• Title/Summary/Keyword: pharmacy management

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Evaluation of Perioperative Antithrombotic Management in Patients Undergoing Moderate to High Risk Surgery (중등도 이상의 위험 수술을 받은 환자에서 수술 전후 항혈전제 약물 사용 평가)

  • Lee, Hyeon-Ah;Jo, Yun Hee;Cho, Yoonsook;Hahn, Hyeon Joo;Lee, Ju-Yeun;Jung, Keun-Hwa;Lee, Sang Kun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.15-21
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    • 2017
  • Objective: The perioperative management of antithrombotic therapy is often challenging and it requires a fine balance between the risk of hemorrhage and thrombosis. We aimed to evaluate the antithrombotic management for moderate to high risk patients in real world setting. Methods: Among the patients who were consulted to the neurologist for the evaluation of perioperative risk from 2010 to 2012, patients undergoing moderate to high risk surgery and taking antithrombotics within 30 days were identified. We analyzed the timing of discontinuation and reinitiation of antithrombotic drugs before or after surgery as well as the status of bridging therapy. In addition, the conformity with the guideline suggested by American College of Chest Physicians was assessed. The rate of thromboembolic event and major hemorrhage were also investigated. Results: A total of 329 patients were included. The concordance rate of warfarin stop and restart time with guideline was 23.4% and 10.3%, respectively. Continuing aspirin in patients undergoing coronary artery bypass surgery or non-cardiac surgery in patients with high risk for cardiovascular events were 59.2% and 2.6%, respectively. Bridging therapy was adopted in 92.9% and 81.2% in patients who had received anticoagulant before surgery and who were at high and low risk thromboembolism, respectively. In entire cohorts, 30-day incidence of major bleeding and thromboembolic event were 31.9% and 3.0%. Co-morbid renal disease were shown as independent predictor for major bleeding (adjusted OR 2.65. 95% CI 1.33-5.28). Conclusion: The concordance rate with guideline regarding perioperative antithrombotic use was low and bridging therapy was prevalent in patients undergoing moderate to high risk surgery.

Efficacy of Mixture of Lactic Acid Bacteria (LAB) and Bifidobacteria Supplement in the Management of Constipation; Demonstration of Functionality in Animal and Clinical Trials (한국형 Bifidobacterium longum SPM1205 혼합제제의 변비 개선 효과)

  • Kim, Jung-Rae;Lee, Do-Kyung;Baek, Eun-Hye;An, Hyang-Mi;Yang, Hwan-Jin;Kim, Mi-Jin;Choi, Kyung-Soon;Yun, Mi-Eun;Jung, Yi-Jung;Oh, Pok-Ja;Chung, Myung-Jun;Ha, Nam-Joo
    • Korean Journal of Microbiology
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    • v.46 no.1
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    • pp.52-62
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    • 2010
  • The aim of this study was to evaluated the efficacy of mixture of Lactic Acid Bacteria (LAB) and bifidobacteria supplement, which are contained with Lactobacillus acidophilus, Bifidobacterium longum SPM1205, and Pediococcus pentosaceus for the management of constipation in animal model and clinical trials. 5 ICR mice and 4 female constipation subjects were orally taken mixture of LAB and bifidobacteria for 2 weeks. We investigated the number of fecal LAB and harmful enzymes activities before and after mixture of LAB and bifidobacteria application. As a result, fecal LAB count was increased and harmful enzymes activities of intestinal microflora were generally decreased after mixture of LAB and bifidobacteria application. Also, 61 female subjects were randomly assigned to receive either mixture of LAB and bifidobacteria or lactose and were taken three times a day for 2 weeks. Then, we analyzed mixture of LAB and bifidobacteria effect through the questionnaires. Daily consumption of this mixture of LAB and bifidobacteria improved the constipation in constipation group (56.3%) compared with lactose application group (26.7%). Furthermore, after mixture of LAB and bifidobacteria treatment, frequency of hard stool decreased from 0.22 to 0.03. These results indicated that mixture of LAB and bifidobacteria application is effective to improve the constipation.

Combined Skin Moisturization of Liposomal Serine Incorporated in Hydrogels Prepared with Carbopol ETD 2020, Rhesperse RM 100 and Hyaluronic Acid

  • Kim, Hyeongmin;Ro, Jieun;Barua, Sonia;Hwang, Deuk Sun;Na, Seon-Jeong;Lee, Ho Sung;Jeong, Ji Hoon;Woo, Seulki;Kim, Hyewon;Hong, Bomi;Yun, Gyiae;Kim, Joong-Hark;Yoon, Young-Ho;Park, Myung-Gyu;Kim, Jia;Sohn, Uy Dong;Lee, Jaehwi
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.6
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    • pp.543-547
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    • 2015
  • We investigated the combined moisturizing effect of liposomal serine and a cosmeceutical base selected in this study. Serine is a major amino acid consisting of natural moisturizing factors and keratin, and the hydroxyl group of serine can actively interact with water molecules. Therefore, we hypothesized that serine efficiently delivered to the stratum corneum (SC) of the skin would enhance the moisturizing capability of the skin. We prepared four different cosmeceutical bases (hydrogel, oil-in-water (O/W) essence, O/W cream, and water-in-oil (W/O) cream); their moisturizing abilities were then assessed using a $Corneometer^{(R)}$. The hydrogel was selected as the optimum base for skin moisturization based on the area under the moisture content change-time curves (AUMCC) values used as a parameter for the water hold capacity of the skin. Liposomal serine prepared by a reverse-phase evaporation method was then incorporated in the hydrogel. The liposomal serine-incorporated hydrogel (serine level=1%) showed an approximately 1.62~1.77 times greater moisturizing effect on the skin than those of hydrogel, hydrogel with serine (1%), and hydrogel with blank liposome. However, the AUMCC values were not dependent on the level of serine in liposomal serine-loaded hydrogels. Together, the delivery of serine to the SC of the skin is a promising strategy for moisturizing the skin. This study is expected to be an important step in developing highly effective moisturizing cosmeceutical products.

Qualitative Study for Medication Use among Visually Impaired in Korea (국내 시각장애인의 의약품 안전사용 실태에 대한 심층면접조사)

  • Koo, Heejo;Jang, Sunmee;Oh, Jung Mi;Han, Nayoung;Han, Euna
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.24-32
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    • 2016
  • Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

Improvement of Night Pharmacy Service by Automated Dispensing Cabinet System Implementation in Emergency Medical Center (응급의료센터 자동약품분배 캐비닛시스템 운영으로 인한 야간 약국업무개선)

  • Kim, Kyung Hee;Kim, Sun Ah;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.51-56
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    • 2018
  • Objective: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. Methods: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. Results: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p<0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (${\pm}0.8$). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. Conclusion: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.

A prebiotic fiber increases the formation and subsequent absorption of compound K following oral administration of ginseng in rats

  • Kim, Kyung-Ah;Yoo, Hye Hyun;Gu, Wan;Yu, Dae-Hyung;Jin, Ming Ji;Choi, Hae-Lim;Yuan, Kathy;Guerin-Deremaux, Laetitia;Kim, Dong-Hyun
    • Journal of Ginseng Research
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    • v.39 no.2
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    • pp.183-187
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    • 2015
  • Background: Gut microflora play a crucial role in the biotransformation of ginsenosides to compound K (CK), which may affect the pharmacological effects of ginseng. Prebiotics, such as NUTRIOSE, could enhance the formation and consequent absorption of CK through the modulation of gut microbial metabolic activities. In this study, the effect of a prebiotic fiber (NUTRIOSE) on the pharmacokinetics of ginsenoside CK, a bioactive metabolite of ginsenosides, and its mechanism of action were investigated. Methods: Male Sprague-Dawley rats were given control or NUTRIOSE-containing diets (control diet + NUTRIOSE) for 2 wk, and ginseng extract or vehicle was then orally administered. Blood samples were collected to investigate the pharmacokinetics of CK using liquid chromatography-tandem mass spectrometry. Fecal activities that metabolize ginsenoside Rb1 to CK were assayed with fecal specimens or bacteria cultures. Results: When ginseng extract was orally administered to rats fed with 2.5%, 5%, or 10% NUTRIOSE containing diets, the maximum plasma concentration ($C_{max}$) and area under the plasma concentration-time curve values of CK significantly increased in a NUTRIOSE content-dependent manner. NUTRIOSE intake increased glycosidase activity and CK formation in rat intestinal contents. The CK-forming activities of intestinal microbiota cultured in vitro were significantly induced by NUTRIOSE. Conclusion: These results show that prebiotic diets, such as NUTRIOSE, may promote the metabolic conversion of ginsenosides to CK and the subsequent absorption of CK in the gastrointestinal tract and may potentiate the pharmacological effects of ginseng.

Relationship between the Series named OTC Products and Pharmacist's Professional Workloads in Community Pharmacy (지역약사의 시리즈형 OTC 약물에 대한 약사의 직능 수행에 대한 평가)

  • Kim, Jeong Eun;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.4
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    • pp.226-233
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    • 2020
  • Background: Currently, the over-the-counter (OTC) drug market is flooded with series OTC products. The pharmacist must follow the OTC product's indication, given that the most critical role of a pharmacist is the right selection and recommendation of an OTC drug for a patient's symptoms in a dynamic pharmacy environment. Therefore, pharmacists must know each OTC product information precisely to avoid any ambiguity due to several OTC series brand names. Objective: We evaluated the risk and effectiveness of OTC series medicines. Methods: From December 5 to December 18, 2019, an online survey was conducted among 145 community pharmacists. Results: A total of 51.0% of pharmacists knew the difference between products named in a series and could explain it spontaneously. Only 0.7% of the pharmacists admitted to not knowing the difference between products named in a series. While 42.9% of pharmacists who owned a pharmacy opined that the OTC medicines named in a series have health benefits for patients, 50.0% of employee pharmacists admitted that they were rather confused because there are several OTC series medicines. In contrast, 69.2% of pharmacists who owned pharmacies and 72.2% of employee pharmacists admitted that OTC series drugs with names similar to popular OTC drugs sell better. Conclusion: While pharmacists had different opinions regarding OTC series drugs per employment status, they opined that OTC series are more helpful in pharmacy management than completely new brand names. Further studies in this regard are needed.

Origin and description study for Herba Plantaginis unregistered in official documents

  • Lee, Young-Seob;Choi, Jang-Gi;Kang, Ok-Hwa;Kwon, Dong-Yeul
    • Journal of Evidence-Based Herbal Medicine
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    • v.2 no.1
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    • pp.25-31
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    • 2009
  • The origin and description of the Herba Plantaginis was contemporarily analyzed (family names, scientific names, target regions, preparation, etc.) by comparison to enormous literature in addition to the external features written in the existing books on traditional Korean medicine. Also, galenical description were analyzed in connection with external morphology, internal morphology, microscopy and five senses. The official documents and ancient documents of other countries were reviewed. The technical books on herbage, published in the country and other countries, were compared with each other. Also, on-the-spot surveys were made to learn specialists' know-how. The description of the collected drugstuffs were analyzed in connection with external morphology (size, color, etc.), internal morphology and microscopy. The results of this study can be applied to the publicity and education of galenical test agencies; the effective management of foods and drugs; the improvement of public medical service; the publicity of galenical safety.

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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.

A review of anti-osteoporosis effects of herbal extracts in Korean journals (국내학술지에 발표된 한약추출물의 골다공증에 대한 효능실험 결과 고찰)

  • Ann, Ji-Young;Ki, Ji-Ye;Kim, Ju-Ho;Park, Hye-Jung;Kim, Hyun-Ju;Lee, Jeong-Ho;Kim, Yun-Kyung
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.47-69
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    • 2008
  • Objectives : The purpose of this study is to inspect trends of the papers of osteoporosis in the field of herbal medicines and to establish the future direction for evaluation and development of natural medicines. Methods : We reviewed 80 oriental medicine papers in Korean journals published between 1994 and 2008. Results : There were 6 review, 2 clinical paper, 72 experimental papers and we confirmed that the drugs used in the experiments are almost yang-invigorating drugs which are good for kidney deficiency pattern Conclusions : We found out some of the herbal extracts are very efficacious for osteoporosis. More studies of oriental medicinal herbs are needed for developing anti-osteoporosis drugs with these basic data.

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