著者

尾鳥 勝也 田口 祐子 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.31, no.9, pp.761-767, 2005-09-10 (Released:2011-03-04)

参考文献数

7

被引用文献数

5 6

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We studied the quality and stability of generic sodium ozagrel solution products for injection. Through the use of inspection apparatus, we noted exfoliation of the surface layer of glass ampoules filled with sodium ozagrel solution drug products for injection. Also, foreign insoluble matter, such as oil droplets, which was assumed to be silicone that had been applied to the internal surface of syringe barrels, was observed in pre-filled syringe products. In a stability study performed under accelerated conditions (40°C/75% RH) the generic sodium ozagrel solutions yielded a degradation product that was not detected in the lyophilized original product. The degradation product content of some of the generic products was over 16 mg/mL of sodium ozagrel, exceeding the specification for the original lyophilized product. These results indicate that some of the generic products are inferior in quality and stability to the original lyophilized drug.

著者

大久保 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.31, no.2, pp.121-124, 2005-02-10 (Released:2011-03-04)

参考文献数

10

被引用文献数

3 3

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Using high performance liquid chromatography (HPLC), the author determined the content of nicardipine degradation product (L-1) in brand-name and generic-name nicardipine injection products. The mobile phase consisted of 0.25 % KH2PO4 (pH 6.5) -CH3OH (25 : 75, v/v) and the detection wavelength was set at 254 nmUV. A separate peak for L-1 was identified by using reference standard compounds. Several products of nicardipine injection on the Japanese market were analysed and the L-1 contents varied among them. Through this study, we found that there were differences in quality between the brand-name and generic nicardipine injection products, and that there were also differences in quality among the individual generic products.

著者

鳴戸 郁江 岡本 佳菜美 西方 真弓 松山 賢治

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.32, no.6, pp.523-530, 2006-06-10 (Released:2007-11-09)

参考文献数

9

被引用文献数

6 6

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In order to evaluate generic versions of famotidine, 11 kinds of famotidine tablets and 7 kinds of famotidine injection (both tablets and injection included the branded product, respectively) were subjected to dissolution testing and HPLC analysis.In the case of tablets, both the branded drug (Gaster®) and the 10 generics satisfied the standard dissolution test requirement that more than 70% of tablets should dissolve within 60 min, though there were significant differences in the time taken to achieve more than 70% dissolution. In this respect, some of the generics were quite different from the branded drug.As for the famotidine injection-formulations, both the branded drug, (Gaster® injection) and the 6 generics satisfied the standard for the content test in JP XIV. However, HPLC analysis showed that generic formulations contained a variety of impurities while the branded injection (Gaster® for injection 20 mg) contained very few impurities. In three of the generic injection-formulations-Famostagine® for injection 20 mg, Progogue® for injection 20 mg and Gasport® for injection 20 mg —the contents of impurities were significantly different from that of Gaster® for injection 20 mg.The present study showed that there were appreciable quality differences between the branded and generic versions of famotidine irrespective of formulation.

著者

矢野 良一 中村 敏明 谷 大輔 西里 洋平 後藤 伸之 脇屋 義文 政田 幹夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.33, no.12, pp.998-1002, 2007 (Released:2009-09-04)

参考文献数

9

被引用文献数

3 5

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The purpose of this study was to evaluate the quality of the original and 3 generic formulations of Iopamidol injection.To do this,the free iodine concentration and osmotic pressure were measured.In addition,impurities were tested for using high performance liquid chromatography-tandem mass spectrometry.There were no major differences between the original and generic formulations as regards free iodine concentration and osmotic pressure measurements,though one lot of the original formulation failed the free iodine concentration test.However,in the HPLC analysis,some substances not present in the original product were detected in the generic formulations.One of them was identified as DM 1/2,a substance related structurally to Iopamidol.

著者

木村 康浩 大浜 修 土井 穂波 柴田 ゆうか 木平 健治

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.34, no.6, pp.573-577, 2008 (Released:2009-09-04)

参考文献数

6

被引用文献数

5 4

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Very little information is available on the quality of generic products and it has recently been reported that anaphylaxy shock occurred when a generic formulation of an injectable cefazolin sodium product was used in a patient before surgery.This suggests that the generic product contained impurities that caused such an adverse reaction.It is therefore important to determine the constituents of generic products and compare them with those of the original products.We analyzed the original cefazolin sodium product and 4 generics of it by means of high performance liquid chromatography in order to determine differences in quality between them.Three impurities were found in the original product and 4 in the generic products,respectively.However,the impurity content of all of the generic products was significantly higher than that of the original product and on analyzing synthetic samples of impurities which could possibly be contained in the cefazolin sodium products,the chromatographic peaks of three of them overlapped with the peaks observed in the chromatograms of the original and generic products.These results suggest that there can be great differences in quality between the original and generic products,and that the impurities might be cefazolin-related substances.We must therefore select generics based on an appraisal of the quality information available for them in order to minimize unexpected adverse reactions and achieve more cost effective and safe therapy.

著者

吉田 阿希 舘 知也 兼松 勇汰 杉田 郁人 野口 義紘 大澤 友裕 安田 昌宏 水井 貴詞 後藤 千寿 寺町 ひとみ

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.1, pp.49-53, 2018-01-10 (Released:2019-01-10)

参考文献数

19

被引用文献数

1

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Recently, the use of complementary alternative medicine (CAM) has been increasing in Japan. There are few reports on the use of CAM such as health foods and supplements in cancer patients despite the high interest in it. In this study, we performed a retrospective research to elucidate factors influencing the use of health foods and supplements in cancer patients. The objectives were inpatients diagnosed with cancer at Gifu Municipal Hospital between October 1, 2014 and March 31, 2015. Survey items were age, gender, information on cancer, history of chemotherapy and operation, prescription drugs, and health foods and supplements at admission. A multiple logistic regression analysis was conducted to evaluate the influence of survey items on the use of health foods and supplements. Statistical significance was set at P < 0.05. Patients using health foods and supplements were 5.8% (59/1,012). The use rate of health foods and supplements is significantly high in recurrent patients [odds ratio (OR), 4.83; 95% confidence interval (CI), 2.55-9.15; P < 0.001] and is significantly low in patients receiving operation [OR, 0.363; 95% CI, 0.197-0.667; P = 0.001]. In this study, it was clarified that recurrent cancer patients more frequently use health foods and supplements, and that cancer patients undergoing surgery use them less frequently.

著者

高橋 佳子 樋上 智子 倉本 美佳 檜垣 文子 山下 典子 合田 昌子 足立 亜紀子 濱口 常男 門林 宗男

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.30, no.7, pp.475-482, 2004-07-10 (Released:2011-03-04)

参考文献数

15

被引用文献数

1 3

---

To determine the influence of the angle of holding an eye medication container on the squeezing force needed for each drop of the medication and drop volume, we measured squeezing force and drop weight using a force gauge for 11 prod ucts commercially available in Japan, at 3 different angles to the horizontal surface-90°, 60° and 45°. At 90°, the squeezing force for each drop varied from 0.770kg (Tobracin®) to 1.575kg (Timoptol® 0.25%) and at 60° and 45°, the squeezing force decreased for all products except KetasR. Thus the squeezing force was affected by the angle of holding the container. At 90°, drop weight varied from 33mg (Ketas®) to 44mg (Tobracin®). At 60° and 45°, drop weight decreased for all products except Hyalein® 0.1, Kary Uni® and Sanpilo® 2% (tip and cap type). These results show that the angle of holding an eye medication container is an important factor because of the influence it has on drop size and squeezing force. For this reason, the optimal angle for patients to hold eye medication containers should be investigated in greater depth.

著者

飯田 遥 男全 昭紀 井口 恵美子 猪股 克彦

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.43, no.11, pp.654-660, 2017-11-10 (Released:2018-11-10)

参考文献数

9

被引用文献数

1

---

The clinical condition of patients in intensive care units (ICU) fluctuates significantly. The pharmaceutical-information service is provided by clinical pharmacists. However, the types of pharmaceutical information that merit intervention by clinical pharmacists in the intensive care field are unclear. In this study, we systematically constructed pharmaceutical-information services to clarify the condition in which intervention by clinical pharmacists is allowed for drug therapies in the intensive care field. We investigated clinical pharmacists' interventions in the ICU from June 2013 to December 2014 (excluding the term from February 2014 to March 2014), and constructed a categorization by referring to the pharmaceutical interview form (IF). We configured “the necessity for the drug therapy” in addition to IF categories, because there were several inquiries by the pharmacists as to whether the medication should be started or discontinued. Then we classified clinical pharmacists' interventions from February 2016 to November 2016 using that categorization. During that period, there were 840 cases, and the most common category was “the necessity for drug therapy” which numbered 191 cases. Therefore, of all the cases there were 412 cases labeled “preavoid” in which the interventions improved the safety of the medication.. In this study, it was revealed that intervention by the clinical pharmacists positively identified the necessity for drug therapy. It seems that the clinical pharmacists require the ability to comprehend clinical conditions and evaluate drug therapies. An evaluation of “preavoid” cases using the categorization suggests pharmacists contribute to improvements in the quality and the safety of medication.

著者

今西 孝至 髙松 千世 髙山 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.43, no.11, pp.640-647, 2017-11-10 (Released:2018-11-10)

参考文献数

5

被引用文献数

2

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Pictograms can be used to transmit information to anyone all over the world. In Japan, pictograms regarding interaction, usage, and dosage are developed by the RAD-AR Council Japan; however, pictograms indicating the pharmacological effect remain to be developed. In this study, we created seven kinds of pictograms regarding pharmacological effect: antiarrhythmic drugs, hypnotics, hypoglycemic drugs, antibiotics, diuretics, antihypertensive drugs, and antidementia drugs, and researched the necessity and evaluation of the created pictograms using a questionnaire survey for pharmacists and the general public. Overall, 89.6% of the pharmacists and 86.8% of the general public answered “necessary” regarding pictograms on pharmacological effects. Regarding the usefulness of these pictograms, pharmacists responded “understanding the efficacy of medicine” and “emergencies such as natural disasters.” On the other hand, the general public responded, “distinguish the medicine by myself” and “emergencies such as natural disasters.” The pharmacists had a significantly higher rate of giving correct answers than the general public for all pictograms. In the general public, the rates of correct answers for these pictograms decreased with age. However, the rates of correct answers for pictograms on diuretics and hypotensive drugs were > 90% in the elderly aged ≥ 70 years. In conclusion, although the necessity for pictograms regarding pharmacological effects was proved, the correct answer rate differed significantly between the pharmacists and the general public. Therefore, it is necessary to improve these pictograms so that anyone can understand them more accurately, with or without medical knowledge.

著者

阪田 安彦 岩本 康男 菅原 隆文 阿部 圭輔 赤木 恵 宮森 伸一 伊藤 充矢 大谷 彰一郎 雑賀 隆史 野間 純 檜垣 健二 二宮 基樹 開 浩一

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.38, no.12, pp.780-784, 2012-12-10 (Released:2013-12-10)

参考文献数

10

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Docetaxel is used to treat various types of carcinomas. Since docetaxel is insoluble in water (solubility, 0.002 mg/mL), to improve its solubility, it is administered with alcohol. The amount of alcohol required to improve the solubility of Onetaxotere® is twice as much as that required to improve the solubility of Taxotere®.In this study, we investigated the immediate breath alcohol level of and feeling of drunkenness experienced by patients after administration of chemotherapy with Onetaxotere®. The study was performed in 50 patients, from March 2012 to June 2012. In addition, 25 patients served as controls: these patients were administered chemotherapy with paclitaxel. Breath tests revealed no alcohol in any of the patients who were administered Onetaxotere®. Furthermore, none of these patients experienced a feeling of drunkenness. In contrast, breath tests performed in the control patients revealed alcohol in 15 cases, and 4 out of the 15 patients experienced a feeling of drunkenness.Breath tests revealed alcohol in 60.0% of the patients who were administered paclitaxel. The result is similar to those reported in other studies. No alcohol was detected in any of the patients who were administered Onetaxotere®. Moreover, these patients did not experience a feeling of drunkenness. These findings suggest that the patients who received Onetaxotere® were unaffected by the alcohol used to administer the drug.

著者

田口 和明 猿渡 淳二 平田 憲史郎 丸山 徹

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.4, pp.215-222, 2015-04-10 (Released:2016-04-10)

参考文献数

37

被引用文献数

1

---

Therapeutic drug monitoring (TDM) is an essential tool for the optimal use of drugs. Although rare, the drug concentration in blood determined by TDM can be higher or lower than that predicted from the dosage amount and patient information. In such cases, it is necessary to consider the occurrence of false positives and false negatives in the measurement process. Dose adjustment based on the measured blood drug concentration poses potential risks of underdosing and overdosing in patients suspected of false positive and false negative data, respectively. Therefore, pharmacists involved in TDM are required to become familiar with false positives and false negatives in TDM. In particular, the possibility of false positives in TDM of immunosuppressants by the affinity column-mediated immunoassay (ACMIA) method should be considered, while TDM of vancomycin or phenytoin requires attention to false negatives during measurement by the particle-enhanced turbidimetric inhibition immunoassay (PETINIA) method. Moreover, interference from IgM in the measurement process may be of concern in false-negative results; therefore, the measured blood drug concentration needs to be verified when the blood IgM level is high. This mini-review outlines false positives and false negatives that should be considered in TDM and presents a discussion of the relevant literature.

著者

坂野 昌志 間瀬 広樹 島田 泉 伊藤 由紀 中村 卓巨 青田 真理子 中村 桂 近藤 祥子 堀端 志保 中野 良美 五家 邦子 鈴木 末廣 井端 英憲

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.33, no.11, pp.920-924, 2007 (Released:2009-09-04)

参考文献数

12

被引用文献数

2 2

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In the treatment of cancer,radiotherapy is equally important to chemotherapy,and the pain arising from the adverse reactions of esophagitis and stomatis is treated with sodium aliginate (AL-Na).We decided to try cooling AL-Na because it was felt that doing this would enhance the analgesic effect.When cooled,the time of adhesion to the affected part was longer than that for AL-Na at room temperature and the pain relieving effect was greatly enhanced.

著者

中島 誠 三浦 ひとみ 上野 陽子 岡 智子 奥 麻理 福島 綾子 寺師 守彦 大迫 政彦 林 秀樹 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.41, no.11, pp.799-810, 2015-11-10 (Released:2016-11-10)

参考文献数

28

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The package insert of notandum, a narcotic drug, states that patients who take this drug must not drive a car, or should drive a car carefully. Many drugs used in supportive cancer chemotherapy and palliative therapy contain warnings regarding driving a car. Twenty-one of 127 outpatients in our hospital who received cancer chemotherapy were prescribed drugs that affect car driving. Sixteen patients drove a car on a daily basis. Although patients would receive a warning from their physician or pharmacist regarding driving when prescribed narcotic drugs, repeated warnings should be given, and driving status should be checked. Fourteen patients stated that refraining from driving was difficult. Therefore, pharmacists proposed prescribing drugs that do not affect driving to these patients. By changing their therapeutics to anti-emetics and supplementary analgesics, the patients could drive without worsening their condition. When selecting drugs, the necessity of driving should be checked to maintain quality-of-life. Nevertheless, as all patients who take opioid analgesics in palliative therapy must refrain from driving, and as opioid analgesics cannot be replaced with other drugs, it is necessary to check the validity of the descriptions in the package insert in future.

著者

佐治 守 薄木 玲子 茨木 信博 葉山 修陽 大薗 英一 大國 寿士

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.341-345, 2003-06-10 (Released:2011-03-04)

参考文献数

18

被引用文献数

1 4

---

Benzalkonium chloride is most commonly used as a preservative for ophthalmic solutions at a dosage of 50 μg/mL. In this study, we evaluated the antibacterial activity of this preservative against 16 species and64 clinically isolated strains. Benzalkonium chloride demonstrated a good effect on gram-positive cocci, the minimum inhibitory concentrations (MICs) of benzalkonium chloride to Staphylococcus epidermidis and Staphylococcus aureus including MRSA were less than 12.5μg/mL. On the other hand, benzalkonium chloride was not effective against gram-negative rods ; 95% (42/44) of gram-negative rods strains were not susceptible after treatment with 50μg/mL of benzalkonium chloride. Especially, the MICs of benzalkonium chloride to clinically isolated pseudomonas aeruginosa were over 200μg/mL. These results suggest that benzalkonium chloride as preservative for ophthalmic solutions in effective on gram-positive cocci even when used in concentrationsonly one fourth times as much as those commercially available and to gram-negative rods when used in concentrations which may cause damage to the comeas. The use of lower concentration of benzalkonium chloride may therefore make it possible to reduce the degree of damage to the cellular components of the cornea.

著者

下村 斉 青山 隆夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学

巻号頁・発行日

vol.42, no.12, pp.781-794, 2016

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<p>The incidence of pulmonary <i>Mycobacterium avium</i> complex (MAC) disease is increasing worldwide. Currently, clarithromycin is the key drug for treatment of pulmonary MAC disease, and multidrug therapy with rifampicin and ethambutol is recommended. However, the efficacy of this therapy is reported to be approximately 60-80%. Therefore, this disease is often difficult to treat, and there are some problems concerning this form of chemotherapy. Firstly, rifampicin decreases the serum clarithromycin concentration owing to CYP3A4-related interactions. Although this therapy needs to be administered for more than one year, to our knowledge, no study has investigated the long-term relationship between serum clarithromycin and rifampicin concentrations and CYP3A4 activity, together with treatment efficacy. Secondly, an alternative treatment to the recommended therapy of clarithromycin, rifampicin, and ethambutol has not been established. Therefore, fluoroquinolones are often used when the clinical efficacy of the recommended regimen is insufficient. However, very few previous studies have investigated the clinical efficacy of the combination of clarithromycin and fluoroquinolones, especially levofloxacin.</p><p>Our recent study demonstrated that serum clarithromycin concentrations in patients with pulmonary MAC disease were continuously low because of rifampicin-mediated CYP3A4 induction, which may be responsible for the unsatisfactory clinical outcomes observed. We also investigated the clinical outcomes achieved with the currently recommended dose of clarithromycin and levofloxacin, and suggested the possibility that combined administration of clarithromycin and levofloxacin did not improve clinical outcomes for the treatment of pulmonary MAC disease. In this mini-review, we summarize the findings of our clinical studies concerning chemotherapy for pulmonary MAC disease.</p>

著者

飯原 なおみ 吉田 知司 岡田 岳人 中妻 章 桐野 豊

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.2, pp.67-77, 2014

被引用文献数

5

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There is no report to date regarding the usage status of medications with driving with prohibitions or cautions in Japan. Upon sampling the national health insurance claims database (covering 1% of outpatients), we surveyed the prescriptions and use of medications in outpatient settings for patients aged 25 years and older, with the goal of encouraging the proper use of medications.We analyzed the ratio of outpatients who were administered medications with prohibitions or cautions on driving to total outpatients who were administered medications (prescribed and/or provided to them at the time of examination). We also examined daily dosages and deviations from specified dose-limits for their prescribed oral medications.Of 566,968 outpatients aged 25 years and older who were administered medications, 413,940 (73%) outpatients were given the medications with cautions or prohibitions on driving and 243,405 (43%) outpatients were administered the medications with a prohibition on driving.Daily dosages of many medications were reduced with the increase in age of the patient. The degree of dosage reduction varied widely, with some medications whose dosages were hardly adjusted with age. With some medications with dose-limitations or contraindications for the elderly, prescriptions were found with dosages that often exceeded the recommended limits.We conclude that outpatients given medications and/or prescriptions must exercise appropriate caution when driving and that the dosage of these medications should be adjusted especially in the elderly.

著者

木村 公美 三橋 真由美 奈良輪 知也 尾鳥 勝也 矢後 和夫 伊藤 智夫

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.12, pp.751-756, 2012-12-10 (Released:2013-12-10)

参考文献数

11

被引用文献数

2 2

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The simple suspension method has been developed for performing tubal administration by placing tablets or capsules in hot water (55 °C) and serially decaying/suspending them without crushing/opening them. However, the stability of a cardinal drug against the pH of the suspension and heat remains unclear. In this study, we examined the stability of an oral anti-tumor preparation, capecitabine tablets, against the pH of the suspension and heat. Initially, we assessed the stability of capecitabine tablets suspended in phosphate-buffered saline at various pHs. Subsequently, we investigated the stability of capecitabine tablets suspended in phosphate-buffered saline heated at 25 or 55 °C. In addition, we evaluated the stability of this preparation heated at 55 or 80 °C for 30 minutes after being suspended in phosphate-buffered saline heated at 25 °C. When capecitabine suspension was heated at 80 °C for 30 minutes under acidic conditions, the residual capecitabine rate was approximately 50%. Then, a tube passage test of capecitabine was conducted. Passage was favorable. There was no decrease in the content after passage in comparison with the pre-passage value. Based on these results, the tubal administration of capecitabine should be performed considering both the drug suspension pH and temperature.

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

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

参考文献数

12

被引用文献数

5 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

斎藤 百枝美 佐藤 充子 菅原 由香 佐藤 早織 山本 佳子 井手 基文 丹羽 真一 江戸 清人

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.3, pp.194-202, 2005-03-10 (Released:2011-03-04)

参考文献数

5

被引用文献数

1 2

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We introduced a medication management module (MMM) for the education of psychiatric inpatients that uses a video (FMV) produced by Fukushima Medical University. We then asked 32 staff members to evaluate the usefulness of FMV by filling out a questionnaire. Nine of the staff (28 %) responded that it greatly improved the patients' comprehension level, 19 (59 %) felt that it had improved, and 4 (13 %) thought that there had been no change. We estimated that the workload of staff had decreased from 10 to 3.7 points. Further, by testing the 37 participants in MMM on their comprehension level before and after it with the same questions, the mean score was significantly higher after MMM (21.4 ± 0.9 points) than before (18.3 ± 3.5 points) (p< 0.001).To assess the effect of MMM on post-hospital self-medication behavior, we mailed another questionnaire to patients who had participated in MMM and those who had not. The sixty-three respondents (34 men and 29 women, aged from 15 to 78 years) consisted of 43 schizophrenia patients and 20 manic-depressive psychosis patients, of whom 33 had participated in MMM and 30 had not. The percentage of MMM-participants who were taking medication regularly was not significantly different from that of non-participants. However, the percentages of MMM participants who understood the necessity of medication and knew how to cope with side effects were significantly higher (p< 0.05 and p< 0.001, respectively).These results indicate that MMM is useful in raising patients' level of comprehension of medication and helping them acquire the proper post-hospital self- medication behavior.

著者

Eiseki Usami Michio Kimura Tomoaki Yoshimura Tadashi Yasuda Hitomi Teramachi Tadashi Sugiyama Teruo Tsuchiya

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.38, no.5, pp.282-287, 2012-05-10 (Released:2013-05-10)

参考文献数

14

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Steroids are used in the treatment of patients with non-Hodgkin's lymphoma (NHL) as a one off high dose and are a key antitumor medication. Although the duration of steroid administration is short, Steroid Withdrawal Syndrome (SWS) has been documented after treatment. The aim of this retrospective study was to evaluate the prevalence of SWS and to assess the relevance of steroid tapering in 116 patients newly diagnosed with NHL. The most significant symptoms of SWS documented were fatigue in 70 patients (60.3%) and anorexia in 32 (27.6%). Four elderly patients (3.4%) suffered with serious SWS symptoms of grade 3. Of the 70 patients suffering with SWS, 22 went on to receive tapered steroid therapy during the subsequent chemotherapy treatment. The average steroid tapering period was 4.4 days and 86.4%patients reported a significant improvement of their SWS symptoms. No serious adverse events were noted. Although age did not appear to be a risk factor of SWS it was noted that elderly patients with SWS were more adversely affected.We conclude that steroid tapering is a safe and effective treatment method. If the patient has serious symptoms of SWS we should introduce steroid tapering aggressively and early, especially in elderly patients.