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

18 22

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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

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

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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

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

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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

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

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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

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 2

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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

大島 幹弘 中村 安孝 池田 直人 西山 博隆 小菅 和仁 山田 浩 伊藤 邦彦 松山 耐至

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.8, pp.499-503, 2013-08-10 (Released:2014-08-10)

参考文献数

3

被引用文献数

4 2

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Tablet-splitting is an important practice for pharmacists in hospitals and pharmacies. We investigated the variation of line tablet containing splitting score using 4 splitting methods (scissors, automatically, knife and spoon). We evaluated variation using the coefficient of variation. As a result, scissors and automatically showed small variation, but knife showed big variation. Furthermore, as individual difference using a warfarin tablet was investigated, the scissors showed small variation compared with other methods. As the splitting methods and individual difference results, the tablet scissors method was the most useful division method. We investigated the variation of line tablet non-containing splitting score using scissors and crushing tablet on/off diluting agent. As a result, crushing tablet on a diluting agent showed small variation. Using a score line tablet divided by the tablet scissors method, the non-score line tablet divided by crushing tablet on the diluting agent was small variation.

著者

名取 伸行 花輪 和己 鈴木 正彦 花輪 剛久 小口 敏夫

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.34, no.3, pp.289-296, 2008 (Released:2009-09-04)

参考文献数

6

被引用文献数

8 3

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A questionnaire survey of inpatients of widely varying ages was conducted to investigate the ease of taking internal medicines and desired dosage forms.A similar questionnaire survey of nurses and pharmacists working in a university hospital was also conducted to compare awareness of dosage forms by profession.The results of this survey clearly demonstrated the difference in awareness of patient preference regarding internal medicines among pediatric nurses,nurses working at other hospital wards,and pharmacists.This discrepancy seemed to reflect the difference in awareness of different health care workers concerning impairment of deglutition capability with aging.Awareness of patients' desired dosage forms also varied between pharmacists and nurses,which could be due to the difference in knowledge of pharmaceutics between these 2 professions.Based on the results of this study,it was felt that pharmacists should provide medication instruction to individual patients and provide pharmaceutical information to nurses,and that information sharing is important to ensuring that proper pharmaceutical care is conducted in the hospital.

著者

白水 俊介 岩崎 雄介 畦地 拓哉 安部 智哉 兼平 暖 相良 篤信 里 史明 湯本 哲郎 亀井 淳三

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.46, no.1, pp.1-6, 2020-01-10 (Released:2021-01-11)

参考文献数

10

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Saccharated ferric oxide is an iron preparation for intravenous injection obtained by colloidal particles of ferric hydroxide with sucrose. Although it is necessary to dilute saccharated ferric oxide with a 10-20% glucose injection solution according to the product labeling, it is often diluted with 5% glucose injection solution and/or saline in clinical practice. In the present study, we evaluated the stability of saccharated ferric oxide in various diluted solutions in terms of the abundance of free iron ions. The abundance ratio of free iron ions significantly increased with pH elevation of the diluted solution. Moreover, a marked decrease in the abundance ratio of free iron ions was observed in the sodium chloride solution exceeding the physiological concentration (0.9%). Furthermore, a statistical decrease in the abundance ratio of free iron ions was confirmed in the glucose solution compared to saline, and the degree of liberation of free iron ions in 5% glucose solution was the lowest among various concentrations of glucose solution. These results indicate the possibility that saccharated ferric oxide can be diluted by 5% glucose injection solution with minimal effects on its stability, although its dilution according to the product labeling is basically important.

著者

河崎 陽一 松永 尚 千堂 年昭

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.35, no.4, pp.286-290, 2009 (Released:2010-07-30)

参考文献数

18

被引用文献数

3 3

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The hazardous effects of insoluble microparticles generated in injections has been a matter of concern for some time and recently,plastic ampoules have been developed for injection containers as a means of decreasing particle contamination on opening ampoules.To our knowledge,as no studies have been done on insoluble microparticle contamination arising when plastic ampoules are opened,we performed the present study to compare particle contamination from glass ampoules on opening with that from plastic ones and assessed the contribution of the ampoule material to particle generation.We observed that insoluble microparticle contamination from plastic ampoules was significantly lower than that from glass ampoules and therefore conclude that the amount of insoluble particles appears to be relatedtothematerialoftheampouleand recommend using plastic ampoules to prevent microparticle contamination.

著者

中村 敏史 野村 浩夫 岡本 浩一

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.45, no.11, pp.610-615, 2019-11-10 (Released:2020-11-11)

参考文献数

9

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“LANTUS® XR Inj. Solostar® (450 units / 1.5 mL)” is a preparation that tripled the insulin concentration of existing LANTUS® Inj. Solostar®. As the volume per insulin unit is reduced to one third, the recommended blank beating units before dosing have been increased to 3 units. However, some patients perform 2-unit blank beating as they use the existing injector. A retrospective investigation identified erroneous operation of blank beating in 9.5% of outpatients who had been prescribed LANTUS® XR Inj. Solostar® at Nagoya Ekisaikai Hospital from April to May 2017. In this study, we investigated if 2-unit blank beating with LANTUS® XR Inj. Solostar® is suitable to confirm needle hole clogging and injection of content by naked-eye observation and the amount emitted. Injection of content was confirmed at the second and subsequent 2-unit beatings by naked-eye observation. On the other hand, the emission weighing test with a new needle and syringe barrel revealed that the amount discharged was increased with 2-unit beating and reached the theoretical value at the fourth beating. Based on these results, we concluded that 3-unit blank beating is preferable for LANTUS® XR Inj. Solostar®; however, three successive 2-unit blank beatings are helpful to confirm correct installation of the needle and normal movement of the injector.

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

被引用文献数

1

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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

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

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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

2

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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

地嵜 悠吾 中村 暢彦 松村 千佳子 矢野 義孝

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.37, no.11, pp.637-642, 2011 (Released:2012-11-10)

参考文献数

20

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Regarding the dose amount of steroid ointments, package inserts gives no precise direction and it is necessary to clearly determine the standard method for dose setting. For this purpose, a method called ‘Finger Tip Unit (FTU)’ has been proposed in a guideline for atopic dermatitis, but this method has some demerits that it assume the same caliber of ointment tubes' head among different drugs' formulations and also it does not consider inter-patients' variability of body surface area. In order to establish a new dose setting strategy instead of FTU, we propose a new standard method which is based on the calculated surface area of body regions that drugs are applied. This method uses the published data of age, body weight, height, and surface area ratio of each body region to whole body surface area. Consequently, an equation to calculate the length of ointment to be squeezed out of a tube is presented for each body region, and we also propose the length for a unit area which is useful for applying to small area on any body regions. These results would be useful in the points that it clearly determine dose amount of steroid ointments and also it lead to an improvement of patients' adherence as well as improving clinical efficacy of steroid ointments.

著者

山本 佳久 鎌野 衛 深水 啓朗 古石 誉之 鈴木 豊史 梅田 由紀子 牧村 瑞恵 伴野 和夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.31, no.8, pp.625-631, 2005-08-10 (Released:2011-03-04)

参考文献数

8

被引用文献数

2 1

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A general method of administering powdered medicines to infants is to add a spoonful of water to the powder to make a paste and then making the paste into small dumpling-sized balls. We investigated the optimal amount of water for making a paste for 35 kinds of powdered medicine which included fine granules, granules and dry syrups. The optimal water amount was expressed as an amount per gram of powder. Approximately 80% of the powders examined in this study required 0.2-0.4 mL of water per gram of powder to make a paste that would form small balls. Optimal water amounts were calculated for amounts of powder ranging between 0.1 and 1.5 grams by proportion and when the calculated amounts of water were added, small dumpling sized balls could be formed. In the same way, we also calculated amounts of water required for powdered mixtures of several medicines for 6 prescriptions often prescribed in our pharmacy from corrected standard volumes for each medicine in the mixture. The amounts of water added on this basis achieved the required paste state for all of the powder mixtures used. These results suggest that the optimal water amount for powdered medicines of various weights can be estimated from standard volumes of water by proportion. Thus, optimal water amounts determined by our method may be useful for the administration of mixed powdered medicines to infants.

著者

吉田 和幸 神田 麻香 林 紘司 大谷 喜一 井関 健 Ain Pharmaciez Inc.

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.10, pp.642-648, 2012-10-10 (Released:2013-10-10)

参考文献数

10

被引用文献数

2 3

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Most dispensing errors are derived from human error and personality is considered one of the internal factors of such error. This study aimed to reveal the relation between error frequency and personality traits. A questionnaire survey was performed for pharmacists belonging to Ain Pharmaciez in Hokkaido from May to June in 2011. The questionnaire consisted of 20 items which were mainly supposed to reflect the 7 hypothetical personality traits based on previous studies and reports of the Pharmacy Risk Error Management System (PREM-S). The answers were analyzed using Spearman's rank correlation, Mann-Whitney's U-test, factor analysis and structural equation modeling (SEM). We obtained 156 answers. As a result of factor analyses, four factors such as “timidity”, “lack of self-control”, “lack of safety awareness”, and “distraction” were extracted from 12 items relating to personality traits. The analysis of SEM showed that “distraction” caused error frequency was affected by other factors, particularly by “timidity” whose total effect on “distraction” was 0.61. In addition to this, it was affected by external factors of patients and colleagues. The coefficient of determination (R2) of error frequency was 0.25. These results show that personality traits contribute to error frequency at a rate of 25% and it is necessary to improve external factors for the prevention of errors.

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

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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

福田 裕子 田中 裕貴子 森田 貴子 中永 あやこ 道下 佳子 中蔵 伊知郎 北澤 文章 辻川 正彦

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.47, no.5, pp.264-271, 2021-05-10 (Released:2022-05-18)

参考文献数

19

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We experienced two cases with mild to moderate renal dysfunction in which amantadine hydrochloride (amantadine) intoxication was followed by increases in its blood levels. Case 1 was a patient with mild to moderate renal dysfunction [estimated glomerular filtration rate (eGFRcreat): 48.9 mL/min/1.73m2; glomerular filtration rate (GFR) category: G3a] taking amantadine 300 mg daily. In Case 1, the blood level of amantadine at 13 hours and 30 mins after administration was 2,368 ng/mL, pyrexia, myoclonus, and psychological symptoms were observed. After discontinuing amantadine, the patient’s myoclonus improved, but he died of acute respiratory distress syndrome. Case 2 was a patient with mild to moderate renal dysfunction [eGFRcreat: 55.6 mL/min/1.73m2; GFR category: G3a] taking amantadine 100 mg daily. In the patient, pyrexia, myoclonus, and consciousness disorder were observed. The blood level of amantadine 88 hours after the last dose was 265 ng/mL, and the blood level that was collected 24 hours after the end of administration was estimated to be about 2,600 to 4,200 ng/mL. In all cases, the clinical features were consistent with the common symptoms of amantadine intoxication, and improved by discontinuing amantadine. Taken together, these findings suggest that the patients were intoxicated with amantadine. These results indicate that amantadine intoxication due to elevated blood levels also occurs in patients with mild to moderate renal dysfunction during the administration of the usual dose of amantadine. In addition, the measurement of amantadine blood levels may be useful in avoiding amantadine intoxication.

著者

坪井 謙之介 寺町 ひとみ 葛谷 有美 水井 貴詞 後藤 千寿 土屋 照雄

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.8, pp.522-533, 2012-08-10 (Released:2013-08-10)

参考文献数

24

被引用文献数

18 18

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An important aspect of medicinal treatment is having the patient take the medicines prescribed by the doctor. However, a previous questionnaire about medication compliance and adherence showed that approximately 50% of patients forget to take their medicines. In this study, the status of patient medication-taking behavior and factors affecting adherence were investigated through a survey involving 226 patients who presented at Gifu Municipal Hospital from November 2009 to February 2010. The survey items included patient characteristics (age, sex, occupation, side effects, allergies, etc.), medication status (dosing time, medicine formulations), and factors affecting medication adherence (awareness of taking medication, awareness of illness and medicines, life rhythm, character, relationship of trust with doctor or pharmacist, use of medicine information leaflets). Overall, 73% of patients took medicines as directed. Evaluation by medication adherence status revealed that patients with poor adherence most frequently forgot to take their medicines after lunch and between meals. A separate factor analysis of good and poor medication adherence groups showed significant differences between the groups for 18 of 30 factors. Then, using Customer Satisfaction analysis and excluding factors related to personality, 4 factors for improvement were selected from the remaining 16 factors. These findings suggest that patient medication adherence increases when the factors of “regularity of life rhythm”, “regularity of meals”, “trust in pharmacists”, and “use of medicine information leaflets” are improved.

著者

大谷 道輝

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.1, pp.1-10, 2003-02-10 (Released:2011-03-04)

参考文献数

22

被引用文献数

9 8

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The dilution or mixing of commercially available corticosteroid formulations is a common practice in our country. We therefore evaluated the pharmaceutical stability and clinical effects of such admixtures.The quantities of the aqueuos phase separated by centrifugation employed as an index of the destructution of an emulsion after mixing were measured, with a high value being obtained with the admixtures of corticosteroid ointments and o/w-type moisuturizing creams. In contrast, the admixtures utilizing w/o-type creams were found to be physically stable for a month.To evaluate the preservative efficacy, we attempted to investigate the microbial contamination of these admixtures with Antebete® ointment. For all aqueous phases separated by centrifugation stored and at room either temperature or in a refrigerator for one week, and each mixture was touched by a human finger twice a day. As a result, it was impossible to prevent microbial contamination in these admixtures.The permeability of corticosteroids using hairless mice skin in the admixture of Lidomex® ointment, Antebete® ointment, and Myser® ointment and moisturizing creams through the skin was 5-, 2-, 3-fold greater, respectively, than that from each corticosteroid ointment alone. The extent of the stability of the emulsion after mixing was related to the permeability.The vasoconstrictor activity of humans in the admixture of Lidomex® ointment and moisturizing creams, urea or heparinoid, was about 2 fold greater than that from the corticosteroid ointments alone, and this difference was significant.When the concentration of corticosteroid was reduced by half using an admixture of corticosteroid ointment with vaseline or moisturizing creams, no difference was observed in the systemic side effects between the corticosteroid ointment alone and the admixtures.