著者
久保田 隆廣 千葉 寛 伊賀 立二
出版者
The Japanese Society for the Study of Xenobiotics
雑誌
薬物動態 (ISSN:09161139)
巻号頁・発行日
vol.16, no.2, pp.69-74, 2001 (Released:2007-03-29)
参考文献数
34
被引用文献数
2 4

Approximately 1% of Orientals and 7 to 10% of Caucasians lack the activity of cytochrome P450 (CYP) 2D6, and these individuals are known as poor metabolizers (PM). On the other hand, approximately 4% of Caucasians are PM of CYP2C19, while its frequencies are 18 to 23% in Orientals. These differences in the frequencies of PM seen in the different ethnic populations are mainly due to the differences in the distribution frequency of variously defective alleles of CYP2D6 and 2C19. Recent progress in molecular biology of CYPs has enabled the mechanism of CYP polymorphism to be elucidated and the polymerase chain reaction was developed for its genotyping. Our previous studies showed that the frequencies of CYP2C19*2, *3, CYP2D6*2, *5, *10, *14, and CYP2C9*3 among the Japanese subjects were 28.7, 13.2, 12.9, 6.2, 38.6, 2.2 and 2.1%, respectively. In this review, we compared the frequencies of these mutant alleles of CYPs seen in the Japanese population with those reported previously for other ethnic populations.
著者
伊賀 立二
出版者
The Japanese Society for the Study of Xenobiotics
雑誌
薬物動態 (ISSN:09161139)
巻号頁・発行日
vol.11, no.3, pp.309-314, 1996-06-30 (Released:2007-03-29)
参考文献数
4
被引用文献数
1 2
著者
大谷 道輝 佐久間 博文 高山 和郎 小滝 一 澤田 康文 伊賀 立二
出版者
一般社団法人 日本医療薬学会
雑誌
病院薬学 (ISSN:03899098)
巻号頁・発行日
vol.23, no.1, pp.11-18, 1997 (Released:2011-08-11)
参考文献数
24
被引用文献数
11 9

Six kinds of well-prescribed admixtures of commercially available ointments and/or creams were selected from the prescribed sheets in our hospital. The skin permeability of corticosteroid from these admixtures was investigated by in vitro experiments using hairless mice skin. The permeability of corticosteroid through skin after adaptation of corticosteroid creams (Lidomex®) alone was approximately 9-fold larger as compared with that of the ointments only.The pemeability of conicosteroid in the admixture of Nedsona Universal®cream or Lidomex®ointment and urea ointments respectively was 3-and 5-fold larger than that from the cream and ointments alone. However, urea ointments did not influence the permeability of the drug in Lidomex®creams.This suggested that the w/o-type urea ointments more greatly enhanced the permeability of corticosteroid as compared with the o/w type urea ointments. The extent of the stability of the emulsion after mixing was related to the permeability. These results suggest that admixing ointments and/or creams should be carried done among bases having similar physicochemical characteristics.
著者
尾熊 隆嘉 矢野 義孝 財前 政美 牡丹 義弘 伊賀 立二 全田 浩 奥村 勝彦 安原 眞人 堀 了平
出版者
公益社団法人 日本化学療法学会
雑誌
日本化学療法学会雑誌 (ISSN:13407007)
巻号頁・発行日
vol.45, no.12, pp.987-994, 1997-12-25 (Released:2011-08-04)
参考文献数
18
被引用文献数
1 3

メチシリン耐性黄色ブドウ球菌感染症の治療時におけるバンコマイシンの有効性, 安全性に関与する要因を統計的に検討する目的で, Therapeutic Drug Monitoringの対象となった患者の背景, 病態, 投薬履歴, 血漿中濃度等の要因と, 有効性, 安全性の臨床評価のデータを集積した。有効性としては効果の有無を, 安全性としては副作用として比較的報告例数の多かった腎機能, 肝機能を対象とし, その検査値異常の発現を採用した。患者背景, 病態, 治療履歴, 体内動態の各要因について, さらに項目ごとに有効性, 安全性との関連性を直接確率計算法, ロジスティック回帰分析法にて検討した。有効性に関しては高齢患者におけるアミノグリコシドの先行投与が有効率の向上に対し, 有意な関連性を示した。安全性に関しては肝機能, 腎機能の検査値異常発現率に対する1日投与量の関連性が強いことが示された。特に, 高齢患者においては血清クレアチニン値, 重症度, 総ビリルビン濃度が影響要因になることが明らかとなった。さらに, 腎機能異常値発現率の影響要因となることが示されたトラフ濃度とその発現率についてノンパラメトリックな2値回帰分析により解析したところ, アミノグリコシドとの併用により発現率が高くなることが示されたが, いずれの場合においてもトラフ濃度を10μg/ml以下にコントロールすることにより, 発現率を15%以下に抑制できることが示された。バンコマイシンの適正使用を推進するうえで, 今回の検討において有効性, 安全性に関与する要因を明らかにできたことは意義深いものと考えられるが, 今回の検討によって, 必ずしも十分な結論が得られたとは言い難く, 今後さらに臨床データを蓄積し, より精度の高い検討をする必要があると思われる。
著者
山田 安彦 伊藤 清美 中村 幸一 澤田 康文 伊賀 立二
出版者
The Pharmaceutical Society of Japan
雑誌
Biological and Pharmaceutical Bulletin (ISSN:09186158)
巻号頁・発行日
vol.16, no.12, pp.1251-1259, 1993-12-15 (Released:2008-04-10)
参考文献数
29
被引用文献数
22 21

The usual therapeutic doses for the treatment of both angina pectoris and cardiac arrhythmia vary widely among beta-blocking agents, with a maximum of about a 200-fold difference, despite subjects' same clinical improvement at the varying doses. In order to clarify the mechanism of this difference, we analyzed retrospectively the cardiac pharmacological activities of beta-blocking agents based on the receptor occupancy theory by using both their unbound concentrations in plasma at steady state (Cssf), as well as dissociation constants (KB and KI, which were determined by in vitro binding experiments and by in vitro pharmacological experiments, respectively) for a beta 1 receptor. A significant log-linear relationship between Cssf and the KB values was obtained with a slope of regression line of 0.91 (r=0.83, p<0.01). On the other hand, the correlation coefficient of the relationship between Cssf and the KI values was low, with a slope of about 0.5 (r=0.80, p<0.01). The beta 1 receptor occupancies calculated from KB values at the steady state condition after the oral administration of usual doses were almost constant (80.5±16.8%), regardless of the wide variation of usual doses of the drugs. This result indicated that the receptor occupancy may be an appropriate indicator for the pharmacological activity of the drug. Furtheremore, there were significant relationships between the primary pharmacokinetic parameters : Cb/Cf, CLtot/F, and Vdssf, and the octanol/water partition coefficient (PC), with correlation coefficients of 0.80, 0.50 and 0.85, respectively. Accordingly, it is suggested that the prediction of a ususal dose of a new beta-blocking agent can be carried out by using the KB and PC values based on quantitative structure-Pharmacokinetic/pharmacodynamic relationships. This methodology should be very useful for estimating the rational usual dose of a new beta-blocking agent from the animal experimental and physicochemical data in the preclinical study.
著者
山田 安彦 櫻井 和子 中村 幸一 澤田 康文 伊賀 立二
出版者
The Japanese Society for the Study of Xenobiotics
雑誌
薬物動態 (ISSN:09161139)
巻号頁・発行日
vol.8, no.3, pp.283-293, 1993-06-30 (Released:2007-03-29)
参考文献数
46

It is well known that change in drug distribution occur in association with hepatic disease. The prediction of the variation in the volume of distribution of drugs at steady-state (Vdss) in hepatic disease is very useful for the planning of drug dosage regimens. In the present study, we tried to develop methodology for estimating Vdss in hepatic disease based on physiological pharmacokinetics. The following two methods were utilized to predict Vdss in hepatic disease (hepatic cirrhosis and hapatitis). Method 1 : Vdss in hepatic disease was predicted assuming that Vdss in hepatic disease is not different from that in the normal condition. Method 2 : it is assumed that hepatic disease could not lead to alterations in the tissue binding but in the plasma binding, Vdss in hepatic disease was calculated according to the mass balance equation (Vdss=7.2+7.8·fP+27·fp/fT ; where fP and fT are plasma and tissue unbound fraction, respectively) by using the data of Vdss and fp in normal condition and that in hepatic disease. In hapatic cirrhosis, a significant correlation between the observed and predicted values according to Method 1 was obtained with a slope of regression line of 0.79 (p<0.001). On the other hand, a significant linear correlation between the observed and predicted values according to Method 2 was obtained with a slope of 1.03 (p<0.001). Furthermore, a significant difference in percent errors between the two methods was observed (p<0.05). In hepatitis, same resuls were also obtained. In conclusion, it is suggested that the extent of intrinsic tissue binding of various drugs is little altered in hepatic disease. The prediction of the apparent volume of distribution in hepatic disease according to Method 2 was successful for most drugs studied and very useful for clinical use.
著者
横山 晴子 山田 安彦 山村 喜一 中村 均 伊賀 立二
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.121, no.3, pp.233-237, 2001-03-01 (Released:2002-09-27)
参考文献数
7
被引用文献数
13 11

The effect of mouth wash on the removal of drug residues in both mouth and pharynx after the use of fluticasone propionate dry powder inhaler (FP-DPI) was studied. The concentration of FP in mouth wash after sprinkle and inhalation of Flutide® 50, 100, 200 Rotadisk® was determined by HPLC-UV. The total amount of the removed FP was measured by the sum of the concentration of FP in 5 times of mouth washes. The mouth wash procedures removed totally 79.3±4.4% (50 μg), 68.5±3.6% (100 μg), 69.3±3.4% (200 μg) of sprinkled amount of FP and 29.5±11.1% (50 μg), 35.6±6.6% (100 μg), 31.6±8.3% (200 μg) of inhaled, respectively. It was required for the removal of 90% of the totally recovered FP to do two times of mouth washes in each case. These data suggest that the mouth wash is an effective precaution for candidiasis induced by FP delivered by DPI.
著者
大谷 道輝 山田 伸夫 高山 和郎 小瀧 一 江藤 隆史 假家 悟 内野 克喜 伊賀 立二
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.122, no.1, pp.107-112, 2002-01-01 (Released:2003-02-13)
参考文献数
14
被引用文献数
8 8

A commonly used admixture of commercially available ointments and/or creams was selected from the prescribed sheets in our hospital, and questionnaire to dermatologists. To assess the relationship between permeability of corticosteroid through murine skin and clinical effects in human, we attempted to investigate the vasoconstrictor activity of these admixtures of topical corticosteroid by double-blind controlled study. Test samples were occluded at random on the back of 20 healthy volunteers for 4 hours. The vasoconstrictor activity of corticosteroid creams (Lidomex®) alone was significantly large as compared with that of ointments alone. The vasoconstrictor activity of corticosteroid in the admixture of Lidomex® ointment and urea ointments or heparinoid ointment was 1.5—2 fold significantly larger than that from ointments alone. The extent of the stability of the emulsion after mixing was related to the vasoconstrictor activity. These experiments demonstrated a close relationship between the vasoconstrictor activity of human skin and permeability of hairless mice skin. These results suggested that the vasoconstrictor activity of topical corticosteroids mixed with commercially available ointments and/or creams depends upon their physicochemical characteristics.
著者
清水 孝子 西原 カズヨ 澤田 康文 伊賀 立二
出版者
一般社団法人 日本医療薬学会
雑誌
病院薬学 (ISSN:03899098)
巻号頁・発行日
vol.19, no.6, pp.534-541, 1993 (Released:2011-08-11)
参考文献数
22
被引用文献数
1 1

Food ingestion does not affect the bioavailability of the nifedipine capsule, a calcium channel antagonist, but delays its absorption rate in healthy subjects. On the other hand, in two different sustained-release preparations of nifedipine, both the bioavailability and anti-hypertensive efficacy in one of them increases, whereas the other is not so much affected by meals. Furthermore, the food induces a reduction in the bioavailability of nicardipine sustained-release preparation, while those of nisordipine, benidipine and manidipine increase conversely.Such a change in the bioavailability based on food intake may influence the anti-hypertensive efficacy after the initial dosing of the medicine but not so after multiple dosing.In each medicine or dosage form, there are some differences in the change in the blood level and anti-hypertensive efficacy brought on by food ingestion among the drugs. In general, however, in order to improve patient compliance, we recommend that calcium channel antagonists should be taken after meals following the directions given for this medication.
著者
高柳 理早 山田 安彦 河野 真理子 中村 均 佐藤 均 伊賀 立二
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.28, no.5, pp.489-494, 2002-10-10 (Released:2011-03-04)
参考文献数
5
被引用文献数
1 1

The new Good Clinical Practice (GCP) guidelines, which were based on ICH-GCP, were enforced in Japan in April 1997. These guidelines recommend that pharmacists play the role of managers of investigational drugs and also as cooperators (clinical research coordinator) in the performance of clinical trials. In this study, we carried out a survey of the attitude of the new graduate pharmacists (the group of graduates in the 1998 fiscal year and a group of graduates in the 1999 fiscal year) on clinical trials. After the first questionnaire, we lectured the students on GCP and performed clinical trials, and then the second questionnaire was conducted two months later. The group of graduates in the 1999 fiscal year had more opportunities to come in contact with information on clinical trials than the group in the 1998 fiscal year. Both groups knew that new GCP guidelines had been established, but they did not understand the details. Some of them had a negative impression concerning clinical trials. The lectures improved their knowledge and impression on the practice of clinical trials. After the lecture, over 90% of them thought that pharmacists should manage investigational drugs and provide information on these drugs for the rational practice of clinical trials. Furthermore, in 60% or more of the students, an improvement in the consciousness of evaluating the safety and efficacy of investigational drugs regarding the pharmacist's role was found.
著者
影山 恵美子 古岩 清子 木村 りつ子 折井 孝男 伊賀 立二
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.28, no.5, pp.435-442, 2002-10-10 (Released:2011-03-04)
参考文献数
3

The Ministry of Health and Welfare (the present, Ministry of Health, Labour and Welfare) has begun to report the recall information of medical supplies (in short, recall information) on the home page of the pharmaceutical information provision by the Organization for Pharmaceutical Safety and Research since April 1 st, 2001. However, all recall information on the home page appears the day after the official publication. In case of medical devices in comparison to pharmaceuticals, it takes a longer time to be reported on the home page. However, such recall information is valuable, because it is the only information source, which medical institutions can obtain up-to-date information spontaneously.At Uwajima City Hospital, from May 2001, the pharmacists have participated in a safety management program regarding new medical devices or medical materials.In order to keep all medical materials safe, pharmacists check the recall information regularly and provide them to the clinical site for risk management. Not only the medical institutions but also the dealers have begun to make practical use of such recall information. However, no system for using such information has yet been established among them. According to the regulations of recall information, a contact system from the maker to the dealer has been established. However, the first information of medical devices is always obtained through the home page. The way to obtain the information has been changing.Needless to say, the “Internet” is nowadays the main media for the communications all over the world. Accurate information must be speedy and reliable. The rational use of such information on the Internet is therefore urgently needed.
著者
福岡 恵理子 鎌田 志乃ぶ 中島 克佳 折井 孝男 中村 均 佐藤 均 伊賀 立二
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.27, no.5, pp.523-530, 2001-10-10 (Released:2011-03-04)
参考文献数
2
被引用文献数
1 1

In the University of Tokyo Hospital, the reentry of data, the re-output of documents, the transfer of data by hand writing, etc. has to be routinely carried out in each department, because there is no compatibility in the related work between the systems and generated information.In this study, we developed a medication management system to share drug-requesting information generated inside the hospital with medical wholesalers who introduced the Value Added Network (VAN) -ordering system, and evaluated the usefulness of this system by sending questionnaires to those who are working in the wholesale, clinical wards, and office work sections.The developed medication management system unified a series of information on the request-to-order processing of medicine between the hospital and wholesalers, the warehousing processing in the pharmacy department, the supply processing for the clinical wards, and the expenditure processing of purchased medical supplies. In addition, the system was designed to work with the LAN of our hospital information system under the environment of Windows NT®.In the investigation on the introduction situation of the computer for the drug wholesalers, 14 out of 16 companies (88%) introduced a computerized system to receive orders. Moreover, 12 out of 14 companies (86%) replied with “it is useful” regarding the usefulness of the system. On the other hand, in clinical wards, 41 out of 55 (75%) replied with “the requesting process has become more convenient by using this system”. In office sections, the time needed to process orders was drastically shortened from approximately 20 to 5 minutes on average.By utilizing this newly developed medication management system, it became possible to share the drug-requesting information originally generated in the clinical wards with the pharmacy department and office work section in the hospital and the medical wholesalers ; therefore, we find this system to be a useful supporting system for the proper management not only for hospitals but for medical wholesalers as well.
著者
中村 均 藤沼 由江 松元 美香 大谷 道輝 小瀧 一 内野 克喜 伊賀 立二
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.27, no.5, pp.491-494, 2001-10-10 (Released:2011-03-04)
参考文献数
8
被引用文献数
2 1

In the present study, we investigated the effect of inter-individual variation and dispensing experience as a factor of variation when mixing digoxin powders.Sixteen of the post-graduate trainees (non-experienced group) who entered the Department of Pharmacy, University of Tokyo Hospital in April 1996, and had no dispensing experience with powders, and six pharmacists (experienced group), who had individually amassed 3 to 5-years of dispensing experience, participated in our study.The mean CV values (n=3) of the digoxin contents in the experienced group were 2.7% on the first experiment, 2.7% on the second and 2.5% on the third. Eight of the non-experienced group members produced a CV of less than 6.08% in all experiments. However, the CV values generated by the other eight members of the non-experienced group exceeded the standards of good mixing, and in addition, wide variations were observed. The eight above described trainees had received 3 weeks of training, and, when the mixing experiments were performed again, the registered CV values were less than 6.08% in all experiments.These results showed that, even in the case of digoxin powders requiring a high degree of mixing, good mixing was obtained under our proposed mixing conditions in half of the trainees with no dispensing experience, and in addition, good mixing was generally obtained after all had received 3 weeks of training.
著者
青山 隆夫 松元 美香 中山 紀美子 中島 克佳 渋谷 文則 小滝 一 澤田 康文 伊賀 立二
出版者
一般社団法人 日本医療薬学会
雑誌
病院薬学 (ISSN:03899098)
巻号頁・発行日
vol.23, no.2, pp.108-114, 1997-04-10 (Released:2011-08-11)
参考文献数
16
被引用文献数
1 1

The pyrogenic activity of 10% inulin injections prepared at a hospital pharmacy was measured using the Pyrogen test in Japanese Pharmacopeia (JP), while the endotoxin concentration in the injections was determined by the, Limulus test, which were JP Endotoxin test and a turbidmetric kinetic assay. After the intravenous administration of 30 ml of inulin injections to a rabbit, the rectal temperature rose to 1.5° compared with that before administration. As a result, the endotoxin was found in all lots of the inulin injections tested, and their values were markedly beyond the limit of Water For Injections prescribed in JP (0.25 EU/ml). In addition, the endotoxin content varied between the various lots of inulin powder, and also between the manufacturers. The endotoxin in inulin injection was removed (less than the quantitative limit of 0.031 EU/ml) by adding activated carbon black to the injection or the filtration using a Posidyne® Nylon 66 filter. No pyrogenic activity was observed in the inulin injections after the removal of endotoxin.Based on these results, the adverse effects induced by inulin injections may thus be caused by endotoxin derived from inulin. This method using either adsorption or filtration is thus considered to be useful for the removal of endotoxin when preparing inulin injections.
著者
渡部 恵 杉浦 宗敏 清野 敏一 光永 義治 中村 均 山田 安彦 土屋 文人 大江 和彦 伊賀 立二
出版者
公益社団法人日本薬学会
雑誌
藥學雜誌 = Journal of the Pharmaceutical Society of Japan (ISSN:00316903)
巻号頁・発行日
vol.122, no.10, pp.841-847, 2002-10-01
参考文献数
4
被引用文献数
4 4

In the computerized prescription order entry system, it has been pointed out that a physician's input mischoice for medicine is one of the causes of medication errors. We therefore investigated the input mischoices by physicians at the time of writing prescriptions. Subsequently, the number of input characters in a prescription order was changed to three characters from two characters. Furthermore, 105 items of high-alert medications, which are likely to result in injury if errors occur, were established. A warning screen display system that requests reconfirmation of the effect, name, usage, and dosage of those medicines was also built. It was found that 70% of input mistakes were caused by choosing the medicine displayed immediately above or below the desired drug. By changing the number of input characters of a prescription order to three characters from two characters, the rate of specification of a trademark improved sharply from 36% to 85%. Consequently, the rate of choice of a drug with another trademark decreased significantly from 0.028% to 0.0047%. In 5% of cases when the warning screen was displayed for a high-alert medicine, the prescription was stopped, and 25% were changed to other medicines. The above results show that the system that requires the input of three or more characters for the physician order entry and displays a warning screen for high-alert medicines is useful in preventing mischoices at the time of prescription input.<br>
著者
大塚 亮子 青山 隆夫 高柳 理早 清野 敏一 清水 秀行 中村 幸一 小滝 一 澤田 康文 伊賀 立二
出版者
一般社団法人 日本医療薬学会
雑誌
病院薬学 (ISSN:03899098)
巻号頁・発行日
vol.23, no.3, pp.269-277, 1997-06-10 (Released:2011-08-11)
参考文献数
15
被引用文献数
1 2

We studied the effect of advising outpatients on the rational use of ophthalmic solutions and compliance by a questionnaire (n=158), in order to establish the optimal consultation method. A total of 41.8% of the patients answered the questionnaire. In compairing the actual use of ophthalmic solutions before and after consultation, the rates of rational use increased for all items except for “applications per day”, which decreased slightly from 93.4% before the consultation to 90.2% after that. In particular, “eyelid closure” and “nasolacrimal occlusion” after instillation, and “the 5 min interval of instillation in the case of plural medication”, considerably increased from 34.8% before the consultation to 60.6% after that, from 9.5% to 50.8% and from 45.9% to 73.8%, respectively. The compliance remarkably improved in glaucoma patients after consultation regarding “the 5min interval of instillation” .Based on these results, our consultation method for the rational use on ophthalmic solutions was thus evaluated. However, since some patients who still did not appreciate the need for the rational use of such medication still presented, further improvements in the consultation method requires for the rational use.
著者
伊賀 立二
出版者
医学書院
雑誌
胃と腸 (ISSN:05362180)
巻号頁・発行日
vol.42, no.11, pp.1646, 2007-10-25

1998年,日米欧のハーモナイゼーションに基づいたわが国の臨床試験(治験)における新GCP(Good Clinical Practice)が完全実施された.CRC(Clinical Research Coordinator)はこの新GCPによって誕生した職種で,わが国では治験コーディネーターと呼ばれており,その守備範囲は治験の枠を超えて臨床試験を含む臨床研究全般に及んでいる.医薬品の臨床試験におけるCRCの役割は,臨床試験コーディネーターとして,(1)創薬ボランティアのケア,(2)治験担当医師の支援,(3)治験依頼者との対応(モニタリングと監査),(4)治験が円滑に進むように全体のコーディネーションを行うことと要約され,今では臨床試験になくてはならない重要な職種となっている. CRCの養成は,2000年以前は種々の団体が個別に実施してきたが,2001年に各団体が一堂に会して,「CRC連絡協議会」を結成し活動をともにすることとなり,その後2001年秋に第1回の「CRCと臨床試験のあり方を考える会議」が開かれ,その後,毎年開催され,現在では参加者も2千数百名を超えている.