• Title/Summary/Keyword: medication therapy management

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Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.143-148
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    • 2020
  • Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

Pain Management with Extracorporeal Shockwave Treatment in Multiple Level Clay-shoveler's Fracture in a Novice Golfer: A Case Report

  • Seongho Woo;Kwangohk Jun;Hyoshin Eo;KooWon Mo;Sunyoung Joo;Donghwi Park;Chung Reen Kim
    • The Journal of Korean Physical Therapy
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    • v.35 no.6
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    • pp.163-166
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    • 2023
  • A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

A Survey of Characteristics and Management of Low Back Pain in Postpartum Women (산모의 요통 실태와 관리에 대한 조사 연구)

  • Kim, Suhn-Yeop;Nam, Kun-Woo
    • Physical Therapy Korea
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    • v.9 no.1
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    • pp.69-79
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    • 2002
  • Many pregnant women have experienced low back pain (LBP) during pregnancy and after delivery, and it has been an important component in women health. This study was designed to investigate the characteristics and management of the LBP in postpartum women. Eighty-five postpartum women were participated in this survey. Mean age of 85 women was 28.1 years. Of 85 postpartum women, 55.3% (n=47) had LBP after pregnancy. Thirty of 47 women had pain on lumbar region, 17 postpartum women had pain on sacroilium region. Of 85 postpartum women, 74% (n=54) had LBP before pregnancy and 71.8% (n=61) had LBP during pregnancy. Of 47 postpartum women who had LBP, 83% (n=39) had not received medical management for LBP, 12.8% (n=6) took medication, and 4.3% (n=2) performed self-exercise. None of postpartum women had received physical therapy during pregnancy and after delivery for treatment low back pain. The pain in SI region was more severe than in lumbar region after pregnancy according to VAS (visual analog scale) (p<.05). However, there was no significant difference in VAS scores between SI pain and lumbar pain before and during pregnancy (p>.05). Pain region after delivery was related to pain region of pre-pregnancy and during pregnancy (p<.01). Pain level after delivery was related to the pain and night pain level during pregnancy (p<.01).

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Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma

  • Choi, Woo-Sung;Lee, Jae-Il;Yoon, Hyun-Joong;Min, Chang-Ki;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.1.1-1.7
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    • 2017
  • Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.

Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

  • Jung, Junho;Lim, Hae Soo;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.57-61
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    • 2018
  • Purpose: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine $A_{2A}$ receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. Materials and Methods: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. Result: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. Conclusion: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

A Cost-effectiveness Analysis of the Medication for Osteoporosis (골다공증 치료약제의 비용-효과 분석)

  • 임지영;권순만
    • Health Policy and Management
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    • v.11 no.3
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    • pp.71-88
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    • 2001
  • The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991g/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834g/$cm^2$, respectively.

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Factors Related to the Outpatient Visits for Blood Pressure Management in Patients diagnosed with Hypertension (고혈압 진단자의 혈압 관리를 위한 외래 방문 영향요인)

  • Cho, Hyung-Kyung;Lee, Hyun-Ji;Seol, Jin-Ju;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.26 no.2
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    • pp.56-67
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    • 2021
  • Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

Three Cases Reports of Oligomenorrhea with Obesity (비만을 동반한 희발월경(稀發月經) 환자 치험 3례)

  • Kim, Hyun-Jin;Jeong, A-Rong;Jeong, Eun-Ah
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.247-257
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    • 2008
  • Purpose: The purpose of this study is to report the effect of Traditional Korean Medical therapy on 3 patients with Oligomenorrhea. who were obese. Methods: The overweight patients who had been suffering from Oligomenorrhea visited to OBGY department of Dongseo Oriental Medical Hospital. We diagnosed their cases as Supdam(濕痰) on the authority of the first oriental medical examination and treated them with Traditional Korean Medical therapy such as herbal medication and acupuncture therapy. The process of symptoms was evaluated by checking their Menstrual periods. Results: After Traditional Korean Medical therapy. Three cases of Oligomenorrhea were improved. Their Menstrual periods were shortened and Menstrual cycles were maintained. Conclusion: This study shows that overweight or obesity is connected with Oligomenorrhea. Traditional Korean Medical therapy can be effective for the management of Oligomenorrhea.

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The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

Acute kidney injury and continuous renal replacement therapy in children; what pediatricians need to know

  • Cho, Myung Hyun;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.61 no.11
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    • pp.339-347
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    • 2018
  • Acute kidney injury (AKI) is characterized by abrupt deterioration of renal function, and its diagnosis relies on creatinine measurements and urine output. AKI is associated with higher morbidity and mortality, and is a risk factor for development of chronic kidney disease. There is no proven medication for AKI. Therefore, prevention and early detection are important. Physicians should be aware of the risk factors for AKI and should monitor renal function in high-risk patients. Management of AKI includes optimization of volume status and renal perfusion, avoidance of nephrotoxic agents, and sufficient nutritional support. Continuous renal replacement therapy is widely available for critically ill children, and this review provides basic information regarding this therapy. Long-term follow-up of patients with AKI for renal function, blood pressure, and proteinuria is recommended.