식욕부진을 주소로 내원한 노인 환자 증례 2례- 복약력 확인 및 감염 관리의 중요성
Two Case Reports of Elderly Patients with Anorexia: the Importance of Confirming Medication and a Potential Infectious Disease
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Objectives: This study aimed to put clinical emphasis on the importance of considering medical precautions, such as drug history and a possible infection, when treating elderly patients. Methods: We closely observed two elderly female patients aged 79 and 76 who had been hospitalized for the treatment of anorexia at the Department of Hepato-Hemopoietic System, Kyung Hee University Korean Medicine Hospital in April 2018 for 5 and 9 days, respectively. Results: Through an elaborate medical investigation including a detailed inquiry and laboratory examinations, modifying some drugs and treating a urinary tract infection were preferentially needed to treat these two patients. In the first case, her overall symptoms, including anorexia, were improved after taking Dansambohyeol-tang combined with three types of antacids adjusted by holding 10 drugs in total, including nonsteroidal anti-inflammatory drugs that mainly causing chronic gastric ulcer. In the second case, the urinary tract infection was detected by blood test and urine analysis during the hospitalization period. After taking Geummogpaljeong-san and antibiotics for the treatment of the infection, the chief complaints including anorexia and the negative reaction to nitrite in the urinary analysis were improved. Conclusion: Considering the clinical precautions, including medications and infection possibility, is important especially when treating elderly patients.
Abstract
Objectives: This study aimed to put clinical emphasis on the importance of considering medical precautions, such as drug history and a possible infection, when treating elderly patients. Methods: We closely observed two elderly female patients aged 79 and 76 who had been hospitalized for the treatment of anorexia at the Department of Hepato-Hemopoietic System, Kyung Hee University Korean Medicine Hospital in April 2018 for 5 and 9 days, respectively. Results: Through an elaborate medical investigation including a detailed inquiry and laboratory examinations, modifying some drugs and treating a urinary tract infection were preferentially needed to treat these two patients. In the first case, her overall symptoms, including anorexia, were improved after taking Dansambohyeol-tang combined with three types of antacids adjusted by holding 10 drugs in total, including nonsteroidal anti-inflammatory drugs that mainly causing chronic gastric ulcer. In the second case, the urinary tract infection was detected by blood test and urine analysis during the hospitalization period. After taking Geummogpaljeong-san and antibiotics for the treatment of the infection, the chief complaints including anorexia and the negative reaction to nitrite in the urinary analysis were improved. Conclusion: Considering the clinical precautions, including medications and infection possibility, is important especially when treating elderly patients.
참고문헌 (20)
- 이현복, "노인의료비 추계와 건강보험에 대한 시사점", 보험학회지, (117), pp.43~68 (2019), 한국보험학회[DOI]
- 이준석, "일개 노인복지관 방문 노인환자들의 다약제복용과 부적절한 약물처방 실태", Korean Journal of Family Medicine, 29(12), pp.925~931 (2008), 대한가정의학회
- 서덕성, "종합병원 입원 노인 환자들의 입원 직전 다약제 복용 실태와 시사점", Annals of geriatric medicine and research, 16(3), pp.133~140 (2012), 대한노인병학회[DOI]
- 이종경, "다약제 복용 노인의 약물 오용 행위에 영향을 미치는 요인", 성인간호학회지, 23(6), pp.554~563 (2011), 한국성인간호학회
- Kim SO, "Control scheme of drug cost according to a sort of medical service using", J Korean Acad Soc Nurs Educ, 6(2), pp.376~389 (2008), National Health Insuranc
- Nicolle LE, "Urinary tract infections in the elderly", Clinics in geriatric medicine, 25(3), pp.423~436 (2009)
- Lee SH, "Infectious Diseases of the Elderly", Korean journal of clinical geriatrics, 2(3), pp.159~165 (2001)
- Wehling M, "Guideline-driven polypharmacy in elderly, multimorbid patients is basically flawed : there are almost no guidelines for these patients", J Am Geriatr Soc, 59(2), pp.376~377 (2011)
- Kaufman DW, "Recent patterns of medication use in the ambulatory adult population of the United States : the Slone survey", JAMA, 287(3), pp.337~344 (2002)
- "2011 Survey on the elderly status - A nationwide survey on the elderly living status and welfare needs" (2012)[URL]
- American Geriatrics Society 2015 Beers Criteria Update Expert Panel, "American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults", J Am Geriatr Soc, 63(11), pp.2227~2246 (2015)
- Gurwitz JH, "Incidence and preventability of adverse drug events among older persons in the ambulatory setting", JAMA, 289(9), pp.1107~1116 (2003)
- Hajjar ER, "Adverse drug reaction risk factors in older outpatients", Am J Geriatr Pharmacother, 1(2), pp.82~89 (2003)
- Chan M, "Adverse drug events as a cause of hospital admission in the elderly", Internal medicine journal, 31(4), pp.199~205 (2001)
- Huang JQ, "Role of Helicobacter Pylori Infection and Non-Steroidal Anti-Inflammatory Drugs in Peptic-ulcer Disease : A Meta-analysis", Lancet, 359(9300), pp.14~22 (2002)
- García Rodríguez LA, "Risk of uncomplicated peptic ulcer among users of aspirin and nonaspirin nonsteroidal antiinflammatory drugs", Am J Epidemiol, 159(1), pp.23~31 (2004)
- Baigent C, "Aspirin in the primary and secondary prevention of vascular disease : collaborative meta-analysis of individual participant data from randomised trials", Lancet, 373(9678), pp.1849~1860 (2009)
- Rothwell PM, "Effect of daily aspirin on long-term risk of death due to cancer : analysis of individual patient data from randomised trials", Lancet, 377(9759), pp.31~41 (2011)
- 심기남, "저용량 아스피린 사용 시에 위장관 출혈이 증가하는가?", 대한소화기학회지, 59(4), pp.324~325 (2012), 대한소화기학회[DOI]
- Yoo HJ, "Characteristics of Geriatric Diseases - Geriatric Syndrome", Korean J Intern Med, 77(S4), pp.1073~1076 (2009)