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

---

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

平野 陽子 古俵 孝明 五十嵐 敏明 松嶋 あづさ 川道 美里 小島 慶之 高橋 翠 松井 友里恵 渡瀬 友貴 山下 慎司 宇野 美雪 上谷 幸男 渡辺 享平 矢野 良一 塚本 仁 中村 敏明 岩崎 博道

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.9, pp.502-508, 2017-09-10 (Released:2018-09-10)

参考文献数

9

被引用文献数

2

---

In February 2015, we introduced a drug verification and quantity management system using personal digital assistants and medicine barcodes to prevent dispensing errors. We evaluated the effect of this system by comparing the number of dispensing errors and incident cases for one year before and after the introduction. The time required for dispensing was prolonged from about 28.4 seconds to 37.3 seconds per drug, about 1.3 times. The number of dispensing errors for one year before and after system introduction significantly decreased from 33.8 ± 4.7 per month to 5.8 ± 0.8 per month (P < 0.01). In addition, the number of incidents significantly decreased from 6.0 ± 0.9 per month to 3.2 ± 0.5 per month (P = 0.02). The system seems to be useful as a tool of medical safety measures because it significantly lowers the number of dispensing errors and incidents.

著者

広瀬 雅一 松田 幸久 小川 圭太 太田 愛子 山下 広之 髙橋 伸明 五郎丸 剛 佐藤 英治 長崎 信浩 吉冨 博則

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.4, pp.183-195, 2020-04-10 (Released:2021-04-10)

参考文献数

23

被引用文献数

1 2

---

The role of medication history at pharmacies has increased as a means to realize improved pharmaceutical care. Furthermore, the education guidelines of clinical clerkship for pharmaceutical education were revised in 2013 to provide better clinical training. The principal aim of the new guidelines was to allow the students to experience medication management, such as medication counseling and the recording of medication histories, frequently. In these circumstances, pharmacy students should acquire, to some degree, the cardinal skills of medication management by the initiation of their clinical clerkship. In this study, we established methods to quantitively evaluate the ability of the medication management at pharmacies. Additionally, we conducted the same practice with pharmacists engaged in pharmacies for less than three years to compare their ability with that of the students. In the practice, the participants presumed the patient characteristics and disease state from a scenario and created the medication counseling phrases from a simulated prescription. Subsequently, they recorded a medication history electronically following the SOAP format. The results showed the scores of the pharmacists regarding medication counseling phrases and medication history descriptions were much higher than those of the students. In contrast, the scores of presumption skills in terms of patient characteristics and state were equivalent. To enhance clinical skills, education programs should include problem-oriented system exercises to integrate various factors of patients’ characteristics as well as to build up student knowledge. This study also suggests that the modification of an electronic medication history system might be efficacious for pharmaceutical education.

著者

高井 靖 梶間 勇樹

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.5, pp.279-284, 2020-05-10 (Released:2021-05-10)

参考文献数

8

被引用文献数

1

---

In this research, we examined the effects of collaborative intervention by pharmacists in hospitals and insurance pharmacies on the quality of life (QOL) and medication adherence of heart failure patients. Heart failure inpatients were assigned to the collaborative intervention group (Group A) and the control group (Group B), with each group containing 35 subjects. Both groups were examined 12 months after they were admitted to hospital, and the conditions at the time of admission were used as the baseline. The primary endpoint was QOL, which was evaluated by the Minnesota Living with Heart Failure (MLHF) scale, and the secondary endpoints were medication adherence and prescription complexity index, which were assessed using the medication regimen complexity index (MRCI) and the Morisky Medication Adherence Scale (MMAS-4), respectively. The number of target patients that could be analyzed was 31 in group A (18 men and 13 women with an average age of 78.1 ± 9.9 years), and 29 in group B (17 men and 12 women with an average age of 79.6 ± 8.1 years). The QOL at the time of admission and discharge from the hospital was significantly improved in group A and B (P < 0.05). MMAS-4 improved significantly in group A (P < 0.05) but did not change significantly in group B. MRCI was significantly increased in group B (P < 0.05). It is suggested that the intervention by pharmacists in hospitals and insurance pharmacy pharmacists for heart failure patients may have an impact on improving the quality of life.

著者

近藤 有 榊原 崇芳 加藤 潤 渡邊 雅史 西村 栄輝 實安 健市 下野 大貴 間瀬 悟 三宅 芳男

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.5, pp.239-248, 2020-05-10 (Released:2021-05-10)

参考文献数

17

---

We developed a Markov model to evaluate the cost-effectiveness of nivolumab in patients with advanced or recurrent esophageal cancer receiving second-line treatment in Japan. We assessed an incremental cost-effective ratio (ICER) for nivolumab versus docetaxel from the health insurers' perspective. A threshold ICER was set at 7.5 million JPY. The ICER was calculated to be 12.45 million JPY per quality-adjusted life year, which was above the threshold. In a one-way sensitivity analysis, the results were most sensitive to the utility scores for nivolumab. If the cost of nivolumab per 240 mg could be reduced below 282,817 JPY or nivolumab could prolong the overall survival up to 4.1 months, the ICER fell below the threshold. The probabilistic sensitivity analysis revealed a 17.6% probability that nivolumab was cost-effective as compared to docetaxel. Our study suggests that nivolumab is not cost-effective in patients with advanced or recurrent esophageal cancer receiving second-line treatment as of this moment. Therefore, for future study, it is advisable to review drug prices and select patients who are expected to have high therapeutic effects.

著者

高月 公博 古川 裕之 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.34, no.9, pp.838-846, 2008 (Released:2010-02-07)

参考文献数

14

被引用文献数

2 1

---

The purpose of this study was to clarify the causality assessment information items necessary to improve the usefulness of individual case safety reports (ICSRs) from medical facilities as adverse drug reaction (ADR) information.To do this,we investigated standard causality assessment items used by pharmaceutical companies.The number of the companies responding was 76,93.8% of all Japan Pharmaceutical Manufacturers Association (JPMA) member companies.We found that the use of algorithms for causality assessment,the grades and expressions used to describe causality,and criteria for determining whether reactions were ADRs or not varied among the companies as well as their divisions (whether they conducted clinical trials or post-marketing surveillance).Having such a variety of assessment criteria is inconvenient for the reporters who have to judge it and also lowers the validity of judgments.It also hampers the overall assessment of ADR information and may cause great differences in ADR frequencies.We therefore feel that it is desirable to agree on international criteria for causality assessment as soon as possible.

著者

名徳 倫明

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.31, no.2, pp.89-98, 2005-02-10 (Released:2011-03-04)

参考文献数

19

被引用文献数

1 1

---

Many medical accidents concerning errors in the administration of injections have been reported in recent years but many of them could be prevented through the active involvement of pharmacists in this respect. At the Department of Pharmacy of the Municipal Ikeda Hospital, a ward pharmacy was established in April 2000 and the dispensing of injections, including the mixing of injections, was commenced. In October, 2001, an injection distribution surveillance system was also established. Under the system, injections are distributed to the patients' bedsides, information provided on the drugs in them and monitoring performed.We conducted a survey of the dispensing of injections and the surveillance system. The mixed injection preparations targeted by the survey were drip infusions for administration between 10 : 00 and 22 : 00 whose prescriptions were received by the Department of Pharmacy by 17 : 00 on the day before use, and injection preparations were mixed 4 times a day.The dispensing of injections was divided into 5 tasks : receipt of dispensing requests, preparation of labels, measuring of quantities, mixing of preparations, and preparation of infusion sets and each task was investigated for dispensing errors.Warnings were issued under the distribution surveillance system when pharmacists misidentified patients in distributing injections to the patient's bedside and the situation was investigated.The rate of pharmacist errors in mixing injection preparations was 2.23 % in a 4-month period and though 0.04% of the preparations in error were sent to wards, they were not administered to patients. Out of the 7, 690 instances in which injections were distributed to the patient's bedside by pharmacists in the 4-month period, in 3 instances (0.04%) pharmacists were warned about misidentifying patients. All of errors were human errors, but did not lead to errors in administration. This study suggests that risk of errors made with injections could be avoided by the close involvement of pharmacists in the work of administering injections. Greater use of codes was suggested for preventing human errors in future, since codes were printed on the injection in only 14.5 % of the injections distributed during our survey. Besides the increased use of such codes, the development of an injection dispensing surveillance system using them is also necessary.

著者

北澤 文章 寺田 智祐 高橋 一栄 松本 繁巳 乾 賢一

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.5, pp.337-342, 2009 (Released:2010-07-31)

参考文献数

19

被引用文献数

3 2

---

The aim of this study was to clarify the influence of renin-angiotensin (RA) system blockers on the anti-cancer effect of chemotherapy with bevacizumab and its adverse effects.Twenty-six patients treated for metastatic colorectal cancer at Kyoto University Hospital between August 2007 and July 2008 were assessed.All of the patients received bevacizumab plus mFOLFOX 6 or FOLFIRI,and were divided into a control group (23 patients) and an RA system blocker group (3 patients).Regarding background factors,which included chemotherapy doses,the only significant difference between the groups was with respect to age.However,hypertension grades in the RA system blocker group were significantly higher than those in the control group,and RA system blockers had no significant antihypertensive effect.There was no severe proteinuria in either group.As for anti-cancer effects,in the control group,6 patients exhibited a partial response and in 16 patients,the disease was stable.In only one patient was the disease progressive.On the other hand,the disease was progressive in all patients in the RA system blocker group.These findings indicate that anti-hypertensive agents which provide better hypertension control than RA system blockers may be necessary as first line medication for the management of bevacizumab-induced hypertension.Although RA system blockers are useful antihypertension agents,they might not be able to control bevacizumab-induced hypertension and proteinuria,and could reduce the anti-cancer effect of bevacizumab.

著者

二神 咲子 由井薗 陽一 槙林 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.41, no.9, pp.624-629, 2015-09-10 (Released:2016-09-10)

参考文献数

8

---

The self-injection of insulin or GLP-1 receptor agonists causes mental distress to patients, and pen-type injectors and their needles are being continually developed and improved to alleviate such distress. In Saiseikai Fukuoka General Hospital, Nanopass® 34G Needle II 4 mm (T34) , the thinnest needle available on the market, has been used. To examine usability for patients after changing the injector needle from BD Micro-Fine PlusTM 31G 5 mm (BD31) or Nanopass® 33G Needle 5 mm (T33) to T34, a questionnaire survey was conducted. Sensitive patients perceived differences when changing their injector needles not only from BD31 to T34, with a difference of 3G, but also from T33 to T34, with a smaller difference of 1G. In both cases, patients' perceptions improved as a result of improvements in factors markedly influencing them: frequency of subcutaneous bleeding, pain when puncturing of the needle, and liquid leakage when removing the needle. The results of this study confirmed the usefulness of thinner and shorter injector needles to alleviate patients' distress, suggesting the necessity of considering their usability of needles during guidance on selfinjection.

著者

小森 桂子 友井 理恵子 望月 千枝 丁 元鎭 桝 喜惠 杉本 直俊

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.12, pp.713-720, 2011 (Released:2012-12-10)

参考文献数

28

---

Chemotherapy induced nausea and vomiting (CINV) is one of the most frequent adverse events in cancer patients receiving chemotherapy. Thus, preventing CINV is the key to maintaining the QOL of patients. As aprepitant, a powerful oral prophylactic for CINV, has been recommended for this purpose since it came on to the market, we retrospectively examined the adverse events induced by this drug in 36 patients (Control group 20, aprepitant group 16) with gastric cancer who received combination chemotherapy with S-1 and CDDP between November 2009 and October 2010 at Osaka Medical Center for Cancer and cardiovascular Diseases.We examined the different types of adverse events, including emesis and hiccups, all of which were presumably induced by chemotherapy, and evaluated each of them using CTCAE v3.0 JCOG/JSCO. This confirmed the effectiveness of aprepitant against CINV both in the acute phase and delayed phase. Our results suggested that QOL was mostly improved by it, though the incidence of hiccups was higher than before. Therefore when aprepitant is given with CDDP and DEX, measures such as administering metoclopramide should be taken against hiccups.

著者

佐藤 淳也 大久保 春香 佐々木 ゆうき 横井 誠 荻野 沙也佳 工藤 賢三

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.328-335, 2017-06-10 (Released:2018-06-10)

参考文献数

17

被引用文献数

1 2

---

Urine containing anticancer drugs may be scattered outside the toilet bowl during urination, and these drugs may be spread when they are stepped on. The scattering of urine droplets is dependent on the shape of the toilet bowl, contact point of the urine with the toilet bowl, and the posture assumed for urination. However, this concept has not been well investigated. In this study, we investigated the scattering of urine using fluorescent dye in a urinal and a Western-style toilet.To represent urination in the standing position, we sprayed a fluorescein solution on the wall or the bottom of a urinal. We modeled urination in the standing and sitting positions in a Western-style toilet by spraying fluorescein into the toilet bowl and in three spots around the toilet bowl. The number of droplets, area, scattering distance, and scattering area around the toilet bowl were measured optically.The droplet scattering was more extensive around the toilet bowl when the liquid was aimed at the bottom of the urinal and the front edge bottom of the water in the Western-style toilet. There was no droplet scattering when using the Western-style toilet in the sitting position.If a male patient receiving chemotherapy urinates in the standing position, the anticancer drug will spread through scattered urine and become an environmental pollutant. Therefore, it is important to instruct male patients to urinate in a sitting position when using a Western-style toilet.

著者

山本 譲 粟屋 敏雄 小城 香緒里 森田 真樹子 川守田 早紀 神崎 郁代 小川 聡 板垣 祐一 大滝 康一 山本 久仁子 田﨑 嘉一 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.38, no.1, pp.34-42, 2012-01-10 (Released:2013-01-10)

参考文献数

10

被引用文献数

3 2

---

Shortage of physicians is a serious social issue in Japan. It has become an urgent challenge to support busy physicians. While the number of anesthetists is remarkably insufficient, the number of operations has increased in many hospitals after Diagnosis Procedure Combination (DPC) is implemented. Drugs used in operation rooms include many narcotic analgesic and poisonous drugs, which medical staff are required to strictly control. From the viewpoint of medical safety management, pharmacists should be involved in the management of these drugs. We have started preparation of injections in the operation rooms aiming mainly at supporting anesthetists. Pharmacists make up the anesthetic sets according to anesthetists' order by the evening of the previous day. The pharmacists carry the sets from the pharmacy to the operation room on a wagon. On the early morning of the operation day, two pharmacists mix the injection drugs, fill the syringes, attach the labels, assemble the routes, and check the completed sets in each operating room according to the list. All pharmacists in our pharmacy department engage in this service. We have conducted opinion surveys of pharmacists and anesthetists on this service. Although the workload of pharmacists increased, most pharmacists thought it was worthwhile. Most anesthetists evaluated that this service has improved medical safety. However, there were many requests that the pharmacists should be further involved throughout the entire operation. It is important to support physicians with services such as this by the pharmacist based on pharmaceutical knowledge. This service has a beneficial impact on healthcare professionals.

著者

米内山 みお 小山 佐和子 千秋 和久

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.31, no.4, pp.295-300, 2005-04-10 (Released:2011-03-04)

参考文献数

26

被引用文献数

1 1

---

The use of Tris (2-ethylhexyl) trimellitate (TOTM) as an alternative to di (2-ethylhexyl) phthalate (DEHP) as a plasticizer in polyvinyl chloride (PVC) medical devices is steadily increasing. Four types of administration sets are available : general-type sets made of PVC using DEHP (DEHP-PVC) or TOTM (TOTM-PVC) as a plasticizer, pump-type sets made of DEHP-PVC, and those made of polybutadiene (PB). Since the elution of plasticizer from administration sets when specific drugs are passed though them is a matter of concern, in the present study, we compared the amounts of plasticizer eluted from these 4 types of administration sets after passing fat emulsion through them, for different drip rate.The concentrations of plasticizer eluted were lowest for the TOTM-PVC administration set, followed in ascending order by the general-type DEHP-PVC and pump-type DEHP-PVC sets. Neither DEHP nor TOTM was detected for the PB set. For the general-type administration set, the maximum concentrations of TOTM and DEHP eluted were obtained with a drip rate of 10 mL/hr, which were 0.38μg/mL for TOTM and 10.32μg/mL for DEHP, respectively. At a drip rate of 80 mL/hr, the maximum concentration of DEHP was 0.97μg/mL but TOTM was not detected. These results indicate that TOTM is less easily eluted than DEHP and that TOTM-PVC is an excellent material for administration sets in view of its low elution characteristics, though care needs to be taken with regard to drug adsorption.

著者

黒山 政一 尾鳥 勝也 矢後 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.29, no.3, pp.287-293, 2003-06-10 (Released:2011-03-04)

参考文献数

7

---

Over 100 pharmaceutical products are withdrawn from the market in Japan each year. Nonetheless, there has so far been no report consisting of a specific survey of the volume of work borne by the medical organizations related to such with drawals. As are sult, a survey of the response of medical organizations and the volume of work have been made regarding the withdrawal of Maalox ®in August 2000.Our findings revealed that a considerable amount of time, namely 4, 502 minutes was expended regarding the withdrawal of this product at Kitasato University East Hospital. A total of 2, 770 minutes, or 62% of the total time was spent within 24 hours after receiving the announcement of the drug's removal from the market. When the total time was broken down by job type, 3, 188 minutes, or 71% of the total, were spent by pharmacists A further, 2, 315 minutes, or 52% of the total, were used to determine how to best respond to the matter.In order to efficiently recall pharmaceutical products, an operation was established which was thereafter distributed to all concemed staff members.The total time spent on the withdrawal of Maalox ® was estimated to have utilized approximately ¥285, 000of labor cost, based on the average wages of the employees. As a result, hospitals are forced to bear a significant economic burden whenever such products are withdrawn.Finally, pharmaceutical manufacturers should be equipped with the systems for manufacture and supply as much as possible to minimize such recall incidents. When drug are unavoidably withdrawn, however, the manufacturers should nevertheless provide all appropriate information as quickly as possible to the related medical organizations while carefully taking the economic burden that such organizations must bear into consideration.

著者

本間 秀彰 橋本 義人 宮崎 信義 松本 隆亜 佐々木 希吉

出版者

日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.33, no.5, pp.457-462, 2007-05-10

参考文献数

24

被引用文献数

3 5

---

To ascertain the use of health foods by patients and the associated problems, we asked 364 patients who brought prescriptions to our pharmacy to fill out a questionnaire. The questions asked aimed to determine the percentage of patients using health foods, the purpose of using them and the kinds of health foods used as well as the period, the frequency, amounts, and the effects of using them. Other questions concerned the person advising them on the use of health foods, the side effects of health foods, and the awareness of patients regarding the interactions between drugs and health foods. The knowledge obtained from the responses received should enable us to provide better pharmaceutical care to patients.

著者

倉地 茜 矢野 亨治 西川 佐紀子 岡島 亜衣 船橋 美和 日比 陽子 河野 紀子 宮川 泰宏 永井 拓 山村 恵子 山田 清文

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.3, pp.161-168, 2017-03-10 (Released:2018-03-10)

参考文献数

25

被引用文献数

1 1

---

Warfarin is a useful and effective oral anticoagulant. The management of the prothrombin time-international normalized ratio (PT-INR) is important for ensuring appropriate warfarin-based anticoagulation therapy. Here, we developed an anticoagulation management support (ACMS) system involving self-monitoring of the PT-INR and an Internet-based reporting system for outpatients. In the ACMS system, outpatients monitor their own PT-INR values using a CoaguChek® XS rapid measuring device and report the data to medical staff via a website. Then, the medical staff reply to the patients with information about their next dosage of warfarin based on the reported PT-INR data. We employed protocol-based pharmacotherapy management (PBPM), which was conducted by pharmacists, linked to the ACMS system to treat outpatients who received combination therapy involving warfarin and drugs that can have drug-drug interactions with warfarin, such as rifampicin, miconazole, 5-FU, and S-1. In the present study, we investigated the safety and efficacy of PBPM in 6 patients. There were no major discrepancies between the PT-INR values measured by self-monitoring and those obtained at hospital, and the patients did not make any errors when inputting their data via the website. By applying PBPM, anticoagulation therapy with warfarin was found to be safe and effective, and the time in therapeutic range was 82.1 ± 7.3% (mean ± SD). No major adverse events, such as bleeding or embolisms, occurred in any patient during the observation period. These results suggest that PBPM linked to the ACMS has beneficial effects on warfarin-based anticoagulation therapy in outpatients.

著者

小竹 武 松本 優里香 塚本 あゆみ 井上 知美 石渡 俊二 草薙 みか 坂野 千賀 大里 恭章 伊藤 吉將 長井 紀章

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.41, no.11, pp.786-792, 2015-11-10 (Released:2016-11-10)

参考文献数

6

---

We investigated whether the component in cataplasm transmitted into hemorrhoid ointment in the combined storage of hemorrhoid ointment and non-steroidal anti-inflammatory drugs (NSAIDs) cataplasm. The NSAIDs cataplasm was used as a commercially available methyl salicylate (MS reishippu “TAIHO”, MS cataplasm) and indomethacin (Catlep®, IMC cataplasm) cataplasm. In addition, the hemorrhoid ointment was in a polyethylene container with (Neriproct® ointment, DFV-L ointment) or without aluminum laminate (Posterisan® forte, HC ointment). As for the methyl salicylate, 5.68 mg / pieces in HC ointment were detected at 40 weeks of combined storage with MS cataplasm. The methyl salicylate concentration in DFV-L ointment was lower than that in HC ointment under the same conditions. On the other hand, no contamination of indomethacin in HC and DFV-L ointment was observed in the combined storage with IMC cataplasm. These results show that the methyl salicylate in cataplasm passed the polyethylene container, and provide significant information on the risk of contamination by the combined storage of cataplasm and hemorrhoid ointment.

著者

水野 恵司 蔭山 博之 渋谷 正徳 平井 康夫

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.36, no.3, pp.180-187, 2010 (Released:2012-03-09)

参考文献数

30

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In 1997,PTP sheets containing tables were changed so that they could not be separated into individual doses since there had been several cases in which medicines had been swallowed in the PTP.As there are still cases of this happening,we felt the need to clarify the causes and devise a way of preventing them.Through interviewing 8 patients who had swallowed medicines in the PTP sheet and had them removed at Matsudo City Hospital in last 5 years,the causes of such accidents were being distracted when taking medication and separating medicines into individual doses for convenience.Armed with this knowledge,we questioned a large number of patients visiting community pharmacies on how they kept their medicines at home.Our findings showed that elderly patients and those prescribed multiple drugs tended to separate their medicines,accounting for 45.7% of 368 patients interviewed.There has also been an increase in the number of elderly patients with dementia who have swallowed medicines in the PTP sheet and have not been aware of this until they have had to undergo emergency surgery to remove the PTP when it has caused perforation of the gastrointestinal tract.To decrease the risk of swallowing the PTP sheet,we propose increasing its size so that patients are physically unable to swallow it,and print a pharmaceutical code and expiration date on each sheet.

著者

Kuninori Iwayama Yusuke Takashima Ko-ichi Ohtaki Kikutaro Endoh Yoshiko Tampo Nobumasa Hayase

出版者

Japanese Society of Pharmaceutical Health Care and Sciences

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.10, pp.617-627, 2012-10-10 (Released:2013-10-10)

参考文献数

37

被引用文献数

1 1

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We examined the effects of 8 macrolide antimicrobial agents, including 14-, 15- and 16-membered ring lactone and ketoride derivatives, on hemolysis induced by lysophosphatidylcholine (LPC) in human erythrocytes. LPC induced hemolysis at concentrations above the critical micelle concentration (4 µM). Vitamin E (α-tocopherol), used as a reference drug, attenuated the 50% hemolysis induced by 6 µM LPC when present at concentrations between 1 µM and 100 mM. Clarithromycin significantly attenuated LPC-induced hemolysis at a wider range of concentrations (100 nM to 1 mM), but other macrolides attenuated hemolysis only at high concentrations (100 µM and/or 1 mM). Since vitamin E tends to stabilize membranes due to its high lipophilicity, it appears that the high lipophilicity of clarithromycin is responsible for its protective action against damage induced by LPC. However, rokitamycin was not effective, although it is more lipophilic than clarithromycin, indicating that factors other than high lipophilicity are responsible for the protective effects of macrolide antimicrobial agents against LPC-induced hemolysis. Neither vitamin E nor clarithromycin attenuated hypotonic hemolysis (60 mM NaCl) at concentrations that inhibit LPC-induced hemolysis. On the other hand, both vitamin E and clarithromycin affected LPC micelle formation, suggesting that these drugs directly bind to LPC. We therefore believe that the protective effects of clarithromycin on LPC-induced hemolysis may be related physicochemically to its high lipophilicity and 14-membered ring lactone structure, which help maintain erythrocyte membrane integrity by preventing LPC micelle formation. These drugs likely do not act by a mechanism that protects against osmotic imbalance.

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.