• 약학회지
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• 제58권1호
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• pp.40-46
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• 2014

Drugs with a narrow therapeutic index (NTI) require very precise dosing. Warfarin and digoxin are the examples of NTI-drugs and dosing of them varies widely for different patients. However, in South Korea, only two strengths of warfarin and one of digoxin are commercially available. This is a big barrier for the precise dispensing and has potential safety risks to patients, particularly to elderly patients. To find a potential solution to the problem, an analysis of the prescribed doses and dispensing patterns of those drugs was performed. Data were collected by computer-facilitated prescription review in a university hospital. The period screened was from May 1st, 2012 to April 30th, 2013. All the prescriptions with either warfarin or digoxin tablets were selected for this study and dispensing patterns were analyzed according to the prescribed doses. A total of 17,017 warfarin prescriptions were analyzed; 8,148 for inpatient prescriptions, 8,869 for outpatient prescriptions, respectively. Of the 23 kinds of prescribed doses, 2 mg (19.9%) was most frequent, followed by 3 mg (13.2%) and 2.5 mg (11.7%). By analyzing the dispensing patterns, 60.3% (10,253) of the prescriptions required pill splitting and 72.0% of them were for the patients 65 years old and over. On the other hand, 4,350 digoxin prescriptions were included in this study. Of the 6 kinds of prescribed doses, 0.125 mg (71.2%) was most frequent, followed by 0.0625 mg (20.2%). Among the prescriptions for digoxin, 92.0% (3,998) should be split and 65.7% of them were for the patients aged 65 years and over. Despite limitations of strengths, various doses of warfarin and digoxin were prescribed. Furthermore, more than half of the prescriptions that required pill splitting were for elderly patients. The results from this study suggest that different strengths of warfarin and digoxin should be provided for accuracy of dispensing and safety for patients receiving them.

• 대한한방내과학회지
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• 제43권6호
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• pp.1122-1133
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• 2022

Objectives: The aim of this study was to retrospectively evaluate the efficacy and safety of Ongyeong-tang (OGT) in the treatment of insomnia in patients afflicted with neurological diseases, according to the medical records of one medical institution. OGT is a herbal prescription that originates from the "Synopsis of Prescriptions of the Golden Chamber" and has been used for menopausal symptoms, uterine diseases, skin diseases, insomnia, and other neuropsychiatric symptoms. Methods: Medical records of patients who visited Kyung Hee University Korean Medicine Hospital from January 1, 2021 to June 30, 2022, received outpatient or inpatient treatment, and met the inclusion criteria were used in this study. Results: Twenty-four patients satisfied the inclusion criteria and were included. The Pittsburgh Sleep Quality Index-Korean version (PSQI-K) score was used to evaluate the outcomes before and after treatment. After an average of 14.42±9.2 days of OGT extract intake, 20 patients (83.3%) experienced improvement. The remaining four (16.7%) had no change in their symptoms, but none demonstrated worsening of symptoms. The total PSQI-K score showed a statistically significant decrease from 13.08±4.54 to 10.42±4.58 (p<0.001). Sleep quality, sleep duration, sleep disturbance, use of sleeping medications, and daytime dysfunction also showed statistically significant improvements. Conclusions: Administration of OGT extract may be a relatively safe and effective therapeutic option for insomnia in patients with neurological diseases.

• Hip & pelvis
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• 제35권1호
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• pp.24-31
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• 2023

Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

• The Korean Journal of Pain
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• 제37권2호
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• pp.119-131
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• 2024

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

• 한국임상약학회지
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• 제28권3호
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• pp.230-237
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• 2018

Objective: To compare adverse event reporting patterns between ethical-the-counter and over-the-counter drugs from community pharmacies and outpatient settings. Methods: We conducted a descriptive study using the adverse event reporting database, wherein data were collected from the regional pharmacovigilance centers of the Korean Pharmaceutical Association between January 1, 2016 and December 31, 2016. The reported drugs were classified into either ethical-the-counter or over-the-counter drugs, and we compared the distribution of patient age and gender, frequent adverse events and medications, serious adverse events, and causality assessment results, where causality assessments were performed according to the World Health Organization-The Uppsala Monitoring Centre's system. Results: We included 17,570 reports (75,451 drug-adverse event pairs). Ethical-the-counter and over-the-counter drugs accounted for 81.4% and 18.6% of the total adverse event reports, respectively. The use of over-the-counter drugs was higher in females and patients aged <18 years, whereas the use of ethical-the-counter drugs was higher in those aged >65 years. Alimentary tract and metabolism drugs, and respiratory system drugs were the most frequent ethical-the-counter and over-the-counter drugs, respectively. From causality assessment results, "possible" (75.4%) was the most commonly assigned category for ethical-the-counter drugs, while "possible" (44.0%) and "unlikely" (47.7%) were the most common categories for over-the-counter drugs. The distribution of serious adverse events were similar for both ethical-the-counter and over-the-counter drugs. Conclusion: Differences were observed in age, gender, reported medications, and symptoms for both ethical-the-counter and over-the-counter drugs. Further pharmacovigilance activities considering the adverse event characteristics of over-the-counter drugs, which are comparable to ethical-the-counter drugs, should be performed.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1988년도 학술대회지
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• pp.70-76
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• 1988

고래로 부터 인삼이 익기보강에 관련이 있다는 기록이 한의서에 기록되어 내려온다. 그래서 우리들은 기부족 증상에 대한 인삼의 치료효과를 평가하였다. 중국의과대학 한방내과에서 기부족치료환자 18명에 대해 실험하였다. 그 환자들에게 고려홍삼분말 2g을 1일 3회씩 2주간 계속 투약하였다. 결과의 평가를 위해 질문서와 맥파계에 의한 진단이 투약 전후에 신중히 이루어졌다. 대조군으로 5일이상 절식한 14명의 자원자에 대해 같은 평가를 하였는데 그 중 7명은 고려인삼을 섭취하였고, 나머지 7명은 물만 섭취하였다. 인삼투여군에서 3가지 결과가 관찰되었다. 하나는 피곤, 무력감과 같은 기부족 증상이 개선되었으며, 두번째는 시간에 따른 맥파의 변화로 P-파의 변화, 중복맥박 및 확장기 말기의 몇몇 미세한 파들이 강화 되었다. 세째는 주파수에서의 효과로 데시벨 진폭이 12Hz까지 증가되었다. 이와같은 세가지의 현상들은 서로 잘 일치되었다. 이 세가지 결과들은 한의학에서 말하는 "심장비장의 기"에 대한 효과 증강을 의미한다.