- 著者
- 谷口 律子 錦織 淳美 川崎 博己 黒崎 勇二 荒木 博陽 五味 田裕
- 出版者
- 日本医療薬学会
- 雑誌
- 医療薬学 (ISSN:1346342X)
- 巻号頁・発行日
- vol.30, no.4, pp.246-254, 2004-04-10
- 参考文献数
- 9
- 被引用文献数
- 12 13
It is important for students to acquire the skills of pharmaceutical care with respect to patients. However, clinical pharmacy education in Japan is still not fully developed and teachers at faculties of pharmacy generally teach students by means of lectures, which is too passive for students. Since such a lecture-based system will not help them to acquire pharmaceutical care skills, there should also be training that simulates the provision of pharmaceutical care in the clinical situation. To address this issue, the authors tested problem-based learning (PEL) on students, with the objective of developing problem solving skills and student independence. In the PEL, students gained an understanding of the principles of pharmacotherapy and drew up hypothetical schemes for pharmaceutical care, worked out the problems and discussed them together in small groups. They also practiced role-playing, which was intended to help them learn communication skills. Afterwards, the authors conducted a questionnaire survey to evaluate the student's impressions of the PEL and they evaluated it highly, particularly with regard to learning communication and problem-solving skills. These results suggest that it would be useful to introduce PEL in clinical pharmacy education in Japan.
- 著者
- 木内 祐二
- 出版者
- 日本医療薬学会
- 雑誌
- 日本医療薬学会年会講演要旨集
- 巻号頁・発行日
- vol.14, 2004-09-01
医薬分業が進展し、病院、薬局ともに患者への服薬指導が重要な業務となった現在、患者とのコミュニケーションは薬剤師に最も必要とされる能力の一つであろう。従来、大学ではコミュニケーションの学習は殆ど実施されておらず、実務の現場においてもコミュニケーションの教育や研修は必ずしも標準化されていない。また、医療の中心は言うまでもなく患者であるにもかかわらず、薬剤師側の視点のみで患者とのコミュニケーションが指導されることも多い。このように、多くの薬剤師は自らの経験や先輩薬剤師の経験に基づいてコミュニケーション能力を身に付けてきたため、得られた能力は個人の経験や資質に依存して個人差も大きく、患者にとっては適切と言えないような対応も時に見受けられる。医学部では患者が求めるコミュニケーション能力の習得のために、数年前から臨床実習前に標準化された医療面接のロールプレーの試験(OSCE)が取り入れられ、近々、必修化される。本ワークショップでは、OSCEなどで患者の立場から医療人教育に参加されている模擬患者(SP)さんとの服薬指導ロールプレーを参加者の代表が体験し、患者にとって望ましい医療コミュニケーションはどのようなものかを参加者全員で討議する。薬局と病棟での3つの場面設定における服薬指導のロールプレーとSPさんからのフィードバックを体験あるいは見学・評価する。この参加型のワークショップが、より良い医療を求める患者の思いを知る機会となることを期待している。
2 0 0 0 処方される分量と日本薬局方および添付文書記載の常用量の比較
- 著者
- 牧大 節子 相良 悦郎 中川 冨士雄
- 出版者
- 日本医療薬学会
- 雑誌
- 病院薬学 (ISSN:03899098)
- 巻号頁・発行日
- vol.4, no.3, pp.130-131, 1978-11-20
The study was made on prescribed doses of 317 drug products for oral use which appeared frequently in 6,594 inpatient prescriptions filled at the University of Tokyo Hospital in 28 days purposively selected from a period of 4 months from March to June 1976. The prescribed doses were compared with usual doses stated in the Pharmacopoeia of Japan and package inserts. The drug products prescribed within usual dose range composed 19.6% of the total products used, the drugs within and above usual dose range 24.3%, within and below 30.5%, within and above and below 20.2%, and out of usual dose range 5.4%. The percentage distribution agreed with a conjecture of pharmacists in practice.
2 0 0 0 外来がん化学療法における薬剤師の関与のあり方
- 著者
- 日野 美波理 石井 雅人 藤原 聡子 松香 直行 定金 典明 森山 雅弘 二神 幸次郎 柴田 和彦 五味田 裕
- 出版者
- 日本医療薬学会
- 雑誌
- 医療薬学 (ISSN:1346342X)
- 巻号頁・発行日
- vol.30, no.7, pp.457-467, 2004-07-10
- 被引用文献数
- 7 7
Owing to the approval of reimbursement of fees for antineoplastic chemotherapy on an outpatient basis by the national health insurance scheme in April 2002, an antineoplastic chemotherapy room was set up in the ambulatory area of our hospital in August 2000. In order to ensure the effective use of the safety cabinet and other existing equipment and the safe administration of antineoplastic agents to patients, the authors assigned a mixing pharmacist and a coordinating pharmacist who was to be in charge of antineoplastic chemotherapy for outpatients. First, the mixing pharmacist prepared IV mixtures of the antineoplastic agents and auxiliary medicines in a sterile area and then the coordinating pharmacist audited the mixtures and carried them to the antineoplastic chemotherapy room. Other functions of the coordinating pharmacist included providing pharmaceutical care to patients and cooperating with doctors, nurses and other pharmacists involved in the chemotherapy. They also searched for information on individual medical charts or in patient statements and pointed out doubtful records or potential problems that might affect chemotherapy. Coordinating pharmacists notified 50 potential problems between August 2002 and April 2003. To evaluate our pharmaceutical practices in outpatient antineoplastic chemotherapy, we conducted a questionnaire survey of the patients. Their responses indicated that our pharmaceutical care program was working well and that they hoped we would continue it. However, the usefulness of our program was not entirely clear to all patients and we recognized the need to better inform patients concerning this.
2 0 0 0 キシレン含有油性インクのプラスチック製輸液容器に対する影響
- 著者
- 濃沼 政美 瀬尾 誠 高瀬 知永 西澤 光代 平野 公晟 荒川 秀俊 前田 昌子
- 出版者
- 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.203-209, 2003-04-10
- 参考文献数
- 11
- 被引用文献数
- 2
In hospitals oil-based ink is occasionally used to write the patient's name, his room number, and names of the drugs that are used in a mixture on the plastic containers used for infusion. This is done to prevent medication errors. In the current study, the effect of an oil-based ink on the infusion fluid was investigated. Using an oil-bused ink containing xylene, letters and other characters were written on an infusion fluid container that was made of Polypropylene・Polyethylene・Ethylene vinyl acetate. It was confirmed that some xylene had been transported to the interior of the container (air phase). Furthermore, the xylene concentration in the air phase rose with repetitive writing and erasing, using the same oil-based ink. But no xylene was dissolved in the solution that was in the container (Iiquid phase). This observation convinced us that it is highly unlikely that the xylene in the ink can be infused directly into a patient's body. However, to assure the quality of the medication that is in liquid form, it is not desirable for a substance that does not normally exist as a component of the medication to move through its container. In the present experiment, physiological saline was used as a solution (liquid phase). Our findings showed that xylene had a high possibility of dissolving in solutions known for high xylene solubility (e.g., solutions with a large amount of amino acids or surfactants). Therefore, it is necessary to design a method to prevent ink from centering a container when an oil-based ink is applied to the outside of it.
2 0 0 0 難治性吃逆における柿蒂湯の臨床効果
- 著者
- 齊藤 幹央 宇野 勝次 本田 吉穂 渡辺 徹
- 出版者
- 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.29-32, 2001-02-10
- 被引用文献数
- 1 6
The clinical efficacy of therapy for intractable hiccups using Shitei-to, a folk medicines, was evaluated in 21 patients. Clinical effectiveness was observed in 11 cases, thus resulting in an efficacy rate of 52.4%. Particularly, the hiccups were relieved within two days by the treatment of only Shitei-to in 6 cases, and by the administration of Shitei-to in 2 cases that had been unsuccessfully treated by other drugs for hiccups. In addition, the efficacy rate was 66.7% for centric hiccups and 16.7% for peripheral hiccups. Accordingly, the clinical efficacy of Shitei-to was observed to be significantly higher for centric hiccups than for peripheral hiccups (p< 0.05 Wilcoxon ranksum test). Our findings showed Shitei-to to be very effective for treating patients with intractable hiccups. Furthermore, the clinical efficacy of this herbal medicine was higher for centric hiccups caused by cerebropathy than for peripheral hiccups caused by internal disease.
- 著者
- 高橋 晴美
- 出版者
- 日本医療薬学会
- 雑誌
- 日本医療薬学会年会講演要旨集
- 巻号頁・発行日
- vol.14, 2004-09-01
このワークショップでは初めに心不全(CHF)患者の臨床所見・AHAガイドラインに基づく治療法のポイントと薬物を体内動態パラメターに基づいて特徴づける方法について簡単に説明し、それらの知識を実際の患者症例に応用する練習をしていただきます。どの症例にもあてはめることのできる薬剤師としての基本的な患者症例に対する取り組み方について以下の手順に従って理解し、臨床の現場で患者さんをフォローする時に応用できるようになって下さい。1.まず、必要な患者情報を把握・選択し、カルテやインタビューからそれらを収集します。2.次に、得られた情報を基に患者さんが現在有している医学的問題点や薬物治療に起因する問題点を緊急性の高い順に全てリストアップします。次のステップ以降は各問題点ごとに進めて下さい。3.各問題点のSubjective/Objectiveデータをピックアップします(患者情報、身体所見、検査所見を参考に)。4.各問題点のリスクファクターをリストアップします(背景因子の把握)。5.各問題点ごとに計画されている薬物治療の必要性・妥当性について、以下の項目に従って評価していきます。A.薬物選択-薬物治療が必要か?-Evidenceに基づいた薬物選択か?B.PKシートの作成-投与量・投与方法・投与期間-副作用・相互作用C.コンプライアンス6.各問題点ごとに患者さんに最も適切な治療計画を立案し、治療効果を判定するモニタリングパラメターを設定して、治療のゴールを明確にします。7.計画された薬物治療による副作用や相互作用のモニタリングパラメターを設定し、あらかじめおこった場合の対策を立案しておきます。8.服薬説明を立案します(患者さんの理解度を把握することが重要です)。
- 著者
- 伊東 明彦 小林 由美子 杉原 正泰
- 出版者
- 日本医療薬学会
- 雑誌
- 病院薬学 (ISSN:03899098)
- 巻号頁・発行日
- vol.15, no.1, pp.5-10, 1989-02-20
- 被引用文献数
- 1
The significance of depth of score, the kinds of binders and granules for compression on dividing of scored tablets was investigated. Scored tablets with the rate of depth of score per thickness varying with 10, 20 and 30% were prepared using hydroxypropylcellulose (HPC), potato starch, acacia and gelatin as binder and sieved granules in three particle sizes and no sieved granules as granules for compression. Dividing strength of the scored tablets decreased with an increase in depth of score and was affected by the kinds of binders. Weight variation of the divided tablets was the smallest on the tablet of 30% depth of score prepared from sieved granules irrespective of the kinds of binders and physical characteristics of granules. However, when the rate of depth was lower than 20%, the weight variation of the divided tablets was affected by the kinds of binders and physical characteristics of the granules. With 20% depth of score, tablets using potato starch and gelatin as binder showed little weight variation. In case of the 10%, tablets using potato starch and granules of 16-32 mesh showed better results. Tablets prepared with non-sieved granules showed effect of particle size distribution of granules on weight variation of divided tablets even in the case of the 30% depth.
- 著者
- 樋口 則英 一川 暢宏 嶺 豊春 中嶋 幹郎 平井 正巳 佐々木 均
- 出版者
- 日本医療薬学会
- 雑誌
- 医療薬学 (ISSN:1346342X)
- 巻号頁・発行日
- vol.30, no.6, pp.382-388, 2004-06-10
- 被引用文献数
- 1 2
In recent years, computerized prescription order entry systems have played an increasingly important role in medical risk management as such systems have become more sophisticated. Though prescription order entry systems enable us to access huge amounts of information in drug information databases on drug interactions, adverse reactions and so forth, it is very difficult to manage such large amounts of information. Prescription order entry systems have a prescription checking function but the master maintenance must be done properly for it to work well. With this in mind, we developed an improved system using a commercially available program, PC-ORDERING 2000 (NEC Corp.), to make it easier to use the master maintenance screen of the order entry system. In order to investigate the resulting improvements we did the following : 1) measured the improvement in input efficiency, 2) evaluated the improvement in reference functions, 3) evaluated the improvement in file output functions and 4) made a comparison with the existing system. As a result, we found that the required maintenance time with the improved system was reduced to 66% and considered this to be very important to risk management since the prescription checking function in the order entry system had been enhanced.