著者

今井 俊吾 山田 武宏 西村 あや子 沖 洋充 熊井 正貴 宮本 剛典 笠師 久美子 井関 健

出版者

Japanese Society of Drug Informatics

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.16, no.4, pp.169-178, 2015 (Released:2015-03-10)

参考文献数

13

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Objective: To attain optimal blood concentration rapidly, it is needed to perform initial dose setting appropriately when vancomycin (VCM) used.  In order to design initial dose settings of VCM more currently, we compared the predictive performance of two types of VCM therapeutic drug monitoring (TDM) analysis software retrospectively.Method: We utilized two TDM analysis software, SHIONOGI-VCM-TDM ver.2009 (VCM-TDM) and “Vancomycin MEEK TDM analysis software Ver. 2.0” (MEEK), based on patient’s background. 112 patients who received VCM and performed TDM were analyzed during the period from October 2011 through September 2012 and compared the actual trough level with the predictive trough level.  The predictive performance was evaluated by calculating ME (mean prediction error), MAE (mean absolute prediction error), and RMSE (root mean squared error).  Age, gender, and a renal function were evaluated as patient’s background.Results: VCM-TDM gave good predictive performance for patients overall.  When classified patient’s background complexly (sex, age, and renal function), as for male patients, VCM-TDM showed good predictive performance except for the group over 65 years old and CCr over 85 mL/min.  For female patients, the difference of predictive performance was not accepted by all groups.Conclusion: These results suggest, for male patients, we should use VCM-TDM for initial dose settings except for the group over 65 years old and over CCr 85 mL/min.  For the other patients, we consider that both of software can be used.  These new findings seem to contribute to proper dosage settings of VCM.

著者

小林 洋平 山岡 怜央 三上 龍生 山崎 浩二郎 熊井 正貴 山田 武宏 武隈 洋 菅原 満 井関 健

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.23, no.6, pp.771-779, 2020-12-28 (Released:2020-12-28)

参考文献数

14

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目的:救急/ 集中治療室(以下,ICU)における薬剤師介入の実態や医療経済効果を明らかにすることを目的とした。方法:2017年7,8月に,救急科に入院した患者を対象とし,疑義照会記録を用いて後方視的に調査した。薬学的知識を要しない介入を単純エラー,薬学的知識を要する介入を薬学的介入と定義し,介入の内容および処方反映率を調査した。また,能動的な薬学的介入(薬剤師からの提案)に関して医療経済効果を算出した。結果:介入は391件あり,そのうち76%(297件)が薬学的介入であった。薬学的介入では,抗微生物薬関係の介入がもっとも多く117件(反映率91%)であった。また,医療経済効果は,2カ月間で3,832,000 円であった。結論:薬剤師の救急/ICUへの参画は,医療経済的に有益であることが明らかとなった。また抗微生物薬関係の介入が多く,今後プロトコル作成などにより適正使用推進に寄与できると示唆された。

著者

長田 貴之 柴山 良彦 熊井 正貴 山田 武宏 笠師 久美子 倉本 倫之介 洲崎 真吾 赤澤 茂 真栄田 浩行 坂下 智博 折舘 伸彦 本間 明宏 福田 諭 菅原 満 井関 健

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.51-55, 2012-01-10 (Released:2013-01-10)

参考文献数

14

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Intractable nausea and vertigo induced by opioid treatment are occasionally difficult to treat. It has been reported that antiemetic drugs and opioid rotation may be effective in treating nausea in such cases; however, this approach has been occasionally ineffective. Symptomatic treatment has not been developed for vertigo induced by opioid treatment. Here, we report a case study where combined treatment with perospirone and a histamine H1 receptor antagonist was used in 2 patients who developed intractable nausea and vertigo induced by opioid treatment. Treatment with a histamine H1 receptor antagonist drug (tablet form, containing 40 mg diphenhydramine salicylate and 26 mg diprophylline) suppressed the nausea and vertigo. However, increasing the opioid dosage exacerbated the symptoms, and treatment involving the histamine H1 receptor antagonist and opioid rotation was ineffective. Subsequently, combination treatment with the histamine H1 receptor antagonist (3 tablets per day) and perospirone (maximum daily dose, 16 mg) improved the symptoms. The results of the present study suggest that combination treatment with a histamine H1 receptor antagonist and perospirone might improve intractable nausea and vertigo induced by opioid treatment.

著者

加藤 信太郎 齋藤 佳敬 小野田 紘子 熊井 正貴 今井 俊吾 敦賀 健吉 武隈 洋 菅原 満

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.142, no.7, pp.755-760, 2022-07-01 (Released:2022-07-01)

参考文献数

19

被引用文献数

1

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Naldemedine (Nal) is widely used as a therapeutic drug against opioid-induced constipation. However, patients in phase III trials are limited to those with good performance status (PS). Cancer patients may have inferior PS owing to progression of symptoms and adverse events from chemotherapy. Therefore, it is important to survey the efficacy of Nal in patients with poor PS. This study aimed to evaluate Nal efficacy in patients with poor PS. We retrospectively investigated patients from July 2017 to June 2019 and compared Nal efficacy between patients with good and poor PS. The efficacy of Nal was evaluated using changes in the number of spontaneous bowel movements 7 days before and after the introduction of Nal with reference to previous reports. Multivariate analysis was performed to reveal whether poor PS affects Nal efficacy. In total, 141 patients at the Hokkaido University Hospital were analyzed. The effective rate of Nal from day 1 to day 7 of administration was 71.7% and 71.4% in the patients with good and poor PS, respectively, that from day 1 to day 2 of administration was 61.1% and 57.1%, respectively, and that from day 3 to day 7 of administration was 60.2% and 71.4%, respectively, suggesting an absence of significant differences. Furthermore, results of multivariate analysis showed that “best supportive care” and “body weight (55 kg and above)” reduced Nal efficacy. In conclusion, Nal showed similar effectiveness in patients with poor PS as that in those with good PS.

著者

熊井 正貴 加藤 信太郎 小柳 遼 敦賀 健吉 伊藤 陽一 山田 武宏 武隈 洋 菅原 満 川本 泰之 小松 嘉人

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.17, no.2, pp.51-58, 2022 (Released:2022-04-15)

参考文献数

26

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【目的】緩和ケアに携わる医療提供者のターミナルケア態度の実態とそれに関連する要因を明らかにすることを目的とした.【方法】がん治療医と緩和ケア医を含む緩和ケアに携わる医療提供者を対象にFrommelt Attitude Toward Care Of Dying Scale Form B日本語版(FATCOD B-J)を用いて質問紙調査を実施した.【結果】解析対象は223例であった(回収率42.2%).FATCOD B-J総得点を目的変数とした重回帰分析の結果,偏回帰係数は年代で40代と比較して30代以下が低く(−3.8),業務から得られる満足感を感じているほうが高く(+5.7),緩和ケアへの関心が強いほうが高かった(+6.2).【考察】緩和ケアへの関心と業務から得られる満足感がターミナルケア態度の涵養に重要である可能性がある.

著者

武隈 洋 岩井 美和子 藤原 俊恵 川岸 亨 熊井 正貴 松浦 麻耶 馬渕 朋美 須田 範行 宮本 剛典 荻野 修 菅原 満 宮崎 勝巳

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.31, no.7, pp.575-584, 2005-07-10

被引用文献数

5 6

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The results of cancer chemotherapy have been improved remarkably by the development of new drugs and combining drugs in treatment. However, cancer chemotherapy protocols are complicated and the adverse effects are more severe than those of other pharmacotherapies. It was therefore felt important to create a database of protocols for the preparation and dispensing of drugs used in cancer chemotherapy. Using Microsoft Access, we have created a database from 320 protocols we have collected so far from 12 clinical departments and developed operating programs for it. The database has enabled us to search for a protocol using keywords-names of drugs, diseases and clinical departments-and most of the operations can be carried out by the click of a mouse. With our database, pharmacists are able to access protocols quickly and check prescriptions of anticancer drugs even if they are unfamiliar with computers, and we consider it to be a useful tool for this purpose.