• Title/Summary/Keyword: prescription rate

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The clinical manifestation of migraine and correlation study with autonomic bioelectric response (편두통 환자의 임상 양상 및 생체전기 자율반응과의 상관성 고찰)

  • Lee, Hyun-jong;Jung, In-tae;Kim, Su-young;Lee, Doo-ik;Kim, Keon-sik;Lee, Jae-dong;Lee, Yun-ho;Choi, Do-young
    • Journal of Acupuncture Research
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    • v.21 no.3
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    • pp.215-229
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    • 2004
  • Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sex, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and prescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M:F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is $12.0{\pm}9.9$ years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this report of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

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Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy (대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시)

  • Lim, Hyun-Soo;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.158-166
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    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors (HMG CoA-reductase inhibitors를 복용하는 환자의 잠재적 약물상호작용 연구)

  • Lee, Kyeong Ju;Kim, Kyung Rim;Seong, Jae Min;Ryu, Seung Wan;Lee, Hyun Yoon;Cho, Sekyoung;Cheong, Yeji;Nam, Ki Nam;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.31-35
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    • 2020
  • Objective: The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. Methods: The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. Results: A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. Conclusion: There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

The Effect of the Exercise Performance of Yoga and Pilates on the Autonomic Nervous System (Yoga와 Pilates 운동 수행이 자율신경계에 미치는 영향)

  • Kim, Ji-Sun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4450-4458
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    • 2015
  • The purpose of this study was to examine the influence of the exercise performance of yoga and pilates on the autonomic nervous system in an effort to provide some clinical information on exercise prescription. The subjects were 20 selected college students who majored in P.E. A yoga group and a pilates group were organized with 10 students respectively, the autonomic nervous system of the students was measured before the exercise, immediately after that and 30 minutes after recovery. The findings of the study were as follows: First, there were significant differences in the yoga group's stress index and average pulse according to the main effect of the time and interaction effect between the time and group. Second, there were significant differences in the yoga group's sympathetic nervous system activity and autonomic nerve balance according to all the main effect of the time, interaction effect between the time and group and the main effect of group. Third, there were significant differences in HRV(Heart Rate Variability), parasympathetic nervous system activity, SDNN, and RMSSD according to the main effect of the time, and interaction effect between the time and group and the main effect of group produced no statistically significant differences. In conclusion, yoga seemed to be effective at lowering stress index and average pulse. Specifically, yoga exercise seemed to exert a more positive influence on the decrease of sympathetic nervous system activity and autonomic nerve balance than pilates exercise.

Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea

  • Lee, Jae-Hong;Oh, Jin-Young;Choi, Jung-Kyu;Kim, Yeon-Tae;Park, Ye-Sol;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.47 no.5
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    • pp.264-272
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    • 2017
  • Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

The Effect of Cheonmagudeung-eum for Hypertension: A Systematic Review and Meta-analysis (고혈압에 대한 천마구등음의 효과 : 체계적 문헌고찰과 메타분석)

  • Kang, Ki-wan;Kang, Ja-yeon;Jeong, Min-jeong;Kim, Hong-jun;Sun, Seung-ho;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.22-43
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    • 2018
  • Objective: The purpose of this study is to investigate the effect of Cheonmagudeung-eum (CGE) for essential hypertension by systematic review and meta-analysis. Methods: The period of literature search was until October 30, 2016, and 14 electronic databases were utilized as search engines. The evaluation for the risk of bias (RoB) was conducted by using the Cochrane Risk of Bias Tool. The meta-analysis was performed by synthesizing outcome data, including total effective rate (TER), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of adverse events. Result: There were a total of 64 RCTs using CGE on adult essential hypertension. In the RoB evaluation, most of the items were unclear, and the qualities of studies were rated low. The concurrent treatment of CGE and antihypertensive drug (AHD) showed a significant hypotensive effect since the risk ratio (RR) of TER was 1.17 times (95% CI 1.14, 1.20, p<0.01) higher than that of AHD alone. In addition, the mean difference (MD) appeared low as 8.73 mm/Hg in SBP (95% CI -11.36, -6.09, p<0.01) and 5.81 mm/Hg in DBP (95% CI -7.50, -4.12, p<0.01). Conclusion: Through this study, it was identified that the combined treatment of CGE and AHD on hypertension would be more effective than that of AHD treatment alone. However, due to the low quality of the selected original articles, the significance of this conclusion is somewhat limited, and we hope that this would be complemented through more rigorous RCTs in the future.

Effects of Danggwieumja Administration along with Samhwangseje-gamibang on NC/Nga Atopic Mice (당귀음자(當歸飮子)와 삼황세제가미방(三黃洗齊加味方) 병용이 NC/Nga 아토피 생쥐에 미치는 영향)

  • Song, Seung-Phil;Son, Dae-Beom;Hwang, Chi-Hwan;Song, Seung-Hyeon;Hwang, Chung-Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.5
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    • pp.1210-1218
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    • 2007
  • Recently Atopic Dermatitis(AD) is increasing along with allergic disease. At present, there is no infallible cure for AD. Then AD patients undergo great suffering. This study is carried out to see whether or not the administering Danggwieumja(DG) along with Samhwangseje-gamibang(SG} as a medicine for external aplication, is effective in treating atopic dermatitis. To examine the effectiveness of the above prescription, the author made an observation of diverse immune responses. through the model of NC/Nga atopic mice. Results provided evidence that the DG administration along with SG can be used as a treatment means to atopic dermatitis. The results are as follows: The extent of Clinical skin severities in 13 and 16 week old NC/Nga mice treated with DG and SG, were reduced by 50.9%, 53.9% respectively, compared to the control NC/Nga mice with no drug treatment. IgE, IL-4, IL-5, IL-6, IgM and IgG1 levels in the serum of the NC/Nga mice treated with DG and SG were significantly decreased compared to those of the untreated control mice. In contrary, to the $IFN-{\gamma}$ level, significantly increased. The spleen weight of the NC/Nga mice treated with DG and SG significantly decreased compared to those of the untreated control mice. CCR3 gene expression in the skin tissue of NC/Nga mice treated with DG and SG were highly decreased, and the IL-6 expression significantly decreased, and the $IFN-{\gamma}$ gene expression increased compared to those of the untreated control mice. Histological observation of the ear and dorsal skin tissue of the NC/Nga mice treated with DG and SG, showed that the extents of inflammation and infiltrated immune cells in the epidermal tissue and dermis, were highly reduced compared to those of the untreated control mice. In the model inducing COX-2 activity in RAW 264.7 cell, the denser DG became, the more COX-2 activity was inhibited, compared to those of the untreated control group. $IL-1{\beta}$, and $TNF-{\alpha}$, IL-6 gene expression in RAW 264.7 cell with DG, significantly decreased, compared to those of the untreated control group. According to the assessment of cell toxicity in L929 cell, the rate of cell multiplication increased by 3% in consistency to 100ppm of DG compared to the untreated control group and in more than the 200 ppm consistency, cell toxicity was occurred.

Evaluation of response to stereotactic radiosurgery in patients with radioresistant brain metastases

  • Sayan, Mutlay;Mustafayev, Teuta Zoto;Sahin, Bilgehan;Kefelioglu, Erva Seyma Sare;Wang, Shang-Jui;Kurup, Varsha;Balmuk, Aykut;Gungor, Gorkem;Ohri, Nisha;Weiner, Joseph;Ozyar, Enis;Atalar, Banu
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.265-270
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    • 2019
  • Purpose: Renal cell carcinoma (RCC) and melanoma have been considered 'radioresistant' due to the fact that they do not respond to conventionally fractionated radiation therapy. Stereotactic radiosurgery (SRS) provides high-dose radiation to a defined target volume and a limited number of studies have suggested the potential effectiveness of SRS in radioresistant histologies. We sought to determine the effectiveness of SRS for the treatment of patients with radioresistant brain metastases. Materials and Methods: We performed a retrospective review of our institutional database to identify patients with RCC or melanoma brain metastases treated with SRS. Treatment response were determined in accordance with the Response Evaluation Criteria in Solid Tumors. Results: We identified 53 radioresistant brain metastases (28% RCC and 72% melanoma) treated in 18 patients. The mean target volume and coverage was 6.2 ± 9.5 mL and 95.5% ± 2.9%, respectively. The mean prescription dose was 20 ± 4.9 Gy. Forty lesions (75%) demonstrated a complete/partial response and 13 lesions (24%) with progressive/stable disease. Smaller target volume (p < 0.001), larger SRS dose (p < 0.001), and coverage (p = 0.008) were found to be positive predictors of complete response to SRS. Conclusion: SRS is an effective management option with up to 75% response rate for radioresistant brain metastases. Tumor volume and radiation dose are predictors of response and can be used to guide the decision-making for patients with radioresistant brain metastases.

A Survey on Pharmacists' Prescription Behaviors for Topical Steroids in Regions without Separation of Dispensary from Medical Practice in Korea (의약분업 예외지역 약국의 스테로이드 외용제 복약지도 실태조사)

  • Kim, Kwang-Myo;Kim, Bo-Ri;Lee, Jeong-Seon;Han, Ok-Yeon;Park, Mi-Sun;Yim, Hyeon-Woo;La, Hyen-O;Park, Young-Min
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.161-169
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    • 2011
  • The purpose of this study is to survey on the pharmacists' medication teaching service for topical steroids in regions without separation of dispensary from medical practice. The questionnaire was sent to 199 pharmacists who work inregions without separation of dispensary from medical practice via mail, e-mail or fax. 112 out of 199 pharmacists requested have answered the survey (response rate 56.28%). The questionnaire was composed of 4 categories with demographic characteristics, generally explained contents, adverse effects and precaution in pregnancy, breastfeeding and children. We analyzed the questionnaire by the 6 items with reference to the practical guidelines for medication teaching service. The medication teaching service for topical steroids in terms of generic name, physical characteristics, efficacy, usage and dosage, warning and precaution has been well provided by pharmacists in regions without separation of dispensary except for means and duration of optimal storage. The majority of pharmacists provided their patients with 4 and more kinds of items (69.64%), but the generally recommended 4 kinds of items such as generic name, efficacy, usage and dosage, warning and precaution were provided in as low as 48.22% of the respondents. These results show that the medication teaching service for topical steroids in terms of means and duration of optimal storage (45.54%) and the generally recommended 4 kinds of items have not been enough provided by pharmacists in regions without separation of dispensary. Taken together pharmacists in these regions should make a proper guideline for medication teaching service that can prevent the adverse effects of topical steroids.

Methods of The Promoting Blood Circulation and Removing Blood Stasis by Wang Cheong-Im (왕청임(王淸任)의 활혈거어법(活血祛瘀法))

  • Kim Hya-Sung;Jung Seung-Woo;Lee Jong-Il;Kwon Dong-Yeul
    • Herbal Formula Science
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    • v.12 no.2
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    • pp.47-55
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    • 2004
  • Wang Cheong-Im(1768-1831) in the Ching dynasty conducted the therapy of blood statis syndrome using the methods for promoting blood circulation and removing blood statis in accordance with the description in the book Uirimgaechak(醫林改錯). Thus, this study examined his methods for promoting blood circulation and removing blood statis, therapy of blood statis syndrome and mechanism of function. Since the blood statis symptoms varied on the parts where the blood statis were occurred, the therapy for promoting blood circulation and removing blood statis applied different treatments and drugs depending on the symptoms. The therapy also valued much of qi and blood. Qi is important to the human body so that the therapy replenished qi and simultaneously promoted the blood circulation as mainly focusing on the regulation of the qi flow. Moreover, the therapy adjusted the level of removing blood circulation and rate of replenishing qi. The degree of prescription and drug was differentiated in treating a variety of blood statis because of the difference in the seriousness and characteristics of blood circulation, amount and application of drug and combination of drugs. The therapy was careful about the regulation of qi for the replenishment of qi and the nurishment of blood for the promotion of blood circulation. If the blood circulation was blocked, the blood statis was formed. Accordingly, the phlegm and the blood statis were closely related. Then, the phlegm and blood statis were simultaneously treated. The therapy divided the properties of blood statis into the stagnant excess syndrome, the stagnant deficiency syndrome, the stagnant cold syndrome and the stagnant heat syndrome and treated the patients suitable for each symptom. The function of mechanism in the treatment using the methods for promoting blood circulation and removing blood statis was divided into the stagnation of blood and interruption in blood circulation. The therapy laid stress on promoting blood circulation and removing blood circulation. With such emphasis, the therapy facilitated the circulation in the bloood vessel, prevented the coagulation of blood, removed the blood statis and promoted the metabolism. Then, the physiological function and pathological change internal organs were improved. Furthermore, the therapy strengtened the heart and promoted the blood circulation by improving the systemic blood circulation. Moreover, the therapy facilitated the micro-circulation by adjusting the balance of body.

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