• Title/Summary/Keyword: infusions

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Abuse Potential of Synthetic Cannabinoids: AM-1248, CB-13, and PB-22

  • Hur, Kwang-Hyun;Ma, Shi-Xun;Lee, Bo-Ram;Ko, Yong-Hyun;Seo, Jee-Yeon;Ryu, Hye Won;Kim, Hye Jin;Yoon, Seolmin;Lee, Yong-Sup;Lee, Seok-Yong;Jang, Choon-Gon
    • Biomolecules & Therapeutics
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    • v.29 no.4
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    • pp.384-391
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    • 2021
  • Currently, the expanding recreational use of synthetic cannabinoids (SCBs) threatens public health. SCBs produce psychoactive effects similar to those of tetrahydrocannabinol, the main component of cannabis, and additionally induce unexpected pharmacological side effects. SCBs are falsely advertised as legal and safe, but in reality, SCB abuse has been reported to cause acute intoxication and addictive disorders. However, because of the lack of scientific evidence to elucidate their dangerous pharmacological effects, SCBs are weakly regulated and continue to circulate in illegal drug markets. In the present study, the intravenous self-administration (IVSA) paradigm was used to evaluate the abuse potential of three SCBs (AM-1248, CB-13, and PB-22) in rats. All three SCBs maintained IVSA with a large number of infusions and active lever presses, demonstrating their reinforcing effects. The increase of active lever presses was particularly significant during the early IVSA sessions, indicating the reinforcement-enhancing effects of the SCBs (AM-1248 and CB-13). The number of inactive lever presses was significantly higher in the SCB groups (AM-1248 and CB-13) than that in the vehicle group, indicating their impulsive effects. In summary, these results demonstrated that SCBs have distinct pharmacological properties and abuse potential.

Optimization of the whole extract of Zarawand Mudaharaj (Aristolochia rotunda L.) root by Response Surface Methodology (RSM)

  • Ansari, MD Zakir;Sofi, Ghulamuddin;Hamiduddin, Hamiduddin;Ahmad, Haqeeq;Basri, Rabia;Alam, Abrar
    • CELLMED
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    • v.11 no.3
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    • pp.15.1-15.9
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    • 2021
  • The chemical constitution of a drug has been accepted as an important basis for pharmacological action in Unani medicine. Various dosage forms have been developed on this concept, such as decoctions (Joshanda), infusions (Khesanda), extract (Rub / Usara), and syrup. Zarawand Mudaharaj (ZM.) / Aristolochia rotunda L. root was subjected to extraction process using Soxhlet's apparatus by using Response Surface Methodology (RSM) to design the number of random runs of the extracts with variation in the factors of temperature, the concentration of ethanol in water, time for extraction, for optimizing and maximizing the yield concentration. The data obtained, was analyzed with regression equation and ANOVA two-way summary to interpret the interaction of the factors for yield maximization. Minitab version 18 was used to design and analyze data. Validation of the optimum conditions for maximum yield of the whole extract of ZM. Root was carried out by re-run of the extract using the optimized conditions. The maximum yield percentage thus obtained using RSM was 20.87% whereas using these optimum conditions 21.35 % yield was obtained thereby validating the method. The association between the response functions and the process variables was identified by a three-factor recorded Box-Behnken design. In the present study RSM is used because itis a cheap and affordable method to optimize maximum yield percentage which may be reliably used by researchers. The study set in the surface conditions for ZM. root extraction by the Soxhlet apparatus for maximizing the yield percentage.

Sevoflurane with opioid or dexmedetomidine infusions in dogs undergoing intracranial surgery: a retrospective observational study

  • Marquez-Grados, Felipe;Vettorato, Enzo;Corletto, Federico
    • Journal of Veterinary Science
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    • v.21 no.1
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    • pp.8.1-8.11
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    • 2020
  • This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

Comparative Study of Pyungwi-san extracted by Different Decoction Extractor and Extraction Time (전탕장비 및 전탕시간 변화에 의한 평위산(平胃散) 전탕액 비교)

  • Seok, Ga Hyeong;Moon, Jung Min;Cho, Su In
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.63-69
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    • 2012
  • Objectives : Decoction, in Korean Medicine, is a pharmacological method of extraction, by boiling, of dissolved chemicals, or herbal prescriptions, which may include stems, roots, bark and rhizomes. Decoctions differ from most teas, infusions, in that they are usually boiled. This study was performed to compare the difference of water decoctions extracted by different decoction extractor and extraction time and to analyze the reason of decoctions extracted by each decoction extractor have different taste. Methods : With water decoction samples by Pressure extractor, Non-pressure extractor and Ultrasonic waves merge extractor for 1 hr, 2 hr and 3 hr were investigated the yield and the concentration of hesperidin and glycyrrhizin by HPLC/DAD system in Pyungwi-san decoction. Results : The samples of each extractor were gradually increased the yield and the concentration of hesperidin and glycyrrhizin. The HPLC pattern of samples is similar. The yield and the concentration of hesperidin and glycyrrhizin of Ultrasonic waves merge extractor was most highest of the three. The rate of increase of the yield and the hesperidin concentration of between 1 hr and 2 hr in Pressure extractor was the most highest of the three. But the concentration of glycyrrhizin in Pressure extractor was relatively similar to Non-pressure extractor. Conclusions : The yield and the concentration of reference compounds in Pyungwi-san water decoction was influenced by extracting method and extracting time. For scientific movement and standardization of extracting medicinal herbs method need to study of extractor validation and to study in vitro and in vivo.

Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy (근거기반 중심정맥 주입요법 간호실무지침 개정)

  • Lim, Kyung Choon;Jeong, Jae Sim;Kim, Kyeong Sug;Kim, Hyun Lim;Kim, Hyun Jeong;Kim, Dong Yeon;Lee, Mi Jeong;Lee, Joohyun
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

Development of a model to predict vancomycin serum concentration during continuous infusion of vancomycin in critically ill pediatric patients

  • Yu Jin Han;Wonjin Jang;Jung Sun Kim;Hyun Jeong Kim;Sung Yun Suh;Yoon Sook Cho;June Dong Park;Bongjin Lee
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.2
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    • pp.121-127
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    • 2024
  • Vancomycin is a frequently used antibiotic in intensive care units, and the patient's renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients' renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient's renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = -1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R2 = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.

Is aggressive intravenous fluid prescription the answer to reduce mortality in severe pancreatitis? The FLIP study: Fluid resuscitation in pancreatitis

  • Julia McGovern;Samuel J Tingle;Northern Surgical Trainees Research Association (NOSTRA);Stuart Robinson;John Moir
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.394-402
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    • 2023
  • Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

Effect of intravenous deferoxamine in multiply transfused patients (대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과)

  • Oh, Sang Min;Kang, Joon Won;Kim, Sun Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1225-1230
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    • 2007
  • Purpose : Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions. Methods : From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients. Results : There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable. Conclusion : Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.

Effects of Priming Progesterone on the LH Surge Expressions in Ovariectomized Shiba Goats (LH surge 발현에 대한 서로 다른 Progesterone 농도의 효과)

  • Kim, Seung-Joon
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.25-30
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    • 2014
  • This study tested the hypothesis that the priming effects of progesterone on the timing of the LH surge induced by exogenous estradiol are more potentiated the negative feedback actions of progesterone on LH secretion by the existence of estradiol. In previous studies, the time interval from estradiol infusion until the peak of LH surge was gradually and significantly extended by the different levels of progesterone treated before estradiol infusions. Longterm ovariectomized Shiba goats that had received implants of estradiol capsules (Day 0) and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels. On Day 7, all devices of progesterone and estradiol packets were removed but estradiol capsules were maintained during the experiment, and blood samples were collected at 1 hr interval for 12 h from the time of progesterone removals to determine peripheral changes of estradiol and progesterone concentration. Then all animals were infused estradiol on the Day 7 after 13 h from the removals of progesterone devices with a peristaltic pump into jugular vein at a rate of 3-6 ${\mu}g/h$ for 36 h. For analysis of peripheral LH and estradiol concentration, blood samples were collected via another jugular vein at 2 h intervals for 52 h (from 4 h before the start of estradiol infusion to 48 h after the start of estradiol infusion). In all animals of the three groups treated with estradiol infusion, an LH surge was expressed but the peak time of LH surge was different. This time interval was not extended by the different levels of progesterone treated before estradiol infusions and the difference was not significant during this interval between the Low P and the High P groups. Progesterone pretreatment may contribute to regulating the neural system that is responded by estradiol, and estradiol existence potentiates the negative feedback effect of progesterone on GnRH/LH surge-generating system.

Comparison of Serum Cytokines($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) between Terminal Cancer Patients Treated with Vitamin C and Them without Vitamin C Therapy (Anorexia-Cachexia Syndrome을 가진 말기 암 환자에서 비타민 C 사용여부에 따른 사이토카인 변화 비교)

  • Yeom, Chang-Hwan;Suh, Sang-Youn;Cho, Kyung-Hee;Sun, Young-Gyu;Park, Yong-Gyu;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.51-57
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    • 2003
  • Purpose : Anorexia-cachexia syndrome is one of the most common symptoms and main cause of death in terminal cancer patients. This symptom is due to the enlarged cancer mass as well as tumor released cytokines. Some doctors have suggested that vitamin C was preferentially toxic to tumor cells in vitro and in vivo, and improved clinical symptoms in terminal cancer patients. Therefore, we measured cytokines in serum of terminal cancer patients to determine whether vitamin C treatment improved the anorexia-cachexia syndrome. Methods : We investigated that 49 terminal cancer patients admitted to the department of family medicine, National Health Insurance Corporation Ilsan hospital from March 1, 2002 to August 31, 2002. The study was done on 22 patients who were given 10 g/day of vitamin C infusions during 1 week and 27 patients who were not infused. We measured the cytokines levels ($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) before and after 1 week between terminal cancer patients treated vitamin C and without vitamin C. Results : Out of 49 patients, patents treated with vitamin C infusions were 22 (12 male, 10 female), and these without vitamin C were 27 (18 male, 9 female). In patients treated with vitamin C, $IL-1{\beta}\;were\;6.19{\pm}5.17$ before day and $8.76{\pm}5.72$ after 1 week, IL-6 were $3.07{\pm}8.09$ before day and $1.31{\pm}2.36$ after 1 week, and $TNF-{\alpha}\;were\;2.74{\pm}14.24$ before day and $0.50{\pm}2.00$ after 1 week. In patients treated without vitamin C, $IL-1{\beta}\;were\;2.50{\pm}3.58$ before day and $6.49{\pm}12.01$ after 1 week, IL-6 were $1.00{\pm}2.19$ before day and $17.16{\pm}81.55$ after 1 week, and $TNF-{\alpha}\;were\;1.19{\pm}2.98$ before day and $1.27{\pm}1.52$ after 1 week. The level of cytokines in patients treated with vitamin C decreased more than those without vitamin C. However, this represented no statistical value (P=0.0598 in $IL-1{\beta}$, P=0.1664 in IL-6, and P=0.5395 in $TNF-{\alpha}$). Conclusion : In terminal cancer, even if there was no statistical difference in the cytokines levels between patients treated with vitamin C and those not treated, those who were treated had a decrease all cytokines levels. Vitamin C is very safe with almost no side effects. Therefore, vitamin C treatment in terminal cancer patients can be seen as beneficial and helpful for clinical symptoms.

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