著者
細野 智美 近藤 愛子 神林 泰行 本間 真人
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.8, pp.999-1003, 2017 (Released:2017-08-01)
参考文献数
12
被引用文献数
1

Several case studies have reported a possible drug interaction between warfarin and tramadol where tramadol coadministration enhanced the antithrombotic effects of warfarin. To assess this drug interaction, changes in prothrombin time-international normalized ratio (PT-INR) before and after tramadol coadministration were investigated in patients receiving warfarin. For this study, we examined 54 patients (male/female: 22/32, 68.4±12.7 years) who were being treated with warfarin for deep vein thrombosis, atrial fibrillation, arteriosclerosis obliterans, congestive heart failure, and other vascular diseases. Significant increases in PT-INR were observed 9.5 (1-118) d after coadministration of tramadol (1.81±0.56 vs. 2.47±1.10, p<0.01). Twenty-eight patients (PT-INR increased group) with PT-INR elevation of greater than 0.5 or dose reduction of warfarin after coadministration of tramadol were compared with other groups of patients to find drug interaction risk factors. Logistic regression analysis revealed that lower levels of albumin (3.5 g/dL or less) [odds ratio (OR) 22.1; 95%CI 2.9-169.9]; lower eGFR (50 mL/min or less) (OR 7.7; 95%CI 1.4-42.0); and PT-INR before tramadol coadministration (OR 38.2; 95%CI 3.7-397.6) were characteristic of the PT-INR increased group. These results suggest that tramadol coadministration enhanced the antithrombotic effects of warfarin in patients with higher PT-INR, lower albumin levels and decreased renal function as the risk factors for this drug interaction.
著者
本間 真人 平野 俊彦 湯沢 賢治 大河内 信弘 剣持 敬
出版者
一般社団法人 日本臓器保存生物医学会
雑誌
Organ Biology (ISSN:13405152)
巻号頁・発行日
vol.24, no.1, pp.76-80, 2017 (Released:2017-03-31)
参考文献数
7

Questionnaire survey concerning practical use of generic immunosuppressive agents and the European Society for Organ Transplantation (ESOT) guideline was conducted in 130 clinical institutions including transplant hospitals where the members of The Japan Society for Organ Preservation and Biology were working. Forty five institutions answered the questionnaire survey (the recovery rate: 34.6%). Use of generic immunosuppressive agents in the institutions has been different among the agents; tacrolimus (6.7%), cyclosporin (8.9%) and mycophenorate mofetil (8.9%) and corticosteroid injection (51.1%). The results indicated that use of generic immunosuppressive agents, especially in the agents that require therapeutic drug monitoring (TDM) for dose adjustment, have not been spread in Japan. The most of the institutions (greater than 62%) agreed with the ESOT guideline for generic substitution of immunosuppressive agents. It is considered that the Japanese guideline is also required to prepare according to ESOT guideline, though the use of generic products have not been popular yet Japan.
著者
本間 真人 石原 三也 千 文 幸田 幸直
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.126, no.10, pp.973-978, 2006 (Released:2006-10-01)
参考文献数
33
被引用文献数
19 25

Typical adverse effects of Shakuyaku-kanzo-To (SKT), an herbal medicine containing licorice, is a licorice-induced pseudoaldosteronism with hypokalemia and hypertension. The risk factors for this side effect are still unclear. To identify the risk factors, we surveyed 37 cases of licorice-induced pseudoaldosteronism in the literature and serum potassium levels in our patients receiving SKT and Shosaiko-To (SST), which contain 6 g and 1.5 g of licorice in the daily dose, respectively. In the case report survey, pseudoaldosteronism developed a median 35 (range 2—231) days after the administration of SKT, which is shorter than after SST (450, range 150—2190 days) and other licorice products including glycyrrhizin (210, range 14—730 days). A significant correlation was observed between the glycyrrhizin contents in the licorice preparations and the dosing periods for developing pseudoaldosteronism (r=-0.700, p < 0.01). A negative correlation was also observed between serum potassium level and dosing period for SKT, but not for SST. The difference in age (65.3 ± 11.6 vs. 57.2 ± 17.3 y) and dosing period (57.3 ± 66.3 vs. 19.0 ± 24.3 days) between the patients with and without hypokalemia after the administration of SKT was statistically significant (p < 0.05). The occurrence rate of hypokalemia including pseudoaldosteronism was around 80% with SKT administration for more than 30 days for patients exceeding 60 years old. It was suggested that patient age (>60 y) and dosing period of SKT (>30 days) might be risk factors for developing pseudoaldosteronism or hypokalemia as well as coadministration of drugs inducing hypokalemia.
著者
本間 真人
出版者
公益社団法人 日本薬剤学会
雑誌
薬剤学 (ISSN:03727629)
巻号頁・発行日
vol.66, no.1, pp.44-49, 2006 (Released:2019-04-13)
参考文献数
9
著者
石原 三也 本間 真人 久能 英子 渡邊 真知子 幸田 幸直
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.122, no.9, pp.695-701, 2002-09-01 (Released:2003-02-18)
参考文献数
51
被引用文献数
22 18

The intestinal bacteria, Eubacterium sp. and Bifidobacterium sp., participate in the metabolism of active kampo-ingredients, glycyrrhizin (GL), sennoside (SEN) and baicalin (BL). Since antibiotics and bacterial preparations, Bifidobacterium longum (LAC-B®), Clostridium butyricum (MIYA-BM®), and Streptococcus faecalis (BIOFERMIN®), affect the bacterial population in intestinal bacterial flora, metabolism of the active kampo-ingredients in the bacterial flora may be altered by their combined administration. We investigated 1199 prescriptions including kampo-medicines for 308 patients. Combination use of kampo-medicines with antibiotics and bacterial preparations occurred with 7% and 10% of the kampo-prescription, respectively. Most antibiotics have activity against intestinal bacteria, except that cephems and macrolides are not active against to E. coli. This means that antibiotics may lower the metabolism of GL, SEN and BL when administered in combination. On the other hand, it is also highly possible that bacterial preparations increase the number of Eubacterium sp. and Bifidobacterium sp., resulting in enhanced metabolism of GL and SEN when they are used concomitantly with kampo-medicines. The present results suggested that the drug interactions of kampo-medicines with antibiotics and bacterial preparations should be confirmed in clinical studies.
著者
高橋 昌也 新井 克明 本間 真人 鈴木 勝 佐藤 信一 幸田 幸直
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.28, no.2, pp.172-175, 2002-04-10 (Released:2011-03-04)
参考文献数
9
被引用文献数
2 1

To investigate the description of the expiration date and manufacturing number on the drug packages, “pillow” packages and “heat-seal” packages, the questionnairing was carried out to pharmaceutical companies. Fifty-six drugs consisting of three hundred thirty-seven items, with sales of over 10 billion yen in 1998, were investigated at the corresponding 26 companies. The recovery rate of the questionnaire from the company was 100%, and the answer for all questions was also perfect. Three hundred fourteen items (93%) have had description regarding the manufacturing number and/or the expiration date on the heat-sealed packages. The manufacturing number took precedence over the expiration date. Of 269 pillow packages, 69 items (26%) have had description of manufacturing number and/or expiration date on the pillow package. There were 41 products (12%) that the company did not guarantee an expiration date being described on the box container when the packages were taken out from the box container.As a result, the description of the manufacturing number and expiration date on the packages, “pillow” and “heat-seal”, is still not complete even though the companies guarantee the expiration date when the drugs were stored with these packages. Since the information of the expiration date is necessary for the appropriate management of tablet and capsule products, it is required to describe manufacturing number and expiration date on every drug package including “pillow” and “heat-seal” packages.
著者
本間 真人 田辺 正樹 小宅 典子 幸田 幸直
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.31, no.1, pp.77-80, 2005-01-10 (Released:2011-03-04)
参考文献数
10
被引用文献数
2 1

We report on a case of rhabdomyolysis induced by Shakuyaku-kanzo-To, a herbal medicine for spastic muscle pain. The patient was a 76-year-old female who received Shakuyaku-kanzo-To (TJ-68) and dichlofenac for lumbago. Fifteen weeks later, she was admitted to hospital because of liver dysfunction as determined from increases in AST, ALT and LDH. She was diagnosed with rhabdomyolysis due to marked elevation of CPK and myogloblin levels. The hypertension, hypokalemia and reduced renin and aldosterone levels that were also noted suggested that the rhabdomyolysis was associated with pseudoaldosteronism caused by the licorice extracts contained by Shakuyaku-kanzo-To. We confirmed that blood levels of glycyrrhetinic acid (257 ng/mL), a licorice component known to induce pseudoaldosteronism, were high and found the serum cortisone/cortisol ratio (O.09) to be low indicating reduced activity of 11 β-hydroxysteroid dehydrogenase, which catalyzes the conversion of cortisol to cortisone. The results we obtained suggested that blood glycyrrhetinic acid levels and cortisone/cortisol ratios could be used as diagnostic indicators for pseudoaldosteronism caused by herbal remedies containing licorice extracts.
著者
高橋 昌也 新井 克明 本間 真人 鈴木 勝 佐藤 信一 幸田 幸直
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.28, no.2, pp.172-175, 2002
参考文献数
9
被引用文献数
2 1

To investigate the description of the expiration date and manufacturing number on the drug packages, "pillow" packages and "heat-seal" packages, the questionnairing was carried out to pharmaceutical companies. Fifty-six drugs consisting of three hundred thirty-seven items, with sales of over 10 billion yen in 1998, were investigated at the corresponding 26 companies. The recovery rate of the questionnaire from the company was 100%, and the answer for all questions was also perfect. Three hundred fourteen items (93%) have had description regarding the manufacturing number and/or the expiration date on the heat-sealed packages. The manufacturing number took precedence over the expiration date. Of 269 pillow packages, 69 items (26%) have had description of manufacturing number and/or expiration date on the pillow package. There were 41 products (12%) that the company did not guarantee an expiration date being described on the box container when the packages were taken out from the box container. As a result, the description of the manufacturing number and expiration date on the packages, "pillow" and "heat-seal", is still not complete even though the companies guarantee the expiration date when the drugs were stored with these packages. Since the information of the expiratioh date is necessary for the appropriate management of tablet and capsule products, it is required to describe manufacturing number and expiration date on every drug package including "pillow" and "heat-seal" packages.
著者
本間 真人
出版者
一般社団法人 日本臓器保存生物医学会
雑誌
Organ Biology (ISSN:13405152)
巻号頁・発行日
vol.19, no.1, pp.91-97, 2012-07-10 (Released:2014-11-26)
参考文献数
15

Pharmacogenetic information in the package insert was reviewed. Most of the information was gene polymorphisms for the drug metabolizing enzymes such as cytochrome-P450 (CYP) and UDP-glucuronyl transferase(UGT), which alter the pharmacokinetics for substrate drugs resulting in individual variation of drug response including efficacy and adverse effects. In the typical substrates for these enzymes (proton pump inhibitors, clopidogrel, irinotecan and warfarin), difference in the pharmacological efficacy and side effects are discussed among the patients groups carrying different genotypes. HLA types identified for drug-induced serious dermatitis and hypersensitivity for abacavir, carbanazepine and alloprinol are also included in this review.
著者
塚本 晶子 本間 真人 神林 泰行 木津 純子 幸田 幸直
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.33, no.8, pp.687-692, 2007 (Released:2009-09-04)
参考文献数
16
被引用文献数
5 4

One of the major adverse effects of Shakuyaku-kanzo-To (SKT),a herbal medicine containing licorice,is licoriceinduced pseudoaldosteronism with hypokalemia and hypertension.Owing to the risk of hypokalemia,caution should be therefore exercised when SKT is co-administered with potassium lowering drugs.In order to clarify this risk,we examined the occurrence of hypokalemia in 103 patients receiving SKT.Thirty (29.1%) of the 103 patients developed hypokalemia and SKT dosing periods tended to be longer in these patients than in those who did not develop hypokalemia (54.5 vs.23.0 days,respectively).The co-administration of potassium lowering drugs was more frequent in the patients with hypokalemia (90.0% vs.64.4% for no hypokalemia p<0.01).The occurrence rates of hypokalemia varied with drugs co-administered with SKT ; with 75.0% for glycyrrhizin preparations,47.2% for diuretics,41.9% for glucocorticoids,20.0% for sennoside preparations and 25.0% for others.The above results confirmed that the co-administration of potassium lowering drugs enhanced SKT-induced hypokalemia.Frequent serum potassium monitoring is therefore required when potassium lowering drugs,especially glycyrrhizin preparations,diuretics and glucocorticoids,are co-administered to patients receiving SKT.