Metabolic syndrome is increasing nowadays and one of causes is obesity. Therefore prevention and treatment of obesity is very important to decrease of Metabolic syndrome. However currently many pharmacotherapy for obesity are popular in Korea and it may be dangerous. The aim of this study is to evaluate the purpose and relevance of obese treatment in two areas (capital & local) of Korea and suggest to guide for the right directions of pharmacotherapy in obesity treatment. We selected and surveyed 90 patients (88 females, 2 males, age of $23{\sim}60$) at random who received a prescription after consulting with a doctor at several clinics of Cheongju-area and Seoul-area, from May thru June, 2007. And we evaluated their prescriptions. In results, only 26.7% were obese (13.3%, 2325), most 73.3% patients were normal (65.6%, 18.5$m^2$). The purpose of treatment was for appearance (38.9%), health (41.1%) or both (18.9%, p<0.01). 94% patients had the past history of obese treatment. Prescriptions were consisted of CNS stimulant, anticonvulsants, antidepressant, laxatives, diuretics, or antianxietics. Obese treatment is very important for health to prevent disease such as Metabolic Syndrome. However it should not be abused. In conclusion, some patients of obese treatment is not relevant to obesity and pharmacist role is important to guide them for the right directions in obesity treatment.
Background: Androgenetic alopecia (AGA), one of alopecias, requires continuous treatment in order to prevent or stop it, and patient's compliance is very important. Currently, only two drugs (finasteride, minoxidil) have been approved for AGA by Food and Drug Administration of United States (US FDA). However, another ${\alpha}-2$ reductase inhibitor, dutasteride, is approved by Korea Ministry of Food and Drug Safety (MFDS) through a phase III trial. For treatment, pharmacotherapy of AGA usually combines topical minoxidil 7% with one of oral <${\alpha}-2$ reductase inhibitor. Objectives: We evaluated the comparative efficacy and adverse effect between topical minoxidil 7%/finasteride 1 mg and topical minoxidil 7%/dutasteride 0.5 mg pharmacotherapy for outpatients with AGA. Also we evaluated the relationship between therapeutic effect and regular hospital visit. Method: This study was performed retrospectively based on electronic medical record (EMR) data of total 98 patients (topical minoxidil 7% with dutasteride 0.5 mg ($Avodart^{(R)}$) or finasteride 1 mg ($Alopecia^{(R)}$, $Propecia^{(R)}$) with diagnosis of AGA from department of dermatology at a secondary hospital from January $1^{st}$, to May $31^{st}$, 2014. Results: The efficacy and adverse event of topical minoxidil 7%/dutasteride 0.5 mg (DUTA group) were 100% and 45.7%, and of topical minoxidil 7%/finasteride 1 mg (FINA group) were 92.1% and 33.3%, respectively. The mean onset time of responses and adverse events in the FINA group were 3.86 months and 4.43 months. Those in the DUTA group were 3.97 months and 5.06 months. Conclusion: Both FINA and DUTA group were highly effective, but the DUTA group showed higher efficacy and adverse effects than those in the FINA group. Dutasteride may be another alternative in AGA treatment.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제24권3호
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pp.157-163
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2013
Objectives : Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. Methods : The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. Results : After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. Conclusion : Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.
Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.
Objectives : This study aimed to investigate the therapeutic effect of combined biofeedback training with pharmacotherapy for patients with anxiety disorder. Methods : 12 patients with panic disorder and generalized anxiety disorder were enrolled this study. They were tested for State Trait Anxiety Inventory-State (STAI-S), State Trait Anxiety Inventory-Trait (STAI-T), Beck's Depression Inventory (BDI) and Symptom CheckList-90-Revision Somatization (SCL-90-R-SOM) before and after the biofeedback training program. Results : The score of STAI-T (p=0.023) and BDI (p=0.0018) were the significantly decreased after the biofeedback training program. In Female group, the score of STAI-T (p=0.028), STAI-S (p=0.028) and BDI (p=0.009) were significantly decreased after the biofeedback training program. In the group which age is lower than 40 years old, the score of BDI (p=0.046) were significantly decreased after the biofeedback training program. In Panic disorder group, the score of STAI-S (p=0.046) were significantly decreased after the biofeedback training program. Conclusion : The result of this study is useful for the treating the anxiety disorder patients using the biofeedback training program.
The pharmacotherapy of schizophrenia exhibits wide inter-individual variabilities in clinical efficacy and adverse effects. Recently, human genetic diversity has been known as one of the essential factors to the variation in human drug response. This suggests that drug therapy should be tailored to the genetic characteristics of the individual. Pharmacogenetics is the field of investigation that attempts to elucidate genetic basis of an individual's responses to pharmacotherapy, considering drug effects divided into two categories as pharmacokinetics and pharmacodynamics. The emerging field of pharmacogenomics, which focuses on genetic determinants of drug response at the level of the entire human genome, is important for development and prescription of safer and more effective individually tailored drugs and will aid in understanding how genetics influence drug response. In schizophrenia, pharmacogenetic studies have shown the role of genetic variants of the cytochrome P450 enzymes such as CYP2D6, CYP2C19, and CYP2A1 in the metabolism of antipsychotic drugs. At the level of drug targets, variants of the dopamine $D_2$, $D_3$ and $D_4$, and 5-$HT_{2A}$ and 5-$HT_{2C}$ receptors have been examined. The pharmacogenetic studies in schizophrenia presently shows controversial findings which may be related to the multiple involvement of genes with relatively small effects and to the lack of standardized phenotypes. For further development in the pharmacogenomics of schizophrenia, there would be required the extensive outcome measures and definitions, and the powerful new tools of genomics, proteomics and so on.
Objective:This study was performed to investigate the prescribing patterns of antimanic agents in the treatment of acute bipolar disorder inpatients in Korea from 1990 through 2000. The results will serve as the basic data for the practice guideline for the pharmacotherapy of bipolar disorder patients in Korea. Method:Retrospective chart review of bipolar disorder inpatients of Soonchunhyang Medical Center in Seoul and Chun-An was conducted for each of the year 1990, 1995, and 2000. The following data are collected ; 1) demographic data, 2) history of bipolar disorder, 3) length of hospital stay, 4) detailed drug titration records of antimanic agents and antipsychotic agents. Results:During the last decade, the frequency of lithium monotherapy was decreased obviously. Instead, more than half of the patients in 2000 were on combination therapy of lithium and anticonvulsants. Lithiumvalproate combination was the preferred strategy and the use rate of carbamazepine has been decreased. In addition, most of the patients were given antipsychotic agents during the last 10 years. And recently, atypical antipsychotics were increasingly prescribed. These changes in the field of pharmacology of bipolar disorder have resulted neither in shorter hospital stays nor lower dosages of concurrent neuroleptics. Conclusions:The results indicate the trends in the prescribing of antimanic agents for the treatment of bipolar disorder in Korea across the past 10 years. Mostly, the change seems to correspond to the international practice guideline. More systematic research is needed to find out the clinical benefits of the anticonvulsants in the real practice of treatment of bipolar disorder.
Objectives In the current study, we quantitatively estimated changes in appetite and eating behavior of bipolar disorder patients during the pharmacotherapy. We also investigated their contribution to the weight gain and their association with specific food-craving characteristics of the patients. Methods Subjects included forty-one bipolar disorder patients and fifty-six controls. Currently sustained natures of food craving were assessed using the General-Food Craving Questionnaire-Trait (G-FCQ-T) and changes in appetite and eating behavior were measured using the Drug-Related Eating Behavior Questionnaire (DR-EBQ). Results Compared to the control group, the patients' group showed significantly higher body mass index (t=2.028, p=0.045). The patients' group had significantly higher 'Preoccupation with food' factor score of G-FCQ-T (p=0.016) than that of the control group. Hierarchical multiple regression analysis showed that only 'preoccupation with food' factor independently predicted psychotropic medication-induced appetite change. Conclusions Appetite change while receiving psychotropic medication seems to be related to the weight-gain and associated with craving natures of 'preoccupation with food' in bipolar disorder. Appetite and/or eating behavioral changes measured by G-FCQ-T and DR-EBQ could be regarded as an important mediating factor in future studies exploring biological mechanisms of weight gain related with pharmacotherapy for bipolar disorder.
1. Objectives This research is purposed to present developmental direction of traditional Korean medicine, through summarizing original medical mind of traditional Korean medicine. 2. Methods It was researched as bibliographic study with chief writings of traditional Korean medicine such as "DongEuiBoGam(東醫寶鑑)" and "Dongyi Suse Bowon(東醫壽世保元)" 3. Results and Conclusions (1) Huh Jun regarded Three Precious(三要: 精, 氣, 神) as important factors in Morpho-imaginary viewpoints. So he suggested finding out the pathological states according to the states of Three Precious. (2) As Huh Jun recognized that the essence(精) is the origin of the body, he suggested the medical mind of laying emphasis on the essence. And he suggested that circulating of the essence is important to health and longevity, which is different from previous trational medicne laying emphasis on the tonifying of five organs(五臟). (3) Dong-mu suggested diagnostic method that is to find out "Natural Principle of Organ(臟腑性理)" by observation of "Knowing-Acting(知行)" and "Morphological aspect and Temper(體形氣像)". And he suggested finding out pathological states according to states of "Good Qi of each constitution(體質正氣)". (4) Dong-mu recognized that the disease should be treated by recovering "Good Qi of each constitution" with both pharmacotherapy and non-pharmacotherapy. So he uggested the medical mind of laying emphasis on "Good Qi of each constitution", which is different from previous trational medicne laying emphasis on the tonifying of five organs. (5) To be brief, Huh Jun layed emphasis on the essence and Dong-mu layed emphasis on "Good Qi of each constitution". Emphasizing internal vitality which is applyed to treatment and prevention of disease is the original medical mind of traditional Korean medicine.
Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that can affect many organs of the body but usually affects the lungs. The prevalence of TB in Korea is considerably higher than that in other countries with similar economic levels, and is much higher in elderly people. Pharmacotherapy is important in the treatment of TB and requires relatively high compliance for a prolonged duration. Methods: We analyzed sample data of elderly patients obtained from the Health Insurance Review and Assessment Service. We used logistic regression analysis and frequency analysis to identify factors that could affect prevalence of TB in elderly patients, compliance with prescribed medication regimes in these patients, and use of medical institutions. Korean Standard Classification of Diseases, version 7 (KCD-7) was used to diagnose pulmonary TB, and medications were analyzed using Korean standardized drug classification codes. Results: 1,276,331 patients were analyzed in the sample of the elderly population, and 16,658 TB patients were included in the study. The mean age of the TB patients was 76.19 years (SD 6.899). A total of 699 patients were prescribed isoniazid, rifampicin, ethambutol, or pyrazinamide at least once. Of these, 352 (50.4%) were prescribed all four medications and 101 (14.4%) were prescribed only isoniazid, rifampicin, and ethambutol. The mean duration of prescription was 28.75 days (SD 36.13). Conclusion: In the elderly population, old age and poor socioeconomic conditions correlated with TB prevalence. Most patients did not meet the criteria for effective pharmacotherapy of TB.
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