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엄고혜,이주연,조윤희,조윤숙,한현주,손인자 한국병원약사회 2006 病院藥師會誌 Vol.23 No.3
The prescriptions and dispenses for inpatients are conducted on a daily basis at Seoul National University Hospital (SNUH). The prescriptions for inpatients are received according to order sites and types of prescriptions. And in some cases, more prescriptions can be ordered than those needed actually, so returned-medications will be occurred, and also increased. Then the purposes of these studies are to analyze the states of returned medications in inpatients, and to make strategies to reduced those at SNUH Pharmacy. As the methods of the studies, we made the lists of returned-medications during April 11~15. 2005, and analyzed current conditions and reasons of returned medications. The results of the studies are as follows. The total prescriptions of returned-medications were 2,732 cases which were 5.14% of all prescriptions. There were 15 kinds of reasons to returned-medications. Among them, three reasons were in charge of 67% of all returned-medication, such as 765 cases of canceled prescriptions after dispense, 535 cases of overlapped prescriptions before and after operations and 527 cases of excessive PRN orders, respectively. Except those reasons, there were 196 cases of left medications caused by a daily basis prescription, 174 cases caused by discharges or deaths of inpatients, and 82 cases caused by continuous prescriptions of multiple use drugs, etc. The strategies to decrease returned-medications were established as follows. First, The one more - checking system was applied whether prescription was canceled or not before transferring UDS carts to nurse stations. Second, if prescriptions before and after operations were overlapped, those of post-operation were canceled. Third, in cases of multiple use drugs, we confirmed medical histories of inpatients, and canceled the prescriptions in which the multiple use drugs were continuously prescribed. In order to check the effectiveness of three strategies, we made second studies which were same as first studies during september 5~9, 2005 after introductions of these strategies to dispensing services for inpatients. The total prescriptions of returned-medications were 2,314 cases which were 3.97% of all prescriptions. The 22.8% of cases of returned-medications were decreased after interventions. From the results of these studies, it was noted that three strategies established on the steps of dispense for inpatients were effective to decrease returned-medications.
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상급종합병원 암센터에서 Nivolumab 사용평가와 치료성과에 미치는 영향인자
엄고혜,조윤숙,이정연,Eoum, Gohye,Cho, Yoonsook,Rhie, Sandy Jeong 한국임상약학회 2018 한국임상약학회지 Vol.28 No.2
Background: We strived to evaluate the status of nivolumab use and associated factors on the clinical efficacy of the drug. Methods: The study was retrospectively conducted in patients who had been administered nivolumab at least once at the cancer center of Seoul National University Hospital from June 2015 to April 2017. Data were collected from electronic medical records. A medication-use evaluation was performed based on the American Society of Health-System Pharmacists mediation-use guidelines. Results: Sixty-six of the 74 patients (89.2%) showed indications approved for nivolumab use by the Korean Ministry of Food and Drug Safety (MFDS; n=55) or the US Food and Drug Administration (FDA; n=11). Approximately 73.0% of the patients were administered the approved dose of 3 mg/kg but 25.7% were administered an unapproved fixed dose of 100 mg. The overall response rate was 21.7%, and the response rate of non-small cell lung cancer patients, who accounted for the largest number of indications, was 18.8%. Adverse reactions were found in 90.1% of the patients and were mostly mild (86%). The expression of programmed death-ligand 1 (PD-L1) was analyzed as a factor affecting treatment response (p=0.028, odds ratio [OR]=11.331). Conclusion: PD-L1 expression was found to affect treatment response. However, caution is required while using an unapproved dosage and in the absence of monitoring for effectiveness and safety. Therefore, an effective protocol or instruction manual for the proper use of nivolumab should be considered.
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조윤숙,한현주,손인자,엄고혜,이주연,조윤희 韓國病院藥師會 2006 병원약사회지 Vol.23 No.3
The prescriptions and dispenses for inpatients are conducted on a daily basis at Seoul National University Hospital (SNUH). The prescriptions for inpatients are received according to order sites and types of prescriptions. And in some cases, more prescriptions can be ordered than those needed actually, so returned-medications will be occurred, and also increased. Then the purposes of these studies are to analyze the states of returned medications in inpatients, and to make strategies to reduced those at SNUH Pharmacy. As the methods of the studies, we made the lists of returned-medications during April 11~15. 2005, and analyzed current conditions and reasons of returned medications. The results of the studies are as follows. The total prescriptions of returned-medications were 2,732 cases which were 5.14% of all prescriptions. There were 15 kinds of reasons to returned-medications. Among them, three reasons were in charge of 67% of all returned-medication, such as 765 cases of canceled prescriptions after dispense, 535 cases of overlapped prescriptions before and after operations and 527 cases of excessive PRN orders, respectively. Except those reasons, there were 196 cases of left medications caused by a daily basis prescription, 174 cases caused by discharges or deaths of inpatients, and 82 cases caused by continuous prescriptions of multiple use drugs, etc. The strategies to decrease returned-medications were established as follows. First, The one more - checking system was applied whether prescription was canceled or not before transferring UDS carts to nurse stations. Second, if prescriptions before and after operations were overlapped, those of post-operation were canceled. Third, in cases of multiple use drugs, we confirmed medical histories of inpatients, and canceled the prescriptions in which the multiple use drugs were continuously prescribed. In order to check the effectiveness of three strategies, we made second studies which were same as first studies during september 5~9, 2005 after introductions of these strategies to dispensing services for inpatients. The total prescriptions of returned-medications were 2,314 cases which were 3.97% of all prescriptions. The 22.8% of cases of returned-medications were decreased after interventions. From the results of these studies, it was noted that three strategies established on the steps of dispense for inpatients were effective to decrease returned-medications.
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