Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences)
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
Volume 38, Issue 1
Displaying 1-8 of 8 articles from this issue
Regular Articles
  • Masako Yasuhara, Takeharu Yokota, Kumiko Doi, Kumiko Ishibashi, Keiko ...
    2012 Volume 38 Issue 1 Pages 1-8
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    Between April 2006 and March 2009, research into extended-spectrum β-lactamase (hereafter ESBL)-producing organisms at eight facilities in the eastern region of Hiroshima prefecture showed increases in both the number of detection and isolation rates year by year. There are also indications of a correlation between the isolation rates of ESBL-producing organisms and the antimicrobial usage density of third-generation cephem medicines. In addition, Escherichia coli accounted for 92.7% of the bacterial strains in the examination materials: urine, sputum, and stool in descending order. When the multivariate classification was analyzed after the questionnaire surveys from the eight facilities, as the isolation rates of ESBL-producing organisms exceeded 5%, it was found that more than 200 beds were provided, in addition to a bacteriological examination room, and a screening test was practiced, ICT rounds enforced, and the hospital functional evaluation had not been assessed. Through this study, it became possible to improve the detection of the ESBL-producing organisms and an opportunity was created to practice infection control at these facilities, and other neighborhood facilities based on the surveillance data. It is thought that the approach that was applied is necessary for prevention and infection control in district facilities in the future.
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  • Miho Utsumi, Yuichiro Sato, Yumiko Yamaoka
    2012 Volume 38 Issue 1 Pages 9-17
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    Pharmacists who will graduate from the 6-year program are expected to have more clinical ability than those who graduate from the 4-year program. In 2008, the Japanese Society of Hospital Pharmacists designed a plan, “New development of the expanded pharmacist's practices”. In some medical facilities and educational facilities some pharmacists and pharmacy students are performing new clinical practices even though the practices are not clarified in existing medical law.
    So far, medical law has indicated the roles of pharmacists as only “dispensing drugs”. We should reconsider whether the concept of “dispensing drugs” includes some part of medical practices and how pharmacists should develop their expanded roles practically. We must discuss them concretely including the revision and the interpretation of the existing medical law.
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  • Yoko Watanabe, Hiroki Sato, Toshiya Minagawa, Ryota Tsukioka, Yasuhiro ...
    2012 Volume 38 Issue 1 Pages 18-24
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    In addition to promoting the reduction of medical costs, safety management for medication, such as the prevention of dispensing errors and dosing errors by patients, is also an important role of pharmacists in generic drug dispensing. While the similarity in appearance of press-through-package (PTP) drug products is known to have a significant influence on safety management for medication, none of the previous generic drug studies has focused on this issue. The objectives of this study were to evaluate the influence of the similarity in appearance of PTP packaging between original and generic drug products on safety management for medication, and to discuss preventative approaches. We first analyzed the risk of dispensing errors made by pharmacists working for community pharmacies and found that approximately 80% of responders had experienced near-miss episodes. Then, a similar analysis was conducted to determine the risk of dosing errors made by patients in their medication process and it was found that approximately 14% of patients had experienced episodes that could have led to misdosing due to packaging similarity. Furthermore, we also evaluated the similarity in PTP packaging of 1327 original and 1137 generic drug products and found that approximately 3% of all products (37 combinations) were considered to have a similar packaging appearance. These included high-risk drugs, such as digoxin and oral antidiabetics. We believe that an effective approach for reducing these risks is to promote information-sharing by listing those original and generic drug products that have similar PTP packaging appearance.
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  • Noriko Ishida, Tatsuya Ono, Yasuko Morimoto, Shogo Tokuyama, Hideyuki ...
    2012 Volume 38 Issue 1 Pages 25-33
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    A smoking cessation section for outpatients with the aid of champix® (varenicline) was started in this hospital in March, 2010. Here we present the outline of the support system which was directed by pharmacists mainly, and established in cooperation with many staff members. We also discuss the factors that led to patient success in smoking cessation.
    The results showed that the cases of advanced age found it easy to stop smoking. And, about 70% of the patients who achieved to stop smoking hammered it into them that they do stop smoking, in contrast, anyone who had failed in the smoking cessation did it. This result suggests that the patients who failed held unrealistic expectations of the efficacy of the medicine. Thus, such patients must be informed about the necessity of will power. In the failed group, 71.4% lived in the vicinity of smokers, compared to 11.8% in the successful group, suggesting the considerable influence of surrounding smokers in the difficulty to stop smoking.
    In conclusion, in our guidance for smoking cessation, a more frequent and active approach is required by younger smokers. And we have to inform them that will power is more important than relying solely on the medicine to work. Because of the probability of surrounding smokers inducing failure in smoking cessation, it is also necessary to request surrounding people such as family or coworkers to cooperate with the applicant. The treatment for smoking cessation is one element in the smoking cessation service, and pharmacists should render many other services to the treatment.
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Notes
  • —Preparation of Injections in the Operation Room—
    Joe Yamamoto, Toshio Awaya, Kaori Koshiro, Makiko Morita, Saki Kawamor ...
    2012 Volume 38 Issue 1 Pages 34-42
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    Shortage of physicians is a serious social issue in Japan. It has become an urgent challenge to support busy physicians. While the number of anesthetists is remarkably insufficient, the number of operations has increased in many hospitals after Diagnosis Procedure Combination (DPC) is implemented. Drugs used in operation rooms include many narcotic analgesic and poisonous drugs, which medical staff are required to strictly control. From the viewpoint of medical safety management, pharmacists should be involved in the management of these drugs. We have started preparation of injections in the operation rooms aiming mainly at supporting anesthetists. Pharmacists make up the anesthetic sets according to anesthetists' order by the evening of the previous day. The pharmacists carry the sets from the pharmacy to the operation room on a wagon. On the early morning of the operation day, two pharmacists mix the injection drugs, fill the syringes, attach the labels, assemble the routes, and check the completed sets in each operating room according to the list. All pharmacists in our pharmacy department engage in this service. We have conducted opinion surveys of pharmacists and anesthetists on this service. Although the workload of pharmacists increased, most pharmacists thought it was worthwhile. Most anesthetists evaluated that this service has improved medical safety. However, there were many requests that the pharmacists should be further involved throughout the entire operation. It is important to support physicians with services such as this by the pharmacist based on pharmaceutical knowledge. This service has a beneficial impact on healthcare professionals.
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  • Shinichiro Suzuki, Masayoshi Koinuma, Tsuyoshi Hoshino, Takashi Kawagu ...
    2012 Volume 38 Issue 1 Pages 43-50
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    Many patients have to discontinue treatment with pegylated interferon ribavirin (PEG-IFNα-2b/RBV) combination therapy due to haematological side effects such as thrombocytopenia after the start of combination therapy, and the drop in sustained virological response rates due to the cessation of therapy is problematic. The present study, therefore, examined 121 hepatitis C patients who underwent PEG-IFNα-2b/RBV combination therapy at Nihon University Itabashi Hospital from April 2003 to March 2009, fitted them into a multiple regression model with the lowest platelet level up to 3 weeks after the start of treatment as the objective variable and patient demographics before the start of treatment as the explanatory variable, and prepared a predictive model of the lowest platelet level. Using this, a predictive model of the lowest platelet level (R2 = 0.70, p <0.0001) was prepared for (1) the dose of PEG-IFNα-2b (μg/kg) per 1 kg of body weight, (2) platelet count (×109/L), and (3) ALP (IU/L) as a variable. This predictive model is not only expected to make it easier to avoid treatment discontinuation, but also to call attention to any hemorrhagic tendency early on and allow measures to be taken, and should lead to qualitative improvement in treatment.
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  • Takayuki Osada, Yoshihiko Shibayama, Masayoshi Kumai, Takehiro Yamada, ...
    2012 Volume 38 Issue 1 Pages 51-55
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    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.
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  • Takako Kurokata, Tomofumi Okamura, Hirofumi Yamasaki, Takehiko Ogawa, ...
    2012 Volume 38 Issue 1 Pages 56-60
    Published: January 10, 2012
    Released on J-STAGE: January 10, 2013
    JOURNAL FREE ACCESS
    For preparation using an infuser pump, the use of a filter is recommended on package inserts. However, there are no concrete data on the necessity of the outside filters. Therefore, we compared the number of particles in the preparation fluid in the infuser pump with and without using a filter. Particles with a diameter of 1.3-100 μm were counted using a light blockage particle counter KL-04 (Rion K.K., Tokyo, Japan). Without using a filter, the mean numbers of particles with diameters of 1.3-5, 5-10, and > 10 μm were 187.4 ± 76.6, 6 ± 3.3, and 1 ± 1, respectively. Using a filter, the mean numbers of particles with diameters of 1.3-5, 5-10, and > 10 μm were 12.4 ± 4.2, 1.2 ± 0.8, and 0.2 ± 0.4, showing decreases in each particle size range including significant decreases in particles with diameters of 1.3-5 and 5-10 μm. The preparation using the outside filter was necessary for removing contaminating particles.
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