MAO阻害劑의 危險한 相互作用

J., Pharm.,D'Arcy, P. F. 藥業新聞社 1985 (月刊) 醫藥情報 Vol.1985 No.8

스타틴이 폐경기 여성의 골밀도 혹은 골절위험에 미치는 효과 - 보고된 임상연구결과 분석을 중심으로 -

방준석 Pharm.D. 한국임상약학회 2006 한국임상약학회지 Vol.16 No.2

스타틴이 골형성을 자극하며 골밀도를 개선한다는 다수의 동물실험과 임상보고에 의해, 스타틴을 폐경기 이후 노령의 여성 고지혈증 환자에게 골다공증의 예방 혹은 치료적 용도로 사용할 수 있는가에 대한 관심이 고조되어 왔다. 하지만, 보고된 문헌들이 예방 혹은 치료효과를 제시하거나 해석됨에는 아직도 실험결과가 상이하거나 의견이 상충되고 있다. 본 연구는 폐경기 이후의 고지혈증을 지닌 골다공증 환자에게 처방된 스타틴이 실질적으로 골다공증 혹은 골절위험을 경감시키는 예방적 또는 치료적 효과를 지니는지 규명하고자, 1990년부터 2005년 사이에 MEDLINE에 등재된 데이터베이스 중에서 6개의 키워드를 사용하여 인체대상 연구보고서를 cross-sectional study, prospective cohort study 및 case-control study의 연구유형별로 수집, 분류하여 각각의 결과를 비교, 평가하였다. 각 연구결과들은 골다공증 평가에 이용하는 다수의 측정지표들에 대하여 공히 인정될 만한 수준의 유의성 여부를 제공하기에는 곤란했는데, 이는 연구디자인이 부적절했거나 실험대상 환자들이 보유한 각종 질병요소들과 치료상황이 복잡한 상호관계를 지녔기 때문이다. 따라서 대규모의 잘 계획된 이중맹검형 다국가 임상시험을 통해서 임상적 효과 유무가 입증되기 전에는 스타틴을 고지혈증을 보유한 폐경기 이후 노령 여성의 골다공증의 예방 혹은 치료적 용도로 사용하는 것은 아직 시기상조로 사료된다. There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

저속 전기자동차 제어용 비접촉식 조이스틱 개발

팜쭝히웨(Trung Hieu Pharm),안진우(Jin-Woo Ahn) 대한전기학회 2012 전기학회논문지 Vol.61 No.4

Noncontactable joystick for a low speed electric vehicle(LSEV) is developed. The joystick is proposed to replaced the steering wheel in a conventional LSEV. The main advantages of the proposed joystick are a durable and a stable in structure, simple and easy to control through discriminating the driving and braking area. To reduce error and stability in the joystick control, input and output signal of the joystick are manipulated by data averaging and differntiation. With this algorithm, the driving resolution and capability are improved. To verify the proposed algorithm, a simple prototype model which has two electric motors for propulsion and steering are used. Test results show that the prototype joystick control system is applicable to an LSEV dirve.

The Influence of NAT2 Genotypes on Isoniazid Plasma Concentration of Pulmonary Tuberculosis Patients in Southern Thailand

( Usanee Ungcharoen¸ B. Pharm ),( Hutcha Sriplung ),( Surakameth Mahasirimongkol ),( Saranyou Chusri ),( Nuanjun Wichukchinda ),( Phongpan Mokmued ),( Sukanya Wattanapokayakit ),( Virasakdi Chongsuviv 대한결핵 및 호흡기학회 2020 Tuberculosis and Respiratory Diseases Vol.83 No.-

Background: Isoniazid (INH) is metabolized by polymorphic N-acetyltransferase 2 (NAT2 ) enzyme, which noticeably alters INH plasma concentration. We aimed to determine the distribution of NAT2 genotype in Thai tuberculosis (TB) patients and correlate their genotype with plasma INH concentrations. Methods: Blood samples from 55 newly diagnosed pulmonary tuberculosis participants from three hospitals were collected to classify the subject by NAT2 genotype performed by the Multiplex haplotype-specific polymerase chain reaction method. Patients were grouped into three acetylators (fast, intermediate, and slow). On day 14 of tuberculosis treatment, the second blood sample was taken to estimate the peak plasma concentration at 2 hours after oral administration. INH plasma concentration was analyzed by liquid chromatography-tandem mass spectrometry/mass spectrometry method. Results: The NAT2 genotype distribution of fast, intermediate, and slow acetylator was 10.9%, 36.4%, and 52.7%, from six, 20, and 29 patients, respectively. The median (interquartile range) of INH plasma concentration at 2 hours post drug administration for these three genotypes were 0.75 (0.69-0.86), 2.56 (2.12-3.97), and 4.25 (3.56-5.50) μg/mL from four, 14, and 12 cases, respectively. The INH plasma concentration at 2 hours after administration was significantly associated with body weight and NAT2 acetylator. Conclusion: The INH plasma concentration was found lower in fast than intermediate and slow acetylators. Body weight and NAT2 acetylator influenced INH plasma concentrations at 2 hours after drug administration. Therefore, the NAT2 genotype should be known before starting TB treatment to maximize therapeutic outcomes.

Vaccines development in India: advances, regulation, and challenges

Teenu Sharma, M Pharm 대한백신학회 2023 Clinical and Experimental Vaccine Research Vol.12 No.3

One of the most significant medical advancements in human history is the development of vaccines. Progress in vaccine development has always been greatly influenced by scientific human innovation. The main objective of vaccine development would be to acquire sufficient evidence of vaccine effectiveness, immunogenicity, safety, and/or quality to support requests for marketing approval. Vaccines are biological products that enhance the body’s defenses against infectious diseases. From the first smallpox vaccine to the latest notable coronavirus disease 2019 nasal vaccine, India has come a long way. The development of numerous vaccines, driven by scientific innovation and advancement, combined with researcher’s knowledge, has helped to reduce the global burden of disease and mortality rates. The Drugs and Cosmetics Rules of 1945 and the New Drugs and Clinical Trials Rules of 2019 specify the requirements and guidelines for CMC (chemistry, manufacturing, and controls) for all manufactured and imported vaccines, including those against coronavirus infections. This article provides an overview of the regulation pertaining to the development process, registration, and approval procedures for vaccines, particularly in India, along with their brief history.

Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis: Concern to Bedaquiline

( Oki Nugraha Putra ),( M. Clin. Pharm ),( Affan Y. N. Hidayatullah ),( B. Pharm ) 대한결핵 및 호흡기학회 2021 Tuberculosis and Respiratory Diseases Vol.84 No.4

Continued Innovation in Respiratory Care: The Importance of Inhaler Devices

Sinthia Zrinka Bosnic-Anticevich,B.Pharm. 대한결핵및호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

약물대사효소의 유전적 다형성 및 임상적 응용

김경임 BS,김승희 BS,박지은 BS,채한정 Ph.D,최지선 MS,신완균 Pharm.D. Ph.D,손인자 Ph.D.,오정미 Pharm.D 한국임상약학회 2006 한국임상약학회지 Vol.16 No.2

Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

Continued Innovation in Respiratory Care: The Importance of Inhaler Devices

( Sinthia Zrinka Bosnic-anticevich ),( B. Pharm. (hons. ) ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

Optimal Bronchodilation for COPD Patients: Are All Long-Acting β₂-Agonist/Long-Acting Muscarinic Antagonists the Same?

( Marc Miravitlles ),( Seungjae Baek ),( Vatsal Vithlani M. Pharm ),( Rahul Lad ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.3

Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting β₂-agonist/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD.