• Title/Summary/Keyword: diuretics

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Biological Activities of Pedicularis resupinata var. oppositifolia (마주송이풀의 생리활성(生理活性))

  • Yoo, Seung-Jo;Yim, Dong-Sool;Lee, Sook-Youn
    • Korean Journal of Pharmacognosy
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    • v.24 no.3
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    • pp.258-262
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    • 1993
  • The plant of Pedicularis resupinata var. oppositifolia(Scrophulariaceae) is described to be used for treatment of rheumatoid arthritis, malignant abscess (tumor), urolith and diuretics in oriental medicinal books. This study is concerned with some general pharmacological activities. It was observed that the methanol extract of the aerial part of this plant showed some effects on acute toxicity, carrageenin induced edema in rat paw, bile juice secretion and antibacterial effect. From this result it was obtained that the methanol extract revealed the antiinflammatory activity and bile juice secretion increasing effect. Thus, it was fractionated and buthanol fraction has obvious inhibition effect on edema and bile juice secretion increasing effect. The total extract showed low acute toxicity i.e., the minimum lethal dose was more than 8000mg/kg in oral administration in mice.

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Evaluation of Blood Volume State Using the Quotient of Urine Sodium and Potassium Excretion in Primary Nephrotic Syndrome in Children (일차성 신증후군 환아에서 소변 나트륨과 칼륨 농도를 이용한 저혈량증 평가)

  • Choi, Jung-Youn;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.9-15
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    • 2007
  • Purpose : Edema is one of the cardinal features of nephrotic syndrome. Although the pathogenesis of edema is not entirely understood, it is caused by hypovolemia or hypervolemia by different mechanisms. Accordingly it is important to evaluate the volume status of patients in order to treat the edema, but it is difficult to evaluate the patient's volume status only by clinical parameters. The quotient of urine sodium and potassium excretion $U_K/(U_{Na}+U_K)$ is introduced as a more useful way to evaluate volume status. In this study we will propose the usefulness of $U_K/(U_{Na}+U_K)$ in evaluating the volume status of children with nephrotic syndrome. Methods : Primary nephrotic syndrome patients at Yeungnam University Hospital since January 1995 to June 2005, were included in the study. We analyzed clinical parameters such as tachycardia, cardiomegaly, pleural effusion, blood chemistry and urinalysis prospectively. We defined hypovolemia when $U_K/(U_{Na}+U_K)$ exceeded 60%. Intravenous albumin and diuretics were administered to hypovolemic edematous patients. On the other hand, hypervolemic edematous patients were treated only with diuretics. Results : There were 50 cases of primary nephrotic syndrome patients(hypervolemia: 29 vs hypovolemia: 21). There were no significant differences in clinical symptoms and laboratory findings except for FeNa While $F_eNa$ and $U_K/(U_{Na}+U_K)$ had a significant negative correlation, BUN and $U_K/(U_{Na}+U_K)$ had a significant positive correlation. Urine output after edema treatment was effective and there were no treatment-related side effects in both groups. Conclusion : FeNa, BUN and $U_K/(U_{Na}+U_K)$ are a useful parameters for evaluating volume status of edematous nephrotic syndrome patients. We could suggest a therapeutic option for using albumin and/or diuretics according to volemic status by means of measured $U_K/(U_{Na}+UK)$.

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Evaluation of Factors Affecting Glomerular Filtration Rate by Contrast Media in Patients with Coronary Angiography (심혈관 조영술 시행 환자의 조영제 사용 시 사구체여과율 변화에 영향을 미치는 인자들 평가)

  • Kim, Eun-Young;Lee, Ok-Sang;Lim, Sung-Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.103-112
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    • 2012
  • Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

A Study on Health condition and Drug use of Female Workers in Incheon area (산업장 여성 근로자의 건강과 약물사용)

  • Cho Wonsun
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.17-32
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    • 1995
  • The purpose of this study is to promote health for young female workers. It is based on questionnaires collected from 215 female workers in Incheon area. This study includes health condition (fatigue scores), occupational disease, knowledge of abused drugs and the actual condition of drug use. The results are summerized as follows: - $47.4\%$ visited their health center and were treated with diseases like cold and headache $(34.9\%)$, gastroenteric disease $(6.5\%)$, trauma $(7.9\%)$ and chronic disease such as diabetes and hypertension $(3.3\%)$ - $44.7\%$ received regular health education and $4.7\%$ among them received education on abused drugs. - $20.5\%$ were suffering from work related diseases such as gastroenteric disease, headache, trauma, repiratory disease, skin problem, arthritis, low back pain, shortsightness and tuberculosis. - Total mean fatigue score as an indication of health status was $9.0\pm5.4$ points out of 30 points. Physical mean score (group I) was $3.92\pm2.2$ points and psychological mean score was $2.5\pm2.3$ points and neurosensory mean score was $2.6\pm2.1$ points out of each 10 points. - They recognized analgesics $(55.0\%)$ and the next are laxatives $(49.8\%)$, inhalants $(40.0\%)$, narcotics $(24.2\%)$, stimulants $(24.0\%)$, antihistamines$(5.9\%)$, diuretics $(3.0\%)$, tranquilizer $(2.4\%)$ and sedatives $(1.4\%)$ - They used analgesics $(37.2\%)$ the most and then laxatives $(6.0\%)$, stimulants$(5.6\%)$, diuretics $(1.9\%)$, antihistamines$(0.5\%)$, And nobody used tranquilizer, sedatives, narcotics and inhalant. - The relationship between career, drug abuse education, health center utilization and and the actual condition of drug using was examined. The longer the career and the more educated with drug abuse, the less drug used. And those who utilized health center rarely used more drugs. - The relationship between career, health center utilization, the score of fatigue and use of analgesics was also examined. Those group who have a longer career above 3 years and the group who have never used health center used more analgesics. And the group of fatigue score above 11.0 points used a little more analgesics than the other group. These results indicate that analgesics are the most frequent used drugs among female workers. Those analgesics such as geborin, penzal, saridon, aspirin, tyrenol should be used properly. These basic data is submitted for the education and consultation which are carried out by industrial nurses for promoting health of industrial workers.

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Drug Use Evaluation of Antihypertensive Agents by JNC VI Guidelines (고혈압 치료 지침 Vl에 의한 항고혈압제의 사용평가)

  • Kim, Kyung Hwa;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.29-38
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    • 2002
  • Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

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SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (악안면(顎顔面) 외상환자에서 나타난 항이뇨(抗利尿)호르몬 분비장애증후군(分泌障碍症候群))

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Choi, Jae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.7-10
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    • 1993
  • The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

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Falls Risk Factors of Inpatients (입원환자의 낙상 위험 예측 요인)

  • Kim, Eun-Kyung;Lee, Jae-Chang;Eom, Mi-Ran
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.676-684
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    • 2008
  • Purpose: The purpose of this study was to identify the risk factors for falls and to suggest data for developing a program for preventing falls. Methods: This was a case-control study in five university hospitals and a general hospital. In total, 216 patients over the age of 18 yr admitted from January 1 to December 31, 2007 participated. One hundred eight patients with experience of falling were matched by gender, age level, diagnosis, and length of stay with 108 patents with no experience of falling admitted on the same unit. A quality assurance coordinator nurse in each hospital examined 35 fall risk factors developed by researchers. Results: In acute hospitals, history of falls, orientation ability, dizziness or vertigo, general weakness, urination problems, transfer/mobility difficulty, walking dependency, impatience, benzodiazepines, diuretics, and vasodilators showed significance on adjusted-odds ratios for fall. Logistic regression analysis was performed to elucidate the factors that influence falls. The probability of falls was increased by dizziness/vertigo, general weakness, and impatience/agitation. Conclusion: This finding can be used as a useful resource in developing nursing intervention programs to predict and prevent the falls of inpatients.

A Case Report of Improvement of Docetaxel-induced Fluid Retention in a Patient with Advanced Gastric Cancer using Herbal Decoction, Modified Bangkihwangki-tang

  • Choi, Seong-Heon;Lee, Jee Young;Lee, Sung-Un;Lee, Soo-Min;Park, Sora;Jung, Yee-Hong
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.110-115
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    • 2014
  • Objectives: A 54-year-old advanced gastric cancer patient developed severe fluid retention after docetaxel chemotherapy, at cumulative dose of $930mg/m^2$, with no improvement using diuretics or prophylactic glucocorticoids. Consequently, he changed chemotherapy regimen from docetaxel to paclitaxel. After he treated with herbal decoction Bangkihwangki-tang (BHT), which is widely used to treat several symptoms including edema in traditional Korean medicine, docetaxel-induced fluid retention (DIFR) was significantly improved along with associated symptoms, such as peripheral edema, pleural and pericardial effusion, pain, scleroderma, and hypoesthesia. As the symptoms were relieved, his performance status and ambulatory ability were improved. During herbal treatment, he continued chemotherapy without any problems and didn't show any adverse events related to herbal medicine. Although there is possibility of natural improvement progress after withdrawal of docetaxel, he showed shorter recovery period and significant improvement despite of severity of initial symptoms.

Effect of Drug Use during Pregnancy (약물이 임신에 미치는 영향)

  • Park, Yong Kyun
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.139-148
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    • 1996
  • In recent year, problems caused by the abuse of drugs hove been analyzed in many cases, especially women's pregnancy. The purchasing of drugs without prescription, the misunderstanding of symptoms of pregnancy(such os vomiting, headache) os other ilnnesses, taking medicine during the pregnancy because of a chronic disease has caused many unfortunate cases Apart from these cases, pregnant women may take several medicines such as anodyne, tranquilizers, hypnotics, and diuretics which also cause critical situations. According to Piper and his colleagues 1987 study, in overage, pregnant women in the United Slates intake 3.1 kinds of additional dregs other than prenatal vitamins and mineral supplements. In those cases, both pregnant women and physicians anticipate inborn deformity. Most drugs which have whole body effects get to the unborn child via the placenta, however, many of these drugs do not have adverse effects(Shepard 1986, 1989). In general, drugs present a stronger effect to unborn children than they do to pregnant women due to the baby's excretion and to the drug metabolism that occurs in the mother's body through the placenta. The effects of dregs on unborn children show different results. depending upon the type of drug, dosage, characteristics. gestational weeks, genetic characteristics of the mother an baby, and many other environmental factors.

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Unexpected Severe Cerebral Edema after Cranioplasty : Case Report and Literature Review

  • Lee, Gwang Soo;Park, Sukh Que;Kim, Rasun;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.76-78
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    • 2015
  • This report details a case of unexpected, severe post-operative cerebral edema following cranioplasty. We discuss the possible pathological mechanisms of this complication. A 50-year-old female was admitted to our department with sudden onset of stuporous consciousness. A brain computed tomography (CT) revealed a subarachnoid hemorrhage with intracranial hemorrhage and subdural hematoma. Emergency decompressive craniectomy and aneurysmal neck clipping were performed. Following recovery, the decision was made to proceed with an autologous cranioplasty. The cranioplasty procedure was free of complications. An epidural drain was placed and connected to a suction system during skin closure to avoid epidural blood accumulation. However, following the procedure, the patient had a seizure in the recovery room. An emergency brain CT scan revealed widespread cerebral edema, and the catheter drain was clamped. The increased intracranial pressure and cerebral edema were controlled with osmotic diuretics, corticosteroids, and antiepileptic drugs. The edema slowly subsided, but new low-density areas were noted in the brain on follow-up CT 1 week later. We speculated that placing the epidural drain on active suction may have caused an acute decrease in intracranial pressure and subsequent rapid expansion of the brain, which impaired autoregulation and led to reperfusion injury.