ABSTRACT
Since some antagonists or antidotes in cases of acute poisoning are not commercially available in Japan, in many hospitals they are prepared on their premises for clinical use. However, no specific legislation for the procedures of quality assurance and informed consent of these hospital-prepared products as yet exists. Further, the standard procedures for clinical use of the hospital-prepared products have yet to be established. For the treatment of patients with methemoglobinemia, we prepared methylene blue for injectable use in our hospital. In this paper, we describe our procedures ranging from its preparation to clinical use of this product. Methylene blue injection was prepared by using reagent-grade chemicals. The quality of hospital-prepared methylene blue injection was examined in accordance with the United States Pharmacopoeia. The contents of methylene blue injection remained constant at room temperature during storage for 12-month. The sterility testing also gave negative results during the same period. In order to obtain approval for its clinical use by the in-hospital ethical committee, relevant documents such as instructions for the preparation method, product information on safety usage and consent form were created. After these procedures, clinical applications of methylene blue injection were finally initiated.
Subject(s)
Antidotes , Drug Compounding , Methylene Blue , Pharmacy Service, Hospital , Acute Disease , Antidotes/administration & dosage , Antidotes/standards , Drug Approval , Drug Stability , Drug Storage , Humans , Informed Consent , Injections , Japan , Methemoglobinemia/drug therapy , Methylene Blue/administration & dosage , Methylene Blue/standards , Quality ControlABSTRACT
Several cases of anaphylaxy after hamster bites have recently been reported. We report a case of anaphylaxis after a bite from a prairie dog. To our knowledge, this is the first case to be reported in Japan. The patient was a 26 year old male who was transported to our hospital suffering from dyspnea. The dyspnea occurred within several minutes after a bite from a prairie dog to his left little finger. He was successfully treated by the administration of epinephrine, dopamine and hydrocortisone, and transfusion. Allergies to allergens derived from saliva are speculated to be involved in the mechanism of anaphylaxis in cases caused by hamster bites. We speculate similar mechanisms may also be involved in the case of our patient.
