6 0 0 0 OA 病院と薬局の合意に基づく院外処方せんにおける疑義照会簡素化プロトコルとその効果
- 著者
- 三木 芳晃 塚本 啓介 奥村 裕英 半崎 隼人 安井 良則 松元 加奈 森田 邦彦 萱野 勇一郎
- 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.44, no.7, pp.349-354, 2018-07-10 (Released:2019-07-10)
- 参考文献数
- 4
There are few reports regarding the optimal decomposition condition of the antimicrobial agent. We therefore conducted a questionnaire about the decomposition operation of the antimicrobial agent vial preparation for nurses in Osaka Saiseikai Nakatsu Hospital. Furthermore, the optimal dissolution conditions for “Zosyn ® IV for intravenous injection 4.5 (tazobactam/piperacillin; TAZ/PIPC)” were examined. As a result of the questionnaire survey, most nurses selected a syringe of 10 mL for formulations that are easy to dissolve while, for difficult to dissolve formulations, answers were split between 10 mL and 20 mL. The shaking time of vials ranged from under 5 seconds to under 30 seconds for the soluble formulations and from under 5 seconds to more than 1 minute for the difficult to dissolve formulations. We set each decomposition condition from the questionnaire results and examined the optimal condition, which accorded with the clinical settings in the decomposition operation of TAZ/PIPC. As a result of having examined the decomposition condition from the absorbance of each complete decomposition preparation of TAZ/PIPC, it was found that more than 93% of dissolution was carried out with the injection of saline at 15 mL and the shaking time of 10 or 20 seconds, or the injection of saline at 20 mL and the shaking time of 10 seconds. If the injection volume and the shaking time are less than these conditions, residual drugs are found in the vials.
- 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.
1 0 0 0 OA ヘパリン生食キット製剤の便益性に関する検討
- 著者
- 後藤 伸之 吉村 直人 萱野 勇一郎 渡辺 享平 林 美由 青池 美穂 白波瀬 正樹 脇屋 義文 政田 幹夫
- 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.28, no.4, pp.401-406, 2002-08-10 (Released:2011-03-04)
- 参考文献数
- 5
- 被引用文献数
- 1
A heparin lock is technique performed in order to prevent blood coagulation in the needle detained in the vessel, or a catheter. In Japan, when we perform a heparin lock, a heparin injection is diluted with physiological salt solution before use. We need to use prefilled syringes with diluted heparin. We received a sample of this product. We investigated the user-friendliness of the product. From our results, the prefilled syringe with the diluted heparin was found to be useful. Furthermore, when we use the prefilled syringe with diluted heparin, patient safety is increased.
1 0 0 0 OA 薬物動態変動機構評価を目的とする探索的臨床試験のデザインおよびデータ解析
医薬品を適正に使用するためには、薬物動態特性と個体間変動機構を明らかにし、患者個々に投与設計を行う事が必要である。しかし、一人の患者から速度論的解析に耐えるほど数多くの血中薬物濃度データを得ることは多くの場合困難であることに加え、市販後に一施設で行う臨床薬物動態試験では、対象患者が多くても数十人に限られるため、従来の薬物速度論的解析法は適用が困難である。本研究では、症例数および採血点数が少ない探索的な臨床試験データの解析法として、最近申請者らが考案した三段階の解析法が有用であることを検証するとともに、臨床試験のデザインとデータ解析の発展を目指した。