著者

川上 恵 北田 徳昭 米澤 淳 岡村 みや子 尾崎 淳子 池見 泰明 中川 俊作 今井 哲司 中川 貴之 土井 恵太郎 秋月 修治 武藤 学 寺田 智祐

出版者

一般社団法人 日本医薬品情報学会

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.25, no.2, pp.83-90, 2023-08-31 (Released:2023-09-15)

参考文献数

18

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Objective: In patients with specific backgrounds, comprehensive identification of health problems and proactive pharmacist intervention are crucial to providing safe and effective medical care. However, there are insufficient reports on chemotherapy regimen selection and supportive care management in patients taking immunosuppressants. In this study, to circumvent adverse events, pharmacists intervened with a patient administering tacrolimus (TAC) using known information, focusing on multiple factors attributable to the patient in addition to drug interactions.Methods: The patient was a male in their 70s who received palliative chemotherapy for gastric cancer during their dermatomyositis treatment with TAC. Pharmaceutical support for cancer chemotherapy was provided using the following four procedures: (1) Patient information was collected from interviews and electronic medical records to identify patient-specific problems; (2) Basic pharmacological information was collected from tertiary sources, focusing on the interaction between TAC and aprepitant (APR). Furthermore, clinical reports were collected, and the pharmacokinetic drug interaction significance classification system was used for quantitative predictions; (3) The information obtained in steps 1) and 2) was evaluated, and comprehensive proposals linked to the patient information were presented; (4) Adverse events, TAC blood level, and patient outcomes were monitored after treatment initiation.Results: A chemotherapy regimen consisting of S-1/oxaliplatin therapy without APR was selected. The adverse effects were controllable, and the treatment was completed without many adverse events. Meanwhile, TAC adherence was unaffected by cancer chemotherapy, and the TAC blood concentration or dose ratios were controlled within the same range as previously reported.Conclusion: In cancer chemotherapy, for cases with limited evidence or information, comprehensive pharmaceutical support was provided using known patient information, considering multiple patient factors. This report is beneficial as an example of supportive care management by a pharmacist and contributes to providing optimal service in cases with specific backgrounds.

著者

大野 能之 樋坂 章博 岩本 卓也 木村 丈司 百 賢二 米澤 淳 伊藤 清美

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.11, pp.537-545, 2018-11-10 (Released:2019-11-10)

参考文献数

11

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The first academic subcommittee of the Japanese Society of Pharmaceutical Health Care and Sciences has a plan to create a guide on how to manage drug interactions in clinical settings. This review describes the information that forms the basis of the guide. This article, part (1), reports the results of a questionnaire on the content of the guide and also describes how to evaluate and manage drug interactions in clinical settings. The contents of the ʻDrug Interaction Guideline for Drug Development and Labeling Recommendationsʼ, the new Japanese guideline, are also described. It is important also in clinical practice to appropriately evaluate and manage drug interactions based on a sufficient understanding of the new guideline and related information.

著者

櫻井 香織 尾崎 淳子 矢野 育子 安達 昂一郎 木村 嘉彦 松村 勝之 西脇 布貴 吉田 優子 池見 泰明 萱野 勇一郎 米澤 淳 深津 祥央 松原 和夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:18821499)

巻号頁・発行日

vol.42, no.5, pp.336-342, 2016-05-10 (Released:2017-05-10)

被引用文献数

7

著者

木村 丈司 岩本 卓也 大野 能之 樋坂 章博 百 賢二 米澤 淳 伊藤 清美

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.11, pp.546-558, 2018-11-10 (Released:2019-11-10)

参考文献数

44

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The first academic subcommittee of the Japanese Society of Pharmaceutical Health Care and Sciences has a plan to create a guide on how to manage drug interactions in clinical settings. This review describes the information that forms the basis of the guide. This article, part (2), summarizes the practice reports on managing drug interactions in clinical settings, their problems, and the proper concepts of drug interactions in patients with special background. Each pharmacist is expected to enhance the literacy of drug interactions and manage them adequately, which will lead to the improvement of clinical outcomes.

著者

百 賢二 米澤 淳 岩本 卓也 大野 能之 木村 丈司 樋坂 章博 伊藤 清美

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.11, pp.559-567, 2018-11-10 (Released:2019-11-10)

参考文献数

31

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The first academic subcommittee of the Japanese Society of Pharmaceutical Health Care and Sciences has a plan to create a guide on how to manage drug interactions in clinical settings. This review describes the information that forms the basis of the guide. As evidence for drug interactions with various mechanisms has not been clarified for all combinations, each case needs to be managed based on knowledge of clinical pharmacology regarding drug interactions. This article, part (3), shows the examples of both experimental and surveillance studies on drug interactions and also summarizes the points that require consideration when conducting surveillance studies.The focus on drug interactions based on polypharmacy is increasing given that the number of elderly people continues to increase in Japan. Pharmacists are expected to contribute to the proper use of drugs through the assessment and performance of wet and dry studies.

著者

森田 真樹子 米澤 淳 森 美奈子 田﨑 嘉一 長屋 健 千石 一雄 松原 和夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.39, no.8, pp.504-509, 2013-08-10 (Released:2014-08-10)

参考文献数

16

被引用文献数

1 1

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Breastfeeding is important in infant rearing. To support safe breastfeeding in a patient using lamotrigine, the transfer of lamotrigine to the infant via breast milk was evaluated in two couples of Japanese mother and infant. The infants took their mothers' milk expressed a day ahead. The plasma and breast milk concentrations of lamotrigine at 4 (or 5) and 89 (or 90) days after the birth were measured by HPLC. The lamotrigine concentrations of the two mothers were 12.63 and 6.21 µg/mL in plasma, 11.50 and 4.13 µg/mL in milk at Day 4. Milk/Plasma ratios (M/P) were 0.91 and 0.67, and the estimated Relative Infant Dose (RID, at Day 5) was calculated to be 12-29%. At 89 and 90 days after birth, the milk concentrations and RID, respectively, were similar to those at 4 days, which indicates that the transfer of lamotrigine into milk is high in Japanese mothers. The infant plasma concentrations of lamotrigine at 5 and 90 days were between 2.8 and 6.7 µg/mL, which was within the therapeutic range in children with epilepsy. Typical adverse effects were not observed in these infants under meticulous surveillance. In conclusion, pharmaceutical healthcare is necessary for lactating mothers using lamotrigine and their infants.

著者

片田 佳希 中川 俊作 田上 裕美 津田 真弘 都築 徹教 端 幸代 小高 瑞穂 米澤 淳 萱野 勇一郎 矢野 育子 南方 謙二 坂田 隆造 松原 和夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.42, no.1, pp.14-22, 2016-01-10 (Released:2017-01-10)

参考文献数

14

被引用文献数

4 6

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Vancomycin (VCM) is a first-line antibiotic used for methicillin-resistant Staphylococcus aureus (MRSA), and therapeutic drug monitoring (TDM) is recommended to minimize the risk of nephrotoxicity and ensure successful therapeutic outcomes. In Kyoto University Hospital, we have developed a new approach of pharmacist intervention in the medication with VCM, which is named “Protocol-Based Pharmacotherapy Management (PBPM).” PBPM is based on a protocol approved in a hospital committee, which mentioned that pharmacists could order TDM and propose the most appropriate treatment plans with VCM to surgeons. From April 2011 to September 2014 in Kyoto University Hospital, a total of 54 patients hospitalized for cardiovascular surgeries received VCM without the treatment of hemodialysis. Twenty-nine patients before introducing PBPM were the control group. The VCM treatment according to PBPM was applied to 25 patients (protocol group). The incidence of acute kidney injury (AKI) due to VCM therapy, the retention rates of VCM blood concentration maintained in the therapeutic range (10-20 µg/mL) and in the toxic range (over 20 µg/mL) were retrospectively surveyed. The incidence of AKI was significantly lower in the protocol group than that in the control group (8.0% vs 31.0%, P < 0.05). The retention rates maintained in the therapeutic blood concentration range and in the toxic blood concentration range were significantly different between the control group and the protocol group. These results demonstrate that pharmaceutical intervention based on PBPM for MRSA treatment is effective for maintaining VCM blood concentration in the therapeutic range, resulting in a reduction of adverse drug reactions.

著者

米澤 淳

出版者

日本DDS学会

雑誌

Drug Delivery System (ISSN:09135006)

巻号頁・発行日

vol.27, no.5, pp.381-388, 2012-11-30 (Released:2013-02-28)

参考文献数

24

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プラチナ系抗がん剤は現在も幅広く臨床使用されている。これらの毒性発現機構は酷似しているにも関わらず、腎毒性をはじめとして異なった特徴を呈する。トランスポータはその基質認識特異性、発現分布、機能特性によって、組織への薬物の輸送を司る。近年の研究により、有機カチオントランスポータOCTとmultidrug and toxin extrusion MATEがプラチナ系抗がん剤のドラッグデリバリーに重要な役割を果たすことが明らかにされてきた。本稿では、トランスポータを介したプラチナ系抗がん剤のデリバリーに焦点を当てて解説する。