• Korean Journal of Clinical Pharmacy
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• v.16 no.2
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• pp.92-95
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• 2006

Medication counseling improves patients' compliance, which enhances the effectiveness of treatment and reduces the medical cost consequently. Since separation of dispensary from medical practice took place, most patients have had to go to pharmacy after receiving prescription from hospital. The importance of medication counseling in pharmacy thus has been emphasized. To study the present conditions of medication counseling from the pharmacists and the patients satisfaction with them, we conducted a survey with questionnaires. The subjects were 146 outpatients and 55 pharmacies located in Yeongdeungpo-gu. The research showed that 69.9% of the outpatients had received medication counseling and only 35.5% of them were satisfied with it. The main reason for their unsatisfaction was insufficiency of explanation. A number of patients(75.3%) were thinking that medication counseling from the pharmacists is necessary for appropriate administration and optimal efficacy of the medicine. Among 55 pharmacies involved in the research, 17 of them(30.9%) answered that they have been giving patients medication counseling, which were mostly verbally done. Only 8 of them(l4.5%) were providing medication information sheets for some specific drugs. The pharmacists referred to a few problems disturbing optimal medication counseling like these: 1) Lack of time, 2) insufficient information, 3) inappropriate counseling skills. To improve these problems, they hope to get more information about prescription and specific medicines from pharmacy in hospital. If hospital decides to hold the lectures on medication counseling, about 80% of the pharmacists tend to take part in them.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.67-73
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• 2022

Objectives: Hyponatremia is prevalent electrolyte disorder and can be fatal in older adults. Evaluative studies on hyponatremia among older adults are scarce, especially targeting for those who visited emergency department (ED). We aimed to estimate the prevalence and to identify risk factors of hyponatremia among elderly patients visiting the ED. Methods: A retrospective chart review was completed including 65 or older patients who visited ED at Seoul National University Bundang Hospital from September to December 2019. Patients with the serum sodium concentration of less than 130mEq/L was defined as a hyponatremia group. Logistic regression analysis was conducted to assess predictive factors for hyponatremia. Results: Of the total 2,445 patients, 155 (6.3%) were confirmed to have hyponatremia at the time of ED visits. Risk factors for hyponatremia identified in logistic regression analysis were thiazides (aOR=2.64, 95% CI 1.66-4.21), opioids (exclude tramadol) (aOR=3.45, 95% CI 1.72-6.94), and desmopressin (aOR=6.98, 95% CI 2.45-19.84). Compared to the use of thiazides alone, it was confirmed that the possibility of hyponatremia was more than quadrupled when proton pump inhibitor (PPI) was used together (aOR=4.08, 95% CI 1.74-9.55). Conclusions: About 6.3% of older adults visiting the ED had hyponatremia. Age, number of medications taken, previous history of hyponatremia, heart failure, cirrhosis, pneumonia, sepsis, prescribed drugs including thiazides, opioids (exclude tramadol), or desmopressin or taking PPI together with thiazides was confirmed to correlate with the risk of hyponatremia.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.57-64
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• 2013

Purpose: Drug can be hazardous for people if misused although they are useful for their indication. In urgent incidences such as overdose, proper treatment for intoxication can save patients' lives. In emergent case regarding drug overdose, pharmacists should know how to provide correct information including antidote to other healthcare providers. However, in Korea, there is neither regular class nor education material regarding detoxification. Therefore, the object of our study is to investigate the perception of pharmacists about it. Method: We surveyed hospital pharmacists by means of self-reporting questionnaire in order to investigate the pharmacists' perception of detoxification treatments from May $12^{th}$ 2012 to August $10^{th}$ 2012. The questionnaire comprised of demographic information, interest in detoxification treatment (inquiry from patients and education about antidote), knowledge of antidote, effective drug search route and perception of the need for education and stocking materials about antidotes). Results: It included total 281 hospital pharmacists from 30 hospitals in S. Korea. Of them, only 16.7% have been questioned about drug overdose from patient or representative and 35% have learned about antidotes in case of drug overdose through education program of Korean association of hospital pharmacist or university. About 98% thought that education and stocking materials about frequently overdosed drug and antidotes are helpful for patients in emergent case. Also, the percentage of correct answer of each questions about antidotes were higher in educated group ($p{\leq}0.001$). The more work years are, the percentage of correct answer of each questions are higher ($p{\leq}0.001$). Conclusion: In conclusion, it will be helpful for reducing damage by drug overdose that pharmacists take regular education about antidote for all pharmacist and pharmacy student. In addition, preparing and keeping booklet for Korean Style-antidote in pharmacy is needed currently for protecting public health.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6135-6140
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• 2013

Background: Breast cancer is a common malignant tumor which affects health of women and multidrug resistance (MDR) is one of the main factors leading to failure of chemotherapy. This study was conducted to establish paclitaxel-resistant breast cancer cell line and nude mice models to explore underlying mechanisms of MDR. Methods: The breast cancer drug-sensitive cell line MCF-7 (MCF-7/S) was exposed in stepwise escalating paclitaxel (TAX) to induce a resistant cell line MCF-7/TAX. Cell sensitivity to drugs and growth curves were measured by MTT assay. Changes of cell morphology and ultrastructure were examined by optical and electron microscopy. The cell cycle distribution was determined by flow cytometry. Furthermore, expression of proteins related to breast cancer occurrence and MDR was tested by immunocytochemistry. In Vivo, nude mice were injected with MCF-7/S and MCF-7/TAX cells and weights and tumor sizes were observed after paclitaxel treatment. In addition, proteins involved breast cancer and MDR were detected by immunohistochemistry. Results: Compared to MCF-7/S, MCF-7/TAX cells had a higher resistance to paclitaxel, cross-resistance and prolonged doubling time. Moreover, MCF-7/TAX showed obvious alterations of ultrastructure. Estrogen receptor (ER) expression was low in drug resistant cells and tumors while expression of human epidermal growth factor receptor 2 (HER2) and Ki-67 was up-regulated. P-glycoprotein (P-gp), lung resistance-related protein (LRP) and glutathione-S-transferase-${\pi}$ (GST-${\pi}$) involved in the MDR phenotype of resistant cells and tumors were all overexpressed. Conclusion: The underlying MDR mechanism of breast cancer may involve increased expression of P-gp, LRP and GST-${\pi}$.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.69-76
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• 2017

Objective: This study was conducted to assess the current status of experiential education, by analyzing pharmacy students' satisfaction and evaluation for practice sites and preceptors for 3 years from 2014 through 2016. Methods: Students evaluated the practice sites and preceptors using a 5-point and a 4-point Likert scale, respectively. Analysis was performed based on the types of curriculums and practice sites. In addition, sub-analysis was conducted based on the types of health-system pharmacy and the community pharmacy. Results: Total 203 students responded to the survey questionnaires. The 3-year average score of students' satisfaction with practice sites was 4.25. In the sub-analysis conducted based on the types of health-system pharmacy, the score was higher in the tertiary hospital pharmacies than that of the general hospital pharmacies (4.49 vs. 4.06, P<0.001). For community pharmacy, the difference in the score of the 3-year analysis was not significant, depending on the types (4.51 vs. 4.33, P=0.054). The average score of students' evaluation on the preceptors was 3.37 in the 3-year analysis. The score was significantly higher for the preceptors of tertiary hospital pharmacies than those of general hospital pharmacies (3.61 vs. 3.25, P<0.001). For community pharmacy, no significant differences were found, depending on the types of pharmacy (3.53 vs. 3.43, P=0.309). Conclusion: The students' satisfaction with practice sites and preceptors in pharmacy experiential education was high. However, it varied greatly depending on the types of educational institutions. Mutual effort between university and educational institutions is required, to narrow the gap in the degree of students' satisfaction.

• Molecules and Cells
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• v.44 no.8
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• pp.557-568
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• 2021

Global knockout of the BK channel has been proven to affect bone formation; however, whether it directly affects osteoblast differentiation and the mechanism are elusive. In the current study, we further investigated the role of BK channels in bone development and explored whether BK channels impacted the differentiation and proliferation of osteoblasts via the canonical Wnt signaling pathway. Our findings demonstrated that knockout of Kcnma1 disrupted the osteogenesis of osteoblasts and inhibited the stabilization of β-catenin. Western blot analysis showed that the protein levels of Axin1 and USP7 increased when Kcnma1 was deficient. Together, this study confirmed that BK ablation decreased bone mass via the Wnt/β-catenin signaling pathway. Our findings also showed that USP7 might have the ability to stabilize the activity of Axin1, which would increase the degradation of β-catenin in osteoblasts.

• Korean Journal of Clinical Pharmacy
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• v.30 no.3
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• pp.149-160
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• 2020

Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.279-284
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• 2018

Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.