著者

中村 誓志 森田 恵美子 木村 貞恵 定本 裕美 上野 正嗣 岩井 礼子 生島 忍 広川 慶裕

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.34, no.10, pp.938-942, 2008 (Released:2010-02-07)

参考文献数

13

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Scabies is a major form of dermatitis and in the second edition of clinical management guidelines for scabies drawn up by a committee of the Japanese Dermatological Association in 2007,ivermectin was recommended as a drug of choice for its treatment.Ivermectin had been approved as a treatment for scabies and launched in Japan in August 2006.On administering ivermection to 6 patients who developed scabies in our geriatric mental ward,3 of them subsequently developed hepatic function disorders.In order to investigate the cause of these disorders,we examined their weights,ages,drug interactions,and metabolism.We found that blood levels of ivermectin were easily affected by fat in the diet due to its liposolubility.In addition,since CYP3A4,an enzyme considered to be involved in the metabolism of ivermectin,may increase the toxicity of its metabolic products,we concluded that use of ivermectin should be reviewed.It is recommended that hepatic function tests are carried out a week before and after administering ivermectin,and that it should be given at bedtime to avoid drug interactions.

著者

大谷 真理子 山本 陽介 酒巻 智美 大沼 亜紀 赤木 圭太 松田 慶祐 杉山 奈津子 宮嶋 篤志 廣田 孝司 小茂田 昌代

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.38, no.2, pp.78-86, 2012-02-10 (Released:2013-02-10)

参考文献数

9

被引用文献数

5 6

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An oral scabicide, STROMECTOL® Tablets (ivermectin) is often administered to patients as a simple suspension by feeding tube. However, it was reported that the administration by this method was less effective than oral administration of tablets. One reason for this lower efficacy might be that the devices and technique for this method of administration are not appropriate. The aim of this study is to propose an appropriate technique.In this report, we compare the recovery ratio when a simple suspension is pushed through a syringe under various conditions. As a result of washing the syringe with distilled water after the first use, the recovery of ivermectin was higher than that without washing. The recovery of ivermectin from syringes set at an angle of 90° and 45° to the horizon was significantly higher than that at 0° and -45°. And recovery from previously used syringes was about 10% higher than that from new syringes (p<0.05). Furthermore, after having orally administered STROMECTOL® Tablets and gavaged its suspension with an appropriate delivery technique to rabbits, we measured the ivermectin concentrations in plasma by LC-MS/MS. The AUC0-192h of ivermectin was almost equivalent for both methods of administration.In conclusion, to secure the same dosage of administration with a simple suspension as that of tablets, it is highly recommended to employ a previously used syringe at an angle of over 45°, and to inject by a technique that washes out the entire residue in the syringe after first injection.

著者

岩山 訓典 久保 靖憲 小野 尚志 笠茂 紗千子 飯田 慎也 大滝 康一 山田 峻史 安達 知輝 福土 将秀 粟屋 敏雄 田﨑 嘉一

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.44, no.7, pp.333-340, 2018-07-10 (Released:2019-07-10)

参考文献数

6

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One-dose packages are useful for managing complicated medication regimens for older patients. We experienced a case of Bayaspirin® tablet 100 mg (BA) and Micardis® tablet 40 mg (Mic 40) that were fused in a one-dose package at the time of medicine reconciliation. To our knowledge, there are no previous reports assessing the quality of these tablets caused by this physical incompatibility. Therefore, we aimed to examine this phenomenon and its impact on the drug compositions, as well as to identify the mechanisms.BA and Mic 40 in one-dose packages were stored at 30℃/75% relative humidity (RH) or 93%RH condition for 1 week. The stability evaluations were performed on appearance change, hardness, content, and dissolution rate. The active ingredients in each tablet were investigated to determine the mechanisms.Mic 40 showed changes in appearance and hardness, while BA showed a changed appearance, and reduced content and dissolution rate. The enteric coatings of BA and the additive in Mic 40 had an influence on the mechanism of incompatibility.Mic 40 contains meglumine, which is hygroscopic and deliquescent. Therefore, meglumine absorbs moisture and becomes a basic solution. Methacrylic acid copolymer LD dissolved in this basic solution results in adhesion with Mic 40 and leads to a decrease in both the content and the dissolution rate in BA. This is the first study to analyze the physical incompatibilities of enteric-coated aspirin tablets with non-coated telmisartan tablets in one-dose packages and provides useful information for clinical practice.

著者

湧井 宣行 大久保 哲生 岩崎 雄介 伊藤 里恵 小林 岳 早川 和宏 三井 みゆき 矢野 裕一 斉藤 貢一 中澤 裕之

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.37, no.7, pp.425-430, 2011 (Released:2012-08-30)

参考文献数

9

被引用文献数

6 4

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The pulverization of tablets for the preparation of pediatric medicines causes problems with respect to content uniformity and amount of the main ingredient. We compared these 2 factors in a pediatric medicine prepared by 2 methods: tablet grinding and tablet dilution. We also investigated causes of drug loss by means of high-performance liquid chromatography (HPLC).Three pharmacists prepared cortril powder by each method. When the main ingredient content was calculated by quantitative analysis by means of HPLC, there was no significant difference between the 2 methods, and adhesion to the mortar and the package were considered to be major reasons for drug loss.We also examined the effect of the amount of diluent on the loss of the main ingredient in the grinding process, finding that increasing the amount of diluent minimized the loss of the main ingredient content. When the amount of diluent per package was 1.5g, the main ingredient content was 90.8% (n=3).These results suggest that when dispensing small amounts of ground tablets, more attention should be paid to the amount of diluting agents than to the grinding technique.

著者

朝倉 寛達 三科 ますみ 倉田 なおみ 伊藤 喬 雨宮 美智子

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.36, no.5, pp.310-315, 2010 (Released:2012-03-09)

参考文献数

8

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Epadel S®,a seamless capsule form of ethyl icosapentate (EPA-E),was made into a suspension in 20 ml of hot water (55°C) and stirred with a polystyrene (PS) disposable spoon.When left in the suspension,the surface of the spoon started to dissolve after 45 minutes,and was completely dissolved after 12 hours.We also investigated the dissolution of PS utensils in suspensions made from teprenone (Selbex®) capsules or powder,or gefarnate (Gefanil®) capsules.Up till now,there have been no reports of toxicity due to PS or the non-reactants and/or by-products produced in the PS production process.However,as the dissolution of spoons,cups or other common utensils made of PS in drug suspensions could cause concern among patients,caregivers,and medical staff,it is important to instruct them to avoid the use of such utensils when preparing drug suspensions.

著者

小田 雅子 古戸 友里恵 市村 祐一 森 亨 高橋 満里 齊藤 浩司

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.46, no.10, pp.606-612, 2020-10-10 (Released:2021-10-10)

参考文献数

12

被引用文献数

1

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One-dose packaging improves the convenience of patients in drug therapy and is useful for securing medication adherence. As psychiatric patients take plural, sometimes many, drugs before bedtime, there are increasing demands for utilizing one-dose packaging in dispensing drugs for these patients. Suvorexant is a potent and selective antagonist against orexin 1 and 2 receptors and its use as an insomnia remedy is rising rapidly. On the package insert of suvorexant (Belsomra®) tablets, there is a description "Store in the press through package (PTP) until use to protect from light and moisture". So far, however, little information has been available about the correct storage conditions regarding the one-dose packaging of Belsomra® tablets. In this study, we investigated the stability of one-dose packaged Belsomra® tablets, which were preserved for 30 days at room temperature or at room temperature under 85% relative high humidity (high humidity), with a focus on the changes in appearance, hardness, mass, disintegration, content, and dissolution. Suvorexant content and the appearance of one-dose packaged Belsomra® tablets did not change even after 30 days. However, the tablets greatly lost hardness and showed an increase in mass, possibly due to the hygroscopicity of this formulation. These changes resulted in the prolonged disintegration time of one-dose packaged Belsomra® tablets and in the retarded dissolution of suvorexant from the tablets. These results suggest that Belsomra® tablets are hygroscopic and less stable. It is, therefore, desirable to avoid long-term, one-dose packaging of this formulation.

著者

齋田 哲也 藤戸 博

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.32, no.7, pp.693-699, 2006-07-10 (Released:2007-11-09)

参考文献数

16

被引用文献数

4 3

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Furanocoumarin derivatives such as bergamottin and 6',7'-dihydroxybergamottin are inhibitors of CYP3A4 and have been isolated from grapefruit juice. We developed a sensitive and specific enzyme-linked immunosorbent assay for these furanocoumarin derivatives and used it for screening a large number of citrus fruits, vegetables and crude drugs for them. On testing the juice and peel of 25 citrus fruits, significant reactivity was observed with the juice of 4 of them : sweetie, melogold, banpeiyu pummelo and red pummelo and in the case of peel, significant reactivity was observed for 4 fruits : sweetie, melogold, sour pummelo and natsudaidai. For most of the citrus fruits, the peel showed a stronger reaction than the juice. Seven vegetables were tested and only slight reactivity was observed for 4 of them : parsley, celery, Italian parsley and mitsuba. Among the twenty crude drugs tested, significant reactivity was observed for 2 : angelica dahurica root (byakushi) and bitter orange peel (touhi). These findings suggest that 4 of the citrus fruits and 2 of the crude drugs tested would exhibit strong drug interactions.

著者

濃沼 政美 瀬尾 誠 高瀬 知永 西澤 光代 平野 公晟 荒川 秀俊 前田 昌子

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.29, no.2, pp.203-209, 2003-04-10 (Released:2011-03-04)

参考文献数

11

被引用文献数

2 2

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In hospitals oil based ink is occasionally used to write the patient's name, his room number, and names of the drugs that are used in a mixture on the plastic containers used for infusion. This is done to prevent medication errors. In the current study, the effect of an oil-based ink on the infusion fluid was investigated.Using an oil-based ink containing xylene, letters and other characters were written on an infusion fluid container that was made of Polypropylene·Polyethylene·Ethylene vinyl acetate. It was confirmed that some xylene had been transported to the interior of the container (air phase). Furthermore, the xylene concentration in the air phase rose with repetitive writing and erasing, using the same oil-based ink. But no xylene was dissolved in the solution that was in the container (liquid phase).This observation convinced us that it is highly unlikely that the xylene in the ink can be infused directly into a patient's body. However, to assure the quality of the medication that is in liquid form, it is not desirable for a substance that does not normally exist as a component of the medication to move through its container. In the present experiment, physiological saline was used as a solution (liquid phase). Our findings showed that xylene had a high possibility of dissolving in solutions known for high xylene solubility (e. g., solutions with a large amount of amino acids or surfactants). Therefore, it is necessary to design a method to prevent ink from entering a container when an oil-based ink is applied to the outside of it.

著者

加瀬 浩二 松田 公子 原 広一郎 櫻井 正太郎 高山 幸三 浅井 邦彦

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.18-23, 2009 (Released:2010-02-07)

参考文献数

11

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The frequency of accidental falls in psychiatric patients is reported to be markedly higher (46.5%) than in patients in other medical departments (15.7%).In order to prevent accidental falls,we provided physicians and nurses with pharmaceutical information on the adverse effects of cold medicines and traditional Chinese medicines.We also investigated the annual number of falls among inpatients before and after beginning our pharmaceutical information service.To do this,a questionnaire concerning cold medicines and traditional Chinese medicines was sent to physicians and nurses 2 years after starting the service.Owing to the provision of information,there were reductions in the annual number of falls (212 to 143),number of falls in patients taking cold medicines (8 to 1),percentage of falls in patients taking cold medicines among all falls (3.8% to 0.7%),and frequency of prescribing cold medicines for the common cold (96% to 75%).The questionnaire results also showed that 68% of physicians and nurses observed dizziness as an adverse effect of cold medicines,and 71% of physicians exercised caution with respect to the risk of falls due to cold medicines.To analyze the causes of accidental falls,a self-organizing map (SOM) was applied to the clinical data.The results suggested that the administration of cold medicines together with comparatively low dosages of chlorpromazine,or an equivalent antipsychotic,and two or more kinds of medication for Parkinson's disease was likely to lead to accidental falls.Thus,for patients having a high risk of falls,the co-administration of cold medicines and psychotropic drugsmayfurtherincreasesuch risk.

著者

石田 志朗 本池 慶 岡本 育子 山川 和宣 渡辺 智康 安藤 哲信 鈴江 朋子 岡野 善郎

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.40, no.5, pp.285-290, 2014-05-10 (Released:2015-05-10)

参考文献数

5

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Amitiza® is available as an oval, soft gelatin capsule containing 24 μg of lubiprostone dissolved in a medium-chain triglyceride. Lubiprostone is a chloride channel activator indicated for the treatment of chronic idiopathic constipation in adults. Although Amitiza® capsules should be swallowed whole and not broken apart or chewed, the capsules have been administered by a simple suspension method to recipients unable to ingest food or drugs orally. The administration of Amitiza® capsule suspension through nasoenteric feeding tubes has not been investigated. Therefore, we evaluated whether the capsules are appropriate for administration through nasogastric tubes. The capsules disintegrated and dispersed after 10 min in 30 mL of hot water at 55°C. The suspension was transferred into a syringe or suspension bottle and passed through nasoenteric feeding tubes (8 Fr) without obstruction. Lubiprostone levels in each sample were determined by liquid chromatography/mass spectrometry. More than 93% of the lubiprostone was contained in suspension with flash solution through the feeding tubes administered through both the tubes. In conclusion, this study suggests that Amitiza® capsules can be administered to patients by a simple suspension method through nasoenteric feeding tubes.

著者

山田 麻衣子 大野 能之 樋坂 章博 山口 諒 鈴木 洋史

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.39, no.11, pp.660-667, 2013-11-10 (Released:2014-11-10)

参考文献数

22

被引用文献数

1 1

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We investigated the relationships between the renal excretion ratio (RR) and changes in drug exposure in patients with renal dysfunction (RD), to examine the usefulness of RR in determining the optimal dosage for patients with renal dysfunction.The area under the plasma concentration time curve ratios (AUC ratios: AUCRs = AUCRD/AUCNormal) of 52 out of 70 drugs was observed within 67-150% of the theoretical values calculated by the Giusti-Hayton method using the RR value. It was confirmed that the RR is useful for determining the optimal dosage of extensively renally excreted drugs for patients with RD. However, it should be noted that the AUCRs were more than 150 % of the theoretical value for some orally administrated drugs that are excreted renally but less extensively. Especially, for substrates of OATP1B1 or OATP1B3, the AUCRs of four out of five drugs were more than 150%. Substrates of metabolizing enzymes and other transporters showed less relevance in this regard.

著者

日置 智津子 荒井 勝彦 高士 将典 新井 信

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.34, no.6, pp.513-521, 2008 (Released:2009-09-04)

参考文献数

23

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Obesity is one of the most common metabolic diseases,and obesity-associated disorders have reached epidemic proportions.Abdominal obesity in particular has been linked with elevations in total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),and triacylglycerol (TG),as well as with decreased high-density lipoprotein cholesterol (HDL-C),and is also associated with elevated blood pressure.It has been noted that excessive fat tissue in and around the abdomen leads to the very common disorder of metabolic syndrome but effective prophylactic agents and methods for treating it have not yet been discovered.Amid these circumstances,Bofutsushosan (BF),a Kampo (Chinese herbal medicine) remedy,has been studied as an antiobesity drug for the treatment of metabolic disorders.Specialists in Kampo medicine have prescribed BF for“HimanShou”(obesity with large waist and potbelly) through Kampo diagnosis based on“Shou”(constitution),which cannot be said to be the same condition as the obesity that is prevalent worldwide since it is diagnosed by the procedures of western medicine.Thus in order for BF to be accepted as an anti obesity treatment in modern medicine,much data must be collected on the mechanism by which it reduces fat as well as its safety.There also need to be ethical guidelines for its use for this purpose.With this in mind,we first conducted basic experiments on obese mice and then double-blind,randomized controlled trials on outpatients in an obesity clinic.The aim of this study was to test the effectiveness of Bofutsushosan in clinical practice,in particular for obesity with impaired glucose tolerance (IGT) which is reported to increase the risk of cardiovascular events,using western medical procedures and scientific evaluation methods.

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

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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

尾﨑 正和 幸田 恭治 堀 健志 山下 裕司 古川 裕之

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.4, pp.223-229, 2017-04-10 (Released:2018-04-10)

参考文献数

9

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Acetaminophen is approved up to 4,000 mg per day as an analgesic agent in Japan and displays analgesic effects depending on dosage. On the other hand, acetaminophen has some interactional effects. The mechanism of the interaction between acetaminophen and warfarin has not been elucidated, and no interactional cases have been reported in Japan either. However, two cases of marked PT-INR elongation were recognized by two inpatients in our hospital, Japanese males in their 50s and 60s who were treated with concurrent chemoradiotherapy using 70 Gy radiotherapy delivered as 2 Gy daily and triweekly 100 mg/m2 cisplatin, that had been prescribed both drugs. Each PT-INR lapsed into loss of control; the maximum for one was more than 20 which was unmeasurable and for the other, 9.48, given vitamin K2 (VK2) immediately was antagonistic to warfarin. Concomitant drugs of warfarin were promptly checked again to see if it was related to the plasma protein binding ratio and hepatic cytochrome P450 inhibition reaction. Furthermore, each liver function test was also normal. As a result of consideration on these two, the dosage of acetaminophen has possible implications. It could be caused by the active metabolite of acetaminophen, NAPQI (N-acetyl-para-benzoquinone imine), as reported by basic research of VK cycle inhibitory action; however, the mechanism is not completely clear yet so future research is required to clarify this point. In any case, it is necessary to regularly measure PT-INR through the combination of warfarin and acetaminophen.

著者

寺原 史貴 木佐 健悟 山田 航輔 横川 祐美 齋藤 俊一郎

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.43, no.6, pp.306-312, 2017-06-10 (Released:2018-06-10)

参考文献数

10

被引用文献数

2 3

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This study investigated the efficacy of ceftriaxone (CTRX) for the treatment of aspiration pneumonia. We compared patients treated with CTRX versus sulbactam/ampicillin (SBT/ABPC). One-to-one propensity score matching was performed to compare the success rates of antibiotic therapy and in-hospital mortality between the groups. Moreover, the duration of antibiotic use, hospital period, and total antibiotic costs were compared among effective patients in the groups. There were 43 and 20 patients in the SBT/ABPC and CTRX groups, respectively. The propensity score matching included 20 patients in each group. There was no significant difference in the success rate of antibiotic therapy (85% vs 95%, P = 0.62) or in-hospital mortality (25% vs 5.0%, P = 0.22) between the groups. In addition, there was no significant difference in the duration of antibiotic use (median: 9 days vs 10 days, P = 0.94) or hospitalization period (median: 19 days vs 18 days, P = 0.94) among the effective patients in the groups. However, the total antibiotic costs were significantly lower in the CTRX effective group than the SBT/ABPC effective group (13,731 ± 4,903 yen vs 20.772 ± 6,840 yen, P = 0.001). CTRX may be another choice for antibiotic treatment for patients with aspiration pneumonia when they have no risk of drug-resistant bacteria.

著者

高藤 由紀子 菅野 悠子 中島 由紀 清海 杏奈 杉浦 宗敏 大谷 道輝 高塚 隆之

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.2, pp.68-73, 2018-02-10 (Released:2019-02-10)

参考文献数

16

被引用文献数

3

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The measurement of the uniformity of preparations is an important component of quality assessment. This study was conducted to evaluate the appropriate mixing time for external preparations using a planetary centrifugal mixer. Steroid ointment and white petrolatum (5 g each) were added to a 13-mL container and mixed using a planetary centrifugal mixer (NRE-120®, THINKY) at a rotation speed of 800 rpm and a revolution speed of 2000 rpm. We sampled 0.1 g of the mixture from three spots (the top, the middle, and the bottom portions) of the container, measured the steroid content, and evaluated the product uniformity of mixtures of ten different steroid ointments (Dermovate®, Antebate®, Myser®, Nerisona®, Methaderm®, Rinderon®-VG, Lidomex®, Almeta®, Kindavate®, and Locoid®) with white petrolatum (Propeto®). Our results showed that when the coefficient of variation (CV) is less than 15.2%, a mixing time of at least 60 seconds is required to achieve proper mixing to obtain the permissible limit of steroid ointment and white petrolatum, and the greater the difference of the yield point between steroid ointment and white petrolatum the easier mixing was. These results suggest that the spreadability of ointment affects the mixing efficiency of a planetary centrifugal mixer.

著者

坂口 一夫 岩田 由美 堀内 暢子 市川 秀一

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.30, no.5, pp.326-329, 2004-05-10 (Released:2011-03-04)

参考文献数

14

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Iron is known to interact with various foods and drugs taken at the same time and since ascorbic acid generally seems to promote the intestinal absorption of iron, we performed a retrospective medical survey using medical charts to establish the effect of ascorbic acid on patients with iron deficiency anemia taking sodium ferrous citrate. The hemoglobin levels and hematocrits of patients with iron deficiency anemia were markedly improved after taking sodium ferrous citrate containing 50 mg of elemental iron alone for 4 to 8 weeks. However, there was no difference between the hemoglobin and hematocrit results for this group of patients and another group who took ascorbic acid (200mg) in addition to sodium ferrous citrate. These results suggest that ascorbic acid does not influence the efficacy of sodium ferrous citrate when these agents are administered together for the treatment of iron deficiency anemia.

著者

竹内 裕紀 大野 能之 和泉 智 鎌田 直博 田中 章郎 長谷川 功 三宅 健文 奥田 真弘

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.3, pp.160-167, 2016-03-10 (Released:2017-03-16)

参考文献数

14

被引用文献数

1 1

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The dosage and administration of renally excreted drugs to patients with decreased renal function need to be optimized in accordance with their renal function. However, drug package inserts do not necessarily have sufficient information. Therefore, we identified and classified the issues regarding this lack of information and investigated the percentage of affected package inserts.We investigated 341 oral drugs in the Clinical Practice Guidebook of Chronic Kidney Disease 2012.1. The shortcomings in the description of urinary excretion parameters, which is needed for dose adjustment in accordance with renal function, are classified as follows: (1) unchanged drugs and metabolites are not indicated (28%, 95/341), (2) bioavailability for oral dosage is not taken into account (84%, 286/341), and (3) sufficient recovery time for urinary excretion is not acknowledged (3.5%, 12/341).2. With respect to the dosage regimen of renally excreted drugs, the following information was absent: (1) dosage and dosing interval in accordance with renal function are not described (63%, 70/111) and (2) considerations for dose reduction are not provided (32%, 36/111).3. A major shortcoming in the description of drug administration for anuric dialysis patient is that nephrotoxic drugs, such as, nonsteroidal anti-inflammatory drugs, are described as being contraindicated (100%, 11/11).We found that the current information in package inserts of several drugs is insufficient to understand the required dose adjustment or the correct method of administration to patients with decreased renal function. We aim to improve the information in drug package inserts to allow for effective and safe pharmacotherapy.

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

尾関 理恵 湯浅 奈絵 赤木 圭太 真野 泰成 根岸 健一 小茂田 昌代

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.2, pp.88-96, 2019-02-10 (Released:2020-02-10)

参考文献数

12

被引用文献数

2

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STROMECTOL® Tablets (ivermectin), an oral scabicide, is often administered to patients as a simple suspension via a feeding tube. However, other studies have reported that this method reduces the dose of ivermectin by 10-50% compared to that associated with oral administration. There are several devices used for administration via a feeding tube. This study proposes appropriate devices for such administration. First, we compared the recovery ratio of ivermectin by different 6 devices (a syringe, an oral dispenser, a small cup, kendakun, a suspension bottle and a quick bag). Among them, the results showed that the recovery ratio of the oral dispenser, suspension bottle, and quick bag was 100% after flush operation. Next, we conducted a questionnaire survey of 10 students to evaluate the usefulness of the six devices. The result showed that the suspension bottle or quick bag was easiest to use but the suspension bottle required attention regarding back flow. In addition, the cost of the suspension bottle was the lowest, the dispenser was the highest. The usefulness test is limited because it is targeted at students. When administering STROMECTOL® Tablets via a tube, the entire volume could be administered without any loss by flushing using a suspension bottle or a quick bag and setting the angle of administration directly underneath.