著者

大谷 真理子 山本 陽介 酒巻 智美 大沼 亜紀 赤木 圭太 松田 慶祐 杉山 奈津子 宮嶋 篤志 廣田 孝司 小茂田 昌代

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.38, no.2, pp.78-86, 2012-02-10 (Released:2013-02-10)

参考文献数

9

被引用文献数

5 6

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An oral scabicide, STROMECTOL® Tablets (ivermectin) is often administered to patients as a simple suspension by feeding tube. However, it was reported that the administration by this method was less effective than oral administration of tablets. One reason for this lower efficacy might be that the devices and technique for this method of administration are not appropriate. The aim of this study is to propose an appropriate technique.In this report, we compare the recovery ratio when a simple suspension is pushed through a syringe under various conditions. As a result of washing the syringe with distilled water after the first use, the recovery of ivermectin was higher than that without washing. The recovery of ivermectin from syringes set at an angle of 90° and 45° to the horizon was significantly higher than that at 0° and -45°. And recovery from previously used syringes was about 10% higher than that from new syringes (p<0.05). Furthermore, after having orally administered STROMECTOL® Tablets and gavaged its suspension with an appropriate delivery technique to rabbits, we measured the ivermectin concentrations in plasma by LC-MS/MS. The AUC0-192h of ivermectin was almost equivalent for both methods of administration.In conclusion, to secure the same dosage of administration with a simple suspension as that of tablets, it is highly recommended to employ a previously used syringe at an angle of over 45°, and to inject by a technique that washes out the entire residue in the syringe after first injection.

著者

日本皮膚科学会疥癬診療ガイドライン策定委員会 石井 則久 浅井 俊弥 朝比奈 昭彦 石河 晃 今村 英一 加藤 豊範 金澤 伸雄 久保田 由美子 黒須 一見 幸野 健 小茂田 昌代 関根 万里 田中 勝 谷口 裕子 常深 祐一郎 夏秋 優 廣田 孝司 牧上 久仁子 松田 知子 吉住 順子 四津 里英 和田 康夫

出版者

公益社団法人 日本皮膚科学会

雑誌

日本皮膚科学会雑誌 (ISSN:0021499X)

巻号頁・発行日

vol.125, no.11, pp.2023-2048, 2015-10-20 (Released:2015-10-22)

参考文献数

185

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Here, we present our new guideline for the diagnosis and treatment of scabies which we, the executive committee convened by the Japanese Dermatological Association, developed to ensure proper diagnosis and treatment of scabies in Japan. Approval of phenothrin topical use under the National Health Insurance in August 2014 has contributed to this action. Permethrin, a topical anti-scabietic medication belonging to the same pyrethroid group as phenothrin, is already in use worldwide. For making proper diagnosis of scabies, following three points should be taken into consideration: clinical findings, detection of the mite(s) (Sarcoptes scabiei var. hominis), and epidemiological findings. The diagnosis is confirmed when the mites or their eggs are identified by microscopy or by dermoscopy. As we now have a choice of phenothrin, the first line therapy for classical scabies is either topical phenothrin lotion or oral ivermectin. Second line for topical treatment is sulfur-containing ointments, crotamiton cream, or benzyl benzoate lotion. Gamma-BHC ointment is no more provided for clinical use. If the patient is immunosuppressed, the treatment option is still the same, but he or she should be followed up closely. If the symptoms persist, diagnosis and treatment must be reassessed. For hyperkeratotic (crusted) scabies and nail scabies, removal of thick scabs, cutting of nails, and occlusive dressing are required along with topical and/or oral treatments. It is important to apply topical anti-scabietic lotion/cream/ointment below the neck for classical scabies or to the whole body for hyperkeratotic scabies, including the hands, fingers and genitals. For children and elderlies, it is recommended to apply treatment to the whole body even in classical scabies. The dosage for ivermectin is a single oral administration of approximately 200 μg/kg body weight. It should be taken on an empty stomach with water. Administration of a second dose should be considered at one-week with new lesions and/or with detection of mites. Safety and effectiveness of combined treatment with topical and oral medications are not yet confirmed. Further assessment is needed. Taking preventative measures is as important as treating those infected. It is essential to educate patients and healthcare workers and conduct epidemiological studies to prevent further spread of the disease through effectively utilizing available resources including manpower, finance, logistics, and time. (Jpn J Dermatol 125: 2023-, 2015)