著者

森田 真樹子 米澤 淳 森 美奈子 田﨑 嘉一 長屋 健 千石 一雄 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.39, no.8, pp.504-509, 2013-08-10 (Released:2014-08-10)

参考文献数

16

被引用文献数

1 1

---

Breastfeeding is important in infant rearing. To support safe breastfeeding in a patient using lamotrigine, the transfer of lamotrigine to the infant via breast milk was evaluated in two couples of Japanese mother and infant. The infants took their mothers' milk expressed a day ahead. The plasma and breast milk concentrations of lamotrigine at 4 (or 5) and 89 (or 90) days after the birth were measured by HPLC. The lamotrigine concentrations of the two mothers were 12.63 and 6.21 µg/mL in plasma, 11.50 and 4.13 µg/mL in milk at Day 4. Milk/Plasma ratios (M/P) were 0.91 and 0.67, and the estimated Relative Infant Dose (RID, at Day 5) was calculated to be 12-29%. At 89 and 90 days after birth, the milk concentrations and RID, respectively, were similar to those at 4 days, which indicates that the transfer of lamotrigine into milk is high in Japanese mothers. The infant plasma concentrations of lamotrigine at 5 and 90 days were between 2.8 and 6.7 µg/mL, which was within the therapeutic range in children with epilepsy. Typical adverse effects were not observed in these infants under meticulous surveillance. In conclusion, pharmaceutical healthcare is necessary for lactating mothers using lamotrigine and their infants.

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

---

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.