??????Personal Drug????:???????????????????

1
?????Personal Drug
?34???????????(2002.07.26-27???)???????? ??????Per
sonal Drug???????????????????????
??????????????? (????????????????) ?? ??
2
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2001?8? ?????????????????????????? ?????????????
?(?)? 2001?9? ??????????????? ??????????????(?
)? 2001?12? ????????????????????????? ??????
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???????????? ?????????????????????????? 2002?4
? ???????????????????(?)?
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??????????????????? (?)?(1/3)
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????? D. ???????????????????? http//www.pharm
.or.jp/rijikai/curriculum/index.html????
4
??????????????????? (?)?(2/3)
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??????????????????? (?)?(3/3)
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????????????? ?????/????/????????????????? EBM
(????) 1. EBM??????????????????? 2.
EBM?????????????? 3. ???????????????????? 4.
?????????????????????????????(??) 5.
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??????????(??????????????????)?????????? 7.
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????????????3????????
2002?5?17? ??????????(???)???????????????????????
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002?5?17? ????????????????????????????????6???????
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????????????????? 2002?6?4? ?????????????????????
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2002?6?5? ?????????????????1???????? 2002?7?10?
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?????????? 2002?7?10? ????????????????(?????????
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???????????????????? ?????????? (???????????)
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WHO Guide to Good Prescribing (GGP) ? P-drug
P-drug (Personal drug) ??? ????Groningen?????????
???? (?????)???????????? WHO ? Action Programme
on Essential Drugs ? ????????????????? Evidence?
????????????????? ????????????????????? WHO
GGP??????????? ??????????? (therapeutic
reasoning)? ??????????????????????
?????????????????? ????????????????? ????7
?????(219?)????????? ????P-drug????????????
???????????????????
????6???????????? (Lancet, 346, 1454-57,
1995)?
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P-drug Seminar on Rational Pharmacotherapy with
WHO Guide to Good Prescribing Department of
Hospital Pharmacy, Toyama Medical and
Pharmaceutical University
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P-drug???????????????????
????????????????????? ????????????(??)?????????
??????P-drug ????????????????????????????
????????????????????????????????
????????????????????????????? ??WHO????Rational
Use of Drug????Essential Drug Irrational
Use of Drugs Pathology of Prescribing
?????????????????????????????
?????????????????????????????? ?
Prescriber???Dispenser???????
Prescriber(??????)?Dispenser(???????)???
Dispenser?????????????? Dispensing?????????????
??? Prescriber???Dispenser???(????)
????????????????????? ?
?????????????Dispenser???
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LESSON PLANNING SHEET 1. Case/Indication 2.
Objectives a. At the end of lessons, the
students should know about b. At the
end of lessons, the students should be
able to 3. Lesson a. Introduction/Presentation
Time b. Assignment for Students c.
Discussion (Key Points Time) d. Summary
Conclusion 4. Remarks Notes
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MULTI-ATTRIBUTE UTILITY ANALYSIS SHEET
Drugs or Drug group
Efficacy (weight )
Safety (weight )
Suitability (weight )
Cost (weight )
Total Score (weight 100)
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(No Transcript)
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PATIENT CASE FOR TEACHING PATIENT
DRUGS SELECTED INDUCATION Hypertension PATIENT-D
RUG CASE (example) Mr. M.K. is a 51 years old
man working as a department manager in one of the
Japanese top-ranking companies. High blood
pressure (160-170 / 100-105 mmHg) was found
during a routine medical examination by his
company-physician. He is now visiting your
clinic for the treatment of hypertension. His
past medical history is not significant, but
slightly elevated blood glucose level was
suggested for the past 2 years. His father died
of stroke 3 months ago. He weighs 85 kg, and his
height is 170 cm. He smokes 2 packs of
cigarettes and drinks 2 cans of beer a day. He
complains of occasional cough and wheezing.
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PATIENT DRUG CONCEPT 1. Define the
Problem (Diagnose), Therapeutic Objectives
and take your P-drug and/or treatment 2. Control
the Suitability of your P-drug for this Patient
a. Contrainducations b. Interactions
c. Convenience 3. Identify the Definite
(Pharmaco)therapy Choice a. Drug b.
Administrative Form c. Dosage d. Length
of Treatment e. Non-drug Treatment
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PRACTICAL ASPECTS OF PRESCRIBING 4. The full
prescription (prescription form) 5.
Information, instruction, and warnings a.
Effect of the drug (what, when, how long)
b. Side effect (what, when, how long, what to
do) c. Instructions (administration/use,
dosage, intervals, how long, important
points) d. Warnings (maximum dosage,
possible interactions, adverse
reactions, (not) terminating therapy) 6.
Appointment (following appointment, when
to come earlier)
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???????????P-drug????? ?? (1/4)
???????????????????????????????????????(2000-2001?
?n32)?
?.?????????5????????
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???????????P-drug????? ?? (2/4)
5. ????????????????? lt??gt ???????????????????????
????????????? ??????????????????????????? ??????
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? ????????????????????????????????????? ????????
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????????? lt??gt ?????????????????????????????????
?? ???????????????????????????????????? ????????
??????????????????????????? ?????????????????????
???????????????? ?????????????????????????
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???????????P-drug????? ?? (3/4)
5. ?????????????????(??) lt????gt ????????????????
??????????????????? ???? ???????????????????????
??????????? ?????????????????P-drug??????????????
???? lt??????gt ??????????????????????????????????
???? ????????????????????????????????????
???? ?????????????????????????????????????
P-drug????????????????????????????????
?????????????????????? ??????????????????????????
??????????? ????????????????????????????????????
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???????????P-drug????? ?? (4/4)
6. ????????????????? ???????????????????????????
??????? ????????????????????????????????????? ??
??????????????????????????????????
???? ????????????????????????????????????
??????????????????????????????????? ?????5?????
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?????????????? ??????????????????????????????????
?
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????????????P-drug????? ?????????????????
???????????????? ? ??????????????????
etc. ????????????????? ? ????????????????????
??????? WHO Guide to Good Prescribing?????????
? ????????????????????? ??????????????????
? ????????????????? ??????? ???(??)???????
???? ? ?????????? ?????????????????