Ohtsubo Yasuaki, Ishimito Keizo, Tanioka Momoe, Uchiumi Keiko, Fujimoto Naoko, Ishimitsu Tadashi, Uchida Yutaka, Kamiya Akira
Department of Pharmacy, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube 755-8505, Japan.
Yakugaku Zasshi. 2002 Jun;122(6):389-97. doi: 10.1248/yakushi.122.389.
A checking system was developed for risk management of injectable anticancer drug use. Because the dosage and administration of injectable anticancer drugs vary with each patient, checking the prescription and aseptic i.v. admixing can be markedly complicated and time-consuming for pharmacists. The system we investigated in this study provided real-time checking of dosage, drip infusion rate, dosing periods, and dosing-free periods. The prescription parameters for this check included height, weight, body surface area, the medical history of each patient, the patient's ICD10 code' and disease indication from the package insert. Moreover, when preparing for aseptic i.v. admixing, the liquid volume after the anticancer drug has been mixed with other injectable drugs is calculated automatically. The time limits for stability after mixing and clinical laboratory test results are listed on the Work Sheet. As a result, 24 medication errors were prevented in the first 6 months of use of this system. These consisted of over- and under-doses, excessive dosing periods, insufficient dosing-free periods' etc. The time required for preparation of aseptic i.v. admixing decreased by 73% after introducing this system. Because clinical laboratory test results were referenced beforehand, patients to whom the drug should not be administered were recognized in advance. Thus 13 such cases were identified before i.v. admixing. Therefore this system may be useful in terms of rational anticancer drug use and risk management.
开发了一种用于注射用抗癌药物使用风险管理的检查系统。由于注射用抗癌药物的剂量和给药方式因患者而异,对药剂师来说,检查处方和无菌静脉混合操作可能会非常复杂且耗时。我们在本研究中调查的系统可对剂量、滴注速率、给药周期和无给药期进行实时检查。此次检查的处方参数包括身高、体重、体表面积、每位患者的病史、患者的ICD10编码以及药品说明书中的疾病适应症。此外,在准备无菌静脉混合时,抗癌药物与其他注射用药物混合后的液体体积会自动计算出来。混合后的稳定性时间限制和临床实验室检测结果会列在工作表上。结果,在该系统使用的前6个月预防了24起用药错误。这些错误包括剂量过多和过少、给药周期过长、无给药期不足等。引入该系统后,无菌静脉混合的准备时间减少了73%。由于事先参考了临床实验室检测结果,提前识别出了不应使用该药物的患者。因此,在静脉混合前识别出了13例此类病例。所以,该系统在合理使用抗癌药物和风险管理方面可能会很有用。