• Title/Summary/Keyword: management of constipation

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Drug Use Evaluation of Anticholinergic Drugs Prescribed to Elderly Patients in the Ambulatory Setting Based on Beers and STOPP Criteria (Beers Criteria 및 STOPP 근거에 의거한 한국 노인 환자의 항콜린성제 약물요법의 적절성 평가)

  • Cheon, Young Ju;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.5
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    • pp.328-336
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    • 2014
  • Anticholinergic drugs are included in the efficacy group of various antidepressants, antihistamines, antispasmodics like skeletal muscle relaxants. Elderly patients are often taking anticholinergic drugs due to various diseases such as sleep disorders and dysuria. But the use of anticholinergic drugs is restricted in guidelines such as Beers Criteria or STOPP due to the anticholinergic adverse effects including dry mouth, constipation, difficult urination, delirium, hallucinations and especially cognitive impairment. In this study, we investigated the usage of anticholinergic drugs in out-of-hospital prescription of 4,442 elderly patients. Results of the study were obtained that 32% (n=1,421) of overall patients were prescribed with 1~6 products (average 1.37) of anticholinergic drugs. 70.9% of the 1,421 patients (n=1,007) were prescribed with one drug, 22.7% (n=323) were two drugs and 4.9% (n=70) were three drugs. 27.1% of the 1,421 patients (n=430) were 70~74 years old patients who were the most commonly prescribed with anticholinergic drugs. Amitriptyline, chlorpheniramine, dimenhydrinate and quetiapine were most frequent component of ACB Score 3 drugs and amantadine, baclofen, carbamazepine, cyproheptadine and oxcarbazepine were most frequent of ACB Score 2 drugs. Anticholinergic Drug Scale (ADS) of individual patients presented one point (48.5%, n=689), 2 points (15.4%, n=219), more than 3 points (36.1%, n=513), and up to maximum 12 point (n=1). More than 2 points were more than half (51.5%, n=732). Therefore, additional prospective study in the use and adverse effects of anticholinergic drugs for elderly patients will be required. And national management such as DUR program will be required for elderly drug administration from now on.

The Combined Treatment with Oriental Herbal Medicine and Western Biomedical Medicine among Cerebrovascular Attack Patients (뇌졸중 환자의 한약.양약 복합투여에 관한 단면연구)

  • Park Jong-Ku;Koh Kwang-Wook;Kim Chun-Bae;Choi Seo-Young;Yoo Jun-Sang
    • The Journal of Korean Medicine
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    • v.27 no.1 s.65
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    • pp.1-10
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    • 2006
  • Objectives : The combined treatment (CT) with oriental herbal medicine and western biomedical medicine is prevalent in the world including Korea. But the clinical information on frequency, efficacy and safety of CT at lout cerebrovascular attack hat not known thoroughly yet. This study aimed to identify the status and adverse effects of CT for the treatment of stroke patients. Methods : A self-completed questionnaire survey and medical record survey by oriental medical doctors were performed in 20 Korean Oriental medical hospitals. Of the initial 1,000 in-patients through 2-stage sampling method, 883 were participated in this surrey, resulting in a response rate of 88.3%. Results : Among stroke patients, the proportion of CT was 94.1%. 156 respondents (18.8%): were experienced several adverse effects including headache, dizziness (fatigue), diarrhea, constipation, chest discomfort, etc. The severity of these adverse effects was generally mild to moderate. Although they quitted the CT, 9.8% of patients were not relieved from adverse effects. Conclusions : This study suggests that most patients in Korean Oriental medical hospitals used the combined treatment with oriental herbal medicine and western biomedical medicine for management of stroke. Therefore, the medical professionals should provide comprehensive and up-to-date clinical information about potential benefits and risks of CT to the stroke patients.

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Identification and Validation of Symptom Clusters in Patients with Hepatocellular Carcinoma (간세포암 환자의 증상군 분류와 타당도 검증)

  • Cho, Myung-Sook;Kwon, In-Gak;Kim, Hee-Sun;Kim, Kyung-Hee;Ryu, Eun-Jung
    • Journal of Korean Academy of Nursing
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    • v.39 no.5
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    • pp.683-692
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    • 2009
  • Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

A Comparison of Nursing Interventions with Terminal Cancer Patients in a Hospice Unit and General Units (호스피스 병동과 일반병동의 말기암환자의 간호중재 비교)

  • Ro, You-Ja;Han, Sung-Sook;Yong, Jin-Sun;Song, Min-Sun;Hong, Jin-Ui
    • Korean Journal of Adult Nursing
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    • v.14 no.4
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    • pp.543-553
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    • 2002
  • Purpose: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. Method: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. Result: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. Conclusion: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.

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Risk Factors for Recurrent Abdominal Pain in Children with Nonorganic Acute Abdominal Pain

  • Piriyakitphaiboon, Varisa;Sirinam, Salin;Noipayak, Pongsak;Sirivichayakul, Chukiat;Pornrattanarungsri, Suwanna;Limkittikul, Kriengsak
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.129-137
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    • 2022
  • Purpose: The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. Methods: A retrospective, single study was conducted on 2-15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. Results: Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314-8.162), 3.052 (1.172-7.949), 3.706 (1.847-7.435), and 2.649 (1.477-4.750), respectively. Conclusion: RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.

A Comparative Study on the Dietary Habits, Life Habits, Physical Symptoms and Body Composition of University Students by Gender Differences in Incheon City (인천지역 남녀 대학생들의 식습관, 건강관련 생활습관, 신체증상 및 체성분에 관한 비교 연구)

  • Jang, Jae-Seon;Hong, Myung-Sun
    • The Korean Journal of Food And Nutrition
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    • v.26 no.4
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    • pp.928-935
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    • 2013
  • This study was designed to investigate the dietary habits, life habits, physical symptoms, and body composition of male and female students attending college in incheon, based on which to encourage proper dietary habits among and enhance the physical and psychological health of college students. The effects of personal characteristics (such as gender, grade level, residence type, means of transportation), health relative life habits (exercise, smoking and alcohol consumption), dietary habits, physical symptoms and body composition measurement were analyzed by using the questionnaire and Inbody. The subject pool was composed of 96 male and 149 female students. Smoking, drinking, exercise, and fruit intake showed significant differences between the genders (p<0.05), whereas meat intake was not significantly different (p>0.05). Differences on dietary habits and the intake of fruit showed significant differences (p<0.05) between the genders. Especially, more female than male students showed a higher frequency of fruit intake. Physical symptoms such as headache, common cold, dizziness, easy fatigue, poor concentration, indigestion and constipation showed significant differences (p<0.05) between the genders, whereas stomatitis, anorexia and pale face were not significantly different (p>0.05). Differences between the genders on body composition, height, weight, BMI, muscle soft lean mass, body fat mass, skeletal muscle mass and waist-hip ratio were also significantly different (p<0.05). The correlation analysis of college students by gender was negative between intake of milk and physical symptoms (p<0.01), whereas intake of cooked food and physical symptoms showed a positive correlation (p<0.01, p<0.05).

Analysis of Adverse Drug Reaction Reports using Text Mining (텍스트마이닝을 이용한 약물유해반응 보고자료 분석)

  • Kim, Hyon Hee;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.221-227
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    • 2017
  • Background: As personalized healthcare industry has attracted much attention, big data analysis of healthcare data is essential. Lots of healthcare data such as product labeling, biomedical literature and social media data are unstructured, extracting meaningful information from the unstructured text data are becoming important. In particular, text mining for adverse drug reactions (ADRs) reports is able to provide signal information to predict and detect adverse drug reactions. There has been no study on text analysis of expert opinion on Korea Adverse Event Reporting System (KAERS) databases in Korea. Methods: Expert opinion text of KAERS database provided by Korea Institute of Drug Safety & Risk Management (KIDS-KD) are analyzed. To understand the whole text, word frequency analysis are performed, and to look for important keywords from the text TF-IDF weight analysis are performed. Also, related keywords with the important keywords are presented by calculating correlation coefficient. Results: Among total 90,522 reports, 120 insulin ADR report and 858 tramadol ADR report were analyzed. The ADRs such as dizziness, headache, vomiting, dyspepsia, and shock were ranked in order in the insulin data, while the ADR symptoms such as vomiting, 어지러움, dizziness, dyspepsia and constipation were ranked in order in the tramadol data as the most frequently used keywords. Conclusion: Using text mining of the expert opinion in KIDS-KD, frequently mentioned ADRs and medications are easily recovered. Text mining in ADRs research is able to play an important role in detecting signal information and prediction of ADRs.

Clinical Experience in Dietary Management of Phenylketonuria with Maeil PKU-1, PKU-2 Formula (페닐케톤뇨증 환아에서 매일 PKU-1, PKU-2 Formula를 이용한 저페닐알라닌 식이요법의 임상적 효과)

  • Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.2 no.1
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    • pp.89-94
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    • 2002
  • Purpose : This study was performed to determine the safety and efficacy of recently developed specific formulas for phenylketonuria(PKU) patient by observing the growth and developmental pattern and serum phenylalanine level. Methods : We observed 14 patients diagnosed with PKU at Soon Chung Hyang University Hospital fed with formula for 1 year by checking daily diet diary and plasma aminoacids, Hb, Hct, WBC, Platelet count, ferritin, GOT, GPT, protein, albumin, globulin and urinalysis. Results : The 14 patients all liked the formula and height, weight and head circumference showed normal growth. Hemoglobin levels were in normal range, but 4 out of the 14 patients showed ferritin level lower than 12 ng/mL and needed iron supplements. Serum albumin, liver enzyme levels, urinalysis showed within normal range. The plasma phenyalanine levels were normal ranged 0.7-15.6 mg/dL. Adverse reactions such as rash, diarrhea or constipation were not observed. Conclusion : We confirmed that the specific formulas for PKU patients developed in Korea, PKU-1 and PKU-2 showed favorable results In development and treatment of PKU patients and could be used safely to children.

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An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine

  • Hafize Altay;Seyda Toprak Celenay
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.137-246
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    • 2023
  • Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

A Study on the Changes of Early Puerperium Symptoms and Blood Stasis Index of Women Taking Gungguijohyeol-eum-gamibang (궁귀조혈음가미방(芎歸調血飮加味方)을 복용한 여성의 산욕 초기 증상과 어혈 변화에 대한 연구)

  • Choi, Seok-Young;Kim, Chan-Woo;Kim, Nam-Hoon;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.1
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    • pp.1-19
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    • 2018
  • Objectives: The purpose of this study was to investigate the changes of early puerperium symptoms and Blood Stasis Index in women during the first two weeks after childbirth. Methods: 38 women staying at Korean postpartum management facilities were studied. Questionnaires were filled out on the date of arrival and departure. Changes in overall physical conditions including neuropsychiatric, circulatory, digestive, musculoskeletal, and urogenital and breast symptoms as well as Blood Stasis Pattern were studied. Results: 1. Neuropsychiatric symptoms were shown in order of Depressed Feeling, Insomnia, Dizziness, Headache, and Easy to Anger and Nervous on arrival. All symptoms showed improvement after two weeks, without significance. 2. Circulatory symptoms were shown in order of Excessive Sweating, Edema, Fatigue, Hot Flash, Anemic Feeling, Alternating Chills and Fever, Cold Hypersensitivity, Chills, Oppression in the Chest, and Palpitation on arrival. Hot Flash, Excessive Sweating, and Edema showed significant improvement after two weeks. 3. Digestive symptoms were shown in order of Dyspepsia, Dry Mouth, Constipation, and Loss of Appetite. All symptoms showed improvement after two weeks, without significance. 4. Pain of Muscles & Joints showed improvement after two weeks, without significance. Pain of Teeth & Gingiva showed slight worsening after two weeks, without significance. 5. Urogenital and Breast symptoms were shown in order of Wound Pain, Fever and Distending Pain in the Breast, and Lower Abdominal Pain on arrival. All symptoms showed significant improvement after two weeks. 6. Blood Stasis Index showed significant improvement after two weeks. Conclusion: Most symptoms were improved in women staying at Korean postpartum management facilities for two weeks. Hot Flash, Excessive Sweating, Edema, Wound Pain, Lower Abdominal Pain, Fever and Distending Pain in the Breast and Blood Stasis Index showed significant improvement.