著者

入口 慎史 今井 徹 吉田 善一 折井 孝男

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.135, no.5, pp.745-751, 2015 (Released:2015-05-01)

参考文献数

32

被引用文献数

2 6

---

Therapeutic drug monitoring (TDM) of vancomycin (VCM) is recommended to minimize its nephrotoxicity and maximize efficacy. Recently, the concept of systemic inflammatory response syndrome (SIRS) has been introduced to describe a clinical state resulting from the actions of complex intrinsic mediators in an acute-phase systemic response. However, there are few reports on the pharmacokinetics of VCM in patients with SIRS. This study investigated the effect of SIRS on the pharmacokinetics of VCM by analyzing the predictability of TDM and pharmacokinetic parameters in 31 non-SIRS patients and 52 SIRS patients, with stratification by SIRS score. The mean prediction error (ME) and mean absolute prediction error in SIRS score 2 and 3 patients differed from those in non-SIRS patients. The ME in the score 4 group showed a negative value. In the comparison of pharmacokinetic parameters by SIRS score, a significantly lower CLvcm value was observed at score 4 compared with scores 2 and 3, a higher Vd value was observed at score 4 compared with non-SIRS and at score 3, and a longer T1/2 was observed at score 2. In the comparison of patient characteristics by SIRS score, albumin, aspartate aminotransferase, and alanine aminotransferase levels showed differences among the scores. However, no correlation was observed between VCM pharmacokinetics and these three laboratory parameters. These findings suggest that the pharmacokinetics of VCM may be affected by the pathology of SIRS rather than by patient characteristics.

著者

今井 徹 吉田 善一

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.136, no.7, pp.967-972, 2016 (Released:2016-07-01)

参考文献数

7

被引用文献数

1

---

Emergency and critical care centers provide multidisciplinary therapy for critically ill patients by centralizing the expertise and technology of many medical professionals. Because the patients' conditions vary, different drug treatments are administered along with surgery. Therefore, the role of pharmacists is important. Critically ill patients who receive high-level invasive treatment undergo physiological changes differing from their normal condition along with variable therapeutic effects and pharmacokinetics. Pharmacists are responsible for recommending the appropriate drug therapy using their knowledge of pharmacology and pharmacokinetics. Further, pharmacists need to determine the general condition of patients by understanding vital signs, blood gas analysis results, etc. It is therefore necessary to conduct consultations with physicians and nurses. The knowledge required for emergency medical treatment is not provided during systematic training in pharmaceutical education, meaning that pharmacists acquire it in the clinical setting through trial and error. To disseminate the knowledge of emergency medical care to pharmacy students, emergency care training has been started in a few facilities. I believe that medical facilities and universities need to conduct joint educational sessions on emergency medical care. Moreover, compared with other medical fields, there are fewer studies on emergency medical care. Research-oriented pharmacists must resolve this issue. This review introduces the work conducted by pharmacists for clinical student education and clinical research at the Emergency and Critical Care Center of Nihon University Itabashi Hospital and discusses future prospects.

著者

入口 慎史 今井 徹 田中 昌代 田沼 道也 折井 孝男 加藤 敏明

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.137, no.9, pp.1117-1127, 2017 (Released:2017-09-01)

参考文献数

32

---

We conducted a meta-analysis to investigate the influence of antifungal spectrum on the effectiveness and adverse events of empirical antifungal therapy for febrile neutropenia. We searched PubMed and Cochrane Central Register of Controlled Trials (Central), and identified randomized controlled trials reporting mortality, efficacy, adverse events, and hepatic and renal dysfunction. Five trials assessed the efficacy and adverse events of agents with antifungal spectrum covering and those not covering Aspergillus. There were no differences in mortality [risk ratio (RR); 0.79, 95% confidence interval (Cl); 0.60-1.02], efficacy ratio (RR; 1.01, 95%Cl; 0.91-1.12), adverse event ratio (RR; 0.23, 95%Cl; 0.04-1.23), and hepatic dysfunction ratio (RR; 0.81, 95%Cl; 0.59-1.12) between two groups. Antifungals with no activity against Aspergillus were associated with lower renal dysfunction ratio (RR; 0.27, 95%Cl; 0.10-0.71). Five trials compared agents with antifungal spectrum covering versus those not covering Mucor. There were no difference in mortality (RR; 1.24, 95%Cl; 0.98-1.57), efficacy ratio (RR; 1.09, 95%Cl; 0.91-1.30), and hepatic dysfunction ratio (RR; 0.98, 95%Cl; 0.66-1.45) between two groups. Antifungals with no activity against Mucor were associated with lower adverse event ratio (RR; 0.60, 95%Cl; 0.47-0.77) and renal dysfunction ratio (RR; 0.25, 95%Cl; 0.13-0.49). Presence or absence of activity against Aspergillus or Mucor is not associated with mortality or efficacy ratio. Amphotericin B with activity against Aspergillus and Mucor has a higher adverse event ratio. Depending on the case, selection of antifungal drugs considering efficacy and side effects is necessary.

著者

菊池 憲和 今井 徹 中馬 真幸 鏑木 盛雄 吉田 善一

出版者

一般社団法人 日本臨床救急医学会

雑誌

日本臨床救急医学会雑誌 (ISSN:13450581)

巻号頁・発行日

vol.19, no.1, pp.46-51, 2016-02-29 (Released:2016-02-29)

参考文献数

7

---

目的:救急認定薬剤師の現状と今後の課題を把握するために,救急認定薬剤師の業務実態と展望を調査した。方法:2014年4月1日時点で日本臨床救急医学会により認定を受けた救急認定薬剤師に択一選択および自由記述の調査用紙を郵送した。結果:調査用紙の回収率は75%,所属施設の病床数は平均649床,救急・集中治療業務への従事率は77%であった。現在の業務内容として,処方提案,注射薬の監査,麻薬等の管理,投与速度の算出,治療薬物モニタリング(therapeutic drug monitoring; TDM),持参薬の確認については80%以上が行っており,救急認定薬剤師が精通している領域は,救急医療が最も多かった。今後実施したいと考えている業務は初療が60%,今後の展望として,業務のガイドライン作成が73%と最も多かった。考察:救急認定薬剤師が大小さまざまな施設で救急・集中治療に従事しており,今後は初療に関与してゆくことが課題であり,早急に業務ガイドラインの作成を行う必要があると考える。

著者

舩津 保浩 砂子 良治 小長谷 史郎 今井 徹 川崎 賢一 竹島 文雄

出版者

公益社団法人日本水産学会

雑誌

日本水産学会誌 (ISSN:00215392)

巻号頁・発行日

vol.66, no.6, pp.1036-1045, 2000-11-15

被引用文献数

18 25

---

マルソウダから調製した魚醤油(FMS)の呈味成分を, 国内産魚醤油(しょっつる(S), いかいしる, いわしいしる(IS))および大豆こいくち醤油(SS)と比較した。その結果, FMSは遊離アミノ酸やオリゴペプチド態アミノ酸総量が, 比較した全試料の中で最も多く, SSのそれらよりも多かった。全試料で, AMP, IMPおよびGMPは検出されなかった。FMSとSSで有機酸の総量は極めて高いが, その大部分は乳酸であった。FMSとSSはKとP含量が高く, Naが比較的少なかった。官能評価では, SとISでは塩味が強いが, FMSとSSでは, 塩味は強いとは感じられず, まろやかで味のバランスがとれていた。

著者

平田(中原) 久美子 鈴木 慎一郎 今井 徹 鷲巣 晋作 田村 めい 間 勝之 大塚 進 木村 高久

出版者

日本社会薬学会

雑誌

社会薬学 (ISSN:09110585)

巻号頁・発行日

vol.39, no.1, pp.19-22, 2020-06-10 (Released:2020-07-01)

参考文献数

16

---

Distigmine has reversible and persistent cholinesterase (ChE) antagonism, and is used for the dysuria due to low activity bladders such as the neurogenic bladder dysfunction widely postoperatively, but fatal cases were reported by cholinergic syndrome. Therefore a dose was limited to 5mg only for adaptation of “the dysuria due to hypotonic bladder such as after surgery and the neurogenic bladder dysfunction” in March, 2010. In the current study, we examined a ministerial policy in the package insert revision using Japanese Adverse Drug Event Report database (JADER). Using a side effect report registered with JADER from January, 2004 to June, 2016, we calculated Reporting Odds Ratio (ROR) which was the index of the safe signal of the medical supplies adverse event and we compared number of reports and ROR of the cholinergic syndrome by the distigmine in approximately the measure in March, 2010 and evaluated it. The number of reports of the cholinergic syndrome by the distigmine was 138 cases before March 2010 and 65 cases after March 2010. After a measure, the number of reports decreased. The possibility that the package insert revision of the distigmine contributed to a decrease in cholinergic syndrome onset was suggested. Whereas monitoring careful sequentially needs the onset of the cholinergic syndrome in constant frequency to be found.

著者

今井 徹

出版者

日本品質管理学会

雑誌

品質 (ISSN:03868230)

巻号頁・発行日

vol.46, no.4, pp.381-386, 2016-10

著者

座間味 義人 小山 敏広 今井 徹 武本 あかね 相良 英憲 千堂 年昭 名倉 弘哲

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.136, no.7, pp.987-991, 2016 (Released:2016-07-01)

参考文献数

6

被引用文献数

2

---

Pharmacists are expected to be active members of the healthcare team in emergency medicine, because many pharmaceuticals are administered to patients with life-threatening conditions. However, adequate education for pharmacists and pharmacy students is not provided. The “Emergency Pharmaceutical Sciences” course was introduced for the first time in Japan by the Department of Pharmacy, Okayama University, to offer advanced education in emergency medicine and research related to critical care. We offer an emergency pharmaceutical training program with high-performance simulators and have succeeded in improving the clinical skills and confidence of pharmacy students. In this review, we introduce our activities intended to mold pharmacy students into emergency pharmacists who can contribute to emergency medicine.

著者

金澤 成美 山本 隆昭 高田 賢二 藤井 元太郎 石橋 抄織 佐藤 嘉晃 原口 直子 今井 徹 中村 進治

出版者

日本矯正歯科学会

雑誌

Orthodontic waves : journal of the Japanese Orthodontic Society : 日本矯正歯科学会雑誌 (ISSN:13440241)

巻号頁・発行日

vol.57, no.2, pp.92-102, 1998

被引用文献数

31

---

1981年4月から1996年3月までの15年間に北海道大学歯学部附属病院矯正科を来院した矯正患者を調査対象に, 経時的推移を調査し以下の結果を得た.1. 過去15年間の来院患者総数は4, 559名で, 1981年から1990年までは増加していたが, その後の患者数は減少していた.2. 性別では, 男性 : 女性が1 : 1.5と女性が多く, また年齢が高くなるに伴い女性が増加していた.3. 初診時年齢は経時的に年齢が高くなる傾向にあり, 成長期の患者が減少し, 永久歯列期の患者が増加していた.4. 来院動機では審美障害が最も多く, 次いで咀嚼障害であった.また, 顎関節症を主訴とする患者が近年は増加していた.5. 来院経路では, 自意が減少し, 院内他科や他の医療機関からの紹介が増加していた.6. 不正咬合の種類では, occlusal anomaliesが74.2%, space anomaliesが78.7%であった.前者では, 反対咬合が40.5%, 上顎前突が13.6%であったが, 経時的に反対咬合は減少していた.後者では前歯部叢生が62.8%と多く, 経時的に前歯部叢生が増加している傾向が認められた.7. 顎顔面領域の先天異常では, 口唇口蓋裂の占める割合が高かったが, 人数では経時的に減少していた.8. 外科的矯正治療患者の割合は全体の約16%を占め, 反対咬合症例が圧倒的に多かった.9. 顎関節症状を有する患者は増加する傾向にあり, 特に女性の占める割合が高かった.