著者

杉本 智哉 近藤 有 一木 万奈美 荒川 裕貴 間瀬 広樹 牛膓 沙織 佐久間 昌基 小山 佐知子 大島 有美子 宮崎 雅之 築山 郁人 佐藤 由美子 久田 達也 板倉 由縁 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.44, no.9, pp.441-448, 2018-09-10 (Released:2019-09-10)

参考文献数

26

被引用文献数

1

---

The objective of this study was to evaluate the cost-effectiveness of pegfilgrastim (Peg-G) and daily filgrastim (Fil-G) for the primary prophylaxis against febrile neutropenia (FN) in patients with non-Hodgkin lymphoma (NHL) who received cyclophosphamide, vincristine, doxorubicin and prednisolone (CHOP) therapy. We developed a decision analytical model reflecting the clinical processes of NHL patients who received first CHOP therapy. The probabilities at each clinical endpoint were obtained from published sources. To estimate the costs and duration of FN treatment, we analyzed the medical records of NHL patients in hospitals participating in this study. The costs of Peg-G and Fil-G were calculated according to the National Health Insurance drug price list. We assessed an incremental cost-effectiveness ratio (ICER) for a single dose of Peg-G versus 11-days of Fil-G from the perspective of health insurance payers. The sensitivity and robustness of this model were validated by the tornado-diagram and Monte Carlo Method. The costs associated with primary prophylaxis with a single dose of Peg-G and 11-days of Fil-G were 109,628 JPY and 109,243 JPY, respectively. The quality adjusted life years (QALYs) associated with the two strategies were 0.0339 QALYs and 0.0337 QALYs, respectively. The ICER for the Peg-G versus Fil-G was 2,788,571 JPY per QALY. The tornado-diagram revealed that the main influential factors included the cost of Peg-G, number of Fil-G doses, and cost of Fil-G. Monte Carlo simulation revealed an 18.3% probability that Peg-G was cost-effective compared with Fil-G. A single dose of Peg-G was cost-effective compared with 11-days of Fil-G.

著者

向井 淳治 岸本 典子 坂本 竜平 竹原 涼子 名徳 倫明 奥田 広志

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.9, pp.471-477, 2018-09-10 (Released:2019-09-10)

参考文献数

2

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As part of standardizing the prescription format of oral drugs, the Ministry of Health, Labour and Welfare has stipulated that the amounts of oral drugs in prescriptions should be described as “amounts-per-dose” and not as “amounts-per-day.” However, because of the sense of resistance among physicians arising from concerns of increases in medical accidents and work volume, the transition from “amounts-per-day” prescription to “amounts-per-dose” prescription has not been implemented in most facilities. We conducted a survey to investigate the attitudes of physicians in our hospital toward the “amounts-per-dose” prescription and changes in their attitudes by the provision of appropriate information to them. The same questionnaire consisting of 15 items reflecting the “amounts-per-dose” prescription was conducted before and after the presentation of references related to the “amounts-per-dose” prescription to the physicians. The survey results were analyzed by two-way repeated measures analysis of variance using “clinical departments” and “presentation of references” as factors. No interactions were observed. Only two items in the “clinical departments” factor showed significant differences in the main effects, whereas six items in the “presentation of references” factor showed significant differences in the main effects. All of these items showed positive changes after the presentation of references. These results demonstrated that physicians' sense of resistance to the “amounts-per-dose” prescription was derived from a lack of appropriate information and that their sense of resistance was alleviated after being appropriately informed.

著者

佐野 梓 末次 王卓 秦 晃二郎 柊迫 美咲 片山 美幸 田中 瑠美 田島 壮一郎 グリム 理恵子 辻 敏和 渡邊 裕之 金谷 朗子 増田 智先

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.5, pp.229-235, 2018-05-10 (Released:2019-05-10)

参考文献数

16

被引用文献数

4

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We have disclosed 14 standardized laboratory data on out-of-hospital prescriptions since June 2015. In this study, we analyzed questions on out-of-hospital prescriptions related to laboratory data over 2 years. There were 229 prescription questions related to laboratory data (3.4% of the total prescription questions), and 79.5% of these were related to renal function. Among renal function-associated laboratory data, serum creatinine was used in most cases. The rate of prescription change after prescription questions was 66.5% for laboratory data associated with renal function, which was significantly higher (P < 0.001) than the 25.5% for other types of data. Furthermore, the clear description of dose reduction requirements on a package insert was confirmed to be one of the common factors for renal excretory drugs. Therefore, it is important to provide renal function laboratory data to facilitate the appropriate adjustment of out-of-hospital prescription doses. In addition, to enable appropriate dose adjustments using laboratory data, the description on the drug package insert should make it easy for pharmacists who are auditing prescriptions to make appropriate judgments.

著者

國府田 真綾 鈴木 学 金地 夏実 福本 実咲 桑原 千明 林 秀樹 亀山 千里 生木 庸寛 小原 道子 棚瀬 友啓 杉山 正

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.8, pp.395-402, 2018-08-10 (Released:2019-08-14)

参考文献数

8

被引用文献数

3

---

Gifu Pharmaceutical Association conducted a survey on the actual situation of family pharmacists in collaboration with Gifu Pharmaceutical University in 2016. Data of 3,340 people were obtained from 342 pharmacies. A total of 2,666 patients received prescriptions in May 2017 and family pharmacists were assigned to 221 patients (8.3%). The patients group who selected family pharmacists had a greater tendency to bring all the prescriptions to the same pharmacy, to bring the medicine notebook with the prescriptions, and to buy over the counter drugs (OTC) from the family pharmacy than the group not covered by the family pharmacists. The patients ask family pharmacists for reliability, health consultation, and advice in selecting OTC. They are satisfied with family pharmacists on consultations being responded to at any time and feeling that they could ask questions that they could not ask the doctor.

著者

伊藤 智代 中出 順也 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.44, no.8, pp.403-409, 2018-08-10 (Released:2019-08-14)

参考文献数

12

---

FOLFIRINOX is a novel chemotherapy that has been approved for the treatment of advanced pancreatic adenocarcinoma. In comparison with the conventional gemcitabine single agent therapy, FOLFIRINOX is advanced for objective responses, progression-free survival, and median overall survival. Cholinergic syndromes are frequently observed in patients receiving FOLFIRINOX and have been suggested to occur due to the inhibition of acetylcholinesterase by irinotecan (CPT-11). However, no research has been performed on the incidence and risk factors of cholinergic syndromes under FOLFIRINOX. This study aimed to evaluate the incidence and risk factors of cholinergic syndromes induced by FOLFIRINOX in retrospective investigation. Forty-eight patients who were treated with the first cycle of FOLFIRINOX were analyzed and 33 (68.8%) of those experienced cholinergic syndromes including diaphoresis (50.0%), acute diarrhea (33.3%), abdominal pain (29.2%), dysarthria (8.3%), and one for each case of bradycardia, nasal flow, miosis and numbness in the hands. Diaphoresis was experienced more frequently in younger patients (P = 0.029). Other characteristics of patients had no significant relationship with the induction of cholinergic syndrome; sex, stage of cancer, performance status, prior chemotherapy, dose of CPT-11, use of opioid, use of NSAIDs and/or acetaminophen and UGT1A1 genotype. This study indicated for the first time that cholinergic syndromes are observed in almost 70% of patients treated with FOLFIRINOX, and it might be due to the combination of CPT-11 and oxaliplatin. Since cholinergic syndromes can deteriorate the quality of life, patients should be monitored carefully regardless of their characteristics under FOLFIRINOX.

著者

大石 泰也 尾田 一貴 田嶋 信子 齊藤 紀子 坂田 理枝 中村 啓二 石丸 敏之

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.5, pp.222-228, 2018-05-10 (Released:2019-05-10)

参考文献数

18

被引用文献数

6

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Blood culture collection is strongly recommended prior to the start of broad spectrum antibiotics. Once causative organisms are identified, the narrow spectrum antibiotics are introduced (de-escalation). In Fukuoka Red Cross Hospital, the infection control team (ICT) has been encouraging doctors to take 2 sets of blood culture, prior to the commencement of carbapenem. We compared the implementation of blood culture collection prior to the commencement of carbapenem from 2013 to 2016. During this period, the implementation rate was increased from 33.0% to 71.1% (P < 0.05), respectively. The de-escalation was also improved from 10.3% to 33.0% (P < 0.05), in the respective period. The cost in the use of carbapenem in 2016 was significantly decreased. This cost effectiveness showed a positive outcome when de-escalation took place, compared with a simulated case of continuous use of carbapenem. The total pharmaceutical cost reduction over this period was increased from 136,437 yen to 547,205 yen. The result showed the endorsement of mandatory blood culture collection prior to carbapenem use improved de-escalation as well as pharmaceutical cost.

著者

高子 優子 細見 健悟 久井 裕美子 杉田 裕貴 小牧 佐知子 稲田 智子 増本 憲生 大槻 裕朗 岡本 禎晃 金 啓二 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.44, no.7, pp.363-369, 2018-07-10 (Released:2019-07-10)

参考文献数

11

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Some powder formulations of anticancer drugs are currently distributed under negative pressure in vials. However, the internal pressures of the vials are not described in the package inserts. Therefore, an awareness survey was conducted involving pharmacists regarding their descriptions.Anonymous questionnaires, consisting of a 5-grade scale and free description questions, were distributed to the member hospitals of Hyogo Pharmaceutical Society, and responses were collected by FAX and 2-top ratio analysis was performed. In addition, an intergroup comparison was conducted by dividing the responders into two groups based on their experiences (i.e., more or less than 3 years) of dispensing anticancer drugs.Responses were collected from 246 pharmacists of 67 hospitals: “Need prior information” (82.5%) and “Need description” (79.3%). Among the pharmacists with experience of less than 3 years, “Feel anxiety,” “Need prior information,” and “Feel safe with description” were more common (P < 0.05). Of them, 79.3% specified description sites: vial body (90.8%), cap (65.1%), and package insert (39.5%). Internal pressures were listed on a sheet or described in the procedure manual in only 13 hospitals, demonstrating dependence on dispensers' experiences. Besides the internal pressure, they needed information on the recommended gauge, amount of dissolution, and kind of solvent on the vial bodies.

著者

小山内 康徳 木村 礼志 高杉 公彦 櫻井 秀彦

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.44, no.6, pp.288-298, 2018-06-10 (Released:2019-06-10)

参考文献数

15

被引用文献数

4

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A survey was conducted among patients that use health insurance pharmacies to determine the importance of drug consultation contents that are discussed during “holiday and night hours” and “regular open hours”. We investigated differences in the degree of importance in consultation topics for each drug between “holiday and night hours” and “regular open hours”. Also, for each time period, we also attempted to identify priority drug consultation topics for multiple medications. Three important consultation topics during “holiday and night hours” were found to be “drug interaction”, “actions to be taken in an emergency” and “whether or not to take a medication”. When drug consultation topics were compared between “holiday and night hours” and “regular open hours”, topics regarding “expiration date” and “indication” were found to be of higher importance during “regular open hours”. In regard to ideal patient consultations at pharmacies, based on the fact that i) the consultation contents differ depending on the patient's background and the time of day, and ii) the patient's needs differ from the topics of information covered when providing medication instructions and other information, the above results suggest that consultations need to be improved and aligned with the patient's needs.

著者

鈴木 亮平 深津 哲 大津 史子

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.44, no.6, pp.270-279, 2018-06-10 (Released:2019-06-10)

参考文献数

8

被引用文献数

2

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The most frequently reported medical incidents were drug-related and made by nurses.Excessive dosing can cause adverse reactions and possibly lead to patient deaths. On the other hand, underdosing can delay treatment and prolong hospitalization. We investigated drugs associated with and factors leading to excessive dosing or underdosing incidents to clarify when pharmacists should intervene to reduce medication-related incidents. We analyzed incident reports collected by the Japan Council for Quality Health Care between January 2009 and June 2015. In total, we found 3,024 cases of excessive dosing and 2,119 cases of underdosing. In the excessive dosing group, dosing errors and the administration of an excessive dose without an order to do so comprised 785 cases and 482 cases, respectively. In the underdosing group, there were 902 cases of dosing errors and 366 cases where the dose was discontinued too early.We used logistic-regression analysis to compare cases of causative drugs and incident factors with dosing errors and other medical incidents. Our analysis revealed that there was a significant association between steroids, narcotic analgesics, antibacterial drugs and both excessive dosing and underdosing incidents. Also, there was a significant association between nurses not confirming the correct dose and misdosing incidents.It is easy for dosing errors to occur with the aforementioned drugs because the correct dosage varies with the patient's age, renal function, overall condition, and test results. These findings suggest that pharmacists in hospital wards need to check the correct dosage before administering the medication to prevent dosing errors.

著者

高良 恒史 大西 憲明 堀部 紗世 橋詰 勉 金澤 治男 横山 照由

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.1, pp.77-82, 2003-02-10 (Released:2011-03-04)

参考文献数

12

被引用文献数

3 3

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For the development of a practical training system to effectively teach sterilization techniques, we conducted on unregistered questionnaire survey of the undergraduate student's view about the training practice for glass ample cutting, and then evaluated and discussed the introduction to practical training of pharmaceutical health care and sciences for the third-grade undergraduate students. Among 96 third-grade undergraduate students, 54 students (56%) had some experience in cutting glass amples while the remaining students did not. Twenty-six of the 54 students with some experience (48%) had some anxiety regarding glass ample cutting, while only 13 of the 42 inexperienced students (31 %) had such anxiety. Twelve of the 13 inexperienced students overcame some anxiety against glass ample cutting. Moreover, 87 of 96 students (91%) considered that receiving practice in glass ample cutting was necessary for them. Consequently, the training programs on glass ample cutting were found to be appropriate and useful for students to develop sufficient practical skills and accurate ability in sterilization techniques. As a result, we are now preparing to introduce a training program for glass ample cutting in addition to the regular practical training of pharmaceutical health care and sciences at Kyoto Pharmaceutical University.

著者

重松 誠 菅 純子 西田 嘉英 澤井 英子 小川 雅史 中川 文夫

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.1, pp.56-61, 2003-02-10 (Released:2011-03-04)

参考文献数

26

被引用文献数

2 2

---

Cancer chemotherapy and radiation therapy-induced stomatitis often involves symptoms severe enough that the oral ingestion of food may become difficult. We therefore prepared a polaprezinc (zinc N- (3-aminopropionyl) -L-histidine) suspension dispersed in sodium alginate solution (P-AG) as a specific treatment and agent for the prophylaxis of severe stomatitis, and examined the chemical and physico-chemical stability of P-AG for clinical use.The chemical and physico-chemical stability of P-AG was established from its appearance, the percentage polaprezinc content and viscosity immediately after steam sterilization and uniformity after being left to stand for14 days at 25 and 5°C. Similarly, these parameters were examined in photostability testing (40°C, 2000lux) for14 days at the same time. As a result, a change in appearance was observed after steam sterilization according to photostability testing. However, the percentage of polaprezinc contents did not decline after either steam sterilization, photostability testing or after being left to stand for 14 days regardless of the storage temperature. On the other hand, the viscosity of P-AG declined after steam sterilization according to the findings of photostability testing.

著者

武隈 洋 志賀 弘康 山下 恭範 須田 範行 岩井 美和子 岸野 吏志 宮崎 勝巳

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.1, pp.62-65, 2003-02-10 (Released:2011-03-04)

参考文献数

8

被引用文献数

2 2

---

A 0.625% povidone-iodine solution (PVP-I) for eye washing, a pharmaceutical product prepared in our hospital, is used to disinfect the conjunctival sac in eye surgery. Since iodine is unstable, its bactericidal activity is reduced when PVP-I is diluted. Therefore, the stability of a 0.625% PVP-I solution under various preservation conditions was studied. Its stability was evaluated by pH variation, visual inspection and the residual rate of available iodine. The 0.625% PVP-I solution was stored for 5 weeks at room temperature (25°C) and at 4°C under diffused light or in a dark place. The amount of available iodine was determined by the oxidationreduction titration method according to the fourteenth revised edition of the Japanese Pharmacopoeia (JPXIV). No apparent changes were found by pH variation or visual inspection after storage for 5 weeks either at 4°C or 25°C. The residual rates of available iodine after 5 weeks of storage were 91 % at 25°C and 98% at 4°C, thus suggesting that a reduction in available iodine is smaller at 4°C than at 25°C. This finding also suggests that a reduction in available iodine is dependent on temperature.The results of this study indicate that a 0.625% PVP-I solution for eye washing remains stable for 5 weeks if stored at a temperature of less than 4°C.

著者

有田 悦子 坂本 満夫 恩地 ゆかり 小俣 栄 圓藤 孝子 近藤 芳子

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.1, pp.47-55, 2003-02-10 (Released:2011-03-04)

参考文献数

9

被引用文献数

5 5

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During our efforts to develop a training program for new pharmacists, we have come to the opinion that it is essential to understand the personality characteristics of each individual pharmacist. The present study was undertaken to examine the effects of various personality characteristics of new pharmacists regarding their work by psychological tests with existing education programs. The ultimate goal of obtaining basic data would be useful for devising effective training plans for new pharmacists. The subjects consisted of 16 new pharmacists who participated in the training program for new pharmacists conducted at the Q Pharmacy in April through June of 2001. A psychology test, the Tokyo University Egogram (TEG), was administered at the beginning and at the end of training, and the State-Trait Anxiety Inventory (STAI) was administered at the beginning and at the end of training and once a month for two months.An analysis of changes in egograms taken both before and after the training suggested that the effects of the training were manifested in their personality even after a short period of training.Some personality characteristics that seem desirable for pharmacists were derived from the data obtained for pharmacists with highly appraised performances. These include moderately high Critical Parent (CP) and Free Child (FC), high Nurturing Parent (NP) and Adult (A), and moderately low Adapted Child (AC). It is possible that more effective training can thus be provided if not only the trainee but also the trainer understands one's own personality haracteristics.

著者

平川 雅章 立石 真理 牧野 和隆 千堂 年昭 伊藤 善規 大石 了三

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.29, no.1, pp.20-27, 2003-02-10 (Released:2011-03-04)

参考文献数

10

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Although the standards for the quality of rubber closures on injectable glass vials were specified in USP 24 in the U.S. and BP 2001 in the U.K., no such guidelines for quality control exist in Japan. In the present study, we investigated the quality of rubber closures on glass vials of frequently-used anti-biotic and anti-viral injections in our hospital, according to the quality control method of rubber closures for aqueous infusion that was standardized in JP14. Sufficiently washed rubber closures were immersed in distilled water, and test solutions were prepared after gently shaking them for 5 min or heating them at 121°C under high-pressure steam for 60 min. The optic transmittance in the resultant solutions was measured at 430nm and 650nm, and the findings were compared with those for the standard values in JP14 for rubber closures on aqueous infusions. Of 23 different rubber closures tested, only one showed a lower transmittance at 430nm when the solution was prepared by gentle shaking. Under the condition of heating with high-pressure steam, 15 products did not reach the criteria at both wavelengths, 3 did not meet the standards set at either of the wavelengths, but 5 had no qualitative problems. We also checked the materials stuffed in 0. 45μm membranes after filtration with an injection by microscopic observations using scanning electron microscopy and by an element analysis with an X-ray energy dispersive microanalyzer. A number of micro-particles were observed and they were found to be composed of silicon, aluminium and titanium.These results indicate that the quality of rubber closures of injectable glass vials varies among products. Therefore, the standards and guidelines for the quality control of rubber closures of injectable glass vials should be established in JP.

著者

鈴木 正彦 荒井 千春 手塚 春樹 中澤 美科 田中 睦子 河野 健治 花輪 剛久 中島 新一郎

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.28, no.6, pp.623-629, 2002-12-10 (Released:2011-03-04)

参考文献数

7

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Regarding the management of blood preparations, since September 1995 the Ministry of Heath, Labour and Welfare has had to make and/or to keep documentary records such as the product name, date of dispensing, the patient's name and lot number and so on. At Yamanashi Medical University Hospital, to cope with deleterious accidents caused by blood preparations, we developed a new system for the management of blood preparations. This system consists of a printing system for confirmation labels for blood prescriptions and a computerized management system concerning the medication. In this study, the effect of this new management system on the rational use of blood preparations was evaluated. Compared with the former system, the time required to dispense blood preparations decreased from about 500 to 170 seconds per case. Furthermore, based on a questionnaire to medical doctors and/or nurses, it appeared that this system could reduce the time required to manage blood preparations and improve the rational use of injectable drugs.

著者

二神 幸次郎 定金 典明 西原 茂樹 三牧 祐一 荒木 博陽 五味田 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.28, no.6, pp.630-636, 2002-12-10 (Released:2011-03-04)

参考文献数

5

被引用文献数

2 2

---

Our hospital established a Center for Clinical Research of New Drugs and Therapeutics in April 1999. The Center consists of 6 departments : i.e. departments which help to coordinate clinical research, which help to manage the investigated drugs, preview clinical research study protocols, coordinate clinical research, educate research staff and support clinical research at other medical institutions. Pharmacists are involved in all 6 departments of the Center and have been playing various roles. Under this situation, the Institutional Review Board (IRB) started to review investigator-initiated clinical research on drugs, regarding the study protocol, written information (IC) for trial subjects and other information about the drugs beginning in January 2000. All research was performed according to the new Good Clinical Practice, but studies were initiated without providing sufficient compensation in cases of severe adverse drug reactions. The IRB reviewed thirty-four clinical research protocols from January 2000 to December 2001 and an average of 1.5 cases were reviewed by the IRB per meeting. The average reviewing time was 28 minutes (max. 68 minutes). Sixteen, eight, eight and two protocols of clinical research involved Phase III, I/II and II trials and medical instruments, respectively. Considerable clinical research has been performed by such departments as Internal Medicine I, II and Urology, in particular.We recognized that considerable clinical research has been performed with unapproved drugs at our hospital. After the IRB review, pharmacists played various important roles, e.g. dispensing test drugs, preparing some manufactured drugs and confirming the written informed consent. However, up to now the clinical research coordinator (CRC) has not sufficiently supported these studies. The CRC should thus support this research by improving the quality of these studies and the safety performance for patients.

著者

遠藤 敏成 久津間 信明 小林 大介 沼尻 幸彦 上田 秀雄 駒田 冨佐夫 齋藤 侑也 森本 雍憲

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.6, pp.615-622, 2002-12-10 (Released:2011-03-04)

参考文献数

6

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When a pharmacist informs a patient of premonitory symptoms to prevent any adverse effects of each prescribed medicine, such instructions are often to complicated to be understood by the patients, mainly due to the fact that numerous medicines have a wide range of adverse effects, and furthermore, an such adverse effects have many premonitory symptoms. We attempted to make a computer aided adverse effect informing program to assist pharmacists. This program arranges the symptoms according to their order of importance, and gives the probable information of adverse effect, which is not mentioned in the package leaflet. The most frequent and common premonitory symptoms of adverse effect were suggested to be fever and fatigue as a result of running the program when many individual patient prescription data were inputted.The incorporation of this program into the computer system that manages the patient's medicine history will be useful for pharmacists to inform patients of understandable premonitory symptoms and to monitor any potential adverse effect.

著者

栄田 敏之 中村 任 奥村 勝彦 栃尾 信治 長田 俊治

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.6, pp.594-598, 2002-12-10 (Released:2011-03-04)

参考文献数

7

被引用文献数

3 3

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Dissolution tests of acetaminophen filled into the gelatin capsules (SHIONOGI QUALICAPS, Japan) and hydroxypropylmethylcellulose (HPMC) capsules (SHIONOGI QUALICAPS, Japan) were performed after the cap-sules were stored under conditions of 30°C/60%RH for one year, 40°C/75%RH for 6 months, or 60°C for one week. The Japanese Pharmacopoeia 1st fluid, acetic acid buffer (pH4.0), Japanese Pharmacopoeia 2nd fluid and purified water were used as dissolution media. The dissolution profiles of the gelatin capsules changed significantly in comparison to those of the initial profiles after the capsules were stored at 40°C/75%RH for 6 months or 60°C for one week. On the other hand, no delay in dissolution was observed for the HPMC capsules.Dissolution tests were additionally conduced using three commercially available HPMC capsules (SHIONOGI QUALICAPS, Japan ; CAPSUGEL, USA ; SHOGHUN, Korea), and the dissolution profiles of the HPMC capsules of SHIONOGI QUALICAPS were thus found to be independent of the dissolution medium, while the others showed different dissolution profiles depending on the dissolution medium.

著者

小林 大介 久津間 信明 中山 惠 鵜近 篤史 鈴木 暢之 佐次田 優子 遠藤 敏成 上田 秀雄 沼尻 幸彦 駒田 富佐夫 齋藤 侑也 森本 雍憲

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.6, pp.571-575, 2002-12-10 (Released:2011-03-04)

参考文献数

10

被引用文献数

2 1

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When a novel additional adverse effect is reported for a marketed medicine, the medical information leaflet has to be revised to inform physicians and pharmacists of this. Pharmacists are responsible for informing patients of early warning symptoms to avoid the subsequent appearance of severe adverse effects. However, at present, patients may suffer from severe adverse events because such symptoms may remain unrecognized until the medicine is on the market. As a result, investigations to predict and prevent novel additional adverse effects of medicines are required. In this study, we investigated a novel additional adverse effect classified as a pharmacological effect based on the drug safety update (DSU). As a result, skin disorders including toxic epidermal necrolysis and Stevens Johnson syndrome, and pseudomembranous colitis have become evident as additional adverse effects of antibiotics, with a high incidence. In addition, neuroleptic malignant syndrome and aplastic anemia have also been reported as adverse effects of central nervous system agents.Therefore, it is important to provide patients with information about the early warning symptoms related to such adverse effects, even though such adverse effects are not contained in the patient information leaflet.

著者

薄井 順子 川島 真理子 小林 幸枝 大竹 智子 小清水 美千子

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.28, no.6, pp.605-609, 2002-12-10 (Released:2011-03-04)

参考文献数

1

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In February 2000, a Drug Safety Emergency Bulletin reporting that some patients taking Benzbromarone developed fulminant hepatitis as a side effect was reported on newspapers and TV. We made a counter survey regarding how patients received this news. The aim of the present study is to consider how a pharmacist should behave when a similar situation occurs in the future.We selected patients taking Benzbromarone from the medication records and checked their liver function value from their charts. We discussed with the doctor about the patients whose liver function values indicated abnormal levels.After discussions with doctors, we decided to give the information to the patients and surveyed them individually. We recorded the contents on their medication records and the records of our inquiries.Seventy-five% (43/57) of the patients noticed the report and their reactions varied. Some patients did not know about the reports or did not recognize that the medicine reported was the same as one they were taking. We also gave information positively to these patients.After giving the information, 81 % (47/58) of the patients continued to take Benzbromarone. We thought that a positive explanation given by pharmacist could minimize the anxiety of such patients, as a result, they were taking the medicine with an increased understanding.As a result of the survey, we found how the patients reacted to the side effect reports and recognized again that it was important to communicate with the patients individually in such instances.