Influence of CYP2D6 Polymorphism on the Pharmacokinetic/Pharmacodynamic Characteristics of Carvedilol in Healthy Korean Volunteers

BACKGROUND: Carvedilol is commonly used to treat hypertension as a β- and α1-adrenoreceptor blocker, but it is metabolized by CYP2D6, and CYP2D6*10 allele is dominant in Asian population. The objective of this study was to assess the influence of CYP2D6 polymorphisms on the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of carvedilol in healthy Korean volunteers. METHODS: A PK/PD study for a single and multiple dosing of carvedilol were conducted. All volunteers in 3 genotypic groups received single oral dose of carvedilol 12.5 mg for 3 days, then 25 mg QD for 5 days, and 12.5 mg QD for another 3 days. PK parameters for carvedilol and its three metabolites were determined using non-compartmental analysis. For PD properties, blood pressure, heart rate, and the chronotropic dose 25 (CD25) value were obtained. RESULTS: The IM_2 group with two *10 alleles (intermediate metabolizers) exhibited lower clearance of carvedilol as well as higher area under the curve (AUC) for O-desmethyl carvedilol. The ratio of CD25 to baseline at multiple dosing was significantly higher in the combined IM group (IM_1 and IM_2) than in the EM group, however, the ratio of CD25 after single and multiple dosing and the other PD markers were not significantly different between the 3 genotypic groups compared with the baseline. CONCLUSION: These findings showed that CYP2D6 genotype influenced the PK characteristics of carvedilol and no differences in PD response were observed in Korean healthy volunteers. Registered at the ClinicalTrials.gov, NCT02286934.

[Effects of antenatal depression and antenatal characteristics of pregnant women on birth outcomes: a prospective cohort study].

PURPOSE: This study was done to evaluate the effects of antenatal depression on birth outcomes. METHODS: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. RESULTS: Level of antenatal depression was associated with low birth weight (χ²=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. CONCLUSION: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy BMI≥23 kg/M² should be monitored and managed to ensure favorable birth outcomes.

[Evaluation and application of the Korean version of the sexuality attitudes and beliefs survey for nurses].

PURPOSE: This study was conducted to evaluate the validity and reliability of the Korean version of the Sexuality Attitudes and Beliefs Survey (SABS) and to assess SABS for Korean nurses. METHODS: The Korean version of SABS was developed through forward-backward translation techniques. Internal consistency reliability and construct validity using confirmatory factor analysis were conducted using PASW+ PC Win (18.0) and AMOS (18.0). Data were collected from 567 nurses who worked in one of six general hospitals across the country. RESULTS: The Korean version of SABS showed a reliable internal consistency with Cronbach's α of subscales ranging from .59 to .73. Factor loadings of the 10 items of three subscales ranged from .38 to .83. The three subscales model were validated by confirmatory factor analysis (GFI>.97, RMSEA<.05). Sexuality attitudes and beliefs for Korean nurses were more negative than that of European or American nurses. The SABS scores for Korean nurses were significantly different according to age, marriage, education, clinical experiences, and feeling about sexuality. CONCLUSION: The Korean version of SABS has satisfactory construct validity and reliability to measure Korean nurses' attitudes and belief toward sexuality. Education is essential to enhance importance and self-efficacy and to relieve barriers to addressing patients' sexuality.

Relating Factors in Pap Smears by Stages of Change among Married Nurses.

PURPOSE: This study was to examine the differences in health belief variables and HPV (Human Papillomavirus) knowledge in Pap smears according to the stages of change using Trans-theoretical Model (TTM) among married nurses. METHODS: The research design was a cross sectional survey. Participants were 387 married nurses working in general hospital located metropolitan city. Measurement variables were perceived threatening, perceived severity, benefits of Pap, HPV knowledge and stages of the change in Pap smear. RESULTS: Classified stages were pre-contemplation 3.9%, contemplation 17.8%, relapsing 29.5%, action 31.0%, and maintenance 17.8%. Accuracy rate of HPV knowledge were low ranging from 15% to 45%. Among the variables, perceived threatening (F=3.56, p=.007), perceived severity (F=9.73, p<.001) and HPV knowledge (F=7.52, p<.001) were significantly different by stages of change. CONCLUSION: Application of TTM to Pap smears was efficient to know the nurse's level of health behaviors, Health belief variables and HPV knowledge were main factors to identify the stages of change. The continuation of Pap smears and the education in relation to HPV knowledge should be encouraged for married nurses.

Influencing Factors on Antenatal Depression.

PURPOSE: This study examined the influencing factors on antenatal depression among pregnant women. METHODS: This was a cross sectional descriptive study with 255 pregnant women who visited a general hospital in a metropolitan city for their regularly scheduled check-up. Measurement tools employed were the Korean version of Beck Depression Inventory (BDI), the food habits, and the Pittsburg Sleep Quality Index (PSQI). Socio-demographic variables and the status of high risk pregnancy were identified. Influencing factors on antenatal depression were identified using a stepwise multiple regression analysis. RESULTS: The mean score of antenatal depression was 7.2 +/- 5.0; 18.4% with mild depression, 5.9% had moderate depression, with 0.8% identified with severe depression on BDI scale. Influencing factors on antenatal depression accounted for 47.8% of the total variance which consisted of quality of sleep, marital satisfaction, food habits, gestation periods, sexual satisfaction, high risk pregnancy, and age. CONCLUSION: Findings show that antenatal depression should be monitored on a regular basis during early pregnancy and in high risk pregnancy if possible, and quality of sleep and food habits should be incorporated in the management of antenatal depression.

[Development and application of a feeding program for infants postoperatively following cardiac surgery].

PURPOSE: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. METHODS: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. RESULTS: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. CONCLUSION: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.