- 著者
- 中島 誠 中木原 由佳 高橋 武士 野間口 寛 寺師 守彦 林 秀樹 杉山 正
- 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.13-21, 2016 (Released:2016-06-13)
- 参考文献数
- 19
Objective: We have used therapeutic drug monitoring (TDM) analysis software to set the initial dose of vancomycin in our hospital. In contrast, the TDM guideline, in which the initial dose of vancomycin per body weight was set, was published in 2012. We looked forward with utilizing the TDM guideline in the clinical setting, after which we conducted multiple surveys to determine the important points of the TDM guideline.Methods: We surveyed patients treated with vancomycin, in whom the initial dose was set using the TDM analysis software and the concordance rate between the vancomycin dose set with the software and that set with the TDM guideline.Results: The concordance rate of vancomycin dose was 42.1%. The mean age of the high-dose group (vancomycin dose higher than that recommended by the TDM guideline), was younger than that of the recommended-dose group. Additionally, the mean body weight of the high-dose group was significantly lower than that of the recommended-dose group. The corrected creatinine clearance of the low-dose group was significantly lower than that of the recommended-dose group.Conclusion: Our results suggest that when the initial dose is set after referring the TDM guideline in patients who are not very high age, and having low body weight and decreased renal function, the dose may differ from the dose set by using TDM analysis software. In addition, since the recommended dose per body weight is a range and not a single value, setting the dose appropriate to target trough concentration is necessary.
- 著者
- 中島 誠 三浦 ひとみ 上野 陽子 岡 智子 奥 麻理 福島 綾子 寺師 守彦 大迫 政彦 林 秀樹 杉山 正
- 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.41, no.11, pp.799-810, 2015-11-10 (Released:2016-11-10)
- 参考文献数
- 28
The package insert of notandum, a narcotic drug, states that patients who take this drug must not drive a car, or should drive a car carefully. Many drugs used in supportive cancer chemotherapy and palliative therapy contain warnings regarding driving a car. Twenty-one of 127 outpatients in our hospital who received cancer chemotherapy were prescribed drugs that affect car driving. Sixteen patients drove a car on a daily basis. Although patients would receive a warning from their physician or pharmacist regarding driving when prescribed narcotic drugs, repeated warnings should be given, and driving status should be checked. Fourteen patients stated that refraining from driving was difficult. Therefore, pharmacists proposed prescribing drugs that do not affect driving to these patients. By changing their therapeutics to anti-emetics and supplementary analgesics, the patients could drive without worsening their condition. When selecting drugs, the necessity of driving should be checked to maintain quality-of-life. Nevertheless, as all patients who take opioid analgesics in palliative therapy must refrain from driving, and as opioid analgesics cannot be replaced with other drugs, it is necessary to check the validity of the descriptions in the package insert in future.