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Nadroparin calcium을 5% 포도당 수액에 희석시의 안정성 연구
권명순,김귀숙,한현주,손인자 韓國病院藥師會 2005 병원약사회지 Vol.22 No.2
Nadroparin is a low-molecular-weight heparin and has been effective in the prophylaxis and treatment of thromboembolism. Nadroparin is usually used for prevention of hepatic venoocclusive disease in SNUCH. Hepatic veno-occlusive disease (VOD, a common complication of stem cell transplantation) is a result of intensive conditioning by chemo-radio-therapy. The pathogenesis is probably multifactorial, but the key event is endothelial damage, which triggers the coagulation cascade, inducing the deposition of fibrin in the affected venules. Thus, the use of antithrombotic therapy is a logical prophylactic approach to VOD. Since immune function and platelet number is decreased after stem cell transplantation, nadroparin in 5% dextrose solution is continuously infused for 24 hours instead of subcutaneous injection but it is failed to cite data on the stability of nadroparin with diluent. The stability of nadroparin in 5% dextrose solution was studied. Duplicate solutions of 5,700 IU/0.6 ml of nadroparin and 100 ml of 5% dextrose solution were prepared. Samples were taken at 15 minutes, 2 hours, and 24 hours. Inspections for color change and precipitation performed with naked eyes. Samples were evaluated for pharmacologic activity by anti-factor Xa assay according to European Pharmacopoeia 4th. Throughout the 24-hour study period, the nadroparin admixtures were free of color change, precipitates. The pharmacologic activity of nadroparin remained 99.8~100.5% of activity measured immediately preparation. In conclusion, nadroparin 57 IU/ml in 5% dextrose solution based on 50 kg child was stable for up to 24 hours at 15~25°C.
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금속심장판막 치환환자를 대상으로한 warfarin 용량 조절 guideline의 적절성 평가
권명순,정영미,김귀숙,이병규,손인자 韓國病院藥師會 2004 병원약사회지 Vol.21 No.3
The effectiveness and safety of warfarin therapy are critically dependent on a dose-response relationship, which is extremely individualized and can be influenced by several different factors. Therefore, patients on oral anticoagulant therapy require a close and careful monitoring of their daily dosage to prevent any complication possibly related to overdosing or underdosing. Patient with mechanical prosthetic valves are at high risk of systemic embolism therefore, they require an appropriate and lifelong anticoagulation. In 2001, the warfarin guideline for outpatients with mechanical heart valves replacement was developed by anticoagulation service team. This study goal was to evaluate the guideline. Data abstracted from the records of 100 patients whose warfarin dose has been changed by the guideline. After dosage adjustment, 60% were within the therapeutic range of INR 2.0 ~ 3.0, 23% were less than INR 2.0, and 17% were greater than INR 3.0. There was no thromboembolism but two bleeding sign and two ER visits occured. These were done because of hematuria, fever and chill which was not related anticoagulation therapy. A pharmacy-managed guideline for dosing warfarin achieved therapeutic goals and promoted use for outpatients with mechanical heart valves replacement.
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3차의료기관 약제부내 의약정보센터의 의약정보 문의에 대한 해결능력 및 정확성 평가
이주연,김민정,문순란,김귀숙,박경호,조남춘 한국병원약사회 1997 병원약사회지 Vol.14 No.1
In the last few decades, the role in phamacy has been extended beyond typical distributive function. One of these extended role involves drug and toxicology information services. Drug information services of Korean hospital pharmacy were adopted since 1969 to provide accurate and timely medication drug information. The objectives of this study were to assess the accuracy of response to drug information request and to determine the relationship between accuracy of answers accuracy of answers and characteristics of Drug Information Centers(DIC) in Korean hospital phamacy. Drug Information Centers located in tertiary care hospital phamacy were contacted by telephone from September to October in 1996. Each DIC received standard request for identification of product, Fosamax^(R)(alendronate), that was a new drug approved by FDA in 1995, but availablee market in Korea at that time. However this drug could be found I AHFS DI 96, Martindale(31th ed), Medline, CCIS other clinical and journals. Each center correctly identifying Fosamax^(R) was asked more questions concerning the recognition of clinical signs of adverse effects. Fosamax^(R) was correctly identified by seventeen hospital drug information centers. (36.2 percent) and thirty centers responded that could not make an identification with a product name. Of the 17 centers correctly identifying with Foamax, only five centers recognized drug adverse effects and offered recommendations. From this study, it was noted that the ability and the accuracy of drug information responses were significantly related with pharmacist's work-load drug information resources.
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FPIA에 의한 vancomycin 혈장 농도의 과측정
박선영,김민정,김귀숙,손인자,서옥경 한국병원약사회 2003 병원약사회지 Vol.20 No.3
Vancomycin is eliminated mainly through the kidneys. As this drug is potentially nephro- and ototoxic in patients with renal insufficiency, quantitation of its levels in patient blood is required to maintain therapeutic level. While using FPIA, there have been reports regarding possible interference by vancomycin breakdown product(CDP-1) that accumulates in patients with renal failure. The purpose of this study was to evaluate the perfomance of FPIA assay in comparison to HPLC with vancomycin level, especially related to renal function and duration of treatment. Total 53 adult patients receiving vancomycin with measurement of vancomycin levels from July to September 2002 were achieved in the study. All serum samples were analyzed initially by FPIA(Abbott TDx) and again by HPLC. When measured by FPIA as compared with HPLC, mean values were overestimated by 26.4·23.4% (-38.6 ~ 78.2%). No association was found between the overestimation and the renal function, duration of the therapy, and TDx concentration. If reported concentrations are falsey elevated, the potential for underdosing and therapeutic failure is of obvious concern. In our study, vancomycin levels were generally overestimated when measured using FPIA. Further controlled studies should be performed in a larger population to document the vancomycin overestimation and its relationship to other factors.
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