著者

小林 星太 大木 孝弘 金谷 祐希 寺沢 明宏 徳久 宏子 菅 幸生

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.48, no.5, pp.212-217, 2022-05-10 (Released:2023-05-10)

参考文献数

11

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Terminal cancer patients receiving home care medicine require emergency home visits by a medical professional during sudden changes in symptoms. However, the actual situation of these visits by health insurance pharmacists is yet to be clarified. Therefore, in this survey, we retrospectively analyzed the actual situation of emergency home visits to terminal cancer patients by the Tokuhisa-chuo Pharmacy during a 1-year period in 2020. We included 134 emergency home visits conducted for 76 terminal cancer patients. Results indicated that emergency home visits tended to be more frequently performed closer to the patient’s end-of-life stage. Patients’ symptoms during emergency home visits were predominantly pain, dysphagia, fever, and respiratory and gastrointestinal symptoms. Drugs such as opioids, gastrointestinal drugs, antimicrobials, and antipyretic analgesics were frequently used to control these symptoms. In particular, the number of emergency home visits intending to manage pain and provide opioids significantly increased in the week before death. This survey clarified the need for emergency home visits by health insurance pharmacists in cancer patients receiving home care medicine in their dying stages.

著者

小林 星太 大木 孝弘 徳久 宏子 菅 幸生

出版者

一般社団法人 日本老年薬学会

雑誌

日本老年薬学会雑誌 (ISSN:24334065)

巻号頁・発行日

vol.3, no.3, pp.65-69, 2020-12-31 (Released:2021-01-28)

参考文献数

8

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Serotonin syndrome refers to the adverse events caused by serotonin-based drugs such as antidepressants. Its clinical manifestations include psychiatric and neurovegetative symptoms. In this communication, we report our experience with an 83-year-old woman receiving antidepressants, who developed subjective symptoms such as heavy sweating, dizziness, and tremor after starting treatment with dextromethorphan. Treatment with antidepressants was continued, but five months later, the patient experienced symptoms of heavy sweating, elevated blood pressure, tremor, and anxiety. In her case, serotonin syndrome was suspected by a pharmacist working in a pharmacy, who promptly carried out early intervention and assisted in the prevention of recurrence. In elderly patients who are prescribed dextromethorphan and antidepressants, the possibility of occurrence of serotonin syndrome needs to be taken into consideration in the follow-up of the clinical course.

著者

林 誠 杉村 勇人 菅 幸生 河原 昌美 相宮 光二 宮本 謙一

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.35, no.2, pp.89-95, 2009 (Released:2010-02-07)

参考文献数

22

被引用文献数

10 13

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Hiccups often occur in patients receiving cisplatin (CDDP)-based chemotherapy.In the present study,we investigated the incidence of hiccups in 162 patients who received CDDP as well as risk factors for developing hiccups.Hiccups occurred in 40 (25%) of the 162 patients,and 93% were men.Twenty-six of the patients had hiccups within 48 hr of CDDP,and in 31 of them the hiccups continued for between 1 and 4 days.Twenty-eight of the patients received medication (shitei-decoction,chlorpromazine,metoclopramide,etc.) to relieve hiccups,which was effective in 30% of them.Hiccups developed in patients with osteochondro sarcoma (56%),lung cancer (49%),pancreatic cancer (40%) and esophagus cancer (23%) receiving the following 4 chemotherapy regimens : CDDP+ADM+CAF (56%),CDDP+DTX (50%),CDDP+5 FU (40%),and CDDP+TS 1 (20%) respectively.The CDDP dosage (mg/m2)was higher in patients who had hiccups than in those who had none (80±22 vs 45±33,p< 0.0001)and there was a positive correlation was between CDDP dosage and incidence of hiccups (p<0.001),though all patients developing them received corticosteroids and 5 HT3 antagonists.Multiple logistic regression analysis showed that there were significant differences for the male sex (odds ratio (OR)=8,95% CI=1.5-45.6),CDDP dose (1.03,1.01-1.06),dexamethasone(≥16 mg) (19.4,3.9-95.2)and granisetron (6 mg) (20.9,3-143).We therefore concluded that the independent risk factors influencing the development of hiccups were the male sex and a high dose of CDDP in combination with dexamethasone(≥16 mg),and granisetron (6 mg).

著者

中川 祐紀子 鈴木 拓也 志村 裕介 菅 幸生 嶋田 努 崔 吉道

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.1, pp.26-33, 2017-01-10 (Released:2018-01-10)

参考文献数

10

被引用文献数

2 3

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The ward pharmacist received a report from ward nursing staff that an aggregation formed when lansoprazole OD tablets and ground levofloxacin tablets were suspended simultaneously in water. In this study, we elucidated the factors of aggregation focusing on additives, the main drug, and pH in suspension, and also considered ways of preventing the aggregation. To elucidate the contribution of additives in levofloxacin tablets, drugs containing similar additives to those of levofloxacin tablets were suspended with lansoprazole OD tablets in water, but no aggregation was observed. Levofloxacin hydrate intravenous drip infusion (pH 4.8) did not form an aggregation with lansoprazole OD tablets, meanwhile levofloxacin hydrate intravenous drip infusion adjusted to pH 7.3 and levofloxacin hydrate solution adjusted to pH 7.3 formed an aggregation with lansoprazole OD tablets. When lansoprazole OD tablets and ground levofloxacin tablets were suspended in a buffer solution of pH 5.0, pH 6.0, and pH 7.0, no aggregation was observed in a buffer solution of pH 5.0. When generic lansoprazole OD tablets and generic lansoprazole capsules were suspended with levofloxacin tablets in water, aggregation was also observed. On the other hand, the aggregation of lansoprazole OD tablets was not observed when lansoprazole OD tablets and levofloxacin tablets were suspended in apple juice. According to the above results, factors related to the formation of the aggregation were involved in the preparation of lansoprazole, levofloxacin hydrate, and around pH 6.0, and the suspending of lansoprazole OD tablets and levofloxacin tablets simultaneously in acidic drinks such as apple juice is means of avoiding the aggregation.

著者

山本 奈歩 堀 祐貴 髙廣 理佳子 菅 幸生 嶋田 努 崔 吉道

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.45, no.3, pp.127-134, 2019-03-10 (Released:2020-03-11)

参考文献数

19

被引用文献数

2

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Albumin-bound paclitaxel (nab-PTX) plus gemcitabine (GEM) therapy (GnP) is often administered to patients with unresectable metastatic pancreatic cancer. However, chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect. In this study, we investigated the risk factors for CIPN in patients who were receiving GnP therapy for pancreatic cancer at our hospital and had a history of prior chemotherapy. The patientsʼ background, laboratory data, previous treatment history, concomitant medication, dose and number of medicines, and occurrence status of side effects were examined. The frequency of CIPN in patients receiving GnP therapy at our hospital was 72%. Multiple logistic regression analysis revealed that a history of FOLFIRINOX therapy (FFX), including oxaliplatin (L-OHP) administration, (odds rate: 3.864, 95% CI: 1.160-12.868) and female sex (odds rate: 3.673, 95% CI: 1.102-12.242) were risk factors for CIPN. In addition, the severity of CIPN was significantly higher in patients with a history of FFX administration (P = 0.011). Further, the cumulative dose and the administration period of nab-PTX until the onset of CIPN were significantly lower in patients with a history of FFX administration (P = 0.016, P = 0.004, respectively). We suggest that special care in monitoring GnP therapy is necessary in female patients with a history of FFX administration.