著者
益戸 智香子 小川 ゆかり 山下 直美 三原 潔
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.139, no.1, pp.113-122, 2019-01-01 (Released:2019-01-01)
参考文献数
41
被引用文献数
6

Benzodiazepine receptor agonists (BZDRAs) have been associated with an increased risk of falls in the elderly. However, the association between the elimination half-life (t1/2) of BZDRAs and the difference between benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs) has not been clarified. By conducting a meta-analysis of observational studies, we compared the risk of falls with respect to 1) short-acting BZDRAs (t1/2<12 h) vs. long-acting BZDRAs (t1/2≥12 h) and 2) BZDs vs. Z-drugs in elderly patients. Data were retrieved from MEDLINE, the Cochrane Library, and Igaku Chuo Zasshi. In total, 13 observational studies from 12 articles were included in our study (short-acting BZDRAs, n=12; long-acting BZDRAs, n=9; BZDs, n=13; Z-drugs, n=7). The risk of falls was significantly increased by the use of short-acting BZDRAs [Odds ratio (OR) (95% Confidence interval (CI)): 2.00 (1.46-2.73)], long-acting BZDRAs [OR (95%CI): 2.16 (1.61-2.89)], BZDs [OR (95%CI): 1.67 (1.31-2.13)], and Z-drugs [OR (95%CI): 2.42 (1.35-4.34)] compared to the risk in BZDRAs non-users. The increased risk of falls in elderly patients was similar in each group and unrelated to t1/2. This study suggested that all BZDRAs including Z-drugs should be avoided in elderly patients.
著者
山口 巧 堀尾 郁夫 後藤 正博 宮内 芳郎 出石 文男
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.136, no.8, pp.1185-1193, 2016 (Released:2016-08-01)
参考文献数
16
被引用文献数
2

It has been 6 years since the establishment of the position of “sports pharmacist” as one type of pharmacist. In the sporting world of Japan, sports pharmacists are expected to promote athletes' awareness of antidoping regulations and provide them with relevant education. However, currently, these pharmacists' main duty is to provide athletes and their coaches with guidance on medication. Using a model for the prediction of athletes' actions, we have worked to promote athletes' awareness of antidoping regulations and encourage sports pharmacists to perform relevant activities, such as antidoping education. As a result, we clarified that athletes' awareness regarding antidoping rules influences their actions when experiencing minor illnesses. In addition, we have proposed approaches to encourage athletes to undertake antidoping activities. The present study aimed to clarify competitive sports coaches' awareness of antidoping regulations, the instructions that those coaches give athletes when they experience minor illnesses, and coaches' awareness of athletes' usage of drugs and supplements. Analysis using a model for the prediction of actions revealed that to promote coaches' awareness of antidoping regulations, education aimed at raising their level of knowledge of doping is warranted. Furthermore, coaches were aware of the necessity of continuously providing athletes with antidoping instructions, but they did not keep sufficient track of athletes' usage of drugs and supplements. To encourage sports coaches to perform antidoping activities, it is effective to provide them with opportunities to develop their knowledge of doping prevention in their areas.
著者
眞島 崇 大原 宏司
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.17-00167, (Released:2017-11-09)
参考文献数
16
被引用文献数
2

The scope of pharmaceutical education in Japan has been expanding, and with it an awareness of the importance of team medical care. However, pharmaceutical education still gives little attention to the psychosocial aspects of care, instead focusing on the structures and functions of drugs. In contrast, nursing education emphasizes the fact that medical care involves patients' family and significant others as much as the patients themselves, and thus nursing students are taught the basic needs and developmental stages of those people requiring care alongside their practical nursing skills. In this study, we examined the effect of incorporating certain aspects of introductory nursing education into pharmaceutical education on the self-efficacy of pharmaceutical students. We thus ran an introduction to nursing education course for fourth-year pharmaceutical students (n=86). After the course had finished, we surveyed students about the course. Approximately 94.2% of the students became more interested in team medical care and nearly all (98.8%) thought that what they had learned in the course would be useful in their career. The results indicated that the introduction to nursing education course offered students an opportunity to acquire different viewpoints on clinical situations because the lectures were given by a pharmacist with a nurse license and they were based on his clinical experiences. We therefore propose that more facets of introductory nursing education be incorporated into pharmaceutical education to help students develop their ability to consider patients' psychosocial backgrounds.
著者
野崎 阿季子 高橋 栄造 岡本 敬の介 伊東 秀之 波多野 力
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.130, no.6, pp.895-902, 2010 (Released:2010-06-01)
参考文献数
9
被引用文献数
3 5

Candidiasis is a common opportunistic fungal infection that responds well to amphotericin B (AMPH) treatment. However, AMPH often causes adverse effects such as kidney injury and hypokalemia. Because some essential oils have been reported to have antifungal effects, we investigated the antifungal activity of various essential oils and their major constituents against Candida spp. Most essential oils examined in this study showed antifungal activity, and several enhanced the antifungal effect of AMPH. Clove oil in particular, and its major constituent eugenol, had potent effects. These findings suggest that combining certain essential oils or their constituents with AMPH may be useful for suppressing the adverse effects of AMPH treatment.
著者
内山 奈穂子 鎌倉 浩之 政田 さやか 辻本 恭 細江 潤子 徳本 廣子 丸山 卓郎 合田 幸広 袴塚 高志
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.17-00136, (Released:2017-07-19)
参考文献数
14
被引用文献数
2

In January 2017, counterfeits of the hepatitis C drug 'HARVONI® Combination Tablets' (HARVONI®) were found at a pharmacy chain through unlicensed suppliers in Japan. A total of five lots of counterfeit HARVONI® (samples 1-5) bottles were found, and the ingredients of the bottles were all in tablet form. Among them, two differently shaped tablets were present in two of the bottles (categorized as samples 2A, 2B, 4A, and 4B). We analyzed the total of seven samples by high-resolution LC-MS, GC-MS and NMR. In samples 2A, 3 and 4B, sofosbuvir, the active component of another hepatitis C drug, SOVARDI® Tablets 400 mg (SOVARDI®), was detected. In sample 4A, sofosbuvir and ledipasvir, the active components of HARVONI®, were found. A direct comparison of the four samples and genuine products showed that three samples (2A, 3, 4B) are apparently SOVARDI® and that sample 2A is HARVONI®. In samples 1 and 5, several vitamins but none of the active compounds usually found in HARVONI® (i.e., sofosbuvir and ledipasvir) were detected. Our additional investigation indicates that these two samples are likely to be a commercial vitamin supplement distributed in Japan. Sample 2B, looked entirely different from HARVONI® and contained several herbal constitutents (such as ephedrine and glycyrrhizin) that are used in Japanese Kampo formulations. A further analysis indicated that sample 2B is likely to be a Kampo extract tablet of Shoseiryuto which is distributed in Japan. Considering this case, it is important to be vigilant to prevent a recurrence of distribution of counterfeit drugs.
著者
今西 孝至 川端 崇義 髙山 明
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.137, no.7, pp.883-891, 2017 (Released:2017-07-01)
参考文献数
6
被引用文献数
6

In 2009, the Japan Anti-Doping Agency (JADA) established the “Sports Pharmacist Accreditation Program” to prevent doping in sports. Since then, anti-doping activities in Japan have been attracting attention. In this study, we investigated research about the current status of doping from 2007 to 2014 in Japan to make anti-doping activities more concrete, and we also discussed future anti-doping activities by pharmacists. In Japan, bodybuilding was the sporting event with the highest number and rate of doping from 2007 to 2014. Many of the positive doping cases were detected for class S1 (anabolic agents), S5 (diuretics and masking agents), and S6 (stimulants). Within class S1, supplements were the main cause of positive doping. Within class S5, medicines prescribed by medical doctors were the main cause of positive doping. Within class S6, non-prescription medicines (e.g., OTC) were the main cause of positive doping. When we looked at the global statistics on doping, many of the positive doping cases were detected for class S1. On comparing the Japanese statistics with the global statistics, the rate of positive doping caused by class S1 was significantly lower, but that caused by classes S5 and S6 was significantly higher in Japan than in the world. In conclusion, pharmacists in Japan should pay attention to class S1, S5, and S6 prohibited substances and to the sport events of bodybuilding. Based on this study, sports pharmacists as well as common pharmacists should suggest new anti-doping activities to prevent doping in the future.
著者
池田 剛 宮下 裕幸 中野 大輔 野原 稔弘
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.130, no.5, pp.679-686, 2010 (Released:2010-05-01)
参考文献数
12
被引用文献数
1 1

Recent progress in glycobiology reveals that sugar-chains play a crucial role in cell-cell recognition among immunity, inflammation, and malignant tumor in the living body. To study the mechanism of action requires a sample of sufficient quantity. However, isolating a sugar chain and a glycoside in pure form, difficulty follows sugar chain composition again, and studies have been limited to a few sugar chains. Glycosides are a group of compounds known to be the active principle of a natural drug. We have isolated triterpene glycosides from a Leguminosae plant, which improved liver disorder, and steroid glycosides from a plant of the Solanaceous with cytotoxic activity against human cancer cell lines. A biological activity test suggested an important role of the aglycone part and the sugar chain part of those glycosides. Although many studies of sugar chains of glycoprotein and glycolipid are known, there are few examples of studies of the sugar chain function of a glycoside of a natural drug, and the role of a sugar chain of a glycoside for its pharmacologic action expression is unknown. Therefore, as a biological tool investigating the function of a sugar chain of a natural glycoside, we have begun to synthesize a useful “glycoside” which can be utilized as a lead compound having activity.
著者
小栁 香織 窪田 敏夫 小林 大介 木原 太郎 吉田 武夫 三井所 尊正 斎藤 友亮 打越 英恵 髙木 淳一 瀬尾 隆 島添 隆雄
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.133, no.11, pp.1215-1221, 2013 (Released:2013-11-01)
参考文献数
16
被引用文献数
6 17

Pharmacists, being compensated through the new dispensing fee, are required to educate patients on their adhesion to the use of prescribed drugs, and to inventory the levels of leftover drugs in outpatients. Recently, Fukuoka City Pharmaceutical Association started a campaign for regulating leftover drugs (Setsuyaku Bag Campaign). Thirty-one pharmacies joined the campaign. Pharmacists distributed convenience bags, called ‘SETSUYAKU-BAG.’ The patients put their leftover drugs in the bags and brought them to community pharmacies. The pharmacists inventoried the returned drugs and reported their results to the doctors. The doctors adjusted the prescriptions accordingly. We counted and analyzed old and new inventories. The number of leftover drugs was 252, for a total value was ¥839655. Cost of leftover drug prescriptions could be reduced by ¥702695, and the value of drugs thrown away was ¥94801. In total, we could reduce the amount of leftover drugs by 83.7%. The cost of leftover drug for one dose package (ODP) is higher than that for non-ODP. However, there were no significant differences in results per age, sex, number and kinds of drugs, prescription days and premium contribution rate. These results suggest that prescription regulation by inventory of leftover drugs in community pharmacies could significantly reduce overall medical expenses. Further studies are necessary in order to account for patients’ health, and to establish more efficient patient education to raise outpatients’ adherence to the new programs.
著者
山田 勇磨
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.136, no.1, pp.55-62, 2016 (Released:2016-01-01)
参考文献数
27
被引用文献数
1 2

A variety of human diseases, including neurodegenerative disorders, ischemic heart disease, diabetes, and cancer have been reported to be associated with mitochondrial dysfunction. Because of this, mitochondrial therapy is expected to be useful and productive in the treatment of such diseases. We previously reported on the development of a MITO-Porter, a liposome-based nanocarrier that permits macromolecular cargos to be delivered into mitochondria via membrane fusion. Intracellular observations using the green fluorescence protein as a model macromolecule provided confirmation that a macromolecule could be delivered to mitochondria in living cells by the MITO-Porter. Here, we present our current findings on the development of mitochondrial medicine and mitochondrial gene therapy based on our mitochondrial drug delivery system (DDS). In this review, we propose “mitochondrial DDS” as a theme for “DDS research for innovative drug development” and discuss the contribution of mitochondrial DDS to innovative drug development.
著者
西沢 元仁
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.136, no.7, pp.955-963, 2016 (Released:2016-07-01)
被引用文献数
1

In the amendment of the Pharmaceutical Affairs Law in 2013, a new category, Pharmacist Intervention Required Medicines (PIRM), was introduced, and other OTC medicines, which were classified after the 2006 amendment, were allowed to be sold via the Internet. Regarding PIRM, Japan's Ministry for Health, Labour and Welfare designates medicines which require special intervention by a pharmacist who explains their proper use to a patient through a face-to-face consultation, wherein the pharmacist provides guidance based on pharmaceutical knowledge and experience. This encourages consumers to approach their longer term personal healthcare with a rational knowledge of medicines, and dovetails with the direction described in “Japan is Back”. Along with the 2006 amendment, an upgraded 6-year curriculum for the study of pharmacy in preparation for becoming a pharmacist was introduced. This allows student pharmacists to have more experience working in community pharmacies, thus supporting and providing pharmacists with the knowledge they need to better help the consumer to rationally use OTC medicines and self-select proper OTC medications. And this is not only restricted to OTC medicines, as there are many items sold in local pharmacies available to be utilized by the consumer with reasonable support by pharmacists. There is an expectation that the pharmacist be prepared to assist the consumer not only with prescriptions, but also with OTC medications, supplements, medical accessories, etc. using their knowledge and experience.
著者
中田 亜希子 赤川 圭子 山本 仁美 加藤 裕久 山元 俊憲
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.136, no.2, pp.351-358, 2016 (Released:2016-02-01)
参考文献数
8
被引用文献数
2

A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, “This health provider is professional”, or “What a great person he/she is as a health provider”. We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy—American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was “patient” (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, “professional knowledge and skills” was mentioned most often (151 students).
著者
小林 大高 坂巻 弘之 小松 涼 飯島 伴典 飯島 康典 大津賀 博之 斉藤 克也 関 徹也 中村 英俊 山浦 知之 横林 邦明
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.14-00013, (Released:2014-04-25)
参考文献数
4
被引用文献数
2

This study aimed to determine how much time can be saved with the use of unit-of-use packaging for prescription drugs as compared with bulk packaging in community pharmacies as well as to determine the number of errors. In a simulation, mock prescriptions were dispensed either in unit-of-use packages or by transferring medication from a bulk container, and a time study was conducted to measure the time spent on dispensing and prescription auditing by pharmacists. Pharmacists' and patients' degree of satisfaction was also surveyed. The time saved with unit-of-use packaging was 66.25 seconds per prescription. The sole dispensing error that was found in the study occurred with bulk dispensing. Among both pharmacists and patients, many were of the opinion that dispensing with unit-of-use packaging was preferable to bulk dispensing. Unit-of-use packaging shortens the time that pharmacists spend on dispensing activities and increases the efficiency of their work. Unit-of-use packaging is also thought to reduce the number of counting errors.
著者
小栁 香織 窪田 敏夫 小林 大介 木原 太郎 吉田 武雄 三井所 尊正 斎藤 友亮 打越 英恵 高木 淳一 瀬尾 隆 島添 隆雄
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.13-00181, (Released:2013-08-23)
参考文献数
16
被引用文献数
6 17

Pharmacists, being compensated through the new dispensing fee, are required to educate patients on their adhesion to the use of prescribed drugs, and to inventory the levels of leftover drugs in outpatients. Recently, Fukuoka City Pharmaceutical Association started a campaign for regulating leftover drugs (Setsuyaku Bag Campaign). Thirty-one pharmacies joined the campaign. Pharmacists distributed convenience bags, called ‘SETSUYAKU-BAG.’ The patients put their leftover drugs in the bags and brought them to community pharmacies. The pharmacists inventoried the returned drugs and reported their results to the doctors. The doctors adjusted the prescriptions accordingly. We counted and analyzed old and new inventories. The number of leftover drugs was 252, for a total value was &yen839,655. Cost of leftover drug prescriptions could be reduced by &yen702,695, and the value of drugs thrown away was &yen94,801. In total, we could reduce the amount of leftover drugs by 83.7%. The cost of leftover drug for one dose package (ODP) is higher than that for non-ODP. However, there were no significant differences in results per age, sex, number and kinds of drugs, prescription days and premium contribution rate. These results suggest that prescription regulation by inventory of leftover drugs in community pharmacies could significantly reduce overall medical expenses. Further studies are necessary in order to account for patients' health, and to establish more efficient patient education to raise outpatients' adherence to the new programs.
著者
吉田 徳幸 吉岡 靖雄 堤 康央
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.132, no.11, pp.1231-1236, 2012 (Released:2012-11-01)
参考文献数
22
被引用文献数
3

A diverse array of nanomaterials (NMs), such as amorphous nanosilica (nSP), carbon nanotubes and titanium dioxide, has become widespread in use due to the development of nanotechnology. NMs are already being applied in universal fields because they have unique physicochemical properties. On the other hands, the safety of NMs has not been well assessed, because NMs have been considered as safe as common larger sized materials which are known not to be absorbed by the body. Because NMs have the potential to improve the quality of human life, it is essential to ensure the safety of NMs and provide information for designing safer NMs. In this regard, we studied the biological distribution and hazard identification of nSP following dermal administration, because nSP is used NMs in the cosmetics field. In the future, our study would help to set the no observed adverse effect level (NOAEL) and acceptable daily intake (ADI), and be useful information for the safety/hazard assessment and evaluation.
著者
佐塚 泰之 山下 恵代 岸本 修一 福島 昭二 竹内 由和 園部 尚
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.122, no.11, pp.995-999, 2002-11-01 (Released:2003-02-18)
参考文献数
14
被引用文献数
6 8

We have confirmed that theanine, a major amino acid in green tea, enhances the antitumor activity of doxorubicin (DOX) without an increase in DOX-induced side effects. We believe that the action of theanine is due to decreases in glutamate uptake via inhibition of the glutamate transporter, intracellular glutathione (GSH) synthesis, GS-DOX conjugate level, and subsequent extracellular transport of GS-DOX by the MRP5/GS-X pump. To increase the clinical usefulness of theanine, we examined its effects on the antitumor activity of cisplatin and irinotecan (CPT-11), which a known to be transported by the efflux system related to MRP. Cisplatin decreased tumor volume in M5076 tumor-bearing mice. Furthermore, the combination of theanine with cisplatin increased the decrease in tumor volume as compared with the cisplatin-alone group. Tumor volume in the CPT-11-alone group did not show a decrease, but the combination of theanine with CPT-11 significantly reduced tumor volume. The concentration of cisplatin in the tumor was significantly increased by combination with theanine, and thus we assume that it correlated with the enhancement on the antitumor activity of theanine. On the other hand, changes in drug concentrations with theanine were not observed in normal tissues, but rather it is indicated that theanine tends to reduce their concentrations. Therefore theanine enhances the antitumor activity not only of DOX but also of cisplatin or CPT-11.
著者
鹿村 恵明 大山 明子 高橋 淳一 赤木 祐貴 根岸 健一 伊集院 一成 上村 直樹 青山 隆夫
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.132, no.6, pp.753-761, 2012-06-01 (Released:2012-06-01)
参考文献数
18
被引用文献数
13 8

This study examined the impact of pharmaceutical inquiries regarding prescriptions on drug costs by surveying the actual condition of inquiries at 13 pharmacies. The study also investigated the significance of inquiries from a medical economics perspective by calculating the medical cost savings realized by preventing adverse drug reactions (ADRs). As a result, the total change in drug costs for the 13 pharmacies after pharmaceutical inquiries represented an increase of ¥9,018/month. However, upon recalculating the cost of drugs by assuming that those with an “Incomplete entry in the prescription (compared with previous prescription, etc.)” should in fact have been prescribed, and excluding them, the total drug costs for the 13 pharmacies is decreased to ¥154,743/month, translating to a cost-savings of ¥7.2/prescription. The study then undertook a comprehensive assessment based on the Diagnosis Procedure Combination (DPC) system to determine the total medical cost-savings for 5 patients in whom ADRs could have occurred if the prescriptions had not been modified as a result of pharmaceutical inquiries. The obtained figure of ¥1,188,830 suggests that pharmaceutical inquiries contribute to reduced medical costs. The findings of this study indicate that pharmaceutical inquiries regarding prescriptions by staff pharmacists not only ensure the proper delivery of drug therapy to patients, but are also effective from a medical economics perspective.
著者
家入 一郎 樋口 駿
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.129, no.2, pp.231-235, 2009-02-01 (Released:2009-02-01)
参考文献数
12
被引用文献数
5 4

Intra- and inter-ethnic differences in pharmacokinetic and pharmacodynamic profiles of clinically relevant drugs are important issues not only for scenes of appropriate drug use in clinical settings but also for those of the drug development. Pharmacogenomics is extremely useful for understanding these racial differences. In this presentation, I will introduce pharmacogenomic concepts (e.g., single nucleotide polymorphisms (SNPs) and haplotype) for interpretation of racial differences in some drugs; pharmacogenomics of drug transporters such as OATP1B1 (organic anion transporting-polypeptide 1B1) and OCT1 (organic cation transporter 1) in pravastatin, metformin, and rosuvastatin will be discussed as model drugs.
著者
入江 徹美
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.142, no.4, pp.389-400, 2022-04-01 (Released:2022-04-01)
参考文献数
53
被引用文献数
1

Cyclodextrins (CDs) are used not only as pharmaceutical excipients but also as active pharmaceutical ingredients. CDs can act as artificial carriers or shuttles to ameliorate lipid transport disorders. Niemann-Pick disease type C (NPC) is an inherited, progressive neurodegenerative disorder caused by mutations in NPC1 or NPC2 genes, in which unesterified cholesterol accumulates in lysosomes and the transport of cholesterol from lysosomes to the endoplasmic reticulum is impaired. 2-Hydroxypropyl-β-CD (HPBCD) has activity as a cholesterol shuttle and can attenuate NPC-related manifestations in model cells and animals. HPBCD can also be an effective treatment for NPC patients, but has produced lung damage and ototoxicity at therapeutic doses in clinical trials. Like HPBCD, 2-hydroxypropyl-γ-CD (HPGCD) can normalize disrupted cholesterol homeostasis in cells derived from NPC patients and NPC model mice. HPGCD interacts with unesterified cholesterol with a mode of interaction distinct from that of HPBCD and acts as a fine-tuned cholesterol shuttle for the treatment of NPC with a wider safety margin than HPBCD in terms of ototoxicity and pulmonary toxicity. By bridging clinical and basic research, it is hoped that progress will be made in the development of therapeutic agents against neurodegenerative lipid storage disorders that share common pathogenic mechanisms with NPC.
著者
松本 俊彦
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.133, no.6, pp.599-615, 2013-06-01 (Released:2013-06-01)
参考文献数
26
被引用文献数
3 6

In Japan, a national countermeasure has been forwarded since the enactment of the Basic Act on Suicide Countermeasures in 2006 and the Comprehensive Suicide Prevention Initiative in 2007. The distinctive policy of the Japanese countermeasure is expressed as the word, “comprehensive,” which means that suicide prevention may not only be carried out only by mental health measures but also by comprehensive measures including chance of administrative practices. This policy is proper, although mental health measures appear to be too simple inclining to psychiatric treatments for the classic type of “depression” by a pharmacotherapy. The authors have insisted that mental health measures including psychiatric treatments are also required to be more comprehensive. This paper describes that benzodiazepine (BZ)-abuse problems including overdosing by suicidal intents have got worse recently as psychiatric clinics have increased and most of BZ abusers obtain the abused drugs form psychiatrists. This current situation indicates that pharmacists need to monitor psychiatrists' prescribing behavior and qualities of psychiatric treatment is required to be refined, suggesting pharmacists may be one of the “Gate Keeper,” as supporting resources for suicide prevention. Additionally, this paper explained that basic attitudes and responses acquired by pharmacists as a supporter for suicide prevention.