著者

小茂田 昌代

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.141, no.7, pp.887-909, 2021-07-01 (Released:2021-07-01)

参考文献数

33

被引用文献数

1

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The difficult experience of treating scabies in an elderly hospital reaffirmed my determination and responsibilities as a pharmacist. In 2000, there was no effective treatment for scabies in Japan. With the Japan Pharmaceutical Association as well as the Japanese Dermatological Association, the indication of ivermectin which is the intestinal fecal nematode was expanded for scabies. Since it was found that the administration of ivermectin through a tube to patients who could not take it orally had a dose loss of 50% depending on the injection method, an appropriate administration method was proposed. However, the oral administration of ivermectin has side effects including systemic liver damage, and external preparations require labor for systemic application, and recurrence from unapplied areas is also a problem. Therefore, we devised a whole-body bathing, in which patients are immersed in a fluid that contains ivermectin. The repeated ivermectin bathing three times a week cured scabies and has no problematic side effects in the clinical trial, suggesting that this method is a safer treatment. Next, in Okinawa, phenothrin-resistant head lice infestation was prevalent, and no medical drug for this infestation is available in Japan yet. Hence, to address this situation, we conducted a clinical trial to investigate the efficacy and safety of a combination regimen of 5% topical phenothrin and the unapproved 0.5% topical ivermectin. Consequently, 92% and 100% effectiveness were obtained in Okinawa and Tsukuba, respectively. As a result, we were able to conduct research aimed to maximize the safety and effectiveness of ivermectin in Japan.

著者

鹿村 恵明 真野 泰成 小茂田 昌代 根岸 健一 佐藤 嗣道 宮崎 智

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.9, pp.1263-1273, 2016 (Released:2016-09-01)

参考文献数

21

被引用文献数

17 10

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This nationwide survey aimed to evaluate reduction of drug and medical costs due to prevention of serious adverse drug reactions through pharmaceutical inquires by community pharmacist, and investigate relation with iyaku bungyo (separation of dispensing from medical practice) rates. Using the national list of pharmacies, 10% of pharmacies were randomly selected by prefecture and asked to participate in an Internet-based survey. The survey period was 7 days, from July 21 to July 27, 2015. Of the 5575 pharmacies queried, 818 responded to the survey (response rate: 14.7%). The proportion of inquiries to total prescriptions was 2.6%. Among these, the proportion of prescriptions changed in response to inquiry was 74.9%. An estimated 103 million yen was saved by reducing drug costs, and 133 million yen was saved by reducing medical costs due to prevention of serious adverse drug reactions. Comparison of prescription change rates between pharmacies with high and low iyaku bungyo rates indicated that the proportion of prescriptions changed was significantly higher in pharmacies with high iyaku bungyo rates than in those with low iyaku bungyo rates (78.2% vs. 69.9%, p<0.01). The findings suggest that inquiries about prescriptions are useful in ensuring the safety of pharmacotherapy and reducing the cost of healthcare. They also suggest that iyaku bungyo promotes prescription changes through inquiries, leading to proper use of pharmaceutical products.

著者

大谷 真理子 山本 陽介 酒巻 智美 大沼 亜紀 赤木 圭太 松田 慶祐 杉山 奈津子 宮嶋 篤志 廣田 孝司 小茂田 昌代

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.2, pp.78-86, 2012-02-10 (Released:2013-02-10)

参考文献数

9

被引用文献数

5 6

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An oral scabicide, STROMECTOL® Tablets (ivermectin) is often administered to patients as a simple suspension by feeding tube. However, it was reported that the administration by this method was less effective than oral administration of tablets. One reason for this lower efficacy might be that the devices and technique for this method of administration are not appropriate. The aim of this study is to propose an appropriate technique.In this report, we compare the recovery ratio when a simple suspension is pushed through a syringe under various conditions. As a result of washing the syringe with distilled water after the first use, the recovery of ivermectin was higher than that without washing. The recovery of ivermectin from syringes set at an angle of 90° and 45° to the horizon was significantly higher than that at 0° and -45°. And recovery from previously used syringes was about 10% higher than that from new syringes (p<0.05). Furthermore, after having orally administered STROMECTOL® Tablets and gavaged its suspension with an appropriate delivery technique to rabbits, we measured the ivermectin concentrations in plasma by LC-MS/MS. The AUC0-192h of ivermectin was almost equivalent for both methods of administration.In conclusion, to secure the same dosage of administration with a simple suspension as that of tablets, it is highly recommended to employ a previously used syringe at an angle of over 45°, and to inject by a technique that washes out the entire residue in the syringe after first injection.

著者

日本皮膚科学会疥癬診療ガイドライン策定委員会 石井 則久 浅井 俊弥 朝比奈 昭彦 石河 晃 今村 英一 大江 麻里子 金澤 伸雄 久保田 由美子 小茂田 昌代 関根 万里 田中 勝 谷口 裕子 常深 祐一郎 頓宮 美樹 夏秋 優 牧上 久仁子 松田 知子 宮嶋 篤志 吉住 順子 四津 里英 和田 康夫

出版者

公益社団法人 日本皮膚科学会

雑誌

日本皮膚科学会雑誌 (ISSN:0021499X)

巻号頁・発行日

vol.128, no.13, pp.2791-2801, 2018-12-20 (Released:2018-12-20)

参考文献数

73

著者

大谷 真理子 大谷 道輝 野澤 茜 松元 美香 山村 喜一 小茂田 昌代 江藤 隆史

出版者

公益社団法人 日本皮膚科学会

雑誌

日本皮膚科学会雑誌 (ISSN:0021499X)

巻号頁・発行日

vol.122, no.1, pp.39-43, 2012-01-20 (Released:2014-11-13)

被引用文献数

3

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塗布量および塗布回数の違いによる保湿剤の効果を客観的に評価するために,人工乾燥皮膚を用いて検討した.ヒルドイド®ローションおよびヒルドイド®ソフト軟膏を1日1回朝0.5,2および3 mg/cm2あるいは1日2回朝および夜の入浴後2 mg/cm2を14日間アセトン/エーテルおよび水で処理した前腕部の屈側の人工乾燥皮膚に塗布した.角層水分量は塗布1,2,5,6,7,8,9,12,13および14日後に経時的に測定した.塗布量による比較では,ローション・軟膏とも電導度に有意差はなかった.塗布回数による比較では,1日2回はローション・軟膏ともにほとんどの測定時点で1日1回と比較して電導度が有意に高かった.本研究により,ヒルドイド®製剤では1日1回よりも2回塗布した方がより効果的であることが示唆された.

著者

尾関 理恵 湯浅 奈絵 赤木 圭太 真野 泰成 根岸 健一 小茂田 昌代

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.2, pp.88-96, 2019-02-10 (Released:2020-02-10)

参考文献数

12

被引用文献数

2

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STROMECTOL® Tablets (ivermectin), an oral scabicide, is often administered to patients as a simple suspension via a feeding tube. However, other studies have reported that this method reduces the dose of ivermectin by 10-50% compared to that associated with oral administration. There are several devices used for administration via a feeding tube. This study proposes appropriate devices for such administration. First, we compared the recovery ratio of ivermectin by different 6 devices (a syringe, an oral dispenser, a small cup, kendakun, a suspension bottle and a quick bag). Among them, the results showed that the recovery ratio of the oral dispenser, suspension bottle, and quick bag was 100% after flush operation. Next, we conducted a questionnaire survey of 10 students to evaluate the usefulness of the six devices. The result showed that the suspension bottle or quick bag was easiest to use but the suspension bottle required attention regarding back flow. In addition, the cost of the suspension bottle was the lowest, the dispenser was the highest. The usefulness test is limited because it is targeted at students. When administering STROMECTOL® Tablets via a tube, the entire volume could be administered without any loss by flushing using a suspension bottle or a quick bag and setting the angle of administration directly underneath.

著者

日本皮膚科学会疥癬診療ガイドライン策定委員会 石井 則久 浅井 俊弥 朝比奈 昭彦 石河 晃 今村 英一 加藤 豊範 金澤 伸雄 久保田 由美子 黒須 一見 幸野 健 小茂田 昌代 関根 万里 田中 勝 谷口 裕子 常深 祐一郎 夏秋 優 廣田 孝司 牧上 久仁子 松田 知子 吉住 順子 四津 里英 和田 康夫

出版者

公益社団法人 日本皮膚科学会

雑誌

日本皮膚科学会雑誌 (ISSN:0021499X)

巻号頁・発行日

vol.125, no.11, pp.2023-2048, 2015-10-20 (Released:2015-10-22)

参考文献数

185

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Here, we present our new guideline for the diagnosis and treatment of scabies which we, the executive committee convened by the Japanese Dermatological Association, developed to ensure proper diagnosis and treatment of scabies in Japan. Approval of phenothrin topical use under the National Health Insurance in August 2014 has contributed to this action. Permethrin, a topical anti-scabietic medication belonging to the same pyrethroid group as phenothrin, is already in use worldwide. For making proper diagnosis of scabies, following three points should be taken into consideration: clinical findings, detection of the mite(s) (Sarcoptes scabiei var. hominis), and epidemiological findings. The diagnosis is confirmed when the mites or their eggs are identified by microscopy or by dermoscopy. As we now have a choice of phenothrin, the first line therapy for classical scabies is either topical phenothrin lotion or oral ivermectin. Second line for topical treatment is sulfur-containing ointments, crotamiton cream, or benzyl benzoate lotion. Gamma-BHC ointment is no more provided for clinical use. If the patient is immunosuppressed, the treatment option is still the same, but he or she should be followed up closely. If the symptoms persist, diagnosis and treatment must be reassessed. For hyperkeratotic (crusted) scabies and nail scabies, removal of thick scabs, cutting of nails, and occlusive dressing are required along with topical and/or oral treatments. It is important to apply topical anti-scabietic lotion/cream/ointment below the neck for classical scabies or to the whole body for hyperkeratotic scabies, including the hands, fingers and genitals. For children and elderlies, it is recommended to apply treatment to the whole body even in classical scabies. The dosage for ivermectin is a single oral administration of approximately 200 μg/kg body weight. It should be taken on an empty stomach with water. Administration of a second dose should be considered at one-week with new lesions and/or with detection of mites. Safety and effectiveness of combined treatment with topical and oral medications are not yet confirmed. Further assessment is needed. Taking preventative measures is as important as treating those infected. It is essential to educate patients and healthcare workers and conduct epidemiological studies to prevent further spread of the disease through effectively utilizing available resources including manpower, finance, logistics, and time. (Jpn J Dermatol 125: 2023-, 2015)

著者

布施 春奈 大西 優香里 松井 布美 杉山 奈津子 小茂田 昌代

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.18, no.2, pp.64-71, 2016 (Released:2016-09-27)

参考文献数

39

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Objective: Tamoxifen is a drug that is frequently administered for 5 years to treat hormone receptor-positive breast cancer in premenopausal women.  Metabolism of tamoxifen by cytochrome P450 enzymes such as CYP3A4 and CYP2D6 is required for drug efficacy.  However, reports suggest that the effect of tamoxifen is attenuated in the presence of CYP2D6 inhibitors.  In this study, I evaluated drug-drug interactions that may attenuate tamoxifen action for improved pharmaceutical management.Data Source: Potential interactions were evaluated by using the tamoxifen package insert, Kyoto Encyclopedia of Genes and Genomes (KEGG), Pharmaceuticals and Medical Devices Agency (PubMed), and Lexicomp Online.  We have searched the paper using the PubMed and JDream III.The Choice of Research: The paper about the interaction related CYP2D6 and 3A4 of tamoxifen.Results and Conclusion: The use of tamoxifen is often long term; however, adverse effects such as hot flashes, can cause poor regimen adherence.  Although selective serotonin reuptake inhibitors (SSRIs) can effectively treat menopausal hot flashes, many SSRIs inhibit CYP2D6.  In particular, paroxetine has been reported to adversely affect tamoxifen metabolism.  There are 31 drugs and 843 compounds that inhibit CYP2D6.  Thus, it is necessary to avoid these combinations.  In addition, there are many CYP2D6 gene polymorphisms that have been identified in Japanese patients, and some reports indicate that they affect tamoxifen efficacy.  Therefore, in order to continue use of these medications without attenuating the effect of tamoxifen, development of medical database which can be updated daily is required to avoid CYP-related interactions.

著者

浦野 公彦 波多野 紀行 尾関 佳代子 小茂田 昌代 河原 昌美 小崎 彩

出版者

一般社団法人 日本薬学教育学会

雑誌

薬学教育 (ISSN:24324124)

巻号頁・発行日

vol.6, pp.2022-035, 2022 (Released:2022-08-23)

参考文献数

17

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日本の薬学教育においてevidence-based medicine(EBM)の重要性は認識され,薬学教育モデル・コアカリキュラムにも明記されている.しかし,現状では臨床で活用できるEBMスキルを身につけるトレーニングが十分とはいえない.効果的なEBM教育を実践するには大学と臨床との間で教育の循環を行うことが必要であると考える.そのためには臨床現場である薬局や病院からのエビデンスの創出を薬剤師から発信し,大学ではアカデミック・ディテーリングの理念に基づき,基礎と臨床の橋渡し教育を通した処方の最適化への貢献を目指し,また,フォーミュラリーの作成など臨床に直結した実習の実施が望まれる.さらに米国では基礎教育から実務実習までの薬学教育全般を通したEBM教育が実施され,これは今後日本でも取り入れるべき教育体系である.

著者

小茂田 昌代

出版者

一般社団法人 国際P2M学会

雑誌

国際P2M学会研究発表大会予稿集 2017 春季 (ISSN:24320382)

巻号頁・発行日

pp.IS-1-IS-2, 2017 (Released:2017-05-12)