Practice Preferences on Dabigatran and Rivaroxaban for Stroke Prevention in Patients with Non-valvular Atrial Fibrillation

박유경,이정연,강지은,김승준,라현오 한국임상약학회 2016 한국임상약학회지 Vol.26 No.3

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ≥ 3 (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

Ginkgolide B 유도체인 SKI 5051의 항 혈소판 응집작용

김윤철,김학철,이남인,라현오,김진학,송현주,손의동,허인회 중앙대학교 약학연구소 1999 약학 논총 Vol.13 No.-

This study was performed to test the antiplatelet aggregating effect of a derivative of Ginkgolide B(SKI 5051) alone and with calcium antagonist and aspirin on the mouse pulmonary thromboembolism and collagen-induced rabbit platelet aggregation. Ginkgolide B is a potent PAF antagonist, which was isolated from the leaves of Ginkgo biloba and 10' -(3,5-Dimethylpyridine-2-methoxy) Ginkgolide B(SKI 5051) is a derivative of Ginkgokide B. A derivative of Ginkgolide B(SKI 5051) protected mice from sudden death by collagen and epinephrine mixture and inhibited collagen-induced rabbit platelet aggregation dose-dependently. These effects increased by concurrent administration with aspirin and verapamil. These results suggest that a derivative of Ginkgolide B(SKI 5051) is a effective drug for preventing disease associated with platelet aggregation and this effect is increased by concurrent administration with calcium antagonist and aspirin.

Vancomycin 사용의 적절성 평가

김승희,배성미,홍경자,라현오,김양리,강문원 한국병원약사회 1998 병원약사회지 Vol.15 No.4

A restrospective Drug Use Evaluation(DUE) study was conducted by reviewing medical records of 38 patients, who were given vancomycin during their hospitalization period at Kangnam St. Mary's hospital, from 1 Oct 1997 to 31 November 1997. The criteria was midified from the criteria on vancomycin established by American society of Health-System Pharmacists(ASHP). As a result, 27 cases(71.1%) were met with the criteria for the justification of use. In 33 cases(86.8%), blood culture tests were performed within 48 hours before the initial doses. In 34 cases(89.5%), serum creatinine tests were conducted within 48 hours before the initial doses. In 22 cases(57.9%), fever peaks decreased at least 1 degree within 3 days after the initial dose and in 22 cases(57.9%), WBC values were in normal range after treatment. According to the study, inappropriate use of vancomycin was up to 28.9%. considering that vancomycin is categorized into one of restricted antibiotics, which can be used with an approval of infection specialist in the hospital, a more thorough control on use of vancomycin is required. Moreover, renal test should be carried out periodically before and during the use of vancomycin to prevent, if any, adverse reactions.

Ceftriaxone 사용의 적절성 평가

김진영,배성미,홍경자,라현오,김양리,강문원 한국병원약사회 1999 병원약사회지 Vol.16 No.1

In order to find out whether ceftriaxone, a third generation cephalosporin antibiotics, is used appropriately, safely and effectively, DUE study was conducted by reviewing 70 charts of patients who were treated at Kangnam St. Mary's hospital from Oct. 1997 to Nov. 1997. The DUE criteria was modified from the criteria on ceftriaxone use established by American Society of Health-System Pharmacists. As a result, 33 cases (47.2%) were met with criteria for the justification of use. The analysing process indicators including CBC, SCr were taken before the initial dose and the vital sign monitoring were relatively well documented showing the accepted levels of above 80%. On the other hand, blood sampling for the culture and sensitivity test before the initial antibiotic dose WBC Count, SCr, LFT during the therapy were in low accepted levels. As an outcome analysis, the result of blood culture after discontinuing drug were documented with accepted level of 24.3%. As a conclusion, it is suggested that above finding should be communicated to the medical staff, and an active intervention, such as feedback control system by pharmacist, also be necessary for the rational medication use.

비판막성 심방세동 환자의 뇌졸중 예방에서 dabigatran과 rivaroxaban의 임상적용의 현황

박유경,강지은,김승준,라현오,이정연 한국임상약학회 2016 한국임상약학회지 Vol.26 No.3

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ≥ 3 (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

신성 고혈압 흰쥐의 초기단계에서 내피 의존적인 혈관반응의 변화

김주원,김학림,박조영,염지현,라현오,이영욱,안형수,손의동,허인회 대한약학회 1999 약학회지 Vol.43 No.6

We investigated whether endothelium-derived NO and endothelin-1 might result enhanced vasoconstriction induced by administration of norepinephrien (NE) at the early stage of one-kidney, one-clip (1K1C) renal hypertensive rats. We also studied the relation ship of renin-angiotensin system (RAS) using rat aorta in this hypothesis. L-NMMA (30$\mu$M) and L-NAME(30${\mu}M$) enhanced vasoconstriction induced by NE in thoracic aorta of control rats. However angiotensin converting enzyme (ACE) inhibitor didn't. The aorta of 1KIC rats showed a singnificantly exaggerated contractile response to NE as compared with control rats. Rub-bing the endothelium abolished this difference. Ach and SNP-induced vasorelaxation show no significant difference between 1KIC and control rats. The treatment of phosphoramidon (10${\mu}M$) and oral administration of captopril (0.05, w/v%) abolished the exaggerated contractile response to NE at early stage of 1KIC rats. These results suggest that the increase of contractile response at the early phase in 1KIC rat is partially involved in the activation of ACE.

정맥영양액과 5-FU의 Y-site 투여시 안정성

안혜진,서영희,윤정이,홍경자,라현오,윤석중 한국병원약사회 2001 병원약사회지 Vol.18 No.3

The compatibility of 5-fluorouracil (5-FU) with Parenteral Nutrient (PN) solution during simulated Y-site administration was studied. Five mililiter of representative PN solution was combined in duplicate in a 1:1 ratio with 5 ㎖ sample of solution of 5-FU in 5% dextrose injection (25, 50, 75, 100 ㎎/㎗). Chemical compatibility was examined the HPLC. The test was performed at intervals up to fourteen hours ; storage was at room temperature. Physical compatibility was performed for nonsoluble particle sizing and counting. All evaluations were performed at intervals up to six hours. The test group result of HPLC test were reduced 7.9, 7.6, 4.5, 7.9% in the 25, 50, 75, 100 ㎎/㎗. The blind group test were reduced 10.6, 8.7, 6.5, 5.8% in the 25, 50, 75, 100 ㎎/㎗. The result of nonsoluble particle sizing and counting were suitable for KSP criteria. During simulated Y-site administration, PN solution was compatible with 5-FU solution.

Omeprazole - cholestyramine resin 제제의 위산분비에대한 억제효과

이영욱(Young Wook Lee),김일웅(Ill Woong Kim),정지훈(Ji Hoon Jeong),라현오(Hyun O La),최경범(Kyeong Bum Choi),이남인(Nam In Lee),손의동(Uy Dong Sohn),허인회(In Hoi Huh) 한국응용약물학회 2000 Biomolecules & Therapeutics(구 응용약물학회지) Vol.8 No.4

We have examined inhibitory effects on gasritis using omeprazole-cholestyramine resinate, which has been developed to increase the stability of omeprazole, the well-known proton pump inhibitor, in an acidic condition. To test the pharmacological action of this, we investigated the effect of omeprazole-cholestyramine resinate on indomethacin-induced gastritis in rats. Omeprazole was used as a reference drug. Orally administered omeprazole-cholestyramine resinate inhibited the indomethacin-induced gastritis in a dose-dependent manner. The inhibitory effect of omeprazole-cholestyramine resinate on the gastritis was similar to that of reference drug. In addition, rectal adminstration of the omeprazole-cholestyramine resinate inhibited the indomethacin-induced gastritis in a dose-dependent manner. The inhibitory effect of omeprazole-cholestyramine resinate was equipotent to reference drug. The basal gastric acid secretion was decreased when it was administered either orally or rectally. This inhibition of omeprazole-cholestyramine resinate was similar to that of omeprazole. These data suggest that omeprazole-cholestyramine resinate inhibit the gastritis in rats, and are comparable to omeprazole available in market.