• Title/Summary/Keyword: sedative prescription

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Comparison of Prescription Patterns and Clinical Features according to Clinical Departments in Sedative-hypnotic Intoxication (진정수면제 중독 환자의 처방과에 따른 처방 및 임상양상 비교)

  • Kim, Do Min;Park, Won Bin;Lim, Yong Su;Kim, Jin Joo;Jang, Jae Ho;Jang, Jee Yong;Yang, Hyuk Jun;Lee, Geun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.54-62
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    • 2014
  • Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

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Effects of Pinellia temata tuber on the emetic and sedative action of xylazine hydrochloride in cats (고양이에 대한 염산 Xylazine의 구토 및 진정작용에 미치는 반하의 영향)

  • Park, Joon-hyoung
    • Korean Journal of Veterinary Research
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    • v.32 no.3
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    • pp.341-345
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    • 1992
  • The tuber of Pinellia ternata Breitenbach(Araceae), which is distributed in Korea, China, and Japan, has been used in traditional Chinese medicine. The prescription containing Pinellia tuber shows anti-emetic, sedative, and anti-tussive effects. The purpose of this study was to investigate the effects of Pinellia ternata tuber on the xylazine-induced emetic and sedative responses in cats. The results were as follows ; 1. Intramuscular injection of xylazine hydrochloride(1.0mg/kg) reliably evoked vomiting with an incidence of 100% and sedated with a mean sedation time of 34.22 min. 2. The xylazine-induced emetic and sedative responses were not prevented by oral administration of powder (0.5g/head), decoction ($1.0m{\ell}/100g$), and methanol extract ($0.1m{\ell}/100g$) of the Pinellia ternata tuber. 3. The xylazine-induced emetic and sedative responses were inhibited by intravenous injection of decoction($0.3m{\ell}/100g$) of the Pinellia ternata tuber. 4. The xylazine-induced emetic and sedative responses were inhibited by intravenous injection of a combined mixture of yohimbine hydrochloride(0.125mg/kg) and 4-aminopyride(0.3mg/kg).

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Development of Safety Usage Guidelines for Sedative Hypnotics Using the Delphi Technique (델파이 기법을 이용한 다빈도 수면진정제 안전사용지침 개발)

  • Nam, Yoon-Ju;Cho, Chul-Hyun;Lee, Yujin;Lee, Heon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.26 no.2
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    • pp.86-103
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    • 2019
  • Objectives: The objective of this study was to develop evidence- and consensus-based clinical safety usage guidelines for sedative hypnotics using the Delphi technique. Methods: A group of 15 sleep experts from Korean Academy of Sleep Medicine were chosen for this study comprising a three-round web-based Delphi survey. The first round survey was composed of 39 questions to identify problems with sedative hypnotics usage in Korean clinical practice and the result roughly outlined what should be included in the guidelines. The second round survey was composed of 21 questions to collect specific opinions of experts on clinically important issues in prescribing sedative hypnotics, and its result provided the basis for the guidelines. A third round survey aimed to evaluate the reliability and validity of the established guidelines. Results: In the third round, all 17 items showed a median of 4 or more, with an average of 4.12 and a standard deviation of 0.32. Thus we present safety usage guidelines with 13 propositions for prescription, maintenance, and withdrawal of sedative hypnotics. Conclusion: The safety usage guidelines on sedative hypnotics developed from this study could lead to safe and effective prescription of hypnotics in clinical practice, especially for the non-experts in sleep medicine. Furthermore, the guidelines will help to improve the quality of insomnia treatment by contributing to the establishment of a safe regime for sedative hypnotics without excessive use of drugs.

Effects of Jingansikpungtanggagam-bang on Central Nerve System (진간식풍탕가감방(鎭肝熄風湯加減方)이 중추신경계(中樞神經)에 미치는 효능에 관한 연구(硏究))

  • Lee, Sang-Taek;Kim, Kyeong-Ok;Lee, Ihn;Jung, Yun-Gwan;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.21-43
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    • 2006
  • This study was designed to assess Effects of jingansikpungtanggagam-bang on Central Nerve System. Method : jingansikpungtanggagam-bang, a Korean traditional prescription, was evaluated for its anticonvulsant effect, hypnotic activity, analgesic action, anxiolytic effect, memory enhancement, and MAO inhibitory activity and detennined the content of neurotransmitter in brain by HPLC method. Result : 1. The extract increased potently anticonvulsant effect at 1g/kg by 5.6-fold extention of onset time against control group. 2. The extract increased hvrmsis at 500mg/kg by over twofold length of sleeping time compared to control. 3. The extract showed a significant analgesic effect with 86.0% inhibition on writhing frequency at 500mg/kg by phenylquinone-induced writhing test. 4. The extract inhibited dose-dependently the activity of monoamine oxidase in vitro. 5. This prescription increased the brain levels of serotonin and 5-hydroxyindoleacetic acid by 3.3% and 1.4%, respectively. 6. the extract exhibited the anxiolytic effect with 21.3% decrease of the immobility duration against control group. 7. the extract enhanced memory recovery on scopolamine-induced impairment of passive avoidance performance at 1g/kg pretreatment with 20.2% increase of latency time. Conclusion : The result sugguest that jiugansikpungtanggagam-bang can be used effectively as a sedative prescription in Korean traditional medicine.

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Flumazenil administration in suspected patients with acute hypnotics and sedatives poisoning: risk-benefit re-evaluation (급성 진정제 중독 추정 환자에서 플루마제닐의 투여: 위험도/이익 재평가)

  • Huh, Jae Hong;Choi, Sang Chun;Lim, Yong Gyun;Lampotang, Samsun;Park, Eung Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.92-99
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    • 2016
  • Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

The Acute and Subacute Toxicities and Pharmacological Actions of Gami Ssanghwa Tang Preparations (가미쌍화탕류(加味雙和湯類)의 독성(毒性) 및 약효연구(藥效硏究))

  • Shin, Kuk-Hyun;Lee, Eun-Bang;Jung, Myung-Sook;Kim, Oon-Ja;Yoon, Ki-Young
    • Korean Journal of Pharmacognosy
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    • v.21 no.2
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    • pp.179-185
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    • 1990
  • The acute and subacute toxicities and pharmacological actions of two preparations of Ssanghwa Tang prescriptions have been evaluated in mice, rats and rabbits. The two prescriptions were found to be safe drugs because those preparations exhibited almost no acute and subacute toxicities even at a high dosage level. The two prescriptions elicited CNS depressant activities characterized by potentiation of hexobarbital-induced narcosis, antipyretic activity in typhoid-vaccinated rabbits and a significant antifatigue effect against cold immobilized stress, the activities of prescription B being more potent.

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A Bibliographic Studies on the Bufonis Venenum for Clinical Treatment: Important to Toxicity and Processing (섬수의 임상적 활용을 위한 문헌적 고찰 -독성 및 수치를 중심으로-)

  • Lee, Seung-Hoon;Choi, Do-Young;Baek, Yong-Hyeon;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.121-133
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    • 2009
  • Objectives : The purpose of this study is to find out the clinical possibility of Bufonis Venenum used without toxicity and side effect. Methods : We investigated the pharmacological effects, toxicity and processing of Bufonis Venenum through the literatures and studies. Results : Bufonis Venenum is made by parotid gland of dermato gland of Bufo bufo gargarizns or B. melanostictus Schneider, and it is dried for using. The medical ation of Bufonis Venenum are cardiotonic, respiration stimulation, anticancer, topical anesthesia. The toxic symptoms of Bufonis Venenum are relative with digestive, circulatory, nervous system similared with digitalis toxicity. It is important to take 0.015-0.03g by mouth, external use about 1-4% 0.5-3ml and 2-8ml injections by 20ml mix to 5% dextrose fluid. Bufonis Venenum is processed to prevent toxicity and evaluate efficacy by alcohol and milk. There are 68 prescription consisted by Bufonis Venenum in KTKP(Korean Traditional Knowledge Portal). They usually use for antiabcess, anticancer with Moschus moschiferus(麝香), Cinnabar(朱砂). Conclusions : The results from above literary studies show that internal, external medicine and Aqua-acupuncture of Bufonis Venenum could be clinically used to sedative, antiinflammatory, anticancer and topical ataralgesia without toxity through optimum dose and processing.

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Study on the Agonistic Effect of Chunmajeongal-tang Extract to the $GABA_A/benzodiazepine$ Receptor Complex (천마전헐탕의 $GABA_A/benzodiazepine$ 신경수용체(神經受容體) 효능활성(效能活性)에 관(關)한 연구(硏究))

  • Kim, Sung-Wook;Gong, Dae-Jong;An, Hyeon-Guk;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.1
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    • pp.77-86
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    • 2004
  • Objective : This study was performed to investigate the agonistic activity of Chunmajeongal-tang extract to the $GABA_A/benzodiazepine$ receptor complex. Methods : Male mice and Sprague-Dawley rats were used for this experiment. Chunmajeongal-tang Prescription was extracted with 80% methanol, evaporated in vacuo and dried with freeze dryer. The agonistic activity to the GABA/ benzodiazepine receptor complex and GABA transaminase activity were measured in vitro. Results : Chunmajeongal-tang extract inhibited dose-dependently the binding of [3H]Ro15-1788, an antagonist on GABA/benzodiazepine receptor complex, in rat cerebral cortices, showing $82.4{\pm}4.12%$ inhibition at a dose of 5.0 mg/kg. This extract inhibited dose-dependently the binding of [3H]flunitrazepam, an agonist on GABA/benzodiazepine receptor complex, in rat cerebral cortices, showing $5.6{\pm}1.24%$ inhibition. Furthermore, Chunmajeongal-tang extract inhibited the binding of [3H]flunitrazepam in the presence of GABA/NaCI with $13.2{\pm}0.44%$ inhibition, its inhibitory effect exhibited a positive GABA shift, which means that this extract activates a GABAergic neurotransmission.

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한국 청소년의 약물남용과 비행행위

  • 김성이
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.54-66
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    • 1988
  • I. Introduction Since the 1970's drug abuse among young people has increasingly become a social problem in Korea. In the 1980's, drug abuse, especially glue sniffing, has become the cause of many unfortunated incidents resulting in harm to others as well as the abusers themselves. Taking into consideration of the seriousness of this problem, the Republic of Korea National Red Cross initiated a nation-wide research programme, to understand the present situation and to raise the level of public awareness. The goal of this research was to begin a nation - wide campaign against drug abuse. The research team was composed of the Advisary Committee members and the staff of the Youth Department of the Republic of Korea National Red Cross. The data were collected in February 1988 with the collaboration of the staff and volunteers in the local Chapters. The respondents were allocated nation-wide by the quota sampling method. The questionnaires were distributed to the respondents in three groups :2, 700 to junior and senior high school students, 605 to working youths, and 916 to delinquent youths. A total of 4, 221 questionnaires were collected. II. Characteristics of the Respondents The respondents in each group were selected evenly from rural and urban areas. The general characteristics of the respondents can be described as follow: in case of students, the proportions between male and female respondents, and between senior high school and junior high school students were almost evenly distributed. In case of working youths, the proportion of females (80.5%) was higher than those of the students and the delinquents groups. Delinquent youths were defined as those currently being under custody of the centers for juvenile delinquents. Of this number, 38.8% and 68.2% were junior and senior high school drop-outs respectively. The majority of them (92.6%) were male. As for the family background of the respondents, the proportion of those residing in poverty - stricken areas, and the proportion of those from broken families were higher in case of working youths and delinquent youths than those in case of students. III. Present Patterns of Drug Abuse The following summarizes the presents of drug abuse, as tabulated from the results of the survey. 1. Smoking The percentage of youths who smoke was 36% in the student group, 32% m the working youths group, and 94.4% in the delinquent youths group. 2. Alcohol 50.3% of students, 71.6% of working youths, and 93.3% of delinquent youths has experienced drinking alcohol beverages. 3. Tonic: non - alcoholic, caffeinated beverages popular in Korea and Japan The percentage of those who have used tonic at least once was over 90% in all of the three groups. 4. Sedative About 70% of each group has used sedative with the proportion of working youths use higher than those in other groups. 5. Stimulants Those who have used stimulants comprised around 15% in each group. 6. Tranquilizers Somewhat less than 5% of students and working youths, and 28% of delinquent youths, have used tranquilizers. 7. Hypnotics The users of hypnotics amounted to 0.4% of students, 2.6% of working youths and 7.1% of delinquent youths. 8. Marihuana Those who have used marihuana indicated 0.7% of students, 0.8% of working youths, and 13% of delinquent youths. 9. Glue-sniffing The percentage of glue-sniffing was 3.7%, 5% in the students group and in the youths group respectively, but the proportion was unusually high, at 40.7% in the delinquent youths group. From the results of the survey the present situation of drug abuse in Korea can be summarized as follows: 1. A high percentage of Korean youths have experienced smoking cigarettes and drinking alcoholic beverages. 2. Tonics (non - alcoholic, caffeinated beverages), antipyretic analgesics and stimulants quite regularly used. 3. Tranquilizers, hypnotics, marihuana and glue-sniffing are more widely used among delinquent youths than the other youths. From this fact, there exists a correlation between drug abuse and juvenile delinquency. IV. Time-series Analysis of the First Experience of Drug Abuse and Deviant Behaviour The respoundents were asked when they were first exposed to drugs and when they committed deviant acts. By calculating the average age of each experience, the following pattern was found (See Figure 1). Youths are first exposed to drugs by abuse of tonic(non - alcoholic, caffeinated beverages). At the age of 13, they amoke cigarettes, the use of antipyretic analgesics begins at 14 year old, while at the age of 15, they use tranquilizers, and at 16 hynotics. The period of drug abuse which starts from drinking caffeinated beverages and smoking cigarettes and ends in the use of hypnotics takes about three years. During this period, other delinquent behaviours begin to surface, that is, at the age of 13 when smoking cigarettes begins, the delinquent behaviour pattern starts with truancy. Next, they start taking money from others by using physical force. Prior to the age of 15, they are suspended from school, become hostile to adults, begin running away from home, and start using stimulants and alcohol. Soon they become involved even in glue-sniffing and in the use of marihuana. At the age of 15, they begin to see adult videos and carry weapons. Sexual promiscuity and usage of tranquilizers follows the viewing of adult videos. Consequently, by the time they reach the age of 16, they visit drinking establishments, and are picked up by police for committing delinquent acts. And finally, they come to use hypnotic - type drugs. From the above descriptions, drug abuse can be assumed to have a close correlation with delinquent behaviour. V. Social Factors Related to Drug Abuse As for the Korean youths, glue-sniffing is found to he related to aggressive delinquency, in such cases as run - aways, being picked up by the police, and taking money by force. Smoking cigarettes and drinking alcohol is found to be related to seeing adult videos and visiting drinking establishments. Hypnotics and marihuana were found to be representive of drugs which are related to degenerational delinquency, irrespective of social delinquency. The social factors connected with these drug abuse are as follows: 1. Individual factors Male students were more heavily involved in the usage of drug than females. Youths who do not attend church were more likely to be involved in drugs than those who attend. 2. Family factors The youths who were displeased with their mothers smoking and those who thought their parents did not love each other, or those whose parents had used drugs without prescription, were more likely to he drug users. 3. School factors Those youths who found school life boring, were unsuccessful in their studies, spend most of their time with friends, feel their teachers smoke too much, those who had a positive perception of their teachers smoking were likely to he drug users. To sum up, drug abusers depend on the influence of their parents, teachers and peers. IV. Reasons for Drug Abuse Korean students have mainly used drugs to release stress (42.8%), to stay awake (19.7%), and because of the easy accessibility of drugs( 16.6%). Other reasons are due to their ignorance of the side effects of the drugs (3.6%), natural curiosity (4.2%), and to increase strength(3.O%). From the above facts, the major reasons for drug abuse among Korean youths are to release stress and to stay awake in order to prepare exams. Furthermore, since drugs are readily available, we can conclude that drug abuse is caused by the school system(such as entrance exams) in Korea. VII. Conclusion Drug usage among Korean youths are relatively less common than those of western youths. In some cases, such as, glue-sniffing and use of stimulants, the pattern of drug abuse is found. Moreover, early drug abuse is evident, and it has a close connection with deviant behaviour, resulting in juvenile delinquency. Drug abuse cannot be attributed to any one social factor. Specifically, drug abuse depends on parents, peers, teachers and other members of the community, and also is influenced by social institutions such as the entrance exam system. Every person and organization concerned with youth must participate collectively in restraining drug abuse. Finally, it is suggested that social agencial working for youth welfare should make every effort to tackle this serious problem confronted by the Korean youths today.

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