著者

田坂 健 東恩納 司 三上 奈緒子 日野 隼人 大川 恭昌 武本 あかね 河崎 陽一 村川 公央 北村 佳久 千堂 年昭

出版者

一般社団法人 日本臨床救急医学会

雑誌

日本臨床救急医学会雑誌 (ISSN:13450581)

巻号頁・発行日

vol.20, no.5, pp.638-643, 2017-10-31 (Released:2017-10-31)

参考文献数

14

---

目的:薬剤師が集中治療室に常駐し,積極的に塩酸バンコマイシン(以下,VCM)の治療薬物モニタリング(以下,TDM)介入を行うことによる効果を明らかにする。方法:薬剤師が常駐する前後で2群に分け,レトロスペクティブに調査を行った。結果:薬剤師の常駐によりVCM血中濃度測定実施率は86.2%から96.5%,シミュレーション解析実施率は24.1%から95.4%へ有意な増加を認めた。血中濃度分布は,トラフ値10μg/mL 未満の割合が24.1%から15.1%へ有意に減少した。一方でトラフ値20 〜25μg/mLの割合が3.7%から15.7%へ有意に増加していた。また,腎障害の発生率は6.5%から2.1%へ減少傾向を示した。結論:ICUにおいて専任薬剤師がVCMのTDM介入を行うことで,TDM実施率の向上とトラフ値が適正化され,VCM適正使用に貢献できることが示唆された。

著者

小川 敦 牛尾 聡一郎 亀田 雅博 横木 梓 椋田 千晶 江角 悟 渡邊 亜津子 村川 公央 安原 隆雄 北村 佳久 伊達 勲 千堂 年昭

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.47, no.8, pp.445-451, 2021-08-10 (Released:2022-08-10)

参考文献数

22

---

A female patient in her 30s developed intractable trigeminal neuralgia on the left side of her face due to a metastatic tumor in the left middle cranial fossa. Despite being treated with carbamazepine, gabapentin, pregabalin, baclofen, tramadol, lidocaine, Neurotropin, and nerve block, the trigeminal neuralgia was not resolved. After a joint discussion between pharmacists and neurosurgeons, the patient was suspected of having trigeminal neuralgia with facial numbness due to a tumor. We, therefore, administered traditional the Japanese herbal medicine Goshajinkigan, a formulation approved for pain and numbness. An MRI revealed a tumor with edema around the left trigeminal nerve, and the traditional Japanese herbal medicine Saireito was also administered to reduce edema. Her neuralgia improved markedly after Goshajinkigan and Saireito administration, i.e., the pain was confined to a narrow area on her left lower eyelid, temple, and lower jaw. Furthermore, her breakthrough pain scale score decreased from numerical rating scale (NRS) 10 to NRS 3, and her continuous pain scale score decreased from NRS 10 to NRS 0. The findings from this case suggest that Goshajinkigan and Saireito may benefit patients with intractable trigeminal neuralgia.

著者

後藤 千尋 村川 公央 西原 茂樹 白石 奈緒子 北村 佳久 千堂 年昭

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.33-37, 2016 (Released:2016-06-13)

参考文献数

6

---

Objective: Pharmacist interventions are effective for appropriate medical management.  The Japanese Society of Hospital Pharmacists has recommended the “pre-avoid report” to foster appropriate pharmacotherapy since 1999.  The “pre-avoid report” format consists of two forms : “serious report” and “preventive report.”  The number of “preventive reports” has comprised about 90% of “pre-avoid reports.”  However, this format of the “preventive report” since 1999 has shown inadequacy due to changes in pharmacists’ ability.  In the present study, we conducted a re-modification of the “preventive report” format using an assay to create the present “preventive report” format.Methods: We retrospectively reviewed the pharmacists’ “preventive report” of the “pre-avoid report” from January 2014 to December 2014 in the Department of Pharmacy, Okayama University Hospital.Results: The present format included 101 cases of “others” in the “preventive report” format.  This “others” section consisted of “non-intervention of pharmacotherapy” (51%), “forget to stop pre-operation drugs” (14.7%), and “inadequate treatment (wrong administration day, unnecessary treatment).  These factors were not identified with the present format of the “preventive report.”Conclusion: In the present study, we suggested that it is necessary to revise the format of the “preventive report” to reflect.