• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.178-184
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• 2022

Background: Migraine is one of the leading causes of poor quality of life and disability, and migraine incidences in pediatrics are increasing. Proper medication is important for the preventive and acute treatment of migraine. This study aimed to identify the current status of prescribed medication in pediatric patients with migraine. Methods: We used data from a sample of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2018) and analyzed the status of prescription drugs and frequency of visits to medical institutions with migraine diagnoses in pediatric patients. Results: A total of 12,228 pediatric patients diagnosed with migraine during 2018 were analyzed. Among these patients, 7,170 (58.64%) were girls and 9,510 (77.77%) were adolescents. Additionally, 9,157 patients (74.89%) received acute treatment, and 592 patients (4.84%) received combination therapy with analgesics and triptans. Acetaminophen for acute treatment and flunarizine for preventive treatment were the most commonly prescribed. In most children and adolescents, acute treatment drugs were prescribed for less than 14 days. Conclusion: Analgesics, such as acetaminophen or non-steroidal anti-inflammatory drugs, were prescribed frequently for acute treatment in pediatric patients with migraine. The drug prescription duration was within the recommended range, indicating a low risk of overdose. For preventive treatment, clinically studied medication for pediatric patients with migraine was used.

• Journal of Life Science
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• v.24 no.4
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• pp.437-446
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• 2014

Problems appear when triptans are taken orally. For example, the bioavailability of triptan is reduced by the digestive system, and the drug level in the blood reduces rapidly over time; there is also a possibility of gastrointestinal disorder. To improve side effects, a transdermal patch has been prepared in hydrogel form. The polymer matrix that makes up the hydrogel uses PVA; PEG is used as an additive to induce inter/intra hydrogen bonding of the PVA and almotriptan drug is added. In addition, to accelerate micro-phase separation between PVA chains, liquid nitrogen is used. In FT-IR analysis, the absorption bands of PVA, PEG, and almotriptan were found. The degree of crystallinity, the water uptake ability and tensile strength were increased with increasing PEG content. In drug release tests, the amount of drug released increased depending on the PEG content. In this study, hydrogels with 10 wt% PEG showed better performance in drug release. Approximately 60% of the total drug amount was released in 2 hr, and the drug continued to release for 1 day. Thus, the prepared hydrogel patch is suitable as a transdermal formulation for the second dose administration of triptans to patients who require recurrent migraine treatment within 24 hr after the first administration.

• Korean Journal of Clinical Pharmacy
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• v.29 no.4
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• pp.247-253
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• 2019

Background: Glutamate is implicated in the pathophysiology of migraine, a common neurological disorder. Therefore, glutamate receptor antagonists (GluRAs) have been suggested as a novel migraine treatment that are able to overcome the limitations of triptans. Objective: The aim of this study was to perform a meta-analysis to assess the efficacy of GluRAs for patients with migraine. Method: The PubMed, Cochrane Library, CINAHL, and Clinical Trial.gov databases were searched for randomized placebo-controlled trials of the efficacy of GluRAs for patients with migraine conducted up to August 2019. Two independent reviewers screened the literature according to inclusion and exclusion criteria and performed quality assessment and data extraction. Review Manager 5.3 software was used for the meta-analysis. Results: Three studies involving a total of 206 patients were included in the final analysis. Compared with placebo, GluRAs significantly improved the pain-free response at 2 hours (odds ratio [OR]=3.85, 95% confidence intervals [CIs]=1.63-9.09) and the 24-hour sustained pain freedom (OR=7.40; 95% CIs=2.36-23.20). The use of rescue medications with GluRAs was lower compared to that with placebo, but the difference was not significant (OR=0.39, 95% CI=0.10-1.47). Conclusion: Our meta-analysis showed that GluRAs were more effective than placebo for patients with migraine.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.120-129
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• 2015

Objectives: Drug utilization review program in Korea has provided 'drug combinations to avoid (DCA)' alerts to physicians and pharmacists to prevent potential adverse drug events or inappropriate drug use. Seven hundred and six DCA pairs have been announced officially by the Ministry of Food and Drug Safety (MFDS) by March, 2015. Some DCA pairs could be grouped based on the drug interaction mechanism and its consequences. This study aimed to investigate the drug-drug interaction (DDI) pairs, which may be potential DCAs, generated by the drug class-drug class interaction method. Methods: Eleven additive/synergistic and one antagonistic drug class-drug class interaction groups were identified. By combining drugs of two interacting drug class groups, numerous DDI pairs were made. The status and severity of DDI pairs were examined using Lexicomp and Micromedex. Also, the DCA listing rate was calculated. Results: Among 258 DDI pairs generated by the drug class-drug class interaction method, only 142 pairs were identified as official DCA pairs by the MFDS. One hundred and four pairs were identified as potential DCA pairs to be listed. QT prolonging agents-QT prolonging agents, triptans-ergot alkaloids, tricyclic antidepressants-monoamine oxidase inhibitors, and dopamine agonists-dopamine antagonists were identified as drug class-drug class interaction groups which have less than 50 % DCA listing rate. Conclusion: To improve the clinicians' adaptability to DCA alerts, the list of DCA pairs needs to be continuously updated.