• Title/Summary/Keyword: prescription drugs

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Guideline for Bioequivalence Studies of Generic Products for Topical Use (국소용 후발의약품의 생물학적동등성시험을 위한 가이드라인)

  • Choi, Sun-Ok;Jung, Sung-Hee;Um, So-Young;Jung, Seo-Jeong;Kim, Joo-Il;Chung, Soo-Youn
    • Journal of Pharmaceutical Investigation
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    • v.34 no.4
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    • pp.333-340
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    • 2004
  • A new medical system of separation of dispensary from medical practice was started in 2000 in Korea. To expand bioequivalence-proven drug products and to ensure the credibility of the therapeutic equivalence of generic drug are hot issues in Korea. The KFDA also has a plan to revise the pharmaceutical affairs law that bioequivalence reports of all the generic prescription drugs should be submitted to the KFDA in the application for drug approval. Therefore, it becomes more necessary to develop bioequivalence-demonstrating methods for specific preparations such as topical drug products. There are some differences between US and Japanese guidances of bioequivalence studies of generic drug products for topical use. In this paper, we examined the recently published Japanese guideline, Guideline for Bioequivalence Studies of Generic Products For Topical Uses, and Q&A of the guideline, which will be references to make a guidance on bioequivalence studies of topical drug products in Korea.

Anti-apoptotic Effect of Bojungbangam-tang Ethanol Extract on Cisplatin-Induced Apoptosis in Rat Mesangial Cells

  • Kim, Nam-Su;Ju, Sung-Min;Kwon, Young-Dal;Shin, Byung-Cheul;Ahn, Kyoo-Seok;Kim, Sung-Hoon;Song, Yung-Sun;Jeon, Byung-Hun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1664-1671
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    • 2006
  • Cisplatin is a anti-neoplastic agent which is commonly used for the treatment of solid tumor. Cisplatin activates multiple signal transduction pathways involved in the stress-induced apoptosis in a variety of cell types. Cytotoxicity of cisplatin was detected in rat mesangial cells and the value of $IC_{50}$ is about 20 ${\mu}M$. The treatment of cisplatin to rat mesangial cells showed the apoptotic bodies and DNA fragmentation. The activation of caspase-3, -8, and -9 and proteolytic cleavage of PARP were observed in the rat mesangial cells treated time-dependently with cisplatin. The activation of ERK, p38 and JNK was also observed in the apoptosis induced by cisplatin in rat mesangial cells. The ethanol extract of Bojungbangam-tang (EBJT), a new hergal prescription composed of nine crude drugs, inhibited cisplatin-induced apoptosis in rat mesangial cells. EBJT reduced sub-G1 peak (apoptotic peak) in cisplatin-treated rat mesangial cells. The cisplatin-induced ERK and JNK activation in rat mesangial cells were blocked by EBJT, but EBJT had no effect on p38 activation. Taken together, these results con suggest that EBJT prevents cisplatin-induced apoptotic cell death in rat mesangial cells through inhibition of ERK and JNK activation.

Electroconvulsive Therapy for Psychiatric Disorders in Elderly Adults (노년기 정신장애의 전기경련치료)

  • Joo, Eun-Jeong;Kim, Hee Cheol;Kang, Ung Gu;Lee, Nam Young;Park, Seung Hyun;Kim, Jung Min;Kim, Yong Sik;Chung, In Won
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.42-57
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    • 2020
  • Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

Medication Use and Drug Expenditure in Inflammatory Bowel Disease: based on Korean National Health Insurance Claims Data (2010-2014) (국내 염증성장질환의 약물치료 및 약제비 현황: 2010-2014 국민건강보험자료 활용 연구)

  • Ha, Jung Eun;Jang, Eun Jin;Im, Seul Gi;Sohn, Hyun Soon
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.79-88
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    • 2019
  • Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

A Study on the Introduction of Self-directed Pharmaceutical Training Education through the Analysis of Pharmaceutical Education in Korea and the U.S. (한국과 미국의 약사 연수 교육 분석을 통한 자기 주도적 약사 연수 교육 도입 방안)

  • Jeong, Su-Cheol
    • The Journal of the Korea Contents Association
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    • v.19 no.1
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    • pp.598-607
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    • 2019
  • The side effects of using drugs can greatly threaten the health of the public. The reality is that there are very few reports of current side effects. This can be activated by linking adverse drug reactions reporting to the Drug Utilization Review (DUR) currently used by pharmacies. A study of the U.S. medication management system, where drug use assessment is activated, can find ways to activate adverse drug reactions reporting. In 'Pharm IT 3000', which is used as a medication management program in pharmacies, we examined how to enable reporting of adverse drug reactions. The literature study and research on actual program operation have found a convenient way to report side effects by linking the Pharm IT 3000 prescription preparation assessment to the item.

Review of the Antioxidant Effect of Herbal Material in In Vivo Parkinson's Disease Models (파킨슨병 in vivo 모델에서 한약재 및 기능성 식품의 항산화 효과에 대한 고찰)

  • Lee, Gi-hyang;Jeon, Sang-woo;Jeong, Min-jeong;Kim, Hong-jun;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.993-1014
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    • 2020
  • Objective: Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Antioxidant stress and inflammatory reactions are important causes of neurodegenerative diseases and are major causes of PD. Many animal experiments have been aimed at treating PD using the antioxidant effects of various traditional medicines and dietary supplements. This review reports the research investigating the antioxidant effects of herbs in in vivo PD models. Methods: The study consisted of a database search for articles related to PD and herbal treatments using the OASIS, NDSL, KTKP, Korean KISS, PubMed, Science Direct, CNKI, Wanfang, and J-STAGE databases. The search period was limited from the start of the search engine application to November 14, 2019. Studies were selected to confirm the antioxidant effects of herbal medicines in an in vivo PD model. Results: Eighty-two studies were summarized for plant species, extracts (or compounds), animal models, neurotoxins, and functional results. The most frequently used herbal materials were Bacopa monnieri, Camellia sinensis, Centella asiatica, and Withania somnifera. MPTP and 6-OHDA were the most commonly used neurotoxins for inducing PD. Most studies confirmed an increased expression and activation of antioxidant enzymes and a decrease in oxidative stress. Herbal materials showed their antioxidant effects regardless of the order of treatment and confirmed their possible use as treatments for the prevention and treatment of neurodegeneration. Conclusion: Many herbal medicines have antioxidant effects and are likely to be effective in delaying neurodegenerative damage by inhibiting or reducing oxidative stress by expression of antioxidant enzymes.

Analysis of Treatment Pattern in COPD Patients Using Health Insurance Claims Data: Focusing on Inhaled Medications (건강 보험 청구 자료를 이용한 COPD 환자에서 치료제 처방 변화 분석: 흡입제를 중심으로)

  • Lim, Hana;Park, Mihai
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.155-165
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    • 2022
  • Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

A Study on The Manufacturing Method, Formulation and Toxicity for Clinical Use of Topical Agents in Geumgweyoryak (《금궤요략(金匱要略)》 외용제의 임상활용을 위한 제법, 제형 및 독성에 대한 고찰)

  • You, Jae-Hyun;Kim, Kyuseok
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.1
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    • pp.24-37
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    • 2022
  • Objectives : The purpose of this literature review is to analyze process of manufacture and formulation and toxicity of Geumgweyoryak(金匱要略)'s external applicants for modern and safe using. Methods : This study used the Geumgweyoryak(金匱要略) reprinted by Zhao Kaimei(趙開美) as basic data for a understanding of the manufacture and formulation and toxicity for external applicants. Among the 25 chapters, the 22 chapters were studied except for the last three chapters, which are known to be written by later writers. Based on the above, Geumgweyoryeok(金匱要略)'s external applicants was analyzed the process of manufacture, formulation and the toxicity. Results : There are 11 types of external applicants of Geumgweyoryak(金匱要略). Washing method(洗法) was used 2 times, Drop method(瀝法) was used 1 time, Smoke method(熏法) was used 2 times, Rubbing method(摩法) was used 1 time, Plaster method(敷法) was used 2 times, Invading method(浸法) was used 1 time, Suppository method (坐法) was used 2 times, Flatiron method(烙法) was used 1 time. According to classified the modern formulation, there are 4 types of powder formulation, 4 types of liquid formulation, 2 types of suppository, and 1 type of Semi-solid formulation. Especially toxic drugs, such as Realgar(雄黃) or Hydrocerussite(鉛粉), should be careful. When Realgar(雄黃) smokes, a toxic substance called AS2O3 can come out. Hydrocerussite(鉛粉) can cause lead poisoning. Lead increases the risk of anemia, dehydration, and lead neuropathy when chronically exposed. Conclusion : We supposed that this study can serve as a basic data to help clinical Korean doctors to use the prescription for external applicants more safely and to easily apply it in the form of external applicants.

Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it's time to act now

  • Kim, Eun-Ji;Hwang, Eun-Jung;Yoo, Yeong-Min;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.361-382
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    • 2022
  • The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.

Selection of Effective Herbal Medicines for Parkinson's Disease Based on the Text Mining of the Classical Korean Medical Literature Donguibogam

  • Bae, Hyo Won;Lee, Tae Wook;Choi, Byung Tae;Shin, Hwa Kyoung;Yun, Young Ju
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.120-132
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    • 2021
  • Objectives: The prevalence of Parkinson's disease is on an upward trend along with an increase in the aging population but there is no available treatment that halts the progression of neurodegeneration. This study reports a numerical analysis on Donguibogam and suggests novel herbal drugs, which have never been researched before but found to be deemed effective in this study. Methods: Referring to 71 Korean medicine symptom terms that represent the symptoms of Parkinson's disease, 4170 prescriptions described in Donguibogam were classified into two groups based on whether their main effects were effective for Parkinson's disease or not. Comparing the two groups, the chi-square test was performed to select statistically significant herbs, while the t-test, Wilcoxon test, and descriptive statistics were performed to determine the appropriate dose. Results: One hundred and twenty-seven prescriptions effective for Parkinson's disease were identified. The chi-square test determined 17 herbs that are effective for symptomatic treatment. Among the medicinal herbs, the authors suggest Osterici seu Notopterygii Radix et Rhizoma, Ephedrae Herba, Aconiti Tuber, Myrrha, Sinomeni Caulis et Rhizoma, and Aconiti Kusnezoffii Tuber as herbal candidates that have never been studied for Parkinson's disease. Through the statistical tests, it was judged that the mean value of the dose of the entire prescription was the appropriate dose for each herb. Conclusions: Seventeen herbs were selected for Parkinson's disease and the appropriate daily dose were calculated. Furthermore, this study presented a new process that applies a statistical method to traditional medical literature and preselecting herbs deemed effective for specific diseases.