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MRI検査時に、剥がさなければならない貼付剤(外用剤)はありますか? | いなかの薬剤師 " /> その他 質問
MRI(磁気共鳴画像診断装置)検査時に、剥がさなければならない貼付剤(外用剤)はありますか?(質問)(注意喚起)
MRI検査を実施した場合、金属を含む一部の貼付剤により火傷を引き起こす
可能性がある
※2005年厚生労働省医薬食品局安全対策課長および
審査管理課医療機器審査室長より発出された
↓
MRIを実施する前に患者さんに確認する必要がある
①ポイント
貼付剤の支持体にアルミニウムや他の金属を使用したもの
※アルミニウムは導電性があり危険
※合成ケイ酸アルミニウムは導電性がない
(フェントステープ®)
②具体例
支持体にアルミニウムを含有し、 添付文書に注意の記載があるもの
ニトログリセリン貼付剤(ニトロダーム®TTS)
ニコチン(ニコチネルパッチ®)→スイッチOTC、第一類医薬品
ニコチン(ニコチネル®TTS)
支持体ではないが、アルミニウムを含むもの
ブプレノルフィン(ノルスパン®テープ)
支持体には金属はないが、インクに金属を含むもの
(火傷の可能性は低い)
フェンタニル(デュロテップ®MTパッチ)
(インクは外側で火傷の可能性は低い)
支持体に金属を含まないもの(大丈夫なもの)
硝酸イソソルビド徐放剤(フランドル®テープ)
ビソプロロールフマル酸塩(ビソノ®テープ)
ツロブテロール(ホクナリン®テープ)
フェンタニルクエン酸(フェントス®テープ)
エメダスチンフマル酸塩(アレサガ®テープ)
③添付文書に注意喚起の例
ニトロダーム®TTS
以下の療法を行うときは、前もって本剤を除去すること。
1) 電気的除細動(DC細動除去等)〔除細動器と接触した場合、
本剤の支持体(アルミニウム箔)が破裂することがある。〕
2) ジアテルミー(高周波療法)〔本剤の温度が上昇するおそれ がある。〕
3) MRI(核磁気共鳴画像法)〔本剤の貼付部位に火傷を引き起 こすおそれがある
ニコチネル®TTS
以下の療法を行うときは、前もって本剤を除去すること。
1)電気的除細動(DC細動除去等)
〔本剤の支持体と類似するアルミニウムが使用されている製剤で、除細動器と接触した場合、製剤の支持体(アルミニウム箔)が破裂したとの報告がある。〕
2)ジアテルミー(高周波療法)〔本剤の温度が上昇するおそれがある。〕
3)MRI(核磁気共鳴画像法)〔本剤の貼付部位に火傷を引き起こすことがある。〕
サウナの使用や激しい運動を行うときは、前もって本剤を除去すること。
〔ニコチンの吸収量が増加し、過量摂取時の症状があらわれることがある。〕
発熱している患者では、ニコチンの吸収量が増加し、過量摂取になるおそれがある。
ノルスパン®テープ
その他の注意
「MRI(核磁気共鳴画像法)による検査を実施する場合は前もって本剤を除去すること。〔本剤の貼付部位に火傷を引き起こすおそれがある。〕」
ノルスパン®テープに関してはインタビューフォームも引用
「本剤は支持層に導電性の金属を使用していないが、組成中に導電性物 質であるアルミニウムアセチルアセトナートを含んでいるため、
MRIの高周波電磁場により、本剤貼付部位が過度の高周波過熱を引き起こすおそれがある。また、ブプレノルフィンテ-プ剤貼付中の患者がMRI 検査を受けたとき、「適用部位熱傷」を発現したとの海外自発報告もあることから、
MRI による検査を実施する場合は前もって本剤を除去すること。
補足
パップ剤は水分を含むので熱く可能性があるので注意すること
参考資料
各製剤の添付文書
ノルスパン®テープ インタビューフォーム