• 한국임상약학회:학술대회논문집
• /
• 한국임상약학회 2007년도 추계학술대회
• /
• pp.182-182
• /
• 2007

• 대한예방의학회:학술대회논문집
• /
• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
• /
• pp.82-83
• /
• 1998

• 한국임상수의학회지
• /
• 제34권3호
• /
• pp.197-199
• /
• 2017

A 14-year-old castrated male ShihTzu diagnosed with chronic kidney disease (CKD) 6 months prior was referred to our clinic. The patient had been experiencing symptoms such as vomiting, poor appetite and hind limbs weakness. Hematology tests showed that he had a non-regenerative anemia. With aggressive treatment, the patient's state had gotten worse. He showed ragged breath, vomiting blood and loss of consciousness temporarily. Hematocrit maintained low level. Gastric hemorrhage was strongly suspected by hematemesis. Whole blood transfusion was performed and heparin was used as an anticoagulant. Prior to transfusion, the blood cross matching between donor and patient was performed and the result was compatible. After the transfusion was stabilized, 1 mg of protamine sulfate for each 100 units of heparin was prepared and given intravenously over 3 minutes to reverse the effects of heparin. Immediately after protamine injection, the patient conducted severe anaphylactic shock. Protamine sulfate is used to reverse the anticoagulant action of heparin in dogs and humans. The adverse reaction of protamine sulfate range from mild reaction to fetal cardiac arrest. When using protamine sulfate as heparin neutralization, it can lead to the death of a patient cause of anaphylactic shock. For this reason, the protamine sulfate should be injected slowly with antihistamine and the clinician should carefully monitor patients.

• 한방재활의학과학회지
• /
• 제30권4호
• /
• pp.133-142
• /
• 2020

Objectives Studies on Chinese herbal injections are increasing. But, its safety are still not well reported. We have reviewed the literature related to the safety of Chinese herbal injection, especially those related to anaphylaxis. Methods The PubMed database was used to select the literatures related to anaphylaxis in China and to study the quality control and safety of Chinese herbal injection. Results Chinese herbal injection is a major traditional medical treatment in China, but it is the cause of adverse drug reactions including anaphylaxis. In order to solve this problem, various proposals have been made to identify the pharmacological and chemical causes of major side effects and to use them safely clinically. In addition, various researches have been conducted from preclinical to postmarketing surveillance to secure the safety of Chinese herbal injection. Based on this, it was found that various efforts are needed to secure the safety of bee sting needles. Conclusion In order to secure the safety of chinese herbal injections, it is necessary to identify the main mechanism of action and the pharmacological components contributing to it, and to develop a standardized formulation based on this. In addition, institutional pharmacovigilance is required.

• 한국화재소방학회논문지
• /
• 제33권6호
• /
• pp.80-86
• /
• 2019

국내에서는 2012년부터 2018년 까지 총 556건의 화학사고가 발생하였다. 화학사고 중 두 가지 이상의 화학물질 이상반응에 의해 발생하는 사고는 그 원인물질을 파악하는데 많은 시간이 필요하여 효과적인 사고대응과 수습을 위해서 신속한 분석이 필요하다. 본 논문은 이상반응에 의해 발생한 화학사고의 원인물질 파악을 위해 양자전이 비행시간 질량분석기를 사용하였다. 이 분석기는 시료채취와 전처리 없이 빠른 응답시간을 가져 실시간 분석이 가능하며 또한 수소친화도가 높은 대부분의 휘발성유기화합물질의 정량·정성 분석이 가능하여 이상반응에 의해 발생되는 화학사고의 원인 물질을 조사하는데 적합하다. 실제로 201◯년 ◯월에 ◯◯ 지역 화학사고 발생 시 양자전이 비행시간 질량분석기를 이용하여 측정한 결과 메탄올과 톨루엔 등이 검출되는 것을 알았으며 이상반응에 의해 발생된 황 계열 화합물이 사고 주변의 강한 악취의 원인임을 알 수 있었다.

• 한국임상약학회지
• /
• 제13권2호
• /
• pp.72-81
• /
• 2003

Adverse drug reaction (ADR) may increase hospital admission, morbidity and mortality and adding extra cost to healthcare expenditures. AIMS: This study was performed to identify the types of ADR being reported in a tertiary hospital, and to find out the ways to improve current ADR monitoring system. To investigate the attitudes of hospital pharmacists towards, and their understanding of ADR reporting. METHODS: Of 117 reports submitted to the pharmacy department during 3 months survey period, A questionnaire survey of 75 randomly selected hospital pharmacists was conducted. RESULT: Of the report was from patients aged between 60 and 70. The medical department with the high frequency in ADR reporting was Internal Medicines $(60\%)$. The most common ADR manifestations were gastrointestinal complaints $(47.8\%)\;and\;80\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $38.4\%.\;55.5\%$ of respondent were aware of the need to education and information about ADR monitoring. The important reasons for unreporting ADR were unknown of how to report ADRs $(94.6\%)$. CONCLUSIONS: An ADR reporting system based on reporting by staff pharmacists has been effective increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs. Pharmacists have the knowledge and responsibility to contribute to ADR reporting program. A great opportunity exists for pharmacists to contribute in this area of patient care.

• 한국임상약학회지
• /
• 제25권3호
• /
• pp.138-144
• /
• 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.

• 한국임상약학회지
• /
• 제21권4호
• /
• pp.353-363
• /
• 2011

The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.

• Journal of Periodontal and Implant Science
• /
• 제39권1호
• /
• pp.1-8
• /
• 2009

Purpose: Bisphosphonates are drugs used to suppress osteoclastic activity and to treat osteoporosis, Paget's disease of bone and bone metastasis. The purpose of this report is to review the literatures on bisphosphonates use that could affect bone healing and cause osteonecrosis of the jaws. Materials and methods: Medline research was carried out to find relevant articles on bisphosphonates and osteonecrosis of the jaw. Results: Oral administration of bisphosphonates is reported to decrease the risk of adverse bone outcomes. On the contrary, IV bisphosphonates is known to significantly increase the risk. Prevention of the osteonecrosis of the jaw is primary concern before usage. If the adverse bone reaction takes place, proper management and treatments are required to alleviate pain of patients and prevent further progression of necrosis. Conclusion: Case reports of bisphosphonates induced osteonecrosis of the jaw are increasing. Dentists and physicians should be aware of the higher frequency of osteonecrosis of the jaw in patients receiving IV bisphosphonates and be prepared to prevent and cope with adverse bone reaction.

• 한국임상약학회지
• /
• 제23권3호
• /
• pp.256-268
• /
• 2013

Objective: To study the attitudes and awareness of healthcare professionals (physicians, pharmacists, nurses and others) toward the Pharmacovigilance system and experience for adverse drug reactions (ADRs) from a Single University Hospital in Deajeon. Methods: A survey was performed using a structured questionnaire involving 360 health-care professionals at the hospital between $1^{st}$ November and $16^{th}$ November, 2012. Results: Sixty-five percent (n=235) of all respondents were experienced incidences of ADRs for their patients and 55.8% (n=201) knew the ADR Spontaneous Reporting System in the hospital. However, three-fourths (n=273, 75.8%) of respondents did not know the existence of the Korean Association of Regional Pharmacovigilance Centers (KARP) and 61.7% (n=222) were unaware of the obligation of ADR report from KFDA in cases of serious ADRs. About 83% (n=299) answered that the electronic ADR report system of the hospital was helpful while their work and most (n=336, 93.3%) agreed on the necessaries of the promotion and education about ADR. Conclusion: Seventy-five percent (n=271) of respondents wanted to continue the work for evaluation and feedback for ADRs reported in the hospital. However, the barriers to reporting ADR were; inconvenient ADR reporting system and the lack of time to report ADRs. This study showed that the easier ADR reporting system and education and promotion about ADRs for health-care providers are needed to improve the ADR reporting.