著者

飯塚 俊介 葉山 達也 内池 明博 堤 大輔 小田桐 功武 中山 敏光 早坂 正敏 村松 高 橋本 修 吉田 善一

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.43, no.3, pp.145-153, 2017-03-10 (Released:2018-03-10)

参考文献数

21

被引用文献数

1

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The absorption of gefitinib is dependent on gastric pH. However, an increase in gastric pH via the use of antacids such as proton pump inhibitors (PPI) and histamine H2 receptor antagonists may reduce the bioavailability and efficacy of gefitinib.In this study, we report the influence of the concurrent use of antacids with gefitinib on the efficacy in epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC). Our subjects were 68 patients with NSCLC who were treated with gefitinib at our hospital between 2008 and 2015.In the study, we compared time to treatment failure (TTF), overall survival (OS), response rate, disease control rate and adverse effect rates in patients receiving antacids in combination as well as (AC; n = 29) with those only receiving gefitinib (no AC; n = 34).The patients in the AC group exhibited a significant difference in TTF (409 days (95%CI: 1.00-4.22) vs 901 days (95%CI: 0.24-0.99), P = 0.0492) as compared to the no AC group. But then the OS, response rate, disease control rate and adverse effects rate were not significant between each group. Therefore, this study suggests that, as long as the combination of gefitinib with antacids is avoided, the combination with antacids should not impair the clinical efficacy of gefitinib. From the results of the sub-analysis, this study suggests that, in particular men, less than 75 years old, PS≧2, pulmonary metastasis, it is preferable to avoid the combination of gefitinib and antacids.

著者

早坂 正敏 青柳 京子 木村 高久 牧原 剛 牧村 瑞惠

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.4, pp.380-385, 2001-08-10 (Released:2011-03-04)

参考文献数

8

被引用文献数

2 2

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We have developed a system for the automatic checking of drug interactions when physicians order drugs using prescriptions. This checking is based on drug interaction data obtained form the package insert, which includes not only contraindicated combinations but also cautions. As these data can be printed out, it is easy to pass on such drug information to patients.The system also has a function whereby contraindications are always shown on the screen, whereas administration cautions and other information may be optionally omitted, or included where necessary. Therefore physicians can also order excess doses of some drugs or certain interacting drugs by prescribing them under special circumstances. These items of information are indicated with an asterisk in the prescription and are also provided to community pharmacies through legal prescriptions.The system displays the referred data on an order screen without any reduction in the response time of the host computer. The average response time was 3 s for up to a total of 17 different prescription drugs, and 4 s for more than 17. The response time from 10 : 00 a.m. to 2 : 00 p.m., when the frequency of outpatient prescription orders is the highest, was about the same as during other periods.These results suggest that this system is useful for checking of drug interactions on prescription in three hospitals affiliated with our medical college.