著者

上敷領 淳 西谷 沙織 村上 仁友美 妹尾 典子 筒井 洋望 山崎 迪子 服部 聖 古屋 憲次 杉原 成美

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.40, no.1, pp.54-61, 2014-01-10 (Released:2015-01-10)

参考文献数

27

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Octreotide is often administered to patients by addition to total parenteral nutrition (TPN) as well as by subcutaneous injection. However, the concentration has not been determined to remain greater than 90% through the completion of its administration. This study investigated the stability of octreotide during administration in ELNEOPA No 1 TPN solution, a four-chambered duplex delivery system.The level of octreotide in the upper-chamber of the ELNEOPA No 1 duplex delivery system, pH 4.0, remained stable, whereas that in the lower chamber, pH 7.0, decreased to less than 90% of the initial concentration immediately after mixing. The final concentration of octreotide in pH 7.5 buffer solution was significantly lower than that in pH 5.1 buffer solution. The influence of pH was reversible. However, a fraction of octreotide suffered decomposition in pH 7.5 buffer solution. Hence, it might be suitable to inject octreotide into the upper chamber that has the lowest pH among the 4 chambers of the duplex drug delivery system used by ELNEOPA No 1.Reducing agents such as sodium hydrogen sulfite caused the concentration of octreotide to decrease. Although the mixed solution of the 4 chambers contains sodium hydrogen sulfite, the concentration of octreotide remained greater than 90% for about 3 days. The decrease in concentration caused by sodium hydrogen sulfite seemed to be protected by the co-presence of glucose or cysteine.The results of our octreotide concentration studies suggest the possibility that the therapeutic effects of octreotide administered via TPN would be equivalent to the effects following subcutaneous administration.

著者

太田 美鈴 高橋 由里 深水 啓朗 伴野 和夫 岩田 政則 日高 慎二

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.36, no.6, pp.425-435, 2010 (Released:2012-03-09)

参考文献数

8

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Very little information is provided with OTC drugs and unlike prescription products,they do not have package inserts or interview forms.The purpose of this study was to examine the stability of 5 acetaminophen-containing OTC drugs by observing temporal changes in their characteristic physico-pharmaceutical parameters (hardness,mass,elution,drug migration) when they were preserved under conditions in which temperature and humidity were altered.From the results,it was assumed that 3 of the 5 drugs were affected by temperature and humidity,and that it was difficult to maintain stability when they were taken out of their packages.In particular,the drugs seemed to be more adversely affected the higher the temperature was and changes in parameters were greater.Also,the results of an elution test conducted after 24 hours of storage suggested that there was deterioration in 3 of the products.In conclusion,our findings clearly showed that patients need adequate explanation on how to keep OTC drugs.

著者

本田 義輝 齋藤 秀之

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.31, no.5, pp.391-398, 2005-05-10 (Released:2011-03-04)

参考文献数

15

被引用文献数

9 11

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Very little quality information is available for generic pharmaceutical preparations and this is particularly so for injectable preparations for which few quality studies have been conducted. With this in mind, we conducted an inter-lot quality variation investigation on nafamostat mesilate preparations for both the original and generic products and compared the results. The investigation involved measuring amounts of impurities other than those of the active ingredient by high performance liquid chromatography.For the nine generic products investigated, impurity amounts were about 2.4 times that of the original (min. 2.0 times-max. 3.1 times). We determined that these differences were not due to hydrolysates of the active ingredient but to unknown substances since the amounts of these unknown substances in the generic products were about 5.7 times (min. 4.7 times-max. 8.0 times) their amount in the original product.Concerning inter-lot variation (maximum value-minimum value), we found that the variation in total impurity amounts for the generic products was 1.8 times (min. 0.7 times-max. 2.8 times) that of the original product, while the variation in unknown substance amounts for the generics was 3.1 times (min. 1.0 times-max.4.6 times) that for the original.The results of the present study suggest that it is necessary to take inter-lot variation into account in evaluating the quality of generic products. They also suggest that the higher contents of unknown impurities in the generics could be a cause of the in-circuit precipitation which has been reported with generic versions of nafamostat mesilate during blood purification in the clinical setting.

著者

塚本 晶子 本間 真人 神林 泰行 木津 純子 幸田 幸直

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.33, no.8, pp.687-692, 2007 (Released:2009-09-04)

参考文献数

16

被引用文献数

5 4

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One of the major adverse effects of Shakuyaku-kanzo-To (SKT),a herbal medicine containing licorice,is licoriceinduced pseudoaldosteronism with hypokalemia and hypertension.Owing to the risk of hypokalemia,caution should be therefore exercised when SKT is co-administered with potassium lowering drugs.In order to clarify this risk,we examined the occurrence of hypokalemia in 103 patients receiving SKT.Thirty (29.1%) of the 103 patients developed hypokalemia and SKT dosing periods tended to be longer in these patients than in those who did not develop hypokalemia (54.5 vs.23.0 days,respectively).The co-administration of potassium lowering drugs was more frequent in the patients with hypokalemia (90.0% vs.64.4% for no hypokalemia p<0.01).The occurrence rates of hypokalemia varied with drugs co-administered with SKT ; with 75.0% for glycyrrhizin preparations,47.2% for diuretics,41.9% for glucocorticoids,20.0% for sennoside preparations and 25.0% for others.The above results confirmed that the co-administration of potassium lowering drugs enhanced SKT-induced hypokalemia.Frequent serum potassium monitoring is therefore required when potassium lowering drugs,especially glycyrrhizin preparations,diuretics and glucocorticoids,are co-administered to patients receiving SKT.

著者

中嶋 瞳 三木 晶子 佐藤 宏樹 堀 里子 澤田 康文

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.40, no.6, pp.360-368, 2014-06-10 (Released:2015-06-10)

参考文献数

14

被引用文献数

1

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Among the adverse effects of anticancer drugs, critical effects have attracted the most attention. However, non-critical adverse effects that lower the quality of life of cancer patients have been gaining recognition. For example, the package insert of tegafur・gimeracil・oteracil potassium (S-1) was modified and lacrimal duct obstruction was added to the list of critical adverse effects on September 25, 2012. In a similar vein, this study aimed to examine the awareness of healthcare professionals regarding the adverse effects of anticancer drugs on the eyes. A web-based questionnaire survey was administered to medical doctors and pharmacists. We received responses from 38 doctors and 123 pharmacists. Only 39.5% (15) of the doctors and 33.3% (41) of the pharmacists were aware of the adverse effects of anticancer drugs on the eyes. Among respondents who had observed these adverse effects, only 12.5% (1/8) of doctors and 11.1% (2/18) of pharmacists reported them to the authorities or the pharmaceutical companies. The results suggest that the adverse effects of anticancer drugs on the eyes should gain more recognition among healthcare professionals. Therefore, we would like to encourage them in obtaining information concerning the safety of medicines and to report all observed adverse effects regardless of their severity.

著者

吉田 実 平川 雅章 堤 千秋 立石 真理 中島 和博 岡部 昌之 末安 正典 吉川 学 中尾 泰史 伊藤 善規 大石 了三

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.29, no.2, pp.189-195, 2003-04-10 (Released:2011-03-04)

参考文献数

11

被引用文献数

1 1

---

We examined the procedures for dispensing tablets or capsules that are not approved for crushing after checking the basis for such non-approval regarding 108 medicines introduced in our hospital. The problems are summarized as 1) a reduction in the pharmacological efficacy, 2) lowering the compliance due to a bitter taste or unpleasant odor, 3) dispersing hazardous powder, and 4) a disappearance of the efficacy of improved formulation such as for enteric coating.The taste of the ground tablets or capsules that are indicated to not be crushed was examined and compared with various concentrations of quinine hydrochloride powder in 8 healthy volunteers who showed a normal response to a bitter taste. Thirty-one out of 43 drugs were found to be tolerable to the taste, in which 13 drugs were less bitter than 0.5% quinine hydrochloride powder. However the other drugs either induced numbness or had a pungent taste and unpleasant odor, which were also considered to become the major reasons for nonapproval for crushing. Therefore, we found that several tablets have no serious problems, when they are dispensed after grinding. On the other hand, a number of hygroscopic medicines and anticancer agents tended to easily disintegrate in water. As a result, they can be prescribed by suspending them in water immediately before taking them. Our findings suggest that several tablets or capsules that are non-approved for crushing may thus be dispensed without any serious problems after crushing or disintegrating them in water. Therefore, our present findings may offer some useful information on the countermeasures for dispensing tablets and capsules that are not approved for crushing.

著者

池田 賢二 竹上 学 但馬 重俊 宮脇 康至 東 真樹子 八木 悠理子 亀川 秀樹 黒川 信夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.32, no.5, pp.436-444, 2006-05-10 (Released:2007-11-09)

参考文献数

15

被引用文献数

3 3

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Pharmaceutical support systems for anti-neoplastic drug preparation for chemotherapy in hospital information systems are in need of improvement. With this in mind we developed a new support system in collaboration with system engineers (SEs) in January 2005. In the presentation of our requirements for the support system to the SEs, the most important part of the development process, we proposed a development model based on an end-user prototype system. The model comprised a five-step design and development of the prototype system through end-user computing, evaluation of the prototype system through actual use, the introduction of a step to determine the exact task requirements, detailed discussions with the SEs, and installation. Among the functions of the prototype system were support functions for the input of prescriptions, inventory management and task data assessment and a print-out function for record sheets. This model produced excellent results for the upgrade whose express purpose was the introduction of an end-user computing step. Furthermore, to evaluate the preparation support system, time-determinative factors involved in the preparation were analyzed and compared using data collected in November 2004 and March 2005. In the evaluation, two pharmacists dispensed a total of 791 and 1003 admixtures for 341 and 426 injection prescriptions, respectively, and the average preparation times were 18.15 and 15.43 minutes/prescription, respectively. Multiple regression analysis revealed several time-determinative factors with correlation coefficients of 0.803 and 0.668. The significant time-determinative factors were the number of vials, ampoules, and bottles for admixtures and the properties of drugs dispensed. The new system has resulted in improved patient safety and operational efficiency.

著者

廣谷 芳彦 原口 清美 向井 淳治 槙本 和加子 浦嶋 庸子 名徳 倫明

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.41, no.4, pp.266-274, 2015-04-10 (Released:2016-04-10)

参考文献数

11

被引用文献数

1 6

---

We conducted a home medical care (HMC) training workshop consisting of presentations given by regional HMC leaders that targeted community pharmacists in collaboration with a nearby pharmaceutical association. Subsequently, we conducted a questionnaire survey with the pharmacists in attendance to assess their opinions of the present HMC situation. The participants' satisfaction with the workshop was relatively high, at an average of 8.13 out of 10. Among the participants, 70.9% had experience with HMC, such as visiting pharmacy services at patients' homes, with the most frequently practiced activity being “drug administration guidance for patients at home.” However, activities such as “accompanying medical rounds” and “participation in home care conferences” were not widely practiced (at a rate of less than 50% of the most popular activity) among the participants. Next, many participants responded that the key HMC factors were the creation of systems of cooperation between different professionals and their environmental arrangements. Participants also made suggestions for future lectures, such as on the subjects of contract procedures and HMC case reports. Furthermore, the participants suggested that the qualities necessary for effective HMC were a wide and practical knowledge of HMC and a positive attitude. In conclusion, many patients stated that cooperation with other professionals is important in deepening pharmacists' HMC involvement, and the pharmacists hoped to establish greater communication between pharmacists and other HMC workers.

著者

寺田 久仁子 岩本 佳代子 小林 睦 辻野 政司 寺岡 文雄 荒川 行生 恩田 光子 前田 頼伸

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.2, pp.96-102, 2009 (Released:2010-02-07)

参考文献数

21

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Bone cements have been widely used to fill the dead space of bone tissues in orthopaedic surgeries.Loaded with antibiotics,these materials are also administered for the prevention and treatment of infections,infectious osteomyelitis for example.We made polymethylmethacrylate cement preparations of five commercial vancomycin (VCM) products and compared the in vitro dissolution profiles of the VCM in them and mechanical strengths of the cements.When immersed in phosphate buffer (PB) for 30 days,dissolved amounts of VCM ranged between just 5 and 19% of the calculated contents and after immersion in PB for 40 days mechanical strengths were significantly decreased (50-75% of the control without VCM).Further,on testing a cement preparation containing pharmaceutical additives as well as VCM,the amount of antibiotic released was significantly larger than that for other preparations and the release was more rapid as well.This cement preparation also had the lowest strength among those studied.By doing this,we showed that pharmaceutical additives could have marked effect on the dissolution of the antibiotic and mechanical strength for antibiotic-laden bone cements for the first time,though these were in vitro findings.The present study clearly demonstrated that the antibiotic products used can cause functional differences in antibioticladen bone cements and also suggested that pharmaceutical additives influence cement functions.It is therefore necessary to pay attention to both the antibiotic content of commercial VCM products and types of pharmaceutical additive in the preparation of such cements.

著者

髙橋 良平 今井 浩一 菅井 沙知 吉田 栄充 中村 益美 浜野 晋一郎 岩﨑 文男

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.12, pp.741-750, 2012-12-10 (Released:2013-12-10)

参考文献数

28

被引用文献数

1

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We evaluated ARCHITECT®・iCarbamazepine using chemiluminescent immunoassay (CLIA) with carbamazepine (CBZ) concentration in the serum of patients with epilepsy. The intra- and inter-assay coefficients of variation were 0.87-1.34% and 2.20-6.06%, respectively. Cross-reactivity of CBZ analogs by CLIA varied from 7.00-9.26% with carbamazepine-10,11-epoxide lower than that evaluated by fluorescence polarization immunoassay (FPIA), and 2.09-2.51% with 10-monohydroxycarbazepine higher than that evaluated by FPIA. Oxcarbazepine was not detected. In addition, we observed a correlation between the values obtained by CLIA method and the high performance liquid chromatography (HPLC) method (y = 1.07x - 0.09, r = 0.98), and FPIA method and HPLC method (y = 0.95x - 0.22, r = 0.97). Our results suggest that ARCHITECT®・iCarbamazepine measured the CBZ concentration in serum lower than that measured by FPIA. However we conclude that ARCHITECT®・iCarbamazepine can be used for routine monitoring of CBZ for the reason that ARCHITECT®・iCarbamazepine showed low cross-reactivity with CBZE by classification of CBZE/CBZ ratio.

著者

中山 季昭 塩月 篤史 春山 修一 須藤 欣三 辻 佳紀

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.276-285, 2013-05-10 (Released:2014-05-10)

参考文献数

12

被引用文献数

3

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The preparation of anticancer drugs necessitates careful work because it can involve the handling of hazardous drugs. In actual clinical settings, liquid leakage can occur if the same rubber stopper is penetrated with injection needles multiple times; special attention should be paid to the fact that the first penetration mark can serve as a site of leakage to increase risk.Hence, we conducted a confirmatory study to detect air leakage, which can be detected with greater sensitivity than liquid leakage, using a number of methods of penetration with a focus on the viscoelasticity of rubber stoppers. In the second penetration, when the bevel was oriented perpendicularly to the first penetration (AB method), a leakage rate of 100% (30/30) was obtained with an 18 G regular-bevel needle penetrating the rubber stopper at a short depth of 0.5 mm from the first penetration mark. When the bevel orientation was changed under otherwise the same conditions (CB method), the leakage rate decreased to 37% (11/30). When the bevel orientation was completely aligned to the orientation of the first penetration (BB method), the leakage rate further decreased to 0% (0/30). Another important factor was the depth of penetration; under all conditions examined, lower leakage rates were obtained with a 1.0 mm depth than with 0.5 mm.As a result, in clinical settings involving two occurrences of penetration, two distinct cases were revealed depending on needle bevel positioning: spills and other forms of leakage prevented by the viscoelasticity of the rubber stopper and those promoted by the same.

著者

廣谷 芳彦 八十 永理 的場 俊哉 池田 賢二 恩田 光子 川瀬 雅也 名徳 倫明

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.6, pp.371-378, 2012-06-10 (Released:2013-06-12)

参考文献数

6

被引用文献数

5 11

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To clarify the issues involved in the promotion of pharmacists’ participation in home medical care, we performed a questionnaire survey on the implementation situation of home medical care and pharmacists’ attitudes and opinions in community pharmacies. We mailed a questionnaire to 715 community pharmacies in July 2010. The pharmacists’ attitudes and opinions were validated through text mining. 78.3% of community pharmacies were requested to visit a patient’s home and provide a pharmaceutical service, but only 53.0% of these visits were made. In many pharmacies, an average of 2.3 pharmacists provided care to within 5 patients and visited the patient’s homes twice a month. Meanwhile, 27.7% of the pharmacies delivered prescription medicines to nursing facilities, and of these, only 19.8% of the pharmacies provided instructions regarding pharmaceutical care. Only 9.1% of the pharmacists participated in training workshops related to home medical care. 48.4% of the pharmacists recognized that they had to provide pharmaceutical care visits for patients coming to their pharmacies. Only 3.7% of the pharmacists participated in joint directions at the time of hospital discharge. Results of text mining showed the need for pharmaceutical care visits for patients with poor compliance, those who found it difficult to go to the pharmacy or had dementia, and the elderly living alone. Also, the patients and other homecare staff felt the necessity for pharmacists to provide pharmaceutical care in the patient’s home. In conclusion, in order to promote home medical care, inhibitory factors such as lack of pharmacists’ manpower and cooperation with home care staff, and insufficient provision of training workshops for home medical care need to be tackled.

著者

大山 勝宏 清水 万紀子 山崎 浩史

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.40, no.5, pp.310-316, 2014-05-10 (Released:2015-05-10)

参考文献数

18

被引用文献数

1 1

---

A retrospective survey of a database containing patient backgrounds and prescribed drugs was conducted to elucidate the detailed characteristics and risk factors of adverse effects caused by topical dermatological formulations of diclofenac. A total of 145,478 patients who had been dispensed topical dermatological formulations of diclofenac at 466 community pharmacies belonging to Nihon Chouzai were included in the study. Of these, 580 patients had adverse effects. The incidence of adverse effects was significantly higher in the elderly (more than 65 years old) and in female patients. A variety of systemic adverse effects were evident in 19 patients. Approximately half of these adverse effects were related to the respiratory system, eg, asthma, but the other adverse effects (eg, edema, decreases in urinary volume, tremor and others) were not described in the drug package inserts. Data from patients with systemic adverse effects, and an age- and gender-matched control group of patients underwent multivariate logistic regression analysis. Asthma (odds ratio: 13.3, 95% confidence interval: 2.40 - 95.5, P = 0.004) and the number of co-administered drugs (odds ratio: 1.25, 95% confidence interval: 1.02 - 1.55, P = 0.035) were identified as risk factors for systemic adverse effects of topical dermatological formulations of diclofenac. Moreover, many of the co-administered drugs affected P450 enzymes other than P450 2C9, the main metabolizer of diclofenac. Therefore, to manage the risk of adverse events, it was concluded that various characteristics of concomitant medications and patient's medical history should be evaluated properly before topical dermatological formulations of diclofenac are prescribed.

著者

有吉 範高

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.2, pp.61-76, 2013-02-10 (Released:2014-02-10)

参考文献数

39

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Utilization of genetic information to achieve more appropriate use of drugs has not yet progressed, although a number of studies on the association between genetic polymorphisms and responses to drugs have been performed. Comparison among groups possessing different genotypes may give a significant difference in median responses to drugs, but little answer to the wide variation of drug response in patients sharing the same genotype. In fact, genetic information alone cannot accurately predict response to drugs in each individual.However, application of genetic information is often extremely useful to correct drug therapy to a more appropriate form in certain cases. Since pharmacists have to take responsibility for drug therapy in each patient, they should use all tools available including genotyping that may achieve better treatment. Nevertheless, since genetic information alone is insufficient to design better drug therapy in most cases at present, it is important to clarify factors, which should be considered together with genetic information. Clinical researches are indispensable to identify these factors.A simple genotyping method is a powerful tool to solve problems of drug therapy encountered at hospitals and/or to provide evidence through clinical studies on usefulness to apply genetic information to improve current drug therapy. The increase in the number of pharmacists, who are interested in not only drugs but also the genetic character of patients, is expected to contribute to better drug therapy in the future.

著者

剱田 侑希 門田 佳子 鈴木 小夜 青森 達 小林 典子 高木 彰紀 手塚 淑人 大谷 壽一 中村 智徳

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.117-123, 2014-02-10 (Released:2015-02-10)

参考文献数

23

被引用文献数

1 2

---

In advanced pharmacy practice experiences (APPE) in community pharmacies in Japan, students are not always satisfied with over-the-counter (OTC) counseling practice. Aiming to improve the quality of such practice, we conducted a questionnaire survey of 167 students after their APPE to assess student satisfaction and the current status and problems they experienced with OTC counseling practice. The results revealed that opportunities for practice differed among sites. While 27.8% of students had experienced selling OTC drugs to patients, 11.4% of students carried out no selling, shadowing or role play (RP). The difference arose also in student satisfaction. As expected, most students who experienced selling OTC drugs to patients rated the practice most favorably, especially students who had experienced consultation sales obtained higher satisfaction. On the other hand, most students who experienced both shadowing and RP but not the opportunity to sell OTC drugs also rated the practice quite positively; in particular, students who had more than six opportunities for shadowing and RP rated the practice favorably. In conclusion, although OTC counseling is not well practiced during APPE, mainly because of limited opportunities to sell OTC drugs, student satisfaction may be improved by introducing and increasing opportunities for shadowing and RP.

著者

宮崎 靖則 谷古宇 秀 浅山 亨 河野 博充 櫻井 正太郎 柳川 忠二

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.12, pp.1077-1085, 2008 (Released:2010-02-07)

参考文献数

13

被引用文献数

4 3

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We compared the in vitro performance of brand-name and generic spherical carbon absorbents by studying their physicochemical and adsorptive properties.There was no correlation between specific surface area and adsorption rate for pigment substances.The adsorption removal rates for pigment substances and uremic toxins were almost the same for Kremezin and Kyucal but the adsorption removal rates of some substances were lower for Merckmezin than those for Kremezin.In addition,the adsorption rates for digestive enzymes,important in vivo substances that should not be adsorbed,were high for Kremezin but low for Kyucal and Merckmezin.We found that Kremezin and Kyucal were comparable as regards the adsorption removal rate of indole in the presence of pepsin and sodium cholate,in vivo substances,but with Merckmezin,the adsorption removal rate for indole was lower.In our findings,we noted that the adsorption performance of the generic product Kyucal for most substances was equivalent to that of Kremezin while the adsorption performance of Merckmezin for some substances was lower than that of Kremezin.As a particular conclusion,the lower adsorption removal rate of Merckmezin for indole in the presence of vivo substances needs to be taken into consideration as this will affect clinical results.

著者

中島 由紀 高尾 斎昭 前川 理沙 寺田 さとみ 椎尾 康 大谷 道輝 杉浦 宗敏 山村 喜一 内野 克喜

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.5, pp.323-325, 2011 (Released:2012-08-02)

参考文献数

7

被引用文献数

1 1

---

We prepared dried thyroid rectal suppositories for the treatment of thyroid papillary adenocarcinoma in patients with hypothyroidism in response to clinicians’ requests. The suppositories had a content of 50 mg or 100 mg and were prepared using dried thyroid powder and hard fat. The initial daily dose of 100 mg, which was given as a single dose in the morning, could be increased on the basis of thyroid stimulating hormone (TSH) levels, as required. In addition, an oral dose of levothyroxine sodium hydrate 150 μg could be switched to a dose of 300 mg of dried thyroid rectal suppositories in this patient.These results suggested that the dose of dried thyroid rectal suppositories for the treatment of hypothyroidism should be titrated for individual patients based on TSH levels.

著者

石塚 良子 深津 祥央 丸山 志穂子 中桐 真樹子 尾崎 淳子 石津 雅弘 乾 賢一 篠山 重威

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.27, no.1, pp.57-62, 2001-02-10 (Released:2011-03-04)

参考文献数

11

被引用文献数

1 1

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Pharmacists play various roles other than merely dispensing test drugs at our hospital for the appropriate performance of clinical trials in accordance with the new GCP guidelines : e.g. do a preliminary review, function as the office of the Institutional Review Board, prepare for monitoring and auditing by the sponsor, conduct the follow-up of patients involved in clinical trials, check for inclusion/exclusion criteria on enrollment. Pharmacists thus contributed to the successful completion of 93 cases from July 1997 to January 2000. The items of management were as follows : 1) the prevention of protocol deviations (46 cases), 2) the follow-up of subjects (22 cases), 3) managing the financial affairs and payments to subjects (14 cases), 4) corresponding to adverse events in subjects (9 cases) etc. Especially, 18 cases of protocol deviation occurred at the time of enrollment, and most of them were a contravention of exclusion criteria such as medication using prohibited combinations. Supports for the appropriate enrollment of patients into clinical trials was thus suggested to be important to ensure the safety of patients. Based on the above information, pharmacists should therefore play an active roll in clinical drug trials since their professional knowledge and skill are often of vital importance.

著者

尾田 一貴

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.6, pp.335-344, 2011 (Released:2012-08-25)

参考文献数

33

被引用文献数

2 8

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In order to contribute to antimicrobial stewardship, it is extremely important for pharmacists to apply PK / PD theory (combination of pharamacokinetics (PK) and pharmacodynamics (PD)) as well as the montecarlo simulation. However, very little useful PK / PD simulation software incorporating the montecarlo simulation is available for the clinical setting. We therefore developed easy-to-use software for this purpose based on Microsoft® Office Excel.With it, drug clearance, volume of distribution, and PK / PD parameters are easily calculated using correlation equations derived from patient parameters, such as serum creatinine level and body weight, based on population pharmacokinetic parameters reported by various researchers. The montecarlo simulation is performed by generating pseudorandom numbers based on antibiograms, or interindividual coefficients of variation for each population pharmacokinetic parameter. We found that population pharmacokinetic parameters reported as following a 2-compartment model could be used as a 1-compartment model in the montecarlo simulation and report for the first time that the RN method (consisting of the RAND function and NORMSINV function in Microsoft® Office Excel) can be utilized as a pseudorandom number generator in the same manner as the MB method (consisting of Mersenne-Twister method and Box-Muller method).Adoption of this software in the clinical setting will enable us to evaluate individual patient PK / PD parameter values and contribute to providing useful evidence for PK / PD theory.

著者

山本 吉章 家田 直幸 三島 信行 松田 一己 高橋 幸利 賀川 義之

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.37, no.7, pp.411-418, 2011 (Released:2012-08-30)

参考文献数

25

被引用文献数

1

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This study was designed to evaluate the persistence and safety of topiramate therapy in children and adults with epilepsy. It was a retrospective cohort study undertaken from October 2007 in which we analyzed the clinical records of 726 patients (216 children and 510 adults) who received topiramate for the treatment of epilepsy at the National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders. Factors associated with discontinuation of topiramate therapy determined from the results of the log-rank test (p<0.1) were subjected to multivariate Cox regression analysis in order to calculate hazard ratios and 95% confidence intervals (95% CI).Suspension (Discontinuation) or dose reduction of topiramate were necessary due to adverse effects in 85 children (39%), of which the major ones were drowsiness (16.2%), anorexia (10.7%), hypohidrosis (4.7%), and irritability (4.2%). There was a higher incidence of hypohidrosis and a lower incidence of speech disorders in children as compared with adults (both p < 0.05). According to Cox proportional hazards analysis, the adjusted hazard ratio for discontinuation of topiramate therapy in children was 0.92 (95% CI : 0.75-1.23 ; p=0.76). In conclusion, this comparative study showed that the persistence and safety of topiramate therapy were similar in children and adults.