著者

國津 侑貴 磯野 哲一郎 平 大樹 寺田 智祐

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.139, no.11, pp.1457-1462, 2019-11-01 (Released:2019-11-01)

参考文献数

16

被引用文献数

1 4

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Recently, there have been reports that the combination of renin angiotensin inhibitors, diuretics, and non-steroidal anti-inflammatory drugs increases the risk of acute kidney injury (AKI). This combination has been dubbed the “Triple Whammy”. However, there have been no reports about its chronic effects on the kidney. In this study, we investigated the chronic effects of the “Triple Whammy” on kidney function. There were 203 outpatients who were prescribed this combination in our hospital for 5 years. We excluded patients who could also confirm the combination in the previous year and patients for whom laboratory data were unavailable, thus, leaving a target patient group of 95 patients. The average estimated glomerular filtration rate (eGFR) decreased significantly from 62.6 to 58.9 mL/min/1.73 m2 immediately after administering the combination (p<0.01). Although no patients were diagnosed with AKI within 90 days after being administered the combination, 7.4% of patients exhibited a ≥25% reduction in eGFR compared with that before commencing the combination. Correlation analysis of gender, age, past renal function, and renal function change demonstrated that eGFR before administration of the combination negatively correlated with changes in eGFR (p<0.01). Considering the effects of individual differences, eGFR changes before and after administering the combination were compared using a case-crossover design and eGFR after administering the combination was found to be significantly reduced (p<0.01). Therefore, it appears that the “Triple Whammy” may cause not only AKI but also chronic renal degeneration.

著者

炭 昌樹 長谷川 千晶 森井 博朗 星野 伸夫 奥貫 裕美 金本 賢枝 堀江 美弥 岡本 陽香 藪田 直希 松田 雅史 神谷 貴樹 須藤 正朝 増田 恭子 岩下 由梨 松田 佳織 本岡 芳子 平 大樹 森田 真也 寺田 智祐

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.138, no.5, pp.715-722, 2018 (Released:2018-05-01)

参考文献数

10

被引用文献数

1

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The importance of community-based care systems has increased due to the highly aging population and diversity of disease. To enhance the cooperation among healthcare professionals in community-based care systems, a two-day on-site training program for community pharmacists based on a multidisciplinary team approach was conducted at the Medical Science Hospital of Shiga University from April 2015 to March 2017. There were two professional courses in this training program: the palliative care course and nutrition support course. Both courses consisted of common pharmaceutical care training as follows: regional cooperation among healthcare professionals, pharmacist's clinical activities in the ward, pressure ulcer care, infection control, and aseptic technique for parenteral solutions. Each course was limited to 2 participants. A questionnaire was given to participants in the training program. Seventy-five pharmacists participated in the training and all of them answered the questionnaire. According to the questionnaire, 86% of participants felt that 2 days was an appropriate term for the training program. Positive answers regarding the content of each program and overall satisfaction were given by 100% and 99% of the participants, respectively. In the categorical classification of free comments regarding the expected change in pharmacy practice after the training, both “support for patients under nutritional treatment” and “cooperation with other medical staff” were answered by 24 participants. These results suggested that the 2-day on-site training for community pharmacists facilitated cooperation among healthcare professionals in the community.

著者

磯野 哲一郎 國津 侑貴 増田 恭子 平 大樹 荒木 久澄 荒木 信一 宇津 貴 寺田 智祐

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.43, no.11, pp.601-609, 2017-11-10 (Released:2018-11-10)

参考文献数

29

被引用文献数

1 3

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The proper use of drugs with renal excretion and nephrotoxicity is an urgent problem due to the increase in CKD patients. We have been sharing renal function data on CKD patients among medical staff, including community pharmacists, using the CKD sticker since March, 2012 in Shiga. The CKD sticker is affixed to the medication log book of CKD patients. We performed questionnaire surveys of all community pharmacies in Shiga for five years from 2012 to 2016, and examined the utility of the CKD sticker. The CKD sticker was recognized at 98.6% of pharmacies in 2016. Pharmacies attended by patients with the CKD sticker increased to 68.8% in 2016. In addition, there were no local differences among 9 branches in the Shiga Pharmacist Society in 2016. The number of pharmacies that performed questionable inquiries based on the CKD sticker increased from 7.7% in 2012 to 24.7% in 2016. Pharmacies that inquired about patients with CKD stickers greatly increased in 2016, and the number of prescription changes increased. The spread of CKD stickers was observed throughout the prefecture, and this study demonstrated that the CKD sticker was a useful tool for questionable inquiries. The CKD sticker helped to avoid the use of drugs in cases with nephrotoxicity and to reduce the quantity of drugs in cases with renal excretion, allowing for safe medication of CKD patients.

著者

平 大樹 角本 幹夫 岡野 友信 寺田 智祐

出版者

日本耳鼻咽喉科感染症・エアロゾル学会

雑誌

日本耳鼻咽喉科感染症・エアロゾル学会会誌 (ISSN:21880077)

巻号頁・発行日

vol.7, no.2, pp.51-54, 2019-05-20 (Released:2019-05-20)

参考文献数

14

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エアロゾル吸入療法は喘息や慢性閉塞性肺疾患(COPD, chronic obstructive pulmonary disease)の治療の第一選択となる.しかし,患者の吸入動作により薬物が治療部位に送達される必要があるため,患者が適切に使用することが十分な治療効果と低い副作用発現の両立に必要不可欠となる.吸入器は大きく分けて,粉末吸入剤(DPIs, dry powder inhalers),加圧式定量噴霧式吸入器(pMDIs, pressurized metered dose inhalers),ソフトミスト吸入器(SMIs, soft mist inhalers)およびネブライザーの4種類に分類される.最適な吸入方法は各々の吸入器によって異なるので,医療者による適切な吸入指導(吸入支援)が非常に重要となる.本稿では,各々の吸入器について,その特徴と吸入支援方法を概説すると共に,吸入支援に関する地域連携事例を紹介する.

著者

大野 恵一 村田 龍宣 近藤 篤 尾上 雅英 松本 公佑 渡邊 裕之 星田 唯史 眞下 惠次 平 大樹 角本 幹夫 菅野 清彦 本多 伸二

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.46, no.7, pp.367-372, 2020-07-10 (Released:2021-07-10)

参考文献数

6

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Albumin-bound paclitaxel (Abraxane®) is a lyophilized preparation that takes time to dissolve. Previously, we used a metal needle for dissolving Abraxane®. We then transitioned to a side hole-type plastic needle to prevent accidental needle-stick injuries. There is no literature regarding the ideal needle type, according to the material it is made of, for dissolving Abraxane®, and the effect on the characteristics of Abraxane® after dissolving with each needle is unknown. Therefore, we investigated the efficacy of the plastic needle for dissolving Abraxane®. The formulation was dissolved in three ways: by injecting saline for 30 s with a metal needle (M30s), injecting saline for 15 s with a plastic needle (P15s), and injecting saline for 30 s with a plastic needle (P30s). Each group was kept at rest for 5 min after saline infusion, and then the dissolution time was estimated. The median dissolution time was 82.5 (15 - 210) s for M30s, 75 (30 - 135) s for P15s, and 45 (15 - 120) s for P30s. P30s had a significantly shorter dissolution time than M30s (P < 0.01) and P15s (P < 0.05). There was no significant difference in the dissolution time between M30s and P15s; however, P15s tended to have a shorter dissolution time than M30s. We measured the diameter of Abraxane® particles after dissolving with each needle and found that the diameter was almost the same. Therefore, a side hole-type plastic needle might reduce the dissolution time compared with a metal needle without affecting the characteristics of Abraxane®.

著者

辻 大樹 斎藤 嘉朗 莚田 泰誠 三浦 昌朋 平 大樹 寺田 智祐

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.46, no.2, pp.66-76, 2020-02-10 (Released:2021-02-10)

参考文献数

12

被引用文献数

1 2

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Given that the cancer gene panel test was approved in June 2019, precision medicine based on the information about somatic mutation is expected to be widely available. Similarly, pharmacogenomics (PGx) associated with germline genes, such as drug-metabolizing enzymes, could also be effective tools. However, its clinical implementation has been delayed.To address this issue, we conducted a survey regarding pharmacists’ involvement in “cancer genomic medicine (CGM)” and actual use of PGx and therapeutic drug monitoring (TDM). The response rate of the survey was 96.8% (121/125).According to this survey, genetic polymorphism analysis for irinotecan (UGT1A1), which is approved for genetic testing, was most commonly used. Among the tests not covered by insurance, tacrolimus (CYP3A5) and voriconazole (CYP2C19) were commonly used. Only a few facilities conducted PGx tests. Unlike PGx, many drugs are covered by insurance for TDM, which was commonly used. Vancomycin was most commonly used, followed by teicoplanin and cyclosporine. Regarding CGM, it was found that the pharmacists were most commonly involved in dose adjustment support, followed by support for selection of anti-cancer agents. Pharmacists’ participation in the expert panel was 21.3%.This survey revealed that PGx testing is less common compared with TDM. PGx of drug-metabolizing enzymes could potentially influence adverse reactions and efficacy. It might be possible to provide individualized pharmacotherapy if PGx testing could be performed at the same time as gene panel tests. Insurance-covered PGx testing may increase in the future if more high-quality clinical trials are conducted and its usefulness is validated.

著者

筒井 静子 三木 貴史 義平 大樹

出版者

酪農学園大学

雑誌

酪農学園大学紀要. 自然科学編 (ISSN:0388001X)

巻号頁・発行日

vol.36, no.2, pp.241-249, 2012-04

著者

義平 大樹 唐澤 敏彦 中司 啓二

出版者

日本作物学会

雑誌

日本作物學會紀事 (ISSN:00111848)

巻号頁・発行日

vol.69, no.2, pp.165-174, 2000-06-05

被引用文献数

2

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道央多雪地帯においてコムギ, ライムギより多収を示す秋播ライコムギ品種と低収にとどまる品種の生育特性の違いを把握し, ライコムギの多収品種育成のための育種目標および多収を実現するための栽培上の注意点を明らかにするために, ライコムギ品種, 北海道の秋播コムギ品種, および秋播ライムギ品種の子実収量とその関連形質を4ヶ年にわたり比較調査した.ポーランド育成のライコムギ品種に, コムギ品種およびライムギ品種に比べて子実収量の高いものが多かった.しかし, ロシア, ウクライナ, フランス, カナダ, 韓国, イングランド育成のライコムギ品種の子実収量はコムギ品種に比べて低かった.前者の多収要因は, コムギに比べて一穂重および地上部重が大きいこと, ライムギに比べ収穫指数が高いことにあると考えられた.後者の低収要因には, 第一に雪腐病発病度が高いこと, 第二に穂数が少ないこと, 第三に収穫指数が低いことがあげられ, 長稈のライコムギ品種において倒伏も低収に関与すると考えられた.道央多雪地帯においてライコムギの多収を実現するためには, 育種目標として冬枯れに対する耐性に優れたもの, 穂数が多く収穫指数の高いものを選抜すること, 栽培技術としては冬枯れによる穂数の減少を防ぐことが重要であり, これらがある程度満たされた時, 穂重型で地上部重の大きいライコムギの特性が多収性に結びつくことが示唆された.