著者

福田 裕子 田中 裕貴子 森田 貴子 中永 あやこ 道下 佳子 中蔵 伊知郎 北澤 文章 辻川 正彦

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.47, no.5, pp.264-271, 2021-05-10 (Released:2022-05-18)

参考文献数

19

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We experienced two cases with mild to moderate renal dysfunction in which amantadine hydrochloride (amantadine) intoxication was followed by increases in its blood levels. Case 1 was a patient with mild to moderate renal dysfunction [estimated glomerular filtration rate (eGFRcreat): 48.9 mL/min/1.73m2; glomerular filtration rate (GFR) category: G3a] taking amantadine 300 mg daily. In Case 1, the blood level of amantadine at 13 hours and 30 mins after administration was 2,368 ng/mL, pyrexia, myoclonus, and psychological symptoms were observed. After discontinuing amantadine, the patient’s myoclonus improved, but he died of acute respiratory distress syndrome. Case 2 was a patient with mild to moderate renal dysfunction [eGFRcreat: 55.6 mL/min/1.73m2; GFR category: G3a] taking amantadine 100 mg daily. In the patient, pyrexia, myoclonus, and consciousness disorder were observed. The blood level of amantadine 88 hours after the last dose was 265 ng/mL, and the blood level that was collected 24 hours after the end of administration was estimated to be about 2,600 to 4,200 ng/mL. In all cases, the clinical features were consistent with the common symptoms of amantadine intoxication, and improved by discontinuing amantadine. Taken together, these findings suggest that the patients were intoxicated with amantadine. These results indicate that amantadine intoxication due to elevated blood levels also occurs in patients with mild to moderate renal dysfunction during the administration of the usual dose of amantadine. In addition, the measurement of amantadine blood levels may be useful in avoiding amantadine intoxication.

著者

北澤 文章 寺田 智祐 高橋 一栄 松本 繁巳 乾 賢一

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.35, no.5, pp.337-342, 2009 (Released:2010-07-31)

参考文献数

19

被引用文献数

3 2

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The aim of this study was to clarify the influence of renin-angiotensin (RA) system blockers on the anti-cancer effect of chemotherapy with bevacizumab and its adverse effects.Twenty-six patients treated for metastatic colorectal cancer at Kyoto University Hospital between August 2007 and July 2008 were assessed.All of the patients received bevacizumab plus mFOLFOX 6 or FOLFIRI,and were divided into a control group (23 patients) and an RA system blocker group (3 patients).Regarding background factors,which included chemotherapy doses,the only significant difference between the groups was with respect to age.However,hypertension grades in the RA system blocker group were significantly higher than those in the control group,and RA system blockers had no significant antihypertensive effect.There was no severe proteinuria in either group.As for anti-cancer effects,in the control group,6 patients exhibited a partial response and in 16 patients,the disease was stable.In only one patient was the disease progressive.On the other hand,the disease was progressive in all patients in the RA system blocker group.These findings indicate that anti-hypertensive agents which provide better hypertension control than RA system blockers may be necessary as first line medication for the management of bevacizumab-induced hypertension.Although RA system blockers are useful antihypertension agents,they might not be able to control bevacizumab-induced hypertension and proteinuria,and could reduce the anti-cancer effect of bevacizumab.