• Title/Summary/Keyword: drug discontinuation

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The Role of Serotonin in Pathology and Treatment of the Mood Disorders (기분장애의 병리와 치료에 있어 세로토닌의 역할)

  • Jung, In Kwa;Kim, Jin Se
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.168-178
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    • 1997
  • The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disroders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs) may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs). Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.

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Simultaneous hypersensitivity reactions to trimethoprim-sulfamethoxazole and amoxicillin-clavulanate in a dog

  • Yunho Jeong ;Yoon-Hwan Kim ;Jin-Ok Ahn;Jin-Young Chung
    • Journal of Veterinary Science
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    • v.24 no.6
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    • pp.77.1-77.7
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    • 2023
  • Antibiotics are known to be able to cause hypersensitivity reactions through various mechanisms. We present a case of drug-induced immune thrombocytopenia (DITP) and anaphylactic shock occurring simultaneously in a dog after the administration of two classes of antibiotics, namely trimethoprim-sulfamethoxazole (TMP-SMX) and amoxicillin-clavulanate (AMC). The patient recovered completely from DITP on discontinuation of TMP-SMX and the anaphylactic shock caused by AMC was treated with intensive care. DITP is a rare adverse drug reaction (ADR), and anaphylactic shock is a life-threatening ADR. This is the first case report of a dog manifesting two types of hypersensitivity reactions caused by two antibiotics.

Clinical Effectiveness of Cefoperazone(Cefobid) in Obstetrics-Gynecological Infection (부인과감염증(婦人科感染症)에 대(對)한 Cefoperazone(Cefobid)의 임상효과(臨床效果))

  • Park, S.K.;Lim, J.K.
    • The Korean Journal of Pharmacology
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    • v.16 no.2 s.27
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    • pp.71-75
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    • 1980
  • A total of 30 cases of gynecological infection were treated with Cefoperazone at the Department of Ob-Gy, Seoul Baik Hospital, Seoul, Korea from Sept. 1979 to Aug. 1980. Cefoperazone sodium was administered in a dose of 2g/day intramusculary or intravenously for 6 to 13 days. The effective rates of Cefoperazone based on clinical and bacteriological response were 100% in 9 cases of acute non-gonorrheal PID, 5 cases of postpartum endometritis, 2 cases of recurrent non-gonorrheal PID and 80% in acute gonorrheal PID(8 out of 10 cases). A case of recurrent gonorrheal PID and 2 out of 3 cases of postoperative infection responded also satisfactorily to Cefoperazone treatment. There were no drug-related abnormal findings in urinalysis, hematology and blood chemistry. Any particular side effects, except for one case of fever and rash which disappeared spontaneously without any treatment or discontinuation of the drug, were not noted during or after the treatment.

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Management of Dental Patients taking Warfarin (와파린(Warfarin) 투여 환자의 치과 치료)

  • Park, Kwan-Soo
    • The Journal of the Korean dental association
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    • v.57 no.10
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    • pp.623-628
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    • 2019
  • Warfarin is an anticoagulant involved in the production of vitamin K dependent blood clotting factors. Dentists should be familiar with the appropriate assessment methods and considerations for the treatment of patients taking warfarin. Dental surgery with the moderate risk of bleeding can be performed without stopping the drug through preoperative examination of the INR(international normalized ratio) value and evaluation. When performing a surgery with a high risk of bleeding, it is necessary to evaluate whether the drug can be discontinued, what the duration is, and the risk of discontinuation. Hemostasis can be obtained by local methods in most cases of postoperative bleeding in patients taking appropriately adjusted doses of warfarin.

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A study on the current status and perioperative management of antithrombotic in a general hospital

  • You, Seoung-Hee;Park, Sungwon
    • International Journal of Advanced Culture Technology
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    • v.10 no.1
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    • pp.108-115
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    • 2022
  • The purpose of this study is to investigate the actual status of antithrombotic management before and after the procedure or surgery, the difference between the duration of medication suspension by clinical and demographic characteristics, and the patient's understanding and satisfaction after medication management by a dedicated nurse. The results were as follows. The most commonly used antithrombotic agents were aspirin and flavitol. The drug discontinuation period according to antithrombotic, procedures, and underlying diseases, there was a significant difference in duration for each variables(p<.000). In the case of antiplatelet drugs, 5-day suspension was the most frequent, and anticoagulants 2-day suspension was the most frequent. Depending on the procedure,colonoscope,nucleoplasty,rotator cuff repair,and total knee arthroplasty commonly showed more than 80% of 5-day discontinuation. The differences according to underlying diseases are as follows. 64.7% of all diseases discontinued on the 5th. The patient's understanding of the nurse's medication management performed before and after the procedure was found to be lower in Angina patients than those with other diseases. In terms of age, those in their 50s showed higher understanding than other age groups. There were no differences in understanding and satisfaction with the remaining characteristics.

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

  • Fu, Si-Rui;Zhang, Ying-Qiang;Li, Yong;Hu, Bao-Shan;He, Xu;Huang, Jian-Wen;Zhan, Mei-Xiao;Lu, Li-Gong;Li, Jia-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3151-3156
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    • 2014
  • Background: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. Materials and Methods: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. Results: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. Conclusions: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.

Venlafaxine-Induced Acute Toxic Hepatitis (Venlafaxine에 의한 급성 독성 간염 1예)

  • Na, Kyeong-Sae;Hwang, Hee-Sung;Kim, Shin-Gyeom;Lee, So-Young-Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.18 no.3
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    • pp.159-162
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    • 2011
  • Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.

Visual Field Defect after Taking Atorvastatin/Ezetimibe, a Case Study (Atorvastatin/ezetimibe 복합제 복용 후 발생한 시야결손 부작용 사례보고)

  • Kim, Jiyoon;Lee, Kyunggyu;Kim, Junyoung;Lee, Jung-Min;Kim, Na-Young;Lee, Mo-Se;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.133-137
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    • 2019
  • Atorvastatin is one of the most widely prescribed medications for dyslipidemia treatment. In Korea, post combined therapy with ezetimibe, a 73-year-old woman was reported by a community pharmacy to have experienced visual field defect, which recovered after drug discontinuation. She had never experienced this symptom before, and several studies have reported an association between use of statins and visual disorders such as blurred vision, diplopia, and cataract. Blockage of cholesterol accumulation, oxidative stress, or myopathy is expected to be a cause of this symptom. Naranjo scale, Korean causality assessment algorithm (Ver.2), and World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria were the three tools used to determine causality between the visual disorder and atorvastatin. The results represent 'probable', 'certain', and 'probable/likely' causality, respectively. Our results, in combination with a review of literature, indicate that ocular adverse effects are highly likely related to atorvastatin.

Effects of Depression, Social Support of Tuberculosis Patients on Self-care

  • Lee, Go Un;Lee, Hye Kyung
    • Research in Community and Public Health Nursing
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    • v.33 no.4
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    • pp.456-464
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    • 2022
  • Purpose: The purpose of this study was by understanding the correlation between the depression, social support and self-care of tuberculosis patients and by identifying the factors that influence the self-care. Methods: The study subjects were 119 outpatients who were diagnosed with pulmonary and respiratory tuberculosis at a university hospital in D city. The survey questions measured depression, social support, self-care. Using the SPSS/WIN 23.0 program, the collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlations and multiple regression analysis. Results: As a result of correlation analysis, there was a statistically significant negative correlation between self-care and depression (r=-.53, p<.001), and there was a significant positive correlation between self-care and social support (r=.68, p<.001). Factors affecting self-care of the subjects were social support (β=.51, p<.001), depression (β=-.32, p<.001), drug discontinuation experience (β=-.30, p<.001) and drug resistance (β=-.14, p<.001). These factors explained 62% of the variance. Conclusion: In order to improve the self-care ability of tuberculosis patients, it is necessary to develop education and nursing intervention programs that can lower patients' depression and strengthen social support.

Economic Value of Pharmaceutical Care for the Elderly Patients in Community Pharmacies (노인환자에게 제공하는 개국약국 약료서비스의 경제적 가치)

  • Sohn, Hyun-Soon;Shin, Hyun-Taek
    • YAKHAK HOEJI
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    • v.51 no.5
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    • pp.327-335
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    • 2007
  • This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.