著者

寺山 和利 渡部 多真紀 渡辺 茂和 三浦 邦久 土屋 雅勇

出版者

一般社団法人 日本ペインクリニック学会

雑誌

日本ペインクリニック学会誌 (ISSN:13404903)

巻号頁・発行日

vol.27, no.1, pp.32-38, 2020-02-25 (Released:2020-03-04)

参考文献数

29

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【目的】痛みの評価はVASなど主観的方法が汎用されている.客観的評価ツールであるPainVision(PV)が痛みの測定に有用であるか,外用NSAIDsの薬効をPVとVASで評価した.【方法】被検者は成人ボランティア33名とした.試験薬剤はインドメタシン・ケトプロフェン・ジクロフェナク・フェルビナクを主成分とする外用NSAIDs 19剤を用いた.鎮痛効果はPVとVASを用いて検討した.【結果】PVとVASはr=0.681(p<0.01)と相関を示した.クリーム剤のミカメタン,テイコク,ユートクはインテバンに比べ有意差をもって強い鎮痛効果を示した(p<0.05).ゲル剤のエパテック,ナボールはイドメシンに比べ有意差をもって強い鎮痛効果を示した(p<0.05).【結論】PVが痛みの評価に有用なツールである可能性を示した.外用NSAIDsは主成分や剤型により鎮痛効果が異なるため,医師や薬剤師が薬剤を選択する際には,鎮痛強度の違いを考慮すべきである.

著者

松木 祥彦 塚本 哲也 細山田 真 渡部 多真紀 渡辺 茂和 土屋 雅勇

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.15, no.2, pp.51-56, 2013 (Released:2013-09-05)

参考文献数

17

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Objective: In previously reported comparisons of aminoglycoside antimicrobials administered once daily versus multiple administration, toxicity was found to be equal or lower while efficiency remained high.  However, there are few reports on the clinical condition of targeted elderly persons.  The objective of this study was to evaluate the once-daily dosing regimen of 400 mg of AMK involving elderly pneumonia patients aged 75 years or older with regard to clinical evaluation including the efficacy and toxicity.Methods: A survey to clinically evaluate the efficacy and toxicity of 400 mg AMK administered once daily for 30 min at 24 h intervals was carried out.  One hundred twenty-seven patients with pneumonia and who were 75 years or older at Funabashi General Hospital were targeted, with the aim of an expected clinical effect of Cmax/MIC≥ 8-10.  Serum concentration monitoring was carried out after administration began.Results: There were 121 patients (95.3%) of controlled AMK concentration with a trough serum concentration of <10 μg/mL, which is a safe concentration range.  There were 6 patients (4.7%) where trough serum concentration in the toxic range >10 μg/mL, with an average at 15.1±5.0 μg/mL, and the average administration days were 7.5 ± 3.3 days.  Moreover, before/after AMK administration, there were 3 patients (2.4%) where CRE values increased more than a 150% over the previous values, and were evaluated as renal dysfunction.  Average trough serum concentration at that time was 3.6 ± 1.1 μg/mL, and average number of days of administration were 13 ± 1.4 days.  Patients of trough serum concentration in the toxic range >10 μg/mL were not included.  The average peak serum concentration calculated by Winter’s pharmacokinetic parameter and the 1-compartment model was 35.3 ± 8.0 μg/mL, and the average Cmax/MIC which correlates with the AMK effect was 9.9 ± 2.2.  The treatment was effective for 83 (65.4%) of the 127 patients.Conclusion: By once-daily administration of AMK 400 mg to aged persons 75 years or older, change in trough serum concentration into a safe range and Cmax/MIC≥ 8-10, the level at which clinical effectivity can be expected, could be achieved.  This administration method is shown to be useful in maintaining AMK in the target serum concentration range for aged persons.