine. The patient is a 50 years old female diagnosed with functional dyspepsia. The patient had gastric discomfort and alternation between diarrhea and constipation. All symptoms showed nearly complete remission with continued korean traditional medical treatment. The patient had been injected with contrast media for Computed tomography(CT) evaluation of her breast cancer history. Rashes appeared on back and abdomen, and urticaria and pruritus appeared on the patient's finger 1 day after injection. We prescribed Goreisan(TSUMURA CO &, TJ-17) and acupuncture on Quchi(LI11), Zusanli(ST36), Yangxi(LI5), Yanggu(SI5). Consequently, the drug eruption showed remarkable improvement. So the author reports korean traditional medicine is effective complementary treatment for drug eruption.

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Proposal of the Pharmacoepidemiologic Methodology Application to Research for Sasang Constitutional Pharmacology (약물역학연구 방법론의 체질약리연구 적용에 대한 제안)

  • Kim, Sang-Hyuk;Yoo, Jong-Hyang;Lee, Si-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.5
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    • pp.753-757
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    • 2010
  • The objectives of this paper is to propose the pharmacoepidemiologic methodology to Research for Sasang Constitutional Pharmacology. We mainly searched "Journal of Pharmacoepidemiology and Risk Management". And we also searched "J Korean Oriental Med.", "J of Sasang Constitutional Med.", "J. Oriental Physiology & Pathology", "Korean J Orient Int Med." using these kew words - "adverse event" or "side effect" and "Sasang Contitution" or "Constitution" or "Constitutional medicine". Through the examination of the Pharmacoepidemiologic methodology and current research for sasang constitiutional pharmacology, we could establish the proposal to collect objective constitutional medical reaction. For the actualization of this proposal, the more advanced studies will have to be carried out continuously.

Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program (내과계 중환자실 약료 서비스 도입과 약물상호작용 모니터링)

  • Choi, Jae Hee;Choi, Kyung Sook;Lee, Kwang Seup;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.138-144
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    • 2015
  • Objective: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. Method: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-$Comp^{(R)}$ Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed. Results: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes. Conclusion: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.

Factors Affecting the Adverse Drug Reactions of Mycophenolate Mofetil (Mycophenolate Mofetil 부작용 발생에 미치는 요인 분석)

  • Kim, Keum-Hi;Lee, Ju-Yeun;Park, Kyung-Ho;Son, In-Ja;Lee, Hye-Suk
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.151-158
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    • 2010
  • Therapeutic drug monitoring of Mycophenolate mofetil(MMF) has been suggested in some clinical trials, but has not been widely adopted in Korea. The purpose of this study was to analyze the withdrawal rates of MMF and determine the characteristics of the patients who experienced adverse reactions with MMF therapy and to suggest the criteria for selecting patients who need monitoring of MMF levels. We retrospectively collected data of patients who started MMF between July 2007 and June 2008. A total of 154 adult patients were included in our study. Among them, ninety seven patients discontinued MMF with 59 cases being due to adverse drug reactions. Thirty one patients required dosage reduction of MMF with twenty three cases being due to adverse reactions. Twenty six patients continued the MMF without or with mild adverse reactions. Of the 82 adverse reaction cases, hematologic adverse reactions accounted for 38 cases (46%) and gastrointestinal (GI) adverse reactions accounted for 28 cases (34%). Older age and lower serum albumin levels were significantly different characteristics between the patients who withdraw MMF due to hematological adverse reactions and those who were able to continue therapy. The group who experienced GI adverse reactions had higher MMF dosages based on body weight and lower serum albumin levels. In conclusion, the factors affecting the adverse reactions of MMF were age, serum albumin level and higher dosage, therefore therapeutic drug monitoring of MMF should be considered in these patients.