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- 저자 : 최경업 ( Kyung Up Choi ) (검색결과 4 건)
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한국인 환자에 있어서 아미노글라이코사이드의 약동학적 변수를 이용한 반코마이신 약동학 예측
임현정,정지은,서옥경,최경업 한국병원약사회 2000 병원약사회지 Vol.17 No.1
Aminoglycosides (AG) and vancomycin are frequently prescribed for the treatment of serious bacterial infections. Since both agents have similar pharmacokinetics, it would be desirable to estimate vancomycin's pharmacokinetic parameters by using the patient's measured aminoglycoside pharmacokinetic parameters or vice versa. The objectives of this study were to determine if pharmacokinetic relationships exist between AG and vancomycin with respect to pharmacokinetic parameters in Korean patients in phase Ⅰ and to evaluate the clinical utility of these relationships by applying the derived regression equations to a different patient group in phase Ⅱ. 81 patients in phase Ⅰ and 39 in phase Ⅱ receiving concurrent intravenous vancomycin and AG were enrolled in this retrospective study. Steady-state serum concentrations of AG and vancomycin were obtained and pharmacokinetic parameters (Ke, t_(1/2), Vd, Cl) were calculated using first-order pharmacokinetic equations. In phase Ⅰ, there was significant linear correlation between AG and vancomycin pharmacokinetic parameters. The pharmacokinetic parameters of vancomycin derived from AG were superior to those derived from creatinine clearance (Clcr). Correlation coefficient between Ke, t-(1/2), Vd, and Cl values of AG and vancomycin were 0.862, 0.874, 0.438, and 0.787, respectively. Correlation coefficient between Ke, t_(1/2), Vd, and Cl values of vancomycin and those derived from Clcr were 0.728, 0.622, 0.408, and 0.675, respectively. In phase Ⅱ, the correlation between pharmacokinetic parameters of AG and vancomycin may be beneficial for predicting pharmacokinetics of vancomycin, especially in Ke when AG concentrations have already been obtained. Regression equations derived from correlation between AG and vancomycin were less biased in Ke and more precise in Vd. But, vancomycin's Vd and Cl from current regression equations were slightly overpredicted. Thus, revised regression equations ablout predictions of Vd and Cl, and its prospective evaluation will be completed. In conclusion, regression equations derived from AG may be safety used in predicting vancomycin pharmacokinetic parameters.
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OCS 운영병원에서의 병동 약반납 업무 현황분석과 개선방향
오윤경,김희수,이영미,손기호,최경업 한국병원약사회 2000 병원약사회지 Vol.17 No.1
Information about returned-medications after preparing as prescribed may serve as a part medication history, and to patients that information may be associated with increased medical expenses. Therefore, it is very important that such information is handled rapidly and accurately among departments involved in a hospital. Furthermore, accurate medication administration history serves as a basic information pharmacists needs in order to expand the role of a pharmacist as patient-oriented drug therapy specialist. In Samsung Medical Center (SMC), the information about returned medications is done by written communication and the information delivered to pharmacists is inaccurate. So the purpose of this study was to analyze work related to returned medications in hospitals with Order Communication System (OCS). First the problems with work related to processing returned-medications were identified. Based on this result, questionnaires were sent by mail to 50 tertiary hospitals all over the country. Finally, based on these, a new model for handling returned-mediations has been proposed. In SMC, the biggest problem in work associated with returned-medications was inaccurate information on slips for returned-medications. This problem could not be solved by short-term education in such matter. Of 50 hospitals where questionnaires were mailed 50% replied. and among these hospitals, 60% were with OCS. But in most hospitals with OCS, inaccuracy of slip was not a problem, because slip was done by on-line program and not a hand-written one. However, accurate patient information was not shared between wards and pharmacy as in SMC. The workflow related to returned medications could be divided into two types; however they presented with different patterns of cost loss. A poor appreciation by pharmacist regarding workflow associated with returned-medications and a difficulty in sharing information between wards and pharmacy were listed as common problems. The workflow related to returned medications must be managed by pharmacists. Thus we need to develop a new model for processing returned medications with accuracy and appropriate information.
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장승연,최지선,민명숙,인용원,손기호,최경업,김화정,신완균 한국병원약사회 2002 병원약사회지 Vol.19 No.3
To evaluate the usage of total parenteral nutrition(TPN) and to assess the nutritional benefits ad risks of TPN in pediatric hematopoietic stem cell transplantation, 52 pediatric patients who received hematopoietic stem cell transplantation were studied retrospectively. Each patient was monitored until TPN was discontinued or for a maximum of 21days. The mean daily energy intake given intravenously was 80.6±23.3% of basal metabolic rate(BMR) and protein intake was 1.07±0.49g/㎏/d(mean±S.D.). Weight did not present statistically significant variations. Serum albumin levels fell markedly on day 7(3.47±0.34g/dL), but returned to normal on day 14(3.71±0.34g/dL) and then keep up to day 21. Total protein levels were significantly increased on days 7, 14, 21. Blood glucose levels significantly rose from day 14. In metabolic complication, the most frequent abnormalities were hypomagnesemia(65.4%). Blood urea nitrogen(BUN) was below normal on day 0(7.12±3.47㎎/dL) and significantly rose during TPN(11.58±6.87㎎/dL on day 7). Serum creatinine levels significantly decreased on day 14. Transaminases were moderately elevated at the start of TPN, but returned to normal on day 7. Total bilirubin and alkaline phosphatase(ALP) were normal during TPN, with slight fluctuation, always in the normal range. Nutritional support with TPN was effective in maintaining weight and viceral proteins. It is need to close monitoring during TPN in pediatric hematopoietic stem cell transplantation.
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