1.A Drug Utilization Study on Off-Label Uses
Nobuyuki GOTO ; Kazuo SATO ; Masaki SHIRAHASE ; Hisao HATTA ; Mikio MASADA ; Kazuhisa MATSUBA ; Yoshihiro KATAGIRI ; Masahiro NAKANO ; Keizo ISHIMOTO ; Takeo MINAMI ; Shikifumi KITAZAWA
Japanese Journal of Pharmacoepidemiology 1999;4(1):1-8
Objective : Heparin lock flush solution is diluctes and divided into vials before its use while it is used in quantity in Japan. Then, we carried out the research on use of heparin lock flush solution.
Methods : We executed the nationwide questionnaire investigation concerning making heparin lock flush solution.
Results : The recovery of the nationwide questionnaire investigation was as high as 78% (64/82) indicating general concern for the problem.
Heparin lock flush solution was made in 97% (246/253) of wards. 69% (174/253) of wards had a standard for preparation. Therebon, it is thought that the standardization of heparin lock flush solution is possible. The use concentration employed most frequently for the peripheral intravenous injection was 10 units/ml and that for the central vein injection was 100/ml units. In many wards the amount used at 1 time for the peripheral intravenous injection was 5 ml or 10 ml and that for the central vein injection, was 5 ml, 10 ml, or 20 ml.
84% of nurses requested marketing of heparin lock flush solution.
Conclusion : We investigated the use realities and the problem of heparin lock flush solution from a past report etc. Heparin lock flush solution is listed to the pharmacopeia in the United States and Britain. Heparin lock flush solution should be supplied as the goods on the market immediately even if it is seen from the profit, the safety, the medical economy.
2.A Drug Utilization Study on Off-Label Uses
Nobuyuki GOTO ; Kazuo SATO ; Masaki SHIRAHASE ; Hisao HATTA ; Mikio MASADA ; Kazuhisa MATSUBA ; Yoshihiro KATAGIRI ; Masahiro NAKANO ; Keizo ISHIMOTO ; Takeo MINAMI ; Shikifumi KITAZAWA
Japanese Journal of Pharmacoepidemiology 1999;4(1):9-19
Objective : Percutaneous ethanol injection (PEIT) for hepatocellular carcinoma is basic treatment of hepatocellular carcinoma. However, it is off-label uses to use ethanol for this treatment in the current state. Then, we executed the drug utilization study of Absolute ethanol injections at this time.
Methods : We executed the drug utilization study of Absolute ethanol injections at this time.
Results : The recovery of the questionnaire was high with 84.4% (151/179 medical institutions). The ethanol injections was made by 85% (129/151 facilities). Facilities where 100 or more ethanol injections was made annually were 76%. The raw material for making the ethanol injections was the reagent which was not the medicine in 44% of facilities. Information on safety and effectiveness concerning the ethanol injections was hardly offered from pharmacy. Finally, 96% (124/129 facilities) demanded marketing the ethanol injections.
Conclusion : We investigated the research report number by using “ICHUSHI” CD-ROM version (1988-1998) which was the medical literature data base. We were able to collect reports concerning PEIT of hepatocellular carcinoma of 636 reports. We were able to collect reports which used PEIT as a treatment method of hepatocellular carcinoma by as many as 636 reports. It has been understood that PEIT is enforced in Japan. Next, we reviewed the document and collected and evaluated information on effectiveness and safety concerning the ethanol injections used for PEIT. The treatment object, the usage, and the dosage have been decided at the relating academic meeting. Moreover, there was a report concerning a lot of effectiveness and safety in the PEIT treatment method of hepatocellular carcinoma. The ethanol injections used for PEIT is one of the medicines where information and scientific evidence concerning effectiveness and safety are accumulated. Moreover, a large amount of ethanol injections are nationally made in the pharmacy in the hospital. However, it has been proved that there are a lot of problems about the making. The ethanol injections is the medicine which should be supplied and made by the pharmaceutical company.
3.Investigation of the Botanical Resource of Traditionally Used Crude Drug : Exploration of Traditional Production Technique of Paeoniae Radix
Kyoko TAKAHASHI ; Kayoko SHIMADA-TAKAURA ; Kazuhisa GOTO
Kampo Medicine 2022;73(4):422-433
This study is based on the investigation of Japanese ancient experienced agricultural techniques and historical and current exploration of strain and morphology of plants. We aim to dig up the tacit knowledge, which can guarantee the quality of production and profitability when they are applied for current medicinal plant cultivation. We focused on Paeonia lactiflora Pallas as the candidate of the farming products for the vitalization of mountainous area. Bon-ten (with white double-petaled flowers) is considered to produce highly qualified Paeoniae Radix in medical practice. We found several strains of the plant source different from Bon-ten as the origin of Yamato-Shakuyaku, bred after TOKUGAWA Yoshimune’s policy promoting the domestic cultivation of medicinal plants in Edo period. These strains include the cultivar with red single-petaled flower, which is drawn in ‘Matsuyama-Honzo’ by Morino Tosuke-Saikaku, who established private herb garden, ‘Morino herbal garden,’ supported by Tokugawa shogunate. Among Morino family documents, we also found the unpublished historical papers suggesting the various productions of crude drugs at Yamato region in Edo period, and considered the transition of domestic production area, cultivation strains and cultivation skills. We can find the descriptions of picking of buds and flowers among current production manuals, but it is suggested the possibility of flowers for ornamental or commercial use to improve economic efficiency by the investigation of regional cultures and interviews of experts of crude drugs.