Adsorption characteristics of creatinine by activated carbon beads consisting of about 67% activated carbon powder in ager were studied in vitro and compared with those of Kremezine^® from the standpoint of usefulness for sequestering uremic wastes and uremic toxins exsorbed into the intestine. The extent and rate of creatinine adsorption on carbon in the beads were almost equal to those of the naked powder, and the preparation also demonstrated a similar adsorption behavior for creatinine as compared with Kremezin under the conditions of the presence of various ionic and nonionic additives. Furthermore, uremic peaks 2a and 2b on HPLC specific to chronic renal failure were readiy eliminated by the treatment of the beads in the uremic plasma. On the other hand, although the adsorption capacities of Kremezin for drugs were generally equal to those of medical carbon, the adsorption rate by Kremezin was smaller, but inferiority was not so serious as to make Kremezin useless as an oral antidote in acute intoxications brought on by drugs.

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The beads-thimble filter (B-TF) method was investigated in an effort to develop a useful release test method applicable via suppository in vitro. The progesterone suppository which is used for replacement therapy for sterility and infertility resulting from luteal defect was chosen as the model suppository. The time required for a 16% release for the B-TF method was half of that for the rotatory cell method and a quarter of that for the Muranishi method.
When the suppositories were administered to rectum of rabbit, the profile of drug concentration in plasma was similar to the drug release profiles in vitro. The influence of two factors, number of beads and rotating speed, on the release pattern was examined in line with the composite experimental design. The release parameters were predicted by second-order polynomial regression equation.
The results suggest the usefulness of the B-TF method as in vitro suppository release test method.

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Five population parameter sets for intermittent intravenous drip infusion of vancomycin (VCM) were evaluated retrospectively to assess the effect of those on the predictive performance of the Bayesian method employing two measurements of one hour after the end of infusion and within 15 minutes of dose initiation (trough) in predicting plasma VCM concentration. Population mean values studied were taken from the literature of Moellering et al.(I), Matzke et al.(II), Uaamnuichai et al.(III), Grasela et al.(IV), and Burton et al.(V).
Root mean squared errors (RMSEs) as a composite measure of bias and precision were 8.16, 8. 38, 8.42, 7.95 and 8. 00μg/ml in predicting the one-hour plasma concentration after the end of infusion, and were 5.04, 5. 53, 5. 32, 5. 18 and 5. 83 μg/ml in predicting the trough plasmaconcentration for the method using Is, Ills, IVs and Vs, respectively. The mean prediction error (ME) as a measure of bias demonstrated that the predictive performance of the Bayesian method in predicting trough plasma concentration underpredicted the measured concentration significantly.
On reevaluation of Grasela's parameters in patients with different degrees of renal function, the predictive performances of the Bayesian method were more precise than those available by population parameter. The predictive performance of the Bayesian method employing two measurements using Grasela's parameters is concluded to be clinically acceptable.

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5'-Deoxy-5-Fluorouridine (5'-DFUR) ointment was prepared for local chemotherapy application to inoperable breast cancer. Polyethyleneglycol-4000, ammoniumpolyacrylate and hydroxypropylcellulose-H were employed to prepare the ointment base. 1-Dodecylazacycloheptan-2-one (Azone) was added to 5'-DFUR ointment as an absorption promoter. The spreadability of the ointment was only slightly changed by Azone addition.
Azone was dispersed well in the ointment when the concentration was 1%. 5'-DFUR in mouse skin and intestine were analyzed after the application of ointment and oral administration of 5'-DFUR solution. The AUC_0-6 value observed with 5'-DFUR ointment containing 1% Azone was seven times greater than without Azone.
Application of Azone-5'-DFUR ointment significantly lowered the levels of 5'-DFUR in plasma and intestinal tissues over those of the oral administration of 5'-DFUR solution. Furthermore, no change occurred in histopathological findings of mouse skin following ointment application.
These results suggest that the addition of Azone in 5'-DFUR ointment may provide a better therapeutic effect in the local chemotherapy treatment of breast cancer.

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In an attempt to construct the rational use of suppositories, we developed an experimental method for the discharge of suppositories from rabbit rectum, and investigated the change of the pharmacokinetic behavior of the drug subsequent to discharge. Acetaminophen (ACA) was chosen as the model drug. The plasma concentration of ACA reached the maximum (Cmax: 25 μg/ml) at 17 minutes after rectal administration of one commercially available suppository containing 100mg of ACA. When the suppository was discharged from the rectum at 1 and 3 minutes after insertion using the pre-inserted device, the C_max decreased markedly (4.5 and 11 μg/ml, respectively). However, the plasma concentration of ACA still increased even after discharge at 1 or 3 minutes after insertion, with their times required to reach the peak concentration being 7 and 9 minutes, respectively.
Developed for the pharmacokinetic analysis of the plasma concentration after the discharge of suppository from the rectum was a pharmacokinetic model involving the assumption that only the undissolved portion (solid) of the suppository was discharged from the rectum and the dissolved portion (solution) remained. Consequently, the observed plasma concentrations well coincided with the predicted values.
In conclusion, the experimental method employing the device for the artificial discharge of the suppository from the rectum should be a useful model for depicting suppository discharge from the rectum. Accordingly, the drug remaining in the rectum (dissolved portion) following the discharge of suppositories from the rectum should be considered.

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We reviewed the handwashing procedures and disinfectants used to prevent nosocomial infections. Povidone iodine, chlorhexidine gluconate and benzalkonium chloride-ethanol are routinely used for hygienic handwashing in Tokai University Hospital. The cost of the disinfectants has increased 2.2 times during the last 5 years.
According to a survey of nurses in the Plastic Surgery Department, they used these disinfectants to wash their hands before changing patients' dressings. In other instances, the nurses generally used soap. Accordingly, the hands of 80% of these nurses have become roughened from frequent washing.
In addition, our investigation of the bacteria remaining on the hands of the nurses after washing revealed that a large number of skin bacteria (103) were present even after thorough washing with disinfectants.

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This survey was designed to study the recent trend in hypnotics for outpatients and their response after changing the triazolam tablet dosage from 0.25mg to 0.125mg. One hundred and seventy-one outpatients suffering from sleep disturbances participated in this survey, of whom seventy-four were male with a mean age of 67.5 years (range of 32-90 years), and ninety-seven were female with a mean age of 66.9 years (range of 34-89 years). The hypnotics prescribed were: triazolam, zopiclone, estazolam, brotizolam, nitrazepam, flunitrazepam and flurazepam hydrochloride.
Of 91 subjects in the triazolam group, 37 were male and 54 were female. The same interviewer asked about their impression after taking 0.125mg tablets at the dispensing counter. Although all 91 subjects were initially recruited into this survey, 17 were omitted. Of these 17, eight started taking hypnotics after changing the triazolam tablet from 0.25mg to 0.125 mg, and nine did not take them at all. Thus, 74 subjects in the triazolam group were considered in the survey analysis. Of the 74, 62 were prescribed half doses, 11 equal doses, and only one female multiplied her dose in comparison with the formerly prescribed dose. Of these 74, 55 showed good responses and they did not express any different feeling between the two kinds of tablets. However, 19 did not receive any hyptonic effect after taking the 0.125 mg trazolam tablet. The interviewer explained the instructions for taking the medication and the side effect of hyptonics to all of hyptonics to all of them and recommend to some that they consult their doctor. Subsequently, however, he received no information of their reactions to their medication.

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The bioavailability of phenytoin is well known to be dependent on the dosage forms as is the fact that ground tablets of phenytoin are often ordered instead of the powdered form in doctorwritten prescriptions. Studied in the present study was weight loss of the drug resulting from the dispensing process and adherence to the package.
Used as model forms were three dosage forms of phenytoin: ground tablets, fine granules and powder. Simulative dispensing was performed using the conventional method in which tablets were ground with excipients, mixed with a mortar and pestle, and divided and packaged employing two kinds of packaging machines for dispensing.
The extent of total weight in loss was dependent neither on the types of packaging machines, nor on the dosage forms of phenytoin except for ground tablets. For ground tablets, a large weight loss was observed in the dispensing process, with this phenomenon being caused by splashing in the packaging process. Observed with fine granules and powder was a small weight loss relative to the dispensing process and a large one involving adherence to the package. The total loss in dispensing and package adherence was found to be 6% regardless of the phenytoin dosage form.
We conclude that fine granules in the powdered form of phenytoin are the most suitable dosage form because of the compositis equivalent bioavailability to the tablet form and its only slight loss in weight during the dispensing process.

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In the present study, blood concentrations of iohexol were measured in hemodialysis patients and in subjects with renal dysfunction in order to determine the hemodynamic and dialytic features of iohexol. Adverse reactions to the agent were also investigated.
The subjects were six inpatients, including three hemodialysis patients with mild-to-moderate renal dysfunction, who were given iohexol at our hospital. Iohexol concentrations in serum and dialysate were measured using HPLC. The T_1/2 in hemodialysis patients was 78.81±43.83 hr in the γ phase and 2.41±1.27 hr during hemodialysis. The elimination rate was 59.4±8.3% and the clearance rate was 98.8±25.3 ml/min 2 hr after the start of hemodialysis. No adverse reactions were observed in the hemodialysis patients.

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The prescription entry systen which runs on the ACOS system 3600/6 “ORDERING” (NECCorporation) was implemented on January 4, 1992 for outpatients and on September 1, 1993 for inpatients of Kanazawa University Hospital.
Six decision-making support functions were added to the system: verifying prescription overlap (1) and clinically significant drug interactions (2), warning of new-entry and important adverse reactions (3), supplying information on patients' drug-allergies (4), automatic calculating of pediatric dosage (5) and providing of drug information (6). In addition, four printing functions on prescription sheet were introduced to support the dispensing process, which includes information on patients' other prescriptions and changes or modifications in medication orders.
In particular, the two functions of verifying the prescription overlap and clinically significant drug interactions are decision-making supportable and are expected to be effective in preventing overdosing and dangerous adverse reactions.

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Most hospitals provide their staff members with drug information in printed form. This method is inefficient and causes problems when frequent updating is essential. In order to rectify this problem, we developed a drug information query system (DIQS) in out hospital Pharmacy Division based on the Formulary of Osaka Medical College Hospital. The DIQS allows anyone at a work station to have immediate access to our database management system (DBMS) operable through Osaka Medical College's local area network (LAN).
The DIQS accepts multiple platforms and provides useres with real-time accession to the most updated drug information using a simple operational procedure.

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When administering aminoglycoside antibiotics (AMGs), it is widely known that an individualized dosage regimen based on both measured serum concentrations and patient-specific pharmacokinetic parameters is essential to achieve desirable serum concentrations. The dosage regimen with AMG based on clinical pharmacokinetics, however, required a number of steps which involve a complicated set of calculations.
We thus developed an AMG consultation support program for the purpose of applying it to routine practices. This program can readily estimate that pharmacokinetic parameters of each patient and can predict the peak and trough concentrations at a steady state. The program comprises three separate methods: the Sawchuk-Zaske dosing method, modified Sawchuk-Zaske dosing method and Dettli method. This enables a user to select one of them according to the routine clinical situation at hand.
We believe that the system offers substantial support for effective and safe treatment of AMGs.

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Since a great many microorganisms (10³) were detected on the hands of nurses who used disinfectants for hygienic washing, we developed a 30-second handwashing-warning chime (scrub timer) to aid in the progreesive reduction of resident skin bacteria by disinfection. Setting the scrub timer on the dispenser of the disinfectant (povidone iodine), enables a sound to be emitted when the handwashing dispenser is pushed.
In the Plastic Surgery Department, the nurses can maintain constant contact with disinfectants for 30 seconds using the scrub timer, which serves to decrease the amount of resident hand bacteria (10²) following disinfectant use more so than if the scrub timer was not used.
Using the scrub timer was concluded to be effective for handwashing with disinfectants.

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