著者
大野 能之
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.3, pp.337-345, 2018-03-01 (Released:2018-03-01)
参考文献数
38
被引用文献数
1 1

Drug-drug interactions (DDIs) can affect the clearance of various drugs from the body; however, these effects are difficult to sufficiently evaluate in clinical studies. This article outlines our approach to improving methods for evaluating and providing drug information relative to the effects of DDIs. In a previous study, total exposure changes to many substrate drugs of CYP caused by the co-administration of inhibitor or inducer drugs were successfully predicted using in vivo data. There are two parameters for the prediction: the contribution ratio of the enzyme to oral clearance for substrates (CR), and either the inhibition ratio for inhibitors (IR) or the increase in clearance of substrates produced by induction (IC). To apply these predictions in daily pharmacotherapy, the clinical significance of any pharmacokinetic changes must be carefully evaluated. We constructed a pharmacokinetic interaction significance classification system (PISCS) in which the clinical significance of DDIs was considered in a systematic manner, according to pharmacokinetic changes. The PISCS suggests that many current ‘alert’ classifications are potentially inappropriate, especially for drug combinations in which pharmacokinetics have not yet been evaluated. It is expected that PISCS would contribute to constructing a reliable system to alert pharmacists, physicians and consumers of a broad range of pharmacokinetic DDIs in order to more safely manage daily clinical practices.

言及状況

外部データベース (DOI)

Twitter (6 users, 7 posts, 1 favorites)

https://t.co/06v0fBJDC9 こういう、相互作用を定量的に調べたエビデンス、もっと増えてほしいな 併用禁忌とか注意とか曖昧な表現じゃなくてね https://t.co/Bz7Xp4RuJg
大野先生のPISCS 2Dスケール すぐに見つかるとこに置いておこう https://t.co/l6TbAEoxHC
@ruruuuuwn https://t.co/l6TbAEoxHC ミダゾラムのAUC変動データで補完しようとすると、大野先生のデータと合わせるとRFPと同等かそれ以上に誘導してそうですね。 やはり自分ならエドキサバンか、ワーファリンの管理も確認してみると思います。
参考?になればということで 臨床でのAUC変動を網羅的に予測しようという試みの話を… https://t.co/Cy5bWLwuv1 ここでも変動倍率とその危険度は薬剤ごとに分けてるのでその辺の観点(安全域の薬剤間差)は必須だなぁ… https://t.co/R7KhD94gjn

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