• 제목/요약/키워드: prescribed doses

검색결과 86건 처리시간 0.027초

Warfarin 및 Digoxin 정제의 처방 용량 실태 및 조제 양식의 고찰 (Study on the Prescribed Doses and Dispensing Patterns of Warfarin and Digoxin Tablets)

  • 김윤숙;이승미;천부순
    • 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.

Association between Inhaled Corticosteroid Use and SARS-CoV-2 Infection: A Nationwide Population-Based Study in South Korea

  • Lee, Sang Chul;Son, Kang Ju;Han, Chang Hoon;Jung, Ji Ye;Park, Seon Cheol
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.80-88
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    • 2022
  • Background: Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. Methods: Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results: Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. Conclusion: Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

부자(附子) 및 천오(川烏)를 포함한 처방이 심전도 변화에 미치는 영향 (Consequences of Doses of Herbal Medicine Including Buja and Cheono on Electrocardiography)

  • 안수연;황원덕;김원일
    • 대한한방내과학회지
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    • 제36권4호
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    • pp.458-469
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    • 2015
  • Objectives: Buja and Cheono, containing aconitine known for its cardiotoxicity, are not commonly prescribed, but they are necessary for some clinical conditions. Hence, consequences for electrocardiography (EKG) after short- and long-term dosage of herbal medicine including Buja and Cheono are here reported.Methods: From September 2014 to April 2015, 36 patients belonging to the sixth internal medicine department of the Dong Eui Oriental Medicine Hospital took herbal medicine including Buja and Cheono, and after these doses, they underwent an EKG. Thirty-one patients who took the medicine for 7-8 days comprised the short-term group, and 18 patients taking the medicine for 17-106 days comprised the long-term group. The results of the EKGs for each group, before and after dosage with herbal medicine, are compared.Results: No significant changes in EKG appeared in either the short- or the long-term group after taking herbal medicine including Buja and Cheono.Conclusions: If Buja or Cheono are prescribed along with other suitable herbs by a doctor of Korean medicine, no cardiac trouble will occur on an EKG regardless of the term of the dosage.

Low doses of amitriptyline, pregabalin, and gabapentin are preferred for management of neuropathic pain in India: is there a need for revisiting dosing recommendations?

  • Kamble, Sanjay Vasant;Motlekar, Salman Abdulrehman;D'souza, Lyndon Lincoln;Kudrigikar, Vinay Nanda;Rao, Sameer Eknath
    • The Korean Journal of Pain
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    • 제30권3호
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    • pp.183-191
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    • 2017
  • Background: Current therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin was more for low-dose unit packs than that of the high-dose unit packs, raising the belief that these drugs are prescribed at a lower dose than is actually recommended in the guidelines. To test this hypothesis, a survey was conducted across speciality throughout the country to observe the prescription pattern of these drugs amongst the health care providers in India. Methods: Three hundred fifty survey forms were distributed of which 281 forms were included for analysis. Results: It was observed that the commonly used initiation and maintenance dose for amitriptyline, pregabalin, and gabapentin was 5-10 mg/day, 50-75 mg/day, and 100-300 mg/day, respectively. The reason to select the lower dosages was to have a balancing effect to achieve good efficacy with minimum side effects. Care-givers reported no side effects/not many side effects as a reason in 22.2%, 16.88%, and 23.86% patients with amitriptyline, pregabalin, and gabapentin, respectively. Sedation and giddiness were commonly reported with all three drugs. Conclusions: Commonly prescribed drugs for management of neuropathic pain, such as amitriptyline, pregabalin, and gabapentin are preferred at lower doses in Indian clinical settings. Acceptable efficacy and low tolerance to the standard dosage is believed to be the reason behind the prescribed dose.

Determination of Absorbed Dose for Gafchromic EBT3 Film Using Texture Analysis of Scanning Electron Microscopy Images: A Feasibility Study

  • So-Yeon Park
    • 한국의학물리학회지:의학물리
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    • 제33권4호
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    • pp.158-163
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    • 2022
  • Purpose: We subjected scanning electron microscopic (SEM) images of the active layer of EBT3 film to texture analysis to determine the dose-response curve. Methods: Uncoated Gafchromic EBT3 films were prepared for direct surface SEM scanning. Absorbed doses of 0-20 Gy were delivered to the film's surface using a 6 MV TrueBeam STx photon beam. The film's surface was scanned using a SEM under 100× and 3,000× magnification. Four textural features (Homogeneity, Correlation, Contrast, and Energy) were calculated based on the gray level co-occurrence matrix (GLCM) using the SEM images corresponding to each dose. We used R-square to evaluate the linear relationship between delivered doses and textural features of the film's surface. Results: Correlation resulted in higher linearity and dose-response curve sensitivity than Homogeneity, Contrast, or Energy. The R-square value was 0.964 for correlation using 3,000× magnified SEM images with 9-pixel offsets. Dose verification was used to determine the difference between the prescribed and measured doses for 0, 5, 10, 15, and 20 Gy as 0.09, 1.96, -2.29, 0.17, and 0.08 Gy, respectively. Conclusions: Texture analysis can be used to accurately convert microscopic structural changes to the EBT3 film's surface into absorbed doses. Our proposed method is feasible and may improve the accuracy of film dosimetry used to protect patients from excess radiation exposure.

자의전호탕(自擬前胡湯)이 천식 모델 생쥐의 BALF 내 관련 면역세포 변화에 미치는 영향 (Suppressive Effects of Jauijeonhotang(JHG) on Immune cells in BALF of OVA-sensitized Balb/c Mice)

  • 홍상철;최학주;김선빈;김동희
    • 혜화의학회지
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    • 제17권2호
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    • pp.137-148
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    • 2008
  • In order to investigate the effects of JHG on immune cells in BALF, clinically prescribed JHG was tested using OVA induced asthma animal model. The results are shown below: 1. JHG significantly reduced the total number of cells in BALF compared to that of the control at 400 mg/kg doses. 2. JHG significantly reduced the number of CD3+/CD69+ cells in BALF at 400 and 200 mg/kg doses. 3. JHG significantly reduced the number of CCR3+ cells in BALF at 400 and 200 mg/kg doses. 4. JHG significantly reduced the number of B220+/CD22+ cells in BALF at 400 and 200 mg/kg doses. 5. JHG significantly reduced the number of B220+/IgE+ cells in BALF at 400 and 200 mg/kg doses. 6. JHG significantly reduced the number of B220+/CD45+ cells in BALF at 400 and 200 mg/kg doses. From the results above, anti-asthmatic efficacy of JHG through anti-oxidative activity as well as immune control activity has been experimentally proven. In depth study of JHG on various pathological factors and individual drug contents of JHG should follow.

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인체 및 인형 팬톰에서 전신방사선조사시 열형광선량계(TLD)를 이용한 선량분포 균일성 확인 (In vivo and in vitro Confirmation of Dose Homogeneity in Total Body Irradiation with Thermoluminescent Dosimeter)

  • 지의규;박석원;강위생;김일한
    • Radiation Oncology Journal
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    • 제17권4호
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    • pp.321-328
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    • 1999
  • 목적 : 면역억제, 악성림프종 및 백혈병의 치료, 골수이식 등에 적용되는 전신방사선치료에 시행되는 좌우 이문대향조사법의 표면 방사선량 및 중심 방사선량의 균일성을 열형광선량계를 이용하여 확인하고자 하였다. 대상 및 방법 : 1996년 9월부터 1998년 8월까지 좌우 이문대향조사법으로 전신방사선치료를 시행한 10명의 환자 중 매번 방사선량이 측정된 8명의 환자를 대상으로 하였다. 열형광선량계를 사용하여 두부, 경부, 액와부, 대퇴부, 족관절부 등의 표면 선량을 측정하였고 인형 팬톰에서 동일한 조건하에서 두부, 경부, 액와부, 복부, 둔부 등의 표면 선량과 중심 선량을 측정하였다. 결과 : 중심부인 복부 처방 선량을 기준으로 할 때 부위별로 환자의 두부, 경부, 액와부, 대퇴부, 족관절부에서 표면 방사선량은 각각 $98.3{\pm}7.8,{\;} 98.3{\pm}7.5,{\;}95.1{\pm}6.3,{\;}98.3{\pm}5.5,P{\;}95.3{\pm}6.3\%$였다. 인형 팬톰에서 처방 선량에 대하여 두부, 경부, 액와부, 복부 및 둔부에서의 표면 방사선량은 각각 $85.0{\pm}4.0,{\;}86.6{\pm}5.8,{\;}83.9{\pm}4.9,{\;}94.8{\pm}5.3,{\;}94.88{\pm}2.8\%$였고, 중심 방사선량은 각각 $96.6{\pm}2.2,{\;}95.3{\pm}3.2,{\;}80.4{\pm}1.9,{\;}100.0{\pm}3.1,{\;}90.5{\pm}2.2\%$였다. 표면 선량 대비 중심 선량의 비는 두부, 경부, 액와부, 복부 및 둔부에서 각각 $1.14{\pm}0.06,{\;}1.10{\pm}0.09,{\;}0.96{\pm}0.05,{\;}1.06{\pm}0.06,{\;}0.95{\pm}0.02$였다. 인형 팬톰에서 얻은 표면 선량 대비 중심 선량의 비를 이용하여 환자에서의 중심 선량을 계산하였을 때, 두부, 경부, 액와부, 대퇴부, 족관절부에서 각각 $103.4{\pm}9.0,{\;}107.8{\pm}10.5,{\;}91.1{\pm}6.1,{\;}93.8{\pm}4.5,{\;}104.5{\pm}9.3\%$였다. 결론 : 환자에서의 측정된 표면 선량과 계산한 중심 선량의 분포는 $-8.9\~+7.8\%$였으나, 선량 분포가 $+5\%$ 이상 증가 또는 감소된 부위인 경부와 액와부에서는 인형 팬톰과 환자와의 좌우 두께의 차이에 의해서 실제보다 크게 계산되었으므로 실제 환자에서의 전신 선량 분포는 이보다 더 우수할 것으로 생각된다.

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A Study on Estimation of Radiation Exposure Dose During Dismantling of RCS Piping in Decommissioning Nuclear Power Plant

  • Lee, Taewoong;Jo, Seongmin;Park, Sunkyu;Kim, Nakjeom;Kim, Kichul;Park, Seongjun;Yoon, Changyeon
    • 방사성폐기물학회지
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    • 제19권2호
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    • pp.243-253
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    • 2021
  • In the dismantling process of a reactor coolant system (RCS) piping, a radiation protection plan should be established to minimize the radiation exposure doses of dismantling workers. Hence, it is necessary to estimate the individual effective dose in the RCS piping dismantling process when decommissioning a nuclear power plant. In this study, the radiation exposure doses of the dismantling workers at different positions was estimated using the MicroShield dose assessment program based on the NUREG/CR-1595 report. The individual effective dose, which is the sum of the effective dose to each tissue considering the working time, was used to estimate the radiation exposure dose. The estimations of the simulation results for all RCS piping dismantling tasks satisfied the dose limits prescribed by the ICRP-60 report. In dismantling the RCS piping of the Kori-1 or Wolsong-1 units in South Korea, the estimation and reduction method for the radiation exposure dose, and the simulated results of this study can be used to implement the radiation safety for optimal dismantling by providing information on the radiation exposure doses of the dismantling workers.

Trends in the prescription of opioids and gabapentinoids in patients with failed back surgery syndrome in Korea: a population-based study

  • Jinyoung Oh;Jinseok Yeo
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.73-83
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    • 2024
  • Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

항생제 처방 지원 프로그램이 항생제 처방과 사용량에 미치는 효과 (Effects on the Antimicrobial Use of Clinical Decision Support System for Prescribing Antibiotics in a Hospital)

  • 김현영;조재현;고영택
    • 한국임상약학회지
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    • 제23권1호
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    • pp.26-32
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    • 2013
  • Objective: This study was to define the clinical effect on the clinical decision support system (CDSS) for prescribing antibiotics integrated with the order communication system in a National Hospital. Method: We extracted data collected before integrating the CDSS of 4,406 adult patients in 2007 and data collected after integrating the CDSS of 4,278 adult patients in 2009. These patients were 50.4% and 45.2% of all patients admitted in 2007 and 2009, respectively. The clinical effect was defined as the proportion of prescribed antibiotics, the length of antibiotics use, and the DDDs (defined daily doses) of antibiotics per 1,000 patient-days using these retrospective data. Results: There were a significant change in the proportion of patient prescribed penicillins with extended spectrum (OR=0.55, p=001), penicillins included beta-lactamase inhibitors (OR=0.75, p<.001), 3rd cephalosporin (OR=1.47, p<.001). The mean of the length of antibiotics use was decreased statistically from $6.09{\pm}5.48$ to $5.85{\pm}5.51$ days (p=.003). The DDD of glycopeptides was decreased from 24.43 DDD to 19.55 DDD per 1000 patient-days. The DDD of 3rd cephalosporins was also decreased from 15.88 to 11.65. Conclusion: Therefore, the clinical decision support system for prescribing antibiotics was effective for the clinical outcomes.