Pub Date : 2000-12-10DOI: 10.5649/JJPHCS1975.26.632
Keiko Butatsu, Yoriko Tanaka, Y. Kosugi, T. Nagasaka, S. Awazu
In order to study the proper use of urate-lowering drugs, we searched and analyzed a recently established database of 151, 804 community pharmacy records for the one-year period ending in August 1997. A total of 5, 312 prescriptions for typical urate-lowering drugs, allopurinol and benzbromarone, were searched. The number of male patients was found to be approximately 6.5 times that of females (578 and 89, respectively). The average age was 59.8 years (range 15 to 90 years). Of the 5, 312 prescriptions examined 81.4% were for allopurinol, 17.1% for benzbromarone and 1.5% for both. The number of prescriptions for allopurinol was approximately 4.5 times greater than that for benzbromarone. Hyperuricemia is classified into three types. The first type, includes patients who under-excrete uric acid, occurs in approximately 55% of patients. Uricosuric drugs such as benzbromarone are considered to be the drugs of choice. The second type, consists of over-producers of uric acid, occurs in approximately 10% of patients. The third type, comprising a mixed category, accounts for the remaining 30%. Allopurinol is recommended for the latter group of both under-excreters and over-producers. Given this classification, benzbromarone should thus be prescribed on a relatively frequent basis.The average number of drugs per prescription was 5.9 (range 1 to 25 drugs) thus indicating that patients with hyperuricemia tend to be prescribed multiple-drug regimens. From the analysis of concomitant drugs, it was found that the most frequently prescribed drug was furosemide (22.4%), followed by nifedipine sustained-release preparations (15.7%), pravastatin sodium (11.7%) and aspirin diaulminate for children (10.7%). The most frequently prescribed drug group was vasodilators (60.2%) including calcium antagonists and nitrates, followed by peptic ulcer agents (44.4%), anti-arteriosclerotic agents (27.1%), anticoagulants (25.1%), diuretics (24.2%) and ACE inhibitors (20.7%). These finding suggest that patients with hyperuricamia tend to have multiple complications such as hypertension, hypercholesterolemia, and ischemic cardiopathies.Inappropriate drug use and combinations are as follows: Alkalinizing agents, which prevent urate stone formation and are recommended for hyperuricemia, appear to be under-utilized (only 11.8%). Diuretics, trichlormethiazide (2.5%) and furosemide (22.4%) commonly cause hyperuricemia and thus should be avoided. When allopurinol and captopril are administered concomitantly (2.9%), a dangerous hypersensitivity reaction can also sometimes occur.These results indicate that doctors and pharmacists need to obtain a greater awareness of inappropriate drug use and dangerous drug combinations.
{"title":"An Analysis of Urate-Lowering Drugs Using a Prescription Database","authors":"Keiko Butatsu, Yoriko Tanaka, Y. Kosugi, T. Nagasaka, S. Awazu","doi":"10.5649/JJPHCS1975.26.632","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.632","url":null,"abstract":"In order to study the proper use of urate-lowering drugs, we searched and analyzed a recently established database of 151, 804 community pharmacy records for the one-year period ending in August 1997. A total of 5, 312 prescriptions for typical urate-lowering drugs, allopurinol and benzbromarone, were searched. The number of male patients was found to be approximately 6.5 times that of females (578 and 89, respectively). The average age was 59.8 years (range 15 to 90 years). Of the 5, 312 prescriptions examined 81.4% were for allopurinol, 17.1% for benzbromarone and 1.5% for both. The number of prescriptions for allopurinol was approximately 4.5 times greater than that for benzbromarone. Hyperuricemia is classified into three types. The first type, includes patients who under-excrete uric acid, occurs in approximately 55% of patients. Uricosuric drugs such as benzbromarone are considered to be the drugs of choice. The second type, consists of over-producers of uric acid, occurs in approximately 10% of patients. The third type, comprising a mixed category, accounts for the remaining 30%. Allopurinol is recommended for the latter group of both under-excreters and over-producers. Given this classification, benzbromarone should thus be prescribed on a relatively frequent basis.The average number of drugs per prescription was 5.9 (range 1 to 25 drugs) thus indicating that patients with hyperuricemia tend to be prescribed multiple-drug regimens. From the analysis of concomitant drugs, it was found that the most frequently prescribed drug was furosemide (22.4%), followed by nifedipine sustained-release preparations (15.7%), pravastatin sodium (11.7%) and aspirin diaulminate for children (10.7%). The most frequently prescribed drug group was vasodilators (60.2%) including calcium antagonists and nitrates, followed by peptic ulcer agents (44.4%), anti-arteriosclerotic agents (27.1%), anticoagulants (25.1%), diuretics (24.2%) and ACE inhibitors (20.7%). These finding suggest that patients with hyperuricamia tend to have multiple complications such as hypertension, hypercholesterolemia, and ischemic cardiopathies.Inappropriate drug use and combinations are as follows: Alkalinizing agents, which prevent urate stone formation and are recommended for hyperuricemia, appear to be under-utilized (only 11.8%). Diuretics, trichlormethiazide (2.5%) and furosemide (22.4%) commonly cause hyperuricemia and thus should be avoided. When allopurinol and captopril are administered concomitantly (2.9%), a dangerous hypersensitivity reaction can also sometimes occur.These results indicate that doctors and pharmacists need to obtain a greater awareness of inappropriate drug use and dangerous drug combinations.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"41 1","pages":"632-641"},"PeriodicalIF":0.0,"publicationDate":"2000-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77557117","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 : 2000-08-10DOI: 10.5649/JJPHCS1975.26.427
Tazuko Ogawa, Naoshi Osawa, T. Uchida, K. Matsuyama
We selected eight generic drugs of sodium loxoprofen, a nonsteroidal anti-inflammatory drug (NSAID), and examined the dissolution ability of these drugs using the paddle method described in JP XIII.When performing the dissolution test performed on the 1st solution (disintengration test solution, pH 1.2) under the condition of 100 rpm and 37°C, the pioneer drug (Tablet A) was found to completely dissolve within 15 min. Some generic drugs showed almost the same dissolution profiles as the pioneer drug, whereas only one generic drug (Tablet F) showed a slower dissolution profile, a 63.8% release within 15 min.Furthermore, for Tablet A and Tablet F, the dissolution test using the 1st solution was performed at 50 rpm and 37°C. As a result, tablet F did not meet the minimum requirement established by the Ministry of Health and Welfare.The above dissolution tests were performed by the authors at the pharmaceutical laboratory of the School of Pharmaceutical Sciences, Mukogawa Women's University. Such collaboration by pharmacists in hospitals with pharmaceutical college in order to evaluate generic drugs should be more strongly encouraged in the future.
{"title":"Collaboration of Hospital Pharmacists with Pharmaceutical College on Evaluation of Generic Drugs : The Case of Dissolution Test of Sodium Loxoprofen Tablets","authors":"Tazuko Ogawa, Naoshi Osawa, T. Uchida, K. Matsuyama","doi":"10.5649/JJPHCS1975.26.427","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.427","url":null,"abstract":"We selected eight generic drugs of sodium loxoprofen, a nonsteroidal anti-inflammatory drug (NSAID), and examined the dissolution ability of these drugs using the paddle method described in JP XIII.When performing the dissolution test performed on the 1st solution (disintengration test solution, pH 1.2) under the condition of 100 rpm and 37°C, the pioneer drug (Tablet A) was found to completely dissolve within 15 min. Some generic drugs showed almost the same dissolution profiles as the pioneer drug, whereas only one generic drug (Tablet F) showed a slower dissolution profile, a 63.8% release within 15 min.Furthermore, for Tablet A and Tablet F, the dissolution test using the 1st solution was performed at 50 rpm and 37°C. As a result, tablet F did not meet the minimum requirement established by the Ministry of Health and Welfare.The above dissolution tests were performed by the authors at the pharmaceutical laboratory of the School of Pharmaceutical Sciences, Mukogawa Women's University. Such collaboration by pharmacists in hospitals with pharmaceutical college in order to evaluate generic drugs should be more strongly encouraged in the future.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"84 1","pages":"427-431"},"PeriodicalIF":0.0,"publicationDate":"2000-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85676914","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/JJPHCS1975.26.183
Megumi Morii, K. Ueno, M. Takada, Y. Hino, Y. Sasako, M. Shibakawa
A 56-year-old woman inpatient that had been administrated warfarin, digoxin, verapamil and disopyramide after undergoing surgery for a mitral and aortic valve replacement associated with artrial fibrillation received a 300mg daily dose of disopyramide therapy before and after the operation. Although the serum disopyramide concentration was within the normal therapeutic range, dry mouth appeared as a side effect. Disopyramide was thus changed to pirmenol. The trough level of pirmenol was 2.1μg/mL at seven days after starting pirmenol therapy at the dose of 300 mg/day, and the dose was there after decreased to 200mg/day. About two weeks after pirmenol therapy was started, liver injury was observed. At approximately 30 days after pirmenol administration was stopped, the liver function returned to a normal level.On the other hand, according to recent reports pirmenol was suggested to show a high level in the liver. The reported levels of pirmenol were also similar to for amiodarone and aprindine, which are both well known to induce side effect in the liver. Therefore, one of the reasons that pimenol induced liver injury may be due to its high levels in the liver.
{"title":"A Case Report and Evaluation of Pirmenol Toxicity Appeared with Liver Injury","authors":"Megumi Morii, K. Ueno, M. Takada, Y. Hino, Y. Sasako, M. Shibakawa","doi":"10.5649/JJPHCS1975.26.183","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.183","url":null,"abstract":"A 56-year-old woman inpatient that had been administrated warfarin, digoxin, verapamil and disopyramide after undergoing surgery for a mitral and aortic valve replacement associated with artrial fibrillation received a 300mg daily dose of disopyramide therapy before and after the operation. Although the serum disopyramide concentration was within the normal therapeutic range, dry mouth appeared as a side effect. Disopyramide was thus changed to pirmenol. The trough level of pirmenol was 2.1μg/mL at seven days after starting pirmenol therapy at the dose of 300 mg/day, and the dose was there after decreased to 200mg/day. About two weeks after pirmenol therapy was started, liver injury was observed. At approximately 30 days after pirmenol administration was stopped, the liver function returned to a normal level.On the other hand, according to recent reports pirmenol was suggested to show a high level in the liver. The reported levels of pirmenol were also similar to for amiodarone and aprindine, which are both well known to induce side effect in the liver. Therefore, one of the reasons that pimenol induced liver injury may be due to its high levels in the liver.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"57 1","pages":"183-187"},"PeriodicalIF":0.0,"publicationDate":"2000-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72600476","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/JJPHCS1975.26.202
E. Negishi, Y. Nakajima, R. Endoh, Yasuhiko Yamada, Hitoshi Nakamura, Hitoshi Sato, T. Iga
An investigation of package inserts was performed for 794 oral prescription drugs, in order to assess the package inserts as an information resource regarding the timing of drug intake which is important for rational usage of medicine. As a result, the number of package inserts which described the proper timing of drug intake was only 157 (20%). The timings of drug intake could be classified into five categories, i.e., before a meal, immediately before a meal, immediately after a meal, after a meal and between meals (at a hunger state). Evidence for the timing of drug intake is written in only 9% of the package inserts. However, such evidence could be provided from interview forms and original articles for 24% and 44% of the drugs, respectively. Furthermore, most of the evidence for the timing of drug intake (94%) was shown to be meant for either the appropriate onset of therapeutic actions (58%) or the prevention of adverse reactions (36%). On the other hand, there was a clear tendency that more evidence is provided for drugs which were put on market more recently. From these results, the information only from package inserts was found to be insufficient for the rational usage of medicine and that the timing of drug intake should thus be explained to patients based on additional investigation from interview forms and original articles as described in this study in order to achieve an improved efficacy and safety of drug administration.
{"title":"Investigation of the Timing of Drug Intake Described in Package Inserts and Their Assessment with Respect to Rational Usage of Medicine","authors":"E. Negishi, Y. Nakajima, R. Endoh, Yasuhiko Yamada, Hitoshi Nakamura, Hitoshi Sato, T. Iga","doi":"10.5649/JJPHCS1975.26.202","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.26.202","url":null,"abstract":"An investigation of package inserts was performed for 794 oral prescription drugs, in order to assess the package inserts as an information resource regarding the timing of drug intake which is important for rational usage of medicine. As a result, the number of package inserts which described the proper timing of drug intake was only 157 (20%). The timings of drug intake could be classified into five categories, i.e., before a meal, immediately before a meal, immediately after a meal, after a meal and between meals (at a hunger state). Evidence for the timing of drug intake is written in only 9% of the package inserts. However, such evidence could be provided from interview forms and original articles for 24% and 44% of the drugs, respectively. Furthermore, most of the evidence for the timing of drug intake (94%) was shown to be meant for either the appropriate onset of therapeutic actions (58%) or the prevention of adverse reactions (36%). On the other hand, there was a clear tendency that more evidence is provided for drugs which were put on market more recently. From these results, the information only from package inserts was found to be insufficient for the rational usage of medicine and that the timing of drug intake should thus be explained to patients based on additional investigation from interview forms and original articles as described in this study in order to achieve an improved efficacy and safety of drug administration.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"124 1","pages":"202-206"},"PeriodicalIF":0.0,"publicationDate":"2000-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84912563","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/jjphcs1975.26.592
Takanori Miura, R. Kojima, Kazumasa Negita, Akio Katsumi, M. Ota, E. Yoneyama, T. Saitake, M. Mizutani, F. Takatsu, Yoshio Suzuki
Our previous studies suggested that menopause and a preexisting abnormal renal function may be risk factors leading to an increased occurrence of adverse reactions to contrast media. The present prospective clinical study was carried out to examine the effect of pretreatment with domperidone, etizolam and fluid replacement on a reduction of adverse reactions induced by contrast media in patients with these risk factors.In 3009 patients undergoing a coronary angiography examination, a randomized and controlled trial was conducted from April 1, 1998 to March 31, 2000. Perimenopausal patients (n=732) were divided into two groups including: a post menopause group within 5 years (n=265) and over 5 years (n=467). Next, these two groups were further individually classified into two groups including: a domperidone and etizolam pretreated patient group (within 5 years; 132 patients, over 5 years; 233 patients) and a non-treated patient group (within 5 years; 133 patients, over 5 years; 234 patients). In addition, patients (n=83) with an abnormal renal function (serum creatinine level of 1.5 mg/mL or greater) were also divided into a pretreatment with fluid replacement group (42 patients) and a non-treatment group (41 patients).The overall incidence of adverse reactions of contrast media was 11.2%, and there were no serve or fatal adverse reactions. In female patients, the predominant adverse reactions included headache, vomiting, dizziness, glow and palpitations. Pretreatment with a combination of domperidone and etizolam suppressed the adverse reactions due to contrast media by 77% in post menopausal patients within five years. On the other hand, in postmenopausal patients (n=467) over five years, the pretreatment (n=233) did not effectively reduce the side effects of contrast media. In addition, in patients with an abnormal renal function, the incidence (16.7%) of adverse reactions in fluid replacement pretreatment-patients was significantly less than that (51.2%) in the non-treated patients.These results indicate that the pretreatment of patients with domperidone, etizolam and fluid replacement was found to successfully reduce the incidence of adverse reactions induced by contract media in patients with risk factors such as menopause and a preexisting abnormal renal function, respectively.
{"title":"Suppressive Effect by Pretreatment with Domperidone, Etizolam and Fluid Replacement of Adverse Reactions in Patients with a High-Risk of Side Effects Induced by Nonionic Contrast Media","authors":"Takanori Miura, R. Kojima, Kazumasa Negita, Akio Katsumi, M. Ota, E. Yoneyama, T. Saitake, M. Mizutani, F. Takatsu, Yoshio Suzuki","doi":"10.5649/jjphcs1975.26.592","DOIUrl":"https://doi.org/10.5649/jjphcs1975.26.592","url":null,"abstract":"Our previous studies suggested that menopause and a preexisting abnormal renal function may be risk factors leading to an increased occurrence of adverse reactions to contrast media. The present prospective clinical study was carried out to examine the effect of pretreatment with domperidone, etizolam and fluid replacement on a reduction of adverse reactions induced by contrast media in patients with these risk factors.In 3009 patients undergoing a coronary angiography examination, a randomized and controlled trial was conducted from April 1, 1998 to March 31, 2000. Perimenopausal patients (n=732) were divided into two groups including: a post menopause group within 5 years (n=265) and over 5 years (n=467). Next, these two groups were further individually classified into two groups including: a domperidone and etizolam pretreated patient group (within 5 years; 132 patients, over 5 years; 233 patients) and a non-treated patient group (within 5 years; 133 patients, over 5 years; 234 patients). In addition, patients (n=83) with an abnormal renal function (serum creatinine level of 1.5 mg/mL or greater) were also divided into a pretreatment with fluid replacement group (42 patients) and a non-treatment group (41 patients).The overall incidence of adverse reactions of contrast media was 11.2%, and there were no serve or fatal adverse reactions. In female patients, the predominant adverse reactions included headache, vomiting, dizziness, glow and palpitations. Pretreatment with a combination of domperidone and etizolam suppressed the adverse reactions due to contrast media by 77% in post menopausal patients within five years. On the other hand, in postmenopausal patients (n=467) over five years, the pretreatment (n=233) did not effectively reduce the side effects of contrast media. In addition, in patients with an abnormal renal function, the incidence (16.7%) of adverse reactions in fluid replacement pretreatment-patients was significantly less than that (51.2%) in the non-treated patients.These results indicate that the pretreatment of patients with domperidone, etizolam and fluid replacement was found to successfully reduce the incidence of adverse reactions induced by contract media in patients with risk factors such as menopause and a preexisting abnormal renal function, respectively.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"70 1","pages":"592-600"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73951944","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/jjphcs1975.26.44
M. Hozumi, M. Mizugaki, N. Satoh, T. Tadano, K. Kisara
( Received April 23, 1999 Accepted October 27, 1999 ) The pharmacological spectrum of triazolam (TZ), estazolam (ES) and zopiclone (ZP) in mice given benzodiazepine receptor agonists (BZ-RAs) by i.p. injection were investigated. The altertness, grooming, grip strength and locomotor activity assessed by Irwin's method were suppressed at 30 min after the injection of these drugs. In contrast, the injection of these drugs induced a head-twitch response, which is regarded as an experimental model for hallucination. These behavioral changes induced by TZ, ES and ZP with respect to the monoaminergic effect on behavioral pharmacology are also discussed.
{"title":"Pharmacological Effects of Benzodiazepine Receptor Agonist on the General Behavior in Mice.","authors":"M. Hozumi, M. Mizugaki, N. Satoh, T. Tadano, K. Kisara","doi":"10.5649/jjphcs1975.26.44","DOIUrl":"https://doi.org/10.5649/jjphcs1975.26.44","url":null,"abstract":"( Received April 23, 1999 Accepted October 27, 1999 ) The pharmacological spectrum of triazolam (TZ), estazolam (ES) and zopiclone (ZP) in mice given benzodiazepine receptor agonists (BZ-RAs) by i.p. injection were investigated. The altertness, grooming, grip strength and locomotor activity assessed by Irwin's method were suppressed at 30 min after the injection of these drugs. In contrast, the injection of these drugs induced a head-twitch response, which is regarded as an experimental model for hallucination. These behavioral changes induced by TZ, ES and ZP with respect to the monoaminergic effect on behavioral pharmacology are also discussed.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"42 1","pages":"44-51"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89725605","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 : 1999-12-10DOI: 10.5649/JJPHCS1975.25.608
T. Toyoguchi, M. Ebihara, F. Ojima, J. Hosoya, Y. Nakagawa
Abstract-Vancomycin hydrochloride (VCM) has a potent bactericidal activity against Gram positive bacteria, especially, Methicillin-resistant Staphylococcus aureus (MRSA). In the clinical situation, patients infected with not only with MRSA, but also with Gram negative bacterium or fungi are encountered. Because VCM has an adverse reaction of nephrotoxicity, we examined the nephrotoxicity and drug interactions of VCM and some antibiotics and antifungus agents in rabbits. We have already reported on the attenuation of nephrotoxicity by VCM with imipenem/cilastatin sodium, flomoxef sodium, fosfomycin sodium or minocycline hydrochloride, but no attenuation with ceftazidime, cefpimizole sodium or fluconazol. In this study, we investigated the renal function and VCM clearance in MRSA-infected patients, and compared our findings with those in the patients coadministered antimicrobial agents which decreased the nephrotoxicity of VCM in rabbits (decreasing group, n=23) and the patients coadministered the drugs which didn't decrease the nephrotoxicity in rabbits or administered VCM alone (non-decreasing group, n=22). No significant differences were observed regarding age, serum creatinine, BUN, serum potassium, total protein, albumin, WBC and CRP at the starting time of VCM-treatment, VCM doses, period of VCM treatment, and serum VCM concentrations (peak, trough) between the decreasing group and the non-decreasing group. However, the serum creatinine levels in the nondecreasing group were significantly higher than those of the decreasing group at 2 weeks after the VCM theatment. In addition, the serum creatinine levels at the end of the VCM treatment in the non-decreasing group were higher than those of the dereasing group.However, no significant differences were observed in the VCM clearance and BUN between the decreasing group and the non-decreasing group, even though the serum creatinine in the nondecreasing group significantly increased. The high ratio of cancer in our patients (decreasing group n=12, non-decreasing group n=15) may have influenced our resuls. Further investigations are needed to estimate whether or not antimicrobial agents may influence the renal functions in VCM administered patients.
{"title":"Effects of Antimicrobial Agents on Renal Function in Patients Administered Vancomycin Hydrochloride","authors":"T. Toyoguchi, M. Ebihara, F. Ojima, J. Hosoya, Y. Nakagawa","doi":"10.5649/JJPHCS1975.25.608","DOIUrl":"https://doi.org/10.5649/JJPHCS1975.25.608","url":null,"abstract":"Abstract-Vancomycin hydrochloride (VCM) has a potent bactericidal activity against Gram positive bacteria, especially, Methicillin-resistant Staphylococcus aureus (MRSA). In the clinical situation, patients infected with not only with MRSA, but also with Gram negative bacterium or fungi are encountered. Because VCM has an adverse reaction of nephrotoxicity, we examined the nephrotoxicity and drug interactions of VCM and some antibiotics and antifungus agents in rabbits. We have already reported on the attenuation of nephrotoxicity by VCM with imipenem/cilastatin sodium, flomoxef sodium, fosfomycin sodium or minocycline hydrochloride, but no attenuation with ceftazidime, cefpimizole sodium or fluconazol. In this study, we investigated the renal function and VCM clearance in MRSA-infected patients, and compared our findings with those in the patients coadministered antimicrobial agents which decreased the nephrotoxicity of VCM in rabbits (decreasing group, n=23) and the patients coadministered the drugs which didn't decrease the nephrotoxicity in rabbits or administered VCM alone (non-decreasing group, n=22). No significant differences were observed regarding age, serum creatinine, BUN, serum potassium, total protein, albumin, WBC and CRP at the starting time of VCM-treatment, VCM doses, period of VCM treatment, and serum VCM concentrations (peak, trough) between the decreasing group and the non-decreasing group. However, the serum creatinine levels in the nondecreasing group were significantly higher than those of the decreasing group at 2 weeks after the VCM theatment. In addition, the serum creatinine levels at the end of the VCM treatment in the non-decreasing group were higher than those of the dereasing group.However, no significant differences were observed in the VCM clearance and BUN between the decreasing group and the non-decreasing group, even though the serum creatinine in the nondecreasing group significantly increased. The high ratio of cancer in our patients (decreasing group n=12, non-decreasing group n=15) may have influenced our resuls. Further investigations are needed to estimate whether or not antimicrobial agents may influence the renal functions in VCM administered patients.","PeriodicalId":17399,"journal":{"name":"Journal of the Nippon Hospital Pharmacists Association","volume":"29 1","pages":"608-613"},"PeriodicalIF":0.0,"publicationDate":"1999-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81105818","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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