1.The Role of Pharmacists in Supporting Home Catecholamine Therapy for Inotrope-Dependent Patients With End-Stage Heart Failure
Miki TAKAMIZAWA ; Toru SHINOHARA ; Mitomi TAKANO ; Makoto TAKAMIZAWA ; Yoshiyuki AOKI ; Hirokazu KOMATSU ; Takahiro TACHIBANA ; Yutaka AOKI ; Atsushi MIURA ; Kenichi HORIUCHI ; Yoshikazu YAZAKI
Journal of the Japanese Association of Rural Medicine 2025;73(5):415-424
Patients with heart failure often have difficulty in stopping cardiotonic drugs as the disease stage progresses, and long-term hospitalization is a factor that significantly reduces quality of life. To solve this problem, in September 2017, our hospital started an initiative to support overnight stays at home by using a portable precision infusion pump and continuously injecting cardiotonic drugs with the approval of the hospital’s medical ethics committee. Since there are few case reports of similar efforts in Japan, here we describe the use of drugs and the content of the intervention by pharmacists. The drug is administered via a peripherally inserted central venous catheter using an ambulatory precision infusion pump. The pharmacist calculates the drug dose and flow rate required during the at-home period using spreadsheet software, and proposes a prescription to the doctor. In addition, if multiple cardiotonics and diuretics are administered, the presence or absence of compounding changes is confirmed, and the feasibility of mixing should be examined, and then prepared aseptically on a clean bench on the day of administration. We started to administer catecholamine while in the hospital on the day before the stay at home. Then we prepared the catecholamine in a portable precision infusion pump and administered it during stay at home. To date, we have supported 8 cases in stays at home without emergency hospitalization or sudden death due to exacerbation of heart failure.
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