한국인 시각 장애우 환자의 복약지도 증진을 위한 점자용 보조라벨 개발의 필요성과 개발방법 제시

임성실,이명구,이종길,이보름,Lim, Sung-Cil,Lee, Myung-Koo,Lee, Chong-Kil,Lee, Bo-Reum 대한약학회 2008 약학회지 Vol.52 No.3

All pharmacists must provide the drug consultation whenever dispense drugs to patients by the Korean Pharmacy Law. Drug consultation is very important procedure for increasing pharmacotherapy. Because it maximizes the therapeutic effects or/and minimizes adverse drug reaction during the drug therapy. However, it is not easy to do because of the dynamic and hectic pharmacy environment. Especially, if someone has a disabling body function, they required more time and efforts to perform consultation by pharmacist. Currently several auxiliary labels for helping drug consultation are using in pharmacy practice but not for disabling patients. Therefore we developed the total 53 auxiliary labels with size of 0.7 cm (width) and 1 cm (length) by Braillewriter letters for blind patients. This research has been performed for total 12 months (Mar. 15ts, 2007$\sim$Feb. 25th, 2008) and the developing methods are consisted of 4 steps: 1) selection of essential informations, 2) simplification of information, 3) changing for Braillewriter letters, 4) application and revising by blindness patients. Also the labels are consisted of 12 for adverse reactions and precautions, 8 for directions, 2 for storages, 9 for duration, 9 for dosage forms, and 12 for common names. After developed those labels, we revised those labels by discussion with 2 blind people. In conclusion, the new auxiliary labels for blind patients can increase therapeutic effects and decrease risks from pharmacotherapy besides decreasing of pharmacist's work load in the future.

외국 약사 국가시험 문항관리 분석연구

권경희,임성실,손의동,Kwon, Kyenghee,Lim, Sung Cil,Sohn, Uy Dong 대한약학회 2015 약학회지 Vol.59 No.5

The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.

통풍을 동반한 고혈압 환자에서 요산감소를 위한 losartan과 다른 ARBs간의 임상적 의미 평가

예경남,임성실,Ye, Kyong Nam,Lim, Sung Cil 대한약학회 2016 약학회지 Vol.60 No.4

Elevated serum uric acid was a risk factor for the development of cardiovascular disease, particularly in patients with hypertension (HTN). In a recent study, losartan is only ARBs on serum uric acid level reduction. However, the effects of losartan on serum uric acid levels in the patients concomitantly treated with urate lowering agents have not been fully elucidated. The purposes of the present study were to evaluate the clinical effects of losartan compared with other ARBs on serum uric acid level in hypertensive patients concomitantly treated with urate lowering agents. Data were retrospectively retrieved from medical records of patients with the diagnosis of HTN and gout who were treated with antihypertensive agents (ARBs) and urate lowering agents. Serum uric acid were measured at 0, $1^{st}$ and $2^{nd}$ OPD f/u after the ARB treatment was started. 59 patients were selected by the research protocol. Of these, 9 took losartan, 16 took olmesartan, 5 took irbesartan, 3 took telmisartan, 8 took valsartan, 5 took candesartan, 2 took fimasartan and 11 not took ARBs. Losartan did not significantly reduced serum uric acid compared with the other ARBs during follow-up (2.37 mg/dl vs. 2.36 mg/dL, p = 0.68). And, this effect was still continued (2.87 mg/dl vs. 2.66 mg/dl, p = 0.58). In conclusion, this study shows that losartan has no effect on reducing serum uric acid levels in hypertensive patients with gout at combination antihypertensive agent and urate lowering agents. Further related studies are needed to confirm these results.

약학대학 학생들의 교과외활동 현황 평가 및 동기에 대한 분석

최미나,김수지,임성실,이윤정,Choi, Mina,Kim, Suzy,Lim, Sung Cil,Lee, Yun Jeong 대한약학회 2016 약학회지 Vol.60 No.3

Extracurricular activities are voluntary participations that students engage in outside of classrooms. This study aimed to determine Korean pharmacy students' degree of involvement in extracurricular activities, motivations behind participation, and influences from those engagements. The study was performed as a voluntary online survey to pharmacy students in four pharmacy schools in Korea and a total of 188 students participated. Sixty-one percent and 34% of students reported that they were involved in at least one extracurricular activities in-school, and out-of-school, respectively. Areas with most involvements were arts/music/sports (73%), followed by volunteer activities (31%). Thirty two percent responded that they have been involved in research internships, followed by 15% and 10% in pharmaceutical company and community pharmacy internships, respectively. For motivations behind involvement, students indicated that their involvement was for hobby (72%) and networking (38%). In conclusion, while Korean pharmacy students actively engage in extracurricular activities, the range of activities was limited in scope, and most students were involved in extracurricular activities as hobbies rather than for career exploration. Opportunities for student involvement in various pharmacy professional organizations and internships in the pharmacy work setting would provide valuable experiences for pharmacy students in their professional development as a pharmacist.

한국인 제2형 당뇨병 환자에 대한 디펩티딜 펩티다제 4 억제제 중 Sitagliptin과 Vildagliptin의 약물 사용 평가

이옥상(Ok Sang Lee),임성실(Sung Cil Lim),박현정(Hyun Jung Park) 大韓藥學會 2012 약학회지 Vol.56 No.2

Type 2 Diabetes Mellitus (T2DM) is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary odification. As the condition progresses, medications may be needed such as oral sulfonylurea or others. Recently, dipeptidyl peptidase 4 (DPP-4) Inhibitor is new drug which can control blood glucose by increasing the active levels of incretin hormone in the body. However, researches have been carried out for mostly Caucasian and Japanese, not for Koreans at all. Therefore, this study was to evaluate the efficacy and safety of DPP-4 inhibitor (Sitagliptin, Vildagliptin) in patients with T2DM in Koreans. This study was carried out retrospectively with reviewing of medical records from the 141 patients who received sitagliptin or vildagliptin over 24 week periods from January 2009, to December 2009. Information including demographics, concomitant medication, disease duration, and exercise was evaluated. HbA1c, random blood glucose, post prandial 2 hour glucose, blood pressure, AST, ALT, serum creatinine, total cholesterol, triglyceride levels were also collected at baseline and endpoint (at 24 weeks). In each post-treatment group, HbA1c, random blood glucose and post prandial 2 hour glucose levels were decreased significantly from baseline in the sitagliptin group (-0.82%, -28.76 mg/dl, -46.65 mg/dl) and vildagliptin group(-1.22%, -27.96 mg/dl, -67.2 mg/dl). Greater HbA1c mean reductions from baseline to 24 weeks were seen in patients with higher baseline values (>7.0%), with shorter disease durations (≤1 year) compared with those with lower baseline values (1 year) in both sitagliptin and vildagliptin groups. The incidences of hypoglycemia, headache and upper respiratory infection were 0%, 8.7%, 5.8% in sitagliptin group and 2.8%, 8.3%, 6.9% in vildagliptin group. In conclusion, our results showed DPP-4 inhibitor provided similar efficacy compared with sulfonylurea after 24 weeks of treatment and were safer than sulfonylurea in hypoglycemia for Korean T2DM. Also vildagliptin was associated with significant improvement in HbA1c reduction in Korean patient with subgroup (body mass index

근·현대사 이후 한국인의 최다 선호 일반의약품의 추이에 대한 연대별 분석 및 종합적 의의에 대한 평가

이윤정,강태진,임성실,Lee, Yun Jeong,Kang, Tae Jin,Lim, Sung Cil 대한약학회 2016 약학회지 Vol.60 No.3

Over-the-counter (OTC) drugs refer to medicines that are generally safe when used according to the product label. We aimed to assess and reflect upon changes in perception of health and health-related demands by decades in Korea according to the consumption and sales trends of OTC drugs. This study was conducted by literature search on the production and sale rankings of OTC drug market in Korea. Changes in the OTC drug market were analyzed and organized by decades to evaluate changes in drug demands and the influence of national and societal factors. There was a specific trend in the most popular drugs by decades. In the 1950s, drugs of top necessity were antibiotics and helminthics. In the 1960s, the pharmaceutical industry quickly grew and invigorators, such as Bacchus$^{(R)}$, Alps$^{(R)}$, Aronamin$^{(R)}$, were top manufactured drugs. Popularity of these invigorating drinks and vitamin products continued until the 1990s. In 1990s, sales of topical nonsteroidal anti-inflammatory drugs (Ketotop Plaster$^{(R)}$, Trast Patch$^{(R)}$), and in 2000s, gum disease medicine (Insadol$^{(R)}$) and liver and intestine supplement (Ursa$^{(R)}$) were prominent. However, after the separation of prescribing and dispensing in 2000, the sales of OTC drugs decreased dramatically from 58.7% of the total market share in 1990s to 39.6% in 2000 and this trend has continued. In 2012, thirteen OTC drugs were allowed to be sold in convenience stores, and as the sales of health functional foods have been expanding beyond pharmacies, sales of invigorators and nutritional supplements in pharmacies have continued to decrease. As government's drug expenditure will continue to grow, reclassification of OTC drugs based on established safety information and deliberate team efforts on continued development of OTC drugs to meet the health demands of Koreans are required by the healthcare professionals, pharmaceutical industries, and the government.

Ethaverine 화합물이 P815 세포중의 Serotonin 함량에 미치는 영향

김응일,신정수,임성실,박승국,이명구,Kim, Eung-Il,Shin, Jung-Soo,Lim, Sung-Cil,Park, Seung-Kook,Lee, Myung-Koo 대한약학회 2007 약학회지 Vol.51 No.2

The effects of ethaverine on serotonin biosynthesis in murine mastocytoma P815 cells were investigated. Ethaverine at 2.5${\sim}$10 ${\mu}$M decreased serotonin content in a concentration-dependent manner. The IC$_{50}$ value of ethaverine was 6.1 ${\mu}$M. Ethaverine at concentrations up to 20 ${\mu}$M was not cytotoxic towards P815 cells. Under these conditions, tryptophan hydroxylase (EC 1.14.16.4; TPH), a rate-limiting enzyme in serotonin biosynthesis, was inhibited by ethaverine in P815 cells (15.3% inhibition at 7.5 ${\mu}$M), however, aromatic L-amino acid decarboxylase (EC 4.1.1.28) was not. These results indicate that ethaverine leads to a decrease in serotonin content by reducing TPH activity in P815 cells.

뇌졸중 환자군의 Warfarin Nomogram 설정을 위한 실제 처방전 평가

장주영,고경미,윤지연,한옥연,임성실,Jang, Ju-Young,Ko, Kyung-Mi,Yoon, Ji-Yeon,Han, Ok-Yeon,Lim, Sung-Cil 대한약학회 2009 약학회지 Vol.53 No.2

Warfarin is the most widely used oral anticoagulant in the world but maintenance of proper therapeutic range and prevention of adverse drug events always need to be careful. Especially, in Korea, warfarin dosing for patients with cerebral infarction is currently based on the nomogram which is done by foreign clinical trials not for the Korean. Therefore we evaluate warfarin dose of patients in the neurology and eventually get the base data of warfarin nomogram for Korean with stroke. We performed this study retrospectively on reviewing the medical charts to evaluate the prescribed loading dose (LD) and maintenance dose (MD) of warfarin and each responding International Normalized Ratio (INR) with any bleeding adverse drug reaction including of patient's characteristics for total 75 patients with stroke in the department of neurology of Kangnam ST. Mary's Hospital from January 2005 to June 2008. All evaluated patients should not be treated with warfarin in the past at all and should be initiated warfarin therapy first.ly at this time. All evaluated patients were divided as two classes by wafarin LD which is; 1) HDG - a high loading dosing group prescribed over 5mg, and 2) LDG - a low loading dosing group prescribed 5mg or below. As a result, average LD was $9.34{\pm}0.22$ mg (p=0.000) in HDG and $4.25{\pm}0.39$ mg (p=0.000) in LDG. Average baseline INR was $0.91{\pm}0.05$ (p=0.161) in HDG and $1.26{\pm}0.14$ (p=0.002) in LDG. On the first and second week, daily MD was $4.21{\pm}0.14$ mg (p=0.000) and $2.96{\pm}0.19$ mg (p=0.696) in HDG and also in LDG, $2.95{\pm}0.29$ mg (p=0.000) and $3.14{\pm}0.36$ mg (p=0.696). Also average reacting daily INR was respectively $2.53{\pm}0.12$ (p=0.141) and $2.51{\pm}0.16$ (p=0.678) in HDG, and in LDG, $2.11{\pm}0.17$ (p=0.141) and $2.42{\pm}0.14$ (p=0.678). After the second week, INR was not measured in regularly. Also most of underlying diseases were hypertension (n=38), diabetes mellitus (n=14), dyslipidemia (n=8) in order. Four ADRs with simple hemorrhage were occurred and those were due to drug interaction by comedication. In the conclusion, proper starting LD for Korean with stroke is 10 mg if baseline INR is around 1.0 or 5 mg if over 1.3. Proper MD need to be more evaluated in the future for setting up warfarin nomogram to make prospective study.

상품명 처방전과 의약품 사용과오(Medication Error)의 상관성에 대한 기초연구

김정은(Jeong Eun Kim),임성실(Sung Cil Lim) 대한약학회 2019 약학회지 Vol.63 No.4

Abstract Medication error can easily occur when pharmacist dispense prescriptions due to so many “trade name” of a same generic in Korea. Because currently doctors prescribe by ‘trade name’ not by ‘generic name’ in the Korea, it can contribute to increase medication error. Therefore we evaluated the risk of sound-alike name drugs in community pharmacy, from February 20 to March 13, 2019 by an online survey. The results are that 87.6% of 113 pharmacists experienced confusion due to sound-alike drug names, 77.9% said that sound-alike drug names have risks associated with patient safety, and 92.0% said improvement were needed. As the most effective method of improvement, government s orders is the most (36.71%). And “Self attention” has the most answers (34.8%) as a way to manage sound-alike name drug at community pharmacies. A total of 135 pairs have been derived from similar-name drug cases experienced so far. In conclusion, many trade names for a drug increase medication error and it can be threaten the patient’s safety.

노린재동충하초의 배양 최적화 및 NO 생성 저해 효과

이기만,이금선,남성희,임성실,강태진,Lee, Ki-Man,Lee, Geum-Seon,Nam, Sung-Hee,Lim, Sung-Cil,Kang, Tae-Jin 한국응용곤충학회 2011 한국응용곤충학회지 Vol.50 No.4

동충하초는 예로부터 아시아권에서 한방약재로 사용되어 온 곤충병원성진균이다. 이 중 노린재동충하초(Cordyceps nutans)는 자연 상태에서 비교적 많이 발견되나 이에 대한 연구가 미미한 편이다. 따라서 본 실험에서는 C. nutans 균사체의 최적 배양 조건을 확립하고 배양액 처치 시대식세포의 NO (nitric oxide) 생성 억제 효능을 조사하였다. 균사 생육 적정 온도는 $25^{\circ}C$이었으며 pH는 7.0~8.0 사이의 중성범위로 조사되었다. MCM (mushroom complete medium), V8A (V8 juice agar), YMD (yeast malt dextrose) 배지에서는 균사 생육이 우수하였으나 MMM (mushroom minimal medium) 배지의 경우 균사 생육이 이루어지지 않아 영양원이 필수적이었다. 영양원 선발에 있어 탄소원은 dextrose와 sucrose가 적합하였고 질소원은 ammonium citrate가 균사 생장에 적합하였다. RAW 264.7 세포에 대한 C. nutans 배양액의 세포 독성은 나타나지 않았으며 LPS (lipopolysaccharide)를 처리 한 세포의 NO 생성량은 농도 의존적으로 줄어들었다. 따라서 본 실험 결과는 C. nutans 배양 시 다량의 균사체를 확보할 수 있는 최적 조건을 제공할 뿐 아니라 C. nutans의 항염 관련 우수한 생리 활성이 있음을 보여준다. Cordyceps (vegetable wasp and plant worm), an entomopathogenic fungi, has been used as a herbal medicine in Asian countries since ancient times. Cordyceps nutans is common but there is little research on this species. This study investigated the optimal culture conditions of C. nutans and the inhibitory effect on nitric oxide (NO) production in RAW 264.7 cell treated culture broth. The optimal conditions for the mycelial growth were $25^{\circ}C$ and pH 7.0-8.0. Mycelial growth was highest on mushroom complete medium (MCM), V8 juice agar (V8A), and yeast malt dextrose (YMD) medium. Mycelial growth on mushroom minimal medium (MMM) did not occur, so nutrient source was essential. Dextrose and sucrose as carbon sources, and ammonium citrate as a nitrogen source were satisfactory for mycelial growth. Cytotoxicity of C. nutans culture broth was not found in RAW 264.7 cells. C. nutans culture broth suppressed NO production of lipopolysaccharide (LPS)-stimulated RAW 264.7 cell in a dose-dependent manner. Thus, our results provided the optimal conditions for cultivation of C. nutans and showed that C. nutans may have excellent physiological activities.