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

布施 春奈 大西 優香里 松井 布美 杉山 奈津子 小茂田 昌代

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.18, no.2, pp.64-71, 2016 (Released:2016-09-27)

参考文献数

39

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Objective: Tamoxifen is a drug that is frequently administered for 5 years to treat hormone receptor-positive breast cancer in premenopausal women.  Metabolism of tamoxifen by cytochrome P450 enzymes such as CYP3A4 and CYP2D6 is required for drug efficacy.  However, reports suggest that the effect of tamoxifen is attenuated in the presence of CYP2D6 inhibitors.  In this study, I evaluated drug-drug interactions that may attenuate tamoxifen action for improved pharmaceutical management.Data Source: Potential interactions were evaluated by using the tamoxifen package insert, Kyoto Encyclopedia of Genes and Genomes (KEGG), Pharmaceuticals and Medical Devices Agency (PubMed), and Lexicomp Online.  We have searched the paper using the PubMed and JDream III.The Choice of Research: The paper about the interaction related CYP2D6 and 3A4 of tamoxifen.Results and Conclusion: The use of tamoxifen is often long term; however, adverse effects such as hot flashes, can cause poor regimen adherence.  Although selective serotonin reuptake inhibitors (SSRIs) can effectively treat menopausal hot flashes, many SSRIs inhibit CYP2D6.  In particular, paroxetine has been reported to adversely affect tamoxifen metabolism.  There are 31 drugs and 843 compounds that inhibit CYP2D6.  Thus, it is necessary to avoid these combinations.  In addition, there are many CYP2D6 gene polymorphisms that have been identified in Japanese patients, and some reports indicate that they affect tamoxifen efficacy.  Therefore, in order to continue use of these medications without attenuating the effect of tamoxifen, development of medical database which can be updated daily is required to avoid CYP-related interactions.