• Title/Summary/Keyword: narcotics

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Suggesting Strategic Countermeasures to the Change of Customs Administration in Korea and Japan (한일 세관행정 변화와 전략적 대응방안)

  • La, Kong-Woo;Kang, Jin-Wook;Kim, Hyoung-Cheol
    • International Commerce and Information Review
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    • v.14 no.1
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    • pp.273-299
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    • 2012
  • Japan's customs ensure the safety of international trade and trade facilitation has been pursuing. To do this, AEO was introduced to this system and expanding the supply chain currently maintain security and improve customer convenience is necessary to continue to be pursued. In addition, the imposition of customs duties in accordance with changes in the environment to Tariff offenders and increased the amount of tax evasion, smuggling of narcotics, including amphetamines and response, the increase in access is required. In this paper, Japan's tariff and customs administration for the change in the future for Japan-related materials around the Treasury Department's analysis will attempt to draw implications for this.

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Treatment of Epidural-Morphine-Induced Pruritus: Propofol Versus Naloxone (경막외 Morphie 투여시 생기는 소양증에 대한 Propofol과 Naloxone의 효과 비교)

  • Park, Chung-Hyun;Jung, Hyun-Jung
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.208-213
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    • 1997
  • Background: Pruritus is the most frequent undesirable symptom associated with epidural morphine. It is unpleasant and often difficult to treat. Naloxone is presently the drug of first choice for treating this symptom. Naloxone however decrease the pain threshold in some cases. Recently it was reported subhypnotic doses of propofol were efficient in relieving epidural-morphine-induced pruritus(EMIP). In a prospective. randomized, double-blinded clinical trial, we compared the efficacy of propofol and naloxone for treatment of EMIP. Methods: Forty patients with EMIP were allocated to receive either 20 mg propofol, or 1.5 ${\mu}g/kg$ naloxone intravenously. Pruritus and level of postoperative pain were assessed after 5 min, using pruritus rating scale and visual analogue scale. Results: The overall success rate in treating pruritus was similar in both groups (propofol 70% vs naloxone 65%). Twenty-five percent of the patients in the naloxone group had an increase in the level of postoperative pain versus none in the propofol group(P=0.018). Conclusions: These results suggest propofol and naloxone are equally effective in treating EMIP. However, the level of postoperative pain is significantly reduced when treated with propofol.

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Caudal Morphine for Postoperative Pain Control after Abdominal Surgery (천골강내로 주입한 Morphine에 의한 상.하복부 수술후 진통효과)

  • Woo, Nam-Sick;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.74-79
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    • 1988
  • Caudal narcotic analgesia was assesses after the injection of 3mg morphine diluted in 30ml (physiologic) saline into the sacral canal in 15 Patients after upper abdominal surgery, in 20 patients after lower abdominal surgery under general anesthesia, and in 20 patients after perianal surgery under caudal block. Pain relief was evaluated by the subsequent need for systemic analgesics. All eases had considerable relief from pain an4 the morphine was effective for 12 or more hours. There were no significant differances between pain relief of the upper abdominal and lower abdominal surgery group, upper abdominal and perianal surgery group, and lower abdominal and perianal surgery group (p>0.05, p>0.05, p>0.05). It is suggested that the morphine, which was administered into the sacral, cannal, reached the subarachnoid space and produced it's effect by direct action on the specific opiate receptors in the substantia gelatinosa of th.8 posterior horn cell of the spinal cord. Consequently, whether analgesia from epidural narcotics appears to be segmental in distribution or not is still in controversy.

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Pain management and Pain knowledge of Nurses (간호사의 암환자 통증관리 및 통증지식에 관한 연구)

  • Choi, So-Young
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.82-90
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    • 2004
  • Purpose: This study is part of questionnaire survey concerned with the views of nursing staff for cancer patients. This study was done to describe cancer pain management problem, pain management knowledge. Methods: The participants were 188 nurses at cancer ward. Data were collected from July 2003 to August 2003. Data were collected with multiple-choice items and one open-ended question, which were constructed structured questionnaire. The data were analyzed by means of SPSS statistical software and content analysis. Results: Experiences of pain education are 53.7%, pain assessment sheet not use 86%, pain management status are partial. Education need of pain management was 87.8% patients in pain were very often(23.9%) or rather often (35.1%) cancer patients. The nurses are respond to open question. Pain management problems as assessed by nurses are categorized 11 item. The health professional problems are Knowledge deficit pain management, Incontrollable pain, Doctor's busy. The patient problems afraid of narcotics for addiction, side effect, distinguishing between physical and suffering, economical problem. The scores of knowledge about pain was average 16.7 score. The pain knowledge showed significant correlation education need(r=.180, p=.013). The effective variable was need of $education({\beta}=.163)$. Conclusion: It was found that pain knowledge was middle score and pain management problem was multiple. The study highlights the need to increase pain education for health professional. Therefore, This study suggest that health professionals education should be done to improve pain management problem.

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Acute Respiratory Distress due to Rapid Tranquilization in a Bipolar Patient with Sleep Apnea (수면 무호흡증이 있는 양극성 장애 환자에서 급속 정온요법으로 인해 발생한 급성 호흡 장애)

  • Ham, Byung-Joo;Seo, Yong-Jin;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.144-147
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    • 2001
  • Chemical restraint or "rapid tranquilization" is another option in treating patients who are a danger to themselves or others and struggle violently once physically restrained. The most commonly used drugs are benzodiazepines and antipsychotics. The use of benzodiazepines, either alone or in combination with high potency neuroleptics, has increased in recent years. Benzodiazepines are extremely safe but may cause respiratory depression and hypotension. Respiratory depression is more likely with intravenous administration, therefore these medications should be given slowly and titrated to the desired effect. Special care should be taken when sedating patients who are under the influence of alcohol or narcotics and are sleep apneic patients. This report deals with a case of respiratory distress in a patient with sleep apnea syndrome after the rapid tranqulization. All patients receiving chemical restraint must be carefully monitored. For critically ill patients who require sedation or chemical restraint, the constant attendance of a physician may be warranted.

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Drug Abuse and Delinquency among Employees of Public House (유흥업소 종사자들의 약물남용과 비행경험 실태)

  • Jhoo, Wang Kee;Lee, Hyun Woo;Ryong, Hye Kyong;Jhoo, Jin Hyung;Kim, Hyoung Chun
    • Korean Journal of Clinical Pharmacy
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    • v.2 no.1
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    • pp.29-39
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    • 1992
  • In a survey of drug abuse of fourteen types of drugs by employees of public house, the results are follows. $87.4\%$ of male and $82.1\%$ of female ever smoked in his/her life time. $82.2\%$ of male and $75.2\%$ of female smoked in the past month. $90.4\%$ of male and $93.9\%$ of female ever drank in his/her life time. $82.2\%$ of male and $81.6\%$ of female in the past month. $57.8\%$ of male and $54.9\%$ of female smoked daily and $27.4\%$ of male and $53.6\%$ of female drank daily. $3.9\%$ of the employees of public house ever used marijuana in his/her life time: $1.7\%$, stimulants : $5.6\%$ inhalants : $10.0\%$ tranquilizers: $14.6\%$, hypnotics : $32.9\%$ analgesics: $3.7\%$, antitussives: and $1.4\%$, antihistamines; $1.5\%$, cocaine; $0.0\%$ amphetamines; $0.6\%$ narcotics: and $4.71\%$, hallucinogens. Drug use and delinquency showed a dosed relationship: drug users committed higher degree of delinquent behaviors and delinquents used drugs more frequently.

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Comparison of Controlled-release Oral Morphine with Transdermal Fentanyl in the Management of Terminal Cancer Pain (말기암 환자의 통증 치료에 있어 서방형 몰핀과 경피형 펜타닐의 비교 연구)

  • Baik, Seong-Wan;Park, Du-Jin;Kim, Inn-Se;Kim, Hae-Kyu;Kwon, Jae-Young;Shin, Sang-Wook
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.60-66
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    • 2000
  • Background: For terminal cancer pain management, controlled-release oral morphine (morphine sulfate tablet, MST) is a simple and convenient regimen. Recently, fentanyl transdermal therapeutic system (F-TTS, transdermal fentanyl) has been developed and became one of the alternative ways of providing adequate pain relief. This open prospective study was designed to compare the analgesic efficacy and safety of MST and transdermal fentanyl in the management of terminal cancer pain. Methods: In this open comparative and randomized study, 64 terminal cancer patients received one treatment for 15 days, controlled-release oral morphine (MST group) or fentanyl transdermal therapeutic system (F-TTS group). Daily diaries about the vital sign, visual analogue scale (VAS) for pain, opioids requirement, co-anagesics, adjuvant drugs and adverse effects were completed with 24 patients in MST group, 18 patients in F-TTS group. Results: The majority of patients in both treatment groups were late-stage cancer and their distribution was not different in both groups. Daily opioids requirement was 126.4 mg in MST uced in F-TTS group (P<0.05). The incidence of nausea, vomiting and constipation was lower in F-TTS group (P<0.05). Patients satisfaction was similar, but F-TTS patient group favored continous use of same treatment compared with MST group after the study was finished. Conclusions: Transdermal fentanyl seems to be safe and similar analgesic effect to controlled-release oral morphine for the control of the terminal cancer patients. However, transdermal fentanyl provides a simpler and more convenient especially in respect to constipation, nausea & vomiting. To determine the exact analgesic effect, cost-effectiveness and complications, controlled trials should be followed.

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The Effect of the Combined Analgesia of Epidural and Cryoanalgesia after Thoracotomy Surgery (개흉술 후 냉각요법과 경막외 Fentanyl 병용요법의 비교)

  • Shin, Jin-Woo;Choi, In-Cheol;Ha, Seung-Ill;Sim, Ji-Yeon;Lee, Cheong;Park, Seung-Ill;Yun, Chang-Seob
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.68-75
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    • 2001
  • Background: Thoracotomy is the operation that produces the most postoperative pain, necessitating the highest requirements for postoperative analgesics. The common methods of treating postthoracotomy pain are the use of thoracic epidural analgesia, intemittent or continuous intercostal nerve blocks, intravenous narcotics and cryoanalgesia. We designed to assess the analgesic effect of epidural analgesia, cryoanalgesia and the combined analgesia in thoracic surgery. Methods: A prospective study was carried out in 59 patients undergoing elective thoracotomy for parenchymal disease. Patients were randomized into three groups: C (cryoanalgesia), CE (cryoanalgesia and thoracic epidural analgesia), E (epidural analgesia). All patients had standard anesthesia with endotracheal intubation using a double lumen endotracheal tube, and one-lung ventilation. Subjective pain relief was assessed on a visual analog scale. Analgesic requirements, complications and the degree of satisfaction were evaluated during the 7 days following surgery. Results: Subjective pain relief was significantly better in Group CE and Group E in comparison with Group C (P < 0.05). Cryoanalgesia provided a better pain score on the 6th and 7th POD than the early postoperative periods. Analgesic requirements were higher in Group C than in the Group CE and Group E during the first POD. The incidence of side effects was similar in Group CE and Group E. Conclusions: If we can reduce the concentration of fentanyl and local anesthetics in combined analgesia of epidural and cryoanalgesia, the disadvantages of each method would be overcome and would be a better method of postthoracotomy pain control.

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Evaluating Appropriateness of Medication Use in the Operating Rooms of a Tertiary Hospital: Based on Survey (일개 병원의 수술실 약제관련 업무 적정화 방안연구: 설문조사를 중심으로)

  • Lee, Ye Ji;Jeong, Kyeong Hye;Kim, Young Nam;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.230-237
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    • 2016
  • Background: Since the use of opioid analgesics is frequent in operation rooms (OR), the risk of medication error is high; however the use of medication in the OR has been operating independently with the hospital pharmacy. Therefore, the assessment on management of medication use in operation and the pharmacist's role is needed. Methods: We conducted the literature review and survey from anesthesiologists, operating nurses at Chung-Ang Hospital on management of medication for operation use, awareness on need for medication management efficiency, need for satellite pharmacy in the operating room and its effect. Results: 56% of medical staffs responded that management of medication in the operating room is efficient; however, 82.6% responded that they felt the inconvenience in medication delivery to the OR when additional prescription was ordered. 51.5% also responded that extra time was required for management of narcotics and inventory/record keeping. 80% agreed that there could be lost costs due to prescription missed. Medical staffs responded improving the drug management system could increase the OR efficiency (87%), and eventually bring the increase in hospital revenue (80.4%). Those who responded that implementation of OR satellite pharmacy was needed include physicians (84.6%), nurses (63.6%), and also responded that it'd bring more profit to the hospital by increasing the efficiency in OR (60.9%). Conclusion: For efficient management of medications, implementation of OR satellite pharmacy would lead to improved drug management and increased efficiency in OR and reduced cost and improved patient care.

Inhalation Sedation with Nitrous Oxide in Dental Treatment (Nitrous Oxide를 이용한 흡입진정)

  • Yoon, Byung-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.1-6
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    • 2002
  • The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.

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