著者

森本 健幹 長島 裕樹 森本 泰子 徳山 尚吾

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.1129-1136, 2017-09-01 (Released:2017-09-01)

参考文献数

20

被引用文献数

7

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Tazobactam/piperacillin (TAZ/PIPC) is a combination antibiotic frequently used to treat pneumonia. It has recently been reported that TAZ/PIPC worsens renal function in patients with existing renal impairment. Creatinine clearance is generally between 10 and 40 mL/min in Japanese patients, so TAZ/PIPC is given at a dose of 2.25 g three times daily or 4.5 g twice daily. If pneumonia is severe or intractable, the dose frequency may be increased to 2.25 g four times daily and 4.5 g three times daily. We examined the effect of these different dosing regimens on renal function. We studied a cohort of 57 patients with impaired renal function hospitalized with pneumonia and treated with TAZ/PIPC between January 2015 and November 2016. Patients were classified into four groups according to TAZ/PIPC dose: 2.25 g three times daily (Group A); 2.25 g four times daily (B); 4.5 g twice daily (C) and 4.5 g three times daily (D). We examined the frequency of acute kidney injury (AKI) and treatment effectiveness. In Groups A, B, C and D, AKI occurred in 5.6%, 0.0%, 25.0% and 38.5% of patient. In groups C and D, hydration and dose reduction were required to address early signs of impending AKI. Our findings suggest that the higher TAZ/PIPC dose of 4.5 g was responsible for the decline in renal function, even if the dose frequency was reduced.

著者

原田 慎一 藤田(濱邊) 和歌子 神谷 浩平 佐武 紀子 徳山 尚吾

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.130, no.5, pp.707-712, 2010-05-01 (Released:2010-05-01)

被引用文献数

2 3

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本総説は、“Biological and Pharmaceutical Bulletin” 誌に掲載された後、取り下げとなった内容と同一か、密接に関連する図表やデータを含んでいることから、編集委員会は本総説を撤回することに決定しました。The Editorial Committee of the Pharmaceutical Society of Japan (February 18, 2020)

著者

原田 慎一 中本 賀寿夫 森 隆治 徳山 尚吾

出版者

一般社団法人 日本医療薬学会

雑誌

日本医療薬学会年会講演要旨集

巻号頁・発行日

vol.23, 2013

著者

徳山 尚吾 高橋 正克

出版者

公益社団法人 日本薬理学会

雑誌

日本薬理学雑誌 (ISSN:00155691)

巻号頁・発行日

vol.117, no.3, pp.195-201, 2001 (Released:2002-09-27)

参考文献数

42

被引用文献数

4 5

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モルヒネをはじめとするオピオイドおよびメタンフェタミンなどの精神賦活薬によって誘発される種々の効果に対する薬用人参の薬理学的·生理学的作用について概説する.薬用人参は, モルヒネ, μオピオイド受容体アゴニストやU-50, 488H, κオピオイド受容体アゴニストの鎮痛効果に対して, オピオイド系を介さない様式で拮抗作用を示す.さらに, モルヒネの鎮痛効果に対する耐性形成および身体的·精神的依存に対しても, 薬用人参は抑制作用を有するとの知見が多いが, その種類, 用量, 投与スケジュール等の違いによって成績が異なる報告もなされている.また, 薬用人参は, メタンフェタミンやコカインなどの反復投与による運動量の経時的な増強作用, すなわち行動感作(逆耐性現象)の形成も阻止する.興味深いことに, メタンフェタミンおよびコカインの反復投与終了後30日間休薬してから, 再びこれらの薬物を投与することによって誘発される再燃現象(フラッシュバック)に対しても, 薬用人参による抑制作用が見出されている.さらに, メタンフェタミンおよびコカインは精神的依存能の評価法の一つとされる条件付け位置嗜好性を示すが, その効果も薬用人参は消失させる.これらの知見は, オピオイドや精神賦活薬による乱用および依存に対して, 薬用人参が有効な治療薬に成りうる可能性を示唆するものである.

著者

相澤 風花 中本 賀寿夫 徳山 尚吾

出版者

日本疼痛学会

雑誌

PAIN RESEARCH (ISSN:09158588)

巻号頁・発行日

vol.33, no.3, pp.203-213, 2018-09-15 (Released:2018-11-06)

参考文献数

47

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It has been accepted the fact that patients with chronic pain comorbid with depression or anxiety appeal profoundly severe pain condition more than healthful emotional condition. The critical treatment of chronic pain has not been appeared although noradrenergic and serotonergic neurons were discovered as a target of treatment such as depression or anxiety. Recently, the importance of function of the n–3 free fatty acids (FFAs) such as docosahexaenoic acid (DHA) and eicosapentaenoic acid is focused on the novel target of chronic pain. However, the mechanism has not been elucidated. The G–protein coupled receptor 40 ⁄ free fatty acid receptor 1 (GPR40 ⁄ FFAR1), a receptor of middle–long chain FFAs including DHA, distribute in the brain of human and rodents. We previously reported that the GPR40 ⁄ FFAR1 suppressed not only various pain stimuli via activation of endogenous pain regulation systems but also depression–like behavior. Our previous study demonstrated that the GPR40 ⁄ FFAR1 knock–out mice show the persistent of mecha­nical allodynia after hind–paw incision. Furthermore, the GPR40 ⁄ FFAR1 knock–out mice show the abnormal emotional behaviors. Our results suggested that the GPR40 ⁄ FFAR1 has the potential of the novel therapeutic target of stress–induced chronic pain.

著者

中本 賀寿夫 小畑 友紀雄 平澤 明 金 啓二 金 守良 徳山 尚吾

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.4, pp.583-589, 2016-04-01 (Released:2016-04-01)

参考文献数

41

被引用文献数

2 2

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Nonalcoholic fatty liver disease (NAFLD) is characterized by the pathological accumulation of fat in the liver in the absence of any other disease related to liver steatosis, which includes a wide spectrum of liver diseases ranging from mild asymptomatic fatty liver to nonalcoholic steatohepatitis (NASH) and cirrhosis. Recently, it was reported that NAFLD is characterized by the impaired bioavailability of liver n-6 and n-3 long-chain polyunsaturated fatty acids (PUFAs). That is, compared with healthy individuals, steatosis and steatohepatitis patients have higher n-6/n-3 PUFA ratios. Furthermore, per recent research, decreasing the intake of total fats and increasing the intake of n-3 PUFAs may be beneficial in the treatment of NAFLD. In contrast, some reports describe that NASH patients have more metabolic abnormalities than NAFLD patients; however, these are not influenced by dietary fatty acids. Thus, at present, various opinions exist regarding the efficacy of n-3 PUFA in the treatment of NAFLD. In this review, we discuss the considerable interest n-3 PUFA has attracted as a potential treatment for NAFLD.

著者

徳山 尚吾 中本 賀寿夫

出版者

Japanese Society of Pharmaceutical Health Care and Sciences

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.39, no.9, pp.511-520, 2013-09-10 (Released:2014-09-10)

参考文献数

70

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Fatty acids are an important source of energy and an essential component of cell membranes. They also function as signal transduction molecules in a range of biological phenomena. There are several reports on the transport mechanisms of fatty acids including fatty acid transport proteins, and lipid chaperones fatty acid-binding proteins. Furthermore, fatty acids can signal through G-protein-coupled receptors or toll-like receptors.The recent westernization of dietary habits and food satiation is becoming a problem. Accordingly, the dietary intake ratio of n-3 fatty acids has dramatically decreased over several decades. Although the health influence in the change of these food habits has received little attention, in a recent study, the functional relationship between n-3 fatty acids and psychiatric disease or neurodegenerative disease has been the focus of many studies. Also, it has become apparent that the functional properties of fatty acids are modulated by factors such as the amount of individual fatty acid intake and their distribution among organs.In particular, it is reported that, in patients with depression, n-3 fatty acid contents in the brain decrease and the intake of the n-3 fatty acids can relieve psychiatric symptoms of depression. Therefore, it is thought that a fatty acid signal in the central nervous system relates to nerve activity and modulation of the synapse plasticity. However, the detailed mechanisms of these disorders have not been fully elucidated.In this mini review, we summarize a number of basic and clinical studies on n-3 fatty acids and psychiatric diseases and neurodegenerative disorders.

著者

藤田(濱邊) 和歌子 赤井 那実香 徳山 尚吾

出版者

Japanese Society of Drug Informatics

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.11, no.3, pp.149-155, 2010-02-28 (Released:2010-08-10)

参考文献数

20

被引用文献数

2

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Objective: It is well known that opioids are the dominant medication for the palliative care of cancer pain.  Although the enhancement of palliative care has been shown as the social issue in Japan, our opioid consumption is 1/7-7/8 of its global average.  These actual conditions of “low consumption of opioid” may affect the enrichment of palliative care in Japan.  In this study, we performed attitude surveys on the current situation of opioid usage for the palliative care in Japan by questionnaire method intended for hospital pharmacists.  Design and Methods: The questionnaire was mailed to pharmacists in randomly selected 100 hospitals among the general clinics involved in palliative care (October 10-16, 2006).  The collection rate was 63% (63 person/100 hospitals).  Results: About 94% of respondents recognized that the palliative care is poor in Japan, of which about 78% considered that there are relationship between the amount of opioid usage and enrichment of palliative care.  Furthermore, the problem of medical staff was considered as the most important factor contributing to the current status of palliative care in Japan.  In addition, in the order, legal barrier (8%)>problems in regard to patients (7%)>problems in regard to medical agents are considered to affect the current status of palliative care in Japan.  Specifically, it is considered that some problems such as deficiency of education (57%), deficiency of number of specialized staff (21%), and lack of experience of opioid usage (10%) or viased view of opioid (5%) are included in the problems of medical staff in Japan.  Conclusions: As the specific issue to achieve advanced palliative care and to improve quality of life in cancer patients, the improvement of curriculum and the training of medical staff for clinical opioid usage in the palliative care seems to be the most important in Japan.  In addition, the improvement of information provision by pharmacists toward the medical staff may be important for the promotion of palliative care using opioid in the future in Japan.

著者

西中 崇 中本 賀寿夫 徳山 尚吾

出版者

公益社団法人 日本薬理学会

雑誌

日本薬理学雑誌 (ISSN:00155691)

巻号頁・発行日

vol.149, no.2, pp.79-83, 2017 (Released:2017-02-01)

参考文献数

30

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幼少期に受ける精神的・身体的なストレスは,成熟期において精神疾患を含む様々な疾患の発症や重症度と強く関連する.この原因として,幼少期ストレスによる内分泌系の調節異常や神経系の機能・構造的変化を介したストレス応答性の変化,すなわちストレス脆弱性が関与することが示唆される.神経障害性疼痛のような慢性疼痛では,痛みの認知や情動に関わる脳神経系の機能変化が認められる.つまり,神経障害などの器質的異常だけでなく,精神的,心理的,社会的な要因が複雑に関与し,慢性疼痛の病態を形成している可能性が考えられる.このような痛みの慢性化に影響する精神的・社会的な要因の一つに幼少期の養育環境が挙げられる.実際に,幼少期の劣悪な養育環境によって,成人期における慢性疼痛の発症リスクが増加することが報告されており,幼少期に受けるストレスは脳内の疼痛制御機構に悪影響を及ぼすことが示唆される.しかしながら,幼少期ストレスと成熟期における慢性疼痛との関係性については明らかにされていない.最近我々は,幼少期ストレスによる慢性疼痛に対する影響を解析するための動物モデルを確立した.幼少期のストレス負荷は,成熟期における神経障害後の痛覚過敏や情動障害の増悪を引き起こす.さらに,幼少期ストレスは疼痛や情動の調節に関わる脳領域において,神経の活性化や可塑的変化の指標となるphosphorylated extracellular signal-regulated kinase(p-ERK)発現を増加させた.これらの知見は,幼少期による脳神経系の機能変化が,慢性疼痛の増悪に関与することを示唆する.本総説では,幼少期ストレスによる成熟期における脳神経系の機能変化と慢性疼痛の関係について紹介する.

著者

坂梨 真穂 吉田 有希 谷車 友菜 名和 文花 藤田 和歌子 徳山 尚吾

出版者

日本医療薬学会

雑誌

日本医療薬学会年会講演要旨集

巻号頁・発行日

vol.21, 2011-09-09

著者

森本 泰子 原田 慎一 中本 賀寿夫 徳山 尚吾

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.133, no.11, pp.1243-1248, 2013 (Released:2013-11-01)

参考文献数

8

被引用文献数

1 1

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The usefulness as one of the tools for self-medication of oral rehydration therapy (ORT), recommended as a safe and effective therapy for mild to moderate dehydration, was surveyed by questionnaire for pharmacists in community pharmacies. ORT products were sold in 112 pharmacies (61%), and the common product was OS-1®. Approximately 50% of sellers answered that they had no particular difficulty in explaining ORT. Percentage to answer “hard to describe” is significantly higher in pharmacists who believe there is a need to consider underlying health conditions of customers or patients when implementing ORT. Around 77% of pharmacists considered ORT to be useful in patients as a method of self-medication. A significant number of pharmacists selling ORT products depends on the consultation from customers or patients and provide advice to them confirming that ORT was useful. From these results, it was suggested that further information concerning ORT, such as its use in patients with chronic disorders or signs for completion, and the initiative of pharmacists to participate are necessary for spread the efficacy of ORT for self-medication in patients.

著者

細見 光一 室井 延之 東 和夫 池田 りき子 魚本 智子 大川 恭子 三宅 圭一 中川 素子 河本 由紀子 清原 義史 金 啓二 沢崎 高志 小野 達也 西田 英之 大野 真理子 緒方 園子 福島 昭二 徳山 尚吾 大西 憲明 平井 みどり 松山 賢治

出版者

日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.32, no.1, pp.64-72, 2006-01-10

被引用文献数

6 7

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We conducted a survey on the practical training of pharmacy students in 47 community pharmacies and 76 hospital pharmacies in Hyogo Prefecture. Items surveyed included the acceptance system for pharmacy students, practical training curriculum, problems and difficulties. In many community pharmacies and hospital pharmacies, instruction in practical training was recognized as worthwhile despite the workload involved. Though the content of the practical training varied, dispensing and medication instruction were the most common items in the practical training for both community pharmacies and hospital pharmacies. Communication with patients and management of medication history were the focus of training in community pharmacies, while the major aspects of training in hospital pharmacies were dispensing of injections and TDM (therapeutic drug monitoring). Many pharmacists were of the opinion that the content and goals of the training should be reviewed and that it needed to be further evaluated. Revision of the practical training in universities was also recommended. Further, in order to achieve an efficient practical training curriculum it was felt that the training should be more linked to the special characteristics of community pharmacies and hospital pharmacies.