著者

Hyerim Park Akiko Miki Hiroki Satoh Yasufumi Sawada

出版者

Japanese Society of Drug Informatics

雑誌

Iyakuhin Johogaku (ISSN:13451464)

巻号頁・発行日

vol.19, no.3, pp.133-141, 2017-11-30 (Released:2017-12-27)

参考文献数

19

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Objective: An aging population results in an increased number of people in need of long-term care. Despite the role of care staff in supporting sufficient medication use, and medication risk management being important in long-term care, attitudes and concerns regarding medication assistance among nursing home staff are unclear. The study aimed to survey fee-based elderly nursing homes staff attitudes and concerns about supporting medication use and drug information.Methods: The questionnaire was designed to survey the attitudes, concerns, and knowledge of the support of residents' medication use by fee-based elderly nursing homes staff. In August 2012, the questionnaire was distributed to 360 staff in 12 fee-based elderly nursing homes in Japan.Results: A total of 201 responses (from 44 nursing staff and 157 care workers) were used in the analysis; 59.1% of nursing staff and 87.9% of care workers were anxious about the lack of basic medication knowledge, and 15.9% of nursing staff and 76.4% of care workers felt anxious that they could not answer residents' questions about medication. Regarding the frequency of behaviors for obtaining drug information, few staff usually ask physicians (17.2%) or pharmacists (24.0%) for information.Conclusion: Many fee-based elderly nursing homes staff were concerned about supporting medication use without knowledge of the medications that elderly residents are taking in fee-based elderly nursing homes. The findings suggest that fee-based elderly nursing homes staff wanted to obtain basic drug information to support safe medication use. It is important to relieve their concerns by providing basic education programs and strengthening collaboration with other health professionals to improve the quality of care involving medication.

著者

Akiko MATSUI-SAKATA Hisakazu OHTANI Yasufumi SAWADA

出版者

The Japanese Society for the Study of Xenobiotics

雑誌

Drug Metabolism and Pharmacokinetics (ISSN:13474367)

巻号頁・発行日

vol.20, no.5, pp.368-378, 2005 (Released:2005-11-01)

参考文献数

96

被引用文献数

140

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Objective: Among various adverse reactions of atypical antipsychotics, weight gain and impaired glucose tolerance are clinically significant. The aim of this study is to analyze quantitatively the contributions of various receptors to these antipsychotics-induced adverse reactions based on the receptor occupancy theory.    Methods: Two indices of antipsychotics-induced weight gain (the values estimated by a meta-analysis and the observed values in clinical trials) and the morbidity rate of type 2 diabetes mellitus during treatment with antipsychotics were taken from the literature. We calculated the estimated mean receptor occupancies of α1 adrenergic, α2 adrenergic, dopamine D2, histamine H1, muscarinic acetylcholine (mACh), serotonin 5-HT1A, 5-HT2A and 5-HT2C receptors by antipsychotics by using the pharmacokinetic parameters and receptor dissociation constants, and analyzed the correlation between the occupancies and the extent of adverse reactions as assessed using the aforementioned indices.    Results: There were statistically significant correlations between the estimated occupancies of H1 and mACh receptors and antipsychotics-induced weight gain estimated by meta-analysis (rs=0.81 and rs=0.83, respectively, p<0.01). There were also statistically significant correlations between these receptor occupancies and observed weight gain in clinical trials (rs=0.66 in each case, p<0.01). The morbidity rate of type 2 diabetes mellitus was highly correlated with H1, mACh, and 5-HT2C receptor occupancies (rs=0.90 in each case, p<0.05). However, H1 receptor occupancy was also highly correlated with mACh receptor occupancy among antipsychotics, so that only one of them may be critically associated with the adverse reactions. Considering that these adverse reactions have not been reported for drugs with mACh receptor antagonistic action, other than antipsychotics, the H1 receptor may contribute predominantly to the antipsychotics-induced weight gain and diabetes mellitus.    Discussion/Conclusion: Model analysis based on receptor occupancy indicates that H1 receptor blockade is the primary cause of antipsychotics-induced weight gain and diabetes mellitus.

著者

Kei Kikuchi Akiko Miki Hiroki Satoh Noriko Iba Rika Sato-Sakuma Hirokuni Beppu Yasufumi Sawada

出版者

International Research and Cooperation Association for Bio & Socio-Sciences Advancement

雑誌

Drug Discoveries & Therapeutics (ISSN:18817831)

巻号頁・発行日

vol.13, no.4, pp.183-188, 2019-08-31 (Released:2019-09-18)

参考文献数

13

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Patient narratives of adverse drug events (ADEs) often differ from the symptoms listed on the package inserts of pharmaceutical products using common ADE terminology and could be a source of great comfort to patients with the same disease. To explore this idea, we analyzed written narratives obtained from 48 patients with breast cancer using the NPO Corporation Database of Individual Patients' Experiences, Japan (DIPEx-Japan). Our analysis aimed to determine the utility of an "Adverse Drug Event Database" for use in clinical settings as a novel source of disease information in patients' own words. An analysis of transcripts from 29 patients, in which they recounted their treatment drugs and the time of onset and duration of ADEs in great detail, revealed several discrepancies between the language they used to describe various side effects and the standard ADE terminology on package inserts. We conclude that the language used to describe ADEs on package inserts is insufficient for helping patients as they struggle to recognize, internalize, and overcome ADEs, and argue the need for available, detailed information in the words of real patients about the nature of the ADEs predicted, as well as their clinical course and duration. Such information would be invaluable in supplementing the standardized language used on package inserts. Databases of patients' narrative accounts of ADEs are needed as information sources that can be reliably disseminated among patients.

著者

Masayuki Ikenishi Akiko Kuroda Haruhiko Tsukazaki Masahiko Nakao Masashi Takeuchi Yuji Konishi Toshiyuki Matsuda Tohru Ohtori Kenji Matsuyama Mitsutaka Takada Hiroki Satoh Yasufumi Sawada Mutsuaki Ueda

出版者

一般社団法人日本医薬品情報学会

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.18, no.3, pp.172-178, 2016 (Released:2017-02-14)

参考文献数

32

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Objective: To compare effects of the fluoropyrimidines S-1 and capecitabine on prothrombin time international normalized ratios (PT-INR) of warfarin following coadministration and after discontinuation of each fluoropyrimidine treatment.Methods: Medical records of patients receiving warfarin with either S-1 (6 patients) or capecitabine (7 patients) were obtained from four hospitals.Results: Increased PT-INR was observed until peak levels of warfarin were achieved in all patients in S-1 and capecitabine treatment groups. Moreover, PT-INR significantly changed after coadministration within each group (p<0.05). Specifically, ratios of peak PT-INR after coadministration of each fluoropyrimidine and those following administration of warfarin alone (PT-INR elevation ratio) were 3.31 and 3.29 in S-1 and capecitabine coadministration groups, respectively. Moreover, numbers of days to peak PT-INR were 38.3 and 31.3 days, respectively, and did not significantly differ between the treatment groups. Furthermore, PT-INR returned to pretreatment levels by 17.5 and 15.1 days after discontinuation of S-1 and capecitabine, respectively, and did not significantly differ between the treatment groups.Conclusion: Coadministration of S-1 and capecitabine similarly prolongs PT-INR by approximately 3-fold compared with administration of warfarin alone; therefore, these drug-drug interactions were clinically suggested to be of high risk for episodes of bleeding and remarkable alterations in coagulation parameters. Therefore, blood coagulation ability should be more carefully monitored with regard to PT-INRs in patients receiving warfarin with S-1 or capecitabine not only during coadministration but also after discontinuation of fluoropyrimidine treatments.

著者

Jahye KIM Hisakazu OHTANI Masayuki TSUJIMOTO Yasufumi SAWADA

出版者

The Japanese Society for the Study of Xenobiotics

雑誌

Drug Metabolism and Pharmacokinetics (ISSN:13474367)

巻号頁・発行日

vol.24, no.2, pp.167-174, 2009 (Released:2009-05-10)

参考文献数

41

被引用文献数

12

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Concomitant administration of certain fluoroquinolone antimicrobials and nonsteroidal antiinflammatory agents (NSAIDs) induces serious convulsion in humans. There are differences in convulsive activity among fluoroquinolones and in the potentiation of fluoroquinolone-induced convulsion among NSAIDs, but a comprehensive, quantitative comparison has not been carried out. This study evaluates the inhibitory effects of twelve fluoroquinolones (ciprofloxacin, enoxacin, fleroxacin, gatifloxacin, levofloxacin, lomefloxacin, norfloxacin, ofloxacin, pazufloxacin, prulifloxacin, sparfloxacin, and tosufloxacin) alone or in the presence of an NSAID (4-biphenylacetic acid, diclofenac sodium, loxoprofen, lornoxicam or zaltoprofen) on the GABAA receptor binding of [3H]muscimol in an in vitro study using mice synaptic plasma membrane. The rank order of inhibitory effects of the fluoroquinolones was prulifloxacin ≈ norfloxacin > ciprofloxacin ≥ enoxacin > gatifloxacin ≥ ofloxacin ≈ tosufloxacin ≈ lomefloxacin > levofloxacin ≥ sparfloxacin ≥ pazufloxacin ≈ fleroxacin. 4-Biphenylacetic acid most potently enhanced the inhibitory effects of the fluoroquinolones, while zaltoprofen, loxoprofen, lornoxicam and diclofenac had essentially no effect. The clinical risk of convulsion for each combination was estimated using a pharmacodynamic model based on receptor occupancy using the in vitro data set obtained and pharmacokinetic parameters in humans collected from the literature. The combinations of 4-biphenylacetic acid with prulifloxacin and enoxacin were concluded to be the most hazardous.