著者

Kayoko Matsubara Kazuaki Matsumoto Yuta Yokoyama Erika Watanabe Yuki Enoki Akari Shigemi Kazuro Ikawa Hideyuki Terazono Norifumi Morikawa Tamao Ohshige Yasuo Takeda

出版者

The Pharmaceutical Society of Japan

雑誌

Biological and Pharmaceutical Bulletin (ISSN:09186158)

巻号頁・発行日

vol.44, no.5, pp.732-736, 2021-05-01 (Released:2021-05-01)

参考文献数

27

被引用文献数

3

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Ampicillin-sulbactam is a first-line therapy for pneumonia and is mainly excreted by the kidney. It is important to optimize the dose and dosing interval of ampicillin-sulbactam because in patients with decreased renal function and low skeletal muscle mass, such as the elderly, excess drug may burden renal function. In this study, we evaluated indices of renal function and optimized the dose and dosing interval of ampicillin-sulbactam based on pharmacokinetics (PK) and pharmacodynamics theory in elderly patients. The serum concentrations of ampicillin and sulbactam were measured by HPLC, and PK parameters were calculated. Correlations between the clearance of ampicillin or sulbactam and renal function were evaluated, and dosing optimization was calculated based on PK parameters. The PK parameters of ampicillin were CL = 6.5 ± 4.0 L/h, Vd = 19.3 ± 0.2 L, Ke = 0.4 ± 0.2, and t1/2 = 2.7 ± 1.6 h. The most correlated renal function index was estimated glomerular filtration rate (eGFRcys-c) calculated by serum cystatin-c (r = 0.7374, correlation formula; CL of ampicillin = 0.1937 × eGFRcys-c−0.6726). Based on this formula, we calculated the clearance of ampicillin and developed dosing regimens for the elderly. Serum cystatin-c concentration is an ideal index to optimize ampicillin-sulbactam antimicrobial therapy in elderly patients with pneumonia.

著者

Masaru Sakurai Junji Kobayashi Yasuo Takeda Shin-Ya Nagasawa Junichi Yamakawa Junji Moriya Hiroshi Mabuchi Hideaki Nakagawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.8, pp.440-446, 2016-08-05 (Released:2016-08-05)

参考文献数

31

被引用文献数

14 20

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Aims: The present study aimed to investigate relationships among abdominal obesity, metabolic abnormalities, and the prevalence of chronic kidney disease (CKD) in relatively lean Japanese men and women.Participants and methods: The participants included 8133 men and 15 934 women between 40 and 75 years of age recruited from the government health check-up center in Kanazawa City, Japan. The prevalence of abdominal obesity, high blood pressure, dyslipidemia, and high fasting plasma glucose levels were assessed according to the Japanese criteria for metabolic syndrome. The estimated glomerular filtration rate (eGFR) was calculated using the modified Modification of Diet in Renal Disease equation for the Japanese population, and participants with an eGFR <60 mL/min/1.73 m2 and/or proteinuria were diagnosed with CKD.Results: Overall, 23% of males and 14% of females met criteria for CKD. Having more numerous complicated metabolic abnormalities was significantly associated with a higher odds ratio (OR) of CKD for men and women, irrespective of abdominal obesity. However, there was a sex difference in the OR of CKD for obese participants without metabolic abnormalities, such that abdominal obesity without metabolic abnormalities was significantly associated with a higher OR for men (multivariate-adjusted OR 1.63; 95% confidence interval [CI], 1.16–2.28) but not for women (OR 1.01; 95% CI, 0.71–1.44).Conclusions: The present findings demonstrated that obesity without metabolic abnormalities was associated with a higher risk of CKD in men but not women in a relatively lean Japanese population.

著者

Kazuaki Matsumoto Akari Shigemi Kazuro Ikawa Naoko Kanazawa Yuko Fujisaki Norifumi Morikawa Yasuo Takeda

出版者

The Pharmaceutical Society of Japan

雑誌

Biological and Pharmaceutical Bulletin (ISSN:09186158)

巻号頁・発行日

vol.38, no.2, pp.235-238, 2015-02-01 (Released:2015-02-01)

参考文献数

17

被引用文献数

5 22

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Ganciclovir is a nucleoside guanosine analogue that exhibits therapeutic activity against human cytomegalovirus infection, and is primarily excreted via glomerular filtration and active tubular secretion. The adverse effects induced by ganciclovir therapy are generally of a hematological nature and include thrombocytopenia and leukopenia. Low marrow cellularity and elevated serum creatinine have been identified as risk factors for ganciclovir-induced neutropenia. However, the risk factors for thrombocytopenia have yet to be determined. Therefore, this study investigated patients administered ganciclovir to determine the risk factors for thrombocytopenia and leukopenia. Thrombocytopenia occurred in 41 of these patients (30.6%). Multivariate logistic regression analysis identified three independent risk factors for thrombocytopenia: cancer chemotherapy (odds ratio (OR)=3.1), creatinine clearance (<20 mL/min) (OR=12.8), and the ganciclovir dose (≥12 mg/kg/d) (OR=15.1). Leukopenia occurred in 36 patients (28.6%), and white blood cell count (<6000 cells/mm3) (OR=3.7) and the ganciclovir dose (≥12 mg/kg/d) (OR=7.8) were identified as risk factors. These results demonstrated that several factors influenced the occurrence of ganciclovir-induced thrombocytopenia and leukopenia, and suggest that special attention should be paid to patients receiving cancer chemotherapy with a low creatinine clearance (<20 mL/min) and high dose (≥12 mg/kg/d) in order to avoid ganciclovir-induced thrombocytopenia.

著者

Maiko KAWAKUBO Masaki MATSUI Sumihisa ISHIKAWA Atsushi HIRANO Osamu YAMAMOTO Yasuo TAKEDA Nobuyuki IMANISHI

出版者

公益社団法人 電気化学会

雑誌

Electrochemistry (ISSN:13443542)

巻号頁・発行日

vol.82, no.8, pp.642-646, 2014-08-05 (Released:2014-08-05)

参考文献数

14

被引用文献数

2

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Degradation processes of carbon negative electrodes for all-solid lithium polymer batteries were investigated using X-ray diffraction (XRD), electrochemical impedance spectroscopy (EIS) and Scanning Electron Microscope (SEM). The cycling performances of the electrodes are significantly affected by the mixing speed of the electrode slurry. The cross-sectional SEM images of the electrodes containing vapor-grown carbon fiber (VGCF) show that more voids remained in the electrodes, if the slurry was mixed at high speed. The voids in the composite electrode expand and increase during the cycling test of the cell resulting in the capacity fading. On the other hand, the electrodes containing carbon nanotubes (CNT) show an opposite trend, because the high mixing speed improves the dispersibility of the CNT resulting in the formation of the less voids in the electrode. The electrode containing both VGCF and CNT prepared at high mixing speed shows the best cycleability among all the electrodes. In spite of some voids initially form in the electrode, the CNT seems to have prevented further increase and expansion of the voids.