薬歴からみた抗結核剤の副作用と服薬指導への応用

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Antituberculosis chemotherapy still requires a long duration of over several months or more than a year, though it has become shorter in recent times than before, and discontinuance of chemotherapy may be occasionally seen during this long course. A retrospective study was carried out with the aid of the pharmacist-conducted medication profiles, in order to find out the reasons for discontinuance of chemotherapy and to know whether pharmacists can assist continuity of long-term chemotherapy in tuberculous patients. From the medication profile, it was found that among 714 cases to whom antituberculous drugs were prescribed in our hospital from March 1988 to January 1990, 179 cases were likely to be involved in some adverse reaction. When these cases were referred to doctor's medication charts, 144 cases were revealed to develop adverse reactions, among which 65 cases had skin rash, 26 cases had drug fever, 41 cases had liver function abnormality, 35 cases had miscellaneous reactions such as gastrointestinal, neurological and haematological disorders. Desensitization was carried out in 66 cases with success in 46 cases. As a whole, the antituberculous chemotherapy was either discontinued or a new drug(s) was given, in 44 out of 714 cases (5.9%) due to adverse reactions. The major reason for discontinuance of drug intakc was adverse reactions, followed by self-stopping or delayed hospital visit and change of drug due to appearance of resistance, retreatments of tuberculosis or surgical operation. Pharmacists can counsel patients effectively by reading medication profile carefully, recognizing their drug intake conditions, identifying the reason for discontinuance of medication and being aware of adverse reactions, and can contribute to improvement of the patient compliance with chemotherapy in long-term tuberculosis treatment.
日本医療薬学会の論文
1992-10-20

薬歴からみた抗結核剤の副作用と服薬指導への応用

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