- 著者
- Kyoko FUKUMOTO Takashi KOBAYASHI Kazuo KOMAMURA Shiro KAMAKURA Masafumi KITAKAZE Kazuyuki UENO
- 出版者
- 日本薬物動態学会 会長/日本薬物動態学会 DMPK編集委員長
- 雑誌
- Drug Metabolism and Pharmacokinetics (ISSN:13474367)
- 巻号頁・発行日
- vol.20, no.6, pp.423-427, 2005 (Released:2006-01-11)
- 参考文献数
- 30
- 被引用文献数
- 13 11
We investigated whether there was a stereoselective effect of amiodarone on the pharmacokinetics of carvedilol. Among a series of 106 inpatients with heart failure, 52 received carvedilol monotherapy (carvedilol group) and 54 received carvedilol plus amiodarone (carvedilol+amiodarone group). The serum carvedilol concentration administered/dose ratio was compared between the two groups based on HPLC measurement of the serum levels of carvedilol, amiodarone, and desethylamiodarone. In 6 patients from the carvedilol group, serum carvedilol levels were compared before and after coadministration of amiodarone. There was no significant between-group difference of the serum concentration to dose (C/D ratio) for the R-enantiomer carvedilol, however, the C/D ratio for the S-enantiomer and the serum S-carvedilol to R-carvedilol (S/R) ratio were both significantly lower in the carvedilol group than in the carvedilol+amiodarone group(47.8±56.7 versus 95.3±105 ng/mg/kg, P=0.0048 and 0.460±0.207 versus 0.879±0.377 ng/mg/kg, P<0.001), respectively. Furthermore, the mean S-carvedilol concentration over 14 days of coadministration with amiodarone was higher than that before coadministration (6.54±1.73 ng/mL versus 3.03±0.670 ng/mL, P<0.001). These results suggest that metabolism of S-carvedilol was markedly inhibited by coadministration of amiodarone.
- 著者
- Noboru Oda Tomoko S. Kato Akihisa Hanatani Kazuo Niwaya Takeshi Nakatani Hatsue Ishibashi-Ueda Soichiro Kitamura Kazuhiko Hashimura Masafumi Kitakaze Kazuo Komamura
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.49, no.11, pp.1013-1016, 2010 (Released:2010-06-01)
- 参考文献数
- 15
- 被引用文献数
- 7 10
Reversible posterior leukoencephalopathy syndrome (RPLS) is one of the important adverse events following organ transplantation, associated with calcineurin inhibitors (CNIs). We describe a case of 54-year-old woman, who was diagnosed with RPLS within weeks after transplantation. Considering the risk of causing fatal rejection by discontinuation of CNIs, the immunosuppressive regimen of the patient was switched from a cyclosporine A-based regimen to a tacrolimus-based regimen. The patient recovered rapidly from RPLS following the switch to tacrolimus. This case demonstrated that not only discontinuation but also a substitution of CNIs would be a valid treatment option for RPLS in transplant recipients.
- 著者
- Mahoto Kato Kazuo Komamura Masafumi Kitakaze
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.70, no.12, pp.1658-1660, 2006 (Released:2006-11-25)
- 参考文献数
- 17
- 被引用文献数
- 6 15
A 77-year-old man was referred to hospital because of dyspnea on exertion. Although the patient had been fully medicated for chronic heart failure (CHF) caused by hypertensive heart disease, the echo-estimated left ventricular end-diastolic pressure (LVEDP) and brain natriuretic peptide (BNP) level had continued to be high for at least 2 years. Pulmonary functional examination revealed concomitant chronic obstructive pulmonary disease (COPD). Because β-agonists were expected to exacerbate the CHF, inhalation of tiotropium, a non-β-adrenergic bronchodilator and novel M3 muscarinic receptor antagonist, was used to treat the COPD. Not only did the pulmonary function improved but the treatment also safely ameliorated CHF signs including LVEDP and plasma BNP. (Circ J 2006; 70: 1658 - 1660)