The importance of providing drug information has increased with the expansion of pharmaceutical care.In order to provide appropriate drug information to healthcare professionals,pharmacists have to understand their needs in this respect and be familiar with the procedure for answering typical questions.In the present study,we analyzed all of the questions (9,999)recorded by the drug information center of Kyushu University Hospital and the answers to them in the period from 2001 to 2007.The questions were from doctors (59.3%),pharmacists (21.5%),nurses (15.4%),and others (3.9%).The most frequent questions were on compatibility and stability of injections (18.8%),selecting drugs (13.2%),and dosage and administration (9.8%).We therefore made information on the compatibility and stability of injections available to other pharmacists via our intranet.We felt it was useful to clarify healthcare professionals’needs for drug information and develop a system enabling drug information to be used more easily.
In parenteral nutrition,each intravenous solution has an optimum infusion rate and proper management of administration is a very important issue.In the case of not using an infusion pump (gravity infusion) and using an infusion pump which controls the number of droplets,the administered volume depends on the droplet size,i.e.droplet volume.While the Ministry of Health,Labour and Welfare (Bulletin No.112)specifies the number of droplets per mL for intravenous administration sets,there is a lack of information on how the physical characteristics of solutions affect droplet volume.Therefore,in the present study,we investigated droplet volume for various intravenous solutions during administration and found that the solution density,surface tension (solutions with and without surfactants),and infusion rate all affect droplet volume.
As pharmacists,we are now required to confirm that the patient is safely and correctly using the medication.We can make no exception for medication brought to the hospital by inpatients. We started to check medication brought to the hospital from July 2005,and found that could have been prevented medicinal accidents.Whereas,we don’t have much time to spare and we were swamped with this work at the beginning. To save our time,we made a program using Microsoft EXCEL to efficiently make the Administrative Drug informationSheets for medication brought to the hospital by inpatient.This program can automatically show a lot of information.If the exact brand name medicine dose not exist in our hospital,the program shows where it is available one including same component.And it shows some marks to call our attention for needs to treat carefully,like diabetes medicines,narcotics and others. We compared the length of time it takes before and after using this program,almost 10 hours per one pharmacist in a month could be saved.Using this program,we can be prompt to provide present medication history of inpatients with useful information for doctors and nurses. It is clear that this program is useful.
In this study,we developed and evaluated an inventory management system based on prescriptions taken in advance via the ordering system with the objective of reducing the requirement for inventory management services,such as those for billing and replenishing medical products for automatic injection dispensers (hereafter,automatic dispensers).We first created a database for matching different medical product codes among systems to allow integration of the ordering system data for previously provided prescriptions and data in the existing medication management system.Next,we used a commercially available database program to develop an inventory management system for automatic dispensers to make it easy to determine which medical products were due for payment,their quantity,and the amount of inventory for them. After the system went into operation,we found that though the time required for billings and payments for automatic dispensers had been reduced by half,the automatic dispenser inventory turnover rate had risen by 17.6%.We also noted that there had been no changes in the number of interim billings during the period under study,indicating that our system was effective in controlling automatic dispenser inventory.
We evaluated drug adsorption onto syringe filters used in the preparation of injectable mixtures in the clinical setting.Bovine serum albumin (BSA) and fifteen injection preparations for total parenteral nutrition (TPN),chemotherapy,and therapeutic drug monitoring (TDM) were evaluated for adsorption in the case of using three syringe filters which were made of polyethersulphone (PES),hydrophilic polyvinylidene fluoride (PVDF),and mixed esters of cellulose nitratecellulose acetate (MEC) membranes,i.e.,PALL® PharmAssure® HP 1002,Millex® GV and Millex® GS,respectively. A significant decrease in the passage rate of BSA was observed with the PVDF and MEC filters at the first filtration and BSA was adsorbed onto the MEC filter to a greater extent than the other two filters.With the exception of digoxin and GCSF,the injections examined were not significantly adsorbed onto the syringe filters.The adsorption of digoxin onto the MEC membrane was particularly significant and G-CSF was significantly adsorbed onto all the filters,in particular the MEC filter (adsorption greater than 80%). These results indicated that most of the injections examined can be used safely in the clinical setting with no appreciable drug loss due to adsorption onto filters used in their preparation.However,as digoxin and G-CSF were adsorbed onto the syringe filter to an appreciable extent,particularly onto the MEC filter,caution must be exercised because a decrease in drug content may jeopardize clinical efficacy. In conclusion,it is necessary to pay attention to the variation in adsorption properties among injections with respect to syringe filters,as well that among filter membranes made of PES,PVDF,and MEC,to ensure that injection mixtures are prepared appropriately.
Problem-solving ability is a general objective of the graduation thesis practical course (multidisciplinary pharmacy research) in the final stage of the 6-year pharmaceutical education system.To make the practical course more meaningful for higher grade students,it was considered important to have those at lower grades do some preparatory study for it.With this in mind,Gifu Pharmaceutical University conducted a problem-based learning (PBL) tutorial on appropriate use of medicines as part of an introductory course in pharmacy for first-grade students in the first semester.The tutorial made use of scenarios with a simple background based on situations likely to be encountered in daily clinical practice. Though it was the students’first experience of a PBL tutorial at the university,the results of a questionnaire administered after it suggested that it had been a good introduction to the practical course for them and had been useful.In groups,students also made product presentations which were evaluated by other students in their groups as well as instructors and students in other groups,and evaluations were subjected to customer satisfaction (CS) analysis.The results of the analysis indicated that“how a person speaks in a presentation”was an item that needed to be improved in order to raise the overall evaluation regarding the question“Was the presentation easy to understand?”This implies the necessity of learning how to speak clearly as a basic presentation skill. The PBL tutorial in the introductory course to pharmacy appeared to be beneficial for students and the use of the new approach of PBL rather than a more conventional learning method had been effective.However,as criticisms,some students said there were too many students per group or that more scenarios were necessary,indicating that there was room for improvement in allocation of time during the PBL tutorial and other aspects.
For training in the provision of drug information in practical training conducted at a hospital pharmacy,we evaluated specific behavioral objectives (SBOs) for 14 items at the master level,and processed the results by correspondence structural (CS) analysis.We then determined whether CS analysis was a useful method of pinpointing areas for improvement.As one conclusion,it was thought that a more concrete improvement plan based on specific improvement items could be developed from the results for experience of the practical training and master level investigation table obtained through the CS analysis.As another,we felt that the improvement items for training in the provision of drug information could be determined by comparing the improvement levels of the CS analysis.It was therefore considered that CS analysis was a useful method of pinpointing areas for improvement during the period that hospital pharmacy training was being conducted.
In recent years,with the continuing ageing of society,the number of users of the nursing care insurance system has been increasing in Japan.Under the system,home helpers play a central role in home care for the elderly at home and provide them with drug administration and other services.To promote the proper administration of drugs for the elderly,we designed an educational intervention for home helpers under which they gain a basic understanding of drug therapy through pharmaceutical study meetings organized by us.Six study meetings were held between March and August 2007,with 3 different lectures delivered twice at each meeting.The study meetings were attended by 131 people who included a small number of repeat participants. We conducted a questionnaire survey of the participants to evaluate the learning effects and benefits of the study meeting curriculum.The results revealed that the home helpers had a favorable impression of the study meetings.Many of them found the lectures easy to comprehend and beneficial for their work,and they increased their interest in gaining knowledge of pharmaceuticals. This kind of educational intervention could aid home helpers in understanding the importance of supportive care based on accurate knowledge in administering medicines,and motivate them to learn more about pharmaceuticals.
Graft-versus-host disease (GVHD) is still one of the most severe complications after allogeneic stem cell transplantation and systemic steroids continue to be the standard first-line treatment.However,immunosuppressive therapy using systemic steroids produces adverse effects and their use for this purpose increases the risk of opportunistic infections,glucose intolerance,and bone demineralization.However,many of the adverse effects associated with systemic steroids can be avoided through the use of beclomethasone dipropionate (BDP),a topically active corticosteroid used in inhalation-type medicines,since it is highly metabolized in mucous membranes.In addition,BDP has a stronger anti-inflammatory action than dexamethasone and it has been reported that BDP is effective for Crohn’s disease and inflammatory bowel diseases. In this study,the authors administered BDP to a chronic GVHD patient with poor condition control.The drug was contained in gastro-resistant capsules and administered 4 times a day at a dose of 4 mg.This resulted in a temporary improvement in the inflammation in the enteric canal over a period of 75 days.There was also an improvement in the mucous membrane edema that had been observed in the intestines.In addition,none of the adverse effects usually caused by the administration of systemic steroids was observed.
The administration of Hange-shashin-to is effective in preventing diarrhea caused by irinotecan hydrochloride (CPT-11)when they are coadministered but a high incidence of constipation has been reported when CPT-11 is used in combination with anti-diarrhea drugs.As many aspects of the occurrence of constipation with the combined use of Hange-shashin-to and CPT-11 were unclear,we decided to clarify the occurrence of constipation and its relationship with the CPT-11 dosage.To do this,we retrospectively compared two treatment groups in which Hange-shashin-to had been coadministered with CPT11 at 60 mg/m2 and 48 mg/m2,respectively.The incidence of constipation was significantly higher in the group treated with CPT-11 at 60 mg/m2 and Hange-shashin-to than that treated with CPT-11 at 48 mg/m2.These results indicate that the occurrence of constipation in such combined use is correlated not only with the CPT-11 dose but also Hange-shashin-to activity.The results also suggest that interaction between Hange-shashin-to and CPT-11 is strongly associated with the occurrence of constipation.