著者

猪狩 賢蔵 鈴木 信也 関 博志 野村 嘉奈子 外園 弥生 吉田 蘭子 阪上 貴子 伊藤 智一 荒瀬 透 林 誠一

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.4, pp.179-184, 2021-04-10 (Released:2022-04-10)

参考文献数

11

---

Postoperative nausea and vomiting (PONV) are common and unpleasant postoperative complications. Although guidelines recommend preventative measures according to PONV risk, anesthesiologists do not always follow the guidelines. In this study, we investigated whether the pharmacists’ proposal of a PONV prevention method to anesthesiologists in accordance with the guidelines affected the decision-making of anesthesiologists and subsequent PONV development. Two hundred and five patients who underwent gynecological surgery at Keiyu Hospital were included in this study, and the number of preventative measures selected by an anesthesiologist and frequency of PONV complications before and after the pharmacists’ intervention were determined. After the intervention, the number of preventative measures implemented by the anesthesiologist increased in the PONV moderate- and high-risk groups (P < 0.01) and incidence of PONV in patients decreased [odds ratio 0.362 (95% confidence interval 0.174 - 0.726) (P < 0.01)]. It is the intention of anesthesiologists for pharmacists to evaluate PONV risk and propose preventative measures that comply with guidelines to anesthesiologists. The results of this study show that the proposal of pharmacists on PONV prophylaxis affects anesthesiologists’ decision-making and is effective in preventing PONV.

著者

鈴木 信也 川口 崇 猪狩 賢蔵 草野 淳一 安藤 栄輝

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.18, no.4, pp.235-241, 2017 (Released:2017-03-17)

参考文献数

24

---

Objective: Celecoxib has been reported to enhance the action of warfarin by inhibiting CYP2C9, its major hepatic drug-metabolizing enzyme, but sufficient information about the mechanism has not been obtained, especially in Japan.Methods: A study was conducted to investigate the prothrombin time international normalized ratio (PT-INR) and the warfarin sensitivity index (WSI) before and after concurrent administration of celecoxib, as well as the Drug Interaction Probability Scale (DIPS) scores to determine causality with drug interactions, in patients commencing concurrent therapy with celecoxib and warfarin at Kanagawa Prefectural Keiyukai Keiyu Hospital during the 4-year period from October 2011 to September 2015.Results: Analysis of 18 patients showed that the PT-INR increased significantly from 1.53±0.43 before concurrent therapy to 2.18±1.01 after concurrent therapy (p=0.0101).  The WSI also increased significantly from 0.76±0.50 before concurrent therapy to 1.01±0.65 after concurrent therapy (p=0.0044).  According to the DIPS scores, the causal relation was not rated as “Highly Probable” in any of the patients, while it was considered to be “Probable” in 3 patients, “Possible” in 10 patients, and “Doubtful” in 5 patients.Conclusion: The findings of this study suggested that when celecoxib treatment is initiated in patients who are already taking warfarin, attention must be paid to changes of coagulation profile, especially in elderly patients.