The distribution of dispensing errors occurring in hospital pharmacy was analyzed statistically. The sample distribution of the daily error rate (ie, rate of the number of dispensing errors detected daily to the number of prescriptions filled daily) could not be fully analyzed, because two peaks of the distribution were observed in the histogram. The sample distribution of the risk rate of dispensing errors (ie, rate of the recorded number of daily dispensing errors to the expected number, D) was stable as compared with the sample distribution of the daily error rate. The distribution of the error risk rate was slightly biased to the left (skewness √β₁>0) and flatter than a normal distribution (kurtosis β₂<3). In spite of the above discrepancy, the distribution of D conformed to a normal distribution in the test of goodness of fit.

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The factors in dispensing errors were studied by means of multiple regression analysis of the number of dispensing errors which occurred in outpatient's dispensing service and were detected by inspection. The data were sampled by the same inspector of dispensed medicines, not by undergraduate externs. The number of dispensing errors detected daily was used as a dependent variable and 18 items as independent variables. The sheet number of outpatient's prescriptions showed close relationship with the number of drugs prescribed for outpatients and with the number of drugs prescribed for outpatients multiplied with administration days. As a result of the analysis, the number of prescriptions filled the day of the survey and the number of interns were found to be statistically significant factors in dispensing errors in outpatient's dispensing service (multiple correlation coefficient: 0.5785). The risk rate of dispensing errors and goodness of fit to dispensing were definedon the basis of the above analysis. The risk rate tends to rise on the day after consecutive holidays and immediately after acceptance of interns, then gradually decreases thereafter.

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In the study on bioavailability of hard capsules, basic physical properties of hard capsules and their preparations were examined. Results of the study on the film and strength of hard capsules and their preparations, as well as on the relationship between the capbody joint methods of capsules and physical properties of capsules, are reported in the following. The strength was largest at the ends of both cap and body of capsules, followed by that of the side and shoulder of the cap, and then the side and shoulder of the body. The thickness was largest also at the ends of the cap and body. There was a great correlation between the thickness of the film of capsules and its strength, so far as the end of the capsules is concerned. Thanks to the recent improvement, the joint method produced only a slight effect on physical properties of capsules when the pressure is applied to the ends of the cap and body.

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Drug interactions were found in 925 (6.3%) out of 14, 575 prescriptions for outpatients filled in three months from November 1, 1976, to January 31, 1977, at Akita University Hospital. The 925 prescriptions included not a serious incompatibility but 59 prescriptions (16.3%) which turned out to have directed improper combinations and 302 (83.7%) directing combinations requiring precautions. It was found out that doctors, under agreement with prescribing physicians, were apt to administer two or more drugs concurrently without confirming the ingredients of the compounds. Even when adverse reactions occurred, the physicians were compelled to use drugs weighing beneficial effect against untoward effect, though they were aware of the interactions they carried out concurrent use of drugs expecting beneficial interactions. In order to prevent serious adverse reactions due to the drug interactions, pharmacists should keep constant communication with physicians so as to examine the drugs before they are ditributed to the patients.

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Effect of parenteral amino acid solution on erythrocytes was examined on the basis of changes in osmotic fragility of erythrocytes with a coil planet centrifuge. At the same time, morphological changes in erythrocytes were examined by a scanning electron microscope, and changes in particle distribution of erythrocytes by automatic particle counter (HIAC). Effect of parenteral amino acid solution on erythrocytes became greater in parallel with the increase in osmotic pressure of the solution, and this was confirmed by the result of scanning electron microscopy. Even when a hypertonic amino acid solution was diluted to the isotonic solution, osmotic fragility of erythrocytes was varied depending on the kind and quantity of amino acids present and the kind of sugars added. The fragility was also affected by mixing ratios of blood and amino acid solution. Sodium hydrogen sulfite added to the parenteral solution as an antioxidant was found to have no specific effect on the osmotic fragility of erythrocytes. These results indicated that the test conditions should be taken into consideration when the effect of drugs on erythrocytes is judged.

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Pharmaceutical properties of 4 kinds (A to D) of multiple digestive enzyme capsules were investigated. Weight variations of the capsules as a whole and those of gastricsoluble and enteric-soluble parts of each capsule were determined. Coefficient of variation (CV) of capsule was less than 2 % for all capsules. However, CV's of gastric-soluble part and that of enteric-soluble one for each capsule were larger than that of the whole capsule (range 2-8%); coefficients of variation of both parts of sample A were less than 4% and those of sample D were 7-8%. For 3 samples except sample A, reciprocal correlation was observed between weights of gastric-soluble part and of enteric-soluble one. Further, relationship between weight of enteric-soluble part and the activity of alkaline protease was good in any capsule, with the favorable correlation coefficient 0.9. From these results, it is suggested that weight variation should be reduced not only of whole capsule but of respective contents.

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Assay and tests on weight variation, disintegration and stability were conducted on various lots of capsules from 4 manufacturers containing 200mg of 1-(2-tetrahydrofuryl)-5-fluorouracil. 1. Contents of capsules were in conformity with the requirements self-imposed by respective manufacturers, but some products of two companies were failed to meet the requirements. 2. No great weight variation was observed among the lots of all of the four companies, except only one lot of a company. 3. All contents of capsules were stable in 1st and 2nd fluids (J. P.). Since some differences were noted in the above reported tests, the products should be examined carefully in the light of the requrements in each test.

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Changes of injectable FOY, a newly developed agent for pancreatitis, on clinically expected combination with 68 injections were studied. The estimated change was studied in indirect method, change in appearance and fluctuation of pH in direct method, residue rate in UV method, and separation and identification by thin-layer chromatography. It is suggested in indirect method that injectable FOY is an agent with high tolerance, but a change was observed when combined with 38 of the 68 injection preparations in direct method, and residual potency was decreased in combination with 41 preparations in UV method. FOY is generally stable to light and temperature changes it is also stable in acidic buffer solutions but unstable in alkaline solutions. The drug was often found to be incompatible with alkaline injections and some cephalosporin antibiotics and synthetic penicillins.

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Copper acetate solution was administered intravenously to two male infants with Menkes kinky hair syndrome at the age of 4 and 10 months, respectively. The serum copper and ceruloplasmin levels in these cases were markedly low. After copper acetate was initially given by intravenous drip in dose of 180μg/kg every other day, transient adverse reactions attributable to copper such as anemia, hematemesis and bloody stools appeared in one of the patients. These acute copper poisonings disappeared and the general condition was improved after blood transfusion was given. Then copper acetate was administered again slowly (5-6 hours) in dose of 90μg/kg every other day, but no signs of copper poisoning were observed. The serum copper and ceruloplasmin levels increased, then decreased to the normal levels 5-6 weeks after the administration. Further, the administration of copper caused activation of the movement of extremities, but brain damage was not improved.

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Annual change in bacteria detected in urinary infections and their sensitivity to antibacterial agents in 3-year drug history was studied for selection of the drugs of choice. Grampositive bacteria decreased in the 3-year period, while gram-negative organisms (mostly E. coli, Klebsiella, Proteus, P. aeruginosa, Enterobacter) increased markedly. E. coli increased resistance to AB-PC, Klebsiella to CEZ, and P. aeruginosa to GM; and E. coli, Klebsiella and Enterobacter increased sensitivity to CP. The drugs of first choice thus selected for controlling the 5 species of bacteria were: CEX, NA, CEZ and GM for E. coli; CEX, NA and CEZ for Klebsiella; CB-PC, AMK and SB-PC for P. aeruginosa; NA, TC and GM for Enterobacter. Then, sensitivity to CB-PC and SB-PC disks of P. aeruginosa and Proteus detected in the urine samples in 3 years was compared. Proteus showed no difference in sensitivity to the two agents, while P. aeruginosa was more sensitive to SB-PC than to CB-PC. It is, therefore, necessary to study the factors in the difference and to compare clinical usefulness of the two drugs.

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