• 약학회지
• /
• 제32권1호
• /
• pp.40-49
• /
• 1988

There is evidence that brain norepinephrine may play a role in experimentally induced seizures in animals. Thus the present experiments were undertaken in an attempt to explore the role of brain norepinephrine in anticonvulsant activity of clonazepam. 6-Hydroxydopamine was given to newborn rats and PTZ-induced seizures were tested $70{\sim}90$ days after birth and the rats were killed for determination of brain norepinephrine 8 days after the seizure test. Depletion of norepinephrine in the rat brain significantly potentiated the PTZ-induced convulsions and antagonized the effect of clonazepam on clonic seizures, tonic seizures and the number of seizures, but the latency to the seizure and the mortality has not been altered. However the 6-hydroxydopamine-induced antagonism of anticonvulsant action was surmountable by increasing the dose of clonazepam. These results show that brain norepinephrine may play an important role in seizure susceptability as well as in the anticonvulsant activity of clonazepam in rats.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제17권4호
• /
• pp.209-213
• /
• 2014

Purpose: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). Methods: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. Results: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepamtrial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). Conclusion: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.

• 대한약학회:학술대회논문집
• /
• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
• /
• pp.244.1-244.1
• /
• 2003

We aimed at determining bioavailability of clonazepam, an anxiolytic drug, and developing a simple analysis in human blood using HPLC. A rapid and sensitive HPLC method was developed and validated using reverse-phase C18 column with retension time and limit of quantification of clonazepam being 2.58 min and 5hg/ml, respectively. Quantification was performed at 235 nm with p-hydroxybenzoic acid ethyl ester as internal standard. The method involved a simple extraction. In order to study blood level profile in time, sight volunteers were enrolled and orally took 6 mg clonazepam once. (omitted)

• Journal of Oral Medicine and Pain
• /
• 제41권1호
• /
• pp.1-6
• /
• 2016

Purpose: To investigate the efficacy of pregabalin for patients with primary burning mouth syndrome (BMS) who are unresponsive to topical clonazepam therapy. Methods: By searching the clinical electronic records from the Department of Oral Medicine, Pusan National University Dental Hospital from 2012 to 2014, a retrospective analysis was performed on patients with primary BMS who were treated with topical clonazepam therapy during this period. Of the patients who were unresponsive to this therapy, 19 patients who were subsequently treated with pregabalin were included in the study. A pain assessment was performed using the 11-point numerical rating scale at first visit, following topical clonazepam therapy, and again after pregabalin therapy. The treatment outcomes were statistically analyzed using the Wilcoxon signed rank test. Results: Following additional pregabalin administration, the mean pain score was slightly reduced. A total of 7 patients reported a marked response (>50% pain reduction), and 3 patients reported a slight reduction in pain. Pain reduction following pregabalin therapy was statistically significant (p<0.05). Conclusions: Pregabalin has a slight therapeutic effect on patients with primary BMS. Therefore, we recommend pregabalin as an alternative drug for BMS patients who are unresponsive to topical clonazepam therapy.

• Journal of Oral Medicine and Pain
• /
• 제34권4호
• /
• pp.429-433
• /
• 2009

구강 작열감 증후군은 혀나 구강점막에 객관적인 이상징후(abnormal sign)를 보이지 않으면서 혀 및 구강점막의 지속적인 통증을 보이는 만성 질환이다. 연관된 것으로 추정되는 요인이 다양하고 환자마다 통증 양상이 다소 다르게 나타날 수 있어 적절한 진단 및 효과적인 치료를 제공하기 어려운 경우가 많다. 혀나 구강점막의 작열감은 알러지, 캔디다감염, 부기능습관, 타액선 기능저하 등과 같은 국소요인과 당뇨병, 갑상선기능저하증, 영양결핍 등과 같은 전신적 요인, 그리고 우울증, 걱정, 암공포증 등과 같은 심인성 요인과 연관되어 발생할 수 있다. 그러므로, 임상가들은 작열감을 유발할 수 있는 원인들에 대하여 숙지하고 있어야 하며, 혈액검사 등의 관련 검사를 통한 적절한 평가를 정확하고 세심하게 시행하여 효과적인 치료를 제공할 수 있어야 한다. 이러한 구강 작열감 증후군의 치료에는 약물요법, 인지행동요법, 심리치료 등 다양한 치료들이 시도되어지고 있다. 현재 구강작열감 증후군의 치료에 이용되고 있는 약물에는 클로나제팜(clonazepam), 가바펜틴(gabapentin), 삼환성항우울제(amitriptyline), 알파리포산(alpha-lipoic acid), 캡사이신(capsaicin) 등이 보고되고 있으며, 이 중 클로나제팜을 국소적으로 적용하는 것이 전신 투여하는 다른 약물에 비해 부작용이 적으면서 효과도 상당히 좋은 것으로 보고되고 있다. 이에 구강 작열감 증후군 환자에게 클로나제팜을 국소적으로 적용한 증례를 통해 그 효과를 확인하고자 하였다.

• Journal of Oral Medicine and Pain
• /
• 제37권3호
• /
• pp.161-167
• /
• 2012

구강작열감증후군은 구강점막의 만성통증성 작열감이다. 구강작열감증후군의 치료로는 약물치료, 심리치료가 있다. 과거의 연구를 통해 캡사이신, 알파-리포산, 도포용 클로나제팜, 전신적 클로나제팜이 구강작열감증후군 증상의 감소에 효과적임이 보고되었다. 이 연구의 목적은 구강작열감증후군 환자에게 전신적 클로나제팜을 투여하여 치료 효과를 평가하고 약제의 효능과 연령, 통증의 강도, 통증의 기간, 과거의 치과병력, 구강점막 상태 등의 다양한 임상적 특징과의 관계를 밝히는 것이다. 이 연구는 2011년 1월과 2012년 8월 사이에 구강작열감증후군으로 진단된 환자를 대상으로 후향적 임상자료 분석을 통해 이루어졌다. 환자들에게 0.5mg 클로나제팜을 하루 2회 처방하였다. 통증은 전신적 클로나제팜의 투여 전과 투여 1-2주 후에 11-점 숫자등급척도(11-point numeric rating scale, NRS)를 통해 측정되었다. 클로나제팜의 효능은 환자의 연령, 초기 통증 강도, 통증 지속기간, 유발인자의 존재유무, 혀의 상태, 의치착용 유무에 따라 평가되었다. 총 50명의 환자(여성 46명, 남성 4명)가 연구에 참여하였다. 환자들은 상기의 임상적 특징에 따라 2-3개의 군으로 나누었다. 강한 초기 통증 환자들의 평균 NRS 감소량은 $3.33{\pm}2.74$인 반면에 경도 혹은 중등도 초기 통증 환자들의 평균 NRS 감소량은 $1.64{\pm}1.54$였다. 70세 이상의 가장 높은 연령의 환자군의 평균 NRS 감소량은 $3.53{\pm}1.94$였으며, 60세 이하 환자군에서는 $2.88{\pm}1.80$, 60세에서 70세 사이 환자군에서는 $1.54{\pm}2.86$의 감소량을 보였다. 결론적으로 높은 연령의 환자들과 강한 초기 통증을 가진 환자들에게서 클로나제팜의 효능이 뛰어난 경향이 있다. 그러나 통증 기간, 유발인자 유무, 열구설 유무, 의치 장착 유무에 의한 클로나제팜의 효능의 차이는 통계학적 유의성이 없었다.

• Archives of Pharmacal Research
• /
• 제21권4호
• /
• pp.418-422
• /
• 1998

Aim of this work is to prepare poly(DL-lactide-co-glycolide) (PLGA) nanoparticles by dialysis method without surfactant and to investigate drug loading capacity and drug release. The size of PLGA nanoparticles was 269.9 $\pm$118.7 nm in intensity average and the morphology of PLGA nanoparticies was spherical shape from the observation of SEM and TEM. In the effect of drug loading contents on the particle size distribution, PLGA nanoparticles were monomodal pattern with narrow size distribution in the empty and lower drug loading nanoparticles whereas bi- or trimodal pattern was showed in the higher drug loading ones. Release of clonazepam from PLGA nanoparticles with higher drug loading contents was slower than that with lower loading contents.

• 약학회지
• /
• 제48권5호
• /
• pp.278-284
• /
• 2004

In order to determine the bioavailability of c1onazepam, an anxiolytic drug, a simple, rapid and sensitive HPLC analysis was developed in healthy Korean volunteers. The analysis system was validated in specificity, accuracy, precision and linearity. The analysis condition we established was 2.58 min and 5 ng/$m\ell$ in retention time and limit of quantitation of c1onazepam, respectively, using reverse-phase C18 column connected to UV detector. Quantitation was performed at 235 nm wave length with p-hydroxybenzoic acid ethyl ester as internal standard. The method involved a simple extraction. In order to study blood level profiles as a function of time, eight volunteers were enrolled and orally took 6 mg clonazepam once. The blood samples were collected from 0 to 120 h after the drug administration. Mean AUC and Cmax value were 1028.17$\pm$568.165 (ng/$m\ell$$.$hr) and 41.25$\pm$10.82 (ng/$m\ell$), respectively. And mean Tmax and T$_{1}$2/ value were 1.08$\pm$0.42 (hr) and 30.78$\pm$3.26 (hr). From the results we determine the pharmacokinetic characteristics of clonazepam in Korean people using a newly developed and useful HPLC method.

• Journal of Oral Medicine and Pain
• /
• 제47권3호
• /
• pp.126-134
• /
• 2022

Purpose: This study aimed to propose an efficient treatment approach for infection with different candida species. Methods: Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups. Results: Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam. Conclusions: Patients with oral mucosal pain should be tested for the presence of Candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans.

• Journal of Oral Medicine and Pain
• /
• 제40권3호
• /
• pp.130-134
• /
• 2015

$Sj{\ddot{o}}gren's$ syndrome (SS) is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. Apart from manifestations due to involvement of exocrine glands, patients with SS can present with muscular and neurological manifestations. Here, we report a rare case of a 59-year-old woman with primary SS, who presented with severe general toothache and masticatory muscle myalgia successfully treated with clonazepam. Although it was not certain that these symptoms could be originated from focal muscle dystonia or neurological changes that are associated with primary SS, our case suggested that comprehensive evaluation including neuromuscular examinations in the oral and maxillofacial area is needed in patients with SS.