著者

髙栗 郷

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.138, no.11, pp.1329-1334, 2018-11-01 (Released:2018-11-01)

参考文献数

30

被引用文献数

8

---

Impaired insulin signaling in adipose tissue and skeletal muscle causes insulin resistance associated with the development of type 2 diabetes. However, the molecular mechanisms underlying insulin resistance remain to be elucidated. In this review, we describe the current understanding of the effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) and tumor necrosis factor (TNF)-α on insulin signal transduction in adipocytes. First, we determined that atorvastatin inhibits the tyrosine phosphorylation of insulin receptor substrate (IRS)-1 through a decrease in the RhoA-Rho-kinase pathway, resulting in the inhibition of glucose uptake. Second, we found that TNF-α induces IRS-1 phosphorylation at serine residues 636/639 and inhibits the tyrosine phosphorylation of IRS-1 through the increase in both extracellular signal-regulated kinase (ERK) and c-jun N-terminal kinase (JNK) phosphorylation. Interestingly, 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside, an AMP-activated protein kinase activator, suppresses TNF-α-induced IRS-1 serine phosphorylation at 636/639 and the phosphorylation of ERK by enhancing interactions between ERK and dual-specificity phosphatase-9. These results may be helpful in understanding the mechanisms underlying insulin resistance.

著者

山本 由似 塩田 倫史 大和田 祐二 福永 浩司

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

vol.131, no.4, pp.497-501, 2011-04-01 (Released:2011-04-01)

参考文献数

23

被引用文献数

1 2

---

Haloperidol as a potent dopamine D2 receptor (D2R) antagonist was a major tranquilizer to treat schizophrenia patients. However, the D2R blocking action in dorsal striatum is thought to cause extrapyramidal symptoms as adverse effects. However, the pathophysiological mechanism underlying extrapramidal symptoms induced by chronic treatment of haloperidol remains unclear. We recently found that lacking of heart-type fatty acid binding protein (H-FABP) in the brain aggravate catalepsy behavior induced by haloperidol. Here, we examined neuronal mechanism of augmentation of haloperidol-induced catalepsy in H-FABP null mice. Notably, catalepsy induced by haloperidol, a D2 antagonist, is augmented, whereas catalepsy induced by SCH23390, a D1 antagonist, was not affected in H-FABP null mice. Interestingly, haloperidol-induced acetylcholine (ACh) release in the dorsal striatum was markedly enhanced in H-FABP null mice compared to wild mice. We also defined the co-localization of D2R with H-FABP in the ACh interneurons in the striatum. Taken together, H-FABP regulates dopaminergic neuronal activity through interaction with D2R in rodent brain. The increased ACh release in the striatum accounts for haloperidol-induced catalepsy.

著者

斎藤 嘉朗 中村 亮介

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.12, pp.1557-1562, 2019-12-01 (Released:2019-12-01)

参考文献数

15

被引用文献数

2

---

Severe cutaneous adverse reactions (SCARs) are important in postmarketing drug safety because SCAR patients were highest in the adverse drug reaction relief system of Japan. The SCAR symptoms of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) include high fever, severe mucosal impairment, and epidermal necrosis-induced erosions and blisters. Approximately 600 cases of SJS and 300 cases of TEN are reported annually in Japan. Many suspected drugs such as acetaminophen, lamotrigine, allopurinol, and carbamazepine have been reported. Over the last 15 years, an association between human leukocyte antigen and SJS/TEN onset has been reported with several drugs. Pathophysiological examinations in those reports revealed marked CD8-positive T cell infiltration into epidermal lesions, and the presence of cytotoxic granulysin, soluble Fas ligand, and tumor necrosis factor (TNF)-α in blister fluid. Therefore, SJS and TEN are immunological disorders that lead to epidermal necrosis and are consequently treated with the systemic administration of corticosteroids and with high-dose intravenous immunoglobulin therapy and plasma exchange in severe cases. Additionally, because the epidermal necrosis has characteristics similar to those of organ rejection after transplantation, the administration of cyclosporine, an immunosuppressant that inhibits helper T cell activation, has been attempted. Further, the administration of the TNF-α inhibitor etanercept has also been reported. This review summarizes current knowledge on the mechanisms of onset of SJS/TEN and their treatments.

著者

本橋 秀之 藤本 敦子 坂根 稔康 山本 昌 矢野 義孝

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.1235-1241, 2013 (Released:2013-11-01)

参考文献数

9

被引用文献数

1 1

---

In recent years there have been over 30000 suicides annually in Japan. This is one of the most serious problems for Japanese society. Because mental disorder is closely associated with suicide, factors related to the increase in mental disorders and suicides should be clarified. In this study, various data regarding social factors were evaluated to assess the correlation of the number of patients with mental disorders and suicides among the 47 prefectures of Japan. Various data regarding social factors, such as income, savings, or rate of divorce, were obtained from the database of the Ministry of Health, Labour and Welfare of Japan. Among the factors, the annual income and the amount of savings were significantly correlated with the number of patients with mental disorder. On the other hand, while the annual income did not have a significant correlation with suicides, the amount of savings had a significant correlation with suicides. In conclusion, the annual income and amount of savings may both be one of the important factors involved in mental disorders, and the savings may also be a factor affecting suicides. These analyses are valuable in helping to clarify the causes of mental disease, and can hopefully contribute to the health and welfare of Japanese.

著者

武富 芳隆 村上 誠

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.5, pp.503-515, 2017-05-01 (Released:2017-05-01)

参考文献数

56

被引用文献数

2 3

---

Mast cells originate from hematopoietic stem cells and undergo terminal maturation in the extravascular tissues, in which they are ultimately resident. Mast maturation, phenotype, and function are dictated by the local microenvironment, which has a significant influence on the ability of mast cells to recognize and respond to stimuli. Activation of mast cells can lead to the release of three distinct classes of mediators, including preformed mediators stored in secretory granules, newly transcribed cytokines and chemokines, and de novo-synthesized bioactive lipid mediators. It is currently recognized that bioactive lipids such as arachidonic acid metabolites (prostaglandins and leukotrienes) released from mast cells modulate innate and adaptive immune responses both directly and indirectly through communication with other microenvironmental immune cells or stroma cells. Moreover, mast cells express a variety of lipid receptors and, if activated by bioactive lipids such as arachidonic acid, ω3 fatty acids, lysophospholipids, and their metabolites, can alter the release and production of other mediators including histamine, cytokines, and chemokines, and thereby alter homeostatic or pathophysiological responses. This review focuses on newly identified functional aspects of bioactive lipids with regard to their immune regulation and functional outcomes in both homeostasis and allergic disease.

著者

奥西 淳二 長原 弘毅 辻谷 久美子 松瀬 仁 久川 和之 曽我 学

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.9, pp.1233-1242, 2016 (Released:2016-09-01)

参考文献数

26

---

Environmental cleaning and disinfection plays an important role as a part of the standard precautions to prevent healthcare-associated infections, whereas hand hygiene is one of the most important strategies for breaking the chain of transmission. Cleaning and disinfection of high-touch areas in a health-care facility is emphasized. And wiping with an alcohol-saturated cloth which has features such as low corrosion and a wide range of antimicrobial activity is performed commonly for this purpose. Although alcohol provides immediate activity against enveloped viruses, its virucidal activity against certain non-enveloped viruses, including norovirus, is insufficient. We created a novel alcohol-based hand rub, MR06B7, which is safe for the skin, and is active against an extended spectrum of microorganisms including non-enveloped viruses. For environmental surface disinfection, a novel disinfectant MR13B15, which is based on MR06B7, has been developed. In vitro antimicrobial activity against a variety of pathogens, material compatibility, and simulated surface disinfection and decontamination efficacy of MR13B15 were investigated. According to the results, MR13B15 demonstrated potent bactericidal, fungicidal, mycobactericidal, and virucidal activity within a short contact time in addition to superior efficacy against non-enveloped viruses compared to ethanol for disinfection. Moreover, MR13B15 showed better material compatibility. Two simulation tests conducted for evaluating the disinfection and decontamination potency on environmental surfaces against feline calicivirus, a surrogate for norovirus, indicated that MR13B15 had superior efficacy for surface treatment compared to ethanol. These findings suggest that MR13B15, which satisfies most requirements of an environmental surface disinfectant, may contribute to accomplishing advanced standard precautions in preventing infections.

著者

齊藤 和季

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.138, no.1, pp.1-18, 2018 (Released:2018-01-01)

参考文献数

245

被引用文献数

7

---

A variety of chemicals produced by plants, often referred to as ‘phytochemicals’, have been used as medicines, food, fuels and industrial raw materials. Recent advances in the study of genomics and metabolomics in plant science have accelerated our understanding of the mechanisms, regulation and evolution of the biosynthesis of specialized plant products. We can now address such questions as how the metabolomic diversity of plants is originated at the levels of genome, and how we should apply this knowledge to drug discovery, industry and agriculture. Our research group has focused on metabolomics-based functional genomics over the last 15 years and we have developed a new research area called ‘Phytochemical Genomics’. In this review, the development of a research platform for plant metabolomics is discussed first, to provide a better understanding of the chemical diversity of plants. Then, representative applications of metabolomics to functional genomics in a model plant, Arabidopsis thaliana, are described. The extension of integrated multi-omics analyses to non-model specialized plants, e.g., medicinal plants, is presented, including the identification of novel genes, metabolites and networks for the biosynthesis of flavonoids, alkaloids, sulfur-containing metabolites and terpenoids. Further, functional genomics studies on a variety of medicinal plants is presented. I also discuss future trends in pharmacognosy and related sciences.

著者

入口 慎史 今井 徹 田中 昌代 田沼 道也 折井 孝男 加藤 敏明

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.9, pp.1117-1127, 2017 (Released:2017-09-01)

参考文献数

32

---

We conducted a meta-analysis to investigate the influence of antifungal spectrum on the effectiveness and adverse events of empirical antifungal therapy for febrile neutropenia. We searched PubMed and Cochrane Central Register of Controlled Trials (Central), and identified randomized controlled trials reporting mortality, efficacy, adverse events, and hepatic and renal dysfunction. Five trials assessed the efficacy and adverse events of agents with antifungal spectrum covering and those not covering Aspergillus. There were no differences in mortality [risk ratio (RR); 0.79, 95% confidence interval (Cl); 0.60-1.02], efficacy ratio (RR; 1.01, 95%Cl; 0.91-1.12), adverse event ratio (RR; 0.23, 95%Cl; 0.04-1.23), and hepatic dysfunction ratio (RR; 0.81, 95%Cl; 0.59-1.12) between two groups. Antifungals with no activity against Aspergillus were associated with lower renal dysfunction ratio (RR; 0.27, 95%Cl; 0.10-0.71). Five trials compared agents with antifungal spectrum covering versus those not covering Mucor. There were no difference in mortality (RR; 1.24, 95%Cl; 0.98-1.57), efficacy ratio (RR; 1.09, 95%Cl; 0.91-1.30), and hepatic dysfunction ratio (RR; 0.98, 95%Cl; 0.66-1.45) between two groups. Antifungals with no activity against Mucor were associated with lower adverse event ratio (RR; 0.60, 95%Cl; 0.47-0.77) and renal dysfunction ratio (RR; 0.25, 95%Cl; 0.13-0.49). Presence or absence of activity against Aspergillus or Mucor is not associated with mortality or efficacy ratio. Amphotericin B with activity against Aspergillus and Mucor has a higher adverse event ratio. Depending on the case, selection of antifungal drugs considering efficacy and side effects is necessary.

著者

吉松 嘉代 北澤 尚 河野 徳昭 飯田 修 川原 信夫

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.130, no.2, pp.237-246, 2010

被引用文献数

2

---

Illegal cannabis (<i>Cannabis sativa</i> L.) cultivation is still a social problem worldwide. Fifty inquiries on cannabis that Research Center for Medicinal Plant Resources (Tsukuba Division) received between January 1, 2000 and March 31, 2009 were itemized in to 8 categories; 1: seed identification, 2: plant identification, 3: indoor cultivation, 4: outdoor cultivation, 5: germination and growth characteristics, 6: expected amount of cannabis products derived from illegal cannabis plant, 7: non-narcotic cannabis and 8: usage of medicinal cannabis. Top three inquiries were 1: seed identification (16 cases), 3: indoor cultivation (10 cases) and 4: outdoor cultivation (6 cases). Characteristics of cannabis, namely seed morphology, germination and growth characteristics, and distinction from kenaf (<i>Hibiscus cannabinus</i> L.) that is frequently misjudged as cannabis, were studied to contribute for prevention of illegal cannabis cultivation.<br>

著者

佐野 知子 井上 元子 滝澤 理貴 島森 美光 黒澤 菜穂子

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.137, no.5, pp.603-610, 2017 (Released:2017-05-01)

参考文献数

13

被引用文献数

1

---

The Hakodate Watanabe Hospital has held pharmacist-led multidisciplinary psychiatric pharmacotherapy conferences since September 2013 in order to optimize pharmacotherapy. The effects of holding regular conferences on the correction of high-dose antipsychotic polypharmacy, prevention and reduction of adverse reactions to antipsychotics, and reduction of the drug costs were investigated in psychiatric inpatients prescribed 4 or more antipsychotics. The results revealed that the number of antipsychotics and number of all drugs were significantly reduced by 1, the chlorpromazine (CP)-equivalent dose was significantly reduced by approximately 350 mg, and the drug costs were significantly reduced by 176.5 yen/d. In regard to the effects on the laboratory test data, the blood glucose and hemoglobin A1c (HbA1c) levels were significantly reduced. In addition, 84.8% of the patients were assessed as “unchanged” using the Clinical Global Impression of Change (CGI-C), indicating the absence of any significant changes in the severity of the clinical psychiatric symptoms. The results confirm that psychiatric pharmacotherapy conferences are effective for promoting appropriate use of antipsychotics, reducing the incidence of metabolic adverse reactions, such as elevation of the blood glucose, and also reducing the drug costs. The above results suggest that psychiatric pharmacotherapy conferences encourage psychiatric medical teams to adjust prescriptions while sharing information, and are effective for optimizing pharmacotherapy.

著者

山國 徹 中島 晶 大泉 康

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.4, pp.517-520, 2010 (Released:2010-04-01)

参考文献数

11

被引用文献数

4 14

---

Alzheimer's disease (AD) has become a major health burden to society. However, no fundamentally therapeutic drugs for AD have been developed. Increasing evidence suggests that the elevation of β-amyloid (Aβ) peptides in the brain is central to AD pathogenesis. Recently, in the course of our survey of substances having anti-dementia activity from natural resources, we have successfully found nobiletin, a polymethoxylated flavone contained in AURANTII NOBILIS PERICARPIUM which is a component of traditional Chinese medicines. In this review, we describe the beneficial effects of nobiletin on memory impairment and Aβ pathology in a transgenic mouse model introduced human “Swedish” and “London” mutant amyloid precursor protein. We also note the possible molecular mechanism underlying the protective action against Aβ-induced memory impairment provided by our studies using cultured hippocampal neurons. Namely, daily administration of nobiletin for four months rescued the memory impairment in fear conditioning, and decreased hippocampal Aβ deposit in the transgenic mice as analyzed by immunohistochemistry. PKA-dependent signaling and membrane trafficking of AMPA receptor subunit, GluR1, which are known to be required for long-term potentiation (LTP), have been demonstrated to be inhibited by a sublethal concentration of Aβ in cultured hippocampal neurons. Our in vitro studies evidently showed that a sublethal concentration of Aβ actually inhibited glutamate-induced increases in both PKA substrates phosphorylation and GluR1 membrane trafficking in cultured hippocampal neurons, whereas nobiletin reversed the Aβ-induced inhibition of such biochemical processes. The natural compound with these unique actions has thus potential to become a novel drug for fundamental treatment of AD.

著者

石﨑 純子

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.137, no.1, pp.9-12, 2017 (Released:2017-01-01)

参考文献数

6

被引用文献数

1

---

Professors and teaching staff in the field of pharmaceutical sciences should devote themselves to staying abreast of relevant education and research. Similarly those in clinical pharmacies should contribute to the advancement of pharmaceutical research and the development of next generation pharmacists and pharmaceuticals. It is thought that those who work in clinical pharmacies should improve their own skills and expertise in problem-finding and -solving, i.e., “clinical skills”. They should be keen to learn new standard treatments based on the latest drug information, and should try to be in a position where collecting clinical information is readily possible. In the case of pharmacists in hospitals and pharmacies, they are able to aim at improving their clinical skills simply through performing their pharmaceutical duties. On the other hand, when a pharmaceutical educator aims to improve clinical skills at a level comparable to those of clinical pharmacists, it is necessary to devote or set aside considerable time for pharmacist duties, in addition to teaching, which may result in a shortage of time for hands-on clinical practice and/or in a decline in the quality of education and research. This could be a nightmare for teaching staff in clinical pharmacy who aim to take part in such activities. Nonetheless, I believe that teaching staff in the clinical pharmacy area could improve his/her clinical skills through actively engaging in education and research. In this review, I would like to introduce topics on such possibilities from my own experiences.

著者

宮田 健

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.12, pp.987-1006, 2003 (Released:2003-11-29)

参考文献数

48

被引用文献数

3 6

---

Disturbance of the normal mucociliary clearance due to hyperproduction of mucus and modification of its physicochemical characteristics is a common finding in airway diseases. Drugs that affect airway secretion have been developed and used to cleanse the respiratory tract for many centuries and in many countries. On the basis of the mechanism of their actions, the mucoactive drugs are classified into several groups. Some mucoactive drugs have direct effects on the production or composition of airway secretions, resulting in increased effectiveness of mucociliary clearance. Other mucoactive drugs do not have a specific action on mucus, but have beneficial effects on airway structure and function, which lead to correction of the pathophysiologic mechanisms that result in abnormal secretions. However, since many drugs have overlapping effects, it is difficult to classify these drugs into groups based on their major actions. Taken together with previous findings on mucoactive drugs, it appears that an antioxidant effect is a common property of mucoactive drugs and that it is a crucial action to exert their effects against airway diseases. In light of this idea, we must use specific experimental models to simulate pharmacologic events in airway inflammation. The development of new techniques has made it possible to identify and measure the mucus components, measure the rheologic parameters more accurately, and evaluate mucociliary clearance precisely in animals and humans. Therefore, with modifications of methods, we have investigated airway-cleansing drugs from various points of view to reflect actions in inflammatory states for more than two decades. Here, I introduce the methods we have used to study many of the parameters involved in airway clearance, including cough reflex, and describe some of the mucoactive-antitussive drugs that we have studied recently. There is an increasing usage of traditional Chinese herbal medicines in clinics and hospitals, because they tend to have moderate side effects and sometimes remarkable efficacy. To renormalize overall defects in airway disorders, Chinese medicines may be adequate, because they are composed of various herbs with weak but ubiquitous pharmacologic activities. We have been investigating Bakumondo-to. Bakumondo-to has been used for the treatment of bronchitis and pharyngitis accompanying severe dry cough. We found that unlike codeine Bakumondo-to had a notable antitussive activity against the cough associated with bronchitis and the cough increased by angiotensin-converting enzyme inhibitors. Recently, we have found that, in alveolar type II cells, Bakumondo-to attenuated phosphatidylcholine secretion increased by oxygen radicals from activated PMNLS. In addition, we found that Bakumondo-to itself stimulated phosphatidylcholine secretion and increased β-adrenoceptor gene expression in rat alveolar type II cells. We studied the mechanism of action and clarified that Bakumondo-to increased glucocorticoid-sensitive promotor activity. The effect may contribute to its ubiquitous effectiveness in the treatment of airway diseases. Various parameters (chemical properties, physical properties, mucus production, surfactant phospholipid production, and mucociliary clearance) are considered to be important for the dynamics and mobilization of airway secretions. Pharmacologic investigation, with appropriate techniques, of the ability of an agent to modify these parameters can provide useful information about its mechanism of action. However, since these parameters are interconnected, it is very complicated to elucidate the precise mechanisms of action of mucoactive drugs. This means that the goal of treatment cannot always be achieved by the modification of a single parameter, but should, more realistically, be aimed at a renormalization of several parameters. On the basis of this idea, glucocorticoids are ideal mucoactive drugs because they exert various…

著者

山下 良子 神山 秀一 山本 明日香 加納 宏樹 結城 祥充 上田 晃 川本 由加里 後藤 仁和 山本 聡

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.12, pp.1641-1649, 2016 (Released:2016-12-01)

参考文献数

28

被引用文献数

6

---

The efficacy of cefepime (CFPM) is known to depend on the ratio of the time that the serum levels exceed the minimum inhibitory concentration (MIC) to the dosing interval (%T>MIC). The objective of this study was to clarify the relation between %T>MIC and clinical outcome of CFPM, and to identify the optimal dosage regimen. We investigated the outcome of CFPM treatment for febrile neutropenia (FN) patients with normal renal function. Treatment success was defined as the completion of FN therapy with CFPM only. And we calculated %T>MIC for each case based on population pharmacokinetic parameters. The MIC value for simulation was set as 8 μg/mL. In logistic regression analysis, treatment success was significantly associated with the elevation of %T>MIC in the group with persistent neutropenia, yielding a receiver operating characteristic curve with an optimal cutoff value of 73.1%. Next, we simulated %T>MIC for each case under various dosing regimens. For patients whose creatinine clearance (CLcr) exceeded 100 mL/min, it was found to be difficult to attain the objective under the current regimen. In contrast, it was calculated that treatment with 2 g three times a day (t.i.d.) could attain the objective for most of the patients with 3 h of infusion. These results suggest that CFPM treatment under the current regimen is ineffective for FN patients with normal or augmented renal function, and that 2 g t.i.d. is necessary in quite a lot cases, although such use is off-label.

著者

鈴木 勉

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.12, pp.1325-1334, 2015 (Released:2015-12-01)

参考文献数

33

被引用文献数

1

---

The World Health Organization has reported that when morphine is used to control pain in cancer patients, psychological dependence is not a major concern. Our studies were undertaken to ascertain the modulation of psychological dependence on morphine under a chronic pain-like state in rats. Morphine induced a dose-dependent place preference. We found that inflammatory and neuropathic pain-like states significantly suppressed the morphine-induced rewarding effect. In an inflammatory pain-like state, the suppressive effect was significantly recovered by treatment with a κ-opioid receptor antagonist. In addition, in vivo microdialysis studies clearly showed that the morphine-induced increase in the extracellular levels of dopamine (DA) in the nucleus accumbens (N.Acc.) was significantly decreased in rats pretreated with formalin. This effect was in turn reversed by the microinjection of a specific dynorphin A antibody into the N.Acc. These findings suggest that the inflammatory pain-like state may have caused the sustained activation of the κ-opioidergic system within the N.Acc., resulting in suppression of the morphine-induced rewarding effect in rats. On the other hand, we found that attenuation of the morphine-induced place preference under neuropathic pain may result from a decrease in the morphine-induced DA release in the N.Acc with a reduction in the μ-opioid receptor-mediated G-protein activation in the ventral tegmental area (VTA). Moreover, nerve injury results in the continuous release of endogenous β-endorphin to cause the dysfunction of μ-opioid receptors in the VTA. This paper also provides a review to clarify misunderstandings of opioid analgesic use to control pain in cancer patients.

著者

藤田 直希 鍋谷 伸子 梅村 紀匡 菊池 千草 鈴木 匡

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.15-00277, (Released:2016-06-28)

参考文献数

7

被引用文献数

3

---

In this study, we took continuous measurements of hemoglobin A1c (HbA1c) levels and conducted lifestyle checks in three cases to determine if these parameters were effective in improving overall wellness. We selected three young men with relatively high HbA1c levels. During the 12-weeks study periods, we regularly measured each participant's HbA1c levels and monitored their lifestyle habits every two weeks at the community pharmacy once every 2 weeks using specific guidelines. The first participant, a 23-year-old man, had a HbA1c level of 5.7% at his first measurement. His HbA1c level decreased to 5.2% at the last measurement. The second participant, a 19-year-old man, had an initial HbA1c level of 5.7% and a final HbA1c level of 5.4%. The third participant was a 22-year-old man with an initial HbA1c level of 5.4%. His HbA1c level had decreased to 5.1% by the last measurement. The lifestyles of all three men improved with respect to exercise and diet. Based on these results, we surmise that continuous measurements of HbA1c and regular lifestyle checks may contribute to reducing the risk of lifestyle-related disease.

著者

出口 弘直

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.973-979, 2016 (Released:2016-07-01)

参考文献数

5

---

A major difference in medical flow between acute and nonacute medical care is the urgency of diagnosis and treatment. In the acute medical setting, diagnosis and treatment sometimes must be done almost simultaneously. Learning clinical management in the acute-care setting can be the basis of drug therapy in other clinical settings. When infusion is performed in emergency medicine, stabilization of blood pH is achieved through kidney and lung functions. At the same time, the oxygen transport capacity is monitored using blood gas analysis. One medical intervention can lead to multiple diagnostic and treatment processes in the emergency medical field. Most pharmacists rarely have the opportunity to learn about the reasoning process in which different body functions are linked together such as heart, lung, and kidney functions when performing infusions in emergency medicine before starting to work in the clinical setting. Learning from emergency medicine can be applied to drug therapy in other clinical settings as it teaches how to link different body functions and understand the relationships between those functions and the results of medical tests. These are considered to be necessary reasoning skills to understand patients' conditions in various clinical situations, including management in intensive care and the treatment of chronic disease. Knowledge of emergency medicine can be the foundation of drug therapy in other clinical settings, for example, the meanings of vital signs.

著者

福島 紀子

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.993-999, 2016 (Released:2016-07-01)

参考文献数

35

被引用文献数

1

---

Among private Universities of Pharmacy in Japan, Kyoritsu University of Pharmacy was the first to introduce courses in social pharmacy in 1991. Social pharmacy is a discipline driven by social needs. By studying the relationship between pharmacy and society, particularly through case studies, the impact of drugs and changes in societal expectation of them, as well as through historical background studies and surveys of current trends, this discipline acts to determine the roles of pharmacists and pharmacies expected by society. Social pharmacy requires a basic knowledge of pharmaceutical science, but an understanding from economic viewpoints of the current systems and structures in which healthcare functions is important as well. Once these are understood, the goal is to identify social problems, and to create and apply models for their resolution which connect pharmacy and society. So far, social pharmacy has played an important role in training programs for community-based pharmacists essential for a hyper-aged society, for community pharmacies' health management programs aimed at promoting the health of residents, and educational programs for elementary and middle school children.

著者

山本 哲也 長谷川 香子 小野田 誠 田中 啓一

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.6, pp.905-911, 2016 (Released:2016-06-01)

参考文献数

13

被引用文献数

1 7

---

Iguratimod (IGU), a disease-modifying antirheumatic drug launched in September 2012, has been reported to carry a risk of severe hemorrhages through a suspected interaction with warfarin (WF) in the all-case surveillance and early postmarketing-phase vigilance. To elucidate possible mechanisms of adverse interaction between IGU and WF, we analyzed the effects of IGU on the pharmacodynamics and pharmacokinetics of WF in rats. IGU was orally administered to male Wistar rats once daily for 5 d at 10 or 30 mg/kg in combination with WF at an oral dose of 0.25 mg/kg. Coadministration of IGU 30 mg/kg enhanced the anticoagulant activity of WF; prolonged blood coagulation time (prothrombin time and activated partial thromboplastin time) and decreased levels of vitamin K (VK)-dependent blood coagulation factors (II, VII, IX, and X) were observed. On the other hand, the pharmacokinetic parameters of WF including maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from 0 to 24 h (AUC0-24 h) were not affected by the combination with IGU. IGU alone did not change blood coagulation time at doses up to 100 mg/kg, while VK-dependent blood coagulation factors decreased slightly at 30 and 100 mg/kg. These results suggest that the pharmacodynamic effect of IGU on VK-dependent blood coagulation factors is involved in the mechanism of drug-drug interaction of IGU with WF.

著者

古川 綾 浅田 美子 森 貴幸 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.251-258, 2016 (Released:2016-02-01)

参考文献数

12

---

The Asheville Project® began in 1996 in Asheville, North Carolina, where community pharmacists, in collaboration with physicians, provide health coaching to patients with lifestyle diseases to accomplish their improved self-management of the disease. The project has now widely expanded across the United States. With periodical coaching by pharmacists, according to the reports of these programs, patients have been reported to show improvements in self-management and laboratory data, including the number of doctor visits, medication adherence and the number of foot examinations. Economically, the total medical costs for this disease have decreased 34% over a 5-year period by complying with the Asheville Project. In implementing this model in Japan, various questions, such as the feasibility for busy pharmacists to expend 30-60 min for meeting individually with patients, effective collaboration between pharmacy and physician, patients' acceptance of support by pharmacists to modify their behavior, etc. had to be answered. Thus, we developed a program entitled, “A Health Coaching Program by Community Pharmacists in a Collaborative Practice,” aimed at preventing the aggravation of lifestyle diseases; we evaluated its feasibility for the above mentioned concerns. The content of this coaching program has been prepared with reference to the Asheville Project® and with the support of Kitasato University School of Pharmacy and the Iowa Pharmacy Association, USA. We herein introduce this coaching program, as well as what the pharmacists have learned through this program.