Analysis of the Risk of Injection Incompatibilities in the ICU and Pharmacistsʼ Contribution toward Avoiding Such Incompatibilities / 医薬品情報学

Objective: Avoiding injection incompatibilities is important. At our hospital, pharmacists are present at the intensive care unit (ICU),where they manage drip lines and use a lookup table for injection incompatibilities. We assessed the risk of injection incompatibilities in the ICU and the contribution of pharmacists toward their avoidance.Methods: We investigated the number of injections and main drip lines used for outpatients admitted to the general ward and ICU from an emergency setting. We further investigated inappropriate drip line conditions, subsequent interventions by pharmacists, and the actual number of injection incompatibilities. The investigation period lasted 1 year from April 2016 onward.Results: The number of injections and drip lines used in the ICU was significantly higher than that used in the general ward (p<0.001). Patients in the ICU received multiple continuous intravenous injections from one drip line despite the number of main drip lines being high. Even using the lookup table, 78.3% inquiries made by nurses were related to injection incompatibilities. Fourteen inappropriate drip lines selected by nurses were associated with a risk of injection incompatibility; these occurred during the absence of pharmacists and involved a combination of continuous intravenous injections to be administered from a side line. Subsequently,pharmacists intervened and avoided injection incompatibilities. There was no report of injection incompatibilities in the ICU.Conclusion: At ICU, the risk of injection incompatibilities is high and it is necessary to focus on the combination of injections to be administered from main drip lines and side lines as well as incompatibilities of multiple continuous intravenous injections to be administered from side lines. A lookup table is insufficient to avoid injection incompatibilities. Therefore, pharmacists can contribute to avoiding injection incompatibilities by maintaining constant presence in the ICU, designing drip line layouts, and proposing line selections.

Light Stability of Cyclosporin Fine Granules after Packaging / 医薬品情報学

<b>Objective: </b>The objective of this study was to clarify the light stability of cyclosporin fine granules 17%?? Mylan ??(CsA-FG) after packaging by a dividing and packing machine.<br><b>Methods: </b>CsA-FG packaged within cellophane-laminate paper was stored under three different covering conditions: (stored uncovered, in a medicine bag, or in a light shielding bag).  In these covering conditions, we examined changes in the residual rate and elution pattern of CsA for up to 12 weeks in the differently covered samples stored at room temperature under fluorescent lighting.<br><b>Results: </b>Under the light exposure condition, the residual rate decreased with time and fell below 95 percent at 12th week.  Although a slight decline in the residual rate was observed in samples stored in the medicine bag at 12th week, the rate was less than 5%.  On the other hand, no change in the residual rate was observed for samples stored in the light shielding bag storage for up to 12 weeks.  There was no change in the elution pattern of CsA in any group, except the decline in the elution rate caused as the resulting from the decline in the residual rate.<br><b>Conclusion: </b>In this study, we have clarified that the packaged CsA-FG covered by stored in a medicine bag or light shielding bag is stable for up to 12 weeks under normal storage conditions.  However, CsA-FG should be stored in a light shielding bag or undergo the split dispensation, if it’s stored in a more severe lighting condition and/or if it is to be stored for more than three months.

An immediately accessible database for information regarding ingestion timing and maximum dose setting: Development and applications to address inquiries to clarify doubts concerning prescription / 医薬品情報学

<b>Objective: </b>Optimizing the time of ingestion and avoiding overdose are important aspects of medication therapy.  However, seeking explanations for selecting the time of ingestion and maximum dose for a certain drug is time consuming.  The aim of this study is to develop a database (DB) that enables a rapid search of the basis for the time of ingestion and maximum dose setting.<br><b>Methods: </b>The basis for the time of ingestion and maximum dose setting were surveyed for 38 and 184 drugs, respectively.  Package inserts, interview forms, and other documents preserved in our department were surveyed, and this was followed by an inquiry of the staff of pharmaceutical companies.  Standard responses to a prescription with incorrect timing or dosage were determined and included into a DB together with information whose quality was dissected.  The efficiency of DB was evaluated: the time taken to obtain information and consistency of inquiries to clarify doubts concerning prescription with the use of DB and without the use DB were compared.<br><b>Results: </b>The information of newer drugs, but not of the older drugs, were easily obtained without the need to inquire the staff of the pharmaceutical companies.  Operation of the DB was convenient and was acceptable for most pharmacists working in our department.  The DB markedly reduced the time taken to obtain information.  Further, with the aid of DB, the consistency in the responses to inquiries to clarify doubts concerning a pharmacist’s recommendation was remarkably increased.<br><b>Conclusion: </b>The DB developed in the present study may contribute to the improvement of not only the efficiency but also the quality of dispensation.

The ideal focus of the study in the drug information sciences / 医薬品情報学

  In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics.  To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers.  Therefore, at the 11^th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents.  The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”.  Related problems raised are the shortness of the history and lack of originality in the study.  From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided.  Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.