著者

河原 敦 中井 清人 倉田 なおみ 亀井 美和子

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.41, no.6, pp.435-441, 2015-06-10 (Released:2016-06-10)

参考文献数

26

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The role of pharmacists in the US that have advanced functions compared to the traditional pharmacists is based on the collaborative drug therapy management (CDTM). Recently in Japan, the importance of enhancing the team approach whose concept is to make the best use of the each health providers' expertise has been discussed in the health care society. As regards pharmacists, pharmacists' pivotal role in medication therapy management is in great demand in the discussion. On the other hand, pharmacists are more exposed to a litigation risk as pharmacists sometimes are sued for their medical negligence these days.In this manuscript, we conducted a literature and case review for pharmacist responsibility conducting the CDTM in the US. However, we could not find reports and cases, though a litigation risk for pharmacists has been enhanced with the pharmacist role expanding in the CDTM. Furthermore, we conducted a literature and case review for nurse practitioner (NP) as well. As a result, in some cases, NP's negligence was judged independently by the action of NP was whether appropriate or not with no consideration for physician's supervise, and the supervising or collaborating physician's negligence was judged according to the physician's action in the consultation is appropriate or not. As the number of litigation for NP increased, nurse societies raised so many opinions on how to judge appropriately such as which the standard of care (SOC) for physicians or for NPs was applicable and as whether a physician might have an expert witness qualification.

著者

峯田 保恵 半谷 眞七子 神谷 俊範 札軒 芽衣 亀井 浩行

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.2, pp.74-82, 2018-02-10 (Released:2019-02-10)

参考文献数

29

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Many pregnant and lactating patients taking medicine feel anxious about its negative effects on their fetuses and infants. To help pharmacists implement safe drug therapy for them, Aichi Pharmaceutical Association holds communication skill training (CST) sessions as part of a “Program for pharmacists to support pregnant and lactating females.” In the present study, pharmacists' communication skills were analyzed prior to and following the CST to examine its usability. The subjects were 34 pharmacists who participated in the CST in 2013 and played the roles of lactating patients and pharmacists. Following this, videos of the role playing were analyzed: analyses of the “implementation of the process for confirmation of an explanatory model consisting of three items” and the structure of conversations using the RIAS. Furthermore, patients' satisfaction, its relation with the structures of conversations, and the implementation of the process for confirmation of the explanatory model were examined. There was an increase in the number of pharmacists who had conducted the three processes for confirmation of the explanatory model following the CST, and the level of patients' satisfaction was higher in the CST group than in the non-CST group. There was also an increase in the number of pharmacists who had asked psycho-social questions following the CST. Since the CST requires pharmacists to conduct the process of confirmation of the explanatory model and understand it before providing pregnant and lactating patients with explanations of drugs, it is an effective method of helping pharmacists to develop their communication skills to reduce patients' anxiety.

著者

齋藤 佑輔 堀田 栄治 上阪 友基 林 由紀子 海崎 佳史 細田 清美 高嶋 孝次郎 藤澤 克憲

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.40, no.2, pp.94-99, 2014-02-10 (Released:2015-02-10)

参考文献数

10

被引用文献数

3 2

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There is less emergence of renal toxicity in Liposomal-amphotericin B (L-AMB) than amphotericin B (AMPH-B). However, there have been few reports on the analysis of this factor. I examined the factors involved in renal function decline via the creatinine clearance (Ccr) for 44 cases of L-AMB administered in our hospital. Reduced renal function was observed in 15 cases (34.1%). Multivariate logistic regression analysis for each factor revealed that Ccr ≧ G 1 (P = 0.006, odds ratio: 12.968, 95% confidence interval: 2.085 - 80.643) was a factor in the occurrence of decreased renal function. Results were subjected to multiple regression analysis of the dependent variable amount of change in Ccr before and after administration, and a significant statistical effect was shown by two factors. One is administration at the start of Ccr (P = 0.007); the other is the administration of concomitant medications (P = 0.04). Pharmacists used L-AMB administration to predict in advance the degree of renal function decline, and a regression equation was obtained. As pharmacists prescribe administration depending on the results, L-AMB is prescribed by doctors. For cases which can be a first choice, more aggressive? We believe that establishment of such a system would be ideal.

著者

松田 裕子 八木 敬子 平井 みどり

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.31, no.2, pp.125-135, 2005-02-10 (Released:2011-03-04)

参考文献数

7

被引用文献数

18 15

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Communication skills are an essential requirement for pharmacists if they are to function competently as medical professionals. Training using simulated patients has recently been introduced in medical education and we considered that the use of simulated patients would help pharmacy students to acquire the communication skills necessary for patient consultations. To do this, we instructed volunteer patients on how to act as simulated patients and started using them as part of the training in consultations for third-year students at Kobe Pharmaceutical University. The results of a survey conducted at the end of the training indicated that students recognized the high educational value of the simulated patients due to the sense of realism they brought into the training and the tension they experienced in interacting with them, saying that this increased their interest in the work of the pharmacist and stimulated their desire to learn. The use of simulated patients was effective in enhancing the communication skills because they had to focus on their attitudes and responses.

著者

簔原 豪人 内山 将伸 緒方 憲太郎 二神 幸次郎

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.37, no.11, pp.649-652, 2011 (Released:2012-11-10)

参考文献数

11

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Using a formula for calculating the glomerular filtration rate (GFR) for Japanese announced in 2009, individual patients' GFRs can be predicted by inversely correcting the formula with body surface area. In this study, we investigated the influence of the dissociation between the GFR normally employed to calculate the dose and inversely corrected GFR on carboplatin (CBDCA)-related thrombocytopenia. In a group with grade 3 or higher thrombocytopenia, the dissociation between the GFRs used to calculate the dose of CBDCA was significantly greater. Also, in an analysis of thrombocytopenia-related factors, including concomitant anti-cancer agents, the only significant difference was that regarding GFR dissociation.These results suggest that the introduction of the inversely corrected GFR for accurate calculation of the GFR and setting of CBDCA doses is useful in decreasing the incidence of serious thrombocytopenia.

著者

上岡 令奈 見元 尚 橋本 将幸 筒井 由佳 入江 博之

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.10, pp.491-495, 2018-10-10 (Released:2019-10-10)

参考文献数

7

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Cardioplegia plays an important role in cardiac surgery. Various cardioplegia solutions have been utilized at different hospitals worldwide; however, Miotecter® is the only commercially available solution in Japan. The del Nido solution is a cardioplegia solution that has been applied to adult patients owing to its advantage in achieving a relatively long duration of cardiac arrest with a single dose. However, the del Nido solution is not available in Japan, and there is no report of del Nido solution use in Japan. Thus, we decided to formulate a cardioplegia solution with the function of the del Nido solution at our hospital (Chikamori Hospital, Chikamori Health Care Group). Although the available preparation equipment was limited, we successfully designed a safe formulation using a commercially available product; the preparation was conducted at a clean bench. The prepared “del Nido Chikamori Modification” extended the redosing interval from its original 20 min to the current 45 min with one administration. We expect the redosing interval to be extended even further in the future. In addition, other reasons for the preferred usage of the del Nido Chikamori are likely to include its advantages in easy blood glucose control and its inexpensiveness.

著者

濱 宏仁 森本 茂文

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.45, no.1, pp.21-27, 2019-01-10 (Released:2020-01-10)

参考文献数

9

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When microbes present on the rubber stopper in a vial or attachment part of closed system drug transfer devices (CSTD), these microbes may contaminate vials by needle puncture. We examined the preservation of sterility in vials by different vial storage conditions on the premise of divided use of single-use vials. Experiments were conducted using liquid medium filled vials under the following conditions A-D. [A: Removed rubber stoppers (open-vials) and placed in safety cabinet (BSC), B: Placed open-vials in preparation room (ISO class 8), C: Placed negative-pressured vials with rubber stopper punctured twice by needle in preparation room, D: Placed the vials connected to CSTD in preparation room.] After 24 hours and 7 days, portions of the culture medium in the vial were cultured. In conditions A, C and D, no growth of microbes was confirmed except in B. Microbial contamination didn't occur when vials were stored in BSC. When the vials were stored under the ISO Class 8 environment, it is suggested that microbes may adhere to the rubber stopper of the vial. Even if the inside of the vial after puncture was negative pressure, the rubber stopper showed a certain protective effect from microorganism adherence, and CSTD was similar. Therefore, the vial storage condition in BSC (ISO class 5) is considered preferable on the premise that a single use vial is divided. However, if the rubber stopper or CSTD is connected even in an ISO class 8 environment, the sterility is retained for 7 days.

著者

矢野 育子

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.28, no.1, pp.1-8, 2002-02-10 (Released:2011-03-04)

参考文献数

21

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Although acetazolamide, a carbonic anhydrase inhibitor, has an effect of lowering the intraocular pressure, a number of side effects have been reported with its use.We therefore investigated the pharmacokinetics and pharmacodynamics of acetazolamide in patients with an intraocular pressure (IOP) elevation. The plasma acetazolamide concentration and IOP in 17 patients with a transient IOP elevation were simultaneously measured after the last acetazolamide administration, and the findings were analyzed by nonlinear mixed effect modeling using the NONMEM software program. The plasma concentration profile of acetazolamide was characterized by a one-compartment model with first-order absorption.The apparent oral clearance (L/hr) showed a correlation with the creatinine clearance (CCR, mL/min), as estimated by the Cockcroft and Gault equation, as follows : 0.0468·CCR. The estimated apparent oral volume of the distribution, first-order absorption rate constant, and absorption lag time were 0.231 L/kg, 0.821 hr-1, and 0.497 hr, respectively. The intraocular pressure after oral acetazolamide administration was characterized by an Emax model. The maximal effect in lowering the IOP (Emax) was 7.2 mmHg, and the concentration corresponding to 50% of Emax (EC50) was 1.64 μg/mL. We next investigated the relationship between the acetazolamide concentration and its side effects in 23 glaucomatous patients who received repeated doses of oral acetazolamide for one week or more. The serum concentration of chloride ion was found to be higher than the normal range, and also showed a significant correlation with the acetazolamide concentration in the erythrocytes. The patients with an erythrocyte acetazolamide concentration of more than 20μg/mL had higher incidents of the side effects. Based on these results, the recommended dosage of acetazolamide was calculated so that the minimum plasma concentration at steady-state exceeded 4μg/ mL. The dosage regimen desired in this study is expected to contribute to the safe and effective pharmacotherapeutic use of acetazolamide.

著者

立石 裕樹 宮津 大輔 田中 博和 平川 雅章

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.47, no.8, pp.397-404, 2021-08-10 (Released:2022-08-10)

参考文献数

26

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A drug-drug interaction (DDI) caused by a drug combination may cause clinical problems. This study evaluated the frequency and details of potential DDI (pDDI) in the discharge prescription and the relationship between pDDI and number of drugs used. The study included patients who were discharged from the rehabilitation ward for a duration of two years between 2018 and 2019. Lexicomp Drug Interactions, a DDI screening program, was used to detect pDDI. Clinically important pDDI was detected in 22.8% (59/259) of patients. The DDI mechanisms were based on pharmacodynamic interactions in 63.6% of cases and on pharmacokinetic interactions in 29.9%. Central nervous system depressant related pDDI was the most frequent type of pDDI detected. Use of hypnotics, antidiabetic drugs, antidepressants and antipsychotics was significantly higher amongst patients with detected pDDI. The incidence and frequency of pDDI increased with the number of drugs used. It is necessary for pharmacists to correctly evaluate the pDDI detected by the DDI screening program and contribute to the optimization of prescriptions and patient treatment.

著者

石川 雄大 高木 昭佳 梶浦 新也 真鍋 優希子 髙橋 則正 小野 敦央 加藤 敦

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.47, no.1, pp.1-9, 2021-01-10 (Released:2022-01-10)

参考文献数

24

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Chemotherapy-induced peripheral neuropathy (CIPN) reduces patient quality of life, but there is little evidence of preexisting supportive care drugs. Mirogabalin is a novel drug with indications for peripheral neuropathic pain, and its mechanism of action involves strong and selective binding to the voltage-gated calcium channel α2δ subunit. We examined the effects of mirogabalin on CIPN. We followed up 21 patients with CIPN caused by taxanes or platinum-based anticancer drugs who started mirogabalin. A numerical rating scale (NRS) was used for the evaluation, and pharmacists evaluated the mirogabalin dose at its initiation by creatinine clearance in all patients, and no overdoses occurred. Mirogabalin significantly reduced NRS scores from a median of 6 to 2 (P < 0.001), and the median number of days of mirogabalin administration until determination of the best effect was 29.5 days. Furthermore, the median NRS significantly decreased by administration of mirogabalin in both the taxanes-based anticancer drug group and the platinum-based anticancer drug group. In the safety investigation, a somnolence grade of 1 or 2 was observed in 4 patients, an edema grade of 1 or 2 in 4 patients, and an edema grade of 3 was observed in 1 patient. There were no serious side effects that required hospitalization. Our study suggests mirogabalin has a palliative effect on CIPN and may be an important supportive care drug for chemotherapy. Simultaneously, it’s considered that pharmacists evaluate renal function and contribute to proper use, so that patients can expect the maximum drug efficacy after the introduction of mirogabalin.

著者

宮津 大輔 秋吉 正貴 山下 大貴 立石 裕樹 後藤 貴央 與田 賢作 安倍 ひろみ 田中 博和 平川 雅章 片岡 泰文 首藤 英樹

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.42, no.4, pp.271-277, 2016-04-10 (Released:2017-04-10)

参考文献数

17

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Fosphenytoin (FOS) is a phosphate ester prodrug developed as an alternative to intravenous phenytoin for acute treatment of seizures. Although both FOS and phenobarbital (PB) are used for status epilepticus as second-line drugs, there is no data on their comparative efficacy and safety. We retrospectively analyzed data from children treated with FOS or PB for convulsive status epilepticus and acute exacerbation of seizures. Our aim was to compare the efficacy and safety of intravenous FOS with those of intravenous PB for convulsive status epilepticus and acute exacerbation of seizures. Seventy-seven children were included in the study: 54 received FOS, and 23 received PB. The primary end point was recurrence of seizures and drug-related adverse events. The response rate, defined as no recurrence of seizures within 24 hours after termination of seizure, was 92% (50/54) and 95% (22/23) in FOS group and in PB group, respectively. Adverse events occurred in 27% (15/54) of patients in FOS group and in 95% (22/23) of patients in PB group (P < 0.01). Although no serious adverse events occurred in patients in both FOS group and PB group, the incidence of both sedation and disturbance of consciousness were significantly higher in PB group than FOS group. From these results, FOS is recommended as second-line drugs for status epilepticus and acute exacerbation of seizures. However, the optimal serum concentration achievement rate was significantly lower in FOS group than PB group. To maintain optimal serum phenytoin levels (10 - 20 µg/mL), higher doses of FOS might be required.

著者

森尾 佳代子 津金 麻実子 岡本 禎晃 糀 桂子 田墨 惠子 上島 悦子

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.39, no.6, pp.381-387, 2013-06-10 (Released:2014-06-10)

参考文献数

14

被引用文献数

2 2

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Dacarbazine (DTIC) produces adverse reactions including local venous pain during the intravenous injection. DTIC is reported to be photolyzed to produce certain kinds of pain producing substances. 5-diazoimidazole-4-carboxamide (Diazo-IC) is considered to be a causative photolyte of venous pain. A newly designed cover shield has been used at Osaka University Hospital when DTIC is administered for the last 4 years. This shield comprises black cotton and covers both the infusion bag and route of infusion. We evaluated the effectiveness of this new shield against photodegradation of DTIC by determining the concentration of Diazo-IC. DTIC was dissolved with an injection solvent and mixed with 5% dextrose in water. Prepared samples were divided into 3 groups (without shield, infusion bag covered with shield, and infusion bag and infusion route covered with shield) and exposed under natural light conditions indoors. Prepared solutions ran down through the route and those samples were taken before and after passing the route pipe. Diazo-IC in the samples was measured by HPLC. Production of Diazo-IC in the non-covered bag was significantly increased in comparison with that in covered infusion bags. Diazo-IC production in samples after passing through the route was significantly increased compared with that in samples taken before passing through the route of the non-covered shield and covered infusion bag only. For the covered infusion bag and infusion route, the samples taken before and after passing through the route did not show significant differences. These data suggest that the new shield, which almost perfectly covers both the infusion bag and route of infusion, is effective in preventing DTIC photodegradation.

著者

津田 壮一郎 清宮 啓介 池淵 由香 島村 奈緒美 袴田 潤 青森 達 別府 紀子 山口 雅也 望月 眞弓

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.45, no.10, pp.596-603, 2019-10-10 (Released:2020-10-10)

参考文献数

4

被引用文献数

1 5

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Model Core Curriculum for Pharmacy Education (2013 version) presents eight disease areas as the minimum medical conditions, and it requires student trainees to be continuously engaged in pharmacotherapy for these diseases. We developed an “Individual Student Report Form” (Report Form) in order to investigate and evaluate each student trainee's engagement and continuity with the eight diseases. The Report Forms were shared between the community pharmacy, hospital, and university, and the effectiveness of collaboration among these institutions was examined.Participants were 25 student trainees who were planning to do their clinical practicums in our hospital in the second term of 2017. During the earlier pharmacy practicum, the trainees were asked to complete the Report Form regarding the diseases they handled. Trainees took notes on the Report Form during their daily reflection time in their hospital practicums about their engagement with the eight diseases. We calculated the cumulative total numbers and percentages of their engagement with the eight diseases to examine engagement rates and continuity across terms.The percentages of trainees who were engaged with all eight diseases were 36% (9/25 persons) at the pharmacy, 24% (6/25) at the hospital, and 68% (17/25) overall at the two locations. The average numbers of the eight tracked diseases that trainees were engaged with were 2.3 at the pharmacy, 3.8 at the hospital, and 4.5 in total. The findings of this study suggest that this tracking tool could help facilitate and efficiently transfer information about the disease engagement of trainees during their two pharmacy practicums.

著者

松岡 知子 宇佐美 英績 吉村 知哲 高田 裕子 安田 忠司

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.37, no.8, pp.487-493, 2011 (Released:2012-08-30)

参考文献数

13

被引用文献数

2 3

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Liposomal-Amphotericin B (L-AMB) may cause hypokalemia. This study was carried out to examine the occurrence of hypokalemia and its primary causes in 74 patients who were administered L-AMB. They were divided into 2 groups regarding the severity of hypokalemia that occurred: Grade 0-2 group: 35 patients (47.3%), and Grade 3-4 group: 39 patients (52.7%). The results of a comparison of the Grade 0-2 group and Grade 3-4 group showed that causes for the Grade 3-4 group were significantly different from those in the Grade 0-2 group, which were a serum albumin level of more than 2.82 mg/dL at the start of the L-AMB administration (p=0.004, OR: 8.711, 95%CI: 2.273-45.823), and a history of hypokalemia before L-AMB administration (p=0.009, OR: 7.859, 95%CI: 1.844-44.109) in the Grade 3-4 group.While combination with trimethoprim-sulfamethoxazole resulted in significant avoidance of Grade 3-4 hypokalemia (p=0.019, OR: 0.233, 95%CI: 0.063-0.750), administration of potassium for preventive or maintenance purposes did not affect the occurrence of hypokalemia (p=0.137, p=0.198). However, for 20 patients with an abnormal serum potassium level (Grade 1 and more) at the start of L-AMB administration, our findings suggested that the preventive/maintenance administration of potassium was indeed effective (p=0.011).It has been proven that L-AMB causes hypokalemia frequently and the primary causes have been clarified. In this regard, it is important to regularly monitor serum potassium levels and adjust them depending on the situation of patients with hypokalemia.

著者

大野 恵一 村田 龍宣 近藤 篤 尾上 雅英 松本 公佑 渡邊 裕之 星田 唯史 眞下 惠次 平 大樹 角本 幹夫 菅野 清彦 本多 伸二

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.46, no.7, pp.367-372, 2020-07-10 (Released:2021-07-10)

参考文献数

6

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Albumin-bound paclitaxel (Abraxane®) is a lyophilized preparation that takes time to dissolve. Previously, we used a metal needle for dissolving Abraxane®. We then transitioned to a side hole-type plastic needle to prevent accidental needle-stick injuries. There is no literature regarding the ideal needle type, according to the material it is made of, for dissolving Abraxane®, and the effect on the characteristics of Abraxane® after dissolving with each needle is unknown. Therefore, we investigated the efficacy of the plastic needle for dissolving Abraxane®. The formulation was dissolved in three ways: by injecting saline for 30 s with a metal needle (M30s), injecting saline for 15 s with a plastic needle (P15s), and injecting saline for 30 s with a plastic needle (P30s). Each group was kept at rest for 5 min after saline infusion, and then the dissolution time was estimated. The median dissolution time was 82.5 (15 - 210) s for M30s, 75 (30 - 135) s for P15s, and 45 (15 - 120) s for P30s. P30s had a significantly shorter dissolution time than M30s (P < 0.01) and P15s (P < 0.05). There was no significant difference in the dissolution time between M30s and P15s; however, P15s tended to have a shorter dissolution time than M30s. We measured the diameter of Abraxane® particles after dissolving with each needle and found that the diameter was almost the same. Therefore, a side hole-type plastic needle might reduce the dissolution time compared with a metal needle without affecting the characteristics of Abraxane®.

著者

中山 アヤコ 冨田 史子 齋木 このみ 近藤 東臣 砂田 久一 岡本 浩一

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.32, no.5, pp.375-382, 2006-05-10 (Released:2007-11-09)

参考文献数

10

被引用文献数

4 3

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We examined various pharmacokinetic parameters of progesterone (P) after its administration in a vaginal suppository to healthy females and compared these parameters with those after injection of P at different sites, in order to evaluate the effectiveness of the P vaginal suppository. The increase in the blood P concentration after administering it in the vaginal suppository was similar to that for injecting P (25 mg) into the gluteal region. Since the P vaginal suppository is a useful P preparation and can be readily used, it can be the dosage form of first choice in P replacement therapy. In addition, since our basic experiment suggested that there was a circadian rhythm in the blood P concentration, it may be possible to determine the optimum administration time for maintaining the blood P concentration based on this rhythm.

著者

寺澤 美穂 山折 大 勝山 善彦 二村 緑 久富 由里子 田中 章 荻原 朋美 萩原 徹也 杉山 暢宏 鷲塚 伸介 大森 栄

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.43, no.7, pp.362-372, 2017-07-10 (Released:2018-07-10)

参考文献数

23

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This study analyzed factors affecting plasma lamotrigine (LTG) concentrations in patients with bipolar disorder. The mean concentration/dose (C/D) ratio of LTG was significantly higher in patients co-treated with LTG and valproic acid (VPA) [3.72 (μg/mL)/(mg/kg/day), n = 9] than in those receiving LTG monotherapy [1.76 (μg/mL)/(mg/kg/day), n = 9; P < 0.01]. LTG monotherapy patients were genotyped for UDP-glucuronosyltransferase 2B7 (UGT2B7) *1/*1 (n = 5) and *1/*2(n = 4), whereas VPA co-administration patients were genotyped for UGT2B7*1/*1 (n = 6), *1/*2 (n = 2) and *2/*2 (n = 1). *There were no significant differences in mean C/D ratios between patients carrying the UGT2B7*1/*1 genotype and the 1/*2 or *2/*2 genotype regardless of pharmacotherapy (P ≥ 0.150). In the LTG monotherapy group, the mean C/D ratio was similar in smoking patients [1.52 (μg/mL)/(mg/kg/day), n = 3] and non-smoking patients [1.88 (μg/mL)/(mg/kg/day), n = 6; P = 0.393]. In the VPA co-administration group, however, the mean C/D ratio in smoking patients [2.62 (μg/mL)/(mg/kg/day), n = 4] was significantly lower than that in non-smoking patients [4.61 (μg/mL)/(mg/kg/day), n = 5; P < 0.01]. In vitro studies with HepG2 cells indicated that benzo[a]pyrene, one of the polycyclic aromatic hydrocarbons contained in tobacco smoke, as well as 3-methylcholanthrene efficiently induced expression of UGT1A4 mRNA but not UGT2B7 mRNA and that VPA potently enhanced their induction. These results suggest that concomitant VPA administration and/or smoking may influence LTG concentrations in patients with bipolar disorder.

著者

渡邉 真一 井上 直人 今井 公江 末丸 克矢 荒木 博陽 相本 太刀夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.32, no.3, pp.221-226, 2006-03-10 (Released:2007-11-09)

参考文献数

21

被引用文献数

9 11

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Interest in dietary fiber has been growing due to the many benefits it has for health. It is well known that dietary fiber reduces the risk of developing health problems such as obesity, hypertension, constipation, type 2 diabetics and hyperlipidemia. However, dietary fiber is also known to reduce the bioavailability of minerals, nutrients and certain drugs, though the interaction between dietary fiber and drugs is still poorly understood. In this study, we examined the adsorption of drugs (theophylline, acetaminophen, metoprolol, chlorpromazine, imipramine, amitriptyline and diclofenac sodium) onto several types of dietary fiber (cellulose, chitosan, pectin, sodium alginate and glucomannan) at pH 3 and pH 7 in order to determine the in vitro adsorption characteristics of dietary fiber. Our findings indicated that adsorption of drugs onto dietary fiber ranged from 0 to 96%, varying with the types of dietary fiber and drugs, and pH. Chlorpromazine, imipramine and amitriptyline showed particularly marked adsorption onto sodium alginate and glucomannan. We considered that ionic bonding was one of the reasons for adsorption.These findings indicate the possibility of the bioavailability of drugs being reduced when they are taken with dietary fiber due their adsorption onto dietary fiber.

著者

三島 江津子 岡戸 洋 加藤 さおり 櫛原 秀之 黒田 純子 榊原 隆志 首代 みどり 鈴木 厚志 松岡 加恵 宮坂 朋恵 渡辺 法男 横田 学 板倉 由縁 鈴木 照美 斉藤 寛子

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 = Japanese journal of pharmaceutical health care and sciences (ISSN:1346342X)

巻号頁・発行日

vol.35, no.6, pp.403-408, 2009-06-10

参考文献数

11

被引用文献数

1

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When pharmacists provide drug guidance to in-patients,they are often asked about health foods such patients are regularly taking in expectation of anti-cancer effects.However,pharmacists cannot always answer these questions based on scientific evidence.<br>To further evaluate the efficacy of health foods for this purpose,we did a survey of the literature concerning 5 frequently used health foods said to have anticancer effects using the PubMed and Ichushi search services,obtaining 1,300 papers from the former and 1,142 papers from the latter.However among them,we could not find any providing data from randomized controlled trials and thus there was no clear scientific evidence,though some of the papers noted an improvement in the quality of life of patients.<br>In conclusion,when pharmacists provide guidance on health foods to patients and their families,it is important for them to collect detailed information and evaluate them on a scientific basis.

著者

植松 卓也 芹澤 健一 鈴木 富仁 松浦 亨 堀井 一輝 小池 道明

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.46, no.9, pp.531-539, 2020-09-10 (Released:2021-09-10)

参考文献数

25

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Despite the bioequivalence of brand-name and generic drugs, some patients have complained about diminished efficacy after consumption. We administered brand and generic name constructs for loxoprofen sodium hydrate to patients in a variety of forms, including tablets and powder. We used the visual analog scale (VAS) to investigate and examine whether efficacy differences were attributed to the drug action or to a placebo effect. The responses of the 5 patients that entered this study showed different results when the brand-name and generic drugs were taken in a state where they could be distinguished from each other, and the VAS change when they were indistinguishable. In particular, three patients yielded large VAS differences when they consumed the brand-name and generic drugs in the form of tablets, but the VAS change was smaller when the drug was pulverized and consumed in powder form. This study suggests that there is no difference in the actual efficacy between the brand-name and the generic drug forms, and that any noted differences are likely attributed to a placebo effect. The placebo effect has positive or negative effects owing to various factors. As healthcare professionals, we must strive to maximize the therapeutic effects.