著者
石田 志朗 本池 慶 岡本 育子 山川 和宣 渡辺 智康 安藤 哲信 鈴江 朋子 岡野 善郎
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.40, no.5, pp.285-290, 2014-05-10 (Released:2015-05-10)
参考文献数
5

Amitiza® is available as an oval, soft gelatin capsule containing 24 μg of lubiprostone dissolved in a medium-chain triglyceride. Lubiprostone is a chloride channel activator indicated for the treatment of chronic idiopathic constipation in adults. Although Amitiza® capsules should be swallowed whole and not broken apart or chewed, the capsules have been administered by a simple suspension method to recipients unable to ingest food or drugs orally. The administration of Amitiza® capsule suspension through nasoenteric feeding tubes has not been investigated. Therefore, we evaluated whether the capsules are appropriate for administration through nasogastric tubes. The capsules disintegrated and dispersed after 10 min in 30 mL of hot water at 55°C. The suspension was transferred into a syringe or suspension bottle and passed through nasoenteric feeding tubes (8 Fr) without obstruction. Lubiprostone levels in each sample were determined by liquid chromatography/mass spectrometry. More than 93% of the lubiprostone was contained in suspension with flash solution through the feeding tubes administered through both the tubes. In conclusion, this study suggests that Amitiza® capsules can be administered to patients by a simple suspension method through nasoenteric feeding tubes.
著者
田坂 祐一 田中 亮裕 井門 敬子 田中 守 荒木 博陽
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.4, pp.208-214, 2014-04-10 (Released:2015-04-10)
参考文献数
7
被引用文献数
4 or 0

Pharmacists have increased the provision of pharmaceutical care services to patients. However, the financial benefit of various pharmaceutical interventions has not been well described. In this study, we estimated the original economic impact associated with pharmaceutical interventions by an evidenced-based approach.We classified pharmaceutical interventions into 12 items, which included preventions of serious adverse drug reactions (ADRs), and avoidance of drug interaction. The cost saving associated with preventions of serious ADRs was calculated as ¥2,140,000 per case based on the amount of costs that were paid by the Pharmaceuticals and Medical Devices Agency. Interventions to transvenous antimicrobial therapy were estimated to have a cost saving of ¥190,000 per case based on the literature in Japan. The rates of preventing serious ADRs related to chemotherapy orders, high-risk drugs and others were 5.21%, 3.91% and 2.6%, respectively, based on the literature in the United States. Using this rate, the values of intervention related to chemotherapy orders, high-risk drugs and others were ¥112,000, ¥84,000 and ¥56,000, respectively.The number of interventions was 209 per year, including 3 avoidances of serious ADRs. According to the number of interventions, we calculated that the total cost saving associated with pharmaceutical interventions was ¥22,816,000.This is the first study to estimate the economic impact associated with various pharmaceutical interventions of pharmacists in Japan. Evaluating the economic impact in relation to the pharmaceutical interventions is an important method for assessing the role of pharmacists.
著者
木ノ下 智康 村田 史子 亀井 浩行 半谷 眞七子
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.41, no.12, pp.833-845, 2015-12-10 (Released:2016-12-10)
参考文献数
25

The study was conducted to qualitatively analyze the attitudes of pharmacists working in community pharmacies toward patients with dementia to examine the status of support provided for them and related problems. Semi-structured interviews with 15 pharmacists in Aichi Prefecture were conducted, and the results were analyzed using a grounded theory approach. The opinions of pharmacists were classified into “the status of consideration for dementia patients and responses to them at the pharmacy counter,” “problems related to the status of drug administration management for patients with dementia,” and “the status of support provided for dementia treatment.” Pharmacists must play various roles at the pharmacy counter and homes of patients: they should report “changes in dementia patients that they have identified” and conduct drug administration management for them. However, the pharmacists had difficulty due to their lack of knowledge and awareness of their roles, the current system of pharmacies only focusing on drug prescription, differences in problems attributed to specific symptoms unique to dementia and the specificity of individual cases, and a lack of understanding of other people and collaboration with them. To help pharmacists provide quality services for dementia patients, it is necessary to encourage them to: undergo training to improve their awareness, learn to provide services with emphasis on the establishment of relationships between patients and their families, and closely collaborate with other pharmacists and different healthcare professionals, as well as enhance the functions of pharmacies as bases for consultation.
著者
五郎丸 剛 佐々木 智也 藤井 利加 一木 孝治 高橋 浩二郎 福長 将仁 江藤 精二
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.1, pp.59-63, 2008 (Released:2009-09-04)
参考文献数
16
被引用文献数
1 or 0

Antibiotic-resistant lactic acid bacteria (RLAB) and clostridium butyricum (CB) preparations are often used to improve symptoms resulting from antibiotic-induced changes in intestinal flora.However,though the resistance of these preparations to fluoroquinolones (FQs) has not been sufficiently studied,they are sometimes prescribed in combination with FQs under off-label use.The reason for this is thought to be that all RLAB and CB preparations are considered to be resistant to all antibiotic agents.In this study,we determined the minimal inhibitory concentrations of FQs with respect to strains isolated from five RLAB and one CB preparation using the microdilution method.Furthermore,the susceptibility to FQs of the strains isolated from the RLAB preparations was compared with that of strains isolated from conventional lactic acid preparations.The strains from most of the RLAB preparations and that from the CB preparation were found to be susceptible to FQs.There was also no difference in bacterial resistance between the RLAB and conventional lactic acid preparations.The concurrent use of RLAB and FQs under off-label use should therefore be avoided.
著者
今井 達男 岡部 信彦
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.41, no.12, pp.907-915, 2015-12-10 (Released:2016-12-10)
参考文献数
23

The infectiousness of diseases such as: the measles, rubella, the mumps, and the chicken pox is quite strong. When people lack antibodies to these diseases, the chance for infection increases. On a university campus, a person without such antibodies can help spread such diseases. However, as vaccines are available for these diseases and people are vaccinated, the chance for infection and the spreading of these diseases will diminish. At our university, Tokyo University of Pharmacy and Life Sciences, at the start of the recent academic year, an antibody survey was taken of 2,647 students to see which students had lower levels of antibodies to help fight the spread of the aforementioned diseases. Our findings showed antibody-positive rates of 49.0% for the measles, 70.8% for rubella, 75.7% for the mumps, and 92.4% for the chicken pox. With the rate for the chicken pox being the only one meeting an acceptable standard (Fine) in terms of community immunity. On the other hand, although the vaccination rates for the measles and rubella were high, they did not meet an acceptable standard for community immunity (Fine). When the community immunity level is low, the risk of infection is increased and this could lead to an outbreak on campus and affect more than just individuals. In the future, we will encourage students to be fully vaccinated before entering school or soon after doing so in order to protect against such an outbreak from occurring.
著者
面谷 幸子 名徳 倫明 山城 美樹 長谷川 渚彩 大橋 甲三郎 長井 克仁 西井 諭司 初田 泰敏 小川 雅史
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.42, no.1, pp.31-39, 2016-01-10 (Released:2017-01-10)
参考文献数
10

Workshops on the use of adrenaline auto-injection (EPIPEN), reconsideration of training programs on food allergies, and an approach to increase risk awareness of food allergies are required. We investigated the current state of education of school teachers and school pharmacists in Tondabayashi City.A total of 120 school teachers and 14 school pharmacists participated in our questionnaire. More than 90% of teachers had experience with children with allergies, and more than 95% of teachers were aware of anaphylaxis. Although most teachers were familiar with EPIPEN, they did not have detailed knowledge and were not confident in using it in an emergency. School teachers who attended EPIPEN workshops had a higher degree of confidence in using EPIPEN in an emergency than school teachers who do not attended the workshops. Attending workshops will increase the self-confidence of teachers in using EPIPEN in an emergency. The survey results indicate that it is important for school pharmacists to hold regular workshops on EPIPEN, including practical training, to develop the EPINEN skills of school teachers and enlighten them on the subject.
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 or 0

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
大野 能之
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.39, no.5, pp.257-270, 2013-05-10 (Released:2014-05-10)
参考文献数
33

Renal dysfunction and drug-drug interactions (DDIs) can affect the clearance of various drugs from the body; however, these effects are difficult to sufficiently evaluate in clinical studies. This article outlines our recent approaches to improve the method of evaluating and providing the drug information on the effects of renal dysfunction and DDIs. These approaches aim to optimize the drug regimens of patients with renal dysfunction and to improve the management of DDIs. The renal excretion ratio (RR) is required to predict alterations in drug clearance in patients with renal dysfunction. However, the estimation of RR requires pharmacokinetic information that is not always provided in the Japanese drug package inserts or interview forms.A systematic approach to predict changes in drug clearance due to DDIs of the cytochrome p450 (CYP) is described. Uniquely, this method uses a small number of parameters, which are only obtained by in vivo DDI studies, i.e., the contribution ratio of CYPs to oral clearance of substrates (CR), the inhibition ratio of inhibitors (IR) or the increase in clearance by induction (IC). Changes in oral clearance for any combination of drugs can be predicted once these parameters have been calculated for each drug. These predictions were used to construct a pharmacokinetic interaction significance classification system (PISCS) to evaluate the clinical risk of DDIs in daily therapy.
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 or 0

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

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
植沢 芳広 内田 明宏 小山 茜 宇田川 三男 武田 直子 富澤 崇
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.4, pp.215-221, 2014-04-10 (Released:2015-04-10)
参考文献数
7
被引用文献数
1 or 0

Patients' waiting times in a community pharmacy closely correlate with prescription dispensing times. Therefore, to decrease patients' stress and present an index in dispensing operations, various factors affecting prescription dispensing were analyzed, and a time-prediction model was constructed. The time from when a prescription was accepted (ie, handed in by a patient) to its checking, as well as time-factors affecting dispensing and checking, were measured at Kitayurakucho Pharmacy. Additional aspects were taken into account, such as: acceptance time, whether questions needed to be asked of the prescribing physician, medicine-counting, number of pharmacists present, and number of patients in the waiting area. Thereafter, a statistical prediction model for waiting time was constructed. It was found that drug counting and congestion level significantly related to waiting time. A multivariate regression model with two such parameters indicated a highly accurate prediction level. It is expected that prediction of the waiting time with this model will be useful for alleviation of the patients' stress.
著者
合田 和史 林 秀樹 加藤 優 上村 里菜 北夕 太郎 岩本 理央 近藤 剛弘 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.1, pp.44-49, 2015-01-10 (Released:2016-01-15)
参考文献数
8

In Japan, the online distribution of over-the-counter (OTC) drugs began in June 2014. A distributor has a duty to explain information about drugs to consumers, as well as to provide OTC drugs that have undergone quality control. In this study, we investigated the method of identifying health conditions of customers and the delivery channels of OTC drugs from the distributors to consumers, using 130 online stores as our sample. First-class OTC drugs were sold at 29 stores; pharmacists are required to explain information about these drugs to consumers. All the stores set up a column on which consumers could select their health conditions on a computer screen. However, in 25 of the stores, “no problem” had been inserted in the column beforehand. This meant that consumers could buy first-class OTC drugs without indicating their health conditions. Felbinac-containing poultices, which are contraindicated for pregnant women, were sold at 99 stores. However, consumers could buy the poultices at 91 stores without providing information about pregnancy. All the stores delivered OTC drugs through home delivery services, which did not store the drugs in cool conditions. In addition, some stores delivered suppositories by mail services in summer. These findings suggest the need for online distribution of OTC drugs to incorporate an improved method of providing drug information to consumers and ensuring quality control.
著者
下川 健一 板橋 知子 山崎 紀子 日野 文男 石井 文由
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.35, no.9, pp.662-668, 2009 (Released:2011-01-14)
参考文献数
13
被引用文献数
2 or 0

A questionnaire survey of children and their parents visiting pharmacies dispensing medical insurance-covered drugs was conducted to gain information on medication methods.It was found that mothers played a very important role in children's drug taking and their skill in getting children to take drugs was important in achieving a high compliance rate.The dosage forms that seemed to be the most difficult to take were powders and granules,partly because of their frequent prescription,followed by liquids,solutions,and syrups.The reasons for difficulty in taking drugs were“bitterness",“smell",“coarseness",“sweetness",and“large volume" in decreasing order of frequency.To have their children take drugs,parents rarely used a commercial jelly for facilitating medication but often gave them ice cream,yogurt,in decreasing order of frequency.The infrequent use of commercial jellies for facilitating medication was despite the fact that the flavor had been changed to one liked better by children.The results of this survey suggest that jellies for facilitating medication for children may contribute more to improving compliance if the various needs of parents for improvements can be met.
著者
内海 美保 徳永 仁 山岡 由美子 高村 徳人
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.36, no.9, pp.657-666, 2010 (Released:2012-03-15)
参考文献数
11
被引用文献数
7 or 0

In order to clarify the status of clinical skills education in the faculties of pharmaceutical sciences at pharmacy schools in Japan,we carried out a questionnaire survey of such faculties at 74 schools in Japan.The results revealed that 67.9% of the pharmacy schools were providing clinical skills education such as that regarding physical assessment and assessment of vital signs.As for the amount of time spent in education on clinical skills,the median lecture time was 225 minutes and the median practical training time was 540 minutes.The ranking of lecture content was :[1]basic knowledge related to vital signs,[2]basic knowledge related to electrocardiography,[3]basic knowledge related to clinical laboratory test results,[4]pathophysiology and symptomatology and[5]Procedures for using assessment equipment,and the ranking of practical training :[1]primary or secondary emergency medical care,[2] assessment of vital signs,[3]electrocardiography measurements and analysis,[4]auscultation,[5]nursing and patient care.The ranking for equipment available at pharmacy schools was :[1]stethoscope (availability rate 50.9%),[2]mercury sphygmomanometer (41.5%),[3]AED trainer (24.5 %),[4]electrocardiograph (22.6%),[5]pulse oxymeter (20.8%).Based on the results of our survey,it is felt that clinical skills education in pharmaceutical science courses will enhance the professional capabilities of pharmacists,and enable them to make greater contributions in various fields including emergency medical care and home medical care.
著者
寺町 ひとみ 齊藤 康介 江﨑 宏樹 加藤 未紗 臼井 一将 野口 義紘 舘 知也 勝野 眞吾
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.12, pp.870-879, 2015-12-10 (Released:2016-12-10)
参考文献数
20
被引用文献数
1 or 0

“Education for Medicines” was initiated in 2012, as part of health and physical education (HPE) classes in junior high schools, through the revision of school curriculum guidelines. We conducted a survey that aimed to clarify the status of the implementation of medical education in schools. A questionnaire survey that targeted junior high school teachers in Japan was conducted via mail.The response rate was 48.0% (524/1,091). HPE teachers, school nurses, and school pharmacists were in charge of Education of Medicines in 91.8%, 6.3%, and 8.4% of schools, respectively. The average duration of classes was 49.6 minutes, and 1.2 times (84.2%). On average, 1.1% of schools did not offer Education of Medicines classes, 1.7% held the “odd hour” of classes, and 1.3% held only “drug abuse” classes. The most commonly used educational material was the school textbook (84.9% of schools).With respect to the delivery of Education of Medicines classes, 84.0% of schools responded “yes” to the item, “lectures are delivered by outside lecturers,” and 72.1% responded “yes” to the item, “we hope to introduce workshop participation.”The results of the survey indicate that HPE teachers provided Education of Medicines classes in accordance with the revision of school curriculum guidelines at many junior high schools. However, some schools did not offer the classes. In Japan, it is necessary to enhance Education of Medicines activities in the pharmaceutical field by involving specialists from different areas.
著者
山田 麻衣子 大野 能之 樋坂 章博 山口 諒 鈴木 洋史
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.39, no.11, pp.660-667, 2013-11-10 (Released:2014-11-10)
参考文献数
22

We investigated the relationships between the renal excretion ratio (RR) and changes in drug exposure in patients with renal dysfunction (RD), to examine the usefulness of RR in determining the optimal dosage for patients with renal dysfunction.The area under the plasma concentration time curve ratios (AUC ratios: AUCRs = AUCRD/AUCNormal) of 52 out of 70 drugs was observed within 67-150% of the theoretical values calculated by the Giusti-Hayton method using the RR value. It was confirmed that the RR is useful for determining the optimal dosage of extensively renally excreted drugs for patients with RD. However, it should be noted that the AUCRs were more than 150 % of the theoretical value for some orally administrated drugs that are excreted renally but less extensively. Especially, for substrates of OATP1B1 or OATP1B3, the AUCRs of four out of five drugs were more than 150%. Substrates of metabolizing enzymes and other transporters showed less relevance in this regard.
著者
今村 知世 加藤 有紀子 下方 智也 安藤 雄一 谷川原 祐介
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.759-767, 2015-11-10 (Released:2016-11-10)
参考文献数
21

The renal clearance of carboplatin, which is a second-generation platinum compound, is correlated with the glomerular filtration rate (GFR). As the area under the concentration-time curve (AUC) of free carboplatin is related with efficacy and toxicity following carboplatin administration, carboplatin dosing is defined as a target AUC and generally calculated by the Calvert formula according to the patient's GFR. We conducted a survey on the usage of the Calvert formula to clarify the current situation in Japan. As a result, the value of creatinine clearance (CLcr), which is higher than GFR due to the tubular secretion of creatinine, has been used as a substitute for GFR for the Calvert formula without appropriate correction in 71 of 109 institutions, where CLcr estimated by a Cockcroft-Gault equation and/or obtained by 24-h urinary collection are used. On the other hand, body surface area-indexed values of renal function have been directly used without conversion to individual values in 42 of 71 institutions, where GFR estimated by a Japanese equation and/or CLcr estimated by a Jelliffe equation are used. It was found that the desired dosing of carboplatin has not been administered to patients in a number of institutions. Back to the original concept of the Calvert formula, it is reasonable to use a GFR estimated by the Japanese equation and converted to an individual value. In addition, we need to assess tolerability following carboplatin administration and discuss the appropriateness of the starting dose for each patient without being overly reliant on the dose obtained by the Calvert formula.
著者
中島 孝則 岩田 政則 縄田 修一 齋藤 博 中村 有貴 小林 靖奈 山元 俊憲 松田 佳和 木村 正幸
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.11, pp.702-707, 2012-11-10 (Released:2013-11-10)
参考文献数
8
被引用文献数
1 or 0

We tried to optimize the formulation for the hospital preparation of mianserin hydrochloride (MS) suppositories. MS as the raw material for the preparation was obtained from Tetramide tablets (MS-T), which were ground. The physicopharmaceutical properties of MS suppositories with bases of Witepsol H15 (H15), Witepsol W35 (W35) and Witepsol S55 (S55) were compared to choose the optimal base for the suppositories. The preparation strength correlated negatively among the three bases. The heat of fusion of MS-H15 suppositories was significantly low relative to MS-W35 and MS-S55 suppositories. The average drug release rate of MS-H15 suppositories exhibited the highest level on moment analysis. Comprehensive evaluation of the properties of MS suppositories, including the heat of fusion due to the solubility of the preparation and the drug release rate indicated that H15 was the optimal base for MS suppositories. Additionally, we examined the optimal mixing rate of ground MS-T and H15. The preparation strength positively correlated with an increased mixing rate of ground MS-T. The mean dissolution time (MDT) of suppositories was reduced with an increased mixing rate of ground MS-T. These results suggested that 0.10 g ground MS-T combined with 0.8 g H15 as the base was the optimal formulation for the hospital preparation of MS suppositories.
著者
鈴木 信也 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.40, no.12, pp.698-715, 2014-12-10 (Released:2015-12-10)
参考文献数
47
被引用文献数
1 or 0

Conventional dose estimation methods do not consider drug factors and do not allow for various pharmacokinetic factors associated with the growth of children. I have therefore established a new method based on drug elimination processes and physiological and biochemical developmental factors in order to more appropriately estimate pediatric doses (the ePPBD method). Renal excretion or hepatic metabolic clearance was calculated for each age based on physiological and biochemical developmental factors, such as the unbound fraction of the drug in plasma, glomerular filtration rate, tubular secretion, liver volume, and CYP enzyme activity. Then the pediatric dose was estimated by multiplying the adult dose by the pediatric/adult ratio of renal excretion or hepatic metabolic clearance. Accuracy of the ePPBD method was compared with conventional methods, using the population mean clearance and the doses listed in package inserts and text books as the standards to quantitate its validity. In brief, accuracy was evaluated by classifying children into the following age groups: 1) neonates in consideration of the post-conceptional age (PCA), 2) infants up to 2 years old, and 3) children over 2 years old for drugs with renal excretion, or 4) children of all ages for drugs with hepatic metabolism. The accuracy of the ePPBD method was superior to that of conventional methods both for drugs with renal excretion and those with hepatic metabolism, and therefore it should be useful for pediatric patients in whom physiological function changes remarkably as they age.