http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
제한항균제 전산 관리 프로그램 도입 전과 후의 반코마이신 사용 평가
안효초,이창섭,이미경,양재헌,Ahn, Hyo-Cho,Lee, Chang-Seop,Lee, Mi-Kyung,Yang, Jae-Heon 대한약학회 2009 약학회지 Vol.53 No.3
Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.
Isoniazid, Rifampicin, Ethambutol, Pyrazinamide의 병용 투여가 Theophylline의 약물동태에 미치는 영향
안효초 ( Hyo Cho Ahn ),양재헌 ( Jae Heaon Yang ),김광훈 ( Gwang Hun Kim ),안혁수 ( Heok Soo Ahn ),장재호 ( Jae Ho Jang ),이흥범 ( Heung Bum Lee ),이용철 ( Yong Chul Lee ),이양근 ( Yang Keun Rhee ) 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.5
콜라겐으로 유발된 관절염에 대한 피록시캄 및 황금 가수분해물 복합 히드로겔의 항염 효과
김태균,안효초,윤미영,임재윤,채병숙,김대근,박병현,양재헌,Kim, Tae-Kyun,Ahn, Hyo-Cho,Yun, Mi-Young,Leem, Jae-Yoon,Chae, Byeong-Suk,Kim, Dae-Keun,Park, Byung-Hyun,Yang, Jae-Heon 대한약학회 2008 약학회지 Vol.52 No.5
In order to access the suppressive effects of piroxicam (PX) and hydrolyzed products of Scutellariae Radix (PSH) on arthritis, we investigated whether PSH gel could suppress the progression of collagen-induced arthritis. PX, one of nonsteroidal anti-inflammatory drugs has been used in the systemic and topical treatment in a variety of inflammatory conditions. Scutellariae Radix, one of the herbal medicines, was used for the purpose of anti-inflammatory and anti-bacterials. For the purpose of transdermal absorption of the hydrogel preparations, two classes of hydrogels (PX, PSH) were formulated with carbomer 940, diethylene glycol monoethyl ether, polyethylene glycol-8-glyceryl caprylate/caprate and triethanolamine. In carrageenan-induced edema in rat hind paws, inhibition of foot swelling was more increased in PSH than PX hydrogel. Rheumatoid factors including serum IgG, IgM and collagen specific antibody were present much lower in PSH gel treated mice than control. Histological examination revealed that PSH hydrogel inhibited infiltration of inflammatory cells into affected paw joint, compared with control. The PSH hydrogel would be a suitable preparation to increase transdermal treatment for anti-inflammatory effects on collagen-induced arthritis.
P-122 Effectiveness and Safety of Tolvaptan for the Management of Hyponatremia
박승용,박미선,안효초,범진선,김주신,박성주,이흥범 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.0
Background: Hyponatremia is the most common electrolyte disturbance in hospitalized patients and has been associated with increased morbidity and mortality. Tolvaptan, a vasopressin receptor antagonist, is increasingly used to treat euvolemic and hypervolemic hyponatremia. The aim of this study was to evaluate the effectiveness and safety of tolvaptan for the management of hyponatremia. Methods: This study was a retrospective evaluation of 106 patients who received at least one dose of tolvaptan for hyponatremia at a tertiary academic university hospital between January 2014 and June 2015. Results: The mean initial dose of tolvaptan was 20.2 ± 7.2 mg and the duration of treatment was 15 (range 1 - 261) days. The maximal changes in sodium levels at 24 and 48 h were 8.2 ± 4.7 mmol/L and 10.5 ± 15.3 mmol/L, respectively, from a mean baseline of 124.4 ± 5.1 mmol/L. Of 99 patients in whom sodium concentrations were followed up, sodium overcorrection was observed in 26 (26.3%) patients, which was associated with concomitant use of a hypertonic solution (odds ratio [OR] = 1.05, 95% confidence interval [Cl]: 1.01-1.10) and treatment with an initial high dose (OR = 4.50, 95% Cl: 1.05-19.31) and an enzyme inhibitor (OR = 3.7, 95% Cl: 1.08-12.75). The most commonly reported side effects were mild and related to aquaresis, such as polyuria, thirst, and constipation. Conclusion: Tolvaptan is effective for treating hyponatremia. However, careful use is necessary due to serious side effects related to sodium overcorrection.
박혜원,범진선,안효초,김주신 한국병원약사회 2015 병원약사회지 Vol.32 No.3
Cefepime is fourth generation class, broad-spectrum cephalosporin. In contrast to older cephalosporins, cefepime penetrates the gram-negative cell more rapidly, targets multiple essential penicillin-binding proteins, and escapes the effects of many beta-lactamases due to the enzymes’ low affinity for the drug. However, it should be used judiciously because unnecessary, improper, and prolonged use may lead to the emergence of cefepime-insensitive bacteria and risk decline in its efficacy. Therefore, this study was performed to evaluate the use of cefepime and its efficacy. We retrospectively analyzed medical records of patients who received cefepime at Chonbuk National University Hospital, from January 2011 to July 2011. As a result, 169 cases were studied; the justification of use showed a high rate of appropriate use 161 cases(95.3%). A majority of the critical(process) indicators also showed a high rate of appropriate use 126~164 cases(74.6~100%). The dosage of cefepime was appropriate in 122 cases(72.2%). Duration of therapy was appropriate in 100% of patients with neutropenia, but other cases were lower. Complications occurred in 35 cases, including nephrotoxicity(9 cases), hepatotoxicity(4 cases), gastrointestinal effects(8 cases), hematologic effects(5 cases), fever(3 cases), skin reactions(5 cases) and neurotoxicity(1 case). In outcome measures, the total therapeutic response rate showed 60.9%. Cefepime was being used for appropriate reasons, but it was not being well monitored. Since the improper use of antibiotics can lead to an increase of multidrug-resistant bacterias, increased safety measures could be taken by authorized clinical pharmacists to prescribe antibiotics for proper use and ongoing monitoring. Additional studies will also need to be considered for a wider variety of clinical data.
Incidence and Risk Factors for QT Prolongation associated with Fluoroquinolones
최은정,범진선,안효초,박승용,이흥범 한국병원약사회 2023 병원약사회지 Vol.40 No.2
Background : Despite the high bioavailability and broad-spectrum activity of fluoroquinolones (FQs), their administration can lead to corrected QT prolongation. However, there is a lack of information on the incidence and risk factors for FQ-induced long QT in critically ill patients. Our objective is to determine the incidence of QT prolongation and identify the associated risk factors under real-time 24 hour monitoring. Methods : We conducted a retrospective review of medical records of critically ill patients from January to December 2018. In additioon to continuous bedside monitoring with lead II, 12-lead electrocardiography was performed regularly daily and immediately on suspected QT prolongation. The criteria for long QT were defined as QTc ≥ 450 ms for men and ≥ 470 ms for women. Dummy variable regression was performed to analyze QT interval changes before and after QT prolongation, and multivariate logistic regression was performed to identify the risk factors independently associated with QT prolongation. Results : Among 455 admitted patients, FQs were administered in 126 patients (46 female; median age, 77 years [interquartile range=63-81]) and the FQs administerd were levofloxacin (n=43), moxifloxacin (n=35), gemifloxacin (n=15), or ciprofloxacin (n=46). QT prolongation was noted on 119 cases (85.6%) after FQ administraion. The greatest QT interval difference was observed in patients receiving levofloxacin (95% confidence interval [CI]: 36.28–68.62, p < 0.001). The use of loop diuretics (OR: 7.66; 95% CI: 1.12–52.47), co-morbid sepsis (OR: 8.81; 95% CI: 1.18–65.96), and number of medications with known risk of torsade de pointes based on CredibleMeds (OR: 4.83; 95% CI: 1.18–19.79) were identified as independent risk factors. Conclusion : QT prolongation was observed frequently in critically ill patients using FQs. Among the FQs, levofloxacin had the highest incidence of QT interval differences. Therefore, these results suggest that caution is needed when administering FQs in critically ill patients, particularly those with sepsis and those receiving levofloxacin infusion.
박미선,박승용,박성주,범진선,안효초,김주신,이흥범 한국병원약사회 2018 병원약사회지 Vol.35 No.4
Background : Hyponatremia is the most common electrolyte disturbance in hospitalized patients and has been associated with increased morbidity and mortality. Tolvaptan, a vasopressin receptor antagonist, is increasingly used for the treatment of euvolemic and hypervolemic hyponatremia. The aim of this study was to evaluate the effectiveness and safety of tolvaptan for the management of hyponatremia. Methods : This study was a retrospective evaluation of 106 patients who received at least one dose of tolvaptan for hyponatremia at a single tertiary academic hospital between January 2014 and June 2015. The primary endpoint was the change in serum sodium concentration after tolvaptan administration within 24 hours, with secondary endpoints of overcorrection and adverse effects. Results : The mean initial dose of tolvaptan was 20.2±7.2 mg and the median duration of treatment was 15 days (range, 1-261 days). The maximal changes in sodium levels at 24 and 48 hours were 8.2± 4.7 mmol/L and 10.5±15.3 mmol/L, respectively. Of 99 patients in whom sodium concentrations were followed up, sodium overcorrection was observed in 26 (26.3%) patients, which was associated with concomitant use of an enzyme inhibitor (odds ratio [OR] = 4.80, 95% Cl: 1.27-18.15). However, sex, body mass index (BMI), serum albumin, a daily dose of tolvaptan, and concomitant use of hypertonic saline did not show any significant difference in overcorrection. The most commonly reported adverse effects were mild and related to aquaresis, such as polyuria, thirst, and constipation. However, severe adverse amioeffects such as hyperkalemia, hypotension, and one death related to osmotic demyelination were also reported. Conclusions : Tolvaptan is effective for treating hyponatremia. Nevertheless, the drug should be used cautiously due to serious adverse effects related to sodium overcorrection.