著者
矢野 育子
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.9, pp.971-975, 2022-09-01 (Released:2022-09-01)
参考文献数
5
被引用文献数
1

In Japan, each society has developed its own certification system for the pharmacy specialists in a specific area of pharmaceutical care. Since 2020, we have conducted research activities supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare to assure the quality of pharmacy specialists similar as other medical professionals. We proposed three reform plans. First, we defined a pharmacist career path after obtaining a license by redefining the name of a qualified pharmacist: Step 1, Training-Certified Pharmacist; Step 2, Board-Certified Pharmacist; and Step 3, Pharmacy Specialist. Second, we proposed common external standards for the Pharmacy Specialist. Third, we proposed the need for third-party certification for pharmacy specialists. New reforms for the pharmacy specialists are required under the autonomy of pharmacists.
著者
冨田 猛 山本 和宏 山下 和彦 大本 暢子 槇本 博雄 矢野 育子
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.45, no.12, pp.698-705, 2019-12-10 (Released:2020-12-11)
参考文献数
15

We began to print the laboratory data of each patient on their in-hospital prescription in April, 2010 and further introduced a prescription checking system associated with laboratory data in December, 2014. This study evaluated the changed prescriptions based on prescription queries and the usefulness of using prescriptions with laboratory data as well as the prescription checking system. We examined the number of changed in-hospital prescriptions after the prescription queries in three periods: before and after using prescriptions with laboratory data (from June, 2009 to November, 2009 and from June, 2010 to November, 2010, respectively), and after the introduction of the prescription checking system (from September, 2016 to August, 2017). Although there were no changed prescriptions based on the laboratory data before using prescriptions with laboratory data, 6.6% of changed prescriptions were based on laboratory data after using prescriptions with laboratory data. In addition, the changed prescription ratio based on laboratory data significantly increased after the introduction of the prescription checking system compared with that after using prescriptions with laboratory data (8.9% versus 6.6%, P = 0.015). In conclusion, using prescriptions with laboratory data and the prescription checking system associated with laboratory data were useful for checking prescriptions effectively in order to avoid adverse drug reactions.
著者
石川 愛子 宇田 篤史 矢野 育子 冨田 猛 阪上 倫行 野崎 晃 西岡 達也 久米 学 槇本 博雄 濱口 常男 岩川 精吾 北河 修治 平井 みどり
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.44, no.4, pp.157-164, 2018-04-10 (Released:2019-04-10)
参考文献数
9
被引用文献数
3 3

Kobe University Hospital created a simplified 14-item protocol for resolving out-of-hospital prescription queries. The protocol was implemented in September 2016 in nine community pharmacies. If prescriptions were changed as per the new protocol or via typical query procedures, we asked community pharmacies to fax the changed prescriptions, and the hospital pharmacists, rather than medical doctors, modified the prescription history. To evaluate the effects of this simplified protocol, we examined the number of changed outpatient prescriptions and administered questionnaire surveys to community pharmacists and hospital-based medical doctors. The ratio of changed to total outpatient prescriptions decreased in January 2017 (4.1%) compared with those in September 2016 (6.4%). Ultimately, more than half of all outpatient prescriptions were changed by the protocol. Drug brand name changes accounted for 52% of the total changes during both September 2016 and January 2017, but the proportion of residual medicine adjustment increased from 12% in September 2016 to 26% in January 2017. Due to the questionnaire survey, 33% of surveyed medical doctors indicated that they knew or had heard of the protocol, and 54% responded that the protocol decreased the burden of addressing outpatient prescription queries. The community pharmacies reported that the burden of clarifying outpatient prescription queries decreased. In conclusion, implementation of the simplified protocol for outpatient prescription queries improved medical efficiency and may help promote cooperative streamlining of community patient pharmaceutical care services.
著者
冨田 猛 野崎 晃 宇田 篤史 山本 和宏 西岡 達也 久米 学 槇本 博雄 矢野 育子 平井 みどり
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.19, no.1, pp.1-7, 2017-05-31 (Released:2017-06-16)
参考文献数
10

Objective: When responding to questions regarding drug-drug interaction by the medical staff of our hospital, pharmacists previously collected information using some drug databases from Japan and the United States.  The aim of this study was to construct a search system for interaction information using drug databases from both Japan and the United States for streamlining questions and answers regarding drug-drug interaction.Methods: Using the drug databases from Japan and the United States, we collected information on the interaction pertaining to drugs prescribed at Kobe University Hospital.  This information was further assessed for consistency.  Furthermore, we constructed an original search system for interaction information for streamlining questions and answers regarding drug-drug interaction.Results: The difference between information obtained from the databases from Japan and the United States was apparent.  Thus, we concluded that it was necessary to obtain interaction information via a database search that included information from both the countries.  Therefore, our original interaction search system was reconstructed with interaction information collected using databases from both the countries.  We compared the response to questions regarding the previous and present methods using our original search system for interaction information; the time required to obtain the responses was 5.89 and 3.09 min, respectively, and it took lesser time for providing responses than the previous method.Conclusion: We evaluated the usefulness of the original search system for interaction information.  We found that the original system provides a more rapid response to questions compared with the previous method.  We are considering a further upgrade and update for the original system by adding information on drugs not prescribed by our hospital.
著者
矢野 育子
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.1, pp.1-8, 2002-02-10 (Released:2011-03-04)
参考文献数
21

Although acetazolamide, a carbonic anhydrase inhibitor, has an effect of lowering the intraocular pressure, a number of side effects have been reported with its use.We therefore investigated the pharmacokinetics and pharmacodynamics of acetazolamide in patients with an intraocular pressure (IOP) elevation. The plasma acetazolamide concentration and IOP in 17 patients with a transient IOP elevation were simultaneously measured after the last acetazolamide administration, and the findings were analyzed by nonlinear mixed effect modeling using the NONMEM software program. The plasma concentration profile of acetazolamide was characterized by a one-compartment model with first-order absorption.The apparent oral clearance (L/hr) showed a correlation with the creatinine clearance (CCR, mL/min), as estimated by the Cockcroft and Gault equation, as follows : 0.0468·CCR. The estimated apparent oral volume of the distribution, first-order absorption rate constant, and absorption lag time were 0.231 L/kg, 0.821 hr-1, and 0.497 hr, respectively. The intraocular pressure after oral acetazolamide administration was characterized by an Emax model. The maximal effect in lowering the IOP (Emax) was 7.2 mmHg, and the concentration corresponding to 50% of Emax (EC50) was 1.64 μg/mL. We next investigated the relationship between the acetazolamide concentration and its side effects in 23 glaucomatous patients who received repeated doses of oral acetazolamide for one week or more. The serum concentration of chloride ion was found to be higher than the normal range, and also showed a significant correlation with the acetazolamide concentration in the erythrocytes. The patients with an erythrocyte acetazolamide concentration of more than 20μg/mL had higher incidents of the side effects. Based on these results, the recommended dosage of acetazolamide was calculated so that the minimum plasma concentration at steady-state exceeded 4μg/ mL. The dosage regimen desired in this study is expected to contribute to the safe and effective pharmacotherapeutic use of acetazolamide.
著者
片田 佳希 中川 俊作 田上 裕美 津田 真弘 都築 徹教 端 幸代 小高 瑞穂 米澤 淳 萱野 勇一郎 矢野 育子 南方 謙二 坂田 隆造 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.42, no.1, pp.14-22, 2016-01-10 (Released:2017-01-10)
参考文献数
14
被引用文献数
4 7

Vancomycin (VCM) is a first-line antibiotic used for methicillin-resistant Staphylococcus aureus (MRSA), and therapeutic drug monitoring (TDM) is recommended to minimize the risk of nephrotoxicity and ensure successful therapeutic outcomes. In Kyoto University Hospital, we have developed a new approach of pharmacist intervention in the medication with VCM, which is named “Protocol-Based Pharmacotherapy Management (PBPM).” PBPM is based on a protocol approved in a hospital committee, which mentioned that pharmacists could order TDM and propose the most appropriate treatment plans with VCM to surgeons. From April 2011 to September 2014 in Kyoto University Hospital, a total of 54 patients hospitalized for cardiovascular surgeries received VCM without the treatment of hemodialysis. Twenty-nine patients before introducing PBPM were the control group. The VCM treatment according to PBPM was applied to 25 patients (protocol group). The incidence of acute kidney injury (AKI) due to VCM therapy, the retention rates of VCM blood concentration maintained in the therapeutic range (10-20 µg/mL) and in the toxic range (over 20 µg/mL) were retrospectively surveyed. The incidence of AKI was significantly lower in the protocol group than that in the control group (8.0% vs 31.0%, P < 0.05). The retention rates maintained in the therapeutic blood concentration range and in the toxic blood concentration range were significantly different between the control group and the protocol group. These results demonstrate that pharmaceutical intervention based on PBPM for MRSA treatment is effective for maintaining VCM blood concentration in the therapeutic range, resulting in a reduction of adverse drug reactions.
著者
曽我 昭宏 矢野 育子
出版者
一般社団法人 日本薬学教育学会
雑誌
薬学教育 (ISSN:24324124)
巻号頁・発行日
vol.5, pp.2021-007, 2021 (Released:2021-06-30)
参考文献数
21

入院患者の栄養状態を改善することは,退院後の人生を含めて考えた場合,生活の質の向上や死亡率の減少へとつながる重要な要素である.高齢社会を迎え,栄養状態の評価やその効率的な改善方法の開発が不可欠である.平成25年度改訂版薬学教育モデル・コアカリキュラムでは,D衛生化学に「栄養」に関する到達目標が追加され,E医療薬学やF薬学臨床では実習前教育として基本的な到達目標が設定されている.しかしながら,薬学が得意とする薬理学・薬物動態学と栄養学との関連を体系的に学ぶ教育はほとんど行われていないのが現状である.ここでは,臨床現場での栄養サポートチームの活動や最近注目されている低栄養の新診断基準であるGLIM criteriaと,栄養状態が薬物動態や薬物反応性に与える影響について紹介し,病院薬剤師の立場から「栄養薬学」という新しい概念の必要性について述べる.
著者
元井 玲子 矢野 育子 尾崎 淳子 鋒山 香苗 山本 崇 深津 祥央 石塚 良子 松村 由美 谷口 正洋 東村 享治 松原 和夫
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.135, no.10, pp.1177-1184, 2015-10-01 (Released:2015-10-01)
参考文献数
13
被引用文献数
2 2

The use of iodine contrast agents occasionally causes serious allergic symptoms including anaphylaxis. At Kyoto University Hospital to prevent nephropathy we began recommending water intake before and after administration of iodine contrast agents in September 2012. In the present study we investigated the effect of water intake on the incidence of allergy-like events after the use of non-ionic iodine contrast agents. We extracted the occurrence of allergy-like events from the incident report system in our hospital from January 2011 to September 2014, and classified these events into the following 3 grades: 1+ (follow-up); 2+ (medication treatment); and 3+ (hospitalization). The allergy-like incidence rate was calculated for subsequent evaluation according to season and water intake. Allergy-like events significantly decreased from 0.49% before the recommendation of water intake to 0.26% at 1 year and 0.20% at 2 years after implementing the recommendation. The incidence of allergy-like events was significantly higher in summer than in winter before water intake was recommended. After implementing the recommendation, the value for summer significantly decreased to an incidence similar to that of winter. Respiratory and gastrointestinal allergy-like symptoms were dramatically decreased after implementing the recommendation. Water intake may be useful for preventing allergy-like events associated with non-ionic iodine contrast agents, especially during the summer.
著者
矢野 育子
出版者
一般社団法人 日本臓器保存生物医学会
雑誌
Organ Biology (ISSN:13405152)
巻号頁・発行日
vol.26, no.2, pp.131-137, 2019 (Released:2019-09-26)
参考文献数
14

A physiologically based pharmacokinetic model adapted to the clinical data was constructed in order to evaluate the contribution of liver regeneration as well as hepatic and intestine CYP3A5 genotypes on tacrolimus pharmacokinetics in adult patients after living-donor liver transplantation. As a result, the oral clearance of tacrolimus was affected by the CYP3A5 genotypes in both the liver and intestine to the same extent. Population pharmacokinetic and pharmacodynamic analysis of mycophenolate was performed in 49 patients undergoing hematopoietic stem cell transplantation. Simulations based on the final parameters show that the dosage adjustment based on plasma concentrations of mycophenolate is required especially for patients with renal dysfunction and/or diarrhea. In conclusion, pharmacometrics is a useful methodology for individualized and optimized therapy of immunosuppressants.
著者
矢野 育子
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.139, no.10, pp.1227-1234, 2019-10-01 (Released:2019-10-01)
参考文献数
31

Pharmacometrics is the mathematical study of pharmacokinetics, disease progression, and clinical outcomes. One objective of pharmacometrics is to facilitate rational drug treatment in patients, also termed clinical pharmacometrics. In this review, our clinical pharmacometric studies conducted over the last 10 years are discussed. Population pharmacokinetic analysis using therapeutic monitoring data for levetiracetam revealed that oral clearance allometrically scaled to both body weight and estimated glomerular filtration rate can accurately predict clinical data from patients of various ages (pediatric to elderly) with varying renal function. Dosage adjustments based on renal function in the package information are effective in controlling the trough and peak concentrations in similar ranges. In addition, a retrospective pharmacokinetic and pharmacodynamic study revealed that the efficacy of low-dose clobazam therapy was significantly influenced by CYP2C19 polymorphisms. Pharmacokinetic and pharmacodynamic models were successfully built using electronic medical information to explain retrospective international normalized ratio values of prothrombin time before and after catheter ablation in warfarin-treated patients. Simulation studies suggest that more than 20 mg of vitamin K2 is unnecessary in the preoperative period of catheter ablation. A physiologically based pharmacokinetic model adapted to tacrolimus pharmacokinetic data in patients who underwent living-donor liver transplantation was constructed, and clarified that oral clearance of this drug was affected by CYP3A5 genotypes in both the liver and intestine to the same extent. In conclusion, pharmacometrics is a useful methodology for individualized and optimized drug therapy.
著者
伊藤 雄大 髙田 麻季 飯田 真之 宇田 篤史 住吉 霞美 秋山 恵里 丸上 奈穂 丹田 雅明 野間 千尋 山本 和宏 五百蔵 武士 木村 丈司 西岡 達也 久米 学 槇本 博雄 矢野 育子
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.44, no.5, pp.236-243, 2018-05-10 (Released:2019-05-10)
参考文献数
18
被引用文献数
2

Team-based learning (TBL) is an active learning method which has been designed to help students solve problems both by themselves and as a team. In this study, TBL was introduced in the journal club (gathering to read and discuss medical papers) for pharmacists, and its effectiveness was compared with that of a traditional lecture. The subjects, 29 pharmacists at Kobe University Hospital, were randomly allocated to the lecture group and TBL group. The pre-test was conducted two months before the journal club, and the post-tests were conducted immediately and one month after the journal club. There was no significant difference in the background data of the pharmacists between the lecture group and the TBL group. The score differences between the pre-test and the post-test immediately after the journal club were not significant (11.4 ± 2.3 points (mean ± SD) in the TBL group, 8.8 ± 4.2 points in the lecture group, P = 0.14). The post-test scores immediately after the journal club in the TBL group (19.6 ± 0.5 points) were significantly higher compared with those in the lecture group (17.8 ± 1.5 points) (P < 0.01), and the learning effect provided by TBL tended to be maintained one month after the TBL. In conclusion, TBL was an alternative method of the ordinal lecture and may be a useful learning method for pharmacists to read medical papers critically compared with the ordinal lecture.
著者
矢野 育子 井関 健 東海林 徹 青山 隆夫 木津 純子 中村 均 藤井 俊志 渡邊 美智留 野田 幸裕 脇屋 義文 森田 邦彦 手嶋 大輔 二神 幸次郎
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.1, pp.43-49, 2009 (Released:2010-02-07)
参考文献数
8
被引用文献数
1 1

With the introduction of 6-year pharmacy educational program in 2006,a provision was made to assign pharmacist faculties having working experience as pharmacists in pharmacy schools.In October 2007,we conducted a survey to investigate the situation of pharmacist faculties.We sent a questionnaire to 247 pharmacist faculties in 66 pharmacy schools and the response rate was 84.9%.The faculties consisted of professors (43%),associate professors (23%) and lecturers (23%),and 77% of them had a Ph.D.degree.In a typical week,the major activities they engaged in were educational activities (20.6 hrs),research (12.2 hrs) and management (9.6 hrs).While the average time they were occupied by clinical practice was 3.5 hrs,67% of them did not do any.Half of the faculties did not conduct any research with students or graduate students in their own schools,and in 2007 only 55% applied for Grant-in-aid for Scientific Research from the Ministry of Education,Culture,Sports,Science and Technology of Japan.Twenty-six percent said they were very satisfied or satisfied with their work on a five-point scale,and 44% rated their degree of satisfaction as fair.In conclusion,our survey showed that most pharmacy faculties are not sufficiently engaged in clinical practice and do not spend much time in clinical research.We hope that its results will promote discussions among pharmacy personnel concerning the role of pharmacist faculties so that even better clinical pharmacy education may be provided to students in pharmacy schools.
著者
乾 賢一 矢野 育子 増田 智先
出版者
京都大学
雑誌
萌芽研究
巻号頁・発行日
2006

研究代表者等はこれまでに、生体肝移植患者において、シクロスポリンやタクロリムスの標的分子であるカルシニューリンの酵素活性が、これら薬物の免疫抑制効果の指標となり得ることを明らかにしてきた。本研究では、臨床応用可能な迅速かつ高感度な新規カルシニューリン活性測定法の開発を目指して、ELISA法を用いた測定系について検討した。現在までに、カルシニューリンの特異的基質であるリン酸化RIIペプチドに対する抗リン酸化ペプチド抗体の作成に成功し、さらに抗体の特異性が確認された。続いて、抗リン酸化RIIペプチド抗体をプレートに固相化し、FLAG付リン酸化RIIペプチドを標準物質として、サンドイッチELISA測定系を確立した。FLAG付リン酸化RIIペプチドの定量性は、0.125-4ng/mLの範囲であった。本法は、カルシニューリンによるリン酸化RIIペプチドの脱リン酸化反応(ステップ1)と、FLAG付リン酸化RIIペプチドによる反応終了液中に含まれるリン酸化RIIペプチドの定量(ステップ2)を行うことを特徴とし、反応前後のリン酸化RIIペプチドの物質収支からカルシニューリンの脱リン酸化活性が算出できる。本年度は、リン酸化RIIペプチド定量のための条件検討を実施した。まず、ステップ1の停止液のステップ2に対する影響を調べた結果、常用の5%トリクロロ酢酸/0.lMリン酸二水素カリウム溶液を用いた場合、FLAG付リン酸化RIIペプチド(4ng/mL)の検出が不可能であった。そこで次に、5mM EGTA(カルシニューリンの阻害剤)をステップ1の停止液として用いた場合、ステップ2には影響せず、FLAG付リン酸化RIIペプチドの検出が可能であることが示された。今後、開発したnon-RI ELISA測定系の臨床応用に向けて、カルシニューリン活性測定の最適化及び全自動化を目指す予定である。