• Journal of Sasang Constitutional Medicine
• /
• v.23 no.2
• /
• pp.139-152
• /
• 2011

1. Objectives: This research was proposed to find out the selection and form of addition and subtraction of the Sasang prescription. 2.Methods: The related contents of the pathology and the medical action of a Sasang disease were selected in "Donguisusebowon- Sasangchobongyun, -Gabobon, -Shinchukbon(東醫壽世保元-四象草本卷, -甲午本, -辛丑本)", "Donguisasangsinfyun(東醫四象新編)". 3.Results and Conclusions: 1) The change and development of the Sasang prescription. 2) The selection of drugs are caused by immunity of the ordinary times and a class of present disease. 3) Addition and subtraction of the Sasang prescription can divide 4-type.

• Journal of Korean Medical classics
• /
• v.23 no.6
• /
• pp.1-14
• /
• 2010

The conclusions after studying the rules and the principles of the six-drugs mixing forming the prescription of Yukmijihwanghuan(六味地黃丸) are as follows: 1. Yukmijihwanghuan cares for the three viscera; the liver, the spleen and the kidney and the three entrails; the urinary bladder, the gall bladder, and the stomach and it strengthens them as well. The drug can be used mainly for the cure of the Three Yang Channels of Foot and the Three Yin Channels of Foot. 2. The three drugs of Yukmijihwanghuan; Rehmanniae Radix, Dioscoreae Rhizoma, Corni Fructus altogether has the tonifying effect and the other three; Alismatis Rhizoma, Moutan Cortex, Poria has the purging effect. The first three kinds of drugs tonifies and the last three kinds of drugs purges. While these two groups of drugs are pitted against each other, they also balance each other harmoniously increasing the curative effect(remedial[curative] value). 3. Yukmijihwanghuan cools off the lung which is under metal category, helps the spleen, an earth category to be strong. It also adds the Water Qi to the kidney so that it stabilizes the Fire Qi. 4. Yukmijihwanghuan helps the kidney strongly, helps the urine to be excreted well, cools down the Fire Qi and makes dry things wet. 5. Rehmanniae Radix, the principal drug of Yukmijihwanghuan and Corni Fructus, the minister drug of the medicine have a taste of thick and are materially heavy. The two drugs do the descending action that it tonifies Yin Qi and adds Essence of Life. The other ingredients of Yukmijihwanghuan; Moutan Cortex, Poria, Alismatis Rhizoma have effects on lowering the Fire Qi. If Fire Qi descends, then Water Qi ascends. Yukmijihwanghuan has an efficacy of lowering Fire Qi and increasing Water Qi.

• Korean Journal of Clinical Pharmacy
• /
• v.26 no.4
• /
• pp.324-329
• /
• 2016

Background: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. Methods: Questions and answers posted on the portal site "Naver Jisik-iN" from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. Results: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. Conclusion: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.

• The Journal of Korean Medical History
• /
• v.27 no.2
• /
• pp.11-37
• /
• 2014

Objectives : The purpose of this study was to analyze and identify the problems of the changes in regulations that are relevant to approval, notification, and review of herbal medicinal preparations and crude drug preparations. Methods : I collected the regulations of approval, notification, and review of medicinal products mostly from official gazettes, analyzed enactment and amendments regarding herbal medicinal preparations and crude drug preparations, and studied it from the view point of Korean medicine field. Results : Regulations in regards to approval, notification, and review of herbal medicinal preparations and crude drug preparations were first established in 1978. Herbal drugs started to be categorized as crude drug preparations in 1981 and the regulatory outlines were completed in 1999. From 2008 to 2012, the regulatory standards that let crude drug preparations be new drugs from natural products were established. Through those procedures, the followings became crude drug preparations: 1) wholly new prescriptions that are not recorded in Korean Medical Classics, 2) prescriptions that are recorded in Korean Medical classics but prepared with new standard, composition and efficacy, 3) prescriptions that are recorded in Korean Medical classics but prepared with new formulation, and 4) herbal drugs. In case of herbal medicinal preparations, however, only regulations that are related to 1) drugs prepared with new compositions that are not recorded in Korean Medical Classics, 2) drugs with same prescription and same formulation, and 3) drugs with new formulation were arranged. Conclusions : Actual circumstances on crude drug-oriented regulations regarding approval, notification and review and future forms of prescription and drug administration in Korean Medical Institutions can be expected due to expansion in range of herbal medicinal preparations and shrink in that of on-site preparations. Reasonable improvement in efficient usage of modernized herbal medicinal preparations in Korean medical institutions and prospective cooperation from related pharmaceutical industry are needed.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.5
• /
• pp.2611-2617
• /
• 2016

Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.

• Journal of Korean Public Health Nursing
• /
• v.15 no.2
• /
• pp.398-411
• /
• 2001

The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.

• Korean Journal of Clinical Pharmacy
• /
• v.21 no.3
• /
• pp.249-255
• /
• 2011

Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.

• Health Policy and Management
• /
• v.9 no.4
• /
• pp.65-86
• /
• 1999

In this study, we investigate the welfare effect of mandatory prescription(MP) in Korea. An immediate effect of MP is the increase in the implicit price of prescribed medicine, which could be obtained easily from drug stores before MP. This will lower the quantity demanded. which will in turn reduce the abuse of drugs. The key to the cost-benefit analysis of MP, therefore, should be focused on this point; price increase in the cost side and quantity decrease in the benefit side. Since we do not have as much information as needed for the analysis, however, we made strong assumptions for the clarity of numbers; the severity of moral hazard of medical doctors related to the sales of hospital drugs, constant demand elasticity, constant benefit multiplier of reduced drug usage, and so on, With these rather strong assumptions, we find that i) the benefit side is much more sensitive to demand elasticity than the cost side effect ii) the larger the demand elasticity, the greater the size of net gain of MP, though the result depends on the size of the benefit multiplier. This analysis shows that we need to have more information on the specific institutional path of health benefit diffusion caused by the reduction of drug usage, which was the major target of MP.

• Korean Journal of Clinical Pharmacy
• /
• v.22 no.1
• /
• pp.30-40
• /
• 2012

In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially, neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60% of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist, analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.

• YAKHAK HOEJI
• /
• v.52 no.2
• /
• pp.160-164
• /
• 2008

This study investigated the current status and drug expenditure of the drug shortage prevention program in Korea. National health insurance claims data from 2001 to 2005 were analyzed for the drugs with inadequate supply, which were designated as shortage prevention drugs (SPDs). Drug use of SPDs have increased every year, but the average increase rate of drug expenditure for SPDs, 13.5% was lower than that for all the reimbursed drugs, 18.6%. Drugs with price increase based on production cost were more actively used than drugs with prescription incentives for doctors.