白内障手術患者における服薬状況と緑内障禁忌薬の内服実態

Survey on drugs contraindicated for patients with glaucoma by cataract operation

要約　目的：白内障手術に際しての，薬剤師による服薬管理で明らかになった緑内障禁忌薬の処方状況。対象と方法：当院で行った白内障手術で，術前の薬剤師による服薬管理で処方状況が明らかになった231例231眼を対象とし，緑内障禁忌薬，前房角膜比について検討した。結果：緑内障禁忌薬を処方されていたのは92例（39.8％）で，「抗不安薬，睡眠薬」の割合が69.1％と最も多かった。van Herick法Grade 2以下の症例が23例（10.0％）に認められ，そのうち12例（52.2％）で緑内障禁忌薬が処方されていたが，観察期間中に緑内障発作を発症した症例はいなかった。結論：緑内障禁忌薬は高率で処方されているため，薬剤師や他診療科と協力し正確な処方実態の把握が重要だと思われた。

Abstract.　Purpose：We investigated the drugs that had been prescribed to cataract operation cases to see if they were possibility of inducing acute attack of angle closure glaucoma（ACG）or not. Method：In 231 patients hospitalized for cataract operation in Kiyokawa hospital, pharmacist conducted a face-to-face questionnaire survey with patients. Result：92 patients（39.8％）had used drugs described in package inserts as having contraindications for glaucoma patients. The drugs contraindicated for glaucoma patients that had been most prescribed was“anxiolytics and hypnotics”（69.1％）. Investigation of depth of anterior chamber status showed that the prevalence of narrow angle（van Herick Grade 1 or 2）was 10.0％. Though 52.2％ of narrow angle patients had been prescribed these drugs, there was no incidence of ACG. Conclusion：Cooperation between ophthalmologist and pharmacist is necessary to prevent inducing ACG by drug contraindicated for glaucoma patients.