医療薬学
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
35 巻, 9 号
選択された号の論文の10件中1~10を表示しています
一般論文
  • 兒玉 幸修, 寺田 智祐, 高橋 一栄, 矢野 育子, 乾 賢一
    2009 年 35 巻 9 号 p. 609-614
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    It has been reported that antiemetic therapy based on the guidelines produced by the National Comprehensive Cancer Network (NCCN) and American Society of Clinical Oncology (ASCO) is effective in reducing emetic risk.However,while the effect of antiemetic therapy has been much reported for the intermittent administration of anticancer drugs,there have been few reports on such therapy in the case of the daily administration of anticancer drugs.In the present study,we investigated antiemetic therapy used for the prevention of nausea and vomiting induced by the daily administration of ICE combination chemotherapy (ifosphamide,carboplatin,and etoposide : ICE group) or DeVIC combination chemotherapy (dexamethasone,etoposide,ifosphamide,and carboplatin : DeVIC group) in 30 eligible patients.All patients received 5-HT3 serotonin receptor antagonists prophylactically during the daily administration of both types of chemotherapy but no patient received such prophylactic therapy after the administration of the anticancer drugs.The incidences of nausea and vomiting during chemotherapy for the ICE group (60.0% and 46.7%,respectively) were significantly higher than that in the DeVIC group (6.7% and 0%,respectively) but the incidences were comparable in the ICE (60.0% and 26.7%,respectively) and DeVIC groups (40.0% and 13.3%,respectively) following chemotherapy.These results suggested that dexamethasone could be administered prophylactically during the daily administration of anticancer drugs and its administration should be continued for a few days after the administration of anticancer drugs.
  • 粟屋 敏雄, 長谷部 直幸, 梶野 浩樹, 石谷 麻里子, 山田 武宏, 小野 尚志, 大滝 康一, 山下 恭範, 三好 敏之, 田崎 嘉一 ...
    2009 年 35 巻 9 号 p. 615-621
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    After an overdosing incident at our hospital,we developed an upper limit alert system that checks doses of injection drugs for individual patients as the physician uses the computerized order entry system.Based on each patient’s converted body surface area (BSA),the upper limit for an injection is estimated through comparison with the standard upper limit in a patient with a BSA of 1.6 m2.This is done automatically in accordance with a compensation formula provided by our hospital’s safety committee.Standard upper limits for each injection are based on past records of actual injection dosages administered in our hospital and discussion with clinical departments.When a physician tries to enter an order for an injection at a dose over the upper limit,the computer system issues the alert“non-enterable”and the order cannot be placed.In the case of a regimen for which there is a legitimate reason for using a dose higher than the upper limit,the physician must explain this to the pharmacist who will then unlock the alert system using a secret password that he or she has designated.Passwords are only valid for one day.As far as we know,this is the first computerized injection dosage upper limit alert system in the world.
    On doing a search of our database,we found that there had been 742 overdose alerts (0.47% of all injection prescriptions) during the 3 months following its introduction.Owing to the alerts,physicians altered 155 prescriptions (21.1% of all alerts).Our computerized alert system for checking injection dosages has proved to be very necessary in ensuring medication safety.
ノート
  • 渡辺 享平, 矢野 良一, 五十嵐 敏明, 塚本 仁, 中村 敏明, 政田 幹夫
    2009 年 35 巻 9 号 p. 622-628
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    As the effect of the filling process of portable pumps on the homogeneity of drug concentrations had not been investigated,in this study,we examined the influence of the filling process of the anticancer agent 5-fluorourcil (5-FU) and saline in this respect.We used 3 types of pump and filled the pump in 3 different ways (5-FU first and then saline,saline first and then 5-FU,and mixing 5-FU and saline beforehand and then filling).There was a significant variation in the 5-FU concentration when 5-FU and saline were added separately but the drug concentration did not vary when 5-FU and saline were mixed before filling the pumps.The result also varied with the type of pump.Our findings suggested that the drug and saline were not mixed uniformly in some types of pump when 5-FU and saline were added separately.Therefore,it is important to mix the drug and saline well before filling pumps.
  • 武市 佳己, 末丸 克矢, 井門 敬子, 山下 梨沙子, 天野 学, 町田 仁, 宮岡 弘明, 池田 富士子, 大澤 春彦, 牧野 英一, ...
    2009 年 35 巻 9 号 p. 629-635
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    It has been reported that earthquakes tend to aggravate the physical and mental conditions of diabetic patients in particular due to interruption of their medication and perhaps tremendous deterioration in their living conditions as well.In this study,we conducted a survey of diabetic patients concerning their preparedness for earthquakes at three hospitals in Ehime Prefecture.The results indicated that many diabetic patients did not have a sufficient supply of emergency medicines in the event of such a disaster.In addition,many seemed to be unaware of the names of the medicines that they were taking.Based on these results and previous findings,we prepared“The Disaster Preparedness Guide for Patients with Diabetes” which includes information on medication,food,and ways of monitoring their health.The printed manual was distributed to hospitals in Ehime Prefecture and the PDF file of it was uploaded to the website of Ehime University Hospital.Afterwards,we conducted an anonymous survey of diabetic patients and medical staff concerning this material.Most respondents considered our guide to be useful for learning about disaster preparations.These findings suggest that it is necessary for medical staff to educate diabetic patients adequately concerning disaster preparations.
  • 小柳 多恵子, 溝田 忍, 西川 理, 寺才元 奈美, 蒲原 健一, 今給黎 修, 首藤 英樹, 片岡 泰文, 平川 雅章
    2009 年 35 巻 9 号 p. 636-643
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    Clinical trials are essential for the approval of new drugs and to ensure that they are performed under the highest quality control,the clinical research coordinator (CRC) should play an important role in their various processes.Although some CRC training programs have been developed for pharmacists and nurses,there are still no such practical education programs for pharmacy students,though the Model Core Curriculum for Pharmaceutical Education states that“acquiring a basic knowledge of clinical trials and a professional attitude in their practice”are required as a general instructional objective.Therefore,we performed questionnaire survey of pharmacy students concerning what they would like to learn in practical training on clinical trials and based on the results,proposed a practical clinical trials education program for pharmacy students based on the Model Core Curriculum for Pharmaceutical Education.Our program consists of two courses : a basic course and an applied course.The aims of the basic course are to gain knowledge of the essential aspects of clinical trials and learn basic management skills and those of the applied course to develop communication skills and learn how the CRC can acquire a professional attitude towards the conduct of clinical trials.
  • 森 章哉, 岩本 卓也, 三谷 英嗣, 伊藤 竜吾, 川上 恵基, 奥田 真弘, 中村 祐子
    2009 年 35 巻 9 号 p. 644-648
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    We investigated the optimum time for starting the administration of magnesium oxide for obtaining the best prevention of severe constipation due to (R-)CHOP therapy (combination therapy with cyclophosphamide,doxorubicin,vincristine (VCR),and prednisolone) with or without rituximab.Thirty-eight patients who received (R-)CHOP therapy at JA Mie Suzuka General Hospital were examined retrospectively.Use of a glycerin enema was adopted as a criterion for constipation as stated in Common Terminology Criteria for Adverse Events v 3.0 (JCOG/JSCO version).The median time for starting magnesium oxide was day 5 following administration of VCR in patients receiving glycerin enemas,which was significantly later than for patients not receiving glycerin enemas (day 1,p<0.01).In addition,the median duration of lack of bowel movement following administration of VCR in patients receiving glycerin enemas (2days) was significantly longer than that in the patients not receiving them (<1 day,p<0.01).Furthermore,patients who received magnesium oxide prior to or on the same day as VCR administration needed glycerin enemas significantly less frequently than patients who received magnesium oxide after VCR (p<0.05).
    Our results suggest that the use of magnesium oxide before (R-)CHOP therapy is beneficial in preventing the progression of constipation and should provide a useful reference for constipation care in patients receiving (R-)CHOP therapy.
  • 矢島 慶子, 保戸塚 麻里, 高橋 佳奈子, 冨ヶ原 由季, 明石 貴雄, 河合 隆, 山科 章, 木津 純子
    2009 年 35 巻 9 号 p. 649-659
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    In Western countries,low-dose aspirin has been reported to cause upper gastrointestinal complications even if it is enteric-coated.In particular,gastrointestinal bleeding due to the antiplatelet effect of low-dose aspirin can cause serious problems.In this study,we conducted upper gastrointestinal tract endoscopy to determine the occurrence of ulcers,ulcer scars and erosive lesions as upper gastrointestinal complications in patients taking enteric-coated preparations of low-dose aspirin.We also carried out a questionnaire survey on the effects of low-dose aspirin to evaluate the extent of patients' knowledge of them.
    More than half of the patients were found to have upper gastrointestinal complications and it was also noted that these patients were less aware of upper gastrointestinal complications than patients without complications.This suggests that lowdose aspirin causes upper gastrointestinal complications despite being an enteric-coated preparation,and that most patients with complications tend to lack awareness of the adverse effects of low-dose aspirin.Therefore,it is very useful for patients taking low-dose aspirin to undergo upper gastrointestinal tract endoscopy regularly to identify any complications in the early stages.It is also necessary for pharmacists to provide patients with more information to give them a better understanding of low-dose aspirin and its adverse effects.
  • -ランク付け評価法と分散構造分析を用いた解析-
    新藤 正人, 小野田 裕子, 占部 彌昌, 田中 久美子, 中島 香菜子, 岩川 精吾
    2009 年 35 巻 9 号 p. 655-661
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    We studied the effect of drug consultation provided by pharmacists on the medication adherence of 1127 inpatients (433 females,694 males) using six objective assessment terms in three rank orders.The data were analyzed based on structural equation modeling (SEM) and 2 factors were determined.One factor was the patient’s“intention to comply with medication”,and the other was“intention to understand their therapy”.Application of the path model showed that“intention to comply with medication”strongly influenced several objective assessment terms in the setting of patients taking daily medication by themselves.
    The“intention to understand their therapy”factor strongly influenced objective assessment terms for understanding the prescribed drug’s actions,knowledge of the relationship between the patient’s disease and drug therapy,and comprehension of the adverse effects of prescribed drugs.There was a moderate correlation between the patient’s interest in the prescribed drugs and the“intention to comply with medication”and“intention to understand their therapy”.
  • 下川 健一, 板橋 知子, 山崎 紀子, 日野 文男, 石井 文由
    2009 年 35 巻 9 号 p. 662-668
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    A questionnaire survey of children and their parents visiting pharmacies dispensing medical insurance-covered drugs was conducted to gain information on medication methods.It was found that mothers played a very important role in children's drug taking and their skill in getting children to take drugs was important in achieving a high compliance rate.The dosage forms that seemed to be the most difficult to take were powders and granules,partly because of their frequent prescription,followed by liquids,solutions,and syrups.The reasons for difficulty in taking drugs were“bitterness",“smell",“coarseness",“sweetness",and“large volume" in decreasing order of frequency.
    To have their children take drugs,parents rarely used a commercial jelly for facilitating medication but often gave them ice cream,yogurt,in decreasing order of frequency.The infrequent use of commercial jellies for facilitating medication was despite the fact that the flavor had been changed to one liked better by children.The results of this survey suggest that jellies for facilitating medication for children may contribute more to improving compliance if the various needs of parents for improvements can be met.
  • 武立 啓子, 高野 昭人, 廣原 正宜
    2009 年 35 巻 9 号 p. 669-675
    発行日: 2009年
    公開日: 2011/01/14
    ジャーナル フリー
    The purpose of this study was to evaluate the web-based practical training in drug information that has been used since 2006.One computer was provided per student for the training.After an introductory lecture on drug information,the first web-based practical training session was conducted,with 140 students in each class.It involved browsing major drug information-related websites and searches of medical literature.This was followed by a lecture on the evaluation and processing of drug information and web-based training with 23 students in each group.Students were required to identify drugs and suggest alternate drug presentations,draft patient information sheets,search for safety information,process it and compare it with foreign drug descriptions,search for and evaluate information using Ichushi Web,a Japanese medical database,and prepare reports.The second web-based training involved problem-based learning using a question and answer format and required a final report to be written on the entire education process.
    The web-based practical training and writing of reports was positively evaluated,with an average of 8.3±1.2 points (out of 10 points).Various comments indicating increased motivation among students were noted in the written reports,such as “I realized the high quality of websites”,“I was able to review the content of the lecture”,and“I want to continue using them”.
    Although the overall evaluation was positive,based on differences in degree of understanding among students,our findings suggest that there is a need to refine teaching methods.There is also a need to improve medical English education to help students use foreign websites.
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