전문약사 자격 보유여부에 따른 전문성 및 직무만족도 영향 분석

정선회,최경희,권경희,유기연 한국병원약사회 2018 병원약사회지 Vol.35 No.4

Background : The prevalence of the chronic metabolic disease is increasing due to the aging society. Therefore, Korean Society of Health-system Pharmacists (KSHP) has a specialty pharmacist system to improve the professionalism of pharmacists. The purpose of this study is to suggest the difference between specialty pharmacist and non-specialty pharmacist with regards to their knowledge, delivery of information on medication, service provision, and job satisfaction. Methods : An online survey research was conducted for hospital pharmacists. The reliability of the questionnaire items was presented using Cronbach's αtest. The t-test or ANOVA analysis was used for evaluating differences in continuous variables. Results : A total of 171 pharmacists responded to the questionnaire, and 87.7% of the respondents were aged less than 30 years (76.6%) and four-year graduates (86.0%). Typically, 108 (63.2%) were candidates for the pharmacist’s specialty certificate, and the remaining 63 (36.8%) were not enrolled. Considering the field of specialty with overlapping, the total number of certificated patients was 140 (26.3% of the total of 532 in 2016). The results of the reliability analysis of the specific questionnaire showed that the Cronbach’s αvalue was over 0.78. There was no significant difference in customer directionality between the two groups. However, there was a significant difference (p 0.05) with respect to overall knowledge about the treatment process, drug efficacy, and side effects, information about medicines and adverse drug reactions, and in providing appropriate information to medical staff including patients and physicians. Conclusions : The pharmacist with specialization showed a positive result of self-evaluation of items such as knowledge about drugs, communication of information on medications, and service provision, compared to other pharmacists, and the result was in correlation with the numbers of specialization. There was no difference in job satisfaction related to working environment. Henceforth, it is hypothesized that there is a necessity for continuous improvement in the working environment to suit the purpose of the pharmacy specialist system.

Nutritional Support in Diabetes, Dyslipidemia and Metabolic Syndrome

정선회 한국정맥경장영양학회 2017 한국정맥경장영양학회 학술대회집 Vol.2017 No.-

數種 自動分割分包機에 의한 分割後 重量變動의 檢討

鄭善會,吳惠善,黃玉仁,李丙球,孫仁子,金洛斗 한국병원약사회 1987 병원약사회지 Vol.4 No.1

Various types of machines have been used for dividing and packing of powders and granules in most hospital pharmacies. It is essential that powders and granules should be accurately divided by machine. Comparative studies were performed to compare the weight variations using the following 3 machines 1)Konishi KC 800-K 16 type(K)equipped with a linear vibrator to feed powders 2) Tousho VS-42 type(V), and 3) Hyup-Shin UP501-45E type(H). Four types of digoxin preparations were tested 1) 10,000 times dilution with powdered simple lactose(D-1), 2) 10,000 times dilution with equal dose of powdered simple lactose and fine granuled lactose(D-2), 3) 10,000 times dilution with fine granuled lactose(D-3), and 4) Rizaben® granule(D-4). Fifteen grams of the each sample were divided into 15 parts by leach of the machines, and the process of dividing was repeated 10 times. The machine V showed the smallest weight variations after division than 3 other machines. The coefficients of variation of weight were 2.0∼15.2, 1.0∼6.1, 5.0∼10.2 and 2.0∼5.3% for D-1, D-2, D-3 and D-4, respectively.

환자의 안전을 위한 의약품포장 표기사항에 대한 제언

정선회 한국에프디시규제과학회(구 한국에프디시법제학회) 2013 한국에프디시법제학회 학술대회 Vol.2013 No.1

Ciprofloxacin에 대한 집중 약물이상반응 모니터링

정선회,한동신,박경호,손인자,박병주,약물이상반응모니터링소위원회 한국병원약사회 2003 병원약사회지 Vol.20 No.1

Ciprofloxacin has been associated with various adverse drug reaction such as headache, skin rash, nausea, vomiting, diarrhea and abdominal pain. A 60-year-old female developed skin rash, itching, urticaria following the line of vein in injection site. After cessation of the infusion, these symptoms disappeared soon. Because there were three more patients who experienced these symptoms, intensive monitoring for evaluating this phenomenon more thoroughly. From July 11, 2002 to September 6, 2002, Seoul National University Hospital Adverse Drug Reaction SNUH ADR) Monitoring Subcommittee conducted intensive monitoring for all patients prescribed ciprofloxacin and then we identified 27 cases of adverse drug reactions among 88 patients during the monitoring period. The incidence of ciprofloxacin was 30.7 per 100 patients, 0.36 per 100 drug prescriptions. The contents of adverse drug reaction were skin rash, itching, urticaria, nausea, vomiting, dizziness and general weakness. Dose of ciprofloxacin was 200㎎/100㎎.bag and the Lot. No. were 2011~2016. The administration sites were mostly dorsum of the hand or forearm. The incidence of the adverse drug reactions was not related to the infusion rate of ciprofloxacin, but was less frequent when the anticubital vein was used for infusion than the smaller peripheral veins were used.

HMG-CoA Reductase Inhibitor의 간독성 평가

이정란,정선회,이혜숙,손인자,오정미 韓國病院藥師會 2008 병원약사회지 Vol.25 No.3

First statin approved by U.S Food and Drug Administration(FDA) in 1987 was Lovastatin and the statins are now one of the most widely prescribed classes of medications. The statins have shown evidence of reducing coronary heart disease events, but on the other hand they have been implicated in causing complications in muscle, liver and kidney. There’re no papers about hepatotoxicity in Koreans even though there’re a lot of papers about muscle-toxicity at home and abroad. So we have studied to assess the risk of liver function test (LFT) abnormalities with Koreans using statin. We retrospectively reviewed of Electronic Medical Records(EMR) of 12,860 new users of six statins(Atorvastatin, Fluvastatin, Lovastatin, Pitavastatin, Rosuvastatin, Simvastatin) during the period 1 May 2003 through 30 April 2006 in Seoul National University Hospital(SNUH).The patients in their 60s were the largest population (36.6%) and 55% of them were female. The spread of patients of statins indicated 30.4%, 2.2%, 8.7%, 1.1%, 10.6% and 47.0% in Atorvastatin, Fluvastatin, Lovastatin, Pitavastatin, Rosuvastatin and Simvastatin, respectively. Assessing LFT abnormalities, among the patients, 26.1% were more than mild(AST or ALT >40), 5.6% were more than moderate(AST or ALT >80) and 1.7% were more than severe(ALT or ALT >120). Especially, we’ve analyzed the data of Severe(AST or ALT >120) LFT abnormalities by using ‘Ranking by Clinical Significance of the Definition of Liver Function Test’to estimate hepatotoxicity clearly. This trial has revealed same result that all six statins have effecting severe hepatotoxicity around 1% with papers reported abroad. Also severe hepatotoxicity was related with dose but with age(p<0.05). Severe hepatotoxicity is uncommon and is reported in less than 1% of the statins therapy but it is related with dose, it is important to check LFT periodically in case of high dose therapy.

Olanzapine으로 인한 과혈당 발생 연구

아영미,정선회,박경호,손인자 한국병원약사회 2005 병원약사회지 Vol.22 No.4

Olanzapine is an effective atypical antipsychotic agent and has smaller adverse effects than typical antipsychotics. Since Olanzapine was used, it's been reported hyperglycemia and diabetic ketone acidosis induced by it. Hyperglycemia which increases morbidity and mortality of patients isn't easily recognized. Therefore this study was carried out to investigate the aspect of hyperglycemia induced by Olanzapine. We selected patients who were administered Olanzapine in Seoul National University Hospital from September 2002 to August 2004. We excluded patients who were taken other antipsychotic agents and have diabetes mellitus and no Blood Sugar Level(BSL). And patients whose duration of Olanzapine administration was below 8 weeks were also excluded. The number of selected patients was 77. The mean age of selected patients was 35.8(± 13.5) years old and mean dosage and mean duration were 10.2(± 6.2) mg/day, 533.2(± 259.1) days. Subjective patients were consisted of 44 male and 33 female. We found 26 patients whose fasting BSL was over 110 mg/dl. The mean age of them was 43.7(± 15.05) years old and each number of male and female was 15, 11 respectively. The incidence of elevation of blood glucose level was 33.8%. The mean age of elevated BSL group was more higher than that of normal group(P=0.02). When the age of patients was divided 8 grades, the relationship of age and BSL elevation percentage was evaluated linear. We found no significant relativity between BSL elevation and mean age, sex.

약사의 전문성강화를 위한 국가별 평생교육제도 비교연구

정애희,정선회,권경희 대한약학회 2014 약학회지 Vol.58 No.4

The purpose of this study is to provide the comparative study results for the purpose of the developing con- tinuing professional educational systems for Korean pharmacists. The professional continuing educational systems of the UK, USA, Japan and Korea were analyzed. General Pharmaceutical Council in UK controls the pharmacy professions for the protection of the health of the citizens in UK and certifies the schools of pharmacy and the continuing education pro-viders. The USA and Japan have the several accreditation bodies for the pharmacy education and the continuing phar-maceutical education. However, the quality assurance systems in Korea for the continuing education and specialty programs are not implemented, yet. The renewal system of the pharmacist license should be introduced like the health care providers like doctors to improve professionalism. Finally, it is recommended that all of these things should be done by a single admin-istrative authority such as Korean Accreditation Council for Pharmacy Education.

내과계 중환자실의 다빈도 사용 약물에 의한 유해 사례 조사 연구

김경애,정선회,이혜숙,손인자 한국병원약사회 2009 병원약사회지 Vol.26 No.2

Abstract: The patients in the intensive care unit(ICU) are known to have more Adverse Drug Events(ADEs), but there are few voluntary ADE reports from ICU. The objective of this study was to form the basis of active ADE monitoring system by reviewing the charts of medical ICU patients who took high-use drugs in a university hospital rcu. We reviewed charts of patients who were in the MICU between January 1^(st) and July 31^(st) in 2007, and obtained ADEs for high-use drugs. High-use drugs were defined as the top fifty percent drugs of the quantities of prescrip-tion except for fluids , and they were dopamine, midazolam, salbutamol nebulizer, ipratropium nebulizer, vecuronium, furosemide, dobutamine, norepinephrine, nafamostat, NaHC03, ambroxol and KCl. Adverse drug events were defined as adverse drug reactions on Drug Information Handbook and CCIS. Probability and the severity of the ADE were decided by the Naranjo algo-rithm and Common Terminology Criteria for Adverse Events(CTCAE) version 3. We checked patients who matched for the ADE laboratory test signal which was set in the hospital. 37(12.2%) of 303 patients went through 44 ADEs(1O.6 events per 1000 patient days). The average age of ADE-suffering-patient was 65.1 , 20(54.1%) patients were women. The medication which is asso-ciated with the most ADEs(14 , 31.8%) was furosemide and the most frequent event(5, 11.4%) was hypokalemia. All the ADEs were possible or probable at Naranjo scale, and 36(8 1.8%) cases were moderate or severe in severity. There were 5(11.4%) cases that might be preventable Adverse Drug Events. Therefore it would be possible to use drugs more safely if Adverse Drug Events are moni-tored systemically in the ICU.

제 2형 당뇨 환자에서 Sitagliptin과 Sulfonylurea계 약물 병용 시혈당 조절 효과와 저혈당 발현에 관한 연구

강민경,정선회,김향숙,오정미,최경희 한국병원약사회 2014 병원약사회지 Vol.31 No.3

Background : Sitagliptin, which inhibits dipeptidyl polypeptidase-4 and stimulate thesecretion of insulin, is primarily used as a combination therapy with other oral hypoglycemicdrugs. Sitagliptin is known to have lower incidence in hypoglycemia compared to other oralhypoglycemic drugs. However, several studies suggest that combination therapy includingsitagliptin, can cause hypoglycemia. The aim of this study is to analyze the effectiveness and thefrequency of hypoglycemia in Korean patients with type 2 diabetes treated with sitagliptin andsulfonylurea. Methods : From August 2008 to April 2010, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed sulfonylurea and sitagliptin over a periodof 6 months at Seoul National University Hospital. We excluded patients who had been usinginsulin as well as those, who had ESRD or kidney transplantation. Results : A total of 232 Korean patients were enrolled in this study. The effectiveness in thereduction of blood glucose was statistically significant (P<0.05). In the sulfonylurea maintenancegroup (n=206), 10 patients experienced hypoglycemia, however two of them were not related tothe medicine. In the sulfonylurea reduction group (n=26), one patient who had problems of alcoholabuse, experienced hypoglycemia. Therefore, he recovered from hypoglycemia after quittingdrinking. Conclusions : In this study, the combination therapy of sitagliptin and sulfonylurea significantlyimproved glycemic control. Yet, hypoglycemia occurred in some patients after adding sitagliptin.