サン調剤薬局

滋賀県守山市にある『サン調剤薬局』のブログ

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研修日時   平成31年1月8日火曜日13:00~13:30
研修タイトル 冬の脱水について
1、冬の脱水リスクは子どもや高齢者が高い
  乳幼児…体温調節機能が未熟、皮膚から蒸発しやすい
  高齢者…体内水分量が減少、温度感受性が低下
 空気が乾燥しやすく、暖房により湿度が下がって不感蒸泄が増えるため
2、体重減少率が1~2%:軽度…喉が渇くなど
          3~9%:中等度…倦怠感、頭痛、めまい、嘔吐など
          10%以上:高度…QOL,が下がり、死の危険性もある
3、主原因:ウイルスによる感染症
  胃腸炎、インフルエンザ、ノロウイルス、ロタウイルスなど
4、下痢や嘔吐によって体内の水分や電解質を大量に失ってしまう
  →脳梗塞、心筋梗塞リスクが高くなる
  ⇒「目覚め・寝る前の1杯、水分を」
5、水欠乏性脱水症(高張性)…乳幼児・高齢者に多い
 Na欠乏性脱水症(低張性)…長時間スポーツしている時、発汗時に多い
 混合性脱水症→水分のみの摂取で低張性脱水症に移行する
6、経口補水液=飲む輸液
  ORSは水1L+砂糖20~40g+塩3g(+α:レモンなど)で作ることができる
   日常→水や茶など
   運動時→Na多めのスポーツ飲料
   発熱時→Na少なめのORS
   嘔吐・下痢時→ORS
7、ソリタ配合顆粒:低浸透圧なので水分吸収能・Na保持能が優れている
           1日分をまとめて溶かして冷所保存OK
  摂取量 乳幼児:30~50ml/㎏
        幼児:300~600ml
        学童~高齢者:500~1000ml
8、ソリタT配合顆粒2号はオレンジ味で、塩化ナトリウムが多く配合されていることから、嘔吐・下痢のひどい
  時に、ソリタT配合顆粒3号は青りんご味で、熱中症に適している。
9、SGLT2阻害薬及びその配合薬を服用中の方は、カゼなどをひいていなくても、水分補給を行うよう指導が
  必要である。
10、現在在庫しているSGLT2阻害薬及びその配合薬は、デベルザ・カナグル・カナリア配合の3種類である。

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局内研修会報告 冬の脱水について

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サン調剤薬局

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研修日時   平成31年1月5日土曜日15:00~15:30
研修タイトル DI変更・新発売情報
1、主な新発売は以下の通りである。
  ベオーバ錠 選択的β3受容体作動薬
  ラグノスNF経口ゼリー分包 慢性便秘症の適応症を取得した初のラクツロース製剤  
  メトアナ配合錠 スイニー+メトホルミン
  ジェミーナ配合錠 月経困難症治療薬
  トラディアンス配合錠AP/BP トラゼンタ+ジャディアンス
  モビコール配合内用液 慢性便秘症
2、主なGE発売は以下の通りである。
  ビマトプロスト点眼液(ルミガン)
  トアラセット配合錠(トラムセット)
  ミルタザピン(リフレックス/レメロン)
  エレトリプタン(レルパックス)
  アトモキセチン(ストラテラ)
  ノルエチステロン・エチニルエストラジオール(ルナベル配合)
  シロドシン(ユリーフ)
  ゲフィチニブ(イレッサ)
  カペシタビン(ゼローダ)
  オロパタジンDS1%「日本臓器」
  ヘパリン類似物質外用泡スプレー0.3%200gポンプ
3、主な販売中止は以下の通りである。
  ホモクロミン錠
4、主な投与期限解除は以下の通りである。
  ルパフィン 
  レクタブル注腸フォーム
5、主な経過措置品は以下の通りである。
  トミロン細粒小児用10% 20%が代替で発売済

 

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局内研修会報告 DI変更・新発売情報

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サン調剤薬局

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1、心房細動診療の基本は以下3点が重要である。
  ・生命 併存疾患を管理する 
  ・脳 リスクに応じた抗凝固療法
  ・QOL(生活の質) 年齢、QOL,心房細動のタイプに応じて
              抗不整脈薬・心拍数調整薬・アブレーション
2、脳卒中患者の内訳は以下の通りである。
  ・脳梗塞 75.4%       アテローム梗塞 33.9%
                 ラクナ梗塞 31.9%
                  心原性脳塞栓症 27.0%
  ・脳出血 17.8%
  ・くも膜下出血 6.8%
3、心房細動に対するアスピリンの効果・安全性をみたJAST研究(日本)の結果は以下の通りであった。
  ・アスピリンはプラセボに比べて、脳梗塞・死亡ともに減らせない。
  ・アスピリンはプラセボに比べて、副作用の出血が増加する。
4、アメリカでは、ワーファリンによる抗凝固療法が普及するにつれて、脳卒中が減少した。しかし、日本人では
  INR2.5を超えると頭蓋内出血が増加してしまう問題が。また、INRが1.5を下ると脳梗塞予防の有効性が期待
   できない。そのため、ワーファリンは日本人には使いにくいとも言われている。
  〇日本人の心房細動患者に対し、ワーファリン治療を行っても、脳卒中の発生頻度が減らせなかったという実地医
    家での報告もある。Fushimi AF Registry
  〇DOACはワーファリンに優るとも劣らない有効性が報告されている。安全性もワーファリンと同等もしくは優ると言
    われている。
  〇新規抗凝固薬DOACの特徴は以下の通りである。
    ・標的因子はダピガドランがトロンビン、リバーロキサバン・アピキサバン・エドキサバンが第Xa因子である。
    ・半減期はいずれの薬剤も12時間程度であるが、投与回数はダピガドランとエドキサバンは1日2回、リバーロキ
       サバンとアピキサバンは1日1回である。
    ・ダピガドランの排泄は腎が80%と高い。
  〇日本循環器学会の心房細動治療ガイドライン2013には、同等レベルの適応がある場合、新規経口凝固薬
    DOACがワーファリンより望ましいと記載されている。
  〇DOACに関する課題
    ・アドヒアランス
    ・ポリファーマシー
    ・超高齢者に対する抗凝固療法の拡大
    ・腎機能低下患者(Ccr30㎖/min未満)に対するDOAC
    ・不適切減量
    ・周術期の管理
    ・脳梗塞超急性期のDOAC使用
    ・消化管出血
  〇10種類以上薬を飲んでいる方に抗凝固療法を行うと、5種類未満の方に比べて死亡率が2倍になると報告され
    ている。大出血についても10種類以上薬を飲んでいる方は5種類未満の方に比べて、2倍の頻度で起きている
    と報告されている。
  〇抗不整脈薬の用い方 ESCガイドライン
    1.抗不整脈薬治療の目的は症状軽減
    2.抗不整脈薬の洞調律維持効果はあまり大きくない
    3.抗不整脈薬で心房細動の再発は防げず、減らすことで満足すべき
    4.抗不整脈薬変更には意味があるのかもしれない(意義はまだ不明)
    5.抗不整脈薬による副作用はしばしば生じる
    6.抗不整脈選択は効果より安全性を重視すべき
  〇心房細動患者さんにアブレーションを行うかどうかについて、ESCガイドラインには、患者さんに選んでもらうべき
    と記載されている。

                 


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局内研修会報告 心房細動治療の最新情報

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サン調剤薬局

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研修日時   平成30年10月20日
研修タイトル 胃瘻造設に関する相談事例
研修要旨
1、PEGとは経皮内視鏡的胃瘻増設術のことで、内視鏡を使ってお腹に小さな口を造る手術である。
2、胃瘻は胃と体表などが穴でつながっている状態で、腹部の口から長期間栄養を補給することができる。
  その間、口から食べるリハビリや言語訓練も行える。栄養状態が改善することで体力が戻り、20%の患者が
  食べる機能が回復したとの報告もある。しかし、終末期の患者では、人工的な延命につながりかねないとも
  言われている。
3、胃瘻の対象となる方は次のような方である。
 ・口から食事のとれない方
 ・食べるときにむせて誤嚥を起こしやすい方 
4、胃瘻の対象となる疾患は以下のような疾患である。
 ・認知症・脳血管障害で摂食が困難な方
 ・神経筋疾患で物が飲み込めなくなった方
 ・食道や胃噴門部に狭窄のある方
4、胃瘻が広がった理由の一つに、病院や老人施設だけでなく自宅でも栄養補給を行える点がある。
5、Drが胃瘻を勧めた理由として以下が考えられる。
 ・誤嚥性肺炎を起こす→嚥下能が低下しており、再発リスクが高い。
 ・継続的な栄養補給が可能なため、延命効果が期待できる。
6、胃瘻のデメリットの一つとして、誤嚥を減らすことはできるが、食道付近の筋肉が弱り、逆流による誤嚥性
  肺炎を起こすリスクもある。

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局内研修会報告 胃瘻

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研修日時   平成30年11月20日火曜日
研修タイトル 不整脈治療の最新情報
研修要旨
1、不整脈の分類は以下の通りである。
  ・頻脈性 期外収縮
        心房細動
        心房粗動
        上室頻拍
        心室頻拍
        心室細動
  ・徐脈性 洞機能不全症候群
        房室ブロック
2、不整脈治療に用いられる薬物療法には以下がある。
  抗不整脈薬 キニジン、リスモダン、リドカイン、メキシチール、サンリズム、タンボコール、シベノール等
  心拍数調整薬 β遮断薬、ジギタリス、Ca拮抗薬
  抗凝固薬 ワーファリン
         プラザキサ、イグザレルト、エリキュース、リクシアナ
3、不整脈に用いられる非薬物療法には以下がある。
  ライフスタイルの是正 減塩・運動療法
  カテーテルアブレーション 高周波アブレーション
                   バルーンアブレーション
  埋め込み型デバイス ペースメーカー
                埋め込み型除細動器
4、心室期外収縮は少ない方が生存率が高いことが知られていたが、心室期外収縮をもつ陳旧性心筋梗塞患者を
  対象にしたCAST研究では、抗不整脈薬で期外収縮を減少させた群はプラセボより生存率が低くなっていた。
、Framingham Study観察研究で、脳卒中リスクが高まる因子として、高血圧・冠動脈疾患・心不全・心房細動が
   報告されている。
6、脳卒中予防効果を確認した試験では、アスピリンは脳卒中を減らすことはなく、ワーファリンはプラセボより60~
  70%脳卒中を減らしていた。
7、心房細動を対象としてAFFIRM試験2002年では、抗不整脈薬による洞調律維持を目指した群と、心拍数調整薬で
  心房細動を受容した群で、脳卒中の発生に差はみられなかったことが報告されている。
8、不整脈治療における患者のアウトカムは以下の2点である。
  ・生命予後を良くして欲しい
  ・QOLを良くして欲しい
9、不整脈治療の基本的な考え方は以下の2点である。
  ・放置した場合の患者のデメリットは何か
  ・治療した場合の患者のメリット・デメリットは何か

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局内研修会報告 不整脈治療

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サン調剤薬局

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研修日時   平成30年10月20日土曜日
研修タイトル 爪白癬治療について
研修要旨
1、爪白癬の罹患者は、日本人の10人に1人と推計されている。繰り返す足白癬や体部白癬が元になっており、
  季節変動はない。
  症状:爪の色が白や黄色に濁ったり、爪の厚さが増して変形したり、爪がもろく崩れやすく
     なったりする。痛みや痒みはないことが多い。
  診断:真菌学的に検査し、爪白癬かどうかの確定診断が必須。
  治癒の定義:爪甲混濁部が完全に消失、かつ真菌学的治癒(直接鏡検にて白癬菌が陰性化)したもの。
     爪の生え変わりに、足は約1年、手は約半年かかるが、高齢者ではもう少し遅くなる。
2、爪白癬の治療は病型や重症度、患者背景、アドヒアランスを考慮して選択する。
  経口薬が適する場合
  ・合併症や併用薬がない
  ・罹患爪が多い
  ・アドヒアランスが低い
  ・早期に治癒することを希望
  外用薬が適する場合
  ・合併症や併用薬などにより経口薬を選択できない
  ・罹患爪が2~3本と少ない
  ・アドヒアランスが高い
3、主な爪白癬治療薬は以下の通りである。
  ・内服 イトリゾールパルス療法 併用禁忌が多い。肝機能の血液検査が望ましい。むくみの副作用があり、
                       うっ血性心不全に注意が必要。治癒率は85%。
                       パルス療法は1回4カプセル200mgを1日2回食直後7日服用し、3週間                  
                       休薬を3サイクル行う。
                       表在性皮膚真菌症は1回1~2カプセル50~100mgを1日1回食直後服用。
                       副作用はうっ血性心不全、肺水腫、肝障害、SJSなど。                      
       テルビナフィン 毎月の肝機能血液検査が必要。6カ月連続投与。治癒率は70%。禁忌はないが、
                 併用注意は多く、特にピルは注意が必要。
                 1回1錠125mgを1日1回食後服用。副作用は重篤な肝障害、血液障害、SJSなど。
       ネイリン  12週連続投与。肝機能検査が望ましい。治癒率は60%。禁忌はない。
              1回1Pを1日1回服用、新薬のため2週間しばり。副作用は肝障害、消化器症状。
  ・外用 真菌学的治癒率は55%、完全治癒率は約20%。
       クレナフィン爪外用液10% 
       ルコナック爪外用液5%(ルリコンと同じ成分)

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局内研修会報告 爪白癬

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サン調剤薬局

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研修日時   平成30年10月20日土曜日 
研修タイトル インフルエンザ薬警告改訂
研修要旨
1、タミフルの添付文書警告欄に以下の記載があったが、削除となった。
  「10歳以上の未成年患者はハイリスクと判断した場合以外は原則使用を避ける。」
  インフルエンザの患者さんで、抗インフルエンザウイルス薬の服用の有無や種類にかかわらず、異常行動
  に関連すると考えられる転落死等が報告されていることから、重要な基本的注意欄に予防措置に関する
  記載がされた。
2、異常行動発生の特徴と事例は以下の通りである。
  〔異常行動の特徴〕 
  ①就学以降の小児・未成年者の男性で報告が多い(女性でも発現する)
  ②発熱から2日以内に発現することが多い
  〔異常行動の例〕
   ・突然立ち上がって部屋から出ようとする
   ・興奮して窓を開けてベランダに出て、飛び降りようとする
   ・人に襲われる感覚を覚え、外に走り出す
   ・突然笑い出し、階段を駆け上がろうとする
   ・自宅から出て外を歩いていて、話しかけても反応しない
   ・変なことを言い出し、泣きながら部屋の中を動き回るなど
3、事故を防止するため、発熱から少なくとも2日間は、就寝中を含め、特に小児・未成年者が容易に住居外へ
  飛び出さないために、以下のような具体的な対策を講じるよう、保護者の方にご説明する。  
   ・玄関や全ての部屋の窓を確実に施錠する(内鍵、チェーンロック、補助鍵がある場合はその活用を含む)
   ・ベランダに面していない部屋で寝かせる
   ・窓に格子のある部屋がある場合は、その部屋で寝かせる
   ・一戸建てにお住いの場合は、できる限り1階で寝かせる

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局内研修会報告 インフルエンザ薬添付文書改訂

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サン調剤薬局

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研修日時    平成30年7月21日
研修タイトル  認知症疾患診療ガイドライン2017について
研修要旨
1、アルツハイマー型認知症ではコリンエステラーセ阻害薬(ChEI)やNMDA受容体拮抗薬の使用が推奨され、
  レビー小体型認知症についてはコリンエステラーゼ阻害薬の使用が推奨される。今回のガイドラインでは、
  アルツハイマー型認知症の治療において、4剤(ドネペジル、メマンチン、ガランタミン、リバスチグミン)を
  どう使い分けるか、治療選択のアルゴリズムが示された。
  ・軽度:コリンエステラーゼ阻害薬ChEI 1剤選択
       効果なし・不十分/副作用→他のChEIに変更
  ・中程度:ChEI 1剤かメマンチンを選択
        効果なし・不十分/副作用→他のChEIかメマンチンに変更あるいはChEIとメマンチンの併用
  ・重度:ドネペジルかメマンチンを選択
       ドネペジル5㎎の場合は10㎎に増量あるいはドネペジルとメマンチンの併用
2、4種類いずれも有効性を示す科学的根拠があり、使用するよう勧められている。
3、メマンチンは中程度から重度のアルツハイマー型認知症に適応が認められ、ChEIとの併用も可能。
4、レビー小体型認知症に保険適応があるのは、ドネペジルのみ。
5、行動・心理症状(BPSD)の薬物療法の使用例は以下の通りである。
  ・焦燥性興奮:リスペリドン、アリピプラゾールなどの非定型抗精神病薬、抑肝散、チアプリド、カルバマゼピン、
           セルトラリン、シタロプラム、トラゾドン
  ・幻覚・妄想:リスペリドン、オランザピン、クエチアピン、アリピプラゾール、抑肝散
  ・うつ症状:SSRI、SNRI
  ・徘徊:リスペリドン、チアプリド
  ・不安:リスペリドン、オランザピン、クエチアピン


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局内研修会報告 認知症疾患診療ガイドライン2017について

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研修日時   平成30年9月1日
研修タイトル DI変更・新発売情報
研修要旨
1、主な添付文書改訂は以下の通りである。
  トレリーフ錠25㎎(50㎎は変更なし) 効能効果に「レビー小体型認知症に伴うパーキンソニズム」を追加
  リンゼス錠0.25㎎ 効能効果に「慢性便秘症(器質的疾患による便秘を除く)」を追加
  シクロスポリン(ネオーラル・サンディミュン) 併用禁忌に「パルモディア」を追加
  タクロリムス水和物(アザチオプリン・シクロスポリン) 禁忌の「妊娠又は妊娠している可能性のある婦人」削除
  デザレックス錠 副作用に「食欲亢進」を追記
2、主な新発売は以下の通りである。
  ヒルドイドフォーム0.3%92g
3、主なGE発売は以下の通りである。
  コソプト点眼→ドルモロール点眼
  フェントステープ→フェンタニルクエン酸塩1日用テープ
  タミフル→オセルタミビルCap75mg「サワイ」
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  ホスレノール→炭酸ランタン顆粒分包・OD錠
4、主な投与期限解除は以下の通りである。
  アメナリーフ錠(平成30年9月~)

  


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研修日時   平成30年9月1日
研修タイトル 高齢者の高血圧の特徴について
研修要旨
1、高血圧の有病率は加齢により上昇し、50歳代以上の男性と60歳代以上の女性で60%をを超える。
2、高齢者の高血圧には以下のような特徴がある。
  ・収縮期高血圧が多い
  ・血圧が変動しやすい(白衣高血圧が増える)
  ・起立性低血圧などを伴う高血圧が増加
  ・食後血圧低下の頻度が高い
  ・食事や水分摂取量の減少による血圧低下の程度も強い
3、65歳以上の高血圧患者に対する降圧目標の原則として、日本老年学会・高血圧治療ガイドライン2014で
  以下のように記載されている。
   65~74歳 140/90mmHg未満
   75歳以上 150/90mmHg未満(忍容性があれば積極的に140/90mgHg未満)
  忍容性があれば、さらに130/80mmHg未満を目指す病態
  ・心筋梗塞後や心血管イベントリスクが重積した心臓病合併
  ・蛋白尿陽性のCKD合併
  ・抗血栓薬服用中(脳出血予防)
  ・ラクナ梗塞、脳出血、くも膜下出血の既往
  ・糖尿病合併
4、米国の大規模臨床実験(SPRINT)は、75歳以上の高齢者においても、収縮期140未満より120未満を
  目指す積極的な降圧療法が心血管イベントや死亡リスクを低下させることを示した。
5、高齢者高血圧の第一選択薬はARB、ACE阻害薬、サイアザイド系利尿薬である。CCB、RA系阻害薬
  (ARB、ACE阻害薬)、利尿薬から2剤を選んだ組み合わせが有効と考えられる。
  ・Ca拮抗薬(CCB):末梢血管への選択性が高いジヒドロピリジン系を主に用いる。
              安静時狭心症を有する患者には冠動脈拡張作用のあるCCBが第一選択薬となる。
              副作用は下腿浮腫、顔面紅潮、歯肉腫張、頻尿など。
  ・ACE阻害薬:新規糖尿病発症抑制、心肥大抑制、尿たんぱく抑制などの臓器保護効果が報告されているが、
                        高齢者におけるエビデンスは十分でない。副作用は空咳、味覚異常など。
  ・ARB:ACE阻害薬と類似の薬理作用を有する。ヒドロクロロチアジドやCCBとの合剤あり。
              副作用はふらつき、高カリウム血症など。
  ・サイアザイド系利尿薬:食塩過剰摂取や食塩感受性の強い患者には特に有効。副作用は脂質代謝・糖代謝の
              悪化、尿酸値の上昇、電解質異常など。腎機能低下例では、効き目が低下するため
              ループ利尿薬への変更する。
  ・β遮断薬:収縮不全を伴う心不全、安定狭心症、心筋梗塞後、頻脈性不整脈を伴う高血圧には投与が推奨
              される。高齢者はふらつき、眠気、意欲低下に注意する。
  ・アルドステロン拮抗薬:本態性高血圧で第一選択薬を用いても効果が得られない場合、低カリウム血症を
              伴う場合に考慮する。副作用は高カリウム血症、女性化乳房(スピロノラクトン)。
6、高齢者の高血圧患者に対し薬剤師としてできることは以下の通りである。
  ・服薬アドヒアランスの管理 残薬確認、ポリファーマシー対策、家庭血圧測定の励行、合剤への切替。
  ・副作用対策 利尿薬→電解質異常、脱水
            CCB→下肢浮腫
            α遮断薬→起立性低血圧
  ・生活習慣の改善 極端な改善はQOLを低下させる可能性がある。

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