Current state of drug analysis in Japanese emergency departments: a nationwide survey

Otani, Norio; Hifumi, Toru; Kitamoto, Takeshi; Kobayashi, Kentaro; Nakaya, Nobuaki; Tomioka, Joji

doi:10.1002/ams2.566

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…However, with the spread of simple automated analyzers based on ligand-binding assays and the promotion of outsourcing to clinical laboratories, the number of medical institutions with HPLC capability has decreased [ 1 ]. In the area of clinical toxicology, precision analytical equipment was installed in emergency departments in 1998 with support from the Ministry of Health, Labor, and Welfare, but most of the equipment are systems for high-performance liquid or gas chromatography coupled with mass spectrometer detectors; not many facilities use HPLC with UV–visible detectors as their main equipment [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Ebihara

Hamada

Kato

et al. 2022

IJERPH

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Under the Japanese health insurance system, medicines undergoing therapeutic drug monitoring (TDM) can be billed for medical fees if they meet the specified requirements. In Japan, TDM of vancomycin, teicoplanin, aminoglycosides, and voriconazole, which are used for the treatment of infectious diseases, is common practice. This means the levels of antibiotics are measured in-house using chromatography or other methods. In some facilities, the blood and/or tissue concentrations of other non-TDM drugs are measured by HPLC and are applied to treatment, which is necessary for personalized medicine. This review describes personalized medicine based on the use of chromatography as a result of the current situation in Japan.

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Section: Introductionmentioning

confidence: 99%

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Ebihara

Hamada

Kato

et al. 2022

IJERPH

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Development of a simple estimation method of serum caffeine concentration using a point-of-care test kit for urinary caffeine

Tsujikawa,

Okada,

Segawa

et al. 2024

Forensic Toxicol

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Purpose Serum caffeine concentration is an indicator of caffeine intoxication; however, it is difficult to measure it in most emergency departments. We developed a simple estimation method using a point-of-care test kit for urinary caffeine. Methods Caffeine-spiked human serum (100, 50, 25, and 10 µg/mL) was diluted 10-, 20-, 50-, and 100-fold with phosphate-buffered saline and applied to the kit. After 5 min incubation, the kit was scanned by a flatbed scanner and the membrane image was processed with ImageJ. Results When the 20-fold diluted serum was applied, serum samples with initial caffeine concentration ≤ 25 and ≥ 50 µg/mL were caffeine-negative and -positive, respectively. When the 100-fold diluted serum was applied, none of the caffeine-spiked serum samples gave positive results. Therefore, we proposed the following test procedure: (i) 20-fold diluted serum was initially tested and (ii) 100-fold diluted serum was additionally tested when the initial result was caffeine positive. Using this procedure, caffeine concentration is expected to be classified into three levels: ≤ 25, > 25– ≤ 100, and > 100 µg/mL, which almost correspond to no or mild, severe, and potentially fatal intoxication, respectively. The test procedure was validated using postmortem heart blood from two cases of fatal caffeine intoxication (caffeine concentration: 276 and 175 µg/mL) and two cases of other intoxication. Conclusions Our developed method using point-of-care urinary caffeine test kits enabled simple estimation of serum caffeine concentration.

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Potential Clinical Benefits of TDM of Antimicrobials in Japan

Ebihara¹,

Hamada²,

Maruyama³

et al. 2022

Preprint

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Under the Japanese health insurance system, medicines undergoing therapeutic drug monitoring (TDM) can be billed for medical fees if they meet the specified requirements. In Japan, TDM of vancomycin, teicoplanin, aminoglycosides, and voriconazole, which are used for the treatment of infectious diseases, is common practice. This means the levels of antimicrobial agents are measured in-house using chromatography. This review describes personalized medicine based on the use of chromatography as a result of the current situation in Japan.

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Current state of drug analysis in Japanese emergency departments: a nationwide survey

Abstract: We investigated the drug analysis environment in Japanese emergency facilities. Currently, the analytical environment is not sufficient. Further improvement is necessary for fulfilling medical care

Cited by 4 publications

References 6 publications

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Development of a simple estimation method of serum caffeine concentration using a point-of-care test kit for urinary caffeine

Potential Clinical Benefits of TDM of Antimicrobials in Japan

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