호흡기계 작용 약물의 치료군 중복처방 평가기준 개발

최경업(Kyung Eob Choi),손현순(Hyun Soon Sohn),김남효(Nam Hyo Kim),신현택(Hyun Taek Shin),이영숙(Young Sook Lee) 대한약학회 2012 약학회지 Vol.56 No.2

Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO’s Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral β2-agonists, long-acting β2-agonists, short-acting β2-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.

흰쥐에서의 Fluoroquinolone계 항균제 농도와 광독성의 상관관계

최경업 ( Kyung Eob Choi ),정지은 ( Jee Eun Chung ),김명민 ( Myoung Min Kim ) 한국응용약물학회 2002 Biomolecules & Therapeutics(구 응용약물학회지) Vol.10 No.4

8-Fluorociprofloxacin과 Ciprofloxacin의 시험관내 및 생체내 항균 효과와 약물동태의 비교

최경업(Kyung Eob Choi),정용환(Yong Hwan Jung),김제학(Je Hak Kim) 대한약학회 1993 약학회지 Vol.37 No.3

8-Fluorociprofloxacin(8-FCP) is an investigational quinolone derivative that is substituted with fluorine at the C-8 position of ciprofloxacin(CP). It was found that the in vitro activity of 8-FCP against Gram(+) bacteria was more potent that of CP, but the opposite against Gram(-) bacteria was true. However, 8-FCP showed better in vivo efficacy than CP against representative Gram(-) organisms, E. coli and K pneumoniae. In an attempt to seek for factors causing this discrepancy in the antibacterial activities, a comparative pharmacokinetic study of 8-FCP and CP was conducted in mice and rats treated either intravenously or orally at a single dose of 30mg/kg. The pharmacokinetic parameters in mice were as follows; the mean peak serum concentrations(Cmax) following i.v. and oral doses were 12.4 and 5.3mcg/ml for 8-FCP, and 9.5 and 2.5mcg/ml for CP, respectively. The terminal half-life(tl/2beta) was 72.9 min for 8-FCP, and 98.2 min for CP, and the oral bioavailability(F) was 89.9% for 8-FCP, and 50.5% for CP. In rats, the mean (+/-SD) Cmax after i.v. administration were 11.6 +/- 1.6 mcg/ml for 8-FCP, and 10.2 +/- 1.3 mcg/ml for CP, whereas oral administration produced Cmax of 5.9 +/- 1.8 mcg/ml for 8-FCP and 1.1 +/- 0.9 mcg/ml for CP, respectively. The tl/2beta was 67.9 +/- 8.4 min for 8-FCP, and 76.4 +/- 7.2 min for CP. The F was 88.6 +/- 6.3% for 8-FCP, and 40.7 +/- 6.5% for CP. Marked differences were observed between the two quinolones in the Cmaxand the area under the concentration-time curve obtained after oral administration in mice and rats. The extent of 8-FCP absorption in both mice and rats was approximately 2-fold higher than that of CP, suggesting that the fluorine atom attached to C-8 plays an important role in facilitating oral absorption from the gastrointestinal tract.

중동호흡기증후군(MERS) 발생관련 전국 약학대학의 실무실습교육 대응현황

최경희,최경숙,이영숙,김재연,정경혜,오정미,최경업,나현오,김은경,Choi, Kyung Hee,Choi, Kyung Suk,Lee, Young Sook,Kim, Jaeyoun,Jeong, Kyeong Hye,Oh, Jung Mi,Choi, Kyung Eob,Ra, Hyeon Oh,Lee, Euni 한국임상약학회 2017 한국임상약학회지 Vol.27 No.1

Background: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. Methods: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. Results: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. Conclusion: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.

Considerations of Intermaxillary Fixation Methods in the Management of Mandibular Fractures

( Kyung Ho Song ),( Seul Ki Lee ),( Jae An Chung ),( Jin Eob Shin ),( Jwa Young Kim ),( Sang Hoon Song ),( Byoung Eun Yang ),( Young Jun Choi ),( Seong Gon Kim ) 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.2S

Refractory cardiac arrest 환자에서 high-dose epinephrine의 투여 효과

최경훈,박금수,임경수,안무업,황성오,강성준 대한응급의학회 1991 대한응급의학회지 Vol.2 No.1

Despite of extensive research about cardiopulmonary resuscitation, success of resuscitation remains inconstant and unpredictable. One of the most important factors determining successful resuscitation is the coronary perfusion pressure influencing to myocardial blood flow. Epinephrine has been a essential drug of cardiopulmonary resuscitation. Epinephrine increases coronary perfusion pressure and cerbral blood flow by elevation of mean arterial pressure via its alpha-adrenergic activity. Recently, the dose of epinephrine administered during cardiopulmonary resuscitation has been reevaluated in animal model and victims of cardiac arrest. On the basis of the recent controversies about epinephrine dose, 10 consecutive patients with cardiac arrest who failed to respond to standard therapy for 10 minutes were received high dose of epinephrine(10-20 times of the current AHA recommendation). We defined as return of spontaneous circulation(ROSC) if patients developed a sustained spontaneous palpable pulse or blood pressure for 3 minutes or more. Eight of ten patients had recovered spontaneous circulation and two of eight patient with ROSC survived more than 3 days although there was no hospital discharge. This results suggests that high-dose epinephrine therapy caused the return of spontaneous circulation and currently recommended epinephrine dosage may be too low to treat cardiac arrest.

Seismic observation of the nuclear explosion test in North Korea and the implications

Tae-Kyung Hong,Chang-Eob Baag,Hoseon Choi,Dong-Hoon Sheen 대한지질학회 2007 대한지질학회 학술대회 Vol.2007 No.

한국 신생아에서의 Amikacin 약동학적 연구 및 새로운 투여지침의 제시

이은경,김정선,최경업,장윤실,박원순 한국병원약사회 1996 병원약사회지 Vol.13 No.4

The pharmacokinetic(PK) parameters of amikacin were evaluated in 28 Korean neonates. The NEOFAX regimen was used to determine the amikacin dose that was administered intravenously over 30 minutes by a syringe pump. The peak and trough levels of amikacin were measured at steady-state and analyzed by fluorescence polarization immunoassay. PK parameters were computed by utilizing one-compartment open model and Kruskal-Wallis test was used for statistical analysis. The calculated volume of distribution(Vd) and half-life(t_(1/2)) in the neonates were 0.52±0.15L/㎏ and 5.6±3.2 hrs, respectively. Linear correlations were found between the postconceptional age(PCA)and clearance(CL=-0.1312+0.0057PCA; r=0.74; P=0.0001), and between PCA and half-life(t_(1/2)=22.38-0.4379PCA; r=-0.90; p=0.0001). Since 78.8% of measured peak levels were subtherapeutic, most neonates required higher amikacin doses. In case of neonates whose gestational age(GA) was 30-36 weeks, the dosing interval was shortened to achieve optimal peak levels. Based on these PK data we propose using modified NEOFAX regimen, which needs to be confirmed by further prospective study.

Ketorolac 주사제와 Ketoprofen 주사제의 약물 사용 평가

배희경,김정미,손기호,최경업,이숙향 韓國病院藥師會 2004 병원약사회지 Vol.21 No.2

The nonsteroidal anti-inflammatory drugs(NSAIDs) provide relief from the acute pain associated with surgery or trauma. However, the use of NSAIDs needs to be carefully considered because they may produce severe adverse effects such as gastrointestinal(GI) bleeding or renal toxicity. The objectives of this study were to evaluate the appropriateness of using injectable Ketorolac(KRL) and injectable Ketoprofen(KPF) in Samsung Medical Center and to find out methods to improve their use. The charts of 101 patients who received KRL and 85 patients who received KPF for one month(Feb. 2003), were retrospectively reviewed. The criteria of DUE were based on the standard of the American Society of Health-System Pharmacists(ASHP) and modified appropriately according to our hospital settings. Only 34.7% of the patients in the KRL group and 67.1% in the KPF group were found to meet criteria for justification for use. Analysis of critical indicators revealed that the appropriateness in measuring of SCr within 48 hours before initial dose was 53.5% for the KRL group and 27.1% for the KPF group. The appropriateness of maximum daily dosage and duration of therapy accounted for 97.0% and 85.1% of the KRL patients according to the ASHP criteria(120 mg/day, 5 days) and for 94.1% and 66.3% of the KRL patients according to Korean National Insurance criteria(90mg/day, 2days). On the basis Martindale's usual dosage(200 mg/day, 3days), 82.4% of KPF use was appropriate in maximum daily dosage and 75.3% in duration of therapy. It was found that 10.9% of the KRL patients and 5.9% of the KPF patients had complications such as GI effects, CNS effects, etc. In outcome measures, the pain decreased in 98.0% of the KRL patients and 96.5% of the KPF patients. In conclusion, justification for use was inadequate and consideration for critical indicators was insufficient. Therefore, we suggest that there is necessity to elevate the level of physicians' understanding regarding the use of injectable NSAIDs and to provide continuous interventions of pharmacists.

아펜탈정의 생물학적 동등성 평가

배준호,최경업,지상철,박은석 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

The bioequivalence of two aceclofenac tablets was evaluated in 14 normal volunteers (age 21∼29yrs) following oral administration. The test product was "Apental tablet" made by Asia Pharmaceutical Co. and the reference was "Airtal tablet" made by Daewoong Pharmaceutical Co.. After one tablet containing 100 mg aceclofenac was administered, blood was taken at predetermined time intervals and the concentration of the drug in plasma was quantitated with an HPLC method. AUC, C_max and T_max were calculated and statistically analyzed for the bioequivalence of the two products. The results showed that the differences in AUC, C_max and T_max between two products were 4.23%, 2.15% and 0%, respectively. The powers for AUC, C_max and T_max were >90%,>90% and 85.8%, respectively. Confidence intervals were within ±20% for three parameters. All of these parameters met the criteria of KFDA for bioequivalence, indicating that "Apental tablet" is bioequivalent to "Airtal tablet". (Kor. J. Clin. Pharm. 1999; 9(1): 44-48)