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< 美容師さんも手袋を | メイン | 職業性鼻出血(急性） >
2009.05.29 21:30 |  診療  |  医療事故  |  その他（医療関連）  |  ミチバ  | 推薦数 : 3

「重篤副作用疾患別対応マニュアル」ってご存じ？

・今回，私の「知ったら，知らせるポリシー」により，書いた記事です．  

・厚労省が，重篤な薬剤の副作用対策の一環として，「重篤副作用疾患別対応マニュアル」を作成しています．以下のようなものが現在作られているそうです．

皮膚

肝臓

腎臓

血液

呼吸器

消化器

心臓・循環器

神経・筋骨格系

精神

代謝・内分泌

過敏症

口腔

骨

泌尿器

感覚器（眼）

 

上記臓器・系統別の「大分類」ですが，その中がまた，細かく分かれています．以下のようにそれぞれマニュアルが作成されています．

 

・皮膚

スティーブンス・ジョンソン症候群

中毒性表皮壊死症

薬剤性過敏症症候群

急性汎発性発疹性膿疱症

・肝臓

 薬物性肝障害

・腎臓

急性腎不全

間質性腎炎

・血液

再生不良性貧血（汎血球減少症）

薬剤性貧血

出血傾向

無顆粒球症（顆粒球減少症、好中球減少症）

血小板減少症

血栓症（血栓塞栓症、塞栓症、梗塞）

播種性血管内凝固（全身性凝固亢進障害、消費性凝固障害）

・呼吸器

間質性肺炎

非ステロイド性抗炎症薬による喘息発作

急性肺損傷・急性呼吸窮迫症候群（急性呼吸促迫症候群）

肺水腫

胸膜炎、胸水貯留

・消化器

麻痺性イレウス

消化性潰瘍

偽膜性大腸炎

急性膵炎（薬剤性膵炎）

・心臓・循環器

心室頻拍

うっ血性心不全

・神経・筋骨格系

薬剤性パーキンソニズム

白質脳症 

横紋筋融解症

末梢神経障害

ギラン・バレー症候群：

ジスキネジア

痙攣・てんかん

・精神

悪性症候群

薬剤惹起性うつ病

・代謝・内分泌

偽アルドステロン症 

甲状腺中毒症

甲状腺機能低下症

高血糖

・過敏症

アナフィラキシー

血管性浮腫

喉頭浮腫

非ステロイド性抗炎症薬による蕁麻疹／血管性浮腫 

・口腔

ビスホスホネート薬剤による顎骨壊死　

薬物性口内炎

抗がん剤による口内炎

・骨

 骨粗鬆症

・泌尿器

尿閉・排尿困難

・感覚器（眼）

網膜・視路障害

緑内障

 

こっちのサイトでも見れます↓

http://www.info.pmda.go.jp/juutoku/juutoku_index.html  

・今日の夜間診療は，４時間かかりました．疲れました．

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肺の最初で薬剤性肺臓炎、薬剤性肺障害、といわずに間質性肺炎、というところが日本の役人らしいですねえ。

なんでもかんでもよくわからない胸部単純写真の陰影をみたら「間質性陰影が疑われ...」と一生言い続ける医者と同レベルですねえ....

＞Paul Carpenterさま，コメントありがとうございます．
なかなか，厳しいご意見で．私もなかなか確定的な所見をいえないでおります．（でも，「一生」ではないとおもいますが）
written by Paul Carpenter / 2009.05.30 08:24

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