著者
田坂 健 東恩納 司 三上 奈緒子 日野 隼人 大川 恭昌 武本 あかね 河崎 陽一 村川 公央 北村 佳久 千堂 年昭
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.20, no.5, pp.638-643, 2017-10-31 (Released:2017-10-31)
参考文献数
14

目的:薬剤師が集中治療室に常駐し,積極的に塩酸バンコマイシン(以下,VCM)の治療薬物モニタリング(以下,TDM)介入を行うことによる効果を明らかにする。方法:薬剤師が常駐する前後で2群に分け,レトロスペクティブに調査を行った。結果:薬剤師の常駐によりVCM血中濃度測定実施率は86.2%から96.5%,シミュレーション解析実施率は24.1%から95.4%へ有意な増加を認めた。血中濃度分布は,トラフ値10μg/mL 未満の割合が24.1%から15.1%へ有意に減少した。一方でトラフ値20 〜25μg/mLの割合が3.7%から15.7%へ有意に増加していた。また,腎障害の発生率は6.5%から2.1%へ減少傾向を示した。結論:ICUにおいて専任薬剤師がVCMのTDM介入を行うことで,TDM実施率の向上とトラフ値が適正化され,VCM適正使用に貢献できることが示唆された。
著者
江角 悟 佐藤 智昭 黒田 智 河崎 陽一 名倉 弘哲 北村 佳久 千堂 年昭
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.18, no.2, pp.72-80, 2016 (Released:2016-09-27)
参考文献数
15

Objective: In drug treatment for pregnant and lactating women, pharmacists need to contribute to adequate drug treatment by collecting much information from various sources.  However, it takes much time to collect information using plural sources.  In this study, we tried to develop a database system which enables expeditiously collecting the domestic and foreign drug use criteria information in order to streamline collecting information for pregnant and lactating women.  In addition, we assessed the utility of the database by comparing the time to collect information using the database to that using each information source and the usability by questionnaires.Methods: We developed a database system that integrates drug information from the FDA Pregnancy Category, Australian categories for prescribing medicines in pregnancy, “Drugs in Pregnancy & Lactation,” and Japanese package inserts.  For assessment of the usability of the database, we assessed the time required to collect information and subjective evaluation using the five-method questionnaires.Results: The database significantly reduced the time needed for collecting criteria information and made it possible to compile the information simultaneously from various sources.  The questionnaire survey showed that over 80% of pharmacists and students were satisfied with the database.Conclusion: It is suggested that our database system is useful to efficiently collect drug use criteria information for pregnant and lactating women.
著者
座間味 義人 相良 英憲 萱野 由佳 小山 敏広 白石 奈緒子 江角 悟 鵣川 豊世武 千堂 年昭 氏家 良人 名倉 弘哲
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.19, no.3, pp.461-465, 2016-06-30 (Released:2016-06-30)
参考文献数
9

エダラボンを用いた治療は患者の神経学的予後を改善する一方,急性腎障害発現のリスクがあると報告されている。本研究はエダラボン投与による急性腎障害発現を予防するために,エダラボン投与時の患者背景から危険因子を解析することを目的とした。岡山大学病院においてエダラボンが投与された患者を対象に,患者基本情報およびエダラボン投与情報,血液検査結果を電子カルテより遡及的に調査した。調査データから単変量解析を実施し,抽出した因子を用いて二項ロジスティック回帰分析を行った結果,感染症の併発が,エダラボンによる急性腎障害発現の有意な危険因子(予測因子)であることが示唆された。したがって,感染症の所見がある患者にエダラボンを投与する際は,急性腎障害発現に留意する必要がある。
著者
江角 悟 河崎 陽一 猪田 宏美 北村 佳久 千堂 年昭
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.138, no.5, pp.649-653, 2018-05-01 (Released:2018-05-01)
参考文献数
5

Pharmacists are required to contribute to evidence-based medicine (EBM) by providing drug information, which can be collected from various sources such as books, websites, and original articles. In particular, information from original articles is needed in some situations. For example, original articles by international researchers are used to aid the management of novel in-hospital preparations on which little knowledge is available. We introduced an information evaluation program, the Okayama University Hospital EBM Model, into the clinical training of 5th-year pharmacy students. It aims to enable students to evaluate the validity of novel in-hospital preparations using original articles. This program has improved students' knowledge of EBM, and the satisfaction level of those enrolled was high. In addition, customer satisfaction analysis revealed that the overall degree of student satisfaction was related to their understanding of the necessity for EBM and the difficulty of practical training. In addition, students' achievements were evaluated using rubrics, and that method allowed the achievements of each student to be assessed appropriately. We hope to revise this program with the aim of improving students' understanding of EBM.
著者
岩澤 真紀子 上田 彩 錦織 淳美 上塚 朋子 中川 直人 島田 美樹 千堂 年昭
出版者
日本社会薬学会
雑誌
社会薬学 (ISSN:09110585)
巻号頁・発行日
vol.37, no.2, pp.109-116, 2018-12-10 (Released:2019-01-19)
参考文献数
17

The demand for pharmacy services has increased recently, and the skills required for pharmacists have also advanced. Therefore, it is important to implement a working system in which experienced pharmacists can continue working full-time when they require child care or nursing care. In September 2016, we conducted a survey of hospital pharmacists on their work-life balance at a symposium of the 26th annual meeting of the Japanese Society of Pharmaceutical Health Care and Sciences. The purpose of this survey was to examine the current trends and issues of hospital pharmacists’ experience of work-life balance in Japan. A total of 84 responses were included for analysis. Overall, 68.4% of pharmacists reported that they were not satisfied with their work-life balance, and 65.8% reported that they were not satisfied with their working environment. In addition, 90.4% of hospital pharmacists reported they worked overtime, and 76.3% reported that their workload level at their place of practice was high; therefore, they could not complete their duties within regular work hours. Seventy four percent of hospital pharmacists answered that they will not able to continue working if they encounter life events such as childbirth and caring for children or parents. These results show that a majority of hospital pharmacists was not satisfied with their work-life balance, and they were concerned about continuing their pharmacy career when they encountered certain life events. As such, it is critical that each work place implement policies on work-life balance to further help support their pharmacists.
著者
後藤 千尋 村川 公央 西原 茂樹 白石 奈緒子 北村 佳久 千堂 年昭
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.18, no.1, pp.33-37, 2016 (Released:2016-06-13)
参考文献数
6

Objective: Pharmacist interventions are effective for appropriate medical management.  The Japanese Society of Hospital Pharmacists has recommended the “pre-avoid report” to foster appropriate pharmacotherapy since 1999.  The “pre-avoid report” format consists of two forms : “serious report” and “preventive report.”  The number of “preventive reports” has comprised about 90% of “pre-avoid reports.”  However, this format of the “preventive report” since 1999 has shown inadequacy due to changes in pharmacists’ ability.  In the present study, we conducted a re-modification of the “preventive report” format using an assay to create the present “preventive report” format.Methods: We retrospectively reviewed the pharmacists’ “preventive report” of the “pre-avoid report” from January 2014 to December 2014 in the Department of Pharmacy, Okayama University Hospital.Results: The present format included 101 cases of “others” in the “preventive report” format.  This “others” section consisted of “non-intervention of pharmacotherapy” (51%), “forget to stop pre-operation drugs” (14.7%), and “inadequate treatment (wrong administration day, unnecessary treatment).  These factors were not identified with the present format of the “preventive report.”Conclusion: In the present study, we suggested that it is necessary to revise the format of the “preventive report” to reflect.
著者
座間味 義人 小山 敏広 合葉 哲也 天野 学 安藤 哲信 倉田 なおみ 名和 秀起 名倉 弘哲 北村 佳久 千堂 年昭
出版者
日本静脈経腸栄養学会
雑誌
静脈経腸栄養 (ISSN:13444980)
巻号頁・発行日
vol.29, no.4, pp.1027-1033, 2014 (Released:2014-08-20)
参考文献数
16
被引用文献数
1

【目的】従来の薬剤経管投与法である粉砕法は薬効の減少につながる薬剤量の損失が指摘されている。そこで粉砕法による薬剤量損失に対する簡易懸濁法の有用性について検討した。【方法】頻繁に粉砕指示がなされる5種類の薬剤を用いて粉砕・分包による薬物含量減少、薬剤調製時の懸濁性および実際の経管投与を想定した薬物含量について2つの方法を比較した。【結果】薬剤を粉砕・分包するとそれぞれの薬物含量は減少した。またワーファリン®錠を粉砕して水に溶解すると完全には懸濁せず、小さな塊が生じたが、簡易懸濁法では均一に懸濁した。ワーファリン®錠の経管投与を想定した実験において粉砕法では薬物含量が大幅に減少したが、簡易懸濁法では、ほとんど損失が認められなかった。【結論】簡易懸濁法は粉砕法に比べて薬剤損失の面で有用性が高いことが示唆され、ワーファリン®錠のように安定性が悪い薬剤では特に適正な薬物投与に貢献出来ると考えられる。
著者
平川 雅章 立石 真理 牧野 和隆 千堂 年昭 伊藤 善規 大石 了三
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.29, no.1, pp.20-27, 2003-02-10 (Released:2011-03-04)
参考文献数
10

Although the standards for the quality of rubber closures on injectable glass vials were specified in USP 24 in the U.S. and BP 2001 in the U.K., no such guidelines for quality control exist in Japan. In the present study, we investigated the quality of rubber closures on glass vials of frequently-used anti-biotic and anti-viral injections in our hospital, according to the quality control method of rubber closures for aqueous infusion that was standardized in JP14. Sufficiently washed rubber closures were immersed in distilled water, and test solutions were prepared after gently shaking them for 5 min or heating them at 121°C under high-pressure steam for 60 min. The optic transmittance in the resultant solutions was measured at 430nm and 650nm, and the findings were compared with those for the standard values in JP14 for rubber closures on aqueous infusions. Of 23 different rubber closures tested, only one showed a lower transmittance at 430nm when the solution was prepared by gentle shaking. Under the condition of heating with high-pressure steam, 15 products did not reach the criteria at both wavelengths, 3 did not meet the standards set at either of the wavelengths, but 5 had no qualitative problems. We also checked the materials stuffed in 0. 45μm membranes after filtration with an injection by microscopic observations using scanning electron microscopy and by an element analysis with an X-ray energy dispersive microanalyzer. A number of micro-particles were observed and they were found to be composed of silicon, aluminium and titanium.These results indicate that the quality of rubber closures of injectable glass vials varies among products. Therefore, the standards and guidelines for the quality control of rubber closures of injectable glass vials should be established in JP.
著者
松永 尚 千堂 年昭
出版者
岡山医学会
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.119, no.3, pp.319-322, 2008-01-04 (Released:2008-07-04)
参考文献数
14

1 0 0 0 OA 薬剤性肺障害

著者
伊藤 善規 千堂 年昭 大石 了三
出版者
公益社団法人 日本薬理学会
雑誌
日本薬理学雑誌 (ISSN:00155691)
巻号頁・発行日
vol.127, no.6, pp.425-432, 2006 (Released:2006-08-01)
参考文献数
62
被引用文献数
5 5

薬剤の投与により,肺間質組織へのマクロファージ,好中球,好酸球およびリンパ球などの炎症性細胞の浸潤によって炎症を呈し,肺胞壁の肥厚によって呼吸困難などの症状を呈するのが薬剤性間質性肺炎である.間質性肺炎や肺線維症,さらには肺水腫や急性呼吸不全症候群といった肺障害を引き起こす可能性がある薬剤は極めて多い.薬剤性肺障害は発症機序から肺組織に対する直接的な障害作用に基づくものとアレルギー反応に基づくものに分類されるが,多くの場合は両機序が相伴って発症すると考えられている.直接的な細胞障害作用を引き起こしやすい薬剤として,抗癌薬や抗不整脈薬(アミオダロン)があり,肺障害の発現頻度は投与量に依存する.一方,アレルギー性肺障害を引き起こしやすい薬剤としては,抗生物質,抗リウマチ薬,インターフェロン(IFN),顆粒球コロニー刺激因子製剤,小柴胡湯などが挙げられ,この場合の発現は投与量に依存しない.アレルギー性肺障害は予測が困難であり,かつ,症状の進行が早く,発症後,数日以内に呼吸不全に陥ることもある.本稿では,肺障害を起こしやすい代表的な薬剤を取り上げ,その発症機序と対策について述べる.
著者
座間味 義人 小山 敏広 今井 徹 武本 あかね 相良 英憲 千堂 年昭 名倉 弘哲
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.136, no.7, pp.987-991, 2016 (Released:2016-07-01)
参考文献数
6
被引用文献数
1

Pharmacists are expected to be active members of the healthcare team in emergency medicine, because many pharmaceuticals are administered to patients with life-threatening conditions. However, adequate education for pharmacists and pharmacy students is not provided. The “Emergency Pharmaceutical Sciences” course was introduced for the first time in Japan by the Department of Pharmacy, Okayama University, to offer advanced education in emergency medicine and research related to critical care. We offer an emergency pharmaceutical training program with high-performance simulators and have succeeded in improving the clinical skills and confidence of pharmacy students. In this review, we introduce our activities intended to mold pharmacy students into emergency pharmacists who can contribute to emergency medicine.