著者

窪田 幸恵 斉藤 和幸 小野 俊介 児玉 庸夫

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.43, no.6, pp.287-296, 2017-06-10 (Released:2018-06-10)

参考文献数

11

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In an effort to promote self-medication in Japan, drugs switched from prescription to over-the-counter (OTC) have received a lot of attention. We conducted a survey of community pharmacists to investigate views on Rx (Prescription) -to-OTC switched drugs, aiming at the enhancement of self-medication and proposals to the Regulatory Authorities. A total of 336 respondents completed the survey. About two-thirds of respondents (65.2%) regarded the expansion of Rx-to-OTC drugs as necessary. The percentage of pharmacists who responded that Rx-to-OTC expansion was necessary at pharmacies for prescription and OTC drugs (73.2%) was significantly higher than those at pharmacies for prescription drugs (51.2%) (P < 0.001). The most common reason for Rx-to-OTC expansion being necessary was “it has a certain level of effect on reducing healthcare costs”. On the other hand, the most common reason against Rx-to-OTC expansion was “it causes safety issues for consumers”. The number of candidates for Rx-to-OTC recommended by pharmacists in favor of Rx-to-OTC expansion was 43 with 14 therapeutic areas excluding 5 drugs accepted as Rx-to-OTC switched drugs by the Ministry of Health, Labour and Welfare. Six out of 43 candidate drugs are considered to meet the requirements for Rx-to-OTC drugs. We revealed some differences in pharmacists' views on Rx-to-OTC switched drugs depending on the pharmacy category. To promote self-medication, constructing a mechanism to collect opinions of community pharmacists providing OTC drugs is required. Further research in other areas and pharmacies of different categories to confirm generalizability should be done for making a proposal to the Regulatory Authorities.

著者

村上 雅裕 中谷 真由美 太田 千裕 安田 恵 天野 学

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.10, pp.592-598, 2017-10-10 (Released:2018-10-10)

参考文献数

15

被引用文献数

1

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To provide appropriate information concerning ethical or Rx-OTC-switch drugs containing the same ingredients by pharmacists, it is necessary to understand the properties of both. In this study, pharmaceutical properties and economics were compared between ethical and Rx-OTC-switch anti-allergy ophthalmic solutions containing tranilast, pemirolast, or acitazanolast.Regarding 14 ethical and 3 Rx-OTC-switch products, the squeeze force, drop weight, pH, specific gravity, and total number of drops were measured. The usable period per bottle and daily cost were calculated from the total number of drops.The squeeze forces of the three drugs differed about 1.5-2 times among their products. Single-drop volumes calculated from the drop weights and specific gravities ranged from 30 to 46 μL for 0.5% tranilast ophthalmic solution, larger for the original drugs than for the Rx-OTC-switch and generic ones. The pH values of the ophthalmic solutions differed among the drugs, but not among their products. The usable periods of each bottle of the three drugs were longer for the Rx-OTC-switch drugs. However, the daily drug costs of 0.1% pemirolast ophthalmic solution were higher for the Rx-OTC-switch drug than for the original one, although those of 0.5% tranilast ophthalmic solution were lower.The present study demonstrated that the squeeze forces and drop volumes differed between the Rx-OTC-switch and ethical drugs and that the usable periods of each bottle and daily costs differed among the drugs. It is important for pharmacists to obtain information on the pharmaceutical properties and economics for in order to select products for individual patients.

著者

薄井 健介 小室 治孝 月村 泰規 渡辺 雄一 神 雅人 伊藤 千裕 井口 智恵 野島 浩幸 井上 岳 厚田 幸一郎

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.39, no.6, pp.338-346, 2013-06-10 (Released:2014-06-10)

参考文献数

13

被引用文献数

3

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We investigated the effectiveness of using a “Sports Pharmacist” to prevent the occurrence of doping in sports.During the first step, we individually interviewed 17 high school softball team athletes and determined their regular and/or occasional use of prescription and OTC medications, herbal agents, vitamins and supplements. A total of 76% of these players were either taking or had access to medications for occasional use that contained prohibited substances. Athletes determined to be using a prohibited compound were sent a written notice that recommended they avoid carelessly taking these banned substances.In the subsequent step, we gave an educational lecture to the entire team on how to avoid doping in sports. Before and after the presentation, we evaluated the effectiveness of the lecture by examining the athletes’ knowledge and awareness of anti-doping in sports. The results indicated a significant difference after the lecture with regard to appropriate knowledge and awareness of anti-doping in sports. This specific awareness continued for at least a month.In summary, medication reviews and one-on-one consultation with athletes in conjunction with a follow-up educational lecture to the team as a group resulted in successfully educating and helping team members avoid doping. In addition, these findings demonstrated the effectiveness of the “Sports Pharmacist” profession in working with athletes to help prevent doping in the future.

著者

粟屋 敏雄 長谷部 直幸 梶野 浩樹 石谷 麻里子 山田 武宏 小野 尚志 大滝 康一 山下 恭範 三好 敏之 田崎 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.35, no.9, pp.615-621, 2009 (Released:2011-01-14)

参考文献数

11

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After an overdosing incident at our hospital,we developed an upper limit alert system that checks doses of injection drugs for individual patients as the physician uses the computerized order entry system.Based on each patient’s converted body surface area (BSA),the upper limit for an injection is estimated through comparison with the standard upper limit in a patient with a BSA of 1.6 m2.This is done automatically in accordance with a compensation formula provided by our hospital’s safety committee.Standard upper limits for each injection are based on past records of actual injection dosages administered in our hospital and discussion with clinical departments.When a physician tries to enter an order for an injection at a dose over the upper limit,the computer system issues the alert“non-enterable”and the order cannot be placed.In the case of a regimen for which there is a legitimate reason for using a dose higher than the upper limit,the physician must explain this to the pharmacist who will then unlock the alert system using a secret password that he or she has designated.Passwords are only valid for one day.As far as we know,this is the first computerized injection dosage upper limit alert system in the world.On doing a search of our database,we found that there had been 742 overdose alerts (0.47% of all injection prescriptions) during the 3 months following its introduction.Owing to the alerts,physicians altered 155 prescriptions (21.1% of all alerts).Our computerized alert system for checking injection dosages has proved to be very necessary in ensuring medication safety.

著者

田中 直哉 近藤 澄子 田中 秀和 佐藤 均

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.320-328, 2005-04-10 (Released:2011-03-04)

参考文献数

12

被引用文献数

2 2

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We report on the development and introduction of our original SOAP (Pharmacy-oriented SOAP : P-SOAP) form, an expanded version of the conventional SOAP form, which is highly suited to community pharmacies. In P-SOAP, patient follow-up items and pharmaceutical care planning actions have been added. We conducted a questionnaire survey of 13 newly graduated pharmacists who had been educated on the use of the conventional SOAP for about half a year to ascertain their opinions of P-SOAP. They felt that the conventional SOAP had unclear assessment (A) and planning (P) definitions, and that actual medication instructions did not fit in with the SOAP form. However, they thought that P-SOAP enabled them to easily acquire detailed patient information and prepare patient records in a relatively short time. In conclusion, P-SOAP should be a useful tool for recording medication history in an optimal manner for the community pharmacy, and contribute to raising the quality of patient care.

著者

丹羽 隆 篠田 康孝 鈴木 昭夫 大森 智史 太田 浩敏 深尾 亜由美 安田 満 北市 清幸 松浦 克彦 杉山 正 村上 啓雄 伊藤 善規

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.5, pp.273-281, 2012-05-10 (Released:2013-05-10)

参考文献数

38

被引用文献数

1 15

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Antimicrobial resistance in hospitals is increasingly becoming a major problem worldwide, thus appropriate use of antimicrobial agents should be promoted. Since August 2009, our hospital has established a review system for checking prescriptions in all patients receiving antimicrobial injections according to the intervention and feedback of antimicrobial stewardship (AMS) guideline. The antimicrobial use density (AUD), duration of administration, length of hospital stay, and antimicrobial resistance in a year were compared before and after starting the intervention into AMS. Suggestions made by members of the infection control team (ICT) to the prescribers were for the major part the choice and dose elevation of antimicrobials. Most of the proposals (91%) were accepted by the prescribers. Although AUD was not changed after AMS intervention, the proportion of prolonged antimicrobial use (over 2 weeks) was significantly reduced from 5.2% to 4.1% (p=0.007), which led to the saving of costs for antibiotics (4.48 million yen/ year). The incidence of MRSA tended to decrease after AMS intervention (p=0.074). The median length of hospital stay was ultimately shortened by 1.0 day (p=0.0005), which led to an estimated saving of medical costs by 520 million yen/year. We consider that our intervention profoundly affects this cost saving. These findings suggest that the extensive intervention into AMS is effective in reducing the frequency of inappropriate use of antimicrobials, suppressing the occurrence of antimicrobial resistance, and saving medical expenses.

著者

脇 由香里 吉見 陽 千﨑 康司 宮田 はるみ 伊東 亜紀雄 相馬 孝博 上田 裕一 毛利 彰宏 山田 清文 尾崎 紀夫 野田 幸裕

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.37, no.8, pp.475-480, 2011 (Released:2012-08-30)

参考文献数

16

被引用文献数

1 1

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Falls and fall-related injuries among inpatients are one of the most important concerns in medical safety management and sometimes cause a significant decrease in activities of daily living (ADL). It has been suggested that the adverse reactions of psychotropic drugs related to their sedative-hypnotic, cognitive deficit producing and muscle reaction-related effects are closely associated with falls.In this study, we examined a relationship between the risk of falls and psychotropic drugs based on prescriptions in fall incident reports at Nagoya University Hospital in a 12-month period beginning in April 1, 2005. In July 2006, we conducted an educational intervention involving instructing health care staff on the optimal use of psychotropics. After doing this, we examined prescriptions in fall incident reports over a 12-month period beginning in April 1, 2006. The results showed a decrease in fall incidence due to long-acting drugs in 2006 as compared with 2005 and this indicated that, among psychotropics, sedativehypnotic-anxiolytics were one of the highest risk factors for falls. These results suggest that an educational intervention can be an effective means of reducing the number of falls and fall-related injuries among inpatients.

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, 2014-02-10 (Released:2015-02-10)

参考文献数

12

被引用文献数

2 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

後藤 佐昌子 八軒 浩子 高田 充隆

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.1, pp.21-30, 2011 (Released:2012-04-27)

参考文献数

17

被引用文献数

4

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To quantitatively investigate the history of medical pharmacy research in Japan,we analyzed the titles of articles in theJapanese Journal of Pharmaceutical Health Care and Sciences and the Japanese Journal of Hospital Pharmacy,the principalmedical pharmacy journals in Japan,by text-mining.All article titles (2884 articles) between 1975 and 2009 were collectedfrom article databases,and the text of titles was analyzed using the KH Coder,free software for quantitative textanalysis of the Japanese language.This software produces basic information on text data such as the rate of occurrence ofcertain words.Nine research categories were identified through multivariate analysis of frequently appearing words.Also,coding rules were created to assign article titles to these research categories,and the categorization results were analyzed quantitatively.Pharmaceutical investigation was the principal category in the 1970 s and 80 s,with the quality evaluation of drugs asthe major area of research.Articles assigned to this category accounted for 41.4% of all articles published during the period1980-1984.Articles assigned to the drug therapy category began to gradually increase in the 1990 s,and since 2000,drugtherapy has been the major area of medical pharmacy research in Japan.In addition,there has been an increase in investigationsassociated with the education of pharmacists and pharmacy students in recent yearsOur findings suggest that there has been a shift in the dominant research area of medical pharmacy in Japan from qualityevaluation of drugs to patient care.

著者

谷口 律子 錦織 淳美 川崎 博己 黒崎 勇二 荒木 博陽 五味 田裕

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.30, no.4, pp.246-254, 2004-04-10

参考文献数

9

被引用文献数

12 13

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It is important for students to acquire the skills of pharmaceutical care with respect to patients. However, clinical pharmacy education in Japan is still not fully developed and teachers at faculties of pharmacy generally teach students by means of lectures, which is too passive for students. Since such a lecture-based system will not help them to acquire pharmaceutical care skills, there should also be training that simulates the provision of pharmaceutical care in the clinical situation. To address this issue, the authors tested problem-based learning (PEL) on students, with the objective of developing problem solving skills and student independence. In the PEL, students gained an understanding of the principles of pharmacotherapy and drew up hypothetical schemes for pharmaceutical care, worked out the problems and discussed them together in small groups. They also practiced role-playing, which was intended to help them learn communication skills. Afterwards, the authors conducted a questionnaire survey to evaluate the student's impressions of the PEL and they evaluated it highly, particularly with regard to learning communication and problem-solving skills. These results suggest that it would be useful to introduce PEL in clinical pharmacy education in Japan.

著者

齊藤 順平 歌野 智之 倉富 未来 廣川 太士朗 小村 誠 赤羽 三貴 牧山 稔 石川 洋一

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.1, pp.1-7, 2018-01-10 (Released:2019-01-10)

参考文献数

12

被引用文献数

4 1

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The methods for the preparation of hospital drugs (i.e., powder dilution, opening the capsule shells and tablet crushing) are not validated and vary among medical facilities. In order to explore a quick and effective preparation method for dantrolene sodium diluted powder from capsule formulation without any weight loss and to maintain acceptability in pediatric patients, the uniformity test, particle size distribution analysis, pass efficiency test (the feeding tubes patency) and sensory evaluation of the mouth feel were examined.The diluted powder prepared by the capsule opening method has uniformity, although the recovery rate was slightly low compared to the crushing method. The crushing of whole capsules using the mill provided non-uniformity of content and variable particle size distribution. The contamination of capsule shell debris is probably part of the explanation for the non-uniformity of the contents. The powder sieved through a 100-micron screen following capsule crushing provided uniformity of contents without any loss. The results of passing tests, and administration via a feeding tube including gastrostomy were acceptable in both capsule opening and capsule crushed powder formulation. In the sensory test, the products that were screened using a 100-micron screen filter after capsule crushing had a less gritty mouth feel. These results suggest that capsule crushing and screening are validated as an alternative preparation method for dantrolene sodium diluted powder.In this study, we succeeded in developing effective methods for dantrolene sodium diluted powder. Most hospital preparations were not validated for pediatric patients and further tests in practical use are required.

著者

平 雄文 大磯 茂 仮屋薗 博子

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.45, no.8, pp.441-450, 2019-08-10 (Released:2020-08-10)

参考文献数

26

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We investigated the relationship between drug administration and the onset of acute pancreatitis using the Japanese Adverse Drug Event Report database (JADER) of the Pharmaceuticals and Medical Devices Agency. Upon analysis of the proportional reporting ratio, an indicator of signal detection in pharmacovigilance, signals were detected for 65 drugs such as L-asparaginase, mesalazine, and estrogen among 1,129,350 reports in JADER. Data suggest that the younger age groups have a higher risk of acute pancreatitis for 7 drugs including L-asparaginase and azathioprine, as do men compared to women for 4 drugs including telaprevir and sodium valproate. In analysis of the time-to-onset profile using Weibull distribution, 6 drugs including L-asparaginase and mesalazine were estimated to be the early failure type, and peginterferon alfa-2b and telaprevir were estimated to be the wear out failure type. Logistic regression analysis showed a significant association between the presence of concomitant drugs and the onset of acute pancreatitis for 4 drugs namely L-asparaginase, azathioprine, tacrolimus, and methylprednisolone sodium succinate. These results will be useful for monitoring acute pancreatitis induced by drugs.

著者

林 剛 舘 知也 野口 義紘 杉岡 まゆ子 青山 智 田中 和秀 安田 昌宏 後藤 千寿 山田 浩司 水井 貴詞 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.47, no.9, pp.464-476, 2021-09-10 (Released:2022-09-10)

参考文献数

15

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In this study, we evaluated the effect of risk minimization activities in a risk management plan (RMP) formulated for sodium-glucose cotransporter-2 (SGLT2) inhibitors using both the Japanese Adverse Drug Event Report database (JADER) and real-world clinical data. We extracted data from the JADER, which is maintained by the Pharmaceuticals and Medical Devices Agency, from the first quarter of 2004 to the second quarter of 2020. We also used real-world clinical data of the patients who took SGLT2 inhibitors among those who visited or were admitted to Gifu Municipal Hospital from June 2014 to January 2018. We conducted a comparison before and after implementing the risk minimization activities. We compared the reported rate of clinical trials with the reported rate after marketing using the JADER. In addition, we compared the prevalence rate of the clinical trials of SGLT2 inhibitors with that in real clinical data. Furthermore, we compared the onset of side effects (in days) reported in clinical trials recorded in the JADER with that in real clinical data. The pre/post comparison showed a significant increase in the reported rates of increased ketone body, volume depletion, urinary tract infections, and genital infections. A significant decrease in the prevalence rates for hypoglycemia and increased ketone body was also observed. Moreover, the time to onset of side effects was significantly shortened in volume depletion. In conclusion, the risk minimization activities in RMP would contribute to the increased reported rate, decreased prevalence rate, and early detection of side effects.

著者

吉田 宣政 河原 菜摘 入村 健児 福原 佐知 檜山 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.47, no.1, pp.38-42, 2021-01-10 (Released:2022-01-10)

参考文献数

6

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Streptococcus faecalis is the primary ingredient of medical probiotics. It has now been identified as an enterococcal species, after being reclassified as Enterococcus faecalis. Despite this reclassification, most package inserts and drug interview sheets have maintained the name S. faecalis. Meanwhile, reports of results from drug susceptibility tests using medical probiotics that contain S. faecalis commonly refer to this species of bacterium as E. faecalis. In this study, we used biochemical identification testing, mass spectrometry and 16S ribosomal RNA gene sequencing to verify whether the seven strains of S. faecalis, which is present in various medical probiotics, could be identified as the strain currently classified as E. faecalis. All strains were identified as E. faecium by all techniques.

著者

齋田 哲也 中野 行孝 藤戸 博 宮﨑 翼 進 正志

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.39, no.7, pp.423-429, 2013-07-10 (Released:2014-07-10)

参考文献数

17

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Recently, six furanocoumarin derivatives isolated from grapefruit juice were found to be inhibitors of CYP3A4, suggesting that they may be clinically active and useful constituents. We succeeded in developing a sensitive and specific enzyme-linked immunosorbent assay (ELISA) for these furanocoumarin derivatives in grapefruit juice.In this study, we examined the correlation between immunoactivity as indicated by ELISA and CYP3A4 inhibitory effects, in order to determine whether ELISA is a useful method for analysis of the CYP3A4-inhibitory activity of furanocoumarin derivatives. Our results show a close correlation between the values. Therefore, our findings strongly indicate that ELISA is a useful method for analysis of these furanocoumarins.Using this ELISA, grapefruit-derived products (grapefruit juice, jam and marmalade) were examined for furanocoumarin derivatives. Immunoactivity analysis was used to determine the amount of 6',7'-dihydroxybergamottin conversion. The amount of 6',7'-dihydroxybergamottin conversion was 13.0 μg/g with grapefruit juice, 40.0 μg/g with grapefruit marmalade and 1.7 μg/g with grapefruit jam. In addition, it was found that the heat treatment of grapefruit juice decreases the immunoactivity as indicated by ELISA and the CYP3A4-inhibitory activity. Moreover, the decreasing rate of the CYP3A4-inhibitory activity was lower than that of the immunoactivity as indicated by ELISA. Therefore, when the heat-treating grapefruit-derived products were analyzed by the ELISA, it was suggested that the CYP3A4-inhibitory activity might be estimated low. These findings will become indexes of the drug interaction of grapefruit-derived products.

著者

清水 幸雄 柚原 亜美 矢野 勝子 北川 佳奈子 飯田 純一 五十嵐 信智 伊藤 清美 落合 和 折井 孝男 杉山 清

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.1, pp.31-36, 2010 (Released:2011-12-24)

参考文献数

17

被引用文献数

6 4

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There is concern about the possibility of degradation of the active substance as a result of pH changes when making suspensions of several drugs together by the simple suspension method.However,this has been investigated by few researchers.In the present study,we focused our attention on aspirin since it is known to be hydrolyzed at high temperatures or with elevation in pH.In this study,a Bufferin® 81 mg Tablet was suspended alone or together with alkaline drugs by the simple suspension method,and its stability evaluated.When in the suspension alone,the Bufferin® 81 mg Tablet was stable for 5 hours and the amount of salicylic acid (hydrolyte of aspirin) produced was negligible.On the other hand,when it was suspended together with alkaline agents (magnesium oxide tablet/powder,or lithium carbonate tablet),the residual content of aspirin decreased to 77-84% in ten minutes.The pH of the suspensions containing both the Bufferin® 81 mg Tablet and alkaline agents ranged from about 9 to 10 showing that alkalinity had been enhanced as compared with the suspension of Bufferin alone whose pH was 4.It has been reported that in low-dose aspirin therapy,platelet aggregation inhibition is unstable if the daily aspirin dosage is reduced to less than 75 mg.However for Bufferin® 81 mg Tablet,the results of the present study suggested that the beneficial effect of low-dose aspirin therapy might not be fully achieved it were suspended together with alkaline agents by the simple suspension method.

著者

町野 英弥 肥田 典子 原田 努 柴田 佳太 三邉 武彦 龍 家圭 水上 拓也 山崎 太義 諸星 北人 村山 信浩 竹ノ下 祥子 内田 直樹 倉田 なおみ

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.47, no.11, pp.599-608, 2021-11-10 (Released:2022-11-10)

参考文献数

15

被引用文献数

1

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Patients with reduced swallowing function have difficulty taking tablets in their original form. In such cases, tablets are crushed (crushing method) and administered through feeding tubes, but this practice may affect efficacy. A simple suspension method (SSM) has been widely used to address issues of administering crushed tablets through feeding tubes. Most of all angiotensin-converting enzyme (ACE) inhibitors are ester prodrugs. When they are suspended with magnesium oxide, ester prodrugs are hydrolyzed, and the active metabolite increases before absorption. In this study, we investigated the effects of SSM and crushing methods on the pharmacokinetics of the ACE inhibitor using temocapril and magnesium oxide. A human clinical trial was conducted to compare the pharmacokinetics of temocapril and magnesium oxide in three groups in six healthy adult men (period 1, tablet group; period 2, SSM group; and period 3, crushing-and-mixed group). The pharmacokinetics of temocaprilat, which is the active metabolite, were examined. The AUC0-24 and Cmax of the SSM group were 89.3% and 86.1% compared with those of the tablet group, whereas those of the crushing-and-mixed group decreased to 73.0% and 78.9%, respectively. In the crushing-and-mixed group, the concentration of temocapril decreased during crushing and long-term storage. Findings in the present study suggest that the crushing method may decrease in AUC0-24 and Cmax and that the expected drug effect may not be achieved. For ester prodrugs, the use of SSM might be considered rather than the crushing method.

著者

前田 章光 安藤 仁 浅井 徹 石黒 久晶 梅本 紀夫 志水 清和 伊藤 基博 細畑 圭子 牛島 健太郎 藤村 昭夫

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.37, no.8, pp.481-485, 2011 (Released:2012-08-30)

参考文献数

10

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Recent studies carried out in Western countries have suggested a potential adverse interaction between clopidogrel and proton pump inhibitors (PPIs), which inhibit CYP2C19 activity. The purpose of this study was to examine the influence of individual PPIs and CYP2C19 polymorphism on the antiplatelet effect of clopidogrel in Japan. The platelet aggregations induced by 20 μmol/L ADP and CYP2C19 single nucleotide polymorphisms (*2 and *3) were determined in 118 patients on aspirin plus clopidogrel (75 mg/day) therapy. Twenty-five and 13 patients were treated with lansoprazole and rabeprazole, respectively. The platelet aggregation of extensive metabolizers (EM : *1/*1) treated with lansoprazole tended to be higher than those not given a PPI (21.5 % vs. 17.4 %, respectively, p=0.14). Lansoprazole was observed to have no effect on platelet aggregation in intermediate metabolizers (IM : *1/*2 and *1/*3) and poor metabolizers (PM : *2/*2, *2/*3, and *3/*3). Furthermore, platelet aggregation in IMs and PMs not given lansoprazole was significantly higher than that in EMs taking lansoprazole. Rabeprazole did not affect platelet aggregation in any genotype. These results suggest that the influence of PPIs on the antiplatelet effect of clopidogrel is minimal in Japanese patients.

著者

小川 敦 牛尾 聡一郎 亀田 雅博 横木 梓 椋田 千晶 江角 悟 渡邊 亜津子 村川 公央 安原 隆雄 北村 佳久 伊達 勲 千堂 年昭

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.47, no.8, pp.445-451, 2021-08-10 (Released:2022-08-10)

参考文献数

22

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A female patient in her 30s developed intractable trigeminal neuralgia on the left side of her face due to a metastatic tumor in the left middle cranial fossa. Despite being treated with carbamazepine, gabapentin, pregabalin, baclofen, tramadol, lidocaine, Neurotropin, and nerve block, the trigeminal neuralgia was not resolved. After a joint discussion between pharmacists and neurosurgeons, the patient was suspected of having trigeminal neuralgia with facial numbness due to a tumor. We, therefore, administered traditional the Japanese herbal medicine Goshajinkigan, a formulation approved for pain and numbness. An MRI revealed a tumor with edema around the left trigeminal nerve, and the traditional Japanese herbal medicine Saireito was also administered to reduce edema. Her neuralgia improved markedly after Goshajinkigan and Saireito administration, i.e., the pain was confined to a narrow area on her left lower eyelid, temple, and lower jaw. Furthermore, her breakthrough pain scale score decreased from numerical rating scale (NRS) 10 to NRS 3, and her continuous pain scale score decreased from NRS 10 to NRS 0. The findings from this case suggest that Goshajinkigan and Saireito may benefit patients with intractable trigeminal neuralgia.

著者

陳内 博之 豊田 真史 安藤 志帆 五十嵐 玲子

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.48, no.2, pp.79-86, 2022-02-10 (Released:2023-02-10)

参考文献数

22

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Cefmetazole (CMZ) is a widely used antimicrobial agent against various infectious diseases. Few studies have determined the appropriate daily dose, and the dose adjustment criteria based on renal function are unclear. Therefore, this study evaluated the clinically effective dose of CMZ and the validity of dose adjustment using the Giusti-Hayton (G-H) method. Patients who received CMZ at Ebara Hospital from April 2019 to March 2021 were included. The basic daily dose was set at 4 g, which is the maximum dose approved in Japan, and a dose adjustment standard table was prepared with variables calculated using the G-H method. The patients were grouped according to whether their dosage of CMZ was adjusted using G-H method or not into the G-H and non-G-H groups. We set the primary endpoints as the efficacy and safety of CMZ, and the secondary endpoint as the pharmacokinetics/pharmacodynamics parameter (PK/PD parameter). There were 107 and 99 target cases in the G-H and non-G-H groups, respectively. The G-H group included several elderly people with a poor prognosis for infectious diseases; however, there was no significant difference in the efficacy and safety of CMZ between the groups. The time above MIC was significantly higher in the G-H group. Therefore, dose adjustment using the G-H method, based on a dose of 4 g/day, can be useful in terms of PK/PD parameters. Moreover, it has been shown to be highly effective and safe. Thus, the results of this study may help in determining the dose and dose adjustment of CMZ.