著者

Naoto Okada Shuji Fushitani Momoyo Azuma Shingen Nakamura Toshimi Nakamura Kazuhiko Teraoka Hiroyoshi Watanabe Masahiro Abe Kazuyoshi Kawazoe Keisuke Ishizawa

出版者

公益社団法人日本薬学会

雑誌

Biological and Pharmaceutical Bulletin (ISSN:09186158)

巻号頁・発行日

vol.39, no.2, pp.295-300, 2016-02-01 (Released:2016-02-01)

参考文献数

16

被引用文献数

21

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The therapeutic effects of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents, vancomycin (VCM), teicoplanin (TEIC), and arbekacin (ABK), depend on their concentrations in blood. Therefore, therapeutic drug monitoring (TDM) is important when these antibiotics are used. In the hematological ward at Tokushima University Hospital, pharmacists have ordered the measurement of blood VCM, TEIC, and ABK concentrations to promote the use of TDM in accordance with an agreed protocol since 2013. Moreover, the infection control team includes several medical disciplines and has advised on the optimal treatment using VCM, TEIC, and ABK since 2013. This study aimed to investigate the clinical effectiveness of these pharmacist interventions. We retrospectively studied 145 cases in which patients were treated with VCM, TEIC, or ABK between January 2012 and December 2013 in the hematological ward at Tokushima University Hospital. The patients were divided into a control group (71 cases) and an intervention group (74 cases), and their clinical outcomes were compared. The rate of achievement of effective drug concentrations significantly increased in the intervention group (74%), compared to the rate in the control group (55%). Moreover, univariate and multivariate Cox proportional hazard regression revealed that pharmacist intervention and appropriate concentrations of anti-MRSA agents were independent factors associated with reduced hospitalization periods in patients with lymphoma. Our study revealed that proactive pharmacist intervention may improve the therapeutic effect of anti-MRSA agents in hematology ward patients.

著者

Hozumi Tashima Yuka Endo Naoto Okada Shingen Nakamura Kumiko Kagawa Shiro Fujii Hirokazu Miki Keisuke Ishizawa Masahiro Abe Youichi Sato

出版者

International Society of Personalized Medicne

雑誌

Personalized Medicine Universe (ISSN:21864969)

巻号頁・発行日

vol.10, pp.1-6, 2021-12-01 (Released:2022-01-07)

参考文献数

9

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Purpose: Cytarabine arabinoside (Ara-C) is an anti-metabolite that is commonly used as a therapeutic agent for acute leukemia; however, it can cause adverse drug reactions, such as digestive disorders, rashes, and fever. Therefore, identification of gene markers that can accurately predict the development of adverse drug reactions is useful for selecting effective drugs for therapy. After entering the cells, Ara-C is metabolized to Ara-C triphosphate, which inhibits DNA synthesis and exhibits antitumor activity. Therefore, we conducted an association study between the adverse reactions to cytarabine therapy and single nucleotide polymorphisms (SNPs) in cytarabine metabolic genes.Methods: Among the patients treated with cytarabine at the Department of Hematology at Tokushima University Hospital, 46 patients provided informed consent and were included in this study. We selected 14 tag SNPs located in nine genes that are involved in the cytarabine metabolic pathway; these SNPs were genotyped using the polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) technique. Association analyses between adverse reactions to Ara-C therapy and SNPs were performed using logistic regression analysis.Results: The rs9394992 polymorphism in the SLC29A1 gene and rs3886768 polymorphism in the DCTD gene were associated with the development of rash after Ara-C therapy. The rs7277 polymorphism in the DCTD gene was associated with fever, and the rs16945930 polymorphism in the ABCC11 gene was associated with sore throat.Conclusions: Our findings suggest that SNPs in the Ara-C metabolic genes influence the development of adverse reactions to Ara-C, and the results suggest that these genes can be predictive of adverse reactions to Ara-C therapy.