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최준식,유재신,박용채,인진환 한국약제학회 1996 Journal of Pharmaceutical Investigation Vol.26 No.2
This study was attempted to investigate the pharmacokinetic interaction between sodium valproate (4, 8, 16 ㎎/㎏, i.v.) and phenytoin (4 ㎎/㎏, i.v.) in rabbits. The plasma concentration and area under the curve (AUC) of phenytoin were increased significantly (p<0.05, p<0.01) when coadministered with sodium valproate (4, 8, 16 ㎎/㎏g) in rabbits. The volume of distribution and total body clearance of phenytoin were decreased significantly (p<0.05, p<0.01) when coadministered with sodium valproate (8, 16 ㎎/㎏) in rabbit. From the results of this experiment, it is desirable that dosage regimen of phenytoin should be adjusted and therapeutic drug monitoring should be performed for reduction of side or toxic effect when phenytoin will be coadministered with sodium valproate in clinical use.
최준식,Jong Min Kim,김동섭,김시호,조희연,박형두,이수연,Cheol-In Kang,김예진 대한의학회 2020 Journal of Korean medical science Vol.35 No.46
Background: Teicoplanin is used to treat serious gram-positive infections. Optimal teicoplanin trough levels are considered to be ≥ 10 μg/mL. Despite its wide use in various clinical settings, data on teicoplanin trough level in pediatric patients are limited. Therefore, the aim of this study was to investigate the therapeutic drug level monitoring of teicoplanin in Korean pediatric patients, including those with impaired renal function. Methods: A retrospective study was performed in pediatric patients (age ≤ 18 years old) who received teicoplanin from September 2014 to April 2018. The regimen included a loading dose of 10 mg/kg/dose at 12 hours' interval three times in a row, and a maintenance dose of 10 mg/kg/dose commenced at 24 hours of interval after the loading dose, with a maximum of 400 mg/dose, respectively. The first therapeutic drug levels were measured. Distribution and characteristics of trough levels in patients with decreased renal function and those with bacteremia were also assessed. Results: A total of 187 trough levels were collected from 143 patients. Hematologic and oncologic diseases were the most common underlying diseases (83.2%, n = 119). One hundred eighty trough levels were first measured, and their median value was 16.2 μg/mL (range, 2.3–100 μg/mL) and the median interval between initial teicoplanin injection and 1st trough level was 96.5 hours (range 47.6–179.3 hours). Lower steady-state levels were observed in younger age group (median, 13.5 vs. 18.0 μg/mL, P = 0.038). Median trough levels were higher in patients with decreased renal functions (P < 0.001). In addition, among eight with gram-positive bacteremia, seven of them had a favorable outcome. Conclusion: This study provides additive information on trough level monitoring of teicoplanin in children with impaired renal function and treatment effect in patients with gram-positive bacteremia. Careful monitoring for steady state trough levels of teicoplanin is warranted.
최준식,장일효,범진필,Choi, Jun-Shik,Chang, Il-Hyo,Burm, Jin-Pil 대한약학회 1997 약학회지 Vol.41 No.2
The purpose of this study was to determine pharmacokinetic parameters of vancomycin using two point calculation(TPC) and Bayesian methods in 16 Korean normal volunteers and 15 g astric cancer patients. Nonparametric expected maximum(NPEM) algorithm for calculation of population pharmacokinetic parameter was used, and these parameters were applied for clinical pharmacokinetic parameters by Bayesian analysis. Vancomycin was administered 1.0g every 12 hrs for 3 days by IV infusion over 60 minutes. The volume of distribution(Vd), elimination rate constant(Kel) and total body clearance(CLt) of vancomycin in normal volunteers using TPC method were $0.34{\pm}0.06 L/kg,\; 0.19{\pm}0.01 hr^{-1}$ and $4.08 {\pm} 0.93 L/hr$, respectively, The Vd, Kel and CLt of vancomycin in gastric cancer patients using TPC method were $0.46 {\pm} 0.06 L/kg, 0.17{\pm}0.02 hr^{-1}$ and $4.84 {\pm} 0.57 L/hr$ respectively. There were significant differences(p<0.05) in Vd. Kel and CLt between normal volunteers and gastric cancer patients. Polpulation pharmacokinetic parameter, the slope(KS) of the relationship beetween Kel versus creatinine Clearance, and the Vd were $0.00157{\pm}0.00029(hr{\cdot}mL/min/1.73m^2)^{-1},\; 0.631 {\pm} 0.0036 L/kg$ in gastric cancer patients using NPEM algorithm respectively. The Vd and Kel were $0.63{\pm}0.005 L/kg, 0.15 {\pm}0.027 hr^{-1}$ for gastric cancer patients using Bayesian method. There were significant differences(p<0.05) in vancomycin pharmacokinetics between Bayesian and TPC methods. It is considered that the population parameter in the patient population is necessary for effective Bayesian method in clinical pharmacy practise.
최준식,최병철 한국임상약학회 2005 한국임상약학회지 Vol.15 No.1
The purpose of this study is to investigate the effect of aspirin on the pharmacokinetics of pranoprofen by oral coadministration of pranoprofen (5 mg/kg) with aspirin (5, 10 and 20 mg/kg) in Sprague-Dawley rats. After oral coadministration of pranoprofen with aspirin, the area under the plasma concentration-time curves (AUC) of pranoprofen was increased significantly by 10 mg/kg (p<0.05) and 20 mg/kg (p<0.01) of aspirin coadministration, and peak concentrations () of pranoprofen was increased significantly by coadministration of 20 mg/kg aspirin (p<0.05) compared to pranoprofen alone. Relative bioavailabilities (RB) of pranoprofen in coadmistration were higher (from 1.42 to 1.67 fold) than control. The half-lives () of pranoprofen in coadministration were increased significantly (p<0.05) by 20-mg/kg aspirin. Based on these results, we might be considered that the pharmacokinetics of pranoprofen would be affected by coadministration of aspirin, by inhibit its metabolism in the liver and the tubular secretion of the kidney with the same acidic property. It should take into consideration in dosage regimen of pranoprofen when coadministration of pranoprofen with aspirin in treatment of rheumatoid arthritis.
최준식,이종기 한국임상약학회 2004 한국임상약학회지 Vol.14 No.2
당뇨환자가 합병증으로 고혈압이 있을 경우 항고혈압약물인 딜티아젬을 투여시 딜티아젬의 동태학적 측면에서 투여계획을 설계하기 위해서 토끼에 알록산을 당뇨병모델을 만들었다. 알록산으로 유도된 급성 및 만성 당뇨 토끼에서 딜티아젬의 약물동태 변화에 대한 결과는 당므과 같다. 1. Alloxan 45 mg/kg을 토끼의 귀정맥에 투여시 혈당농도는 control군에서 , acute DM군에서는 , chronic DM군에서는 으로 당뇨가 유발되었음이 확인되었다.. 2. Alloxan에 의한 당뇨병 유발토끼에서 딜티아젬의 혈중농도곡선하면적(AUC)값은 대조군 보다 chronic DM군에서 유의성(p<0.05) 있게 증가하였다. 3. 딜티아젬의 요중누적배설량은 대조군에 비해 acute 및 chronic DM군에서 감소되었으나 유의성은 없었다. 4. 당뇨병 유발 토끼에서 딜티아젬의 토탈바디클리어런스 값과 -소실속도정수값이 대조군에 배해서 유의성(p<0.05)있게 감소되었다. 실험적 당뇨 토끼에서 딜티아젬의 생체이용률의 증가는 딜티아젬의 토탈바디클리어런스 값과 베타의 소실속도정수 값이 대조군에 비해서 유의성있게 감소되었기 때문으로 사료된다.