著者
小園 亜希 諌見 圭佑 塩田 喜美子 津曲 恭一 永野 真久 井上 大奨 安達 るい 平木 洋一 中川 義浩 神村 英利 山道 研
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.5, pp.769-776, 2016 (Released:2016-05-01)
参考文献数
27
被引用文献数
5

Falls are common in elderly patients and are often serious. Several drugs have been associated with an increased risk of fall. Older adults often take multiple drugs for chronic diseases, and thus may be at increased risk from drugs associated with fall. We investigated the association between drug use and falling in hospitalized older people, with the goal of identifying medications that may increase the risk of a fall. A retrospective case control study was performed at the National Hospital Organization Kumamoto Saishunso Hospital in Japan. Medications taken by patients who fell (n=57) were compared with those taken by patients who did not fall (n=63). The median age (interquartile range; IQR) of the fall and non-fall groups were 75.0 (67.0-83.0) and 80.0 (70.3-84.5) years, respectively. The characteristics of the two groups were similar, with no significant differences in age, sex, or body weight. The probability of falling increased when the patients used zolpidem [odds ratio (OR)=2.47; 95%CI: 1.09-5.63; p<0.05] and calcium channel antagonists (OR=0.299; 95%CI: 0.13-0.68; p<0.01), and was also related to physical factors (OR=2.27; 95%CI: 1.01-5.09; p<0.05). Elderly patients taking zolpidem may fall due to sleepiness, and blood pressure control may be important to prevent orthostatic high blood pressure. In the treatment of elderly people, medical staff should try to choose drugs that prevent fall or are not associated with falling.
著者
中村 智美 石倉 宏恭 中野 貴文 仲村 佳彦 神村 英利
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.21, no.4, pp.589-596, 2018-08-31 (Released:2018-09-01)
参考文献数
12

播種性血管内凝固症候群(DIC)治療薬の遺伝子組み換えヒト可溶性トロンボモジュリン(rTM)の急性腎障害(AKI)患者への至適用量を検討した。rTM を1日1回380U/kgまたは130U/kgで投与したDIC合併AKI患者129例を対象とし,持続的血液濾過透析(CHDF)の有無およびrTMの投与量別に,有効性・安全性を評価した。DIC離脱率は,CHDFを施行しなかった患者群ではrTMの用量による違いはなかったが,CHDF施行群では380U/kg群のほうが高い傾向であった(p=0.050)。出血率はCHDFの有無およびrTMの用量間で差はなかった。以上より,AKI合併DIC患者にはrTM 130U/kgと380U/kgで有効性,安全性に差はないものの,CHDF施行時には380U/kg投与によりDIC離脱の可能性が高まることが示唆された。
著者
進 健司 小林 大介 川尻 雄大 牛島 悠一 梅田 勇一 金澤 康範 神村 英利 島添 隆雄
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.2, pp.317-325, 2019-02-01 (Released:2019-02-01)
参考文献数
24

Psychiatric treatment is shifting from hospital to ambulatory care. It is important that pharmacists positively support outpatients. Pharmacist-led interviews with outpatients have been conducted in the psychiatric department of Iizuka Hospital before examination by the doctor since 2015. Few studies in this field have reported about the effect of the pharmacist-led interviews using subjective evaluation of outpatients prior to examination by doctors. The aim of this study was to reveal this effect by the evaluation of outpatients. We conducted a questionnaire survey. More than 80% of the patients responded that it was “Good” to have an interview with the pharmacist prior to examination by the doctor. Moreover, 71.7% of the patients were “Satisfied” with the pharmacist-led interview, while 81.7% of them responded to “Agree” about continuing the interview in the future. Patients who were satisfied and wished to continue the pharmacist-led interviews were more likely to report better rapport with the doctor as well, in comparison to the patients who answered negatively. Furthermore, the patients who answered “Satisfied” were significantly less likely to forget reporting to the doctor than those who answered negatively. The pharmacist-led interviews in the psychiatric department were appreciated by the patients. In conclusion, pharmacists can facilitate communication between patients and doctors through these interviews. These results indicate that the pharmacist-led interview before the doctor examination is a useful effort from the perspective of outpatients.