著者

吉田 和幸 神田 麻香 林 紘司 大谷 喜一 井関 健 Ain Pharmaciez Inc.

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.10, pp.642-648, 2012-10-10 (Released:2013-10-10)

参考文献数

10

被引用文献数

2 3

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Most dispensing errors are derived from human error and personality is considered one of the internal factors of such error. This study aimed to reveal the relation between error frequency and personality traits. A questionnaire survey was performed for pharmacists belonging to Ain Pharmaciez in Hokkaido from May to June in 2011. The questionnaire consisted of 20 items which were mainly supposed to reflect the 7 hypothetical personality traits based on previous studies and reports of the Pharmacy Risk Error Management System (PREM-S). The answers were analyzed using Spearman's rank correlation, Mann-Whitney's U-test, factor analysis and structural equation modeling (SEM). We obtained 156 answers. As a result of factor analyses, four factors such as “timidity”, “lack of self-control”, “lack of safety awareness”, and “distraction” were extracted from 12 items relating to personality traits. The analysis of SEM showed that “distraction” caused error frequency was affected by other factors, particularly by “timidity” whose total effect on “distraction” was 0.61. In addition to this, it was affected by external factors of patients and colleagues. The coefficient of determination (R2) of error frequency was 0.25. These results show that personality traits contribute to error frequency at a rate of 25% and it is necessary to improve external factors for the prevention of errors.

著者

齋藤 佳敬 山田 武宏 小林 正紀 榊原 純 品川 尚文 木下 一郎 秋田 弘俊 井関 健

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.139, no.12, pp.1601-1608, 2019-12-01 (Released:2019-12-01)

参考文献数

20

被引用文献数

1

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Paclitaxel (PTX)-associated acute pain syndrome (P-APS) is characterized by disabling but transient arthralgia and myalgia in up to 80% of patients administered with PTX. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely administered to patients with cancer who have pain or fever, and are mainly used to manage P-APS. In this study, we investigated how P-APS appear in the patients who were administered NSAIDs prior to PTX injection. The incidence or severity and duration of P-APS in patients previously administered NSAIDs were compared to those of patients who were not administered NSAIDs. The relationship between previously administered NSAIDs and rescue administration for the relief of P-APS was also evaluated. It was revealed that the incidence and duration of P-APS were 72% and 4.67±2.30 d, respectively, in the control group and 84% and 6.19±3.30 d, respectively, in the NSAIDs group. There was no significant difference in the incidence and duration and the severity of P-APS between the two groups. Patients who were previously administered NSAIDs tended to obtain less pain relief from NSAIDs administered as rescue medications, and needed other medication. Univariate and multivariate analysis revealed no correlation between previously administered NSAIDs or patient characteristics and the incidence of P-APS. In this study, it was found that clinical condition that needs NSAIDs and previously administered NSAIDs prior to PTX injection do not affect the incidence, severity, and duration of P-APS. These results will help in educating patients about their medications and will contribute to the management of P-APS.

著者

山田 武宏 鏡 圭介 今井 俊吾 秋沢 宏次 岩崎 澄央 福元 達也 石黒 信久 井関 健

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.137, no.7, pp.917-925, 2017 (Released:2017-07-01)

参考文献数

16

被引用文献数

3

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Bacteremia is one of the most serious infectious illness resulting from nosocomial infection. Therefore, appropriate antimicrobial chemotherapy should be provided as soon as possible to patients exhibiting symptoms of infectious disease and having positive blood culture results. Antimicrobial stewardship (AS) guidelines were recently released by the Infectious Diseases Society of America. The guidelines recommend “proactive intervention and feedback” as one of the core strategies for implementing optimal antimicrobial drug use to improve patient outcomes in clinical settings. We began using the AS program for optimizing antimicrobial chemotherapy in patients with positive blood culture results. The results of blood cultures and antimicrobial prescriptions for the corresponding patients were daily reviewed by a pharmacist and a physician, members of the infection control team (ICT). If the antimicrobial agents selected were inappropriate, ICT made a recommendation to the attending physicians who prescribed the antibiotics. To evaluate the outcomes of this program, we conducted a single-center, retrospective investigation for near a hundred of patients who underwent intervention by infection-control physician and pharmacist. Resolution of bacteremia (determined by blood culture results) was 96.3% in the group that accepted intervention, whereas only 16.7% of the cases resolved in the group that did not accept intervention. These results strongly suggest the importance of the infection disease-specialist team intervention. This program could become an important method for improving clinical outcomes in patients with bacteremia.

著者

野田 敏宏 新敷 祐士 安西 恵子 川崎 啓子 栗原 智仁 高市 和之 髙野 紀子 中村 峰夫 西野 健三 山田 和也 平井 みどり 田崎 嘉一 松原 和夫 吉山 友二 井関 健

出版者

一般社団法人 日本プライマリ・ケア連合学会

雑誌

日本プライマリ・ケア連合学会誌 (ISSN:21852928)

巻号頁・発行日

vol.36, no.2, pp.93-98, 2013 (Released:2013-07-01)

参考文献数

13

被引用文献数

2 4

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要 旨目的 : 本研究ではサプリメント類の利用に関して来局患者および薬剤師両者の意識および実態を明らかにすることにより, サプリメント類利用における薬剤師の関わり方を検討した. 方法 : 東京都・北海道内の14保険薬局にて来局患者1,253人を対象に, サプリメント類に関するアンケート調査を来局時に実施した. また, 薬剤師289人に対してサプリメント類に関する意識および情報収集の実態について, 保険薬局および北海道薬学大会 (2011年・札幌) においてアンケート調査を実施した. 結果 : 来局患者からの回答数1,253人のうち, 約50%は薬剤師にサプリメント類の安全性や効果についての情報提供を望んでいるものの, 実際には薬剤師が来局患者の疑問に答えている例は7.3%にしかすぎないことが明らかとなった.  一方で, 回答を得られた薬剤師289人のうち67.5%の薬剤師は自身がサプリメント類の情報提供者として来局患者に期待されていると認識しているものの, サプリメント類の情報収集に積極的に取り組んでいる薬剤師は約30%であり, さらにその情報内容もインターネット上の情報に頼っていることが示された. 結論 : サプリメント類の説明に対する患者の期待と薬剤師による説明の実態には, 大きな隔たりがあることが分かった. 来局患者の期待に応えるためにも, 薬剤師はサプリメント類に対し科学的根拠に基づく理解を深め, 医薬品との関連を含めた統合管理の必要性が求められる.

著者

今井 俊吾 山田 武宏 西村 あや子 沖 洋充 熊井 正貴 宮本 剛典 笠師 久美子 井関 健

出版者

Japanese Society of Drug Informatics

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.16, no.4, pp.169-178, 2015 (Released:2015-03-10)

参考文献数

13

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Objective: To attain optimal blood concentration rapidly, it is needed to perform initial dose setting appropriately when vancomycin (VCM) used.  In order to design initial dose settings of VCM more currently, we compared the predictive performance of two types of VCM therapeutic drug monitoring (TDM) analysis software retrospectively.Method: We utilized two TDM analysis software, SHIONOGI-VCM-TDM ver.2009 (VCM-TDM) and “Vancomycin MEEK TDM analysis software Ver. 2.0” (MEEK), based on patient’s background. 112 patients who received VCM and performed TDM were analyzed during the period from October 2011 through September 2012 and compared the actual trough level with the predictive trough level.  The predictive performance was evaluated by calculating ME (mean prediction error), MAE (mean absolute prediction error), and RMSE (root mean squared error).  Age, gender, and a renal function were evaluated as patient’s background.Results: VCM-TDM gave good predictive performance for patients overall.  When classified patient’s background complexly (sex, age, and renal function), as for male patients, VCM-TDM showed good predictive performance except for the group over 65 years old and CCr over 85 mL/min.  For female patients, the difference of predictive performance was not accepted by all groups.Conclusion: These results suggest, for male patients, we should use VCM-TDM for initial dose settings except for the group over 65 years old and over CCr 85 mL/min.  For the other patients, we consider that both of software can be used.  These new findings seem to contribute to proper dosage settings of VCM.

著者

小林 洋平 山岡 怜央 三上 龍生 山崎 浩二郎 熊井 正貴 山田 武宏 武隈 洋 菅原 満 井関 健

出版者

一般社団法人 日本臨床救急医学会

雑誌

日本臨床救急医学会雑誌 (ISSN:13450581)

巻号頁・発行日

vol.23, no.6, pp.771-779, 2020-12-28 (Released:2020-12-28)

参考文献数

14

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目的:救急/ 集中治療室(以下,ICU)における薬剤師介入の実態や医療経済効果を明らかにすることを目的とした。方法:2017年7,8月に,救急科に入院した患者を対象とし,疑義照会記録を用いて後方視的に調査した。薬学的知識を要しない介入を単純エラー,薬学的知識を要する介入を薬学的介入と定義し,介入の内容および処方反映率を調査した。また,能動的な薬学的介入(薬剤師からの提案)に関して医療経済効果を算出した。結果:介入は391件あり,そのうち76%(297件)が薬学的介入であった。薬学的介入では,抗微生物薬関係の介入がもっとも多く117件(反映率91%)であった。また,医療経済効果は,2カ月間で3,832,000 円であった。結論:薬剤師の救急/ICUへの参画は,医療経済的に有益であることが明らかとなった。また抗微生物薬関係の介入が多く,今後プロトコル作成などにより適正使用推進に寄与できると示唆された。

著者

山神 彰 山田 武宏 北川 善政 大廣 洋一 佐藤 淳 石黒 信久 今井 俊吾 小林 正紀 井関 健

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.45, no.5, pp.254-261, 2019-05-10 (Released:2020-05-10)

参考文献数

20

被引用文献数

2 4

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Third-generation oral cephalosporins are broad-spectrum antimicrobial agents and constitute one of the most used antibiotic classes in Japan. In the “National Action Plan on Antimicrobial Resistance (AMR),” the Japanese government declared implementation of efforts to reduce the use of oral cephalosporins by 50% by 2020, compared to 2013. Antimicrobial resistance generally occurs due to inappropriate use or low-dosage exposure to antibiotic agents. Therefore, the choice of appropriate antibiotics is essential for implementing antimicrobial stewardship. To evaluate the prophylactic effects of antibiotics in impacted mandibular third molar surgery, we compared the rate of surgical site infection (SSI) in patients who were administered cefcapene-pivoxil (CFPN-PI) orally with that in patients who received amoxicillin (AMPC) orally. We conducted a retrospective study by reviewing the medical charts of patients from Hokkaido University Hospital from April 2016 to March 2017. The patients evaluated were classified into two groups: the AMPC group (n = 164) and the CFPN-PI group (n = 129). The SSI ratio of the CFPN-PI group was significantly higher than that of the AMPC group (CFPN-PI group, 11.6% (15/129); AMPC group, 2.4% (4/164); P = 0.002). Multivariate logistic regression analysis demonstrated that “use of CFPN-PI for prophylactic treatment” and “hospitalization after surgery” were independent factors related to the onset of SSI following impacted mandibular third molar surgery. These results demonstrated that AMPC was more effective than CFPN-PI in the prevention of SSI after impacted mandibular third molar surgery, and its regulated dosage can effectively contribute to the optimal use of antimicrobial prophylactic treatment.

著者

牧野 利明 中村 峰夫 野田 敏宏 高市 和之 井関 健

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.31, no.7, pp.505-510, 2005-07-10 (Released:2011-03-04)

参考文献数

3

被引用文献数

3 2

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Dietary supplements are gaining wide popularity in Japan and are used by a large number of patients as self-medication. Though dietary supplements cannot be considered as drugs, patients expect pharmacological benefits from them since they usually have very little knowledge of their effects. Thus, pharmacists have the responsibility to expand their knowledge of dietary supplements so that they can give better advice to patients who are using them. However, only a limited amount of information on dietary supplements is available to pharmacists.In the present study, we evaluated the content and solubility of coenzyme Q10 (ubidecarenone, CoQ10) in dietary supplements. CoQ10 is not only used as a dietary supplement, it is also prescribed as a drug by physicians. CoQ10 preparations were ground up and various techniques were used to extract the active ingredient, among them extraction using solvents, ultrasonication and heat. We found that the prescription drug preparations containing CoQ10, both original and generic products, had exactly the same content as stated on the label and had good solubility. Though dietary supplements containing CoQ10 also had the exact content stated on their labels, they showed poor solubility. Such poor solubility would give rise to major differences in elution and bioavailability between dietary supplements and prescription drugs containing CoQ10.

著者

井関 健太 矢口 勇一 岡 隆一

出版者

一般社団法人電子情報通信学会

雑誌

電子情報通信学会技術研究報告. MVE, マルチメディア・仮想環境基礎 (ISSN:09135685)

巻号頁・発行日

vol.108, no.328, pp.101-108, 2008-11-20

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本報告は,任意の対画像のピクセル最適対応を与える2次元連続DPを用い,少ない枚数の画像で精度のよい3次元形状が復元できることを示す.従来法が対象物体から連続的に観測した面像列における特徴点の対応系列を利用するのに対して,提案手法は画像集合の1枚の画像と任意の他の画像とのすべてのピクセル対応を利用する.ピクセル対応点が稠密に利用できるため,因子分解法によって3次元形状を復元する際,少数枚の画像から精密な形状復元ができる.ピクセル対応関係からメッシュ構造が得られる事を利用し,ドロネー三角網を定義する事なく密なテクスチャマッピングを施すことができる.これらのことを実験で示すとともに,従来法の典型であるKLT,SIFT+因子分解法を同一画像集合に適用し,比較実験も行った.これらの実験で提案手法が従来法より精密な3次元形状復元を行うことが分かった.

著者

長田 貴之 柴山 良彦 熊井 正貴 山田 武宏 笠師 久美子 倉本 倫之介 洲崎 真吾 赤澤 茂 真栄田 浩行 坂下 智博 折舘 伸彦 本間 明宏 福田 諭 菅原 満 井関 健

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.1, pp.51-55, 2012-01-10 (Released:2013-01-10)

参考文献数

14

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Intractable nausea and vertigo induced by opioid treatment are occasionally difficult to treat. It has been reported that antiemetic drugs and opioid rotation may be effective in treating nausea in such cases; however, this approach has been occasionally ineffective. Symptomatic treatment has not been developed for vertigo induced by opioid treatment. Here, we report a case study where combined treatment with perospirone and a histamine H1 receptor antagonist was used in 2 patients who developed intractable nausea and vertigo induced by opioid treatment. Treatment with a histamine H1 receptor antagonist drug (tablet form, containing 40 mg diphenhydramine salicylate and 26 mg diprophylline) suppressed the nausea and vertigo. However, increasing the opioid dosage exacerbated the symptoms, and treatment involving the histamine H1 receptor antagonist and opioid rotation was ineffective. Subsequently, combination treatment with the histamine H1 receptor antagonist (3 tablets per day) and perospirone (maximum daily dose, 16 mg) improved the symptoms. The results of the present study suggest that combination treatment with a histamine H1 receptor antagonist and perospirone might improve intractable nausea and vertigo induced by opioid treatment.

著者

堤 竹蔵 今井 俊吾 山田 勝久 山田 武宏 笠師 久美子 小林 正紀 井関 健

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.139, no.7, pp.1055-1061, 2019-07-01 (Released:2019-07-01)

参考文献数

20

被引用文献数

2

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Linezolid (LZD), an antimicrobial agent against methicillin-resistant Staphylococcus aureus, demonstrates good bone and joint penetration, and is used for prosthetic bone and joint infections. Recently, we observed vomiting in several patients administered LZD. However, there are few reports on the incidence rate of, and risk factors for, LZD-induced nausea and vomiting. In this study, we aimed to verify the relationship between LZD administration and vomiting. Patients administered LZD at the Department of Orthopedic Surgery of Hokkaido University Hospital between November 2008 and December 2017 were enrolled in the study. The primary endpoint was the comparison of the vomiting rate between patients administered LZD (LZD group) and those administered other antibiotics (non-LZD group). For the secondary endpoint, to verify the risk factors of vomiting, a univariate logistic regression analysis was performed. In total, 130 patients were included in this study; 77 patients in the LZD group, and 53 in the non-LZD group. Vomiting occurred in 18 patients in the LZD group and 4 patients in the non-LZD group (23.4% and 7.5%, respectively); this was significantly higher in the LZD group. In the univariate logistic regression analysis, LZD administration, gender (female), age ≥65 years, renal impairment (creatinine clearance <60 mL/min) and concomitant use of rifampicin were extracted as potential risk factors of vomiting. The results of this study reveal a possible relationship between LZD administration and vomiting.

著者

井藤 達也 高岡 和夫 竹本 功 秦 温信 井上 勝一 佐々木 健太郎 平野 剛 井関 健 菅原 満 宮崎 勝巳

出版者

The Japanese Society of Clinical Pharmacology and Therapeutics

雑誌

臨床薬理 (ISSN:03881601)

巻号頁・発行日

vol.33, no.2, pp.47-52, 2002-03-31 (Released:2010-06-28)

参考文献数

13

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The purpose of this study was to evaluate the distribution of CPT-11 and its active metabolite, SN-38, in pleural and pericardial fluid after intravenous administration.Two patients with lung cancer were treated with intravenous CPT-11 (60 mg/m2) on days 1, 8, and 15. The CPT-11 was detected in the pleural fluid 1.5 hr after the begining of intravenous infusion, and the level reached the maximum 24 hrs later. Similarly, the active metabolite SN-38 was detected in the pleural fluid 1.5 hr after the begining of intravenous infusion, and SN-38 concentration in the pleural fluid was almost as high as that in plasma 24 hrs later. These results suggest that intravenously administered CPT-11 may penetrate the thoracic cavity and may be metabolized to SN-38 there. The proportions of maximum concentrations of CPT-11 and SN-38 in the pleural fluid to the corresponding plasma levels were 20.4% and 28.5%, respectively. In addition, the AUCs of the lactone form SN-38 were much lower than those of the carboxyl form in the pleural fluid.CPT-11, SN-38 and SN-38 glucronide showed similar pharmacokinetics in the pericardium as that in plasma.

著者

矢野 育子 井関 健 東海林 徹 青山 隆夫 木津 純子 中村 均 藤井 俊志 渡邊 美智留 野田 幸裕 脇屋 義文 森田 邦彦 手嶋 大輔 二神 幸次郎

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.35, no.1, pp.43-49, 2009 (Released:2010-02-07)

参考文献数

8

被引用文献数

1 1

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With the introduction of 6-year pharmacy educational program in 2006,a provision was made to assign pharmacist faculties having working experience as pharmacists in pharmacy schools.In October 2007,we conducted a survey to investigate the situation of pharmacist faculties.We sent a questionnaire to 247 pharmacist faculties in 66 pharmacy schools and the response rate was 84.9%.The faculties consisted of professors (43%),associate professors (23%) and lecturers (23%),and 77% of them had a Ph.D.degree.In a typical week,the major activities they engaged in were educational activities (20.6 hrs),research (12.2 hrs) and management (9.6 hrs).While the average time they were occupied by clinical practice was 3.5 hrs,67% of them did not do any.Half of the faculties did not conduct any research with students or graduate students in their own schools,and in 2007 only 55% applied for Grant-in-aid for Scientific Research from the Ministry of Education,Culture,Sports,Science and Technology of Japan.Twenty-six percent said they were very satisfied or satisfied with their work on a five-point scale,and 44% rated their degree of satisfaction as fair.In conclusion,our survey showed that most pharmacy faculties are not sufficiently engaged in clinical practice and do not spend much time in clinical research.We hope that its results will promote discussions among pharmacy personnel concerning the role of pharmacist faculties so that even better clinical pharmacy education may be provided to students in pharmacy schools.

著者

金内 美妃 郡 修徳 千本木 要 坂井 英夫 井関 健

出版者

公益社団法人日本薬学会

雑誌

藥學雜誌 (ISSN:00316903)

巻号頁・発行日

vol.125, no.2, pp.187-196, 2005-02-01

被引用文献数

3 6

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ケタミンは, 解離性麻酔作用を有する全身性麻酔薬であり, 呼吸抑制などの副作用が少ないことから手術時に繁用されている. 一方, このケタミンは麻酔量より低用量を投与すると, 神経因性疼痛に関与しているといわれるNMDA受容体の非競合的拮抗薬として作用することから, 鎮痛効果も併せ持つ薬剤である.そのため, 非ステロイド性抗炎症薬などに抵抗する難治性疼痛を持つ患者に対し, ケタミンは保険適応外使用ではあるが, 鎮痛薬として静注や筋注以外に経口投与でも用いられている.しかし日本においてケタミンの市販薬は注射液のみであるため, 患者がケタミンによる在宅治療を行う場合, 注射液を経口投与しなければならないが, この注射液は特有の苦味や刺激感を有するため, 患者が服用を拒否する場合もある. そこで臨床現場では, 注射液に単シロップや矯味剤などを添加した液剤やケタミン試薬から調製した錠剤を院内製剤として患者に投与している.

著者

高橋 夏子 小林 正紀 板垣 史郎 平野 剛 武隈 洋 菅原 満 井関 健

出版者

日本薬学会

雑誌

Yakugaku Zasshi (ISSN:00316903)

巻号頁・発行日

vol.132, no.6, pp.777-783, 2012-06-01

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The most effective drugs based on the type of cancer are chosen for chemotherapy. Tumor cells can be targeted at the DNA, RNA or protein level, and most of the classical anticancer drugs interact with tumor DNA in a time-dependent manner or a concentration-dependent manner. However, it has been unclear to date whether a combination therapy is carried out by using exact classification. Thus it is necessary to reclassify a great number of anticancer drugs. We propose a new classification system based on pharmacological effects of anticancer drugs. Classification of four anticancer drugs (cisplatin, carboplatin, paclitaxel and gemcitabine) was performed by the 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The four anticancer drugs were grouped by IC50 values (inhibitory concentration, 50%) in a time-dependent manner and a concentration-dependent manner. The present approach may be combined to enhance the chemosensitivity, improve the dose of cytotoxic drugs and evaluate the effects of novel anticancer drugs.

著者

井関 健太 矢口 勇一 大田 和寛 千葉 将人 岡 隆一

出版者

一般社団法人電子情報通信学会

雑誌

電子情報通信学会技術研究報告. PRMU, パターン認識・メディア理解 (ISSN:09135685)

巻号頁・発行日

vol.108, no.363, pp.105-110, 2008-12-11

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2次元連続DPアルゴリズムと因子分解法に基づく画像からの3次元形状を効率的に復元するシステムを実現した.2次元連続DPでは画像間の全ピクセルに対する非線形対応のマッチングが可能である.そのため,因子分解法において使用される計測行列を,画像集合の1枚と任意の他の画像とのすべてのピクセル対応から生成する事で,特別な計測機器やカメラパラメータを必要とせず,少数枚数の画像のみから3次元モデルを生成する事が可能である.一方,2DCDPによる計算コストがO(N^4)となり,計算速度とメモリサイズに関する問題がある.本報告ではこれらの問題に対処するために,2DCDP計算の並列化に基づく計算機環境を構築した.また,野外の大きな建築物である城郭を対象にし,効率的に形状復元を行うシステム実装した.大規模画像への3次元形状復元には,部分3次元形状のモザイキングにより実現する.今回構築したシステムが良好に動作する事を実験により示した.