著者

荒木 美輝 半谷 眞七子 亀井 浩行

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.2, pp.63-75, 2019-02-10 (Released:2020-02-10)

参考文献数

36

被引用文献数

6

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Despite the demand for pharmacists' active participation in home medical care and cooperation with other professionals, their role in home medical care is not properly understood by other professionals. This study qualitatively analyzed the opinions of other professionals about their perceived need to cooperate with pharmacists.A semi-structured interview was conducted involving 4 visiting nurses and 2 certified care workers providing home medical care services in Aichi Prefecture, and the obtained data were qualitatively analyzed using a grounded theory approach.As medication management of patients at home was difficult due to not only patients' physical factors, but also emotional and social factors, as well as living, environmental, and institutional factors, the ability to care for such patients is essential. Home medication management was performed mainly by care workers, nurses, and pharmacists; however, a difference in the attitude of sharing information with pharmacists was observed between care workers and nurses. Thus, pharmacists must consider emotional barriers, such as concerns and hesitations towards pharmaceutical knowledge among other professionals, as well as emotional conflicts over the overlap of professional domains in the management of medications. Also, since home medical care is provided in the patient's personal domain, excessive emphasis is often placed on the patient's and family's intentions. It is, therefore, important that pharmacists acquire the ability to endure emotional difficulties and dissonance caused by the patient's rejection of professional involvement, and learn and develop an attitude to accept the feelings of patients and their families.

著者

治田 匡平 市田 裕之 石樋 康浩 宇髙 歩 日笠 真一 尾崎 淳子 大槻 真央 矢倉 裕輝 吉野 宗宏 古西 満 杉山 幸正

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.45, no.1, pp.44-53, 2019-01-10 (Released:2020-01-10)

参考文献数

18

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Pharmacists' interventions are considered to be important at the time of starting anti-HIV therapy or changing treatment in outpatient care for HIV infection. We conducted a questionnaire survey to clarify patients' assessments of pharmacists' interventions in outpatient care for HIV infection. The survey was conducted at seven AIDS treatment center hospitals in the Kinki region, and the analysis was performed on 112 patients receiving the initial treatment and 79 patients experiencing treatment change. Pharmacists' interventions were found to be helpful by 97.3% of the initial treatment patients and 96.2% of the treatment change patients; the former often found it helpful in understanding the “necessity of receiving drugs” and “failure in taking drugs and acquisition of resistance”, while the latter often found it helpful in understanding the “difference of the new drug from the previous one” and “side effects”. Pharmacists' interventions relieved anxiety in 89.3% of the initial treatment patients and 89.9% of the treatment change patients, and produced good overall effects such as “relieving anxiety as regards receiving drugs”, “facilitating communication with doctors”, and “reducing questions for doctors”. The survey results showed that pharmacists' interventions at the time of starting anti-HIV therapy or changing treatment met patients' needs and contributed to improving the quality of medical care, such as reducing patient anxiety and the burden on doctors.

著者

松尾 泰佑 富田 隆 工藤 賢三 佐塚 泰之

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.45, no.1, pp.54-60, 2019-01-10 (Released:2020-01-10)

参考文献数

9

被引用文献数

1

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Magnesium oxide tablets are sometimes crushed prior to administration to patients having difficulties in swallowing tablets. However, the quality of magnesium oxide formulations may decrease when stored for a long time as a one-dose package, owing to the absorption of high amounts of moisture by magnesium oxide. Additionally, as magnesium oxide solution is alkaline, it can interact with other medicines, making it incompatible for one-dose packaging. There are three types of magnesium oxide powder formulations: crushed magnesium oxide tablets, magnesium oxide bulk powder, and magnesium oxide granules. However, the appropriate formulation of magnesium oxide for one-dose packages is unknown. The stability of powder formulations stored as one-dose packages at 75% RH for 3 months was evaluated by analyzing the change in weight change and dissolution. The dissolution of the three powder formulations did not change for 3 months. Although the weight had increased in all the formulations, the change in the weight of magnesium oxide granules was the lowest among the three formulations. Isoniazid and levodopa tablets have been reported to interact with magnesium oxide tablets. The incompatibility between the crushed powder of these medicines and magnesium oxide powder formulations was analyzed when stored as one-dose packages. Among the three formulations, incompatibility was the lowest for granule. In conclusion, preserving magnesium oxide and other formulations that causes incompatibility should basically be avoided. However, magnesium oxide granules can be used for storing with the other formulations that interact with magnesium oxide within a term to circumvent incompatibility.

著者

小林 貴志 福本 恭子 土下 喜正 楠本 正明 上野 和行

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.8, pp.772-775, 2006-08-10 (Released:2007-11-09)

参考文献数

11

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It has been reported that the pharmacokinetics and pharmacodynamics of carvedilol vary between the S- and R- enantiomers. The aim of this study was to evaluate the pharmacokinetic characteristics of carvedilol for each enantiomer and apply this in clinical practice. Serum stereoselective concentrations of carvedilol were monitored in 60 Japanese inpatients who received a fixed dose of carvedilol. The concentrations were determined by high performance liquid chromatography (HPLC). Serum carvedilol concentration/dose of administered carvedilol ratios were determined for each enantiomer (R/D, S/D). The means±SD for R/D and S/D were 85.8±264.0 (10-3kg/L) and 29.0±78.2 (10-3kg/L), respectively. The mean for R/D tended to be larger than that for S/D (p=0.11), and the dispersion of R/D was significantly greater than that of S/D (p<0.01). Although a significant positive correlation was observed between R/D and S/D, a remarkable difference was observed in a few inpatients. These results suggest that the pharmacokinetics of carvedilol are different for each enantiomer. The monitoring of the stereoselective pharmacokinetics of carvedilol is therefore necessary to ensure proper use.

著者

岩尾 一生 小林 道也 及川 孝司 中駄 優作 藤崎 博子 室谷 光治 伊藤 昭英 辻 昌宏 井出 肇 遠藤 泰 関川 彬 齊藤 浩司

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.2, pp.112-117, 2008 (Released:2009-09-04)

参考文献数

14

被引用文献数

4 1

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A questionnaire survey was conducted to investigate the use of health foods among outpatients with diabetes mellitus (DM) at the Health Sciences University of Hokkaido Hospital.Responses were obtained from 69.2% of the patients (180 out of 260).The proportions of patients who had used health foods previously or were using them at the time of the survey were 16.7 and 37.2%,respectively,indicating that more than half of the patients had experience of taking health foods and this was irrespective of sex and age.The most frequently consumed health foods were Aojiru (n=25)followed by Kurozu (n=24)and blueberry extract (n=17).Among the health foods taken,those that influence blood sugar considerably were guava leaves polyphenol (n=16),Gymnema sylvestre extract (n=1),Gymnema sylvestre tea (n=1),and Aloe Vera (n=1).One patient was taking a Chinese health food that contained glibenclamide.Many patients took health foods to keep healthy and as a nutritional supplement,and most of them had not consulted their doctors or pharmacists about the use of health foods.More than 70% of the patients targeted by this study had complications such as hypertension.Since there is a possibility of health foods aggravating DM and its complications and of interactions between them and drugs used to treat DM,doctors,pharmacists and other co-medical workers should provide patients with information on the ingredients of health foods as well the adverse effects that they could have.

著者

鈴木 裕之 中村 達也 宮浦 誠治 猪岡 京子 八木 朋美 我妻 恭行 鈴木 常義 髙村 千津子 鈴木 幹子 村井 ユリ子 中村 仁

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.10, pp.503-509, 2018-10-10 (Released:2019-10-10)

参考文献数

17

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Panvitan® powder for prescription (PP) administrated in combination with pemetrexed sodium hydrate (PEM) for the purposes of folic acid supplementation is significantly degraded by exposure to humidity or light. Hence, we investigated the influence of humidity and light on the color of the powder and concentration of folic acid in PP. We prepared samples by placing 1 g of PP into separate bags and stored them for 28 d under normal delivery conditions, intermediate humidity, high humidity, and light exposure. The amount of folic acid was quantified by high-performance liquid chromatography, where the percentage was calculated assuming the initial amount was 100%. Under normal delivery conditions (room temperature, 50% RH, shielded light) and intermediate humidity conditions (25℃, 75% RH, shielded light), no significant changes in appearance or folic acid content were observed. The sample stored under high humidity conditions (25℃, 91% RH, shielded light) changed in color from yellow to brown. The decrease in folic acid content was time dependent, and decreased to 47.1% after 28 d. Under light exposure (room temperature, 50% RH, 5,000 lux, 0.56 W/m2), the yellow color of PP becomes thin with time, while the folic acid content decreased to 73.2% after 28 d. The amount of folic acid may have decreased without any concomitant visible changes in the powder. The results of this study are expected to facilitate the management of adverse effects of PEM.

著者

河添 仁

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.323-332, 2018-07-10 (Released:2019-07-10)

参考文献数

48

被引用文献数

3

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This review describes the clinical outcomes of pharmaceutical interventions and bidirectional sharing of patient information between a hospital and community pharmacies in outpatient chemotherapy. First, we retrospectively evaluated the clinical outcomes of 56 pharmaceutical interventions relating to chemotherapy-induced adverse events and estimated their associated economic impact. Twenty-nine of the pharmaceutical interventions significantly decreased the grade of adverse events compared with before pharmaceutical interventions. The number of reductions in grade 1, 2, and 3 was 14, 11, and 4, respectively. In accordance with the potential economic costs associated with the Adverse Drug Reaction Relief System of the Pharmaceuticals and Medical Devices Agency and reduction of grade, we estimated that the total cost saving associated with the clinical outcomes of pharmaceutical interventions was JPY11,360,000. Second, we developed a system for bidirectional sharing of patient information between a hospital and community pharmacies, which comprised a modified prescription format and a monitoring sheet for tegafur/gimeracil/oteracil potassium (S-1). Questionnaire surveys showed that community pharmacies significantly understood patient information compared with before the sharing system. We also retrospectively investigated the discovery rate of adverse events in outpatients who had received S-1. The proportion of patients who developed all grades of an eye symptom and grade ≥ 2 nausea significantly increased after implementation of the sharing system, showing that the system was able to track adverse events. In addition, the proportion of patients in which clinicians managed the adverse events slightly increased. These results suggest that our interventions contribute to the quality and safety of outpatient chemotherapy.

著者

今村 牧夫 松井 裕典 片山 健太郎 武本 千恵 上原 孝

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.41, no.4, pp.254-265, 2015-04-10 (Released:2016-04-10)

参考文献数

12

被引用文献数

5 8

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Team medical care needs to be improved at the outpatient clinic to manage highly complex cancer chemotherapy. In May 2008, Kurashiki Medical Center was the first medical institution in Japan to start a pharmaceutical outpatient clinic called a “support clinic.” At the support clinic, oncology pharmacy specialists interview patients and propose several suitable options of drug regimens to the physicians to ensure safe and effective treatment. We evaluated the functions expected of the support clinic and the appropriateness of health insurance application to the clinic's services.Physicians and nurses highly evaluated the work of the oncology pharmacy specialists at the support clinic. The function that they expected most of the support clinic was the design of supportive therapies followed by the design of treatment strategies. All 93 patients surveyed said that the support clinic was beneficial to them. Ninety-six percent of the patients considered that the support clinic services were worth paying.The support clinic has been providing oncology pharmacy specialists with great opportunities to fulfill their potential. Its services are needed by medical professionals and patients who want improved outpatient cancer treatment.

著者

中山 季昭 内田 礼人 片山 明香 嶋崎 幸也

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.575-581, 2018-11-10 (Released:2019-11-10)

参考文献数

9

被引用文献数

2

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Recently, drug vial optimization (DVO) for anti-cancer drugs has been recommended as one of the concrete measures to decrease medical costs. DVO enables us to use single-dose vials for more than one patient to minimize unused drug waste to save on medical costs. Multiple needle punctures of the rubber stopper of the vial, however, could potentially increase the leakage of anti-cancer drugs raising concerns for worker exposure risk during the dose formulation preparation. Thus, we evaluated the relationship between the preparation procedure and leakage of anti-cancer drugs to determine an adequate preparation procedure for multiple use with a low risk of worker exposure.No significant increase in leakage of anti-cancer drugs was observed with the adequate preparation procedure following the preparation manual of each anti-cancer drug together with replacing the device between preparation intervals for multiple use, irrespective of the presence or absence of a closed system drug transfer device (CSTD). In contrast, the preparation procedure with deviations from the preparation manual resulted in a significant increase in drug leakage. These results indicate that CSTD is not mandatory to reduce the risk of worker exposure during the preparation for multiple use although it has been generally recommended. To perform the adequate preparation for multiple use without CSTD, however, replacing the syringe and needle for every single preparation should be mandatory in addition to adequate procedures consistent with the preparation manual such as creating a slight negative pressure and adequate needle puncture (including adequate location and direction).

著者

菅原 拓也 荒井 浩一 倉本 敬二 東海林 徹 浅倉 聖岳 白石 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.42, no.10, pp.678-686, 2016-10-10 (Released:2017-10-10)

参考文献数

18

被引用文献数

1

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We previously reported that insoluble particulate matter formed during the mixing of injectable drugs. We considered that the contamination derived from the disposable injection syringe used for the mixture as one of the causes. Therefore, in the present study, we evaluated the amount of insoluble particulate matter caused by using a 50-mL syringe of each manufacturer, using syringes of various capacities and number of piston times (suction and expulsion) of the syringe. Furthermore, we were able to identify the components of the insoluble particulate matter that formed. As a result, we found that a lot of insoluble particulate matter was expelled from the 50-mL syringes of each manufacturer that increased with the capacity of the syringe and the number of piston times. In addition, we found that the insoluble particulate matter was from the silicone oil coating on the inner surfaces of the syringes.

著者

福井 愛子 半谷 眞七子 吉見 陽 野田 幸裕 亀井 浩行

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.10, pp.516-525, 2018-10-10 (Released:2019-10-10)

参考文献数

14

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We investigated the educational effects of fourth-year pharmacy studentsʼ participation in the case presentation performed by senior students during clinical practice. Two hundred eight fourth-year students participated in the case presentation using Meijo Distance Education System (MDES), and a total number of 509 fourth-year students was administered questionnaires. Of the total number of students, 93.7% answered “watching the case presentation was useful,” 91.2% answered “question-and-answer was useful,” 86.6% answered “I gained useful knowledge,” and 79.7% answered “I was satisfied with the content.” Joining the case presentation is an opportunity for fourth-year students to think about how to apply basic knowledge and appropriate interventions for individual patients. It is useful for junior students to consider senior students as role models to gain further understanding of clinical practice and to improve their motivation to study.

著者

小久江 伸介 大野 能之 折山 豊仁 山口 諒 徳田 篤志 長瀬 幸恵 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.42, no.10, pp.694-700, 2016-10-10 (Released:2017-10-10)

参考文献数

7

被引用文献数

1 4

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At the University of Tokyo hospital, we began allocation of ward pharmacists to some wards in August 2012 and to all wards in August 2014. In this study, we qualitatively and quantitatively reviewed cases reported by ward pharmacists to evaluate the effects of this allocation on intervention and consultation that required positive participation.We retrospectively reviewed the pharmaceutical interventions' record from April 2012 through March 2015. We also analyzed cases for three months after the allocation of pharmacists to every ward. We found a highly positive correlation (R2 = 0.928, P < 0.0001) between the number of wards and pharmaceutical interventions. Intervention cases per month increased by 21.5 after allocating a pharmacist to a ward. There were a total of 2,438 intervention cases over three months. Active and passive approaches were employed in 1,833 cases and 605 cases, respectively. High-risk medicines were associated with 39.3% of cases. The prescription change rate was 86.2% for active interventions and 50.9% for passive interventions.Results showed that the allocation of a ward pharmacist could assist pharmaceutical approaches through the evaluation of patient complaints and clinical conditions, participation in the treatment plan, and consultation from medical staff. There were also reports that an active approach led to critical adverse event avoidance and pharmacotherapy effect improvement. These findings suggest that the allocation of ward pharmacists results in the promotion of healthcare services and medical safety.

著者

加藤 隆寛 岩澤 瞳 甚目 陽子 加藤 顕子 築山 郁人 斎藤 寛子

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.43, no.12, pp.680-690, 2017-12-10 (Released:2018-12-10)

参考文献数

34

被引用文献数

1 2

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The efficacy of pharmaceutical interventions for patients with cardiovascular disease has been reported in several countries. However, the interventions especially for patients with cardiovascular disease have not been evaluated for safety, efficacy and economy. To evaluate pharmaceutical interventions in the cardiovascular ward, we evaluated the economic benefit of pharmaceutical interventions retrospectively. We classified pharmaceutical interventions into 3 items, which included type of intervention, intervention that influences patients' outcome, and intervention according to guidelines. Moreover, we evaluated for economic benefit regarding the prevention of serious adverse drug reactions, and avoidance of drug interaction. We also collected interventions for initiating drugs, and the estimated cost savings by decreasing the risk of hospital readmission by initiating drugs.One hundred and thirteen interventions were accepted and 27 interventions were rejected. It was considered that 48 interventions led to safety. The cost saving associated with pharmaceutical interventions that include the prevention of serious ADRs, avoidance of drug interaction and others was estimated to be about 13 million-yen of financial benefit.In addition, 33 interventions were those for changing medications according to several guidelines. The interventions (drug initiation) cut the medical care cost by about one million yen per year by the decreased risk of hospital readmissions.This is the first study to estimate the economic impact directly associated with various pharmaceutical interventions of pharmacists in cardiovascular disease in Japan. Evaluating the economic impact in relation to the pharmaceutical interventions is an important method for assessing the role of pharmacists.

著者

松尾 泰佑 富田 隆 工藤 賢三 佐塚 泰之

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.9, pp.464-470, 2018-09-10 (Released:2019-09-10)

参考文献数

8

被引用文献数

6

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Tablet splitting, an important task of the pharmacist, is performed at hospitals and health insurance pharmacies. Although magnesium oxide tablets have no score line, the accuracy of their division is not assured. Furthermore, as magnesium oxide strongly absorbs moisture, the stability of half-tablets is unknown when stored in one-dose packages. The variation and loss when splitting magnesium oxide 500 mg tablets by using a tablet-divider were evaluated. The stabilities of split tablets after storage in one-dose packages at 75%RH were evaluated through the analysis of weight change, disintegration, and dissolution. The variation in half-tablets of magnesium oxide 500 mg tablets was 5.5 ± 4.4% and the loss of almost all tablets was below 1%. Although the weight of the half-tablets increased when preserved in one-dose packages, this was related to the quantity of magnesium oxide stored in one-dose packages and not on the splitting of tablets. The disintegration time of half-tablets was prolonged by increased moisture absorption, but the disintegration time of split tablets was shorter than that of whole tablets when the same quantity of moisture was absorbed. The dissolution rate was similar among split tablets and whole tablets. Magnesium oxide tablets can be administrated as a split tablet, but caution should be exercised regarding prolonged disintegration time. Pharmacists should be careful when using half-tablets in prescriptions.

著者

杉本 智哉 近藤 有 一木 万奈美 荒川 裕貴 間瀬 広樹 牛膓 沙織 佐久間 昌基 小山 佐知子 大島 有美子 宮崎 雅之 築山 郁人 佐藤 由美子 久田 達也 板倉 由縁 山田 清文

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.9, pp.441-448, 2018-09-10 (Released:2019-09-10)

参考文献数

26

被引用文献数

1

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

著者

向井 淳治 岸本 典子 坂本 竜平 竹原 涼子 名徳 倫明 奥田 広志

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.9, pp.471-477, 2018-09-10 (Released:2019-09-10)

参考文献数

2

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

著者

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

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.5, pp.229-235, 2018-05-10 (Released:2019-05-10)

参考文献数

16

被引用文献数

4

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

著者

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

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.8, pp.395-402, 2018-08-10 (Released:2019-08-14)

参考文献数

8

被引用文献数

3

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

著者

伊藤 智代 中出 順也 嶋田 努 崔 吉道

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.8, pp.403-409, 2018-08-10 (Released:2019-08-14)

参考文献数

12

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

著者

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

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.5, pp.222-228, 2018-05-10 (Released:2019-05-10)

参考文献数

18

被引用文献数

6

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