Drug Use in Renal Insufficiency, Drug-induced Nephropathy / 日本農村医学会雑誌

We should decide the dose in renal insufficiency according to an attachment document, estimated by Cockroft-Gault's formula. It is better not to decide the dose only byexcretion route. In addition, we should not administer the nephrotoxic drugs, especially NSAIDs, to renal insufficiency.<BR>Also, it is necessary to pay enough attention to the overdose of drugs, which do not cause renal toxicity but cause dangerous side effects to the central nervous system.<BR>Many attachment documents have a lot of lacks in the mention for renal insufficiency and need to be improved.

Measures to Cope with Left Dispensed Drugs and Its Effect / 日本農村医学会雑誌

Patient compliance with presciibed drug regimens may be improved by finding out incom-pliant patients and exhorting them to take their medicines, but it's not an easy task. We telephoned those who had not shown up at the pharmacy within 7 days after the preparation of their drugs to come and receive the dispensed drugs. When the dispensed drugs had to be disposed of after a long misplacement, we prepared a “patient compliance report” to inform the attending physicians about noncompliance by attaching it to the patient's visit history. Further, of when they visited the hospital again we gave guidance about drug compliance at the window to those whose dispensed drugs had been disposed.<BR>We contacted 63 patients by telephone during the 3-month period from January to March 1995 of the patients who left their drugs at the pharmacy, and found 30.6% of them had some compliance problems. Telephone calls were effective for reducing the proportion of the patients whose dispensed drugs were disposed of to 0.03% from 0.11%, the percentage worked our during the 5-month period from August to December 1994 during which no telephone call was made. We reported 19 drug disposal cases to the physicians by means of the “patient compliance report”. All the physicians appreciated it as they were brought to a realizatopn of the drug compliance rate of their patients.<BR>As there were some patients who did not know that their drugs were prescribed, we considered how to cope with the left dispensed drugs would not be a question of the pharmacy alone. It should be handled as a problem of the whole hospital from the stage ofconsultation to payment.