著者

細井 義夫

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.126, no.10, pp.841-848, 2006 (Released:2006-10-01)

参考文献数

46

被引用文献数

5 8

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Total-body irradiation (TBI) with 0.02—0.25 Gy has been reported to have antitumor effects. In mice, low-dose TBI induces tumor growth delay, antimetastatic effects, suppressive effects on the incidence of spontaneous thymiclymphoma, sensitization of tumor to ionizing radiation, and decrease in TD50 value. In artificial metastasis, 0.20 Gy TBI suppressed lung metastasis when it was conducted between 3 h before and 3 h after tumor cell injection into a tail vein. In spontaneous metastasis, 0.15—0.20 Gy TBI suppressed lung metastasis. Irradiation with 0.15 Gy twice a week from 11 weeks of age for 40 weeks significantly suppressed the incidence of spontaneous thymic lymphoma in AKR/J mice, which caused prolonged life span. Low-dose TBI has been used in the clinical treatment of lymphomatous malignancies including chronic lymphocytic leukaemia (CLL) and non-Hodgkin's lymphoma (NHL). The usual practice was to give 0.1 Gy TBI three times a week or 0.15 Gy TBI two times a week to a total dose of 1.5 Gy. Despite this low total dose, low-dose fractionated TBI could induce long-term remissions and was as effective as the chemotherapy to which it was compared. Experimental data suggest that the antitumor effects of low-dose TBI could be explained by immune enhancement, induction of apoptosis, and intrinsic hypersensitivity to low-dose irradiation. Possible mechanisms of immune enhancement are elimination of the T-suppressor subset of lymphocytes and augmentation of the immune response including alteration of cytokine release and enhanced proliferative activity of lymphocytes to mitogenic stimuli.

著者

入口 慎史 今井 徹 吉田 善一 折井 孝男

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.135, no.5, pp.745-751, 2015 (Released:2015-05-01)

参考文献数

32

被引用文献数

2 6

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Therapeutic drug monitoring (TDM) of vancomycin (VCM) is recommended to minimize its nephrotoxicity and maximize efficacy. Recently, the concept of systemic inflammatory response syndrome (SIRS) has been introduced to describe a clinical state resulting from the actions of complex intrinsic mediators in an acute-phase systemic response. However, there are few reports on the pharmacokinetics of VCM in patients with SIRS. This study investigated the effect of SIRS on the pharmacokinetics of VCM by analyzing the predictability of TDM and pharmacokinetic parameters in 31 non-SIRS patients and 52 SIRS patients, with stratification by SIRS score. The mean prediction error (ME) and mean absolute prediction error in SIRS score 2 and 3 patients differed from those in non-SIRS patients. The ME in the score 4 group showed a negative value. In the comparison of pharmacokinetic parameters by SIRS score, a significantly lower CLvcm value was observed at score 4 compared with scores 2 and 3, a higher Vd value was observed at score 4 compared with non-SIRS and at score 3, and a longer T1/2 was observed at score 2. In the comparison of patient characteristics by SIRS score, albumin, aspartate aminotransferase, and alanine aminotransferase levels showed differences among the scores. However, no correlation was observed between VCM pharmacokinetics and these three laboratory parameters. These findings suggest that the pharmacokinetics of VCM may be affected by the pathology of SIRS rather than by patient characteristics.

著者

安宅 弘司 伊藤 雅文 柴田 高

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.125, no.12, pp.937-950, 2005-12-01 (Released:2005-12-01)

参考文献数

50

被引用文献数

3 5

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Wood creosote, the principal ingredient in Seirogan, has a long history as a known gastrointestinal microbicidal agent. When administered orally, the intraluminal concentration of wood creosote is not sufficiently high to achieve this microbicidal effect. Through further animal tests, we have shown that antimotility and antisecretory actions are the principal antidiarrheal effects of wood creosote. Wood creosote inhibits intestinal secretion induced by enterotoxins by blocking the Cl- channel on the intestinal epithelium. Wood creosote also decreases intestinal motility accelerated by mechanical, chemical, or electrical stimulus by the inhibition of the Ca2+ influx into the smooth muscle cells. In this overview, the antimotility and antisecretory effects of wood creosote are compared with those of loperamide. Wood creosote was observed to inhibit stimulated colonic motility, but not normal jejunal motility. Loperamide inhibits normal jejunal motility, but not stimulated colonic motility. Both wood creosote and loperamide inhibit intestinal secretion accelerated by acetylcholine. Wood creosote was found to have greater antisecretory effects in the colon than loperamide. Based upon these findings, we conclude that the antidiarrheal effects of wood creosote are due to both antisecretory activity in the intestine and antimotility in the colon, but not due to the microbicidal activity as previously thought. Wood creosote was found to have no effects on normal intestinal activity. These conclusions are supported by the results of a recent clinical study comparing wood creosote and loperamide, which concluded that wood creosote was more efficacious in relieving abdominal pain and comparable to loperamide in relieving diarrhea.

著者

葦沢 龍人

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.939-944, 2016 (Released:2016-07-01)

参考文献数

9

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For appropriate primary care practice corresponding to the various symptoms of a patient, team medicine on that combines the expertise of physicians and other medical staff has been recommended in recent years. It results in (1) higher quality of medical care, (2) lower burden on the physician, (3) better medical safety, and (4) reduced medical expenses. In order to promote team medicine through inter-professional collaboration, the responsibilities of the medical staff need to be reviewed to expand their respective roles. The Ministry of Health, Labour and Welfare designated nine specific medical acts by pharmacists in 2010. Some acts require clinical reasoning (medical interview and physical assessment) in order to manage side effects in patients undergoing drug therapy. The new curriculum introduced in 2015 includes primary care education for pharmacists who see patients before they are seen by a physician. Because such patients are usually seen by the pharmacist on a walk-in basis, medical interview and inspection education is especially important in this situation. However, there is incongruity in the physical assessment education of prospective pharmacists among schools of pharmaceutical sciences in recent years, which tends to focus primarily on vital signs. Moreover, there is currently no consensus among physicians on the optimum range of procedures performed by a pharmacist before the patient is seen by a physician. In this presentation, the practice of primary care by pharmacists is discussed from the following perspectives: (1) target symptoms and patients, (2) clinical reasoning education at pharmaceutical schools, and (3) future issues.

著者

今井 徹 吉田 善一

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.967-972, 2016 (Released:2016-07-01)

参考文献数

7

被引用文献数

1

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Emergency and critical care centers provide multidisciplinary therapy for critically ill patients by centralizing the expertise and technology of many medical professionals. Because the patients' conditions vary, different drug treatments are administered along with surgery. Therefore, the role of pharmacists is important. Critically ill patients who receive high-level invasive treatment undergo physiological changes differing from their normal condition along with variable therapeutic effects and pharmacokinetics. Pharmacists are responsible for recommending the appropriate drug therapy using their knowledge of pharmacology and pharmacokinetics. Further, pharmacists need to determine the general condition of patients by understanding vital signs, blood gas analysis results, etc. It is therefore necessary to conduct consultations with physicians and nurses. The knowledge required for emergency medical treatment is not provided during systematic training in pharmaceutical education, meaning that pharmacists acquire it in the clinical setting through trial and error. To disseminate the knowledge of emergency medical care to pharmacy students, emergency care training has been started in a few facilities. I believe that medical facilities and universities need to conduct joint educational sessions on emergency medical care. Moreover, compared with other medical fields, there are fewer studies on emergency medical care. Research-oriented pharmacists must resolve this issue. This review introduces the work conducted by pharmacists for clinical student education and clinical research at the Emergency and Critical Care Center of Nihon University Itabashi Hospital and discusses future prospects.

著者

渡辺 謹三

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.933-937, 2016 (Released:2016-07-01)

参考文献数

2

被引用文献数

2

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At the time of consultation with a patient regarding OTC drugs, a pharmacist goes through the following five steps. In Step 1 information is collected, including the patient's gender, age, health condition, living situation, etc. In Step 2, upon analyzing and evaluating this collected information, the pharmacist decides whether to recommend that the patient see a medical doctor or whether an OTC drug is sufficient. In Step 3, when an OTC drug is required, the pharmacist suggests the most suitable OTC drug. In Step 4, the pharmacist provides the patient recommendations and information about the selected OTC. In Step 5, sales record entry and aftercare are performed. In these five steps, the pharmacist is making a decision on whether the consultation recommendation is required or optional; the step of making an optimal selection of an OTC drug is distinct from prescription dispensing. In many cases, at the time of OTC drug consultation, since the patient is not consulting a medical doctor, a pharmacist becomes a “first access” health professional. In this instance, the advice of a pharmacist may have a great influence on a patient's prognosis regarding the particular health challenge. Therefore, pharmacists who perform patient consultations regarding OTC drugs are required to have broad medical knowledge and communication skills. The features of consultation and information dissemination about OTC drugs by a pharmacist, and the practice and study of this subject in present-day pharmaceutical education, are described herein.

著者

宮本 法子

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.1001-1015, 2016 (Released:2016-07-01)

参考文献数

14

被引用文献数

1

---

Requirements for education on proper use of drugs were included in the junior high school educational guideline in 2012 incorporating pharmaceutical education in the obligatory school curriculum. This move is closely related to the country's new OTC drug marketing system. The amendment of the Pharmaceutical Affairs Law (PAL) in 2013 highlighted the public's own role in “promoting proper use of drugs and other related products and making greater efforts to acquire knowledge and improve understanding of their effective and safe use”. Furthermore, the Law to Amend the PAL and Pharmacists Law enforced in 2014 allowed all OTC drugs to be sold online under appropriate rules. Deregulation of online sale of OTC drugs is expected further to promote self-medication for minor illnesses and require stricter measures to ensure people's safety through their proper use. These legal amendments in recent years have made people's education about proper use of drugs one of the top priorities Japan should pursue at state level. Since 2000, the author has been offering education on drugs to early primary school children as part of their healthcare education program. In the future, dedicated education on drugs will be necessary for people of all ages including not only school children but also their guardians and elderly citizens as well.

著者

藤井 仁美 森 貴幸 古川 綾 井上 岳 厚田 幸一郎

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.259-263, 2016 (Released:2016-02-01)

参考文献数

5

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For prevention of the aggravation of diabetic nephropathy, a treatment method that combines self-care with medical guidance is becoming increasingly important, leading to the development of programs for lifestyle modification for the patients. To assess the effectiveness of such programs, we have conducted a feasibility study of a patient self-care support program with medical collaboration by registered pharmacists in community pharmacies involving patients with diabetic nephropathy who are under treatment at medical institutions, including our hospital. This study evaluated the two primary measurements, which are A) the actual execution rate versus planned programs, and B) the patient satisfaction rate. In addition, the achievement rate of behavioral objectives, satisfaction rate of diabetes treatment, degree of concerns (Diabetes Treatment Satisfaction Questionnaire; DTSQ, Problem Areas in Diabetes; PAID) and other physiological indicators have been evaluated. With the approval of the IRB at Kitasato University, sixteen out of 18 patients have continued to participate in the support program, and the study has shown high patient satisfaction with pharmacist coaching support. Patients have gained interest in managing their lifestyles, thereby increasing self-efficacy. Also, information shared between the pharmacists and the physicians has clarified patients' issues and concerns pertaining to their lifestyles, which were effectively utilized in the coaching program. Through meetings with pharmacists, patients have been reassured of the expertise of the pharmacist and thus gained mutual trust, which leads to the patient's behavioral change. We believe that the collaboration of patients, pharmacists and physicians has resulted in effective team-based patient care.

著者

鬼頭 英明

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.133, no.12, pp.1319-1323, 2013 (Released:2013-12-01)

参考文献数

16

被引用文献数

1

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To promote the education on medicines in school, guidance is, as a rule, to be given in the health education of the Subject, “Health and Physical Education” indicated as a curriculum standard in lower and upper secondary school, and in the health guidance, which carry out in Special Activities and Integrated Studies, etc. Guidance is mainly carried by the teacher for health and physical in health education and school nurse teacher (yogo teacher) in health guidance. In health education we have only limited school hours, and generally use the text book. Some teachers feel resistance to teach medicines because of needs on the special knowledge, however teachers should deal with medicines based on curriculum standard. School pharmacist is a member of school, and has a special knowledge for medicines, and he/she can support teachers as a provider of teaching materials, an adviser, and for a guest teacher. It is important for school pharmacist to understand the contents indicated in curriculum standard and to use glossary to be able to understand for children. In the guidance of health, it is not necessary to teach based on curriculum standard, and it can deal with advanced contents on medicines. However it is important to understand for children what are appropriate contents according to the development stage. To use the packages and instructions for medicines provided at home are good materials for children to have interest the medicines in their guidance. The objectives of education on medicines enable children to cultivate practical abilities for the maintenance and improvement of health.

著者

稲垣 勳

出版者

日本薬学会

雑誌

薬学雑誌 (ISSN:00316903)

巻号頁・発行日

vol.76, no.11, 1956-11

著者

久保寺 昭子 毛利 哲郎 鶴藤 丞

出版者

公益社団法人日本薬学会

雑誌

薬学雑誌 (ISSN:00316903)

巻号頁・発行日

vol.87, no.5, pp.511-515, 1967-05

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Effect of 10 chelating agents on the excretion of radiostrontium from the body was investigated in mice. Sodium salts and/or monocalcium-sodium salts of these chelating agents were used as test materials. Preliminery toxicity tests were carried out to estimate their approximate maximum safety doses. The sodium salts were generally more toxic and brought about some convulsion with occasional death which were attributed to the decrease of Ca^<2+> ion in the blood. The monocalcium-sodium salts were applicable in 10-folds as compared with their equivalent sodium salts. The chelating agents and radioactive strontium were simultaneously injected into different parts of the body. The animals were killed 24 hours after the injection, and then reduced to ashes individually in an electric furnace after removing the digestive tracts and bladders. Radioactivity of the ashes was assayed to determine the percentage retention of radioactive strontium in the carcasses. Monocalcium-disodium salt of bis(dicarboxyaminoethyl) ether was found to be one of the most effective agents, same as calcium sodium citrate which had been previously reported.

著者

瀬川

出版者

公益社団法人日本薬学会

雑誌

藥學雜誌 (ISSN:00316903)

巻号頁・発行日

no.224, pp.1001-1002, 1900-10-26

著者

栗原 千絵子 松本 佳代子 石光 忠敬

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.123, no.3, pp.91-106, 2003-03-01 (Released:2003-03-26)

参考文献数

102

被引用文献数

1 1

---

The Japanese Pharmaceutical Law was revised at the end of July 2002. The important features of this revision are the postmarketing safety scheme, especially for biological products, and reconstruction of the legislation for effective pharmaceutical development. This is based on the national policy to foster life sciences such as genetic research and regenerative medicine for both healthcare improvement and industrial promotion. Such research requires study participants who donate human tissue including abandoned embryos or aborted fetuses, which may touch the human dignity. In particular, fetal stem cell research appears to have unpredictable risks not only to women who undergo abortions but also to societal epistemology. The authors conducted risk-benefit assessment of fetal stem cell research, reviewing the scientific, ethical, legal, and social aspects, including a case study of critical appraisal on a report of the double-blind, sham surgery-controlled trial of implantation of fetal tissues in patients with Parkinson's disease conducted in the USA. It is concluded that risk-benefit assessment with a wide, profound perspective is necessary for advanced biotechnology. Some types of research should not be assessed based only on such utilitarian viewpoints as risk and benefit. Conscientious reflection is necessary to reach a public consensus on which types of human material can be utilized as research or pharmaceutical resources.

著者

町田 拓自 飯塚 健治

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.143, no.7, pp.599-606, 2023-07-01 (Released:2023-07-01)

参考文献数

36

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The nausea and vomiting that occur as a result of oral iron administration for the treatment of iron-deficiency anemia (IDA) can cause significant physical and emotional stress in patients. Because iron is absorbed from the intestine as ferrous iron, the most widely used treatment for IDA is oral ferrous agents. However, ferrous forms are more toxic than ferric forms because ferrous forms readily generate free radicals. A randomized, double-blind, active-controlled, multicenter non-inferiority study conducted in Japan showed that ferric citrate hydrate (FC) was just as effective as sodium ferrous citrate (SF) in the treatment of IDA, with a lower incidence of adverse reactions such as nausea and vomiting compared with SF. Animal studies have shown that chemotherapy-induced nausea and vomiting (CINV) involves the release of 5-hydroxytryptamine from enterochromaffin cells by free radicals, and that some chemotherapeutic agents cause hyperplasia of these cells. Enterochromaffin cells also contain substance P, which is known to be also closely related to CINV. We found that administration of SF to rats causes hyperplasia of enterochromaffin cells in the small intestine, whereas FC has no effect on enterochromaffin cells. Oral iron agents may induce nausea and vomiting via the effect of ferrous iron on reactive oxygen species production in the intestine and subsequent enterochromaffin cell hyperplasia. Further research to elucidate the detailed mechanism of enterochromaffin cell hyperplasia induced by ferrous iron preparations is needed to develop a treatment for iron deficiency anemia that causes less gastrointestinal damage.

著者

佐久間 詠理 川内 潤也 行田 泰明 及川 由紀枝 渡邉 淳子

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.140, no.7, pp.869-875, 2020-07-01 (Released:2020-07-01)

参考文献数

5

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In recent years, home medical care has been strongly promoted. As a consequence, the conditions managed in home medical care have become increasingly diverse. Heart failure is one of the most common disorders after malignant diseases. Patients with chronic heart failure (CHF) are often forced into hospitalization because of the inability to control symptoms with oral medications, even though they hope to stay at home. Recently, we have experienced a case where the patient required continuous administration of dobutamine at home. In order to carry out CHF care at home successfully, it is necessary to adjust the doses of catecholamine and furosemide swiftly in response to changes in patients' conditions. In this case, the patient was able to spend four months at home thanks to the cooperation of a team of a physician, nurses, and pharmacists. Catecholamine-dependent patients with terminal CHF require expensive medical infusion pumps for precise administration. However, the economic assistance to such patients remains insufficient. Furthermore, dobutamine and furosemide injections are not dispensed extramurally, and therefore might become an impediment to the cooperation of the team. In this symposium, I consider and discuss the role of pharmacists in a home medical care team for patients with terminal CHF.

著者

内林 政夫

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.126, no.12, pp.1341-1349, 2006-12-01 (Released:2006-12-01)

参考文献数

25

被引用文献数

1 1

---

An overview is presented on the reports available so far on sweet potato, Ipomoea batatas, cultivated widely in Polynesia in the pre-Columbian era, with reference to possible ways and presumptive dates of transfer from the Americas to Polynesia, such as (1) Polynesian navigators' travel to Peru, (2) Peruvian fishermen's drift westward, (3) vessel drift, (4) seed drift, (5) root-tuber drift, and (6) transport by birds. The author supports the case (1) as most plausible. Ganshu or Ganchu described in the old Chinese herbal books is identified as Dioscorea esculenta. An introduction of the tuber to China and Japan is briefly mentioned.

著者

内野 克喜 山村 喜一 齋藤 侑也 磯崎 貞夫 田村 善藏 中川 冨士雄 関根 一雄 小島 至

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.104, no.10, pp.1101-1107, 1984-10-25 (Released:2008-05-30)

参考文献数

15

被引用文献数

1 3

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We developed a simultaneous detection method of 9 kinds of diuretics in the urine by using thin-layer chromatographic (TLC) method and/or high-performance liquid chromatographic (HPLC) method. The diuretic drugs were extracted from the urine according to modified Tisdall et al. method by use of 1M phosphate buffer and ethylacetate. The TLC method was performed with a commercially available chromatographic plate containing mixed fluorescent substance and isopropyl alcohol-ammonia mixture as a development solvent. The HPLC method was accomplished with UV detection at 271nm. To examine the limit of detection of the methods, normal subjects were individually administered with commercially available tablets of 11 kinds of diuretics, 9 drugs were detected from 24 h urine of normal subjects. However, 2 drugs were not detected. By applying these methods to urine samples of female patients with hypokalemia, furosemide (FD) and trichlormethiazide (TCT) were detected. The chromatographic peak of FD on HPLC method was further assigned by mass spectrometry. The quantitative determination of TCT in the urine was also developed by HPLC method, and the urine concentration in a patient with self-administration of TCT was 0.80μg/ml.

著者

嶋澤 雅光 原 英彰

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.141, no.1, pp.61-66, 2021-01-01 (Released:2021-01-01)

参考文献数

20

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Glaucoma, the leading cause of blindness in adults, is a progressive neurodegenerative disease characterized by retinal ganglion cell (RGC) death. Currently, many intraocular pressure (IOP)-lowering drugs known to affect this disease progression have been developed as therapeutic agents. However, there are many cases of disease progression, even with sufficient IOP reduction. Therefore, newer therapeutic approaches other than IOP-lowering drugs are needed. To elucidate the pathogenesis of glaucoma and to develop therapeutic agents, the evaluation of RGCs is imperative, as their degeneration is the main cause of this disease. However, it is difficult to obtain RGCs from healthy individuals, let alone glaucoma patients. Therefore, research on the pathophysiology of glaucoma and drug discovery has not progressed sufficiently. Recent developments have made it possible to generate induced pluripotent stem (iPS) cells from the blood or skin of glaucoma patients and induce them to differentiate into RGCs to study the pathogenesis of glaucoma. In addition, drug repositioning for ophthalmological diseases such as glaucoma is one of the most active fields. Many of these repositioned drugs have found therapeutic applications in ophthalmology. Here, we introduce the current status of the pharmacological treatment of glaucoma and its prospects.

著者

河崎 陽一

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.9, pp.1041-1047, 2009-09-01 (Released:2009-09-01)

参考文献数

20

被引用文献数

4 4

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The hazardous effects due to the insoluble microparticles generated in the injections have been pointed out. To our knowledge, however, there have been no reports about insoluble microparticulate contamination at ampoule opening. Therefore, we performed this study to evaluate the relationship between time and glass particulate sedimentation to examine the effect of swabbing the ampoule neck on particle generation to clarify the relationship between the inner-diameter size of an ampoule and the amount of glass particulate sedimentation to find out the effect of methods for ampule opening, and compare particle contamination in glass ampoule and that of plastic, after ampoule opening and assessed the contribution of material of ampoule to the particle generation. We observed that the glass particulate contamination of accumulation value at a size over 2 μm increased significantly after 60 seconds, the swabbing the neck of the ampoule prior to opening had a negative effect on prevention of glass particulate contamination, the glass particulate contamination was positively influenced by the inner-diameter size of the ampoule, but not by the thickness of the ampoule walls, the particulate contamination derived from glass significantly increased by general method as well as using ampoule open adaptor compared with our method, and the insoluble microparticulate contamination in plastic ampoule was significantly lower than that in glass ampoule. The present findings might provide an useful information to reduce glass particules after ampoule opening performed in clinical practice.

著者

石郷 友之 髙田 遼 近藤 蕗 伊部 裕太 中野 敬太 立石 莉穂 藤居 賢 片野 唆敏 北川 学 木明 智子 中田 浩雅 橋本 暁佳 宮本 篤

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.140, no.8, pp.1041-1049, 2020-08-01 (Released:2020-08-01)

参考文献数

47

被引用文献数

3

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Sedative hypnotics are among the classes of drugs reported to influence falls. However, the effects of the sedative hypnotic drugs, suvorexant and ramelteon, on falls are not well known. Therefore, we conducted this retrospective case-control study to examine the association of the use of these two sedative hypnotics with the risk of falls. Conducted at the Sapporo Medical University Hospital in Japan, our study included 360 patients with fall incidents and 819 randomly selected control patients. Patients in the fall group were significantly older with a lower body mass index, and had a history of falls, disabilities in activities of daily living, cognitive impairment, and delirium. Monovariate analysis revealed that patients in the fall group frequently used ramelteon [odds ratio (OR) 2.38, 95% confidence interval (CI): 1.49-3.81, p<0.001], but rarely used suvorexant (OR 0.66, 95% CI: 0.29-1.39, p=0.317), compared with control patients. Furthermore, multivariate analysis revealed that ramelteon use did not increase the risk of falls (adjusted OR 1.43, 95% CI: 0.82-2.48, p=0.207), whereas suvorexant use significantly decreased the risk of falls (adjusted OR 0.32, 95% CI: 0.13-0.76, p=0.009). Although ramelteon tends to be used in patients at a high risk of falls, it may not increase the risk of falls. In contrast, the use of suvorexant may reduce the risk of falls.