著者

吉田 和佳奈 齋藤 栄 酒向 孫市 野田 政充 川口 諭 新井 一也 安齋 沙織 久保田 聡 渋谷 清 町田 充 堀野 忠夫 青木 学一 尾鳥 勝也

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.142, no.8, pp.893-900, 2022-08-01 (Released:2022-08-01)

参考文献数

12

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“Leukerin® powder 10%” containing mercaptopurine (6-MP) is an oral anticancer drug that requires careful handling. As a powder formulation, there are risks of exposure due to scattering during dispensing and possible 6-MP contamination to other drugs due to adhesion to the packaging machine. We previously reported that wiping with an alcohol-containing towel is useful for removing scattered powder after dispensing. However, it is recommended to wipe disk-type powder-packaging machines with water instead of cleaning with the alcohol-containing towel. Hence, we scattered 6-MP powder 100 mg (total amount of 6-MP: 10 mg), and then wiped with water three times using different types of cloth each time. We confirmed that third time wiping cloth did not have any 6-MP. Furthermore, we confirmed that the adhering 6-MP could be removed by wipe-cleaning (water-wiping twice and dry-wiping once) after dispensing 6-MP powder at two pharmacies that routinely dispensed 6-MP powder using a disk-type powder-packaging machine. In addition, we confirmed the adhesion of 6-MP in parts of the machine not cleaned by wipe-cleaning and also in parts that were washed only with water, in both the pharmacies. Based on the above observations, we recommend the following steps for cleaning disk-type powder-packaging machines after dispensing 6-MP powder: (1) wipe-cleaning that includes water-wiping twice and then dry-wiping once, (2) cleaning all areas of the packaging machine, and (3) wipe-cleaning with water before washing with water.

著者

青木 学一 小田 さつき 久保田 聡 齋藤 栄 横田 訓男 柴﨑 淳 渋谷 清 酒向 孫市 尾鳥 勝也

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.141, no.1, pp.125-133, 2021-01-01 (Released:2021-01-01)

参考文献数

15

被引用文献数

1

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The immunosuppressant azathioprine (AZA) is classified as a hazardous drug. AZA contamination during tablet-splitting increases exposure risk. However, there is no study on contamination and exposure during AZA tablet splitting and dispensing. AZA tablet splitting and dispensing methods were classified based on whether tweezers are used during splitting and packaging. In Dispensing Method (1), no tweezers were used in either step. In Dispensing Method (2), no tweezers were used during tablet splitting, but were used during packaging. In Dispensing Method (3), tweezers were used in both steps. After AZA half-tablet split-dispensing, we quantified the adherent AZA removed from the tools, packaging machines, and dispensing counters by three consecutive wipings with water-dampened polypropylene cloths. A large amount of AZA adhered to the gloves used in Dispensing Methods (1) and (2), wherein tablets were placed with gloved hands, compared with Dispensing Method (3), wherein tablets were held with tweezers. Thus, the gloves must be replaced before touching the packaging paper during the final step. After three consecutive wipings, AZA was not detected at most of the sites in the third round. Thus, we recommend that (1) AZA tablet splitting should be performed while wearing gloves, (2) the gloves should be changed before packaging the half tablets, and (3) the tools, packaging machines, and dispensing counters should be wiped twice or thrice with a water-dampened cloth after dispensing.

著者

小川 晃弘 岡野 光博 土井 彰 前田 幸英 西崎 和則 久保田 聡 古川 仭

出版者

Japan Rhinologic Society

雑誌

日本鼻科学会会誌 (ISSN:09109153)

巻号頁・発行日

vol.42, no.1, pp.23-27, 2003-04-01 (Released:2010-03-11)

参考文献数

11

被引用文献数

1 1

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Changes in the sense of smell may be quantitative and qualitative, or possibly even a combination. Quantitative changes may manifest themselves partly as hyperosmia and partly as hyposmia, although hyposmia is much more common. Qualitative changes are segignated a parosmia. Disosmia is a condition in which stimulation of the sense of smell does not result in an adequate olfactory impression, but rather in a distorted sensation, usually unpleasant. The precise mechanism and etiology of parosmia remain to be classified.Recent molecular biological advances enable us to a more accurately assess the prognosis for parosmia or suggest more successful treatment. We present an overview of modern classification or definition of parosmia and related clinical issues requiring greater discussion. We collected 94 parosmic patients from 9 dysosmia clinics and discussed them in this reports.Women over 40 years old are most susceptible to parosmia. Upper respiratory viral disease including common cold, head trauma and also zinc deficiency, are conditions that put patients at high risk for parosmia. About 6% of all patients seen at dysosmia clinics have parosmia. We classified parosmia patients by sites, etiology, and severity.Sites are usually the site of responsible for hyposmia or anosmia. Parosmia patients were divided into organic and functional. The organic type was divided into peripheral, central and mixed peripheral and central. The functional type includes the psychological disorder such as illusions of smell, olfactory hallucination, and the uncinates fits. Etiology was classified as sinonasal disease, upper respiratory disease, head injury, other or miscellaneous. Other categories includes zinc-deficient and drug-inducced. We classified severity as slight, moderate, or severe. Twelve factors, including gender, age, and duration, affect the prognosis of parosmia. We summed up the score for these factors and judged severity. For sever parosmic patients, medical treatment such as medication, local treatment, or surgery must be considered. Major tranquiraizer and surgery should be selected for patients with severe or intractable parosmia.

著者

久保田 聡 白崎 浩隆 西潟 央 藤田 祐之

出版者

東海北陸理学療法学術大会

雑誌

東海北陸理学療法学術大会誌 第28回東海北陸理学療法学術大会

巻号頁・発行日

pp.127, 2012 (Released:2013-01-10)

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【目的】 大腿骨頚部・転子部骨折は早期離床を目的に骨接合術など観血的治療が行われている。しかし全身合併症を有し手術困難と判断される場合や、高齢・認知症を理由に家族が手術を希望しない例も少なくない。保存療法は観血的治療に比べ、痛みの緩和に時間がかかりベッド上で安静になる期間が長く、筋力低下や認知機能低下などの二次的合併症を引き起こすリスクがある。今回当院における大腿骨頚部・転子部骨折保存療法例について調査を行い、現状および今後の課題を検討した。【方法】 2010年11月より2012年4月の間に当院に入院した大腿骨頚部・転子部骨折患者29例中、保存療法13例を対象とした。男性1例、女性12例で受傷時平均年齢は90.8歳であった。骨折型は頚部骨折4例、転子部骨折7例であった。また13例のうち他院からの転院が10例であった。保存療法を選択した理由、入院時の痛みの程度、安静臥床期間、リハビリ治療方法とその開始時期、入院期間、退院時の移動などの日常生活動作を後方視的に調査した。本研究は、当院倫理委員会の承認のもと個人情報の保護に配慮し調査を行なった。【結果】 退院時の生存例は12例、死亡例は1例であった。保存療法を選択した理由は家族の意向が最も多かった。当院入院からリハビリ開始までの期間は平均5.1日、車椅子座位までの期間は平均7.0日、入院期間は平均52.9日であった。退院時移動能力は独歩2例、車椅子自立3例、車椅子介助7例となった。退院先は在宅が2例、介護老人保健施設8例、他病院1例、グループホーム1例であった。また入院中に2例が肺炎を合併した。【考察】 大腿骨頚部・転子部骨折後は受傷が引き金となり全身状態の悪化や心不全や肺炎などの合併症のリスクが高くなることが諸家により報告されている。当院では13例中2例が肺炎を合併した。保存療法では疼痛や骨折部管理をしながら、できるだけ早期離床をすすめ二次的合併を予防することが必要となる。安静臥床から車椅子への離床移行までの期間が平均7.0日間であったが、内科的合併症や強い痛みがあったなどの背景があった。実用歩行獲得は13例中2例で、保存療法患者のほとんどが車椅子レベルとなった。そのうち車椅子介助が7例と多く、認知機能低下の影響が考えられた。また車椅子への離床が遅くなった例では、痛みが原因の一つとして挙げられた。高齢者の場合、認知機能・早期離床の観点から医師と連携し痛みのコントロールが重要である。さらに移動能力の予後を早期に予測し、次の生活の場での移動手段の獲得を考慮したアプローチも必要であると考える。【まとめ】 今回当院に入院した大腿骨頚部・転子部骨折保存療法例を後方視的に調査した。安静臥床から車椅子乗車への離床移行までの期間が約1週間だった。また退院時の実用歩行獲得例は少なく、ほとんどが車椅子レベルとなった。今後は早期離床、移動手段の獲得に向けて検討することが課題として挙げられた。