Objective: To clarify the reason why the target levels of low-density lipoprotein (LDL)-cholesterol are hardly attained.
Methods: The questionnaire was performed for 237 general practitioners on prescription of HMG-CoA reductase inhibitors (statins), just after the publication of “Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2007”.
Results: The responses could be summarized as 1) almost all doctors recognized the significance of target levels of LDL-cholesterol; 2) however, general physicians have such a recognition to a lesser extent, compared with cardiologists; 3) when prescribing statins, 66.2% of them had concerns about drug-drug interactions; 4) as the adverse events with statins, they listed creatine kinase (CK) elevations (86.5%), hepatic dysfunction (74.3%) and myalgias/rhabdomyolysis (70.9%); 5) in contrast, less than 20% of them listed the fulminant hepatic failure, gastrointestinal symptoms and fluctuation of blood glucose levels; 6) the threshold value of CK to discontinue statins was 500 IU/L in 44.4% and 200-300 IU/L in 39.6%; and 7) 78.5% of them believed that statins have the pleiotropic ability such a anti-inflammatory effect clinically, in addition to lipid-lowering.
Conclusions: It is important to serve the drug information about the safety of statins to the general practitioners for the management of hyperlipidemia, based on original articles.

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  Recently, the number of outpatients who visit the hospital only for the examination is increased in Ofuna Chuo hospital.  It is important that the pharmacists manage the contrast media used to these outpatients for the rational drug therapy.  However, there are a few hospitals where the pharmacists work in the laboratory.  Therefore, we investigated the effect of the providing drug information by pharmacists to the patients received magnetic resonance cholangiopancreatography (MRCP) in the laboratory.  The subjects were consisted of 38 patients who were taken with Bothdel®Oral Solution 10 during receiving MRCP.  The pharmacist instructed the patients about Bothdel®Oral Solution 10 before MRCP.  The percentage of patients who were already treated with the other drugs was 92.0%.  The 4 patients were taken the drugs interacted with Bothdel®Oral Solution 10 and then were able to prevent the drug interaction by the pharmacist.  Also, the patients were taken the questionnaire form about the adverse events of this drug and sent it to the pharmacy by mail after more than 5 days.  As the results, the gastrointestinal symptoms such as a loose stool and a diarrhea were reported 28.5% of the patients.  In addition, as the adverse events other than listed in the package insert, epigastric distress, heaviness of the head and hot flash, were shown in each of a patient, respectively.  In conclusion, it was very important that the pharmacists provide the information of rational use of contrast media to the patients who received examination.

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  We have managed information on adverse drug reaction using the clinical records to obtain data from within our hospital and using Medicine-Pocketbooks to obtain data outside our hospital.  Our system for management of side effect information does not require the development of a separate specialized system.  Our method of collecting side effect information was changed in April 2007.  Therefore, we evaluated our present method of collecting information on side effects by comparing the method used before the change with the new method.  The amount of side effect information collected has clearly increased since April 2007.  Although the amount of data collected directly from doctors has increased eight-fold, the amount collected from other data sources has hardly changed.  Side effect symptoms have hardly changed, with skin symptoms being the most frequent side effect.  Suspected drugs have also hardly changed, with antibiotics being the most frequently suspected drugs.  In addition, we conducted questionnaire surveys on the use of Medicine-Pocketbooks by patients who registered side effect information at our hospital to determine whether Medicine-Pocketbooks were being used effectively as a tool for the management of side effect information.  Among patients who registered their side effect information at our hospital, 76% also presented their Medicine-Pocketbooks to other medical institutions.  In addition, all patients received a change in prescription or were questioned about their side effect information when they presented their Medicine-Pocketbooks.  Our present method of collecting side effect information is considered appropriate since there was an increase in the amount of side effect information collected from doctors.  Medicine-Pocketbooks have also been effectively used as a tool for managing side effect information.

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