著者

岩山 訓典 久保 靖憲 小野 尚志 笠茂 紗千子 飯田 慎也 大滝 康一 山田 峻史 安達 知輝 福土 将秀 粟屋 敏雄 田﨑 嘉一

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.333-340, 2018-07-10 (Released:2019-07-10)

参考文献数

6

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One-dose packages are useful for managing complicated medication regimens for older patients. We experienced a case of Bayaspirin® tablet 100 mg (BA) and Micardis® tablet 40 mg (Mic 40) that were fused in a one-dose package at the time of medicine reconciliation. To our knowledge, there are no previous reports assessing the quality of these tablets caused by this physical incompatibility. Therefore, we aimed to examine this phenomenon and its impact on the drug compositions, as well as to identify the mechanisms.BA and Mic 40 in one-dose packages were stored at 30℃/75% relative humidity (RH) or 93%RH condition for 1 week. The stability evaluations were performed on appearance change, hardness, content, and dissolution rate. The active ingredients in each tablet were investigated to determine the mechanisms.Mic 40 showed changes in appearance and hardness, while BA showed a changed appearance, and reduced content and dissolution rate. The enteric coatings of BA and the additive in Mic 40 had an influence on the mechanism of incompatibility.Mic 40 contains meglumine, which is hygroscopic and deliquescent. Therefore, meglumine absorbs moisture and becomes a basic solution. Methacrylic acid copolymer LD dissolved in this basic solution results in adhesion with Mic 40 and leads to a decrease in both the content and the dissolution rate in BA. This is the first study to analyze the physical incompatibilities of enteric-coated aspirin tablets with non-coated telmisartan tablets in one-dose packages and provides useful information for clinical practice.

著者

早勢 伸正 岩山 訓典 大滝 康一 山下 恭範 粟屋 敏雄 松原 和夫

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.161-168, 2011-01-01 (Released:2011-01-01)

参考文献数

22

被引用文献数

1

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Drugs are sometimes covered with oblate or agar jelly. It is said that the medicinal effect of drugs covered with oblate is slow, but no studies have reported results confirming this. Therefore, we examined the dissolution behavior when the drug was covered with oblate or agar jelly. Three types of commercially available formulations of benzodiazepine were used: medazepam sugarcoated tablets, prazepam uncoated tablets, and clorazepate dipotassium capsules. Dissolution tests were performed using solutions of pH 1.2 and 5.6 to simulate normal gastric juice and gastric anacidity, respectively. Drugs covered with oblate were tested by the paddle method, and those covered with agar jelly were tested using the rotating basket method. Dissolution of clorazepate capsules not covered with oblate increased by approximately 10% when the pH was adjusted from 1.2 to 5.6, while those of medazepam and prazepam tablets decreased by approximately 40-60%. In contrast, the dissolution decreased significantly at both pH values for each drug covered with oblate. Dissolution further decreased when the amount of oblate was doubled. No detectable dissolution of medazepam tablets or of clorazepate capsules occurred when the drug was covered with agar jelly. Dissolution of prazepam tablets covered with agar jelly was only about 10% at the end of the test. These results indicate that dissolution is slowed and prolonged when a drug is covered with oblate or agar jelly, permitting sustained release of the drug. But, it is necessary to improve a suitable method for the dissolution.

著者

粟屋 敏雄 長谷部 直幸 梶野 浩樹 石谷 麻里子 山田 武宏 小野 尚志 大滝 康一 山下 恭範 三好 敏之 田崎 嘉一 松原 和夫

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.9, pp.615-621, 2009 (Released:2011-01-14)

参考文献数

11

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After an overdosing incident at our hospital,we developed an upper limit alert system that checks doses of injection drugs for individual patients as the physician uses the computerized order entry system.Based on each patient’s converted body surface area (BSA),the upper limit for an injection is estimated through comparison with the standard upper limit in a patient with a BSA of 1.6 m2.This is done automatically in accordance with a compensation formula provided by our hospital’s safety committee.Standard upper limits for each injection are based on past records of actual injection dosages administered in our hospital and discussion with clinical departments.When a physician tries to enter an order for an injection at a dose over the upper limit,the computer system issues the alert“non-enterable”and the order cannot be placed.In the case of a regimen for which there is a legitimate reason for using a dose higher than the upper limit,the physician must explain this to the pharmacist who will then unlock the alert system using a secret password that he or she has designated.Passwords are only valid for one day.As far as we know,this is the first computerized injection dosage upper limit alert system in the world.On doing a search of our database,we found that there had been 742 overdose alerts (0.47% of all injection prescriptions) during the 3 months following its introduction.Owing to the alerts,physicians altered 155 prescriptions (21.1% of all alerts).Our computerized alert system for checking injection dosages has proved to be very necessary in ensuring medication safety.

著者

山本 譲 粟屋 敏雄 小城 香緒里 森田 真樹子 川守田 早紀 神崎 郁代 小川 聡 板垣 祐一 大滝 康一 山本 久仁子 田﨑 嘉一 松原 和夫

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.34-42, 2012-01-10 (Released:2013-01-10)

参考文献数

10

被引用文献数

3 2

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Shortage of physicians is a serious social issue in Japan. It has become an urgent challenge to support busy physicians. While the number of anesthetists is remarkably insufficient, the number of operations has increased in many hospitals after Diagnosis Procedure Combination (DPC) is implemented. Drugs used in operation rooms include many narcotic analgesic and poisonous drugs, which medical staff are required to strictly control. From the viewpoint of medical safety management, pharmacists should be involved in the management of these drugs. We have started preparation of injections in the operation rooms aiming mainly at supporting anesthetists. Pharmacists make up the anesthetic sets according to anesthetists' order by the evening of the previous day. The pharmacists carry the sets from the pharmacy to the operation room on a wagon. On the early morning of the operation day, two pharmacists mix the injection drugs, fill the syringes, attach the labels, assemble the routes, and check the completed sets in each operating room according to the list. All pharmacists in our pharmacy department engage in this service. We have conducted opinion surveys of pharmacists and anesthetists on this service. Although the workload of pharmacists increased, most pharmacists thought it was worthwhile. Most anesthetists evaluated that this service has improved medical safety. However, there were many requests that the pharmacists should be further involved throughout the entire operation. It is important to support physicians with services such as this by the pharmacist based on pharmaceutical knowledge. This service has a beneficial impact on healthcare professionals.

著者

粟屋 敏雄 大滝 康一 石原 昌司 小野 尚志 千葉 薫 板垣 祐一 山田 武宏 須野 学 早勢 伸正 田崎 嘉一 松原 和夫

出版者

日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.31, no.6, pp.425-434, 2005-06-10

参考文献数

11

被引用文献数

1 5

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出版社版新規システム導入後のオーダシステム内の記録から,処方が試みられた併用禁忌の組み合わせなどを解析した.相互作用チェックは,その処方の投与期間内に重複しているすべての薬品を自処方内および他処方内の薬歴データファイルから抽出し,チェック対象薬剤が重複した場合,チェックメッセージを表示した.システム運用開始以降,13ヵ月間における処方せんおよび注射指示せんの枚数はそれぞれ290956枚,299017枚の計589973枚であった.調査期間内にチェックのかかった回数は299件であった.警告としたものを除く173件中,96件は処方が中止された.時間外の併用禁忌の処方の危険率は時間内に比べ実に4倍近くにも上った.オーダ別にみると,実に80%近くの併用禁忌の組み合わせは注射薬が関与するものであった.最もチェックのかかった頻度が高かった薬剤の組み合わせはトランサミン注とトロンビン細粒の組み合わせであった