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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滋賀県守山市サン調剤薬局西川でございます。
ようやく年末の休みに入れました。
今年の年末は本当に忙しく感じました。
歳をとったせいなのでしょうか?
年明けの仕事に備えて、休み中にしっかりと充電しておきます。

研修日時    平成29年11月18日土曜日15:15~15:45
研修タイトル  DI変更2017年11月
1、主な添付文書改訂は以下の通りである。
  パリエット錠5mg/10mg PPIによる治療で効果不十分な逆流性食道炎の維持療法において、1回10mg
                  1日2回投与が可能に。
  クロルヘキシジンの副作用にアナフィラキシーが追加。ヒビテン・ヘキザック・マスキン等。
  クラリスロマイシンの併用禁忌に家族性高コレステロール血症治療薬ジャクスタピッド、抗血小板薬ブリリンタ、
                  抗悪性腫瘍薬イムブルビガが追記。
    併用禁忌:ピモジド、エルゴタミン含有製剤、スボレキサント(ベルソムラ)、
          ロミタピドメシル酸塩(ジャクスタピッド)、タダラフィル(アドシルカ)、チカグレロル(ブリリンタ)、
          イブルチニブ(イムブルビガ)、アスナプレビル(スンベプラ・ジメンシー)、バニプレビル
  グランダキシンの併用禁忌に家族性高コレステロール血症治療薬ジャクスタピッドが追記。
2、主な新発売は以下の通りである。
  ルパフィン錠(帝國製薬-田辺):抗アレルギー薬
  マヴィレット配合錠(アッヴィ):C型慢性肝炎治療薬
  イブランスカプセル(ファイザー):乳がん治療薬
  レクタブル2mg注腸フォーム14回(EAファーマ=キッセイ):潰瘍性大腸炎治療薬
  アトーゼット配合錠:高コレステロール血症治療薬(ゼチーア+アトルバスタチン)
3、主なジェネリック発売は以下の通りである。
  クレストール(ロスバスタチン)→AG以外が各社より発売予定 26社87品目
  オルメテック(オルメサルタン)→AG以外が各社より発売予定 
  ファムビル(ファムシクロビル)
  アバプロ/イルベタン(イルベサルタン)
  アダパレンゲル(ディフェリンゲル) ニプロからはクリームも発売
4、販売中止は以下の通りである。
  ホモクロミンン錠 2018.4月販売終了
  ケナログ口腔 2018.6月販売終了、2019.3月経過措置期間終了
5、2017.12月の主な投与期限解除品は、デザレックスとビラノアである。

前回研修会報告 アボルブ http://blog.cabrain.net/CN112049/article/id/103864.html
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タイトル:

局内研修会報告 DI変更2017年11月

病院名:

サン調剤薬局

名前:
メール:
通報内容:
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上記の画像を表示されている英数字を入力してください。

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投稿時間 : 14時05分21秒

カテゴリー : 指定なし(ブログ)

ジャンル : 日記

滋賀県守山市サン調剤薬局西川でございます。

寒い日が続いていますが、いかがお過ごしでしょうか。
私は、先週抜歯した親知らずの痛みがようやく癒えてきて、健康はありがたいなと思う今日この頃です。

研修日時   平成29年11月14日火曜日13:30~14:00
研修タイトル 新薬ルパフィン
研修要旨
1、ルパフィンは抗PAF作用と抗ヒスタミン作用を併せ持つ強力な効果を発揮する抗アレルギー薬である。
2、ルパフィンはTmaxが0、91時間と速やかに効果を発揮し、代謝物デスロラタジンのt1/2が20、65時間と、
  強力な効果が持続する。
3、ルパフィンは症状に応じて倍量投与が可能で、用法・用量は以下の通りである。
  通常、12歳以上の小児及び成人には1回10mgを1日1回経口投与する。なお、症状に応じて、1回20mgに
  増量できる。
4、ルパフィンの重要な基本的注意に以下の記載がある。同様の記載は、ザイザルやアレロックにもある。
  眠気を催すことがあるので、本剤投与中の患者には自動車の運転等危険を伴う機械の操作に従事させないよう
  十分注意すること。
5、ルパフィンの主な副作用は眠気で、9.3%と報告されている。

前回研修会報告 アボルブ http://blog.cabrain.net/CN112049/article/id/103864.html
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滋賀県守山市サン調剤薬局西川でざいます。
今週はA型インフルエンザの方が急増しました。
もしかしたら、昨年のピーク週並みの患者さんの人数だったのではと思う程です。
睡眠時間を十分にとり、薬局内の加湿も心掛け、年末の繁忙時期を乗り切りましょう。
年末年始の休みはもうすぐ!

研修日時   平成29年7月21日13:00~13:30
研修タイトル 前立腺肥大症状とアボルブ
研修要旨
1、前立腺肥大の3大症状は以下の通りである。
 排尿症状:尿が出にくい(尿勢低下、力まないと出ない、尿が途切れがち)
 排尿後症状:尿が出きらない(残尿感がある、トイレに行った後に漏れてしまう)
 畜尿症状:尿が十分にためられない(我慢ができない、夜中に何度も起きてしまう、1日8回以上トイレに行く)
 前立腺肥大症になると、様々な尿トラブルが出現するようになり、QOLに影響を与えるようになる。尿トラブルで
 多いのは頻尿だが、尿勢低下や残尿感も挙げられる。
 昼間頻尿:女性1722万人、男性1595万人
 夜間頻尿:女性2347万人、男性2135万人
2、前立腺は男性だけにある生殖器で、前立腺液の分泌機能・射精時の調整機能・排尿機能をもつ。その大きさは
 クルミ大程度であるが、年齢とともに大きくなる傾向にあり、前立腺肥大症は進行性疾患に分類される。重症化
 するとソフトボール大の大きさにまで肥大することがある。日本に比べ、アメリカの方が前立腺が大きくなる割合  
 が高い。
3、前立腺肥大症患者は年々増加傾向にあり、55歳以上の男性の5人に1人(約400万人)が前立腺肥大症
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4、前立腺肥大症治療における障壁は以下の通りである。
 ・初期・軽症:下部尿路症状が出ていても加齢によるものとして受け入れてしまう。
 ・相談するのが恥ずかしい。
 ・中等症・重症:Dr.に相談するのをためらってしまう。
5、前立腺肥大症の合併症は以下の通りである。
 ・閉尿
 ・尿路感染、膀胱結石、膀胱機能低下
 ・腎機能低下
6、前立腺肥大症の診断はIPSS(国際前立腺症状スコア)8点以上が中等症である。
7、前立腺肥大症の治療薬は以下の通りである。
 ・α1遮断薬⇒効果の発現は比較的早い
          3年以上の長期投与は有効性の根拠不十分(安全性は継続している)
          4~5年で約80%が中止になっている(効果不十分または手術に移行)
 ・PDE5阻害薬
 ・5α還元酵素阻害薬(アボルブ)⇒α1遮断薬との併用がグレードAに変更(前立腺の体積が 30ml 以上)
                 combAT試験によりアボルブとα1遮断薬との併用の有用性が示されている。
 ・抗アンドロゲン薬
 ・漢方・植物エキス製剤
 ・抗コリン薬
8、前立腺肥大症のセルフケアとして家庭でできる主なことは以下の通りである。
 ・軽い運動や散歩           
 ・尿を我慢しないようにする
 ・適度な水分をとる(過剰にならないように)
 ・刺激の強い食べ物は避ける   
 ・下半身を冷やさない
 ・アルコールを飲み過ぎない(夕食後のコーヒーも要注意)
 ・便秘にならないようにする    
 ・長時間座った姿勢をとらない
9、アボルブで気を付ける主な点は以下の通りである。
 ・ソフトジェルカプセルのため、夏場など湿度が高いとフニャフニャになる場合がある→涼しいところに保管する。
 ・服用を中止すると徐々に戻ってしまうため、飲み続ける必要がある。
 ・サガーロと同成分。

前回研修会報告 アンチドーピング http://blog.cabrain.net/CN112049/article/id/103778.html
局内研修会履歴 http://www.myph.jp/sun_pharm/pc/free2.html
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局内研修会報告 アボルブ

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滋賀県守山市サン調剤薬局西川でございます。
国体が数年後に滋賀にも来るようです。
せっかく、各県薬剤師会が引き継いできた国体でのドーピング活動ですから、是非、協力したいものです。
ただし、選手の将来を決める大事な場ですので、荷は重いですね。

研修日時   平成29年11月18日土曜日15:00~15:15
研修タイトル アンチドーピング
研修要旨
1、滋賀県薬剤師会の「まかせてよ!もっと身近に薬剤師に」の平成29年11月のテーマは、なくそう「うっかり
  ドーピング」を掲げている。
2、ドーピングとは以下のいづれかの行為のことである。
  〇競技能力を増幅させる薬物あるいは方法を不正に使用すること
  〇フェアプレイに反する行為、スポーツの価値を損なう行為
  〇スポーツのコアバリューPlayTrueの精神に反する行為
3、日本の特殊性として、「意図しないドーピング」がほとんどであるが、「うっかり」でもドーピング防止規則違反と
  なってしまう。そのため、適切な情報を提供する仕組みとしてスポーツファーマシスト制度が設立された。
4、滋賀県薬剤師会薬事情報センターでは禁止薬に関する問い合わせをFAXで受付ている。平成28年度は、
  181件の問い合わせがあり、20件で禁止物質と判定された。禁止物質の一例として以下がある。
  レルベア100エリプタ14吸入用
  ディレグラ配合錠
  エスタック総合感冒
  ツムラ小青竜湯エキス顆粒
5、ドーピング防止規則違反を起こしやすいものとして、以下の3点がある。
  〇市販薬は薬の名前を正確に確認する必要がある。パブロンSゴールドWは問題ないが、パブロンゴールドA
   は違反物質を含んでいる。
  〇漢方薬・生薬は、産地・季節等により成分が変わる可能性があり、問題ないと断言できない。
  〇栄養ドリンクやのど飴にも注意が必要で、浅田飴・南天のど飴は違反物質を含んでいる。

前回研修会報告 ノロウイルスの対応及び注意点とルビスタ嘔吐物処理キットhttp://blog.cabrain.net/CN112049/article/id/103777.html
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局内研修会報告 アンチドーピング

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サン調剤薬局

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滋賀県守山市サン調剤薬局西川でございます。
薬局前の並木の紅葉も終わり、落ち葉を掃くのに追われた1週間でした。
ゴミ袋1袋分のなる日も数日ありました。
焼き芋でもするといいんですけど、火なんて焚いたら近所迷惑ですよね。やっぱり。

研修日時   平成29年11月18日土曜日14:30~15:00
研修タイトル ノロウイルスの対応の注意点とルビスタ嘔吐物処理キット
研修要旨
1、ノロウイルスとはウイルス性の胃腸炎を引き起こす感染症であるが、以下のような特徴がある。
  強い感染力 数個から100個程度で発症することがある。
  嘔吐物・糞便に大量のウイルスが存在 症状が回復後もウイルスの排泄が1~3週間以上続く。発症中の
          患者糞便中にはウイルスが1g中1億個以上、乳幼児では100億個以上いる場合がある。
  感染力の長時間保持 乾燥に強いため自然界でも感染力を失わない。アルコールや石鹸、胃酸、熱にも強い。
          アルコールや逆性石鹸はウイルスの表面を覆う膜であるエンベローブに作用するが、ノロウイルス
          はエンベローブをもたないため効かない。
2、ノロウイルスの予防方法は以下の通りである。
  ①手洗い・うがい 石鹸で失活はされないが、洗い流すことができる。
  ②加熱 中心部が85~90℃を90秒以上
  ③消毒 次亜塩素酸NaはpH5~7、濃度0.1%(嘔吐物)で有効。ハイター5%は希釈して使用する。
3、ルビスタ嘔吐物処理キットの特徴は以下の通りである。
  ①嘔吐物処理に必要な機材がすべてキットに梱包されている。
  ②適切な嘔吐物処理を簡単・迅速に行うことができる。
  ③吸水ポリマーシートで嘔吐物を覆うことにより、汚染拡大を防止できる。
4、ルビスタ嘔吐物処理キットを用いた嘔吐物処理の流れは以下の通りである。
  ①汚染拡大の防止 嘔吐物を吸水ポリマーシートで覆う。
  ②汚物を除去 嘔吐物をシートごと除去する。
  ③除菌・洗浄 残った嘔吐物をペーパータオルで覆い、ルビスタ調整液で浸してペーパータオルごと除去する。
  ④廃棄 ポリ袋に入れて廃棄する。
5、ルビスタ嘔吐物処理キットには以下のものが入っている。
  PPE(個人防護具) 使い捨てマスク、使い捨てエプロン、使い捨て手袋。
  環境除菌・洗浄剤ルビスタパウダー
  添付文書
  調整用水
  吸水ポリマーシート
  ペーパータオル
  ポリ袋 梱包材にセットすることで、ゴミ箱として使用できる。
  使用方法説明書

前回研修会報告 乳がん補助療法 http://blog.cabrain.net/CN112049/article/id/103770.html
局内研修会履歴 http://www.myph.jp/sun_pharm/pc/free2.html
薬局HP http://www.myph.jp/sun_pharm/pc/index.html
薬局スマホサイト http://sun-ph.jp/sumaho/

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局内研修会報告 ノロウイルス

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サン調剤薬局

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滋賀県守山市サン調剤薬局西川でございます。
滋賀も寒くなってきました。

今年夏に行った局内研修会を報告させてもらいます。

研修日時   平成29年8月8日
研修タイトル 乳がん補助療法
研修要旨
1、乳がんはエストロゲンにより成長するため、治療はホルモン療法となる。
2、乳がんのホルモン療法の変遷は以下の通りである。
  1960年(昭和35年) エストロゲン受容体の発見
  1981年(昭和56年) 抗エストロゲン剤:タモキシフェン(ノルバデックス)の承認
  1994年(平成6年)  LH-RHアゴニスト:ゴセレリン(ゾラデックス)の承認
  1996年(平成8年)  LH-RHアゴニスト:リュープロレリン(リュープリン)の承認
  2000年(平成12年) アロマターゼ阻害薬:アナストロゾール(アリミデックス)の承認
  2011年(平成23年) SERD:フルベストラント(フェソロデックス)の承認
3、各ホルモン療法剤の投与方法と対象は以下の通りである。
  LH-RHアゴニスト製剤 投与方法:皮下注射(4週に1回、12週に1回)
                  対象:閉経前
  アロマターゼ阻害薬 投与方法:内服(毎日服用)
                対象:閉経後
  抗エストロゲン剤 投与方法:内服(毎日服用)
              対象:閉経前、閉経後
  治療後、卵巣機能を回復させたい(妊娠を希望している)ときはLH-RHアゴニストを投与してはいけない。
4、タモキシフェンはSERMの第一世代で、乳腺・中枢神経には抗エストロゲン作用を示し、子宮・骨・脂質代謝・
  抗凝固能にはエストロゲン作用を示す。投与期間は術後5年から10年であり、5年投与より10年投与の方が
  対側乳がん(手術した乳房とは反対の乳房に乳がんが発生すること)の発生リスクが低い。さらに、再発リスク
  や死亡リスクも10年投与の方が低いことが確認させている。
5、アナストロゾールは閉経後乳がんにおける第一選択薬で、投与期間は5年投与である。タモキシフェン5年投与
  よりアナストロゾール5年投与の方が効果が高く、リスクが軽減されることがわかっており、アナストロゾールの
  術後5年投与はガイドラインの推奨グレードAである。また、術後タモキシフェンを2~3年投与した後にアナスト
  ロゾールを3年投与する方が、再発率や死亡率、対側乳がん発生リスクが低くなることがわかっており、この
  方法はガイドラインで推奨グレードAとなっている。なお、アリミデックス投与後に月経が戻る方もいる。
6、フェソロデックスは乳房のエストロゲン受容体数だけを減少させる働きがあり、SERMのように骨や子宮に対し
  ては影響がないため、子宮がんや骨折のリスクは無い。

前回研修会報告 DI変更 http://blog.cabrain.net/CN112049/article/id/103612.html
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