Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors

Objective@#The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. @*Methods@#The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. @*Results@#A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. @*Conclusion@#There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors

Objective@#The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. @*Methods@#The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. @*Results@#A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. @*Conclusion@#There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

Prescribing Patterns of Pain Medication in Hospitalized Elderly Patients with Non-Cancer Pain

OBJECTIVE: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. METHOD: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. RESULTS: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). CONCLUSION: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.

Bone mineral density and sex steroids in middle aged men

BACKGROUND: Osteoporosis is a skeletal condition that is characterized by reduction in bone volume and an increased vulnerability to fracture, practically of the proximal femur and vertebrae. But the etiology of osteoporosis in most men without history of alcohol abuse, or glucocorticoid excess is unknown. Several studies revealed that bone density in aged men was associated with serum sex steroids or sex hormone binding globulin (SHBG). METHODS: We have analyzed bone density and sex steroids, and SHBG of healthy 100 middle aged men who visited one university hospital located in Taejon city from Jan. 1997 to Nov. 1997. Aim of this study was to determine whether bone density in middle aged men was associated with serum sex steroids or SHBG. RESULTS AND CONCLUSION: Body mass index was significantly associated with serum FEI. BMI also associated negatively with SHBG. Bone density at lumbar spine was significantly positively associated with FEI (Free Estradiol Index) (r=0.359, P<0.001). SHBG was negatively associated (r=-0.273, P<0.01) with lumbar bone mineral density. After controlling for age, FEI and SHBG were still associated with BMD of lumbar spine. Because of these associations, multiple stepwise regression models were constructed, and accounted for 12-17% of the variability in bone density. Also, these results showed consistent, significant positive associations between bone density and FEI, BMI in middle aged men. Therefore, our data suggest that FEI and BMI may play an important role in the maintenance of the male skeleton.

The relationship between the amount of stress and mental health of the job holder

BACKGROUND: Job holders are groups that have suffered from chronic stressful condition. Nowadays, occupational stress are increasing due to Korean economic crisis. Therefore, this study was designed to evaluate the stress scores of several kinds of jobs, the relationship between the amount of stress and mental health status, factors associated with stress. METHODS: Among workers who had visited a medical college hospital, Taejeon, Korea, for regular health evaluation from April 1 to June 30 1998, we selected 50 clerks, 50 industrial workers, 50 professionals, 50 service or salesmen and 50 public servants in the survey. A total of 159 workers were evaluated as subjects excluding those who had answered in adequately to the questionnaire. Stress scores were measured by Korean-translated BEPSI(Brief Encounter Psychosocial Instrument) and Bae Jong Myun's 30-items SRRQ(Social Readjustment Rating Questionnaire). Mental health status were checked by Korean-translated SCL-90-R(Symptom checklist-90-Revision). RESULTS: The average BEPSI score of workers was 2.07+/-0.72. The mean score of female workers was 2.27+/-.70 and it was obviously higher than male worker's score of 1.85+/-.66. 20-29 year age group and over 40 year age group's amount of stress were obviously higher than 30-39 year age group. The low education level group had higher stress score than those with high education level but the amount of stress showed no significant difference in the monthly income, job tenure, number of family members to support, hobby and religion. According to occupation, clerks, industrial workers, service or salesmen's stress scores were higher than those of professional or public servants. CONCLUSIONS: This investigation has showed that there is a correlation between the amount of job holder's stress and mental health including somatimtian, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychotism Therefore, we conclude that the best way to stay in good menta