The change in the adsorption to infusion sets, the adsorption ratio and the recovery ratio of recombinant human granulocyte-colony stimulating factor (G-CSF) were investigated in vitro by administering a continuous intravenous infusion of G-CSF.
After 250μg of G-CSF (nartograstim) preparation was dissolved with 100 ml of sterile saline in a commercially produced polypropylene container, operating the pump (8 ml per hrs), the G-CSF levels in the container, in the upper part of the final filter, in the lower part of the final filter, and in the collecting vessels, were determined by enzyme-linked immunosorbent assay (ELISA) for GCSF at various time (0, 0.5, 1, 1. 5, 2, 3, 6, and 10 hrs)
In the first day's experiment, that is, using a new infusion set (container, line and filters), the GCSF levels in the upper and lower part of filter and in the collecting vessels were very low during to 0.5 to 1.5 hrs after operating. However their levels roughly recovered until the container's during 3 to 6 hrs. A marked adsorption of G-CSF was also observed not only into the container and filters but also into the line. Notably the recovery of G-CSF was improved in the second day's experiment.
It is necessary for physicians to give consideration to these adsorptions and to the loss of G-CSF when a small amount of G-CSF is dissolved for treatment by continuous intravenous infusion.

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In ascertain the mechanism of the sorption of isosorbide dinitrate (ISDN) from the solution to the ethylene-vinylacetate copolymer (EVA) membrane, we investigated the permeation of ISDN through an EVA membrane, using a membrane permeation apparatus.
The partition coefficient between the EVA membrane and water was constant around 6.3 and was not affected by temperature. It was observed that the permeation-time curve of ISDN through the EVA membrane was straight from the 4 to 7-day period, and that the amount of ISDN permeated was proportional to the time.
The permeation of ISDN through the EVA membrane could be analyzed by means of a distribution-diffusion model, which provided us with a method for precisely calculating Pi, a membrane permeation coefficient. Pi depends on temperature, such that as temperature rises, it increases. For example, it increased from 7.37×10^-5 (cm²·h^-1) at 25°C to 1.73×10^-4 (cm²·h^-1) at 35°C.

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Using the commercial application software called “KIRI” and our original Text-compile software, We succeeded in constructing a database system for the date automatically obtained from SUNET Q & A. This enable us to easily use the SUNET Q & A date on a personal computer, and to publish the DI-NEWS quickly.

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We have impression that the insurance reimbursement program for handling in-patient care services offered by hospital pharmacists in Japan has been established as an important routine work.
Accrdingly, we felt the need to understand clearly the doctors' requirements regarding clinical pharmacy services offered in Hirosaki University Hospital. We therefore made a survey to assess the doctors' idea for clinical pharmacy services in our hospital because we recognized that they should be smoothly introduced in our hospital. Of 259 questionnaires distributed to doctors in Hirosaki University, usable responese of 65.6 % were returned. Although almost all doctors (85.3%) were unaware of the insurance reimbursement program system in Japan, nearly all of them (99.4%) recognized the necessity of providing medicational instruction concerning drug therapy. Almost all doctors (79.9%) thought that the clinical pharmacy services offered by pharmacists were needed for effective clinical drug therapy whereas 20.1 % of them responded that they were unnecessary. Obtaining information on the adverse effects of drugs and on drug interactions constituted the most important request for the clinical pharmacy services from our hospital doctors. From the results of our survey, it was found that almost all of our hospital doctors had their comprehenision of clinical pharmacy services offered by pharmacists.

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We have impression that the insurance reimbursement program for handling in-patient care services prepared by hospital phamacists in Japan has been established as an important routine work. Accordingly, we felt the need to understand clearly the nurses' requirements regarding clinical pharmacy services offered in Hirosaki University Hospital. We therefore made a survey to assess the nurses' idea for clinical pharmacy services in our hospital because we recognized that they should be smoothly introduced in our hospital. Of 363 questionnairs distributed to nurses in Hirosaki University, usable responses of 90.0% were returned. Although almost all nurses (94.4%) were unaware of the insurance reimbursement program system prepared by hospital pharmacists in Japan, nearly all of them (98.5%) recognized the necessity of providing medicational instruction concerning drug therapy. Almost all nurses (78.0%) thought that the clinical pharmacy services offered by pharmacists were needed for effective clinical drug therapy whereas 22.0% of them responded that they were unnecessary. About half nurses in our hospital had expectation or uneasiness about the clinical pharmacy services offered by pharmacists.

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Concurrently with a revision in the format of prescription orders and the construction and introduction of an outpatient ordering system, we examined a number of ways to provide patients with information about their prescriptions. We decided to introduce a “prescription card” containing the information printed on the prescription order. To evaluate the effectiveness of this program, which enables patients to track their own drug histories, we conducted surveys of patients and physicians.
The surveys were carried out in four stages. Patient surveys were carried out through personal interviews at the Pharmacy Department counter between the hours of 10: 00 a.m. and 4: 00 p.m. The results showed that 56% of all patients surveyed were being treated by several departments or at other institutions. With respect to what patients did with their prescription cards, the percentage of respondents who said that they saved the cards in “okusuri techo” was about 30%(103 patients) in the first stage, about 10%(162 patients) in the second stage, and about 40%(297 patients) in the third stage. However, about 10% of patients in all three stages said that they discarded their prescription cards. The percentage of patients who said that they showed their cards to their physicians or pharmacists was about 40% in the first stage, about 80% in the second stage, and about 50% in the third stage. These results show that further education is needed to instruct patients in the benefits provided by their prescription cards.
In the survey of physicians, almost all respondents (66 physicians) answered that the prescription cards were effective and beneficial. However, some responses pointed out limits to their effectiveness, for example, cases in which patients did not show their cards to physicians at other institutions because they did not want it to be known that they were receiving psychological care.
In the fourth stage of the survey, carried out eight months after the prescription card program was introduced, responses were obtained from 1, 195 patients. About 41% said that they saved their prescription cards in a notebook, and of those about 40% said they showed the cards to their physicians.
The provision of drug information to patients through the prescription card program constitutes the first step toward a system that will enable patients to track their own drug histories and to participate in their own drug treatment. Comprehensive menagement of drug information by patients themselves may contribute to improved drug therapy through the prevention of overprescriptions and mutual side effects.

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Theophylline clearance was investigated to compare patient compliance in 136 hospitalized children administered theophylline preparations for asthma or asthmatic bronchitis. The subjects were divided into four groups, that is, administered durable intravenous of theophylline intravenously group (DIV group), sustained-release theophylline granules group (Gr group), sustained-release theophylline syrup group (Syr group), and sustained-release theophylline tablet (Tab group). No differences were observed in the mean clearance between DIV, Gr, and Tab groups in children over 3 years old. However, the mean clearances of the Gr and Syr groups were increased over that of the DIV group in children less than 2 years old. Especially, the dispersion in the Syr group was increased significantly over that in the DIV group. Moreover, the dispersion of the weight of a dose taken by disposable syringe from sustained-release theophylline syrup was studied to investigate the reason why the dispersion of the clearance in Syr group was remarkably increased. Results conformed the dispersion to be markedly large. These results suggested that the mean clearance and dispersion of the Syr group were significantly increased because the dispersion was large when the syrup was taken as a dose.

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We developed an automated injection dispensing machine to minimize pharmacist's involvement in the dispensing of injections, and evaluated its performance. The machine was constructed of four units: tray stocker unit, main unit in which the ampules and vials for each patient are automatically dropped into trays and the patient's name is labeled on the tray, the stock unit of dispensed trays, and the verification unit. The machine was evaluated by measuring the speed and the number of problem arising with each unit.
The time necessary to prepare each unit was 50-90 seconds and to set up each tray was about 90 seconds. During use in experiment (300-800 per unit), we encountered no problem. We considered the automated injection dispensing machine to offer new opportunities for clinical involvement by pharmacists.

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For applying the commercial database software “Tomoko's Information” to the area of Pharmaceutical Management and Counseling Services, we programmed several brands of support softwares. This software the easy inputs of basic information and histories of prescription and counseling, and for the output of a monthly report, as well as other aspects.

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Cherry bark extract oral liquid preparations are widely used. These preparation are obtained by adding senega syrup, apricot kernel water, and water to cherry bark extract (Brocin^®) We investigated microbial contamination in the residual fluid after patients had taken cherry bark extract oral liquid preparations. Of 29 examined samples, 15 (52%) showed microbial contamination with a viabie count >20 CFU/ml. The viable count level was 10⁴-10⁵CFU/ml in three samples (10%), 10³CFU/ml in one (4%), and 10-10² CFU/ml in 11 (38%). To prevent microbial contamination in these preparations, it is necessary to avoid the use of the method in which water is added to obtain a daily liquid preparation volume of 100 ml. Specifically, the addition of water should be avoided, or the water volume should be decreased to obtain a daily liquid preparation volume of 20-40 ml.

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Employing Macintosh application software, we created a systematic method for recording compliance sheet data. This new method improved the quality of patient care services, such that after entering the date, the patient is provided with a through knowledge of the prescription, even if varied use is indicated. The method also remarkably reduces the amount of paperwork required by the pharmacist and administrative staff since the personal computer is programmed to accomplish these tasks.

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Two concentrated electrolyte injections (solution A and B) were used for the rapid and easy preparation of artificial cerebrospinal fluid (ACF). Solution A (10 ml) included Na, K, Mg, Ca, Cl, lactate, and glucose while solution B (20 ml) was composed of KH₂ PO₄ and NaHCO₃. Solution A was first added to 0, 9% NaCl in jection (515 ml) maintained in a soft plastic bag followed by solution B. Notably, the prepared ACF had particulate matter counts far less than the Japanese pharmacopoeia (JP) and United States Pharmacopeia (USP) limits for large volume injections. Application of the present ACF to patients using a ventricular fiberscope caused no significant adverse effects, such as convulsion, headaches or fever.

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