著者

森川 美羽 石崎 武志 高野 智早 渡辺 享平 田畑 麻里 佐藤 義高 西本 武史 小坂 浩隆 片山 寛次

出版者

日本緩和医療学会

雑誌

Palliative Care Research (ISSN:18805302)

巻号頁・発行日

vol.7, no.2, pp.541-544, 2012 (Released:2012-08-21)

参考文献数

18

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【目的】がんの診療に伴い, 吃逆はしばしば経験し, 治療に難渋することが多い. 化学療法に伴って出現した持続性の吃逆に対して, プレガバリンが奏効した2症例を経験したので報告する. 【症例】症例は共に進行肺扁平上皮がんであり, 症例1はカルボプラチン+パクリタキセル, 症例2はネダプラチン+イリノテカンの2剤併用化学療法を施行した. 2症例共に抗がん剤の投与に応じて吃逆の出現, 増悪を認めており, 薬剤が誘発したと考えられた. 吃逆はメトクロプラミド, クロルプロマジン, ガバペンチンに抵抗性であり, プレガバリン 150 mg/日の投与によりすみやかに改善した. 【結論】鎮痛補助薬として近年用いられるようになったプレガバリンは, その薬理作用である神経細胞の過剰興奮の抑制により吃逆にも効果がある可能性がある.

著者

五十嵐 敏明 今野 彩 塚本 仁 矢野 良一 渡辺 享平 中村 敏明 政田 幹夫 後藤 伸之

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.20, no.2, pp.66-71, 2018-08-31 (Released:2018-09-12)

参考文献数

10

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Objective: We have developed an automatic vigilance system (AVS) that automatically reports adverse drug reactions (ADR) based on laboratory finding abnormalities and symptom keywords in electronic medical records. In this study, we aimed to evaluate the impact of detecting ADR using AVS on medical treatment. Methods: In AVS, drugs and their ADR signals, which would be detected and reported by AVS to pharmacists, were defined. Pharmacists evaluated the severity of these signals to identify whether these signals should be discussed with the doctor, continued to be followed up, or ignored. We investigated detection of ADR at University of Fukui Hospital between April 2016 and March 2017 along with whether prescriptions were modified because of ADR and the contribution of AVS. Assuming that ADR had worsened without appropriate treatment, medical expenses needed for treating severe ADR were calculated. Results: In total, 325 signals were defined for 146 drugs. There were 9,103 ADR signals confirmed by pharmacists for 8,531 subjects. Of these, 12 and 164 signals were discussed with the doctor and continuously observed, respectively. The pharmacist's suggestions based on AVS led to prescription modifications in 10 cases, corresponding to a reduction of 2.56 million yen in medical expenses in the event that these cases become severe. Conclusion: AVS assisted prescription revisions because of ADR and is thought to contribute to the prevention of worsening of ADR and reduction of medical expenses.

著者

平野 陽子 古俵 孝明 五十嵐 敏明 松嶋 あづさ 川道 美里 小島 慶之 高橋 翠 松井 友里恵 渡瀬 友貴 山下 慎司 宇野 美雪 上谷 幸男 渡辺 享平 矢野 良一 塚本 仁 中村 敏明 岩崎 博道

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.43, no.9, pp.502-508, 2017-09-10 (Released:2018-09-10)

参考文献数

9

被引用文献数

2

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In February 2015, we introduced a drug verification and quantity management system using personal digital assistants and medicine barcodes to prevent dispensing errors. We evaluated the effect of this system by comparing the number of dispensing errors and incident cases for one year before and after the introduction. The time required for dispensing was prolonged from about 28.4 seconds to 37.3 seconds per drug, about 1.3 times. The number of dispensing errors for one year before and after system introduction significantly decreased from 33.8 ± 4.7 per month to 5.8 ± 0.8 per month (P < 0.01). In addition, the number of incidents significantly decreased from 6.0 ± 0.9 per month to 3.2 ± 0.5 per month (P = 0.02). The system seems to be useful as a tool of medical safety measures because it significantly lowers the number of dispensing errors and incidents.

著者

後藤 伸之 吉村 直人 萱野 勇一郎 渡辺 享平 林 美由 青池 美穂 白波瀬 正樹 脇屋 義文 政田 幹夫

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.28, no.4, pp.401-406, 2002-08-10 (Released:2011-03-04)

参考文献数

5

被引用文献数

1

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A heparin lock is technique performed in order to prevent blood coagulation in the needle detained in the vessel, or a catheter. In Japan, when we perform a heparin lock, a heparin injection is diluted with physiological salt solution before use. We need to use prefilled syringes with diluted heparin. We received a sample of this product. We investigated the user-friendliness of the product. From our results, the prefilled syringe with the diluted heparin was found to be useful. Furthermore, when we use the prefilled syringe with diluted heparin, patient safety is increased.

著者

渡辺 享平 矢野 良一 五十嵐 敏明 塚本 仁 中村 敏明 政田 幹夫

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.35, no.9, pp.622-628, 2009 (Released:2011-01-14)

参考文献数

12

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As the effect of the filling process of portable pumps on the homogeneity of drug concentrations had not been investigated,in this study,we examined the influence of the filling process of the anticancer agent 5-fluorourcil (5-FU) and saline in this respect.We used 3 types of pump and filled the pump in 3 different ways (5-FU first and then saline,saline first and then 5-FU,and mixing 5-FU and saline beforehand and then filling).There was a significant variation in the 5-FU concentration when 5-FU and saline were added separately but the drug concentration did not vary when 5-FU and saline were mixed before filling the pumps.The result also varied with the type of pump.Our findings suggested that the drug and saline were not mixed uniformly in some types of pump when 5-FU and saline were added separately.Therefore,it is important to mix the drug and saline well before filling pumps.

著者

根來 寛 矢野 良一 谷 大輔 渡辺 享平 塚本 仁 五十嵐 敏明 中村 敏明 脇屋 義文 後藤 伸之 横山 照由 政田 幹夫

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.34, no.4, pp.320-327, 2008 (Released:2009-09-04)

参考文献数

23

被引用文献数

2 1

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During cancer chemotherapy,myelosuppression is a frequently observed toxicity manifestation which may sometimes cause severe infections.In this regard,though leukopenia-induced infections are more closely related to neutrophil counts than leukocyte counts,it is important to evaluate both leukocyte counts and neutrophil counts as markers of myelosuppression.Neutrophil counts,however,are sometimes estimated to be half leukocyte counts without conducting differential leukocyte counts.In the present study,the authors evaluated the necessity of differential leukocyte counts during cancer chemotherapy using pooled laboratory data at the University of Fukui Hospital.Variation in the percentage of neutrophils in leukocytes was observed in each leukocyte range,with the neutrophil count decreasing in pace with decreases in the leukocyte count.As an alternative index to the neutrophil count,the utility of the leukocyte count is thus considered to be low in cancer chemotherapy.There was also a divergence between adverse event grade between neutrophil and leukocyte numbers.In addition,neutrophil counts in 14.8% of the patients (26)were less than 1000/μL in spite of the fact that their leukocyte counts were higher than 3000/μL,and it was noted that 23 of them had undergone a paclitaxel-containing regimen.These results suggested that leukocyte differential counts should be measured during cancer chemotherapy,especially during the nadir period and when receiving chemotherapy containing paclitaxel.

著者

渡辺 享平 中村 敏明 政田 幹夫

出版者

じほう

雑誌

調剤と情報 (ISSN:13415212)

巻号頁・発行日

vol.14, no.2, pp.175-181, 2008-02