Construction of Anti-Doping Database for Pharmacist / 医薬品情報学

<b>Objective: </b>The sports community has placed its great hope on pharmacist since the establishment of the Accredited Sports Pharmacist System.  Thus, we constructed an anti-doping database for pharmacist so that pharmacist can support appropriate drug use and contribute to the sports community.<br><b>Methods: </b>The database was constructed by using Microsoft®Access 2007, based on our previously prepared anti-doping list.<br><b>Results: </b>686 prescription drugs and 268 ingredients for non-prescription drug were registered in the data base.  It was able to retrieve the advisability of use for athlete, blood half-life and the other notes of the drugs easily and promptly.<br><b>Conclusion: </b>We confirm that pharmacist can provide drug information easily, promptly and from the viewpoint of pharmaceutics by utilizing the database including necessary information for anti-doping.

A Study on the Consistency of Contraindicated Combinations in Medical Pharmaceuticals / 医薬品情報学

<b>Objective</b>: We studied whether the statements made in the “contradicted combinations” package inserts for medications used at the Kitasato Institute Hospital, Kitasato University (henceforth, “the hospital”) and the combinations of medications listed were consistent.<br><b>Methods</b>: We studied whether both the “contraindicated combinations” in the package insert and the listed combinations were consistent, and when they were not, we telephoned the pharmaceutical company that did not list it as a “contraindicated combination” and inquired as to the reason it was not listed as such.<br><b>Results</b>: 1,347 pharmaceutical products were the target of this study, and among these there were 147 products that had contraindicated combinations listed in its package insert, and there were 239 combinations of contraindicated combinations.  Among the 147 products, most were cardiovascular drugs (40 drugs, 27.2%), followed by central nervous system drugs (30 drugs, 20.4%).  Among the 239 combinations, there were 47 (19.7%) combinations that were inconsistent, and the reasons for the inconsistency were 1) because they would become unusable in the event of an emergency, 2) because there are no safety issues, etc.<br><b>Conclusion</b>: In this study, it was clear that pharmaceuticals that are inconsistent in their contraindicated drug combinations are by no means few in number.  A lack of uniformity in what is listed in the package insert regarding contraindicated combinations, which is a public document, is not something to be at all desired, and we believe it is necessary to create consistency by clarifying the standards for listing contraindicated combinations in order to avoid confusion in clinical settings in the future.

Creation of a Guidebook for the Use of Antimicrobials In-Hospital and Its Assessment / 医薬品情報学

<b>Objective</b>: At Kitasato Institute Hospital, Kitasato University (henceforth, the hospital), the first edition of an antimicrobial use guidebook (henceforth, the guidebook) was produced in 2000.  This time, the Pharmaceutical Department’s members on the hospital’s Infection Control Committee (ICC) took the lead and revised the guidebook so that it better conforms to clinical conditions and assessed the guidebook they created.<br><b>Methods</b>: A Working Group (WG) consisting of two ICC Pharmaceutical Department members and two members of the Medical Products Information Office staff examined the items to be listed in the guidebook.  These items were approved by the ICC and then assigned to physicians and pharmacists to be written up.  A questionnaire survey was conducted on the physicians and pharmacists in the hospital as to their assessment of the content and the conditions of use of the guidebook created.<br><b>Results</b>: In the revised edition, “Antimicrobials PK/PD,” “TDM,” “Empiric Therapy for Infections in Each Department,” etc. have been added, the physicians wrote “Empiric Therapy for Infections in Each Department” and everything else was written by the WG.  The return rate of the questionnaire was 65.7% (<i>N</i>=99), and the guidebook utilization rate was 75.4%.  Frequently viewed items were “List of Antimicrobials Used In-Hospital,” “How to Administer Medication during Decreased Renal Function,” “Empiric Therapy for Infections in Each Department,” etc. by the internal medicine physicians, “List of Antimicrobials Used In-Hospital” and “How to Administer Medication during Decreased Renal Function,” etc. by the surgeons, and “Classification of Antimicrobials,” “List of Antimicrobials Used In-Hospital,” “When Renal Function is Decreased,” “TDM,” and “Empiric Therapy for Infections in Each Department,” etc. by the residents.  Furthermore, there were no items deemed “not necessary for inclusion” for a clear reason.  As to be expected in this guidebook, 72.3% of all respondents mentioned it was “a source of information on basic antimicrobial use” and next, “a source of information for treating infections outside one’s area of specialty.”<br><b>Conclusion</b>: The items listed in the guidebook are thought to be appropriate, and its usage conditions are also good.  As they are specialists on antimicrobials, the pharmacists playing a central role while cooperating with the physicians on the ICC led to the creation of a highly useful guidebook.

Making An Anti-doping Quick Reference List of Ethical and Over-the-counter Drugs / 医薬品情報学

<b>Objective</b>: In the Drug Informatics in Department of Pharmacy, Kitasato Institute Hospital (hereinafter “the hospital”), we have had question-and-answer sessions regarding doping agents (banned drugs) among doctors and other workers and prepared an Anti-doping Quick Reference List (hereinafter “the list”), facing an urgent need to provide precise information quickly.<br><b>Methods</b>: The list consists of drugs adopted by the hospital and over-the-counter drugs according to package inserts, interview forms, and other sources of information.<br><b>Results</b>: In the list, hospital and over-the-counter drugs are classified into three categories in terms of a doping test: (1) “Non-banned” (drugs that can be used), (2) “Banned” (drugs that cannot be used), and (3) “Suspected” (unclear drugs) with their half lives for elimination as an indicator of the disappearance time from the body and divided by medicinal effect.  In addition, we indicated any drug for which the Therapeutic Use Exemption (TUE) application (hereinafter, TUE application) is required before use.<br><b>Conclusion</b>: The list prepared in this investigation offers many benefits, including precise and quickly available information on banned and non-banned drugs, ease in suggesting alternatives, and avoidance of failure in TUE application.

Faster and More Efficient Collection and Dissemination of Information with the Use ofthe Internet Drug Information Service System / 医薬品情報学

<b>Objective</b>: To quickly collect and provide information on package insert revisions, packaging changes, discontinuation of drug manufacturing and distribution, and other information without fail.<br><b>Methods</b>: Information was collected with the use of a drug information service site (SAFE DI) managed by an organization formed by 15 pharmaceutical wholesalers (SAFE Co., Ltd.).  The information obtained was processed into a house journal and provided to the department of pharmacy and other hospital personnel via an employees-only website (hospital LAN).<br><b>Results</b>: Before the introduction of the SAFE DI, incomplete or delayed information collection sometimes forced personnel to urgently cope with packaging changes or discontinuation of drug manufacturing and distribution and assume a heavy workload.  Introduction of the system allowed quick collection and dissemination of such information without fail.<br><b>Conclusion</b>: The recently introduced SAFE DI contributes to qualitative improvement in collection and dissemination of information.  Introduction of such a system may also be useful in other hospitals.