著者
中村 誓志 森田 恵美子 木村 貞恵 定本 裕美 上野 正嗣 岩井 礼子 生島 忍 広川 慶裕
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.34, no.10, pp.938-942, 2008 (Released:2010-02-07)
参考文献数
13

Scabies is a major form of dermatitis and in the second edition of clinical management guidelines for scabies drawn up by a committee of the Japanese Dermatological Association in 2007,ivermectin was recommended as a drug of choice for its treatment.Ivermectin had been approved as a treatment for scabies and launched in Japan in August 2006.On administering ivermection to 6 patients who developed scabies in our geriatric mental ward,3 of them subsequently developed hepatic function disorders.In order to investigate the cause of these disorders,we examined their weights,ages,drug interactions,and metabolism.We found that blood levels of ivermectin were easily affected by fat in the diet due to its liposolubility.In addition,since CYP3A4,an enzyme considered to be involved in the metabolism of ivermectin,may increase the toxicity of its metabolic products,we concluded that use of ivermectin should be reviewed.It is recommended that hepatic function tests are carried out a week before and after administering ivermectin,and that it should be given at bedtime to avoid drug interactions.
著者
加瀬 浩二 松田 公子 原 広一郎 櫻井 正太郎 高山 幸三 浅井 邦彦
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.35, no.1, pp.18-23, 2009 (Released:2010-02-07)
参考文献数
11

The frequency of accidental falls in psychiatric patients is reported to be markedly higher (46.5%) than in patients in other medical departments (15.7%).In order to prevent accidental falls,we provided physicians and nurses with pharmaceutical information on the adverse effects of cold medicines and traditional Chinese medicines.We also investigated the annual number of falls among inpatients before and after beginning our pharmaceutical information service.To do this,a questionnaire concerning cold medicines and traditional Chinese medicines was sent to physicians and nurses 2 years after starting the service.Owing to the provision of information,there were reductions in the annual number of falls (212 to 143),number of falls in patients taking cold medicines (8 to 1),percentage of falls in patients taking cold medicines among all falls (3.8% to 0.7%),and frequency of prescribing cold medicines for the common cold (96% to 75%).The questionnaire results also showed that 68% of physicians and nurses observed dizziness as an adverse effect of cold medicines,and 71% of physicians exercised caution with respect to the risk of falls due to cold medicines.To analyze the causes of accidental falls,a self-organizing map (SOM) was applied to the clinical data.The results suggested that the administration of cold medicines together with comparatively low dosages of chlorpromazine,or an equivalent antipsychotic,and two or more kinds of medication for Parkinson's disease was likely to lead to accidental falls.Thus,for patients having a high risk of falls,the co-administration of cold medicines and psychotropic drugsmayfurtherincreasesuch risk.
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
大谷 真理子 山本 陽介 酒巻 智美 大沼 亜紀 赤木 圭太 松田 慶祐 杉山 奈津子 宮嶋 篤志 廣田 孝司 小茂田 昌代
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.2, pp.78-86, 2012-02-10 (Released:2013-02-10)
参考文献数
9
被引用文献数
5 4

An oral scabicide, STROMECTOL® Tablets (ivermectin) is often administered to patients as a simple suspension by feeding tube. However, it was reported that the administration by this method was less effective than oral administration of tablets. One reason for this lower efficacy might be that the devices and technique for this method of administration are not appropriate. The aim of this study is to propose an appropriate technique.In this report, we compare the recovery ratio when a simple suspension is pushed through a syringe under various conditions. As a result of washing the syringe with distilled water after the first use, the recovery of ivermectin was higher than that without washing. The recovery of ivermectin from syringes set at an angle of 90° and 45° to the horizon was significantly higher than that at 0° and -45°. And recovery from previously used syringes was about 10% higher than that from new syringes (p<0.05). Furthermore, after having orally administered STROMECTOL® Tablets and gavaged its suspension with an appropriate delivery technique to rabbits, we measured the ivermectin concentrations in plasma by LC-MS/MS. The AUC0-192h of ivermectin was almost equivalent for both methods of administration.In conclusion, to secure the same dosage of administration with a simple suspension as that of tablets, it is highly recommended to employ a previously used syringe at an angle of over 45°, and to inject by a technique that washes out the entire residue in the syringe after first injection.
著者
岩山 訓典 久保 靖憲 小野 尚志 笠茂 紗千子 飯田 慎也 大滝 康一 山田 峻史 安達 知輝 福土 将秀 粟屋 敏雄 田﨑 嘉一
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.7, pp.333-340, 2018-07-10 (Released:2019-07-10)
参考文献数
6

One-dose packages are useful for managing complicated medication regimens for older patients. We experienced a case of Bayaspirin® tablet 100 mg (BA) and Micardis® tablet 40 mg (Mic 40) that were fused in a one-dose package at the time of medicine reconciliation. To our knowledge, there are no previous reports assessing the quality of these tablets caused by this physical incompatibility. Therefore, we aimed to examine this phenomenon and its impact on the drug compositions, as well as to identify the mechanisms.BA and Mic 40 in one-dose packages were stored at 30℃/75% relative humidity (RH) or 93%RH condition for 1 week. The stability evaluations were performed on appearance change, hardness, content, and dissolution rate. The active ingredients in each tablet were investigated to determine the mechanisms.Mic 40 showed changes in appearance and hardness, while BA showed a changed appearance, and reduced content and dissolution rate. The enteric coatings of BA and the additive in Mic 40 had an influence on the mechanism of incompatibility.Mic 40 contains meglumine, which is hygroscopic and deliquescent. Therefore, meglumine absorbs moisture and becomes a basic solution. Methacrylic acid copolymer LD dissolved in this basic solution results in adhesion with Mic 40 and leads to a decrease in both the content and the dissolution rate in BA. This is the first study to analyze the physical incompatibilities of enteric-coated aspirin tablets with non-coated telmisartan tablets in one-dose packages and provides useful information for clinical practice.
著者
高藤 由紀子 菅野 悠子 中島 由紀 清海 杏奈 杉浦 宗敏 大谷 道輝 高塚 隆之
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.44, no.2, pp.68-73, 2018-02-10 (Released:2019-02-10)
参考文献数
16
被引用文献数
1

The measurement of the uniformity of preparations is an important component of quality assessment. This study was conducted to evaluate the appropriate mixing time for external preparations using a planetary centrifugal mixer. Steroid ointment and white petrolatum (5 g each) were added to a 13-mL container and mixed using a planetary centrifugal mixer (NRE-120®, THINKY) at a rotation speed of 800 rpm and a revolution speed of 2000 rpm. We sampled 0.1 g of the mixture from three spots (the top, the middle, and the bottom portions) of the container, measured the steroid content, and evaluated the product uniformity of mixtures of ten different steroid ointments (Dermovate®, Antebate®, Myser®, Nerisona®, Methaderm®, Rinderon®-VG, Lidomex®, Almeta®, Kindavate®, and Locoid®) with white petrolatum (Propeto®). Our results showed that when the coefficient of variation (CV) is less than 15.2%, a mixing time of at least 60 seconds is required to achieve proper mixing to obtain the permissible limit of steroid ointment and white petrolatum, and the greater the difference of the yield point between steroid ointment and white petrolatum the easier mixing was. These results suggest that the spreadability of ointment affects the mixing efficiency of a planetary centrifugal mixer.
著者
齋田 哲也 藤戸 博
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.7, pp.693-699, 2006-07-10 (Released:2007-11-09)
参考文献数
16
被引用文献数
4 3

Furanocoumarin derivatives such as bergamottin and 6',7'-dihydroxybergamottin are inhibitors of CYP3A4 and have been isolated from grapefruit juice. We developed a sensitive and specific enzyme-linked immunosorbent assay for these furanocoumarin derivatives and used it for screening a large number of citrus fruits, vegetables and crude drugs for them. On testing the juice and peel of 25 citrus fruits, significant reactivity was observed with the juice of 4 of them : sweetie, melogold, banpeiyu pummelo and red pummelo and in the case of peel, significant reactivity was observed for 4 fruits : sweetie, melogold, sour pummelo and natsudaidai. For most of the citrus fruits, the peel showed a stronger reaction than the juice. Seven vegetables were tested and only slight reactivity was observed for 4 of them : parsley, celery, Italian parsley and mitsuba. Among the twenty crude drugs tested, significant reactivity was observed for 2 : angelica dahurica root (byakushi) and bitter orange peel (touhi). These findings suggest that 4 of the citrus fruits and 2 of the crude drugs tested would exhibit strong drug interactions.
著者
黒田 裕子 徳田 真実 井上 舞鳥 増田 克哉 寺島 朝子 前澤 佳代子 松元 一明 木津 純子
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.10, pp.714-721, 2015-10-10 (Released:2016-10-10)
参考文献数
10
被引用文献数
3 3

Seven products, currently on the market as acetaminophen suppository 100 mg, are commonly used for pyrexia in children, and yet there have been no reports on their solubility and divisibility. We examined the hourly solubility rate of each suppository using a dissolution tester for suppositories. In addition, we conducted a hardness test using the EZ-test, a questionnaire-based investigation on the accuracy and divisibility when the suppositories were divided. There was a significant difference between each suppository (P < 0.01). While 4 types dissolved completely within 60 minutes, one type took 120 minutes to dissolve completely. Another two had only 51 and 67%, respectively, at 180 minutes. The bases are hard fat in all suppositories. The types and additives of hard fat may have had an influence on solubility. The hardest suppository was assessed as showing marked differences in the weight ratio and solubility between the distal and tail portions when divided in half, due to which division was considered inappropriate, and there were differences in accuracy and divisibility among suppositories.From the above, it was suggested that the acetaminophen suppository 100 mg products may show differences in the solubility, time to action onset, and duration of the action. In addition, we should instruct physicians on important points of caution regarding the characteristics of each preparation when dividing the suppositories so that they can be given safely to infants.
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 17

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
小森 浩二 山崎 裕己 古前 竜平 玉登 まき 福田 洋 板橋 司 菊田 真穂 高田 雅弘 宮﨑 珠美 中野 祥子 三田村 しのぶ 首藤 誠 山本 淑子 塙 由美子
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.40, no.3, pp.186-192, 2014-03-10 (Released:2015-03-10)
参考文献数
12

Loxoprofen (Loxonin®) is a widely administered non-steroidal anti-inflammatory drug (NSAID) in Japan, with annual sales exceeding 50 billion Japanese yen. Although it is a very versatile drug and is often administered to breastfeeding women, the information available regarding its mammary gland transfer is inadequate.Therefore, in this study, we analyzed loxoprofen levels in the blood and milk of four breastfeeding women who received the drug for pain relief. These women visited the Obstetrics and Gynecology Department of Hanwa Sumiyoshi General Hospital for consultation or a cesarean section.One tablet of Loxonin® (loxoprofen 60 mg) was orally administered to each of the four women, and blood and milk samples were collected 0, 30, 90, 150 and 330 min after drug administration. Twenty microliters of ethanol was added to the blood and milk samples (10 μL), and the mixture was centrifuged at 12000 g for 15 min. The supernatant was analyzed by high-performance liquid chromatography (HPLC).Loxoprofen levels in blood peaked 90 min after its oral administration in all four patients, with the highest level being 4.5 μg/mL in patient II, whereas loxoprofen level in milk was below the detection limit (0.1 μg/mL) at all time points. Taken together, the data suggest low mammary gland transfer of loxoprofen, and thereby a low lactation risk.
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
被引用文献数
1 1

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
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 1

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
伊野 陽子 上野 杏莉 舘 知也 大坪 愛実 勝野 隼人 杉田 郁人 兼松 勇汰 吉田 阿希 野口 義紘 堺 千紘 井口 和弘 川上 ちひろ 藤崎 和彦 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.43, no.10, pp.533-551, 2017-10-10 (Released:2018-10-10)
参考文献数
6
被引用文献数
1

In recent years, multi-occupational collaboration aiming at patient-centered care is required to provide high-quality medical care. However, there are few studies on collaboration between hospitals or clinics and community pharmacies. In this study, we conducted a questionnaire survey to clarify the present conditions and awareness of hospitals or clinics in Gifu City regarding collaboration with community pharmacies. The following activities with community pharmacies were examined in the survey: “I. Participation in regional care meetings,” “II. Case discussion conferences,” “III. Workshops/study conferences,” “IV. Community service,” “V. Sharing information through medical cooperation network,” “VI. Accompanying community pharmacists at home medical care” and future plans for these items. The percentage of non-implementation was 80% or more in Items I, IV and IV in the hospital and 80% or more in items other than III in the clinics. The percentage of respondents who were not planning to implement Item VI was over 70% in the hospital, and the percentage of respondents who were not planning to implement Items I, IV, VI was over 70% in the clinic. In the comparison between the hospital and the clinic, the proportion of current collaboration is significantly higher for II and III in the hospital. For collaboration in the future, the proportion of respondents who were planning to implement these items other than VI was significantly higher in the hospital. Many hospitals and clinics currently do not collaborate with community pharmacies. And more hospitals are considering collaboration with community pharmacies than clinics.
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
被引用文献数
1

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
内海 美保 佐藤 雄一郎 山岡 由美子
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.38, no.1, pp.9-17, 2012-01-10 (Released:2013-01-10)
参考文献数
11
被引用文献数
2 2

Pharmacists who will graduate from the 6-year program are expected to have more clinical ability than those who graduate from the 4-year program. In 2008, the Japanese Society of Hospital Pharmacists designed a plan, “New development of the expanded pharmacist's practices”. In some medical facilities and educational facilities some pharmacists and pharmacy students are performing new clinical practices even though the practices are not clarified in existing medical law.So far, medical law has indicated the roles of pharmacists as only “dispensing drugs”. We should reconsider whether the concept of “dispensing drugs” includes some part of medical practices and how pharmacists should develop their expanded roles practically. We must discuss them concretely including the revision and the interpretation of the existing medical law.
著者
日置 智津子 荒井 勝彦 高士 将典 新井 信
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.513-521, 2008 (Released:2009-09-04)
参考文献数
23

Obesity is one of the most common metabolic diseases,and obesity-associated disorders have reached epidemic proportions.Abdominal obesity in particular has been linked with elevations in total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),and triacylglycerol (TG),as well as with decreased high-density lipoprotein cholesterol (HDL-C),and is also associated with elevated blood pressure.It has been noted that excessive fat tissue in and around the abdomen leads to the very common disorder of metabolic syndrome but effective prophylactic agents and methods for treating it have not yet been discovered.Amid these circumstances,Bofutsushosan (BF),a Kampo (Chinese herbal medicine) remedy,has been studied as an antiobesity drug for the treatment of metabolic disorders.Specialists in Kampo medicine have prescribed BF for“HimanShou”(obesity with large waist and potbelly) through Kampo diagnosis based on“Shou”(constitution),which cannot be said to be the same condition as the obesity that is prevalent worldwide since it is diagnosed by the procedures of western medicine.Thus in order for BF to be accepted as an anti obesity treatment in modern medicine,much data must be collected on the mechanism by which it reduces fat as well as its safety.There also need to be ethical guidelines for its use for this purpose.With this in mind,we first conducted basic experiments on obese mice and then double-blind,randomized controlled trials on outpatients in an obesity clinic.The aim of this study was to test the effectiveness of Bofutsushosan in clinical practice,in particular for obesity with impaired glucose tolerance (IGT) which is reported to increase the risk of cardiovascular events,using western medical procedures and scientific evaluation methods.
著者
石塚 洋一 近藤 悠希 山川 枝里子 薬師神 壮 前田 記代子 辻口 憲司 丸山 徹 森内 宏志 入倉 充 入江 徹美
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.3, pp.274-280, 2008 (Released:2009-09-04)
参考文献数
8

As ambiguous package descriptions occasionally cause medication errors,measures against this should be taken to help ensure that medicines are used properly.An example is Speel plaster® M,a salicylic acid adhesive plaster,which is used for the treatment of dermal diseases with keratosis.It is supposed to be attached to the diseased skin in a size the same as that of the affected area or smaller than it,in order to prevent the normal skin surrounding the affected area from being irritated and/or being detached.However,we found that some patients covered an area larger than the affected area with the plaster.This may be due to misunderstanding of a Japanese expression in the package description.The expression is “Kanbu-dai”which means the same size as the affected area but some patients take“dai”to mean large making them think that the size should be larger.In a questionnaire given to 180 pharmacy school students,65.6% answered that the proper use of the plaster was to apply it in a size larger than the affected area,since they had misunderstood the meaning of the expression“Kanbu-dai”.This misunderstanding seemed to be connected with the fact that they had not used the plaster before.We therefore devised a user-friendly package with an explanation to patients using illustrations to help ensure that the plaster is used properly.
著者
渡邊 美智留 三田 恭平 中村 春世 田中 恒明 三原 潔 小野 秀樹
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.40, no.12, pp.726-733, 2014-12-10 (Released:2015-12-10)
参考文献数
9

Pregabalin, a useful drug for neuropathic pain, has a high incidence of dizziness and somnolence as side effects. In the present study, the incidence of both side effects and the risk factors were retrospectively investigated in hospitalized patients who were administered pregabalin after their admission. In 65 patients (median 68 years old), 34 cancer patients and 18 opioid users were included. Items studied were cancer/non-cancer, opioid user/non-user, fall/nonfall, age, sex, weight, daily dose of opioids, the number of the drugs that may cause dizziness and somnolence, daily dose of pregabalin, and the ratio of creatinine clearance to daily dose of pregabalin. Fourteen (21.5%) and 21 (23.3%) patients developed dizziness and somnolence, respectively, and 4 (6.1%) patients developed fall. In the case of opioid combination, 7 (38.9%) and 10 (55.6%) patients developed dizziness and somnolence, respectively. A logistic-regression analysis showed that opioid use is a significant augmenting risk factor for dizziness (P = 0.026) and somnolence (P = 0.016) of pregabalin. The ratios of daily dose of pregabalin to creatinine clearance did not show any relation to the incidence of dizziness and somnolence; both side effects were observed in some patients whose renal functions were normal. It is suggested that attention is necessary to the incidence of dizziness and somnolence regardless of renal function, and that particular attention is required when opioids, which have similar side effects, are combined with pregabalin.
著者
小澤 秀介 小林 愛子 高津 亜希子 神田 博仁 山折 大 塩沢 丹里 大森 栄
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.3, pp.202-208, 2016-03-10 (Released:2017-03-16)
参考文献数
20

We report the case of a 35-year-old pregnant woman treated with the calcium channel blocker, nifedipine, for maintenance tocolysis. She was hospitalized due to preterm labor at 21 weeks of gestation by her previous physician. A rash appeared following ritodrine hydrochloride administration for maintenance tocolysis. After changing to magnesium sulfate, a rash appeared again. As these rashes were suspected to have been induced by ritodrine hydrochloride and magnesium sulfate independently, consecutive treatment with these drugs was difficult. Therefore, she was transferred to our hospital for follow-up. At 28 weeks 6 days of gestation, treatment with nifedipine for maintenance tocolysis was started after receiving written informed consent, and the medication was approved by the institutional review board of our hospital. The attending pharmacist considered fetal/neonatal adverse effects of nifedipine, such as teratogenicity, fetotoxicity, and neonatal complications, as well as maternal side effects, such as headache, constipation, and excessive blood pressure drop. The pharmacist provided drug information about nifedipine to the attending physicians and nurses, and gave medication counseling to the patient. Following oral administration of 80 mg of nifedipine daily (20 mg every 6 hours), headache and constipation were evident but gradually improved. Neither excessive blood pressure drop nor exacerbated uterine contraction was observed throughout the period of nifedipine treatment. This medication was finished at 34 weeks 5 days of gestation and the patient was discharged at 36 weeks 2 days of gestation. She delivered a baby at 40 weeks 3 days of gestation.
著者
大野 能之 樋坂 章博 岩本 卓也 木村 丈司 百 賢二 米澤 淳 伊藤 清美
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.11, pp.537-545, 2018-11-10 (Released:2019-11-10)
参考文献数
11

The first academic subcommittee of the Japanese Society of Pharmaceutical Health Care and Sciences has a plan to create a guide on how to manage drug interactions in clinical settings. This review describes the information that forms the basis of the guide. This article, part (1), reports the results of a questionnaire on the content of the guide and also describes how to evaluate and manage drug interactions in clinical settings. The contents of the ʻDrug Interaction Guideline for Drug Development and Labeling Recommendationsʼ, the new Japanese guideline, are also described. It is important also in clinical practice to appropriately evaluate and manage drug interactions based on a sufficient understanding of the new guideline and related information.