液中微粒子計数器を用い, 体外循環回路に付着している微粒子(2μm以上)を測定し、その汚染状態を調べた。さらに, 洗浄フィルターを体外循環回路に組み込み充填液にて洗浄を行い, フィルターの有効性について検討した。in vitro試験において, PP3802およびH-600の5分間洗浄での微粒子除去率は, それぞれ99.3%, 68.3%であった。臨床例(10例)にて5分間の回路洗浄を行った結果, 2μm以上の微粒子は平均4287±836個/mlであった。また, 同一条件にてPP3802を用い洗浄した結果, 平均52±11個/mlで除去率は98.7%であった。以上のことより, 回路洗浄液を測定し日本薬局法の基準をはるかに超える大量の微粒子を認めた。従って, 異物による合併症を防止するため, 体外循環開始前にPP3802を用い人工心肺回路を洗浄することが望ましい。

抄録全体を表示

With the implementation of amended GPMSP (Good Post-Marketing Surveillance Practice), PMS (Post-Marketing Surveillance) has been assuming increasing importance in clinical practice. On the other hand, hospital pharmacists are in a position to acquire objective clinical information about drugs that are used in medical institutions.
We as hospital pharmacists have taken a new approach to PMS by establishing a system whereby objective and reliable information about adverse drug reactions is collected, evaluated, and distributed through direct involvement in PMS and cooperation of prescribing physicians. This communication discusses the results of operation of this system and the direction of its future operation.
In this study, clinical experience with Kaytwo N injection (launched in August 1991), a new injectable vitamin K₂ preparation free of solubilized HCO-60 which is suspected of causing shock-like symptoms, was investigated for 3 years and 3 months from January 1992 through March 1995, conducting a survey of the incidence of adverse reactions and drugs combined in use with Kaytwo N injection.
The investigation was carried out at 29 institutions, with 45 departments in participation, and information was collected from 315 patients with the cooperation of prescribing physicians. The adverse reactions reported consisted of rash, a heavy feeling in the head, and lightheadedness in 2 patients. The incidence of adverse reactions was 0.6%.
To enhance the reliability of PMS and promote appropriate use of drugs, it will become increasingly important for hospital pharmacists to actively participate in PMS and in-house clinical studies and the positioning of pharmacists in medical institutions will likewise be important.

抄録全体を表示

Yokohama City University Medical Center has employed an auto ampule dispensing system (AAD) for injectable medicines connected to a computer order entry system since 2000. AAD is able to pick up the appropriate ampules and vials according to the prescription for each inpatient's prescription. After the employing this AAD system, the opportunity for patients to inquire about prescriptions has increased.
In this study, we focused our attention on injectable medicines of H₂-receptor antagonist (H₂-B) and proton pump inhibitor (PPI) from the pharmacist's standpoint regarding the rational use of medicine.
After asking physicians about mixing problems and change to internal medicines toward physicians, the percent of these injectable medicines ordered by physicians was decreased to 50 % in a year. The percentage of patients using injectable medicines in spite of simultaneously taking internal medicin or meals decreased from 70% to 50%. The administration period of H₂-B and PPI injectable medicine also tended to decrease. The use of this new dispensing system for injectable medicines and the provision of additional information to physicians during the one year period of this study resulted in an improvement in the appropriate use of H₂-B and PPI.

抄録全体を表示