集中治療室における集中治療医と主科担当医の薬剤使用に対する認識の相違

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In general, medical staff members do their utmost to select appropriate medicines for each patient whenever possible. When choosing medicines, pharmacists have to provide medical staff members and patients with high quality information. However, it is often difficult to select the optimal medicine for patients. When physicians in Intensive Care Unit (ICU) and chief physicians select medication, how do they obtain mutual consent, and what kind of drugs are readily provided by mutual agreement ? We tried to investigate this point using a questionnaire against given to both physicians and chief physicians in ICUs.Physicians in ICU and chief physicians were requested to fill in questionnaires regarding how they selectinjection preparations in terms of purpose, reason and expectations of efficacy in order to inject preparations which are used with high frequency in ICU.As a result, three factors when selecting injection preparations were found to vary among the physicians depended on the medications. These three factors were closely correlated with the injection preparations for the circulatory system since it was easy to evaluate their effects. However, when selecting dopamine and furosemide (20mg), disagreements often arouse even when there was agreement on the purpose and expectations of the drug.The effects of other injection preparations are difficult for physicians in ICU and chief physicians to evaluate because they are often used for different purposes. For example, pirenzepin was found to be continually used even though its effects were unclear.These results suggest that purposes and reasons for using injection preparations and the expectations of efficacy do not always correlate between ICU physicians and chief physicians, even though they may hold a meeting to discuss such drug selection in the ICU. As a results, it is important that pharmacists provide information based on evidence for selecting medicines in order to promote the appropriate and rational use of medicines in ICU.