著者

辻 敏和 永田 健一郎 川尻 雄大 山田 孝明 入佐 俊弘 村上 裕子 金谷 朗子 江頭 伸昭 増田 智先

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.11, pp.1573-1584, 2016 (Released:2016-11-01)

参考文献数

20

被引用文献数

3

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There are many reports regarding various medical institutions' attempts at the prevention of dispensing errors. However, the relationship between occurrence timing of dispensing errors and subsequent danger to patients has not been studied under the situation according to the classification of drugs by efficacy. Therefore, we analyzed the relationship between position and time regarding the occurrence of dispensing errors. Furthermore, we investigated the relationship between occurrence timing of them and danger to patients. In this study, dispensing errors and incidents in three categories (drug name errors, drug strength errors, drug count errors) were classified into two groups in terms of its drug efficacy (efficacy similarity (−) group, efficacy similarity (+) group), into three classes in terms of the occurrence timing of dispensing errors (initial phase errors, middle phase errors, final phase errors). Then, the rates of damage shifting from “dispensing errors” to “damage to patients” were compared as an index of danger between two groups and among three classes. Consequently, the rate of damage in “efficacy similarity (−) group” was significantly higher than that in “efficacy similarity (+) group”. Furthermore, the rate of damage is the highest in “initial phase errors”, the lowest in “final phase errors” among three classes. From the results of this study, it became clear that the earlier the timing of dispensing errors occurs, the more severe the damage to patients becomes.

著者

永田 健一郎 辻 敏和 村岡 香代子 米滿 紘子 久光 莉瑛 舞 彩華 橋本 昂介 月野木 祥子 渡邊 裕之 金谷 朗子 江頭 伸昭

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.22, no.2, pp.83-90, 2020-08-31 (Released:2020-09-18)

参考文献数

10

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Objective: In this study, we aimed to develop a new system that can centrally manage and share drug information, and also evaluated its usefulness.Methods: Using PHP v5.3.3 as the programming language and MySQL v5.1.73 as the database, we built a web application that constantly runs on the server. Various drug information was registered in this system, and its usage status was analyzed based on the access log.Results: The system was accessed 31,678 times during the survey period (October 1 to December 31, 2019). The information sought included: basic drug information (ordering category of drugs, dosage forms and strengths, drug price, etc.) (13,962 times, 44.1%),question and answer records (7,221 times, 22.8%), pharmaceutical documents (package inserts, interview forms, documents regarding compatibility of injections, etc.) (7,172 times, 22.6%), notifications regarding new and discontinued drugs (727 times, 2.3%), websites (676 times, 2.1%), PreAVOID reports (663 times, 2.1%), pharmaceutical safety information (525 times, 1.7%), information regarding off-label drug use (409 times, 1.3%), and bibliographic information and guidelines (323 times, 1.0%). Among the users (62 pharmacists), 59.7% accessed the system only via a personal computer (PC), 38.7% via a PC and smart device (smartphone or tablet),and 1.6% via only a smart device. The median number of accesses to this system was significantly higher in pharmacists in charge of wards (190 [9-1,435]) or drug information (3,750 [2,957-5,548]) than dispensing pharmacists (68.5 [3-193]) (p<0.001).Conclusion: This system allowed the central management and sharing of various drug information on the web, permitting access regardless of device type. Since this system was frequently used by pharmacists in charge of wards or drug information, this system was considered particularly useful in hospital pharmacist ward services and drug information services.

著者

崎村 克也 平仁田 尊人 宮本 道彦 永田 健一郎 山本 経之

出版者

公益社団法人 日本薬理学会

雑誌

日本薬理学雑誌 (ISSN:00155691)

巻号頁・発行日

vol.126, no.1, pp.24-29, 2005 (Released:2005-09-01)

参考文献数

52

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薬物依存研究の視点は,(1)依存の形成機構の解明および(2)薬物への“渇望”の再燃・再発機構の解明にある.薬物依存の実験法としては,1)薬物選択試験法,2)条件づけ場所嗜好性試験法,3)薬物弁別試験法および4)薬物自己投与実験法が繁用されている.しかし,前者3つの実験法は依存性薬物の強化/報酬効果または薬物摂取行動の機構解明に迫れても,薬物への“渇望”の再燃・再発の機構解明に向けての妥当性の高い戦略とは言い難いが,ラットの薬物自己投与実験法では“渇望”の動物モデルが確立されている.“渇望”を誘発する臨床上の要因として,(1)少量の興奮性薬物の再摂取(priming),(2)薬物使用を想起させる環境因子(薬物関連刺激),そして(3)ストレスの3種類が知られている.ヒトで乱用される薬物はラットでの薬物自己投与行動が成立し,上記の刺激により生理食塩液投与下でのレバー押し行動(薬物探索行動)が発現する.この行動が臨床上の“渇望”を表す動物モデルとして考えられている.脳内局所破壊法と薬物の脳内微量注入法により,薬物摂取行動と薬物探索行動(“渇望”)では,脳内責任部位が異なることが明らかにされている.また,薬物探索行動は,その誘発要因により発現パターンやD2受容体の関与の仕方が異なることも分かっている.これらの知見は,薬物探索行動の発現機序が誘発要因の違いによって異なることを示唆している.一方,近年,薬物探索行動における内因性カンナビノイドの関与が示唆され,内因性カンナビノイドとドパミンやグルタミン酸神経系とのクロストークに熱い視線が注がれている.今後の薬物依存研究は,“渇望”の発現機序の解明と共に,“渇望”のモデル動物での情動や認知機能の変容にも焦点をあて,多面的に薬物依存を捉えていく必要がある.