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Drug-Induced Vitamin Deficiency
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Jung Won Jung, So Young Park, Hyunah Kim
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Ann Clin Nutr Metab 2022;14(1):20-31. Published online June 1, 2022
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DOI: https://doi.org/10.15747/ACNM.2022.14.1.20
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- Drug-induced vitamin depletion can occur in hospitalized patients due to the administration of specific medications, which could potentially adversely affect patient outcomes. Signs and symptoms related to vitamin deficiency while taking certain medications should be monitored carefully and managed appropriately if those deficiencies are clinically significant. This article reviews potential drug-induced vitamin depletion and discusses the evidence supporting vitamin deficiency related to the use of specific medications.
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Parenteral Nutrition in Hospitalized Adult Patients in South Korea
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Miyoung Ock, Sera Lee, Hyunah Kim
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J Clin Nutr 2018;10(2):38-44. Published online December 31, 2018
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DOI: https://doi.org/10.15747/jcn.2018.10.2.38
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Purpose:Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods:We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results:From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion:PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.
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Analysis of Adverse Reactions Associated with Parenteral Nutrition Use in Korea
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Sera Lee, Miyoung Ock, Seonghee Kim, Hyunah Kim
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J Clin Nutr 2017;9(1):16-20. Published online June 30, 2017
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DOI: https://doi.org/10.15747/jcn.2017.9.1.16
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Purpose:To evaluate the clinical manifestations of adverse drug reactions (ADRs) of parenteral nutrition (PN) use in Korea. Methods:The Korean Adverse Event Reporting System (KAERS) database records in 2015 on PN-treated patients were used. ADRs classified as “certain,” “probable,” and “possible” based on the WHO-Uppsala Monitoring Centre criteria were analyzed. Results:In total, 21,436 ADRs from 2,346 patients were included for analysis. The mean patient age was 57.1 years and the mean number of ADRs per patient was 9.1. ADRs were reported frequently with amino acids solutions (682 events, 40.8%), followed by combinations products (519 events, 31.1%), and fat emulsions (363 events, 21.7%). The frequent ADRs were gastrointestinal (507 events, 30.3%), skin (343 events, 20.5%), general disorders (239 events, 14.3%), and central/peripheral nervous system disorders (165 events, 9.9%). The common clinical symptoms were nausea (321 events, 19.2%), vomiting (105 events, 6.3%), and vein pain (102 events, 6.1%). Serious ADRs accounted for 220 patients (9.4%) and dyspnea was the most frequent clinical manifestation. Conclusion:This study analyzed the KAERS data in 2015 from patients treated with PN and revealed gastrointestinal and skin disorders to be the leading ADRs.
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Pharmacologic Therapy for Cancer Anorexia-Cachexia Syndrome
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Seonkyeong Yoon, Hyunah Kim
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J Clin Nutr 2015;7(2):36-41. Published online August 31, 2015
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DOI: https://doi.org/10.15747/jcn.2015.7.2.36
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Cancer-related anorexia-cachexia syndrome (CACS) is a hypercatabolic state, characterized by reduced appetite and weight loss due to ongoing loss of skeletal muscle mass and adipose tissue. CACS occurs mainly in patients with advanced cancer; thus, weight loss in CACS is often associated with poor prognosis and decreased survival. A large number of studies have been conducted on various pharmacologic agents for palliation of cancer-related anorexia. The purpose of this article is to review the pre-existing pharmacologic agents used for CACS and to evaluate the evidence from current studies on each pharmacologic agent. First, appetite stimulants such as corticosteroids, progestins, cyproheptadine, and cannabinoid have been shown to be beneficial by improving appetite and helping with weight changes even if they had no effect on survival rate. Several other agents with anti-inflammatory effects (e.g., eicosapentaenoic acid, thalidomide, and melatonin), prokinetic agents (e.g., metoclopramide), anabolic agents (e.g., androgens and growth hormone), antipsychotics (e.g., mirtazapine and olanzapine), and antiemetics have also been studied in patients in CACS; however further investigations would be required to confirm the beneficial effects.
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