Pub Date : 2000-04-10DOI: 10.5649/JJPHCS1975.26.135
N. Fukuoka, T. Tsukamoto, J. Uno, M. Kimura, S. Morita
We conducted a study to clarify the most suitable factors related to the carbamazepine daily dose (D) with the serum concentration (Ct).Therapeutic drug monitoring data obtained from epileptic patients who were chronically treated with single and repetitive oral administrations of carbamazepine (CBZ). The 119 steadystate data were used.First, when the extracellular water volume (VECW) was employed as a transforming factor, Ct/(D/VECW) ratio was found to be independent of the patient's age. In addition, a multiple regression analysis revealed that Ct was dependent on only D/VECW. From these findings, we concluded that Ct could only be related with D/VECW.Next, a l -compartment model including two assumptions that CBZ binds to plasma protein and the distribution volume of free-CBZ is proportional to VECW, was postulated for our analysis. At steady-state, Ct was expressed as follows:C1=αX (1+KaCbs+αKaX)/(1+αKaX) (X=D/VECW.α, Ka, Cbs: parameter)The parameter values were estimated by the nonlinear least squares method as α, Ka and Cbs were 0.013, 1.6 and 12.8, respectively.The plasma protein binding ratios were 92.3, 90.2 and 87.1 (%) when the serum CBZ concentrations were 6, 8 and 10 [μg/mL], respectively. These values closely corrected with those reported previously.As a result, VECW is considered to be a suitable transforming factor for the relation between Ct and D, and our model seems to be approriate.
我们进行了一项研究，以澄清卡马西平日剂量(D)与血清浓度(Ct)相关的最合适因素。长期服用卡马西平(CBZ)单次和重复口服治疗的癫痫患者的治疗药物监测数据。使用119个稳态数据。首先，当细胞外水体积(VECW)作为转换因子时，发现Ct/(D/VECW)比值与患者年龄无关。此外，多元回归分析显示，Ct仅依赖于D/VECW。从这些发现，我们得出结论，Ct只能与D/VECW有关。接下来，我们的分析假设了一个l -室模型，其中包括两个假设，即CBZ与血浆蛋白结合，以及游离CBZ的分布体积与VECW成正比。稳态时，Ct表示为:C1=αX (1+KaCbs+αKaX)/(1+αKaX) (X=D/VECW)。α， Ka, Cbs:参数)通过非线性最小二乘法估计参数值α， Ka和Cbs分别为0.013,1.6和12.8。当血清CBZ浓度为6、8和10 [μg/mL]时，血浆蛋白结合率分别为92.3、90.2和87.1(%)。这些值与以前报告的值非常接近。因此，我们认为VECW是Ct和D之间关系的合适变换因子，我们的模型似乎是合适的。
{"title":"Advantage of Extracellular Water Volume for the Relation between Serum Carbamazepine Concentration and Transformed Daily Dose","authors":"N. Fukuoka, T. Tsukamoto, J. Uno, M. Kimura, S. Morita","doi":"10.5649/JJPHCS1975.26.135","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.135","url":null,"abstract":"We conducted a study to clarify the most suitable factors related to the carbamazepine daily dose (D) with the serum concentration (Ct).Therapeutic drug monitoring data obtained from epileptic patients who were chronically treated with single and repetitive oral administrations of carbamazepine (CBZ). The 119 steadystate data were used.First, when the extracellular water volume (VECW) was employed as a transforming factor, Ct/(D/VECW) ratio was found to be independent of the patient's age. In addition, a multiple regression analysis revealed that Ct was dependent on only D/VECW. From these findings, we concluded that Ct could only be related with D/VECW.Next, a l -compartment model including two assumptions that CBZ binds to plasma protein and the distribution volume of free-CBZ is proportional to VECW, was postulated for our analysis. At steady-state, Ct was expressed as follows:C1=αX (1+KaCbs+αKaX)/(1+αKaX) (X=D/VECW.α, Ka, Cbs: parameter)The parameter values were estimated by the nonlinear least squares method as α, Ka and Cbs were 0.013, 1.6 and 12.8, respectively.The plasma protein binding ratios were 92.3, 90.2 and 87.1 (%) when the serum CBZ concentrations were 6, 8 and 10 [μg/mL], respectively. These values closely corrected with those reported previously.As a result, VECW is considered to be a suitable transforming factor for the relation between Ct and D, and our model seems to be approriate.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"4 1","pages":"135-144"},"PeriodicalIF":0.0,"publicationDate":"2000-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83754106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-04-10DOI: 10.5649/JJPHCS1975.26.212
惟夫 外間, 準男 芳原, 将之 酒井, 浩昌 亀谷, 進 大城, 又郎 坂梨
Colestimide is a new anion exchange resin synthesized from 2-metyl imidazole and epichlorohydrin, and shows a specific affinity to bile acids among physiological anions. The drug interaction of colestimide with sodium valproate, phenobarbital and carvedilol in the gastrointestinal absorption in male rats was examined.The plasma valproate concentrations in the treatment with colestimide were significantly lower than those in the control at 15 min-1 hr, and the drug pharmacokinetic parameters, Cmax and AUC0-∞ were 40 and 25% decreased after oral administration of 100 mg/kg sodium valproate with 1.05 g/kg colestimide. The plasma phenobarbital concentrations were significantly lower than the control at 30 min-1 hr, and tmax was 3.0 times delayed after oral administration of 80 mg/kg phenobarbital with 1.05 g/kg colestimide. On the other hand, the administration of 20 mg/kg carvedilol with 1.05 g/kg colemide did not change the time dependent profiles of the plasma concentration and pharmacokinetic parameters of carvedilol.These result suggested that the absorption of sodium valproate was decreased and the absorption of phenobarbital was delayed by the coadministrated colestimide, but no significant effect on the bioavailability of carvedilol was observed.
{"title":"Sodium Valproate, PhenobarbitalとCarvedilolのラット血漿中濃度に及ぼすColestimideの影響","authors":"惟夫 外間, 準男 芳原, 将之 酒井, 浩昌 亀谷, 進 大城, 又郎 坂梨","doi":"10.5649/JJPHCS1975.26.212","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.212","url":null,"abstract":"Colestimide is a new anion exchange resin synthesized from 2-metyl imidazole and epichlorohydrin, and shows a specific affinity to bile acids among physiological anions. The drug interaction of colestimide with sodium valproate, phenobarbital and carvedilol in the gastrointestinal absorption in male rats was examined.The plasma valproate concentrations in the treatment with colestimide were significantly lower than those in the control at 15 min-1 hr, and the drug pharmacokinetic parameters, Cmax and AUC0-∞ were 40 and 25% decreased after oral administration of 100 mg/kg sodium valproate with 1.05 g/kg colestimide. The plasma phenobarbital concentrations were significantly lower than the control at 30 min-1 hr, and tmax was 3.0 times delayed after oral administration of 80 mg/kg phenobarbital with 1.05 g/kg colestimide. On the other hand, the administration of 20 mg/kg carvedilol with 1.05 g/kg colemide did not change the time dependent profiles of the plasma concentration and pharmacokinetic parameters of carvedilol.These result suggested that the absorption of sodium valproate was decreased and the absorption of phenobarbital was delayed by the coadministrated colestimide, but no significant effect on the bioavailability of carvedilol was observed.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"8 1","pages":"212-218"},"PeriodicalIF":0.0,"publicationDate":"2000-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87842699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine whether the cotreatment with histamine H1 antagonists (H1) and histamine H2 antagonists (H2) are effective in treating chronic urticaria sufferers whose condition does not improve by H1 antagonist alone, we investigated academic books, papers provided by pharmaceutical companies and the MEDLINE on-line data base. No sufficient information could be found from inquiries of books and company-provided papers. However, from the MEDLINE data base, six papers on clinical trials based on the protocols of randomized controlled on trial were obtained and used as evidence. We also performed a meta-analysis based on the findings of the 6 papers.It is thus considered indispensable for drug information services to find appropriate papers using a data base search and then provide such information to doctors together with a critical appraisal by pharmacists.
{"title":"Evidence-Based Medicineの手法を用いた医師への情報提供の実践","authors":"祐子 関根, 純子 木津, 幸恵 長瀬, 基記 荒川, 伸浩 安野, 睦 遠藤, 柳 真志帆, 緑 山中, 実 大山, 義弘 荒川","doi":"10.5649/JJPHCS1975.26.61","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.61","url":null,"abstract":"To determine whether the cotreatment with histamine H1 antagonists (H1) and histamine H2 antagonists (H2) are effective in treating chronic urticaria sufferers whose condition does not improve by H1 antagonist alone, we investigated academic books, papers provided by pharmaceutical companies and the MEDLINE on-line data base. No sufficient information could be found from inquiries of books and company-provided papers. However, from the MEDLINE data base, six papers on clinical trials based on the protocols of randomized controlled on trial were obtained and used as evidence. We also performed a meta-analysis based on the findings of the 6 papers.It is thus considered indispensable for drug information services to find appropriate papers using a data base search and then provide such information to doctors together with a critical appraisal by pharmacists.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"11 1","pages":"61-68"},"PeriodicalIF":0.0,"publicationDate":"2000-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81998885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A tacrolimus injection is an immunosuppressant which is administered by an intravenous injection of drip infusion over a period from 4-24 hours. We herein investigated the factors effecting the loss of tacrolimus from the intravenous solution, and leaching di-2-ethylhexyl phtalate (DEHP, specified environmental estrogen) from the administration tube into the intravenous solution. The concentrations of tacrolimus and DEHP were measured by high-performance liquid chromatography (HPLC). The factors effecting the loss of tacrolimus from intravenous solutions were thus found to be the length and the inside diameter of the administration apparatus, the concentration of the tacrolimus solution and the drip rate of the solution. When the tacrolimus solution passed through an administration tube consisting of polyvinyl chloride (PVC) measuring 100 cm in length at a flow rate of 5.0 mL/h and an initial concentration 50μg/mL, the concentration of tacrolimus decreased to about 76% and 12μg/mL of DEHP leaked into the solution per hour. On the other hand, when using polyethylene or polyolefin tubes, the amount of tacrolimus did not decrease and no DEHP leaked into the solution. Therefore, when tacrolimus is administered in travenously in a solution from, PVC administation tubes should not be used.
{"title":"精密持続点滴中のタクロリムス注射液の含量低下とフタル酸ジ-2-エチルヘキシルの溶出","authors":"正彦 鈴木, 昭司 高松, 恵美 村松, 中島 新一郎, 睦子 田中, 健治 河野","doi":"10.5649/JJPHCS1975.26.7","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.7","url":null,"abstract":"A tacrolimus injection is an immunosuppressant which is administered by an intravenous injection of drip infusion over a period from 4-24 hours. We herein investigated the factors effecting the loss of tacrolimus from the intravenous solution, and leaching di-2-ethylhexyl phtalate (DEHP, specified environmental estrogen) from the administration tube into the intravenous solution. The concentrations of tacrolimus and DEHP were measured by high-performance liquid chromatography (HPLC). The factors effecting the loss of tacrolimus from intravenous solutions were thus found to be the length and the inside diameter of the administration apparatus, the concentration of the tacrolimus solution and the drip rate of the solution. When the tacrolimus solution passed through an administration tube consisting of polyvinyl chloride (PVC) measuring 100 cm in length at a flow rate of 5.0 mL/h and an initial concentration 50μg/mL, the concentration of tacrolimus decreased to about 76% and 12μg/mL of DEHP leaked into the solution per hour. On the other hand, when using polyethylene or polyolefin tubes, the amount of tacrolimus did not decrease and no DEHP leaked into the solution. Therefore, when tacrolimus is administered in travenously in a solution from, PVC administation tubes should not be used.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"76 1","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2000-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80729700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-02-10DOI: 10.5649/JJPHCS1975.26.69
K. Mizuno, S. Fukuda, F. Kato, T. Nikaido
Aminoglycoside antibiotics are used to manage hemo-dialysis patients after hemodialysis. Using this protocol, the serum concentration of aminoglycoside antibiotics in such patients is kept at a higher level for a long time which thus induces a toxic effect of aminoglycoside antibiotics.We administered tobramycin (TOB) 90 mg to 2 dialysis patients with infectious disease before each hemodialysis, then TOB was removed from the patients by hemodialysis after several hours.One patient was given TOB 90 mg 17 times over 33 days without any symptoms of either ototoxicity or dizziness. Another patient was given TOB 90 mg 5 times over 13 days, and his infectious condition improved markedly.The administration of aminoglycoside antibiotics before hemodialysis was thus suggested to be safe and effective for the treatment of infectious diseases in dialysis patients.We analyzed the postantibiotic effect (PAE) and the postantibiotic effect subMIC effect (PASME) of TOB for Pseudomonas aeruginosa ATCC 27853 in vitro. As a result, higher concentrations of TOB (4 MIC) and a longer exposure to it were thus found to induce stronger PAE and PASME.We therefore recommend that aminoglycoside antibiotics be given before hemodialysis in dialysis patient, and thereafter they should be removed, by hemodialysis after several hours, because high concentrations of arninoglycosides in the serum for several hours can induce stronger PAE and PASME enhance the efficacy and safety of aminoglycoside in addition to its own bacteriocidal activity.
{"title":"A Study on the Effect of Tobramycin Administered to Hemodialysis Patients with Systemic Infectious Disease","authors":"K. Mizuno, S. Fukuda, F. Kato, T. Nikaido","doi":"10.5649/JJPHCS1975.26.69","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.69","url":null,"abstract":"Aminoglycoside antibiotics are used to manage hemo-dialysis patients after hemodialysis. Using this protocol, the serum concentration of aminoglycoside antibiotics in such patients is kept at a higher level for a long time which thus induces a toxic effect of aminoglycoside antibiotics.We administered tobramycin (TOB) 90 mg to 2 dialysis patients with infectious disease before each hemodialysis, then TOB was removed from the patients by hemodialysis after several hours.One patient was given TOB 90 mg 17 times over 33 days without any symptoms of either ototoxicity or dizziness. Another patient was given TOB 90 mg 5 times over 13 days, and his infectious condition improved markedly.The administration of aminoglycoside antibiotics before hemodialysis was thus suggested to be safe and effective for the treatment of infectious diseases in dialysis patients.We analyzed the postantibiotic effect (PAE) and the postantibiotic effect subMIC effect (PASME) of TOB for Pseudomonas aeruginosa ATCC 27853 in vitro. As a result, higher concentrations of TOB (4 MIC) and a longer exposure to it were thus found to induce stronger PAE and PASME.We therefore recommend that aminoglycoside antibiotics be given before hemodialysis in dialysis patient, and thereafter they should be removed, by hemodialysis after several hours, because high concentrations of arninoglycosides in the serum for several hours can induce stronger PAE and PASME enhance the efficacy and safety of aminoglycoside in addition to its own bacteriocidal activity.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"26 1","pages":"69-78"},"PeriodicalIF":0.0,"publicationDate":"2000-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85164373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-02-10DOI: 10.5649/JJPHCS1975.26.102
Moemi Saito, M. Hoshi, H. Ogata, T. Mikawa, H. Yoshida, K. Kurosawa, A. Hirosaka, Y. Maruyama, K. Edo
{"title":"Studies on Hospital Pharmaceutical Manufacturing (V) Preparation and Preliminary Clinical Evaluation of Serotonin Creatinin Sulfate Injection","authors":"Moemi Saito, M. Hoshi, H. Ogata, T. Mikawa, H. Yoshida, K. Kurosawa, A. Hirosaka, Y. Maruyama, K. Edo","doi":"10.5649/JJPHCS1975.26.102","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.102","url":null,"abstract":"","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"44 1","pages":"102-109"},"PeriodicalIF":0.0,"publicationDate":"2000-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83311438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-02-10DOI: 10.5649/JJPHCS1975.26.52
H. Hashimoto, Masayo Tanaka, Tadashi Oyake, T. Gomi, T. Ikeda, Masanori Yoshida, T. Fujimoto, M. Umezu, K. Nagashima, T. Fujita, M. Fujii, Y. Matsumoto, M. Fukuoka, M. Matsumoto, M. Ishi
A cross-sectional study was conducted using the data obtained from a QOL study of Carvedilol to ascertain how the patients' answers on subjective symptoms change depending on how the questions were asked and who asked them. The patients in the present study received Carvedilol for six months, and were then questioned about six subjective symptoms (headache, dull headache, dizziness, palpitation, stiff shoulder, and malaise) by both physicians and pharmacists. The physicians mainly asked patients about the severity of each symptom, whereas the pharmacists asked about the frequency of each symptom. The results showed a discrepancy between the answers given to physicians and those given to pharmacists. The factors associated with the discrepancies in the answers included age, employment and standard of living. The results of the present study suggest that, in order to gather information about subjective symptoms from patients, it is necessary to consider the following factors: how patients are questioned, how they can answer the questions, how much time is spent with patients, and how to should patient privacy be protected.
{"title":"Study on the Discrepancy in Responses Given by Patients to Questions Regarding Subjective Symptoms","authors":"H. Hashimoto, Masayo Tanaka, Tadashi Oyake, T. Gomi, T. Ikeda, Masanori Yoshida, T. Fujimoto, M. Umezu, K. Nagashima, T. Fujita, M. Fujii, Y. Matsumoto, M. Fukuoka, M. Matsumoto, M. Ishi","doi":"10.5649/JJPHCS1975.26.52","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.52","url":null,"abstract":"A cross-sectional study was conducted using the data obtained from a QOL study of Carvedilol to ascertain how the patients' answers on subjective symptoms change depending on how the questions were asked and who asked them. The patients in the present study received Carvedilol for six months, and were then questioned about six subjective symptoms (headache, dull headache, dizziness, palpitation, stiff shoulder, and malaise) by both physicians and pharmacists. The physicians mainly asked patients about the severity of each symptom, whereas the pharmacists asked about the frequency of each symptom. The results showed a discrepancy between the answers given to physicians and those given to pharmacists. The factors associated with the discrepancies in the answers included age, employment and standard of living. The results of the present study suggest that, in order to gather information about subjective symptoms from patients, it is necessary to consider the following factors: how patients are questioned, how they can answer the questions, how much time is spent with patients, and how to should patient privacy be protected.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"23 1","pages":"52-60"},"PeriodicalIF":0.0,"publicationDate":"2000-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84990239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.5649/JJPHCS1975.26.478
K. Morita, S. Koga, H. Konishi, T. Minouchi, A. Yamaji, Takashi Sato
Cimetidine (CIM), a histamine H2-receptor antagonist, has been demonstrated to reduce the clearance (CL) of a number of drugs. Up to date, 29 drugs, whose CLs are reduced by the coadministration of CIM, are listed under their package insert. We reviewed the original articles investigating the potential drug interaction between CIM and these drugs, and analyzed the relationship between the daily dosage of CIM and the alteration of the CL of the coadministered drugs.The decrease in the CL in the coadministration of CIM varied greatly from chlordiazepoxide with the largest decrease (56.7%) to mexiletine with the smallest (6.0%). The dose of the CIM described in original articles also varied greatly with the largest dose 2, 400 mg/day and the lowest 300 mg/day. A dose of over 800 mg/day of CIM, which is the upper limit of the usual dose in Japan, comprised 98% of all reported cases. A 1, 200 mg/day dose (16.6 mg/kg/day) of CIM, which was the most frequent dose described in the literature, was 2.5 times higher than the 400 mg/day dose (6.7 mg/kg/day) which is the usual dose in recent years in our country.The CL and serum trough concentration of theophylline (TP) were measured before and after the oral coadministration with a dosage of 400 mg/day or 800 mg/day of CIM for 5 days in four healthy subjects. The alteration in the serum trough concentration (about a 35% increase) and the CL (about 20% decrease) of TP induced by the coadministration of 800 mg/day of CIM, was much greater than that observed after the coadministration at 400 mg/day.These results suggest that the uniform change in prescriptions only based on the names of the drugs used in combination must be reexamined, and that it is necessary to improve the drug interaction-check system based on scientific evidence. after carefully evaluating the dose of the drug used.
{"title":"The Relation between the Dose of and the Induction of Drug Interaction by Cimetidine. A Survey of the Literature and the Alteration of Pharmacokinetics of Theophylline.","authors":"K. Morita, S. Koga, H. Konishi, T. Minouchi, A. Yamaji, Takashi Sato","doi":"10.5649/JJPHCS1975.26.478","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.478","url":null,"abstract":"Cimetidine (CIM), a histamine H2-receptor antagonist, has been demonstrated to reduce the clearance (CL) of a number of drugs. Up to date, 29 drugs, whose CLs are reduced by the coadministration of CIM, are listed under their package insert. We reviewed the original articles investigating the potential drug interaction between CIM and these drugs, and analyzed the relationship between the daily dosage of CIM and the alteration of the CL of the coadministered drugs.The decrease in the CL in the coadministration of CIM varied greatly from chlordiazepoxide with the largest decrease (56.7%) to mexiletine with the smallest (6.0%). The dose of the CIM described in original articles also varied greatly with the largest dose 2, 400 mg/day and the lowest 300 mg/day. A dose of over 800 mg/day of CIM, which is the upper limit of the usual dose in Japan, comprised 98% of all reported cases. A 1, 200 mg/day dose (16.6 mg/kg/day) of CIM, which was the most frequent dose described in the literature, was 2.5 times higher than the 400 mg/day dose (6.7 mg/kg/day) which is the usual dose in recent years in our country.The CL and serum trough concentration of theophylline (TP) were measured before and after the oral coadministration with a dosage of 400 mg/day or 800 mg/day of CIM for 5 days in four healthy subjects. The alteration in the serum trough concentration (about a 35% increase) and the CL (about 20% decrease) of TP induced by the coadministration of 800 mg/day of CIM, was much greater than that observed after the coadministration at 400 mg/day.These results suggest that the uniform change in prescriptions only based on the names of the drugs used in combination must be reexamined, and that it is necessary to improve the drug interaction-check system based on scientific evidence. after carefully evaluating the dose of the drug used.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"33 1","pages":"478-484"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81458964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.5649/JJPHCS1975.26.123
K. Inagaki, Toshiharu Arakawa, Kohji Yamamoto, M. Nishida, H. Ishihara, J. Okuda, Mikio Ito, S. Takaba, H. Sunada
{"title":"Early Exposure Experiences of Pharmacy Students to Hospital Pharmacy Practice.","authors":"K. Inagaki, Toshiharu Arakawa, Kohji Yamamoto, M. Nishida, H. Ishihara, J. Okuda, Mikio Ito, S. Takaba, H. Sunada","doi":"10.5649/JJPHCS1975.26.123","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.123","url":null,"abstract":"","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"24 1","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87680071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sodium Valproate (VPA-Na) syrup is used in the management of patients following brain surgery for conditions such as traumatic injury or arteriovenous malformation. In our hospital, 65% of post-neurosurgical patients administered VPA-Na syrup were also given enteral nutrition (EN) and/or antacids (AA). We therefore investigated possible drug interactions between VPANa syrup and EN or AA. In a random crossover study, 250 mL of Ensure Liquid® (EN), 20mL of Maalox® (AA) or 50 mL of Purified water were administered to nine normal subjects mixed with 12mL Depakene® (VPA-Na) syrup. Following administration, the serum concentration of valproic acid was then repeatedly measured over the next 48 hours using the FPIA method. Data were analyzed by non-parametric analysis and by population pharmacokinetic analysis using the NONMEM system. The results showed that the coadministration of Ensure and Maalox delayed the rate, but not the extent of bioavailability of VPA-Na syrup.
{"title":"健常人におけるシロップ剤からのバルプロ酸の吸収に及ぼすエンシュア・リキッド®及びマーロックス®の影響","authors":"斉藤 嘉津彦, 瓊子 清水, 幸一 板谷, 迪子 岡崎, 孝 木田, 直樹 渡辺, 貴大 戸田, 黒澤 菜穂子, 栄治 大和田","doi":"10.5649/JJPHCS1975.26.259","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.259","url":null,"abstract":"Sodium Valproate (VPA-Na) syrup is used in the management of patients following brain surgery for conditions such as traumatic injury or arteriovenous malformation. In our hospital, 65% of post-neurosurgical patients administered VPA-Na syrup were also given enteral nutrition (EN) and/or antacids (AA). We therefore investigated possible drug interactions between VPANa syrup and EN or AA. In a random crossover study, 250 mL of Ensure Liquid® (EN), 20mL of Maalox® (AA) or 50 mL of Purified water were administered to nine normal subjects mixed with 12mL Depakene® (VPA-Na) syrup. Following administration, the serum concentration of valproic acid was then repeatedly measured over the next 48 hours using the FPIA method. Data were analyzed by non-parametric analysis and by population pharmacokinetic analysis using the NONMEM system. The results showed that the coadministration of Ensure and Maalox delayed the rate, but not the extent of bioavailability of VPA-Na syrup.","PeriodicalId":14621,"journal":{"name":"Japanese Journal of Hospital Pharmacy","volume":"93 1","pages":"259-263"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86107889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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