著者

長田 貴之 柴山 良彦 熊井 正貴 山田 武宏 笠師 久美子 倉本 倫之介 洲崎 真吾 赤澤 茂 真栄田 浩行 坂下 智博 折舘 伸彦 本間 明宏 福田 諭 菅原 満 井関 健

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.51-55, 2012-01-10 (Released:2013-01-10)

参考文献数

14

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Intractable nausea and vertigo induced by opioid treatment are occasionally difficult to treat. It has been reported that antiemetic drugs and opioid rotation may be effective in treating nausea in such cases; however, this approach has been occasionally ineffective. Symptomatic treatment has not been developed for vertigo induced by opioid treatment. Here, we report a case study where combined treatment with perospirone and a histamine H1 receptor antagonist was used in 2 patients who developed intractable nausea and vertigo induced by opioid treatment. Treatment with a histamine H1 receptor antagonist drug (tablet form, containing 40 mg diphenhydramine salicylate and 26 mg diprophylline) suppressed the nausea and vertigo. However, increasing the opioid dosage exacerbated the symptoms, and treatment involving the histamine H1 receptor antagonist and opioid rotation was ineffective. Subsequently, combination treatment with the histamine H1 receptor antagonist (3 tablets per day) and perospirone (maximum daily dose, 16 mg) improved the symptoms. The results of the present study suggest that combination treatment with a histamine H1 receptor antagonist and perospirone might improve intractable nausea and vertigo induced by opioid treatment.

著者

金子 絵里奈 高木 博子 家入 一郎 山野 徹 石橋 久 園田 正信

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.48, no.2, pp.96-105, 2022-02-10 (Released:2023-02-10)

参考文献数

10

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Although several pharmaceutical inquiries made by community pharmacists meet the PreAVOID criteria, the frequency of PreAVOID reports by community pharmacists is lower than that by hospital pharmacists. We aimed to clarify the characteristics of adverse events (AEs) in pharmaceutical inquiries to increase the number of PreAVOID reports and to improve their quality. We identified AEs using MedDRA/J and compared the types of AEs, information source, and drug efficacies between detected and prevented AEs. In this study, detected AEs were defined as AEs leading to pharmaceutical inquiries after the last visit; prevented AEs were defined as AEs leading to pharmaceutical inquiries before dispensing medicine based on patient interviews, medical records, and laboratory data. We evaluated prescriptions for adults against inquiries at a community pharmacy between April 2016 and March 2019. The chi-squared or Fisher’s exact test was used to compare the number of system organ classes (SOCs) between detected and prevented AEs. We identified 57 detected AEs and 121 prevented AEs from 5,545 prescription inquiries. Gastrointestinal disorders (30 AEs) and skin and subcutaneous tissue disorders (30 AEs) were the most common SOCs that showed a significantly higher number of detected than prevented AEs (P = 0.011 and P < 0.001, respectively). Renal disorder (22 AEs) was the second most common SOC that was associated with prevented AEs (P = 0.001). The results can be used to develop strategies to resolve clinical problems at community pharmacies. Our study contributes to an increase in PreAVOID reports through pharmaceutical inquiries.

著者

中井 將人 吉川 明良 舟原 宏子 開 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.47, no.6, pp.307-315, 2021-06-10 (Released:2022-06-10)

参考文献数

29

被引用文献数

1

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The criteria for palliative chemotherapy discontinuation have not been adequately systematized. We evaluated the relevance of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognostic nutritional index, modified Glasgow Prognostic Score (mGPS), and clinicopathological factors as potential factors for chemotherapy discontinuation in patients with recurrent and unresectable pancreatic cancer.We retrospectively analyzed the data of 91 patients who received palliative chemotherapy for recurrent and unresectable pancreatic cancer at Hiroshima City Hospital between April 2014 and March 2018. Factors significantly related to chemotherapy discontinuation were extracted using Coxʼs proportional-hazard model, and a prognostic model was established by combining these factors.The median overall survival was 76 days. Multivariate analysis of the factors revealed that the mGPS (0/1-2) (hazard ratio [HR] = 3.053, P = 0.005), the presence of distant metastatic disease (HR = 2.605, P < 0.001), and the status of recurrent or initially unresectable disease (HR = 2.587, P = 0.013) were significantly associated with the discontinuation decision. One point was assigned to each of these three factors to create the prognostic model. A total score index of 0-3 was used to categorize three prognostic risk groups. The high-risk group (3 points) had a significantly lower overall survival than the low- (≤1 point) (P < 0.001) and intermediate-risk (2 points) groups (P < 0.001).Our study shows that mGPS and this prognostic model can help determine whether chemotherapy should be discontinued in patients with relapsed and unresectable pancreatic cancer.

著者

小玉 菜央 金本 理沙 叶 隆 金子 雅文 森本 かおり 荻原 琢男

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.4, pp.228-236, 2012-04-10 (Released:2013-04-10)

参考文献数

15

被引用文献数

2 2

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The overall quality of generic drugs (GE) was assessed by sensory evaluation (questionnaire survey) taken by the patient side, a composition analysis by the pharmacist side, and a questionnaire by medical manufacturers, using an icosapentaenoic acid ethyl ester (EPA-E) product. In the sensory evaluation, the original product was superior to the two other GEs in terms of the ease of finding the wrapping's cutting point and its opening and external cutting points. In addition, there were GE products with a peculiar odor, which had residual beads (grain) in several wrappings. According to an analysis of the capsule's odors and surface cleaning solutions, the odor was attributed to the raw material itself adhering to the capsule surfaces during the manufacturing process, and/or by the deterioration of the capsules during the manufacturing period. The result of the stress test also supported this conclusion. The total dioxin content in the original product was extremely low compared to any other GE product. Questionnaires to manufacturers showed that all supplied product information for medical personnel and patients via various media, and were striving to innovate and improve the quality retention of the wrapping. It also emerged that GEs were not always superior to the original product, whereas it is expected that GE manufacturers will provide products that improve on the original drugs for the convenience of patients.

著者

横尾 広美 江本 晶子 中野 行孝 藤戸 博

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.39, no.3, pp.182-188, 2013-03-10 (Released:2014-03-10)

参考文献数

13

被引用文献数

1 1

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Sulfamethoxazole-trimethoprim (ST) is used in the prevention and treatment of Pneumocystis carinii pneumonia (PCP) infection today. However, the relevance of dosing regimens of ST and the preventive effect have not yet been clarified. Therefore, we retrospectively reviewed the medical records of patients who had been treated with ST for the prevention of PCP at Saga University Hospital to investigate the rates and the types of adverse events, and analyzed the factors influencing the adverse events.We compared group A (2 tablets twice-weekly) and group B (1 tablet once-daily). As a result of multivariate analysis and the relationship between background factors (age, sex, doses, concomitant drugs) and adverse events, the incidence of adverse events in group A was significantly lower than in group B (Odds ratio = 6.185, 95% confidence intervals 1.128-33.900, P = 0.036). However, there was no difference in the prophylactic effects of PCP between the two groups.In conclusion, ST should be reduced or discontinued early before adverse events develop, when selecting an ST regimen of 1 tablet once-daily as PCP prophylaxis.

著者

廣田 憲威 北條 雄也 西岡 香代 松村 直美 島内 憲夫

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.45, no.4, pp.214-221, 2019-04-10 (Released:2020-04-10)

参考文献数

12

被引用文献数

4 1

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Aozora Pharmacy is a community pharmacy that has acquired ISO9001-2015 certification and recognized as a “Health Support Pharmacy.” In order to improve the prescription service, we conduct an annual patient satisfaction survey. Using the results from the September 2018 survey (effective responses: 422 persons), a review was conducted on the usefulness of logistics regression analysis (LRA) and the factors that would enhance patient satisfaction at the health support pharmacy by running a conventional method of portfolio analysis (PA) and new LRA. By PA, “Staff’s greeting,” “Staff’s attitude,” “Easy language use,” “Pharmacist’s explanation,” “Environment of pharmacy,” “Privacy,” and “Waiting time” were classified as important items. On the other hand, by LRA, “Staff’s greeting,” “Pharmacist’s explanation,” and “Waiting time” showed a significant difference (P < 0.05). We have confirmed that LRA is available as a method of analysis. At a community pharmacy, importance is placed on the “functions to become a patient’s main pharmacy.” This time, the three items that showed a significant difference in LRA are all important factors for the “function to become one’s own pharmacy”; it is critical for a community pharmacy to make efforts with focus placed on these items.

著者

名徳 倫明 秋山 紗奈江 松浦 亜梨紗 面谷 幸子 長井 克仁 初田 泰敏 向井 淳治 廣谷 芳彦

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.43, no.8, pp.438-443, 2017-08-10 (Released:2018-08-10)

参考文献数

17

被引用文献数

1 1

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In many hospitals, semi-solid enteral nutrients are administered. Dietary fibers are used as the main component of semi-solid agents, but some studies have reported that dietary fibers influence the bioavailability of drugs. In this study, we examined the influence of the adsorption of phenobarbital (PB) to dietary fibers and semi-solid agents used for the manufacturing of enteral nutrients. Five types of dietary fiber or 3 semi-solid agents were dissolved in 0.01% PB solution to prepare concentrations of 1.0, 0.5, and 0.1%, and the adsorption rate and viscosity were measured. In PB solution containing 1.0% guar gum, which was prepared with purified water, the adsorption rate of PB was 33.7%. It reduced with a decrease in the concentration of guar gum. The adsorption rate of PB to xanthan gum was also similar, although it was slightly lower than that to guar gum. There was no adsorption of PB to dextrin hydrate or cellulose under any condition. The first and second solutions established by the Japanese Pharmacopoeia also showed similar results. The results of this study indicate that the adsorption rates of PB to guar gum and xanthan gum were high. When administering drugs to patients receiving semi-solid enteral nutrients, the timing of administration at which there is no influence of adsorption must be reviewed.

著者

高野 由博 加部 春香 溝井 健太 箱田 恵子 峯野 知子 矢野 健太郎 荻原 琢男

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.47, no.4, pp.208-216, 2021-04-10 (Released:2022-04-10)

参考文献数

21

被引用文献数

1 2

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In the simple suspension method, the intended medicine is suspended in hot water when administered to a patient by tube. Suspension of the laxative, magnesium oxide is reported to hydrolyze ester-type drugs. Because several angiotensin converting enzyme (ACE) inhibitors have ester bonds in their structure, magnesium oxide may cause incompatibility when suspended with an ACE inhibitor. The purpose of this study was to clarify the effect of magnesium oxide on the stability of eight kinds of ACE inhibitors in the simple suspension method.When suspended together with magnesium oxide in hot water (55℃), temocapril, delapril, captopril, and benazepril showed a significant decrease in concentration compared to when suspended alone. Enalapril, trandolapril, quinapril, and imidapril, however, showed no significant decrease. When temocapril was suspended with magnesium oxide, the concentration of its hydrolysis product temocaprilat was increased in a time-dependent manner. In addition, when temocapril was suspended in a carbonate-sodium bicarbonate buffer (pH 10.6), temocapril degradation was slower than with magnesium oxide, suggesting that the temocapril decomposition is not a simple hydrolysis caused only by pH but one requiring the presence of magnesium oxide as a catalyst.Ester structures in ACE inhibitors are intended to improve gastrointestinal absorption. Therefore, the condition of several ACE inhibitors kept in suspension with magnesium oxide causes degradation of these drugs, inhibiting their absorption and pharmacological effects. It may be necessary for pharmacists to suggest to physicians that their prescriptions be changed to non-degradable ACE inhibitors and/or laxatives other than magnesium oxide.

著者

花井 雄貴 松尾 和廣 横尾 卓也 大谷 真理子 西村 功史 木村 伊都紀 平山 忍 植草 秀介 草野 歩 小杉 隆祥 西澤 健司

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.41, no.1, pp.1-10, 2015-01-10 (Released:2016-01-15)

参考文献数

22

被引用文献数

2 2

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Hepatotoxicity associated with administration of voriconazole (VRCZ) is a major treatment-related adverse event and in some cases requires discontinuation of therapy. This study aimed to investigate the clinical course and risk factors for VRCZ-induced hepatotoxicity.Demographic and laboratory data were retrieved retrospectively from the medical records of 66 Japanese patients who underwent VRCZ treatment. VRCZ-induced hepatotoxicity was defined as an abnormal increase in liver function tests.VRCZ-induced hepatotoxicity was observed in 30 patients (45%), with 11 (37%) of these patients needing to discontinue the drug. Most of the events were observed within 1 to 2 weeks after the first dose of VRCZ. Of the liver function tests, an abnormal increase in γ-glutamyl transferase tended to occur earlier than changes in the other tests (ie, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total bilirubin). Multiple logistic regression analysis showed that the trough concentration of VRCZ was a risk factor for hepatotoxicity (adjusted odds ratio = 2.89, 95%CI 1.49-5.59, P = 0.002). Based on this result, a VRCZ trough concentration < 4 μg/mL was considered to be the target for minimizing the risk of developing hepatotoxicity. After discontinuation of VRCZ in patients who developed hepatotoxicity, every liver enzyme abnormality improved within approximately 1 week.In conclusion, this study shows that VRCZ-induced hepatotoxicity may occur early after the initiation of VRCZ therapy. We therefore recommend appropriate adjustments of the starting dose and frequent liver function tests in patients treated with VRCZ, especially during the first 2 weeks.

著者

深水 啓朗 山本 佳久 中村 裕美子 鎌野 衛 梅田 由紀子 牧村 瑞恵 古石 誉之 鈴木 豊史 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.32, no.9, pp.964-969, 2006-09-10 (Released:2007-11-09)

参考文献数

17

被引用文献数

17 15

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We investigated the uniformity of content, rheological properties and chemical stability for prescription of Kindavate® ointment diluted with white petrolatum. When the ointment was levigated with white petrolatum (Propeto® for dilution) by a pharmacist or mixed by an autorotation/orbital mechanical mixer, a uniform ointment having the precise drug content could be prepared for all conditions. However, as the dilution ratio increased, the hardness of the ointment seemed to decrease based on the yield point measured with a spread meter and apparent absolute viscosity. Also, using a polarizing microscope, we observed a dispersion of oil droplets (consisting of liquid paraffin in clobetasone butyrate) in petrolatum for both Kindavate® ointment and the diluted ointment showing that the internal structure of ointment had not been affected by preparation of the diluted ointment either manually by pharmacists or using the mechanical mixer. When the diluted ointment was stored at 4 or 25°C in tight container in the absence of light, it was chemically stable for at least a month.Since our results showed that Kindavate® ointment diluted with petrolatum had a precise drug content and was stable over time, it should be feasible to prepare the ointment in advance of use.

著者

中井 清人 河原 敦

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.3, pp.133-143, 2011 (Released:2012-04-25)

参考文献数

16

被引用文献数

6 5

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Pharmacists in the United States perform a wider range of occupational functions,and have greater authority than thosein Japan.Possible reasons for this are that they provide specific evidence of clinical benefits for patients and contribute toreducing medical costs through their involvement in clinical activities.The legal basis for their wider range of functions andgreater authority is defined in Collaborative Drug Therapy Management (CDTM) in the law that authorizes pharmacists totake part in the management of drug therapy and other tasks in accordance with a prior written agreement between physiciansand them.We recently investigated laws and regulations in the states that have introduced CDTM in order to examine the legal basisdefined in it for the wide range of occupational functions of pharmacists in the US,agreements on CDTM,and qualificationsof and requirements for pharmacists who take part in CDTM.We found that although different state laws have differentprovisions,there were no substantial differences among them regarding the basic structure of CDTM.In addition,publicly-available protocols actually used in the clinical setting were obtained from 3 institutions and examinedto determine how pharmacists and physicians reached agreement on the planning and implementation of CDTM,andthe drug therapies they provided according to different protocols,and the protocols were compared.All of them had thesame basic concept of CDTM and were prepared according to the joint statement of ACP and ASTM.

著者

下田 賢一郎 星野 輝彦 塩津 和則

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.9, pp.636-642, 2015-09-10 (Released:2016-09-10)

参考文献数

16

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In the present study, we conducted a retrospective assessment of the abnormal liver and renal function test results of 156 orthopedic patients receiving sulbactam/cefoperazone (SBT/CPZ). We assessed aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase levels for liver function, and serum creatinine and estimated glomerular filtration rate level for renal function. Liver function parameters after the administration of SBT/CPZ showed significantly higher values than that observed before administration. The incidence of abnormal liver function in patients was 23.1% (n = 36). Almost all abnormal liver function test results were grade 1, although grade 2 abnormal AST and ALT levels occurred in 3.2% (n = 5) and 4.5% (n = 7) of patients, respectively. Abnormal liver function of 36 patients recovered after stopping SBT/CPZ administration. In factorial analyses of abnormal liver function test results after SBT/CPZ administration, the abnormal liver function group (n = 36) showed significantly higher AST and ALT values before administration than the normal liver function group (n = 120). In contrast, there were no significant changes in renal function before and after the administration of SBT/CPZ. These results suggest that SBT/CPZ frequently induce hepatic dysfunction. In particular, patients with high AST and ALT levels should be closely followed up to check for hepatic dysfunction caused by SBT/CPZ.

著者

稲葉 一訓 本多 公貴 大竹 裕子 岡本 紀夫 下村 嘉一 小竹 武 長井 紀章

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.2, pp.93-99, 2020-02-10 (Released:2021-02-10)

参考文献数

6

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We proposed an in vitro test based on pH changes in ophthalmic solutions with the addition of lacrimal buffer, and examined anti-allergic ophthalmic solutions (acitazanolast hydrate, amlexanox, epinastine hydrochloride, ketotifen fumarate, levocabastine hydrochloride, olopatadine hydrochloride, pemirolast potassium, sodium cromoglycate, and tranilast) and anti-glaucoma ophthalmic solutions (brimonidine tartrate, carteolol hydrochloride, dorzolamide hydrochloride, isopropyl unoprostone, pilocarpine hydrochloride, timolol maleate, and travoprost) by using the in vitro test. Resistance to the lacrimal buffer capacity of ketotifen ophthalmic solution was higher than that of the other anti-allergic ophthalmic solutions tested. Among anti-glaucoma ophthalmic solutions, resistance to the lacrimal buffer capacity of the isopropyl unoprostone and dorzolamide ophthalmic solutions was higher than that of the other ophthalmic solutions tested. We also found relationships between ophthalmic additives and the pH-buffering effect in ophthalmic solutions, and demonstrated that D-mannitol, which is an ophthalmic additive, resisted the pH-buffering effect in artificial tears. Furthermore, high resistance was observed to the lacrimal buffer capacities of ophthalmic solutions with D-mannitol. These results will contribute to further studies aimed at reducing irritation caused by ophthalmic solutions.

著者

林 誠 杉村 勇人 菅 幸生 河原 昌美 相宮 光二 宮本 謙一

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.35, no.2, pp.89-95, 2009 (Released:2010-02-07)

参考文献数

22

被引用文献数

10 13

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Hiccups often occur in patients receiving cisplatin (CDDP)-based chemotherapy.In the present study,we investigated the incidence of hiccups in 162 patients who received CDDP as well as risk factors for developing hiccups.Hiccups occurred in 40 (25%) of the 162 patients,and 93% were men.Twenty-six of the patients had hiccups within 48 hr of CDDP,and in 31 of them the hiccups continued for between 1 and 4 days.Twenty-eight of the patients received medication (shitei-decoction,chlorpromazine,metoclopramide,etc.) to relieve hiccups,which was effective in 30% of them.Hiccups developed in patients with osteochondro sarcoma (56%),lung cancer (49%),pancreatic cancer (40%) and esophagus cancer (23%) receiving the following 4 chemotherapy regimens : CDDP+ADM+CAF (56%),CDDP+DTX (50%),CDDP+5 FU (40%),and CDDP+TS 1 (20%) respectively.The CDDP dosage (mg/m2)was higher in patients who had hiccups than in those who had none (80±22 vs 45±33,p< 0.0001)and there was a positive correlation was between CDDP dosage and incidence of hiccups (p<0.001),though all patients developing them received corticosteroids and 5 HT3 antagonists.Multiple logistic regression analysis showed that there were significant differences for the male sex (odds ratio (OR)=8,95% CI=1.5-45.6),CDDP dose (1.03,1.01-1.06),dexamethasone(≥16 mg) (19.4,3.9-95.2)and granisetron (6 mg) (20.9,3-143).We therefore concluded that the independent risk factors influencing the development of hiccups were the male sex and a high dose of CDDP in combination with dexamethasone(≥16 mg),and granisetron (6 mg).

著者

林 隼輔 須田 奈美 川久保 孝 下山 直人

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.45, no.12, pp.667-673, 2019-12-10 (Released:2020-12-11)

参考文献数

15

被引用文献数

1

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Opioids are associated with adverse events, such as constipation, nausea/vomiting and sedation. These side effects can directly reduce the patient's quality of life. Naldemedine improved symptoms in patients with opioid-induced constipation (OIC). However, no comparison has been made for the single treatment and combined treatment of naldemedine for OIC. Also, there are no reports on whether naldemedine suppresses opioid-induced nausea/vomiting. In the present study, the suppression effect of naldemedine single treatment for OIC is the same as that for the combined treatment of naldemedine. This result suggests that single treatment of naldemedine is useful for OIC. Naldemedine suppresses opioid-induced nausea/vomiting, but there is no significant difference between naldemedine and prochlorperazine. This result suggests that naldemedine is useful for opioid-induced nausea/vomiting. Therefore, the present study suggests that naldemedine may be a new option in mitigating the side effects of opioids.

著者

三木 芳晃 塚本 啓介 奥村 裕英 半崎 隼人 安井 良則 松元 加奈 森田 邦彦 萱野 勇一郎

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.7, pp.349-354, 2018-07-10 (Released:2019-07-10)

参考文献数

4

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There are few reports regarding the optimal decomposition condition of the antimicrobial agent. We therefore conducted a questionnaire about the decomposition operation of the antimicrobial agent vial preparation for nurses in Osaka Saiseikai Nakatsu Hospital. Furthermore, the optimal dissolution conditions for “Zosyn ® IV for intravenous injection 4.5 (tazobactam/piperacillin; TAZ/PIPC)” were examined. As a result of the questionnaire survey, most nurses selected a syringe of 10 mL for formulations that are easy to dissolve while, for difficult to dissolve formulations, answers were split between 10 mL and 20 mL. The shaking time of vials ranged from under 5 seconds to under 30 seconds for the soluble formulations and from under 5 seconds to more than 1 minute for the difficult to dissolve formulations. We set each decomposition condition from the questionnaire results and examined the optimal condition, which accorded with the clinical settings in the decomposition operation of TAZ/PIPC. As a result of having examined the decomposition condition from the absorbance of each complete decomposition preparation of TAZ/PIPC, it was found that more than 93% of dissolution was carried out with the injection of saline at 15 mL and the shaking time of 10 or 20 seconds, or the injection of saline at 20 mL and the shaking time of 10 seconds. If the injection volume and the shaking time are less than these conditions, residual drugs are found in the vials.

著者

河原 敦 中井 清人 倉田 なおみ 亀井 美和子

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.6, pp.435-441, 2015-06-10 (Released:2016-06-10)

参考文献数

26

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The role of pharmacists in the US that have advanced functions compared to the traditional pharmacists is based on the collaborative drug therapy management (CDTM). Recently in Japan, the importance of enhancing the team approach whose concept is to make the best use of the each health providers' expertise has been discussed in the health care society. As regards pharmacists, pharmacists' pivotal role in medication therapy management is in great demand in the discussion. On the other hand, pharmacists are more exposed to a litigation risk as pharmacists sometimes are sued for their medical negligence these days.In this manuscript, we conducted a literature and case review for pharmacist responsibility conducting the CDTM in the US. However, we could not find reports and cases, though a litigation risk for pharmacists has been enhanced with the pharmacist role expanding in the CDTM. Furthermore, we conducted a literature and case review for nurse practitioner (NP) as well. As a result, in some cases, NP's negligence was judged independently by the action of NP was whether appropriate or not with no consideration for physician's supervise, and the supervising or collaborating physician's negligence was judged according to the physician's action in the consultation is appropriate or not. As the number of litigation for NP increased, nurse societies raised so many opinions on how to judge appropriately such as which the standard of care (SOC) for physicians or for NPs was applicable and as whether a physician might have an expert witness qualification.

著者

峯田 保恵 半谷 眞七子 神谷 俊範 札軒 芽衣 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.2, pp.74-82, 2018-02-10 (Released:2019-02-10)

参考文献数

29

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Many pregnant and lactating patients taking medicine feel anxious about its negative effects on their fetuses and infants. To help pharmacists implement safe drug therapy for them, Aichi Pharmaceutical Association holds communication skill training (CST) sessions as part of a “Program for pharmacists to support pregnant and lactating females.” In the present study, pharmacists' communication skills were analyzed prior to and following the CST to examine its usability. The subjects were 34 pharmacists who participated in the CST in 2013 and played the roles of lactating patients and pharmacists. Following this, videos of the role playing were analyzed: analyses of the “implementation of the process for confirmation of an explanatory model consisting of three items” and the structure of conversations using the RIAS. Furthermore, patients' satisfaction, its relation with the structures of conversations, and the implementation of the process for confirmation of the explanatory model were examined. There was an increase in the number of pharmacists who had conducted the three processes for confirmation of the explanatory model following the CST, and the level of patients' satisfaction was higher in the CST group than in the non-CST group. There was also an increase in the number of pharmacists who had asked psycho-social questions following the CST. Since the CST requires pharmacists to conduct the process of confirmation of the explanatory model and understand it before providing pregnant and lactating patients with explanations of drugs, it is an effective method of helping pharmacists to develop their communication skills to reduce patients' anxiety.

著者

齋藤 佑輔 堀田 栄治 上阪 友基 林 由紀子 海崎 佳史 細田 清美 高嶋 孝次郎 藤澤 克憲

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.94-99, 2014-02-10 (Released:2015-02-10)

参考文献数

10

被引用文献数

3 2

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There is less emergence of renal toxicity in Liposomal-amphotericin B (L-AMB) than amphotericin B (AMPH-B). However, there have been few reports on the analysis of this factor. I examined the factors involved in renal function decline via the creatinine clearance (Ccr) for 44 cases of L-AMB administered in our hospital. Reduced renal function was observed in 15 cases (34.1%). Multivariate logistic regression analysis for each factor revealed that Ccr ≧ G 1 (P = 0.006, odds ratio: 12.968, 95% confidence interval: 2.085 - 80.643) was a factor in the occurrence of decreased renal function. Results were subjected to multiple regression analysis of the dependent variable amount of change in Ccr before and after administration, and a significant statistical effect was shown by two factors. One is administration at the start of Ccr (P = 0.007); the other is the administration of concomitant medications (P = 0.04). Pharmacists used L-AMB administration to predict in advance the degree of renal function decline, and a regression equation was obtained. As pharmacists prescribe administration depending on the results, L-AMB is prescribed by doctors. For cases which can be a first choice, more aggressive? We believe that establishment of such a system would be ideal.

著者

松田 裕子 八木 敬子 平井 みどり

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.2, pp.125-135, 2005-02-10 (Released:2011-03-04)

参考文献数

7

被引用文献数

18 15

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Communication skills are an essential requirement for pharmacists if they are to function competently as medical professionals. Training using simulated patients has recently been introduced in medical education and we considered that the use of simulated patients would help pharmacy students to acquire the communication skills necessary for patient consultations. To do this, we instructed volunteer patients on how to act as simulated patients and started using them as part of the training in consultations for third-year students at Kobe Pharmaceutical University. The results of a survey conducted at the end of the training indicated that students recognized the high educational value of the simulated patients due to the sense of realism they brought into the training and the tension they experienced in interacting with them, saying that this increased their interest in the work of the pharmacist and stimulated their desire to learn. The use of simulated patients was effective in enhancing the communication skills because they had to focus on their attitudes and responses.