著者

小松 弘幸 奥村 学 岩切 智美 林 克裕

出版者

日本シミュレーション医療教育学会

雑誌

日本シミュレーション医療教育学会雑誌 = Journal of Japan Association for Simulation-based Education in Healthcare Professionals (ISSN:21879281)

巻号頁・発行日

vol.2, pp.1-6, 2014

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【目的】最近の6年制薬学教育では、学生へのフィジカルアセスメント(Physical Assessment; PA)実習も徐々に取り入れられているが、病院で勤務している薬剤師を対象にPA実習を行っている施設は少ない。今回我々は、大学病院薬剤師を対象に医療シミュレータを活用した系統的PA実習を実施し、参加者の実習前後での自己評価の変化を検討した。###【方法】対象は本院薬剤師21名。薬剤師におけるPA総論、バイタルサインの診かた、肺音聴診、心電図モニター判読、薬剤による患者の急変と対応の5項目を、医師1名の指導の下、毎月1回ずつ約90分で実施した。実習では肺音聴診シミュレータ"ラング"®やハートシム4000®、Sim Man 3G®を使用した。実習前後でPAに関する自己評価と実習内容に関するアンケート調査を実施した。###【結果】実習前のPA経験は、バイタルサイン測定が3名、心電図モニター判読が4名、聴診は0名と少なかった。患者のバイタルサイン評価について4段階で自己評価してもらった結果、「自信がある」あるいは「ある程度自信がある」と評価した割合は、実習前後で、意識状態:14%→83%、体温:52%→100%、血圧:33%→91%、脈拍:19%→87%、呼吸状態:14%→61%へと有意に上昇した(全てp<0.01)。実習後アンケートでは、対象者全員が全項目とも今後の薬剤師業務に役立つと回答した。###【結語】医療シミュレータを活用した病院薬剤師へのPA実習は、薬剤師生涯教育の一つの方法として有用と考えられる。Aims: Opportunities for pharmacy students to acquire physical assessment (PA) skills have gradually increased since the six-year education system was introduced in Japan. However, learning opportunities for hospital pharmacists are insufficient. Therefore, we provided a series of lessons in PA for hospital pharmacists using auscultation and high-fidelity simulators for training in emergency medical care and evaluated whether their self-assessment of PA improved thereafter.###Methods: Twenty-one pharmacists at our hospital self-evaluated their abilities to measure vital signs before and after undergoing training using simulators in the general theory of PA, vital sign assessment, lung auscultation sounds and interpretation of electrocardiographic patterns on monitors. They were also presented with scenarios simulating drug-induced changes in physical status. ###Results: A preliminary survey revealed that most of the participants had never physically assessed hospitalized patients. The stages of self-assessment for the skill of measurement of vital signs were significantly improved after the training. All participants found that training using medical simulators was an effective method of learning PA skills.### Conclusion: Physical assessment training with medical simulators is a useful method of continuing education for pharmacists in hospitals.

著者

永田 将司 岩切 智美 奥村 学 有森 和彦

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.37, no.5, pp.289-295, 2011 (Released:2012-08-02)

参考文献数

5

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Pharmacists can play a significant role in medical care by helping to ensure the proper use of drugs, and a knowledge of pharmacokinetics is indispensable for this. Therapeutic Drug Monitoring (TDM) is a pharmacy practice that involves the full use of such knowledge. Practical training in TDM in pharmacist education should thus be an optimal way acquiring skill in applying pharmacokinetics knowledge in the clinical setting. However, in the Model Core Curriculum for practical training at hospitals implemented in 2010, there is only 1 specific behavioral objective (SBO) concerning TDM, and only 1 day is given to training on TDM. With this in mind, we developed an original experience-based TDM curriculum that includes 5-days of practical training. The curriculum was introduced for students in the 2010 pharmaceutical internship to evaluate its components.All students who took our curriculum considered that the 1-day of TDM training stipulated in the Model Core Curriculum was not sufficient, and that around 5 days of training, the period we have set, would be necessary. They also indicated a high level of satisfaction with it, viewing the training components as appropriate. These findings suggest that our curriculum would be effective.

著者

荻窪 哲也 日高 宗明 奥村 学 藤田 健一 山崎 啓之 浅生 将英 岩切 智美 佐々木 裕美 児玉 裕文 有森 和彦

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.32, no.5, pp.392-399, 2006-05-10

被引用文献数

2 2

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In view of the lack of information on the extent to which tea beverages inhibit the activity of human cytochrome P 450 3A (CYP 3A), we investigated their effect on the midazolam 1' -hydroxylation activity of CYP 3A contained in human liver microsomes. "Grapefruit (white)" was used as a positive control, and "Valencia Orange", as a negative control. All the tea beverages tested significantly inhibited the midazolam 1' -hydroxylation activity of CYP 3A in a concentration-dependent manner and inhibition was particularly marked for Katekin 600^[○!R] and Banso-reicha^[○!R] (5.0%, v/v). The potency of the inhibitory effects was similar to that of grapefruit. The inhibitory effects on the activity of CYP 3A were enhanced by preincubation of tea samples (2.5%, v/v) with microsomal fractions for 5 to 30min in a preincubation period-dependent manner. These results suggest that Katekin 600^[○!R] and Banso-reicha^[○!R] contain mechanism-based inhibiting agents. Further, the inhibitory effects on CYP 3A of green tea beverages seemed to be enhanced by catechins with the enhancement depending on the catechin concentration indicated on the label. In conclusion, we found that there were ingredients that inhibited CYP 3A activity in all of the tea beverages, and they were probably catechins.