著者
小池 麻由 大津 史子 榊原 仁作 後藤 伸之
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.14, no.4, pp.134-143, 2013-02-28 (Released:2013-03-06)
参考文献数
20
被引用文献数
6

Objective: Recently, use of health foods and supplements, as well as the amount of information available about them, has been steadily increasing.  Therefore, a noticeable increase in adverse drug reactions caused by health foods and supplements has also been seen.  The purpose of this study was to clarify the current status and backgrounds of patients with health food- or supplement-related adverse health effects.Methods: We selected the cases of health food- or supplement-related adverse health effects from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database, which contains over 57,000 case reports of adverse drug reactions.  We investigated the background, suspected products and adverse events in each case and conducted univariate logistic regression analysis to determine significance.Results: We obtained a total of 327 cases consisting of 103 causative products.  Women comprised 66% of study subjects and had a significant association with dietary supplements.  Patients with a history of liver disease had a significant association with liver damage caused by “Ukon,” a drink made from turmeric root and sold as an anti-hangover remedy in Japan.Conclusion: The causative products had several unique features.  This information should be utilized to prevent health food- and supplement-related adverse health effects in the future.
著者
豊田 紗和子 吉村 祐奈 矢野 玲子 青柳 裕 大津 史子 後藤 伸之
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.21, no.2, pp.70-78, 2019-08-31 (Released:2019-10-10)
参考文献数
31

Objective: To clarify the background difference between drug-induced photosensitivity and ultraviolet-visible absorption spectrum or structure and to construct useful information for prevention and prediction of drug-induced photosensitivity. Methods: We investigated whether, for 457 drugs for which the ultraviolet-visible absorption spectrum is listed in the Japanese Pharmacopoeia, there were absorption maxima in the UVA (320 nm or more and less than 400 nm), UVB (280 nm or more and less than 320 nm), or UVA and UVB (280 nm or more and less than 400 nm). Structure was investigated for the existence of “conjugated”, carbonyl, sulfone, nitro and fluorine. The case drug group was taken to be those drugs for which photosensitivity was listed as a side effect on the medical drug package insert. Using statistical software, SPSS statistics ® 24 (IBM), we performed univariate logistic regression analysis, and multivariate logistic regression analysis with a stepwise increment method (likelihood ratio) combining items with p<0.2, and calculated the odds ratio (hereinafter: aOR). The significance level was taken as 0.05.Results: There were 85 drugs in the case drug group, and 372 drugs in the control drug group. As a result of multiple logistic regression analysis, in Model 1, we placed sulfone (aOR: 4.55, 95% C.I.: 2.22-9.35), fluorine (aOR: 3.66, 95% C.I.: 1.82-7.39) and nitro (aOR: 4.46, 95 % C.I.: 1.73-11.48) in this order. In Model 2, we placed sulfone (aOR: 4, 40, 95% C.I.: 2.12-9.15), fluorine (aOR: 3.81, 95% C.I.: 1.87-7.76), UVA (aOR: 2.40, 95% C.I.: 1.37-4.18) and nitro (aOR: 3.61, 95% C.I.: 1.39-9.40) in this order.Conclusion: When a drug is developed, its ultraviolet-visible absorption spectra and structure become clear, and from this information,measures can be taken which bear the potential risk of photosensitivity in mind.
著者
丹羽 浩子 田辺 公一 矢野 玲子 後藤 伸之 大津 史子
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.20, no.3, pp.145-155, 2018-11-30 (Released:2018-12-08)
参考文献数
26

Objective:In this study,we explored adverse reactions and patient background and performed a case/non-case study on a database of adverse reaction case reports in order aid the prevention of non-prescription drug abuse.Study Design:We conducted a case/non-case study on a database of adverse reaction case reports.Methods:We studied case reports of adverse reactions and addiction in Japan and extracted adverse reaction cases associated with taking antipyretic analgesics,antitussive drugs,antitussive expectorant drugs,hypnotic and sedative drugs,anti-anxiety drugs,and purgative drugs. We divided the extracted cases into an abuse case group (adverse reactions associated with non-prescription drug abuse,and divided its intended purpose or the purpose of abuse at the initial dose)and non-case group(other adverse reactions). We performed univariate logistic regression analysis on each item of investigation in the abuse case group and non-case group and calculated the odds ratio,p-value,and 95%confidence interval.Results:There were many abuse case reports of women 20-40 years old in the antipyretic analgesics abuse case group and many of them had liver/biliary lesions and chronic urological impairment. The most common reason reported for taking the initial dose of each drug was for its intended purpose.Discussion:It is important for pharmacists at community pharmacies and drugstores to be able to recognize the characteristics of patients who might be at risk of abuse and the adverse reactions and patient backgrounds elucidated in this study could be helpful in identifying them.
著者
永光 加奈 田辺 公一 後藤 伸之 大津 史子
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.44, no.7, pp.370-379, 2018-07-10 (Released:2019-07-10)
参考文献数
7

We investigated the current situation of pharmacists' recognition of and countermeasures they take against adverse drug reactions (ADRs) in order to elucidate related factors. We administered a web-based questionnaire to pharmacists who work at community pharmacies. The factors included in the questionnaire were basic information, recognition of and countermeasures against ADRs (the frequency of ADR recognition, investigation medium, the recognition of and countermeasures against ADRs and reasons for those). There were 29 questions about ADR education in total. In this study, we focused on the frequency of ADR recognition and countermeasures taken against ADRs, and examined their current status and related factors. As a result, after performing multivariable logistic regression analysis, we found that the group of pharmacists who made prescription inquiries about patients had an association with the investigation medium they used and are likely to investigate actively. Our results suggest the possibility that many pharmacists differed in their knowledge about the onset and recognition of ADRs. Moreover, our results found situations where prescription inquiries were actively made, but ADRs were not adequately reported. In conclusion, pharmacists who make prescription inquiries are likely to investigate and actively use information media, and this suggests the necessity of selecting the appropriate information medium and critically examining information. However, since those who answered our survey were biased towards the young, it is necessary to consider the possibility that this influenced the results.
著者
大津 史子
出版者
日本薬学教育学会
雑誌
薬学教育 (ISSN:24324124)
巻号頁・発行日
vol.2, pp.2018-026, 2018 (Released:2018-11-03)
参考文献数
2

ディプロマポリシーなどで求める能力が,教育課程の成果として身についているかどうかを評価し,実質的な教育改善をすることが求められている.名城大学薬学部では,FD委員会で,教学IR(Institutional Research)に取り組んでいる.まずは,授業評価アンケートや学習活動調査,学習スタイル調査などのIRの基盤となる情報を一元的に蓄積し,他の学習成果の情報等も取り込み,多面的な分析が可能とする環境の構築(IR基盤データベース)を行った.また,ディプロマポリシー及び10の資質に対する長期的ルーブリックを作成し,後期終了時に,学生に1年間の学修成果を振り返らせる取り組みを導入した.本シンポジウムでは,現在取り組んでいる教学IRの事例として,学習成果とアクティブラーニング及び,学習スタイル調査との関連,さらに,ディプロマポリシー及び10の資質に対する自己評価について,検討結果の一端を紹介する.
著者
掛谷 雅之 大津 史子 矢野 玲子 榊原 仁作 後藤 伸之
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.16, no.2, pp.70-80, 2014 (Released:2014-09-06)
参考文献数
23

Objective: The present study investigated risk factors and subjective symptoms associated with drug-induced thrombocytopenia.Methods: We selected 361 patients with drug-induced thrombocytopenia from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65,000 case reports of adverse drug reactions and assigned these patients to a case group.  We also randomly selected 794 cases of adverse drug reactions not associated with thrombocytopenia as a control group.Results: Data were compared between the case and control groups, and results were analyzed using logistic regression analysis.  We identified type of infection (non-viral) and renal failure as risk factors for drug-induced thrombocytopenia.  In addition, administration of carbamazepine, methotrexate, interferon alpha, ticlopidine or valproic acid significantly increased the risk of drug-induced thrombocytopenia.  Significant associations were also found between drug-induced thrombocytopenia and purpura, fever, and mucosal bleeding.Conclusion: These findings provide helpful information for early detection and prevention of thrombocytopenia as a serious adverse drug reaction.
著者
鈴木 亮平 大津 史子 後藤 伸之
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.135, no.7, pp.895-916, 2015 (Released:2015-07-01)
参考文献数
10
被引用文献数
1

The purpose of this study was to develop and validate estimate equations for preventing adverse drug reactions (ADRs). We conducted five case-control studies to identify individual risk factors and subjective symptoms associated with the following five ADRs: drug-induced ischemic heart disease; renal damage; muscle disorder; interstitial pneumonia; and leucopenia. We performed logistic regression analysis and obtained eight regression equations for each ADR. We converted these to ADR estimate equations for predicting the likelihood of ADRs. We randomly selected 50 cases with non-individual ADRs from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65000 case reports of ADRs, and assigned these cases to a validation case group. We then calculated the predictive probability for 50 cases using the eight estimate equations for each ADR. The highest probability for each ADR was set as the probability of each ADR. If the probability was over 50%, the case was interpreted as ADR-positive. We calculated and evaluated the sensitivity, specificity, and positive likelihood ratio of this system. Sensitivity of the estimate equations for muscle disorder and interstitial pneumonia were ≥90%. Specificity and positive likelihood ratios of estimate equations for renal damage, interstitial pneumonia and leucopenia were ≥80% and ≥5, respectively. Our estimate equations thus showed high validity, and are therefore helpful for the prevention or early detection of ADRs.
著者
森 千与 酒井 隆全 矢野 玲子 田辺 公一 後藤 伸之 大津 史子
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.4, pp.261-269, 2017-02-28 (Released:2017-03-17)
参考文献数
24

Purpose: The purpose of this study is to elucidate the characteristics of adverse events in pregnant women, the offending drugs, and patient backgrounds from reports of adverse events.  We performed a case series study.Methods: We used CARPIS, a database of adverse events and toxication reported in Japan spanning from 1987 to 2014 and created by the Drug Information Center, Meijo University.  We extracted cases of adverse events in pregnant women, their fetuses, and newborns and investigated the age, primary disease, and history of allergies of the women and the intended use of/offending drugs, therapeutic category, and names for adverse events.Result: We collected 434 cases of adverse events in pregnant women, and 251 pediatric cases with adverse events.  The most frequent offending drug in both groups was ritodrine hydrochloride.  The most frequent adverse event in pregnant women was pulmonary oedema due to the administration of ritodrine hydrochloride.  The most frequently reported adverse events in pediatric cases were transient hypothyroidism and withdrawal symptoms in newborns and birth abnormalities in fetuses and newborns, all of which were caused by drugs given for the underlying diseases of their mothers.Discussion: We elucidated serious adverse events in pregnant women caused by the administration of ritodrine hydrochloride.  Frequent factors for adverse events were the onset of physiological factors in pregnant women and complicated factors of the mechanism of action of ritodrine hydrochloride.  We need to monitor both mothers and fetuses during the drug administration.  It is suggested that adverse events in pediatric cases are associated with drugs given for underlying diseases in mothers.  Thus, it is necessary to give appropriate information and communicate the risks of taking these drugs before pregnancy.  We believe the results could be helpful in the early detection of adverse events in the future.
著者
鈴木 亮平 深津 哲 大津 史子
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.44, no.6, pp.270-279, 2018-06-10 (Released:2019-06-10)
参考文献数
8

The most frequently reported medical incidents were drug-related and made by nurses.Excessive dosing can cause adverse reactions and possibly lead to patient deaths. On the other hand, underdosing can delay treatment and prolong hospitalization. We investigated drugs associated with and factors leading to excessive dosing or underdosing incidents to clarify when pharmacists should intervene to reduce medication-related incidents. We analyzed incident reports collected by the Japan Council for Quality Health Care between January 2009 and June 2015. In total, we found 3,024 cases of excessive dosing and 2,119 cases of underdosing. In the excessive dosing group, dosing errors and the administration of an excessive dose without an order to do so comprised 785 cases and 482 cases, respectively. In the underdosing group, there were 902 cases of dosing errors and 366 cases where the dose was discontinued too early.We used logistic-regression analysis to compare cases of causative drugs and incident factors with dosing errors and other medical incidents. Our analysis revealed that there was a significant association between steroids, narcotic analgesics, antibacterial drugs and both excessive dosing and underdosing incidents. Also, there was a significant association between nurses not confirming the correct dose and misdosing incidents.It is easy for dosing errors to occur with the aforementioned drugs because the correct dosage varies with the patient's age, renal function, overall condition, and test results. These findings suggest that pharmacists in hospital wards need to check the correct dosage before administering the medication to prevent dosing errors.
著者
岩出 賢太郎 下路 静佳 正木 秀典 酒井 隆全 田辺 公一 後藤 伸之 大津 史子
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
pp.18-00205, (Released:2018-12-05)
参考文献数
19

We investigated the possibility that having pharmacists give asthma patients informational sheets on climate and environmental changes at insurance pharmacies during patient counseling might prevent the worsening of asthma symptoms. Patients with hyperlipidemia were comparative subjects. We created informational sheets about climate and environmental changes and their influence on asthma. During patient counseling, pharmacists gave them to all asthma patients who visited insurance pharmacies over a period of 2 months, between November and December 2017. Based on previous studies, we called days which showed certain climate or environmental changes as compared to the previous day “change days”. We compared the number of visiting patients on change days after preventative information was provided (between January and March 2018) with the number before information was provided (between January and March 2017). In addition, we compared those numbers with the number of patients who visited the target pharmacies between January and March 2016 in order to examine the influence of yearly climate change. The same procedure was used with hyperlipidemic patients. The number of visiting asthma patients after information was provided significantly decreased (5.1±2.1, p=0.03) compared with the number before information was provided, between January and March 2017 (6.1±2.8). The number of aforementioned visits compared to those between January and March 2016 also significantly decreased (p=0.01). Our results suggest that preventative information about climate and environmental changes provided by pharmacists during patient counseling might influence the number of asthma patient visits and prevent the exacerbation of their symptoms.
著者
林 恭子 大津 史子 矢野 玲子 榊原 仁作 後藤 伸之
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.131, no.1, pp.139-152, 2011 (Released:2011-01-01)
参考文献数
32
被引用文献数
3 3

The present study investigated risk factors and subjective symptoms associated with drug-induced leucopenia. We selected 248 patients with drug-induced leucopenia from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 47000 case reports of adverse drug reactions and assigned them to a case group. We also randomly selected 743 cases of adverse drug reactions not associated with leucopenia as a control group. A comparison of patient characteristic data between the two groups using logistic-regression analysis revealed that female sex, autoimmune disease and renal damage were background risk factors for drug-induced leucopenia. In addition, thiamazole, ritodrine, propylthiouracil, ticlopidine, allopurinol, minocycline and captopril administration significantly increased the risk of drug-induced leucopenia. A significant association was also found for fever, chills and pharyngeal abnormalities. Based on these findings, we developed two estimated regression equations to help prevent drug-induced leucopenia in the community pharmacy setting.
著者
大津 史子
出版者
日経BP社
雑誌
日経ドラッグインフォメーションpremium
巻号頁・発行日
no.164, pp.PE13-15, 2011-06

1983年、神戸女子薬科大学卒業。滋賀医科大学外科学第2講座勤務を経て、名城大学薬学部専攻科に入学。87年に同大学薬学部医薬情報センターに入職、同学部医薬品情報学講師などを経て、2008年から現職。症例70歳男性。夜中に、激しい胸痛を感じて目が覚めたが、何とか翌朝まで我慢して、医療機関を受診した。
著者
早川 裕二 大津 史子 矢野 玲子 三輪 一智 後藤 伸之
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.33, no.6, pp.488-495, 2007 (Released:2009-02-02)
参考文献数
20
被引用文献数
2

The purpose of this study was to identify drugs with a risk of causing Stevens-Johnson syndrome (SJS),toxic epidermal necrolysis (TEN) and drug-induced hypersensitivity syndrome (DIHS) and the risk factors involved.From the CARPIS (Case Reports of Adverse Drug Reactions and Poisoning Information System) database,which contains 40,000 case reports of adverse drug reactions,we determined 258 cases (case group) matching the criteria for SJS/TEN/DIHS stated by the Japanese Ministry of Health,Labour and Welfare.We also selected 774 control cases (control group) which were sex- and age- matched (±1)with the case group.Next,various data were compared between the case group and the control group and the results analyzed statistically.In this regard,logistic regression analysis identified 2 drugs - carbamazepine (odds ratio : OR=5.21,95% confidence interval : 95% CI=2.68-10.06)and acetaminophen (OR=3.41,95% CI=1.12-10.51)that were associated with a significant elevation of the risk of SJS and TEN.Further,mexiletine hydrochloride (OR=205.48,95% CI=28.04-2330.89)and diaminodiphenylsulfone (OR=981.56,95% CI=94.84-25212.82),were found to be associated with a significant elevation of the risk of DIHS.By identifying certain risk factors for SJS,TEN and DIHS,the results of the present study would be useful in preventing severe drug reactions.