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慢性腎臓病患者への薬物至適投与 : 新たな展開
http://hdl.handle.net/2298/33361
http://hdl.handle.net/2298/33361f8f6651d-f8fb-4bcd-9827-93e73742b164
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
0031-6903v132_461-470.pdf (684.3 kB)
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| Item type | 学術雑誌論文 / Journal Article(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2015-10-27 | |||||
| タイトル | ||||||
| タイトル | 慢性腎臓病患者への薬物至適投与 : 新たな展開 | |||||
| 言語 | ||||||
| 言語 | jpn | |||||
| キーワード | ||||||
| 主題 | chronic kidney disease, dosage adjustment, active metabolite, non-renal clearance, cytochrome P450, efflux transporter | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | journal article | |||||
| 著者 |
平田, 純生
× 平田, 純生 |
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| 別言語の著者 |
Hirata, Sumio
× Hirata, Sumio |
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| 内容記述 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | The kidney is the most important organ for the excretion of drugs. It was previously thought that appropriate dosages of these drugs could be easily estimated by evaluating the kidney function of patients and the excretion rate of the drug. However, the pharmacokinetic characteristics of patients with kidney disease are as follows: 1) Active metabolites with a higher polarity can accumulate, which can induce unpredictable adverse effects. For example, over sedation with morphine or the development of the fatal toxic syndrome in the case of allopulinol are due to the accumulation of active metabolites derived from these drugs. 2) Although the renal excretion rate of acetoaminophen is only less than 5%, the accumulation of its glucuronide conjugate during multiple dosing in patients with kidney failure may induce high serum acetoaminophen trough levels via the entero-hepatic circulation. 3) Although the renal excretion rate of the drugs are negligible, a remarkable increase in the serum levels of certain drugs were observed in patients with end stage kidney disease, suggesting a significant reduction in non-renal clearance probably by the accumulation of uremic toxins. For drugs that are likely to be administered to patients with kidney disease, even including drugs that are not excreted by the kidney, a full pharmacokinetic study should be conducted in patients and the results carefully assessed. Information on dosing adjustments for impaired kidney function based on estimated glomerular filtration rates should then be clearly stated in the package insert of the drugs. | |||||
| 書誌情報 |
藥學雑誌 巻 132, 号 4, p. 461-470, 発行年 2012 |
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| ISSN | ||||||
| 収録物識別子 | 00316903 | |||||
| 書誌レコードID | ||||||
| 収録物識別子タイプ | NCID | |||||
| 収録物識別子 | AN00284903 | |||||
| DOI | ||||||
| 関連タイプ | isIdenticalTo | |||||
| 関連識別子 | 10.1248/yakushi.132.461 | |||||
| 権利 | ||||||
| 権利情報 | © 2012 The Pharmaceutical Society of Japan | |||||
| フォーマット | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | application/pdf | |||||
| 形態 | ||||||
| 値 | 684305 bytes | |||||
| 著者版フラグ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| 日本十進分類法 | ||||||
| 主題Scheme | NDC | |||||
| 主題 | 499 | |||||
| その他の言語のタイトル | ||||||
| その他のタイトル | Appropriate Pharmacotherapy in Patients with Chronic Kidney Disease : New Approach | |||||
| タイトル（ヨミ） | ||||||
| その他のタイトル | マンセイ ジンゾウビョウ カンジャ ヘノ ヤクブツ シテキ トウヨ : アラタナ テンカイ | |||||
| 出版者 | ||||||
| 出版者 | 日本薬学会 | |||||
| 資源タイプ | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 論文(Article) | |||||
| 資源タイプ・ローカル | ||||||
| 値 | 雑誌掲載論文 | |||||
| 資源タイプ・NII | ||||||
| 値 | Journal Article | |||||
| 資源タイプ・DCMI | ||||||
| 値 | text | |||||
| 資源タイプ・ローカル表示コード | ||||||
| 値 | 01 | |||||
| URL | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | https://www.jstage.jst.go.jp/article/yakushi/132/4/132_4_461/_article/-char/ja/ | |||||
| コメント | ||||||
| 値 | 【著者所属】熊本大学薬学部附属育薬フロンティアセンター臨床薬理学分野 | |||||
