http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
外來 Epilepsy 患者에서의 Phenytoin Dose와 有效血中濃度
張秀延,申院均,金洛斗 한국병원약사회 1988 병원약사회지 Vol.5 No.1
Phenytoin as an anticonvulsant agent is widely used in the treatment of epilepsy, especially in tonic-clonic seizure. Phenytion is predominantly metabolized by the liver and follows non-linear pharmacokinetics(dose-dependent). Plasma concentration of phenytoin is variable depending on age, body weight, renal failure, liver failure, concurrent drugs, bioavailability, compliance and race, furthermore phenytoin has narrow therapeutic window, so clinical pharmacokinetic evaluation is essential for individualized dosage adjustment. This fact spurred research aimed at applying to out-patients the pharmacokinetic dosing methods commonly used for therapeutic monitoring of phenytoin In our study, 41-adults out-patient group in the mean age of 29 years were selected. These patients who had normal renal and liver function treated with phenytion 300 ㎎ per day chronically. The phenytoin blood concentrations of the patients assumed as steady-state concentration were taken and measured by fluorescence polarization immunoassay. We classified the 41 patients into three categories based on the blood concentrations following as optimal therapeutic range(10-20 ㎍/㎖), subtherapeutic range(less than 10 ㎍/㎖) and toxic range(more than 20 ㎍/㎖). On the other hand, we analyzed the dose (300㎎) into the dose rate(㎎/㎏/day) based on the actual body weights of individuals and then classified the patients into the three therapeutic range groups, too. According to our study, it is more desirable to administer the phenytoin depend on dose rate based on the body weight(4-6 ㎎/㎏/day) rather than routine dose (300 ㎎/㎏/day). It also needs to adjust dosage after the clinical pharmacokinetic evaluation because the percentage of the optimal therapeutic range in patients administered by 4-6㎎/㎏/day dose, was only 29.3%.
健康 吸煙者에 있어서 禁煙이 Theophylline의 體內消失半減期에 미치는 效果
金美那,申院均,申鉉澤,趙成石,金辰圭 한국병원약사회 1988 병원약사회지 Vol.5 No.1
Theophylline serum concentrations were measured at 2, 4, and 8 hours after single dose administration of aminophylline plain tablet in both healthy smokers (n=3) and non-smokers(n=3) to observe the effect of smoking withdrawals on the hepatic clearance of theophylline. Sampling procedures were repeated every week in smokers and every other week in non-smokers for 4 weeks of study period. Elimination half-lives of theophylline in smokers were dramatically increased during two weeks and gradually recovered to the mean serum half-life of non-smokers (mean±SD=8.74±1.57 hours) at 4 th week. These results suggest that smoking effect on the metabolic clearance of theophylline may diminish within month when smoking habit withdrawn in smokers. We would recommend more careful monitoring of serum theophylline concentrations in patients with acute respiratory distress with smoking history, especially during initial first month of hospitalization.
TPN solution中의 水溶性 Vitamin의 安定性
白恩英,申院均,金洛斗 한국병원약사회 1988 병원약사회지 Vol.5 No.2
TPN Solutions which consists of dextrose, amino acids, electrolytes, vitamins and trace elements are provided for the hospitalized patients with the purpose of nutritional support. To assure safety, it is advised that TPN solution should be mixed in a laminar air flow unit by aseptic techniques. The stability of water soluble vitamins in TPN solution are questionable. According to recent studies, water soluble vitamins are not stable in the TPN solution with bisulfite which is used as preservatives. Therefore it is necessary to assess the stability of vitamins in TPN solution. Two kinds of SNUH standard formulas, one is IVH-1 with the presence of 0.008% bisulfite and the other is IVH-3 with the presence of 0.05% bisulfite, were stored in 1000㎖ plastic containers under condition of refrigeration and protection from light. And then the amount of remaining water soluble vitamins in TPN solutions were measured by HPLC assay method at 0, 24, 48 and 72 hours under above storage condition. As a result, niacinamide, pyridoxine and riboflavin were stable in IVH-1 and IVH-3 solutions within 72 hours. But thiamine was found to be unstable. Percentages of the remaining thiamine after 0, 24, 48 and 72 hours of storage were 89, 83, 79 and 73 respectively in IVH-1 solution. The percentages of the remaining thiamine after 0, 24, 48 hours were 73, 28, 24 respectively in IVH-3 solution, but after 72 hours, the amount of thiamine remaining in IVH-3 solution is below detection range. Therefore a patient received nutritional support by TPN solution, it is recommended that the TPN solution should be used immediately after preparation.
小兒에 있어서 Nutritional Assessment 基準値 設定에 關한 硏究
車定旼,申鉉澤,申院均 한국병원약사회 1988 병원약사회지 Vol.5 No.2
Prevention and treatment of malnutrition in hospitalized patient are essential to the patient care, For effective and safe nutritional supports, adequate nutritional assessment should be performed. The anthropometric measurement and laboratory parameters constitute the mainstay of the diagnosis of malnutrition, especially anthropometric measurements are perhaps the easiest and most available. But, in Korea standard anthropometric values for nutritional assessment of children are yet to be investigated. This study is primarily aimed to establish the standard anthropometric values for children. Weight, height, triceps skinfold thickness(TSF), midarm circumference(MAC) and arm-muscle circumference(AMC) etc. were measured for 325 females and males with ages between 0 to 17years. The standard anthropometric values of our study may be clinically applicable to the nutritional assessment of Korean children However, further studies may be needed to clarify the usefulness of these standard values.