Updated on 2021/12/21

写真a

 
NAKURA Hironori
 
Organization
Faculty of Medicine, Dentistry and Pharmaceutical Sciences Professor
Position
Professor
External link

Degree

  • 博士(薬学) ( 昭和大学 )

Research Interests

  • Clinical Pharmacy

  • Emergency Pharmaceutics

  • Disaster Pharmaceutics

 

Papers

  • Administration of Kampo medicine through a tube at an advanced critical care center.

    Takahiro Niimura, Yoshito Zamami, Toru Imai, Tsuyoshi Ito, Hidenori Sagara, Hichiya Hiroyuki, Satoru Esumi, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Manabu Amano, Naomi Kurata, Yoshihisa Kitamura, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa

    The journal of medical investigation : JMI   65 ( 1.2 )   32 - 36   2018

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    n emergency and critical care medical centers, tube administration is employed for patients who have difficulty swallowing oral drugs owing to decreased consciousness or mechanical ventilation. However, tube clogging due to drug injection is a concern. We compared the crushing method with the simple suspension method for the passage of amlodipine, an antihypertensive drug, in combination with rikkunshito, which has been used to treat upper gastrointestinal disorders such as functional dyspepsia and gastroesophageal reflux in emergency and critical care medical centers, to ascertain the effect of Kampo products on the passage of other drugs during tube administration. When the crushing method was employed, poorly water-soluble solid products were formed, while a uniformly dispersed suspension was obtained using the simple suspension method. In addition, the passage rate of amlodipine through the tube was 64% and 93% in the crushing and simple suspension methods, respectively, thereby indicating that the simple suspension method provided more favorable than the crushing method. The results of this study suggested that the passage rate of amlodipine for patients who received Kampo products concurrently was higher when the simple suspension method was used, and an appropriate drug amount might well be able to administered to patients using this method. J. Med. Invest. 65:32-36, February, 2018.

    DOI: 10.2152/jmi.65.32

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  • Evaluation of the Benefits of De-Escalation for Patients with Sepsis in the Emergency Intensive Care Unit. International journal

    Takahiro Niimura, Yoshito Zamami, Toru Imai, Kanako Nagao, Masafumi Kayano, Hidenori Sagara, Mitsuhiro Goda, Naoto Okada, Masayuki Chuma, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Tadashi Koga, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa

    Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques   21 ( 1 )   54 - 59   2018

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    PURPOSE: Although the 2016 Japanese guidelines for the management of sepsis recommend de-escalation of treatment after identification of the causative pathogen, adherence to this practice remain unknown. The objective of this study was to evaluate the benefits of de-escalating treatment for sepsis patients at an advanced critical care and emergency medical centre. METHODS: Based on electronic patient information, 85 patients who were transported to the centre by ambulance, and diagnosed with sepsis between January 2008 and September 2013 were enrolled and evaluated. Patients were divided into two groups with and without de-escalation, and comparisons were conducted for several variables, including length of hospital stay, and length of antibiotic administration. Two types of subgroup analysis were conducted between patients with septic shock or positive blood cultures. Statistical analysis was conducted using chi-square and Mann-Whitney U tests. RESULTS: The length of hospital stay after diagnosis was significantly shorter for the de-escalation group than for the non-de-escalation group. In the subgroup analysis, de-escalation for blood culture-positive patients was beneficial in terms of the length of hospital stay and length of antibiotic administration. CONCLUSIONS: The findings of this study suggest that sepsis treatment de-escalation is beneficial for treatment efficacy and appropriate use of antibiotics. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.

    DOI: 10.18433/jpps29737

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  • Meta-analysis of the efficacies of amiodarone and nifekalant in shock-resistant ventricular fibrillation and pulseless ventricular tachycardia. International journal

    Shiho Sato, Yoshito Zamami, Toru Imai, Satoshi Tanaka, Toshihiro Koyama, Takahiro Niimura, Masayuki Chuma, Tadashi Koga, Kenshi Takechi, Yasuko Kurata, Yutaka Kondo, Yuki Izawa-Ishizawa, Toshiaki Sendo, Hironori Nakura, Keisuke Ishizawa

    Scientific reports   7 ( 1 )   12683 - 12683   2017.10

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    Amiodarone (AMD) and nifekalant (NIF) are used in the treatment of ventricular fibrillation or tachycardia; however, only few studies have been conducted on their efficacies. Therefore, a meta-analysis was conducted. Relevant sources were identified from PubMed, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi. The outcomes were short-term and long-term survival in patients with shock-resistant ventricular fibrillation /pulseless ventricular tachycardia. Thirty-three studies were analysed. The results showed that, compared to the control treatment, AMD did not improve short-term survival (odds ratio (OR): 1.25, 95% confidence interval (CI): 0.91-1.71) or long-term survival (OR: 1.00, 95% CI: 0.63-1.57). However, compared to the control treatment, NIF significantly improved short-term survival (OR: 3.23, 95% CI: 2.21-4.72) and long-term survival (OR: 1.88, 95% CI: 1.36-2.59). No significant difference was observed in short-term survival (OR: 0.85, 95% CI: 0.63-1.15) or long-term survival (OR: 1.25, 95% CI: 0.67-2.31) between AMD- and NIF-treated patients. The results suggest that NIF is beneficial for short-term and long-term survival in shock-resistant ventricular fibrillation/pulseless ventricular tachycardia; however, the efficacy of AMD in either outcome is not clear.

    DOI: 10.1038/s41598-017-13073-0

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  • Pharmaceutical Education Focused on Pharmacotherapy in Emergency Medical Care.

    Yoshito Zamami, Toshihiro Koyama, Toru Imai, Akane Takemoto, Hidenori Sagara, Toshiaki Sendo, Hironori Nakura

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   136 ( 7 )   987 - 91   2016

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    Pharmacists are expected to be active members of the healthcare team in emergency medicine, because many pharmaceuticals are administered to patients with life-threatening conditions. However, adequate education for pharmacists and pharmacy students is not provided. The "Emergency Pharmaceutical Sciences" course was introduced for the first time in Japan by the Department of Pharmacy, Okayama University, to offer advanced education in emergency medicine and research related to critical care. We offer an emergency pharmaceutical training program with high-performance simulators and have succeeded in improving the clinical skills and confidence of pharmacy students. In this review, we introduce our activities intended to mold pharmacy students into emergency pharmacists who can contribute to emergency medicine.

    DOI: 10.1248/yakushi.15-00286-4

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  • Possibility of Pharmacist in Emergency Medical Care: To Bring Up a Familiar Pharmacist for Emergency Care by Fusing Clinical Pharmacist Activity and University Education.

    Yoshito Zamami, Toshihiro Koyama, Hironori Nakura, Shuichi Enomoto

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   136 ( 7 )   965 - 965   2016

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  • [Role of pharmacists in disaster medicine: proposal based on relief efforts during the 2011 earthquake in east Japan].

    Shigeo Hirokawa, Hironori Nakura, Takahiko Norose

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   134 ( 1 )   1 - 2   2014

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  • [Role of pharmacists in disaster medicine: required knowledge and skills].

    Hironori Nakura

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   134 ( 1 )   3 - 6   2014

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    Immediately after the Great East Japan Earthquake of March 2011, Okayama University dispatched a medical assistance team based on the request of Iwate Prefecture. The first team was followed by 12 medical teams. I was one of the members of the fourth and fifth medical teams sent to Rikuzen-takata and Ofunato for a week beginning March 16th to support medical relief operations as a pharmacist during the sub-acute phase of the disaster. As a member of the team at the temporary clinic in Rikuzen-takata, pharmacists such as myself required physical assessment skills to perform related tasks, along with expertise in drug dispensing and consultation. In my next medical team, which headed the pneumonia unit at Oofunato Hospital, I played a critical role in the effective use of medicine reserved/provided for disasters, including antibiotics. Throughout the relief operations, strong clinical reasoning and decision making, as well as good teamwork, proved vital, especially in emergency situations. For future community medical systems, emergency/disaster medicine should be included in pharmacy education. The School of Pharmacy at Okayama University will establish emergency medicine program in the next school year, in cooperation with the Medical, Dental and Health Care Departments.

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  • [Usefulness of group work as a teaching strategy for long-term practical training in the 6-year pharmaceutical education].

    Kazuko Kubo, Hiromi Okazaki, Hiroki Ichikawa, Shigeki Nishihara, Hideki Nawa, Masatoshi Okazaki, Yoichi Kawasaki, Hironori Nakura, Hisashi Matsunaga, Toshiaki Sendo

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   132 ( 12 )   1467 - 76   2012

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    At the initiation of long-term practical training in the 6-year pharmaceutical education, there are many issues to be solved. For example, it is necessary for teaching pharmacists, who are in charge of both staffing and teaching pharmacy students, to manage their workload with other staff pharmacists. To overcome this situation and to improve the motivation of teaching pharmacists towards student practical training, we twice held group work (GW) sessions for teaching pharmacists, and then evaluated whether such training was effective for their understanding of the Model Core Curriculum for Practical Training and for promoting a higher level of motivation. During the two-day GW discussions, teaching pharmacists, who work daily in the dispensing area, were separated into two groups to discuss teaching skills. A questionnaire survey was completed by participants before and after each GW session. According to the survey, more than 90% of the pharmacists had a higher motivation level for practical training after the sessions. Particularly in the second GW training, the response rate of "being actively involved" improved from 40% to 70%. Furthermore, "The Educational Evaluation Testing" was conducted, which confirmed the increased participant comprehension. The median scores of the comprehensive exams significantly (p<0.01) improved in twice GW, respectively. Therefore, we conclude that GW sessions are a useful tool for both improving professional knowledge about the Model Core Curriculum and motivating teaching pharmacists involved in the practical training of students. We hope that this exercise will lead to higher student motivation and satisfaction during their practical training.

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  • [Clinical usefulness of the new Japanese glomerular filtration rate equation for initial and individualized dosage adjustment concentrations of vancomycin].

    Naoki Kuroda, Satoshi Ueshima, Tomoaki Sato, Eriko Kobiki, Yoichi Kawasaki, Hisashi Matsunaga, Hironori Nakura, Toshiaki Sendo

    Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan   132 ( 1 )   125 - 33   2012

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    To clarify whether the new Japanese glomerular filtration rate (eGFR) equation was able to accurately determine the initial and individualized dosage adjustment concentrations of vancomycin (VCM), the predictive performance for VCM concentrations using the eGFR and Cockcroft-Gault (CG) equations was compared. Data were retrospectively collected from clinical records of 90 patients with MRSA infection whose trough and peak VCM concentrations had been determined. The predicted VCM initial and individualized dosage adjustment concentrations were performed with the 2-compartment linear model using pharmacokinetic parameter means and their individual values via Bayesian estimation, respectively. The prediction error (PE) and its absolute value (APE) between the observed and predicted VCM concentrations were calculated as indices of bias and accuracy in predictive performance, respectively. In the initial dosage adjustment of VCM, the PE value, calculated with the eGFR equation in trough and peak VCM concentrations of patients whose BMI were 18.5 kg/m(2) and higher, was significantly smaller than that calculated with the CG equation. In particular, both PE and APE values obtained from the eGFR calculated concentrations from nonelderly patients (younger than 65 years old) were significantly improved compared with those from the CG equation. In the individualized dosage adjustment of VCM, the eGFR equation gave a significantly smaller PE value in nonelderly patients' trough concentrations than the CG equation. These findings provide useful information for adjusting the VCM dosage to achieve optimal therapeutic efficacy in patients with MRSA infection.

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  • Regio- and stereoselective oxidation of propranolol enantiomers by human CYP2D6, cynomolgus monkey CYP2D17 and marmoset CYP2D19. International journal

    Shizuo Narimatsu, Toshiyuki Nakata, Takeshi Shimizudani, Kenjiro Nagaoka, Hironori Nakura, Kazufumi Masuda, Takashi Katsu, Akiko Koeda, Shinsaku Naito, Shigeru Yamano, Atsuro Miyata, Nobumitsu Hanioka

    Chemico-biological interactions   189 ( 3 )   146 - 52   2011.2

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    Toxic and pharmacokinetic profiles of drug candidates are evaluated in vivo often using monkeys as experimental animals, and the data obtained are extrapolated to humans. Well understanding physiological properties, including drug-metabolizing enzymes, of monkeys should increase the accuracy of the extrapolation. The present study was performed to compare regio- and stereoselectivity in the oxidation of propranolol (PL), a chiral substrate, by cytochrome P450 2D (CYP2D) enzymes among humans, cynomolgus monkeys and marmosets. Complimentary DNAs encoding human CYP2D6, cynomolgus monkey CYP2D17 and marmoset CYP2D19 were cloned, and their proteins expressed in a yeast cell expression system. The regio- and stereoselective oxidation of PL enantiomers by yeast cell microsomal fractions were compared. In terms of efficiency of expression in the system, the holo-proteins ranked CYP2D6=CYP2D17>>CYP2D19. This may be caused by the bulky side chain of the amino acid residue at position 119 (leucine for CYP2D19 vs. valine for CYP2D6 and CYP2D17), which can disturb the incorporation of the heme moiety into the active-site cavity. PL enantiomers were oxidized by all of the enzymes mainly into 4-hydroxyproranolol (4-OH-PL), followed by 5-OH-PL and N-desisopropylpropranolol (NDP). In the kinetic analysis, apparent K(m) values were commonly in the μM range and substrate enantioselectivity of R-PL<S-PL was observed in both K(m) and V(max) values for the formation of the three metabolites from PL enantiomers. The activity to produce NDP tended to be higher for the monkey enzymes, particularly CYP2D17, than for the human enzyme. These results indicate that in the oxidation of PL enantiomers by CYP2D enzymes, stereoselectivity is similar but regioselectivity is different between humans and monkeys.

    DOI: 10.1016/j.cbi.2010.12.014

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  • Separate evaluation of intestinal and hepatic metabolism of three benzodiazepines in rats with cannulated portal and jugular veins: comparison with the profile in non-cannulated mice. International journal

    J Kuze, T Mutoh, T Takenaka, K Morisaki, H Nakura, N Hanioka, S Narimatsu

    Xenobiotica; the fate of foreign compounds in biological systems   39 ( 11 )   871 - 80   2009.11

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    Pharmacokinetic analyses of three kinds of benzodiazepines--midazolam (MDZ), triazolam (TRZ) and alprezolam (APZ)--were performed in rats with cannulated portal and jugular veins. Each drug was administered to the double-cannulated rats, and pharmacokinetic data for the parent drugs and their 1'- and 4-hydroxylated metabolites were compared with those obtained in non-cannulated mice. In bioavailability, the drugs ranked APZ >> TRZ = MDZ in rats, and APZ > TRZ >> MDZ in mice, with the values for MDZ remarkably different between rats and mice (19% in rats versus 2.3% in mice). In contrast, hepatic availability (Fh) was similar (APZ > TRZ > MDZ) in both species. Highly significant relationships were found between the ratio of the area under the plasma concentration-time curve (AUC) for the parent drugs in portal blood (AUC(por)) to that in systemic blood (AUC(sys)) and Fh in rats and mice. The double-cannulated rat is useful for estimating the hepatic availability of drug candidates by determining the AUC values for the parent drugs in portal and systemic blood samples.

    DOI: 10.3109/00498250903215382

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  • The mechanism causing the difference in kinetic properties between rat CYP2D4 and human CYP2D6 in the oxidation of dextromethorphan and bufuralol. International journal

    Shizuo Narimatsu, Daichi Kazamori, Kazufumi Masuda, Takashi Katsu, Yoshihiko Funae, Shinsaku Naito, Hironori Nakura, Shigeru Yamano, Nobumitsu Hanioka

    Biochemical pharmacology   77 ( 5 )   920 - 31   2009.3

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    The capacity to oxidize bufuralol (BF) and dextromethorphan (DEX) was compared kinetically between human CYP2D6 and four rat CYP2D (CYP2D1, -2D2, -2D3 and -2D4) isoenzymes in a yeast cell expression system. In BF 1''-hydroxylation and DEX O-demethylation, only CYP2D4 showed hook-shaped Eadie-Hofstee plots, the other four CYP2D enzymes exhibiting linear plots. In DEX N-demethylation, rat CYP2D2 did not show any detectable activity under the conditions used, whereas the other four enzymes yielded linear Eadie-Hofstee plots. To elucidate the mechanisms causing the nonlinear kinetics, four CYP2D4 mutants, CYP2D4-F109I, -V123F, -L216F and -A486F, were prepared. CYP2D4-V123F, -L216F and -A486F yielded linear or linear-like Eadie-Hofstee plots for BF 1''-hydroxylation, whereas only CYP2D4-A486F exhibited linear plots for DEX O-demethylation. The substitution of Phe-109 by isoleucine did not have any effect on the oxidative capacity of CYP2D4 for either BF or DEX. These results suggest that the introduction of phenylalanine in the active-site cavity of CYP2D4 simplifies complicated interactions between the substrates and the amino acid residues, but the mechanisms causing the simplification differ between BF and DEX.

    DOI: 10.1016/j.bcp.2008.11.006

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  • Toxin production by Aeromonas sobria in natural environments: river water vs. seawater.

    Rasel Khan, Eizo Takahashi, Hironori Nakura, Mohammad Ansaruzzaman, Sukalyani Banik, Thandavarayan Ramamurthy, Keinosuke Okamoto

    Acta medica Okayama   62 ( 6 )   363 - 71   2008.12

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    Aeromonas are water-borne pathogens. They are halotolerant, which means that they can survive in environments whose salt content corresponds to that of seawater (3.0% NaCl). However, the presence of Aeromonas in seawater is extremely rare compared with that in river water. In this study, we tested the ability of Aeromonas sobria to produce toxins in river water and seawater. First, we cultured A. sobria on skim milk agar plates supplemented with either river water (SARW) or seawater (SASW). The bacteria grew on both plates. A clear zone around the bacteria was generated in SARW. However, such a zone was not observed in SASW, suggesting that proteases were not generated in SASW. Subsequently, we cultured A. sobria in a nutrient broth supplemented with either river water (NRW) or with seawater (NSW), and examined the protease activity of their culture supernatants. The protease activity of the culture supernatant from NSW was extremely low compared to that from NRW. The immunoblotting analysis showed that serine protease (ASP) was not produced by the culture in NSW. By contrast, aerolysin-like hemolysin was produced in all conditions examined in this study. This indicates that the salinity of water is deeply involved in the production of ASP by A. sobria.

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  • CYP3A activity in European American and Japanese men using midazolam as an in vivo probe. International journal

    T Tateishi, M Watanabe, H Nakura, M Asoh, H Shirai, Y Mizorogi, S Kobayashi, K E Thummel, G R Wilkinson

    Clinical pharmacology and therapeutics   69 ( 5 )   333 - 9   2001.5

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    OBJECTIVE: To investigate putative differences in CYP3A activity between European American and Japanese subjects using midazolam as an in vivo probe. METHODS: Midazolam was administered orally (2 mg) to 22 young healthy Japanese men and, on a separate occasion, to 19 of these by the intravenous route (1 mg). The disposition of the drug and its 1'-hydroxy metabolite were determined and compared with data collected in a similar fashion in 20 young healthy European American men. RESULTS: Plasma concentrations of midazolam, especially those attained soon after drug administration, were higher after intravenous injection in Japanese subjects than those in European American men. This observation was associated with smaller initial (2.5-fold) and steady-state (1.8-fold) volumes of distribution for the drug; normalization for body weight only modestly reduced these differences. The systemic clearance value of midazolam was 25% lower (P < .03) in Japanese subjects, but this difference was not apparent after accounting for the smaller body weights of that group. No statistical differences were noted in the elimination half-life (t 1/2) of midazolam between European American and Japanese subjects. Much greater interindividual variability was observed after oral administration compared with intravenous administration, but significant differences were not found between the 2 groups with respect to the maximum midazolam plasma level or its oral clearance. Absolute oral bioavailability and its associated gastrointestinal and hepatic extraction ratios also showed no statistically significant interracial differences. CONCLUSIONS: On average, hepatic CYP3A, as measured by the metabolism of midazolam, is lower in young healthy Japanese men compared with similar European Americans. However, there is considerable interindividual variability, and body size appears to be an important determinant. After oral administration, even greater variability in the plasma level-time profile of midazolam is present, and no statistically significant or clinically important interracial/ethnic difference is present. Possibly because of smaller body mass and differences in body composition, midazolam has a smaller distribution volume(s) in Japanese men than in European American men that might be an important factor when drugs are administered intravenously.

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  • Ursodeoxycholic acid prevents hepatic cytochrome P450 isozyme reduction in rats with deoxycholic acid-induced liver injury. International journal

    M Tanaka, H Nakura, T Tateishi, M Watanabe, S Nakaya, T Kumai, S Kobayashi

    Journal of hepatology   31 ( 2 )   263 - 70   1999.8

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    BACKGROUND/AIMS: Hydrophobic bile acids, such as deoxycholic acid produce cholestatic liver injury. Ursodeoxycholic acid has been shown to be useful in the treatment of cholestatic liver disease. METHODS: In this study, we investigated the effects of deoxycholic acid or ursodeoxycholic acid (1% of diet, for 14 days) and their combination (1% each) on expression of hepatic cytochrome P450 isozymes, their related enzyme activities and mRNA level in rats. RESULTS: Adding 1% deoxycholic acid to chow caused a marked increase in serum total bilirubin (47-fold) and total bile acid (8-fold) concentrations and in alkaline phosphatase (2.5-fold, p<0.01) and alanine aminotransferase activities (23.5-fold, p<0.01). Adding the same dose of ursodeoxycholic acid along with the deoxycholic acid mitigated both the rise in serum total bilirubin and bile acid concentrations and that in alkaline phosphatase and alanine aminotransferase activities, although the use of ursodeoxycholic acid alone did not affect any of the above. Feeding 1% deoxycholic acid caused a decrease (48% of control) in total cytochrome P450 content in hepatic microsomes. Addition of 1% ursodeoxycholic acid along with the 1% deoxycholic acid completely prevented the decrease in total cytochrome P450 content. Feeding ursodeoxycholic acid alone did not affect the total cytochrome P450 content. The expression of cytochrome P450 2B1, 2E1, 3A2, 2C6, 2C11 and 4A1 proteins in hepatic microsomes was decreased by deoxycholic acid (44, 51, 23, 59, 30 and 74% of control, respectively). Likewise, the activities of cytochrome P450 2B1 (pentoxyresorufin O-depentylation), 2E1 (aniline p-hydroxylation) and 3A2 (testosterone 6beta-hydroxylation) isozymes and the 3A2 mRNA levels in liver were decreased by deoxycholic acid. Addition of 1% ursodeoxycholic acid to 1% deoxycholic acid also prevented the decrease in these cytochrome P450 proteins, related enzyme activities and mRNA levels in liver. CONCLUSIONS: These results indicate that, in rats with deoxycholic acid-induced liver injury, ursodeoxycholic acid prevents the decrease in hepatic cytochrome P450 isozymes and suggest that ursodeoxycholic acid is useful for the treatment of liver injury in terms of aiding the normalization of the hepatic drug-metabolizing system.

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  • Dihydropyrimidine dehydrogenase activity and fluorouracil pharmacokinetics with liver damage induced by bile duct ligation in rats. International journal

    T Tateishi, M Watanabe, H Nakura, M Tanaka, T Kumai, S F Sakata, N Tamaki, K Ogura, T Nishiyama, T Watabe, S Kobayashi

    Drug metabolism and disposition: the biological fate of chemicals   27 ( 6 )   651 - 4   1999.6

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    Hepatic metabolism is the main determinant in the pharmacokinetics of 5-fluorouracil (5-FU). Its disposition might be affected with liver dysfunction. In the present study, the influence of liver damage induced by bile duct ligation on dihydropyrimidine dehydrogenase (DPD), a rate-limiting enzyme in 5-FU catabolism, CYP2B, and 5-FU pharmacokinetics were compared in male Sprague-Dawley rats. After 3 weeks of the ligation in two different groups of animals for in vitro and pharmacokinetic experiments, significant increases in serum bilirubin level and spleen weight were found in both groups. No significant differences were noted in bilirubin level or spleen weight of the bile duct ligation group between the two experiment groups. In the in vitro experiment, DPD activity and protein levels determined by Western blot analysis in the bile duct ligation group were slightly but significantly greater than those of a sham-operated group, whereas CYP2B activity and protein level were significantly reduced. These findings were supported by mRNA levels of CYP2B and DPD. When 40 mg/kg 5-FU was administered i.v. in the pharmacokinetic experiment, no significant differences in pharmacokinetic parameters were found between the bile duct ligation and sham-operated groups. These results suggested that DPD activity and protein level were maintained and that 5-FU pharmacokinetics was not altered in the presence of liver damage accompanied by a significant reduction in CYP2B activity and protein level, supporting previous clinical studies showing that mild to moderate liver dysfunction does not affect 5-FU disposition.

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  • Multiple cytochrome P-450 subfamilies are co-induced with P-glycoprotein by both phenothiazine and 2-acetylaminofluorene in rats. International journal

    T Tateishi, H Nakura, M Asoh, M Watanabe, M Tanaka, T Kumai, S Kobayashi

    Cancer letters   138 ( 1-2 )   73 - 9   1999.4

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    We studied the effects of two P-glycoprotein (P-gp) inducers, 2-acetylaminofluorene (2-AAF) and phenothiazine (PTZ), administered intraperitoneally, on the activities and content of hepatic cytochrome P-450 (CYP) subfamilies in hepatic microsomes of Sprague-Dawley rats. After 4-day administration of 2-AAF or PTZ, the P-gp content was increased. The total CYP content after PTZ treatment was significantly increased compared with that of controls. The CYP1A, CYP2B and CYP3A2 contents were induced, while the CYP2C6, CYP2C11 and CYP2E1 contents remained unaffected. A marked increase in CYP1A1 was found after administration of each compound. Ethoxyresorufin O-deethylase, pentoxyresorufin O-deethylase, and testosterone 6beta hydroxylation activities showed a significant increase after both 2-AAF and PTZ treatments. In particular, ethoxyresorufin O-deethylase exhibited more than ten times greater activity than that of the controls after the treatments. These results suggest that P-gp inducers affect several CYP subfamilies in addition to CYP3A, which is reported to be up-regulated coordinately with P-gp by a CYP3A inducer.

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  • Ticlopidine decreases the in vivo activity of CYP2C19 as measured by omeprazole metabolism. International journal

    T Tateishi, T Kumai, M Watanabe, H Nakura, M Tanaka, S Kobayashi

    British journal of clinical pharmacology   47 ( 4 )   454 - 7   1999.4

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    AIMS: To examine the effect of ticlopidine administration on the activities CYP2C19 and CYP3 A in vivo using omeprazole as a model substrate. METHODS: A single dose of 40 mg omeprazole was administered orally with or without ticlopidine (300 mg daily for 6 days) to six Japanese extensive metabolisers with respect to CYP2C19. Blood samples were taken for the measurement of plasma concentrations of omeprazole, 5-hydroxyomeprazole and omeprazole sulphone. RESULTS: Ticlopidine administration increased omeprazole Cmax (1978+/-859/ 3442+/-569 (control phase/ticlopidine phase, nm )) and decreased the oral clearance of omeprazole (CL/F; 25.70+/-16. 17/10.76+/-1.16 (control phase/ticlopidine phase, l h-1 )) significantly. The 5-hydroxyomeprazole to omeprazole AUC ratio (0. 817+/-0.448/0.236+/-0.053 (control phase/ticlopidine phase)) and the 5-hydroxyomeprazole to omeprazole sulphone AUC ratio (1.114+/-0. 782/0.256+/-0.051 (control phase/ticlopidine phase)) were decreased significantly after ticlopidine administration. The decrease in omeprazole CL/F and the 5-hydroxyomeprazole to omeprazole AUC ratio correlated significantly with their respective absolute values when the drug was given alone. The decrease in CL/F following ticlopidine administration correlated with that in the 5-hydroxyomeprazole to omeprazole AUC ratio. CONCLUSIONS: These findings suggest that ticlopidine inhibited the in vivo activity of CYP2C19, but not, or to a lesser extent CYP3 A4, and that the magnitude of inhibition by ticlopidine is related to the in vivo activity of CYP2C19 before inhibition.

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  • Carbamazepine induces multiple cytochrome P450 subfamilies in rats. International journal

    T Tateishi, M Asoh, H Nakura, M Watanabe, M Tanaka, T Kumai, S Kobayashi

    Chemico-biological interactions   117 ( 3 )   257 - 68   1999.2

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    We compared the effect of three different doses (30, 60, and 100 mg/kg) of carbamazepine (CBZ) administered intraperitoneally for 1, 3, and 7 days on the activity and protein content of hepatic cytochrome P450 (CYP) subfamilies in Sprague-Dawley rats. After 3-day- and 7-day administration with CBZ, the total CYP content had increased in a dose-dependent fashion. Among six enzyme activities examined, only aniline hydroxylase activity remained unchanged after 7-day treatment with CBZ. Pentoxyresorufin O-deethylase activity showed the most significant increase and was induced up to 7 days in a time-dependent fashion. Pretreatment of rats with cycloheximide significantly suppressed the pentoxyresorufin O-deethylase induction by one dose of 100 mg/day CBZ. Immunoblot analysis showed a significant correlation between the protein content of each isoenzyme examined and its activity except CYP2E1 after 7-day treatment with CBZ. Similar results were obtained in the mRNA levels of CYP subfamilies. These results suggested that CBZ may induce multiple CYP subfamilies, except CYP2E1, and the activity and the protein content of CYP2B showed the greatest increase with increased CYP2B mRNA.

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  • Role of CYP3A in haloperidol N-dealkylation and pharmacokinetics in rats. International journal

    M Watanabe, T Tateishi, M Asoh, H Nakura, M Tanaka, T Kumai, S Kobayashi

    Fundamental & clinical pharmacology   13 ( 3 )   337 - 42   1999

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    Haloperidol (HP), an antipsychotic drug, is N-dealkylated by cytochrome P450 (CYP) to 4-fluorobenzoylpropionic acid (FBPA). The purpose of this study was to identify whether CYP3A metabolizes HP to FBPA in hepatic microsomes of rats and to investigate whether an inhibitor or an inducer of CYP3A affects HP pharmacokinetics in rats. The rate of FBPA formation was determined in hepatic microsomes from 8-week-old male Sprague-Dawley rats. Among several specific CYP isozyme inhibitors including troleandomycin (TAO), diethyldithiocarbamate, furafylline and quinine, only TAO showed marked inhibition of FBPA formation. Anti-rat CYP3A serum inhibited FBPA formation by 76.4%, while other anti-rat CYP sera (1A1, 1A2, 2B1, 2C11, 2E1) only slightly did. In a pharmacokinetic study, 8-week-old male Sprague-Dawley rats were given 0.5 mg/kg HP intravenously after treatment with 100 mg/kg erythromycin, a CYP3A inhibitor, or 80 mg/kg dexamethasone, a CYP3A inducer, intraperitoneally once a day for 7 days or 2 days, respectively or untreated. HP half-life was prolongated to 171% of the average control value by erythromycin and shortened to 49% of control by dexamethasone. HP clearance was reduced to 63% of control by erythromycin and was increased to 167% of control by dexamethasone. These results suggested that CYP3A mainly catalyzed HP to FBPA in rats, and the modification of this enzyme activity would affect the pharmacokinetics of HP.

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  • A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits. International journal

    T Tateishi, M Watanabe, H Nakura, M Tanaka, T Kumai, T Aoki, S Kobayashi

    Acta anaesthesiologica Scandinavica   42 ( 9 )   1028 - 32   1998.10

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    BACKGROUND: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1. METHODS: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation. RESULTS: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents. CONCLUSIONS: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.

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  • Reduced hepatic expression of CYP7A1 and CYP2C13 in rats with spontaneous hyperlipidaemia. International journal

    P J Brassil, K Debri, H Nakura, S Kobayashi, D S Davies, R J Edwards

    Biochemical pharmacology   56 ( 2 )   253 - 7   1998.7

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    A strain of hyperlipidaemic Sprague-Dawley (HSD) rat was compared with normal Sprague-Dawley (SD) rats for expression of cholesterol 7alpha-hydroxylase activity (CYP7A1) and other cytochrome P450 (P450) enzymes in liver. Hepatic microsomal CYP7A1 activity in male HSD rats was 2-3-fold lower than in male SD rats with CYP7A1 apoprotein levels being similarly reduced. CYP7A1 expression was subject to diurnal variation in HSD rats as found in SD rats. Treatment of HSD rats with cholestyramine caused an increase in hepatic microsomal cholesterol 7alpha-hydroxylase activity of 3.3-fold compared with a 3.5-fold increase in SD rats with similar changes in apoprotein levels. These results indicate that the lower activity in HSD rats is not due to a defect in the catalytic activity of the enzyme, regulation affecting diurnal variation or regulation through bile acid feedback inhibition. No difference between hepatic microsomal methoxyresorufin-O-demethylase, benzoxyresorufin-O-debenzylase or chlorzoxazone 6-hydroxylase activities in SD and HSD rats was found, nor was there any difference in the levels of CYP1A2, CYP2D1, CYP2E1, CYP3A1, CYP3A2 or NADPH cytochrome P450 reductase determined by immunoblotting using specific anti-peptide antibodies. However, unlike in male SD rats, CYP2C13 was absent in male HSD rats and this was associated with a two-fold reduction in testosterone 6beta-hydroxylase activity. In conclusion, while HSD rats do not have a general reduction in P450 levels, they do lack CYP2C13 and have lowered cholesterol 7alpha-hydroxylase activity, as a result of a reduced level of expression of the enzyme.

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  • Effects of anti-androgen treatment on the catecholamine synthetic pathway in the adrenal medulla of spontaneously hypertensive rats. International journal

    T Kumai, M Tanaka, T Tateishi, M Watanabe, H Nakura, M Asoh, S Kobayashi

    Naunyn-Schmiedeberg's archives of pharmacology   357 ( 6 )   620 - 4   1998.6

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    We investigated the effects of the antiandrogen flutamide on the activity of tyrosine hydroxylase, the levels of its encoding mRNA, and catecholamine levels in the adrenal medulla of male spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). Flutamide (30 mg/kg) was administered subcutaneously daily (between 9 and 15 weeks of age). The systolic blood pressure of flutamide-treated SHR rats was lower than that of control SHR. Epinephrine and norepinephrine levels, tyrosine hydroxylase activity, and the levels of encoding mRNA in the adrenal medulla were significantly lower in flutamide-treated SHR rats than in paired controls. Systolic blood pressure, epinephrine and norepinephrine levels, tyrosine hydroxylase activity, and encoding mRNA in the adrenal medulla of WKY rats showed no significant differences between flutamide-treated and control groups. These findings suggested that flutamide may have cardiovascular effects through alteration of the catecholamine synthetic pathway caused by removal of androgen receptor stimulation on the expression of tyrosine hydroxylase in the adrenal medulla of male SHR rats.

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  • Effect of hypoalbuminemia on the disposition of theophylline. Comparative study with Sprague-Dawley rats and a mutant Sprague-Dawley hyperlipidemic strain with hypoalbuminemia. International journal

    H Nakura, T Tateishi, M Watanabe, M Asoh, M Tanaka, T Kumai, S Kobayashi

    Drug metabolism and disposition: the biological fate of chemicals   26 ( 6 )   595 - 7   1998.6

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    We demonstrated the effect of hypoalbuminemia on theophylline disposition in rats. The pharmacokinetic parameters in Sprague-Dawley rats (SDRs) were compared with those in spontaneously hyperlipidemic rats (HLRs), which had approximately one half the serum albumin concentration of the SDRs, after a single 10 mg/kg injection (iv) of theophylline. Theophylline clearance (CL) in the HLRs was increased 1.6-fold, and the AUC was decreased by 36%. Although the elimination t1/2 was not significantly different between the two types of rats, the distribution volume (Vd) was increased significantly in the HLRs, compared with the SDRs. The free theophylline concentration in the SDRs was one half of the total concentration. In contrast, the free theophylline concentration in the HLRs was approximately equal to the total concentration. The enzymatic activities and apoprotein expression levels of CYP1A were decreased significantly in the HLRs, compared with the SDRs. The total theophylline CL was increased in HLRs with hypoalbuminemia, even though they exhibited lower enzymatic activity and CYP1A expression than did the SDRs. Because the unbound fraction and Vd of theophylline in HLRs were much larger than those in SDRs, we conclude that hypoalbuminemia may contribute to an increase in the Vd and a decrease in the CL for theophylline.

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  • Liver damage induced by bile duct ligation affects CYP isoenzymes differently in rats. International journal

    T Tateishi, M Watanabe, H Nakura, M Tanaka, T Kumai, S Kobayashi

    Pharmacology & toxicology   82 ( 2 )   89 - 92   1998.2

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    We examined the influence of liver damage induced by bile duct ligation on the activity and the expression of hepatic cytochrome P450 (CYP) 1A, 2B, 2C6, 2C11, 2E1 and 3A2 in male Sprague-Dawley rats. In the ligation group, testosterone 2 alpha-, 16 alpha-, and 6 beta-hydroxylase activities were severely decreased, whereas ethoxyresorufin O-deethylase and progesterone 21-hydroxylase activities relatively remained. Pentoxyresorufin O-deethylase and chlorzoxazone 6-hydroxylase activities were reduced to approximately one thirds those of control. The protein contents of these isoenzymes expressed in hepatic microsomes of the ligation group were decreased to 45%, 32%, 79%, 13%, 58%, and 23% of control for CYP1A, 2B, 2C6, 2C11, 2E1 and 3A2, respectively. The rank order of magnitude of the influence of bile duct ligation on CYP isoenzymes, assessed by the reduction in the enzyme activity and the protein content, corresponded with each other except CYP1A. The reduction of the enzyme activities significantly correlated with the reduction in the protein contents of different isoenzymes. These results suggested that bile duct ligation affected CYP isoenzyme activities and contents with different extent.

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  • Effects of glucocorticoids on pharmacokinetics and pharmacodynamics of midazolam in rats. International journal

    M Watanabe, T Tateishi, M Asoh, H Nakura, M Tanaka, T Kumai, S Kobayashi

    Life sciences   63 ( 19 )   1685 - 92   1998

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    We investigated the effect of dexamethasone (80 mg/kg per day for 2 days) and prednisolone (600 mg/kg per day for 2 days, equivalent to dexamethasone for glucocorticoid (GC) potency) on both pharmacokinetics and pharmacodynamics of midazolam (MDZ), a substrate for cytochrome P450 (CYP) 3A, in 8-week-old male Sprague-Dawley rats. Animals received a single injection of MDZ (pharmacokinetic study, 10 mg/kg; pharmacodynamic study, 55.5 mg/kg) in the tail vein 24 h after the last dose of GC or placebo. The elimination half-life (t(1/2)) and the area under the concentration-time curve of MDZ were significantly reduced by pretreatment with dexamethasone to 58.9% and 44.7% of the control value, respectively, and the clearance of MDZ was significantly increased by dexamethasone. Similar changes observed by prednisolone pretreatment did not reach significance. The t(1/2) of the dexamethasone pretreatment group (14.4+/-0.7 min) was significantly shorter than that of the prednisolone group (20.9+/-1.5 min). The amount of CYP3A2 protein and the activity of erythromycin N-demethylase were significantly increased by dexamethasone and prednisolone pretreatments, but dexamethasone showed a greater effect than prednisolone. Sleeping time was significantly shortened by dexamethasone and prednisolone pretreatment to 38.7% and 57.1% of control value, respectively. The current study demonstrates that the anesthetic effect of MDZ would be reduced in patients treated with dexamethasone or prednisolone, and that the CYP3A induction was greater by dexamethasone than by prednisolone, implying that the potency of CYP3A induction may differ among GCs even when GC activity is the same.

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  • Enhancement of the affinity of androgen receptor in the adrenal medulla of spontaneously hypertensive rats. International journal

    T Kumai, M Tanaka, T Tateishi, M Watanabe, H Nakura, S Kobayashi

    Clinical and experimental hypertension (New York, N.Y. : 1993)   19 ( 8 )   1179 - 91   1997.11

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    We investigated the alteration of tyrosine hydroxylase (TH) mRNA expression and androgen receptor in the adrenal medulla of spontaneously hypertensive rats (SHR). The TH mRNA expression in the adrenal medulla of SHR was higher than that of Wistar Kyoto rats (WKY). The testosterone increased the TH mRNA expression of SHR, but not WKY. The affinity of androgen receptor in the adrenal medulla of SHR was higher than that of WKY; however, the number of androgen receptor was not different. These results suggested that the increased binding affinity of the androgen receptor of SHR may be related to TH gene transcription in the adrenal medulla.

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  • The effects of streptozotocin-induced hypoinsulinemia on serum lipid levels in spontaneously hyperlipidemic rats. International journal

    H Nakura, M Tanaka, T Tateishi, M Watanabe, T Kumai, S Kobayashi

    Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme   29 ( 9 )   454 - 7   1997.9

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    We compared the effects of streptozotocin (STZ) treatment on serum cholesterol and lipoprotein levels in spontaneously hyperlipidemic rats (HLR), a hereditary hyperlipidemic model animal, with those in Sprague-Dawley rats (SDR). The body weight of control SDR and HLR were increased continuously for 30 days. Both SDR and HLR lost their body weight after STZ administration. Glucose levels of SDR and HLR were significantly increased by STZ treatment. Insulin levels were markedly decreased in HLR compared with those in SDR. Serum cholesterol and triglyceride levels of HLR treated with STZ were significantly higher than those of untreated HLR. The increment of both levels in HLR was much larger than that in SDR. The high density lipoprotein (HDL) cholesterol level of the STZ-treated HLR was significantly lower than that of untreated HLR. In the STZ-treated HLR the intensities of both bands of the very low density lipoprotein (VLDL) and the low density lipoprotein (LDL) were higher than those in untreated HLR, while the intensity of any lipoprotein band remained unchanged between STZ-treated and control SDR. The atherogenic index (the ratio of total cholesterol level minus HDL cholesterol level of HDL cholesterol level) in the STZ-treated HLR was significantly high compared with that in other groups. The STZ-treated HLR showed the extremely hyperlipidemic state and this animal might be useful in experiments for the development of atherosclerosis or the drug evaluation for the agents used in hyperlipidemia.

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  • Halothane inhalation inhibits the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits. International journal

    T Tateishi, M Watanabe, H Nakura, M Tanaka, T Kumai, T Aoki, S Kobayashi

    Anesthesia and analgesia   85 ( 1 )   199 - 203   1997.7

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    We demonstrated the inhibitory effect of halothane (HAL) inhalation on the metabolism of chlorzoxazone (CZZ), a substrate for CYP2E1, in a bolus and a continuous injection study in rabbits receiving artificial ventilation. In a bolus injection study, the inhalation of 1.0% HAL significantly increased the half-life and the area under the curve and decreased the clearance of CZZ compared with those variables in midazolam administration. In a continuous injection study, the effect of various concentrations of inhaled HAL on plasma CZZ concentration at steady state was compared. Systolic and diastolic arterial blood pressure were decreased dose-dependently after 0.5%, 1.0%, or 2.0% HAL was inhaled. Although the plasma concentration of CZZ was increased 2.5-fold after 3 h of HAL inhalation, there was no significant difference in mean plasma concentrations among the groups treated with 0.5%, 1.0%, or 2.0% HAL. In contrast, the plasma concentration of lidocaine, a substrate for CYP3A, remained unchanged after 1.0% HAL was inhaled. These results suggest that general anesthesia obtained with HAL inhalation will affect the metabolism of drugs administered concomitantly when the drug is a substrate for CYP2E1.

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  • Effects of the estrous cycle and the gender differences on hepatic drug-metabolising enzyme activities. International journal

    M Watanabe, M Tanaka, T Tateishi, H Nakura, T Kumai, S Kobayashi

    Pharmacological research   35 ( 5 )   477 - 80   1997.5

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    The aim of the present study was to investigate the effects of the estrous cycle and physiological dose of estradiol (E2) and the gender difference on several hepatic drug-metabolising enzyme activities. Eight-week old female Sprague-Dawley rats at different stages of the estrous cycle [proestrous (P), estrous (E), and diestrous (D)] and 8-week old male rats were used in this study (n = 5, respectively). Serum E2 level at D was higher than that at E and lower than that at P. The hepatic cytochrome P450 content, aniline hydroxylase, ethoxycoumarin O-deethylase and aminopyrine N-demethylase activities in male were significantly higher than those in female at any stage of the estrous cycle and these activities in female remained unchanged during the estrous cycle. Neither the estrous cycle nor the gender difference affected the cytochrome b5 content. NADPH-cytochrome c reductase (fPT) activity at P was similar to that in male, and was significantly higher than that in E and D. fPT activity was increased by the administration of physiological dose of E2 in ovariectomized rats. Uridine diphosphate glucuronyltransferase (UDP-GT) activity at E was significantly lower than that at P or D and that activity in female was significantly lower than that in male. These results indicate that the estrous cycle, especially serum E2 level, may affect both fPT and UDP-GT activities.

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  • Sex- or age-related differences were not detected in the activity of dihydropyrimidine dehydrogenase from rat liver. International journal

    T Tateishi, M Watanabe, H Nakura, M Tanaka, T Kumai, S Kobayashi

    Pharmacological research   35 ( 2 )   103 - 6   1997.2

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    We examined the influence of ageing and gender on the activity of dihydropyrimidine dehydrogenase (DPD) in male and female Sprague-Dawley rats at 3, 8, 40 and older than 60 weeks of age. The body and liver weights of male rats at 8 weeks and older of age were heavier than those of female rats at the same age and the ratio of liver to body weight was significantly reduced with ageing. The amount of produced 5FU metabolites, dihydrofluorouracil and fluoroureidopropionic acid, remained unchanged in the reaction mixture with the cytosol from any group of the rats. The formation rates of 5FU metabolite were 1.03+/-0.08/1.12+/-0.06, 0.98+/-0.11/1.16+/-0.10, 1.13+/-0.09/1.13+/-0.11 and 1.17+/-0.16/1.24+/-0.08 nmol min(-1) mg protein(-1) (mean+/-SD, male/female) in rats at 3, 8, 40 and older than 60 weeks of age, respectively. The results suggest that the DPD activity in the rat liver may not be affected by ageing or gender.

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  • Opposite effects of isoniazid and fasting on the expression of CYP2E1 protein and mRNA in house musk shrew (Suncus murinus). International journal

    H Nakura, S Itoh, H Kusano, H Ishizone, T Kamataki

    Biochemistry and molecular biology international   41 ( 2 )   293 - 301   1997.2

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    The effects of isoniazid and fasting on hepatic CYP2E1 in the suncus were investigated. Aniline hydroxylation and N-nitrosodimethylamine demethylation, which are known to be catalyzed by CYP2E1, in liver microsomes were induced and suppressed by the treatment with isoniazid and the fasting, respectively. Immunoblot analysis indicated that CYP2E1 protein in liver microsomes from isoniazid-treated suncus was increased in contrast to the result with the fasting of the suncus. Northern blot analysis showed that the treatment of suncus with isoniazid increased the expression of CYP2E1 mRNA in livers although the fasting of the suncus significantly decreased CYP2E1 mRNA. These results suggest that the regulation of hepatic CYP2E1 in the suncus by treatment with isoniazid and fasting was different from that in rats.

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  • A comparison of hepatic cytochrome P450 protein expression between infancy and postinfancy. International journal

    T Tateishi, H Nakura, M Asoh, M Watanabe, M Tanaka, T Kumai, S Takashima, S Imaoka, Y Funae, Y Yabusaki, T Kamataki, S Kobayashi

    Life sciences   61 ( 26 )   2567 - 74   1997

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    We immunochemically measured the contents of 9 different cytochrome P450 (CYP) isoenzymes expressed in the liver and compared them between two groups: one group of 6 infant and 4 perinatal patients and one group of 10 patients after infancy (over 1 year old). CYP protein expressed in human liver can be divided into three groups on the basis of expression pattern: (a) CYP2A6, 2C9, 2D6, 2E1, and 3A were present in all samples and no difference was observed between the two groups; (b) CYP1A2, 2B6, and 2C8 were expressed more after infancy than during infancy; and (c) CYP3A7, which has been considered a major CYP enzyme in fetal liver microsomes, was expressed in all infants as well as the four perinatal patients, whereas it was detected in only 2 patients after infancy. These results implied that CYP2A6, 2C9, 2D6, 2E1, and 3A are already expressed during perinatal and infant period, while CYP1A2, 2B6, and 2C8 are expressed highly in subjects over 1 year old, and CYP3A7 disappeared after infancy.

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  • The activity of dihydropyrimidine dehydrogenase from rat liver was not affected by any of five 5-hydroxytryptamine antagonists. International journal

    T Tateishi, H Nakura, M Watanabe, M Tanaka, T Kumai, S Kobayashi

    Cancer letters   108 ( 1 )   1 - 5   1996.11

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    We estimate the influence of five 5-hydroxytryptamine receptor (5-HT3) antagonists on the activity of dihydropyrimidine dehydrogenase (DPDase), the rate-limiting enzyme in 5-fluorouracil (5FU) metabolism. The activity of DPDase from the rat liver was compared in the cytosol mixture of 5FU incubated with or without each of five 5-HT3 antagonists. DPDase activity was not altered in the presence of any 5-HT3 antagonist studied here. It may be inferred from these results that the any 5-HT3 receptor antagonist examined in this study has little or no effect on fluorouracil catabolism.

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  • Preliminary examination of the influence of incubation time or cytosolic protein concentration on dihydropyrimidine dehydrogenase activity. International journal

    T Tateishi, H Nakura, M Watanabe, M Tanaka, T Kumai, S Kobayashi

    Clinica chimica acta; international journal of clinical chemistry   252 ( 1 )   1 - 9   1996.8

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    We examined the influence of incubation time or cytosolic protein concentration on the metabolite production of 5-fluorouracil (5FU). Although the activity of dihydropyrimidine dehydrogenase (DPDase) from rat liver is considered to be retained for up to 60 min, the production rate of 5FU metabolites was reduced, probably due to depletion of the substrate in 40 mumol/l and lower concentration of 5FU. Since the ratio of the metabolite production rate to the cytosolic protein became smaller in higher concentrations of cytosolic protein, the DPDase activity should be compared in the same concentration of cytosolic protein. The production rate of 5FU metabolites was considered to be linear up to 40 mumol/l 5FU incubated with 500 micrograms cytosolic protein. The rate of the metabolite production calculated by one-point sampling significantly correlated with the enzyme activity by the multi-point sampling method. Minimizing sampling points to determine the DPDase activity would save time and expense.

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  • A cardiotonic steroid bufalin-induced differentiation of THP-1 cells. Involvement of Na+, K(+)-ATPase inhibition in the early changes in proto-oncogene expression. International journal

    S Numazawa, N Inoue, H Nakura, T Sugiyama, E Fujino, M Shinoki, T Yoshida, Y Kuroiwa

    Biochemical pharmacology   52 ( 2 )   321 - 9   1996.7

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    Human monocytic leukemia THP-1 cells were induced to differentiate into macrophage-like cells by treatment with cardiotonic steroid bufalin, which was previously shown to interact with the Na+, K+-ATPase with similar kinetics to ouabain, a specific inhibitor of the enzyme. This induction of differentiation was characterized by loss of proliferation, cell adherence, increased ability to reduce Nitro Blue tetrazolium (NBT), and increased expression of interleukin 1 beta (IL-1 beta). During this process, bufalin downregulated c-myb and c-myc expressions and induced c-fos and Egr-1 transcripts. Ouabain also caused similar changes in proto- oncogene expression and induced phenotypic markers of differentiated cells at concentrations comparable to bufalin. The 12-O-tetradecanoyl phorbol-13-acetate resistant THP-1 cell variant, which was unresponsive to this agent as to growth inhibition and proto-oncogene expression, responded to bufalin. The finding that protein kinase inhibitor H7 failed to bufalin-mediated c-fos induction further supports the theory that the signal transduction machinery caused by bufalin is separable from the phorbol ester. The cytotoxic effect of high doses of bufalin apparently disappeared in the medium where Na+ was replaced with choline ions. Furthermore, bufalin failed to induce c-fos expression and to downregulate c-myb transcripts in the low-Na+ medium. These findings indicate that an increased intracellular Na+ concentration resulting from the Na+, K(+)-ATPase inhibition possibly triggers the change in proto-oncogene expression evoked by bufalin.

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  • Elevated tyrosine hydroxylase mRNA levels in medulla oblongata of spontaneously hypertensive rats. International journal

    T Kumai, M Tanaka, M Watanabe, H Nakura, T Tateishi, S Kobayashi

    Brain research. Molecular brain research   36 ( 1 )   197 - 9   1996.2

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    The present study has investigated the expression of tyrosine hydroxylase (TH) mRNA and its activity in medulla oblongata of spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). The TH mRNA levels were determined by Northern blot and dot blot analyses. The TH activity and the expression of TH mRNA in medulla oblongata of SHR were significantly higher than those of WKY. These results suggest that the hypertension of SHR may be related to the high activity of TH due to the high level of TH mRNA which increases norepinephrine levels in the medulla oblongata.

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  • Evidence for the lack of hepatic N-acetyltransferase in suncus (Suncus murinus). International journal

    H Nakura, S Itoh, H Kusano, H Ishizone, T Deguchi, T Kamataki

    Biochemical pharmacology   50 ( 8 )   1165 - 70   1995.10

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    The abilities of liver cytosol fractions from the suncus and Sprague-Dawley (SD) rats to N-acetylate aniline, p-aminobenzoic acid, p-aminosalicylic acid and 2-aminofluorene (AF) were compared. The cytosol from rats N-acetylated these substrates at efficient rates, whereas the cytosol from the suncus did not N-acetylate these substrates at detectable rates. When AF was given to the suncus, 2-acetylaminofluorene (AAF), a metabolite of AF formed by N-acetyltransferase (NAT), was not detectable in serum, whereas the metabolite was seen clearly in rats. Northern blot and Southern blot analyses, using cDNAs coding for human NATs as probes, indicated that not only the transcripts but also the genes of the enzymes were undetectable in suncus. These results suggest that the suncus is among the few species known to lack NATs.

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  • Effects of submaxillariectomy on ovarian androgen and estrogen production in adult female rats. International journal

    M Tanaka, M Watanabe, T Kumai, H Nakura, S Kobayashi

    Biochemical and biophysical research communications   213 ( 2 )   550 - 4   1995.8

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    Submaxillariectomy causes an increase in uterine weight in adult female rats. This increase is due to the elevation of the plasma 17 beta-estradiol (E2) level which is brought on by enhancement of ovarian E2 production. Furthermore, enhancement of ovarian E2 production is due to the enhancement of testosterone and androstenedione production which are the precursors of ovarian E2. However, submaxillariectomy did not affect ovarian progesterone and 17 alpha-hydroxyprogesterone levels. These findings suggest that the submaxillary gland may inhibit the production of ovarian E2 mainly because of the inhibition of ovarian androgen production. Thus the submaxillary gland may play a physiological role in female reproductive systems caused by the change in ovarian steroidogenesis.

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  • Influence of androgen on tyrosine hydroxylase mRNA in adrenal medulla of spontaneously hypertensive rats. International journal

    T Kumai, M Tanaka, M Watanabe, H Nakura, S Kobayashi

    Hypertension (Dallas, Tex. : 1979)   26 ( 1 )   208 - 12   1995.7

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    We investigated the effects of castration and testosterone propionate on tyrosine hydroxylase mRNA, its activity, and catecholamine synthesis in the adrenal medulla of spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). Four-week-old male rats were castrated. Testosterone propionate (500 micrograms per rat) was administered subcutaneously twice a week to castrated rats (between 14 and 25 weeks of age). Systolic pressure was measured at the age of 25 weeks, and rats were decapitated. The systolic pressure of castrated SHR was significantly lower than that of control and testosterone-replaced SHR. Epinephrine and norepinephrine levels, tyrosine hydroxylase activity, and tyrosine hydroxylase mRNA in the adrenal medulla of castrated SHR were significantly lower than in control and testosterone-replaced SHR. Systolic pressure and epinephrine and norepinephrine levels, tyrosine hydroxylase activity, and tyrosine hydroxylase mRNA levels in the adrenal medulla of WKY showed no significant differences among the control, castrated, and testosterone-replaced groups. These results suggest that androgens contribute to the development and maintenance of hypertension in SHR via sustained enhancement of tyrosine hydroxylase synthesis in the adrenal medulla, leading to increased epinephrine and norepinephrine levels.

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  • Activities of drug-metabolizing enzymes in the liver of Suncus murinus: possible lack of N-acetyltransferase activity in liver cytosol. International journal

    H Nakura, S Itoh, H Kusano, H Ishizone, T Kamataki

    Pharmacology   48 ( 3 )   201 - 4   1994.3

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    The amounts of several drug-metabolizing enzymes in livers of Suncus murinus (suncus) were studied in comparison with rats. The content of cytochrome P450 in suncus was less than one third that seen in rats. Activities of glutathione S-transferase, UDP-glucuronyltransferase and arylhydroxycarbon hydroxylase in suncus were less than half those in rats. Activity of flavin-containing monooxygenase in suncus was 71% that of rats. Interestingly, N-acetyltransferase (NAT) activity in suncus liver cytosols was not detectable: no detectable activities were seen with aniline, p-aminobenzoic acid and p-amino-salicylic acid as substrates. We propose that suncus is a unique animal possibly lacking NAT in liver cytosol.

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  • Decrease in the content of cytochrome P450IIE by fasting in liver microsomes of house musk shrew (Suncus murinus). International journal

    H Nakura, S Itoh, H Kusano, H Ishizone, S Imaoka, Y Funae, T Yokoi, T Kamataki

    Biochemical pharmacology   43 ( 9 )   1907 - 10   1992.5

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    The effects of fasting on hepatic cytochrome P450 in the mature male house musk shrew, Suncus murinus (suncus), were studied by Western blot analyses and enzyme assays. The content of P450IIE protein was decreased, by fasting, to 24% of the control level in contrast to the results with rats, in which P450IIE protein was increased to 172% by fasting. These changes reflected on catalytic activities, such as aniline hydroxylase and N-nitrosodimethylamine demethylase activities, which were decreased to about 45% and 28%, respectively, of the control levels by fasting, while in fasting rats, the catalytic activities of these enzymes were 2-3-fold higher than in controls.

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  • Formation of an antibacterial metabolite from a new macrolide compound 23-O-benzyl-5-mycaminosyl-tylonolide (TMC-101), by a hepatic microsomal drug-metabolizing enzyme system.

    H Nakura, H Ohi, T Miura, T Fujiwara, H Ishizone, T Yokoi, M Kitada, T Kamataki

    Journal of pharmacobio-dynamics   14 ( 7 )   377 - 83   1991.7

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    Upon incubation of 23-O-benzyl-5-mycaminosyl-tylonolide (TMC-101) with liver microsomes in the presence of an nicotinamide adenine dinucleotide phosphate-generating system, at least four metabolites were formed: two of them were also formed by an enzyme(s) in rat serum. One of the metabolites formed by liver microsomes possessed antibacterial activity comparable to TMC-101 as examined by bioautography using Micrococcus luteus ATCC 9341 as a tester strain. Incubation of TMC-101 with rat serum degraded most of the parent compound and did not form the active metabolite. The capacity of liver microsomes to produce the active metabolite was increased by pretreatment of rats with 3-methylcholanthrene, phenobarbital and polychlorinated biphenyl. The metabolite with the antibacterial activity was estimated not to be formed by the N-demethylation of TMC-101, and was chemically unstable.

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  • 【救急医療と漢方】救急・集中治療領域における漢方治療の薬学的検証

    名倉 弘哲, 野田 治代, 波多野 力

    漢方と最新治療   28 ( 2 )   157 - 164   2019.5

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  • 豪雨水害に対する岡山県下の対応と課題

    中尾 博之, 渡邉 暁洋, 高田 洋介, 山田 太平, 内藤 宏道, 飯田 淳義, 小崎 吉訓, 塚原 紘平, 名倉 弘哲, 大川 恭昌, 三橋 乙矢, 三木 真彩菜, 井上 智美, 加藤 湖月, 中尾 篤典

    Japanese Journal of Disaster Medicine   23 ( 3 )   331 - 331   2019.2

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  • 平成30年7月豪雨 水害時の消毒用消石灰散布が及ぼす健康被害

    山田 太平, 小崎 吉訓, 飯田 淳義, 塚原 紘平, 内藤 宏道, 高田 洋介, 渡邉 暁洋, 大川 恭昌, 名倉 弘哲, 三木 真彩菜, 三橋 乙矢, 井上 智美, 加藤 湖月, 中尾 博之, 中尾 篤典

    Japanese Journal of Disaster Medicine   23 ( 3 )   423 - 423   2019.2

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  • 薬剤師メディカルラリー実施によって明らかとなった緊急時・災害時の研修課題

    荒川 友理, 名倉 弘哲, 泉 憲政, 山口 勉, 斉藤 忠男, 榎本 由香, 尾川 瑞樹

    日本薬剤師会学術大会講演要旨集   51回   P - 09   2018.9

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  • 大規模災害時に求められる必須医薬品の検証

    山下 莉乃, 村木 惇人, 神田 晴生, 江上 祥一, 富永 孝治, 小林 祐司, 名倉 弘哲

    社会薬学   37 ( Suppl. )   69 - 69   2018.9

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  • 牛車腎気丸、ヨク苡仁湯が下腹部の熱感に奏功した1症例

    小久保 幸菜, 名倉 弘哲, 植田 圭吾, 大塚 文男, 波多野 力

    和漢医薬学会学術大会要旨集   35回   154 - 154   2018.9

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  • 救急・集中治療領域における漢方処方併用リスク評価

    名倉 弘哲, 野田 治代, 中尾 篤典, 波多野 力

    安全医学   15 ( 増刊号 )   70 - 70   2018.5

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  • 薬剤師メディカルラリー実施によって明らかとなった緊急時・災害時の研修課題

    荒川 友理, 名倉 弘哲, 泉 憲政, 山口 勉, 斉藤 忠男, 林 武文, 榎本 由香, 尾川 瑞樹

    国立病院総合医学会講演抄録集   71回   2496 - 2496   2017.11

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  • 【必須の薬剤この1冊にまとめました!救急ナースのお薬早しらべ帳】必見!救急ナースの薬剤基礎知識

    名倉 弘哲

    EMERGENCY CARE   30 ( 11 )   1038 - 1039   2017.11

  • 【必須の薬剤この1冊にまとめました!救急ナースのお薬早しらべ帳】その他、救急で汎用される薬剤

    名倉 弘哲

    EMERGENCY CARE   30 ( 11 )   1087 - 1091   2017.11

  • 熊本地震時の医薬品供給と備蓄体制の最適化へ 各災害フェーズでの医薬品需給分析から

    大森 眞樹, 小林 祐司, 池川 登紀子, 稲葉 一郎, 中村 繁良, 清田 麻起子, 新村 貴博, 名倉 弘哲, 神田 晴生, 江上 祥一, 廣田 誠介

    日本薬剤師会学術大会講演要旨集   50回   [P - 291]   2017.10

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  • 地域密着型災害対策研修会実施による薬局薬剤師の災害対応力向上への検討

    寺井 竜平, 監物 英男, 奥山 勝敏, 岡本 達明, 金田 崇文, 安尾 哲郎, 藤原 孝子, 桶 直美, 山田 公子, 名倉 弘哲, 一般社団法人岡山県薬剤師会相互扶助委員会

    日本薬剤師会学術大会講演要旨集   50回   [P - 296]   2017.10

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  • 熊本地震にて支援にあたった薬剤師が抱えた問題点に関する質的研究

    松元 亨平, 小比賀 美香子, 大谷 尚, 名倉 弘哲

    社会薬学   36 ( Suppl. )   97 - 97   2017.9

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  • 電気的除細動抵抗性心室細動/無脈性心室頻拍に対するニフェカラントの有効性評価メタ解析 アミオダロンとの効果比較

    佐藤 志帆, 今井 徹, 田中 敏, 座間味 義人, 名倉 弘哲

    日本薬学会年会要旨集   137年会 ( 4 )   75 - 75   2017.3

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  • 熊本地震にて基礎疾患を有する避難者と薬剤師が抱えた問題に関する質的研究

    松元 享平, 名倉 弘哲

    Japanese Journal of Disaster Medicine   21 ( 3 )   609 - 609   2017.2

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  • 病棟薬剤業務実施加算 岡山大学病院高度救命救急センターにおける病棟薬剤師の役割と展望

    大月 理恵子, 大川 恭昌, 名倉 弘哲, 内藤 宏道, 寺戸 通久, 佐藤 圭路, 鵜川 豊世武, 中尾 篤典

    日本集中治療医学会雑誌   24 ( Suppl. )   SY15 - 2   2017.2

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  • 漢方薬の簡易懸濁法の実施に向けた検討

    比知屋 寛之, 川崎 奏, 大重 吉俊, 名倉 弘哲

    薬事新報   ( 2975 )   25 - 29   2017.1

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    漢方薬の蒸留水への崩壊懸濁性、経管チューブの通過性及び崩壊懸濁液の液性(pH)について検討した。簡易懸濁法の適否不明な漢方薬19品目を対象とした。六君子湯を含む19品目の全ての漢方薬が崩壊懸濁し、経管栄養チューブを通過した。しかし、麦門冬湯の崩壊懸濁液は粘性が高く、通過性試験時に用いるシリンジの内圧が上昇する傾向があった。また、大黄甘草湯の通過性試験時の洗浄水は多めの蒸留水を用いる必要があった。全ての漢方薬のpH値は3.77〜6.24の範囲(酸性)であった。

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  • 大規模災害時に薬剤師が関与すべき避難所アセスメント

    名倉 弘哲, 山内 英雄, 寺戸 通久, 中道 博之, 岡田 唯花, 三橋 乙矢, 中尾 篤典

    日本救急医学会雑誌   27 ( 9 )   367 - 367   2016.9

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  • 妊婦・授乳婦に関わる国内外の医薬品使用基準データベースの構築と有用性の検討

    江角 悟, 佐藤 智昭, 黒田 智, 河崎 陽一, 名倉 弘哲, 北村 佳久, 千堂 年昭

    医薬品情報学   18 ( 2 )   72 - 80   2016.8

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    妊婦・授乳婦に関わる国内外の医薬品使用基準データベース(DB)を構築し、有用性について検討した。内服薬、注射薬及び外用薬19518品目を対象に、薬品名、一般名、添付文書「使用上の注意」の小項目「妊婦、産婦、授乳婦等への投与」、FDA医薬品胎児危険度分類基準及びオーストラリア医薬品評価委員会によるリスク分類を抽出したCSVファイルを用いて院内医薬品情報マスタを作成した。名称別(製品名及び一般名)あるいは薬効別に検索を行い、該当医薬品について複数の情報(添付文書、FDA、TGA及びBriggs)を同一画面上において閲覧できるDBを構築した。収載した有効成分のうち、添付文書、FDA及びTGAに基準データのある有効成分はそれぞれ1770、1318及び1236成分であった。従来法と比較して有意な情報収集時間の短縮を認めた。さらに、利用者アンケートを行ったところ、DBの利便性あるいは満足度が高い結果が得られた。

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  • 平成28年熊本地震に対する岡山大学病院DMAT活動報告

    寺戸 通久, 山内 英雄, 名倉 弘哲, 中尾 篤典

    岡山医学会雑誌   128 ( 2 )   133 - 139   2016.8

  • 熊本地震で薬剤師が果たした使命

    名倉 弘哲, 松元 享平, 伊藤 裕子, 加藤 博和, 藤本 洋一, 小林 祐司

    社会薬学   35 ( Suppl. )   100 - 100   2016.8

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  • 救急医療における薬剤師の可能性を考える 臨床現場の薬剤師活動と大学教育を融合し救急医療に精通した薬剤師を育成するには 救急医療における薬物治療に主眼を置いた薬学教育

    座間味 義人, 小山 敏広, 今井 徹, 武本 あかね, 相良 英憲, 千堂 年昭, 名倉 弘哲

    薬学雑誌   136 ( 7 )   987 - 991   2016.7

  • 通過性試験時に用いる蒸留水が20mL以上を要する内服医薬品

    比知屋 寛之, 川崎 奏, 大重 吉俊, 名倉 弘哲

    薬事新報   ( 2947 )   25 - 28   2016.6

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    通過性試験時に用いる蒸留水が20mL以上を要する内服医薬品について検討した。採用されている内服医薬品約420品目を対象とした。崩壊懸濁試験は、シリンジ内に内服医薬品(1錠あるいは1包)を入れた後、約55℃の蒸留水約20mLを吸入後、5分間室温放置した。検討した内服医薬品のうち全体の3.4%にあたる14品目が要注意医薬品として評価された。このうち、アセタゾラミド(ダイアモックス錠250mg)、ニホニジピン塩酸塩エタノール付加物(ランデル錠20mg)、ゾニサミド(ゾニサミド散20%「アメル」0.5g)、テオフィリン(テオフィリン徐放ドライシロップ小児用20%「トーワ」1g)、バラシクロビル塩酸塩(バラシクロビル顆粒50%「MEEK」1g及びバルトレックス顆粒50% 1g)は、5分間で崩壊懸濁し「適1」と判定されているにも関わらず、通過性試験時に20mL以上の蒸留水を要した。それ以外の8品目は10分間で崩壊懸濁し、経管チューブを通過して「適1」あるいは「適2」と判別されたが、通過性試験時に20mL以上の蒸留水を要した。

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  • エダラボンによる急性腎障害発現の危険因子解析

    座間味 義人, 相良 英憲, 萱野 由佳, 小山 敏広, 白石 奈緒子, 江角 悟, 鵜川 豊世武, 千堂 年昭, 氏家 良人, 名倉 弘哲

    日本臨床救急医学会雑誌   19 ( 3 )   461 - 465   2016.6

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    エダラボンを用いた治療は患者の神経学的予後を改善する一方、急性腎障害発現のリスクがあると報告されている。本研究はエダラボン投与による急性腎障害発現を予防するために、エダラボン投与時の患者背景から危険因子を解析することを目的とした。岡山大学病院においてエダラボンが投与された患者を対象に、患者基本情報およびエダラボン投与情報、血液検査結果を電子カルテより遡及的に調査した。調査データから単変量解析を実施し、抽出した因子を用いて二項ロジスティック回帰分析を行った結果、感染症の併発が、エダラボンによる急性腎障害発現の有意な危険因子(予測因子)であることが示唆された。したがって、感染症の所見がある患者にエダラボンを投与する際は、急性腎障害発現に留意する必要がある。(著者抄録)

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  • 融合・両立・薬剤師の職務と薬学部教育の両立

    名倉 弘哲

    薬剤学: 生命とくすり   76 ( 3 )   131 - 133   2016.5

  • 脳梗塞患者における発症前後の薬物療法と副作用発現状況の調査

    安尾 哲郎, 座間味 義人, 名倉 弘哲

    日本臨床救急医学会雑誌   19 ( 2 )   425 - 425   2016.4

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  • 小児のための散剤薬用量と薬物相互作用の一覧表作成

    比知屋 寛之, 名倉 弘哲

    薬事新報   ( 2937 )   33 - 37   2016.4

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  • 成人男性のうつ症状が緩和した一症例

    比知屋 寛之, 松澤 大樹, 名倉 弘哲

    薬事新報   ( 2938 )   15 - 16   2016.4

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    症例は40歳男性で、うつ病と診断された。朝食後にも薬を服用することで、うつ症状が少し軽減したが、倦怠感や不眠が続き、就業状態も改善されず、頻尿に変化もみられないことから、処方変更することになった。ジェイゾロフト錠が処方されていたが、同じSSRIに属すが、セロトニンにより選択的に働き、アロステリック効果のため効果が持続するレクサプロ錠に変更した。また睡眠は、ロヒプノール(フルニトラゼパム)の後発品で強力な睡眠作用を有するビビットエース錠が処方されていたが、同種同効薬のフルニトラゼパムに加えてフェノチアジン系抗精神病薬に属し、クロルプロマジン塩酸塩・プロメタジン塩酸塩・フェノバルビタール配合薬のベゲタミンB配合錠を処方した。頻尿は、ムスカリン受容体サブタイプM1、M3受容体に対して拮抗作用を示し、膀胱選択性が高いウリトス錠が処方された。倦怠感や不眠の症状が改善した。また、なんとか仕事をこなせる状態にまで至った。夜間の頻尿は大幅に回数が減少した。

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  • 簡易懸濁法に適さない内服医薬品

    比知屋 寛之, 松澤 大樹, 川崎 奏, 大重 吉俊, 名倉 弘哲

    薬事新報   ( 2934 )   35 - 37   2016.3

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    簡易懸濁法に適さない内服医薬品について検討した。採用している内服医薬品約420品目を対象とした。簡易懸濁法に適さない医薬品は、全体の3.4%に相当する14品目存在した。簡易懸濁法に適さない医薬品のうち、フィルムコーティング錠が9品目、糖衣錠が4品目、徐放性顆粒は1品目存在した。簡易懸濁法に適さない医薬品については、処方医師の了承のもとで同一成分薬の散剤あるいは液剤に代替えして、調剤する必要があると思われた。しかし、崩壊懸濁が不可能な医薬品や代替市販製品が発売されていない場合、あるいは医療機関によって採用がないなど、止むを得ず粉砕または開封しなければならない場合が生じる恐れがあるため、各医薬品の特性と患者の症状を熟慮したうえで適切な対応策をとる必要があると考えられた。粉砕ならびに開封調剤は、品質保証の観点から問題が生じる可能性のある方法ではあるが、臨床現場においては患者の治療のために必要不可欠である。

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  • 簡易懸濁法において崩壊懸濁液のpHが中性を示す内服医薬品

    比知屋 寛之, 松澤 大樹, 川崎 奏, 大重 吉俊, 名倉 弘哲

    薬事新報   ( 2932 )   29 - 32   2016.3

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    簡易懸濁法において崩壊懸濁液のpHが中性を示す内服医薬品について検討した。採用されている内服医薬品約420品目を対象とした。崩壊懸濁試験を実施し、得られた懸濁液を用いて通過性試験を行った。崩壊懸濁液が中性を示す医薬品は全体の21.7%の91品目存在した。ガスコン錠40mg、ダイアモックス錠250mg、テオロング錠200mg、パキシルCR錠12.5mg、ワソラン錠40mg、ケイキサレートDs6%(3.27g)、ゾニサミド散20%「アメル」(0.5g)は通過性試験時に多めの蒸留水を用いる必要があった。カルフィーナ錠1μg、コントミン糖衣錠50mg、セレコックス錠100mg、センナリド錠12mg、トリプタノール錠25mg、パキシルCR錠12.5mg、ヒルナミン錠25mg、メデット錠250mg、ロキソニン錠60mg、ワソラン錠40mgは裸錠を破壊して崩壊懸濁試験を行った。全ての医薬品が10分以内に崩壊懸濁して経管チューブを通過した。それ以外の医薬品については試験開始10分後には崩壊懸濁して経管チューブを通過した。中性を示す医薬品のpHは6.01〜7.47の値を示した。

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  • 先導的薬剤師養成に向けた実践的アドバンスト教育プログラムの共同開発 長期課題研究及びアドバンスト教育プログラムを中心とした取り組みとその成果

    波多野 力, 富岡 佳久, 三田 智文, 平澤 典保, 佐藤 博, 新井 洋由, 草間 真紀子, 山本 武人, 竹内 靖雄, 上原 孝, 名倉 弘哲

    日本薬学会年会要旨集   136年会 ( 1 )   214 - 214   2016.3

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  • 光に対して不安定な薬剤を経管投与する際の有用な投与法の開発

    座間味 義人, 江角 悟, 相良 英憲, 槙田 崇志, 天野 学, 安藤 哲信, 名和 秀起, 北村 佳久, 千堂 年昭, 名倉 弘哲

    医学と薬学   73 ( 4 )   433 - 438   2016.3

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    [目的]光に弱い薬剤を経管投与する場合、粉砕法および簡易懸濁法のいずれの方法を用いた場合でも薬剤の含量が低下する可能性が指摘されている。そこで本研究では、簡易懸濁法を用いた光に不安定な薬剤の経管投与に有用な投与法の開発を目的として検討を行った。[方法]光に不安定な薬剤としてメコバラミン製剤を用い、各種懸濁条件におけるメコバラミン含量を高速液体クロマトグラフィーにより測定した。[結果]薬剤の粉砕、細粒剤および簡易懸濁法いずれの方法を用いても、メコバラミン含量は経時的に低下した。また、室内光下と比較して、光強度の強い窓際では懸濁初期の含量低下が大きかった。さらに、室内光下におけるメコバラミン含量の低下は、褐色フィルムを用いた遮光により有意に抑制された。[結論]遮光処理を施した容器を用いた簡易懸濁法は、光に弱い薬剤の経管投与を行う際に、含量の低下を抑える投与法として有用であると考えられる。(著者抄録)

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  • 薬剤師の未来 災害時に薬剤師に求められる能力と今後の役割 PhDLSコースにかかわる医師の立場から

    本間 正人, 西澤 健司, 渡邉 暁洋, 名倉 弘哲, 阿南 英明, 井原 則之, 近藤 久禎, 梶山 和美, 丹野 佳郎, 大友 康裕

    Japanese Journal of Disaster Medicine   20 ( 3 )   479 - 479   2016.2

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  • 救急薬学の視点から災害時における薬剤師の職能を考える

    名倉 弘哲

    日本薬剤師会学術大会講演要旨集   48回   150 - 150   2015.11

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  • 死や生について主体的に考え、語り、発信する大学生の活動報告 看取り経験豊かな訪問看護師に学び、語り合うことの意味

    大浦 まり子, 時本 麻衣, 長崎 歩, 本村 昌文, 名倉 弘哲, 赤瀬 佳代

    日本緩和医療学会学術大会プログラム・抄録集   20回   259 - 259   2015.6

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  • 院内感染と薬剤管理 トロンボモジュリン投与における出血発現の危険因子解析

    名倉 弘哲, 向井 和也, 座間味 義人, 平山 敬浩, 氏家 良人

    日本臨床医学リスクマネジメント学会・学術集会プログラム・抄録集   13回   54 - 54   2015.5

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  • 敗血症における重症度別de-escalationの有効性評価

    萱野 純史, 永尾 香菜子, 平山 敬浩, 座間味 義人, 鵜川 豊世武, 氏家 良人, 名倉 弘哲

    日本臨床救急医学会雑誌   18 ( 2 )   389 - 389   2015.4

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  • 救急病棟における薬剤経管投与の実態調査と漢方製剤の経管投与方法の検討

    座間味 義人, 伊藤 剛志, 名倉 弘哲

    日本臨床救急医学会雑誌   18 ( 2 )   447 - 447   2015.4

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  • 救急医療における薬剤師の可能性を考える 臨床現場の薬剤師活動と大学教育を融合し救急医療に精通した薬剤師を育成するには 救急医療における薬物治療に主眼を置いた薬学教育

    座間味 義人, 小山 敏広, 今井 徹, 武本 あかね, 相良 英憲, 千堂 年昭, 名倉 弘哲

    日本薬学会年会要旨集   135年会 ( 1 )   261 - 261   2015.3

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  • 先導的薬剤師養成に向けた実践的アドバンスト教育プログラムの共同開発 長期課題研究・アドバンスト教育プログラム及び最先端創薬研究プログラム

    草間 真紀子, 新井 洋由, 三田 智文, 波多野 力, 竹内 靖雄, 上原 孝, 名倉 弘哲, 富岡 佳久

    日本薬学会年会要旨集   135年会 ( 1 )   231 - 231   2015.3

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  • ERにおけるBNPの活用法 BNPにeGFRとageを併用した新たな重症度評価分類(鵜川分類)

    鵜川 豊世武, 山内 英雄, 野坂 宜之, 平山 敬浩, クアウプ 絵美里, 塚原 紘平, 飯田 淳義, 湯本 哲也, 寺戸 通久, 佐藤 圭路, 名倉 弘哲, 氏家 良人

    医工学治療   27 ( Suppl. )   121 - 121   2015.3

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  • 救急医療における薬剤師の可能性を考える 臨床現場の薬剤師活動と大学教育を融合し救急医療に精通した薬剤師を育成するには 救急集中治療領域における薬剤師への期待 医師の立場から

    氏家 良人, 名倉 弘哲

    日本薬学会年会要旨集   135年会 ( 1 )   261 - 261   2015.3

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  • 救急・集中治療領域における漢方処方の使用状況(第4報)

    野田 治代, 名倉 弘哲, 平山 敬浩, 氏家 良人, 千堂 年昭, 波多野 力

    日本薬学会年会要旨集   135年会 ( 4 )   179 - 179   2015.3

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  • 岡山大学病院高度救命救急センターにおける敗血症患者へのde-escalationの有益性評価

    萱野 純史, 永尾 香菜子, 平山 敬浩, 座間味 義人, 鵜川 豊世武, 氏家 良人, 名倉 弘哲

    日本薬学会年会要旨集   135年会 ( 4 )   192 - 192   2015.3

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  • トロンボモジュリン投与における出血発現の危険因子解析 敗血症性DIC患者に対する統計解析

    三宅 真史, 向井 一也, 平山 敬浩, 座間味 義人, 鵜川 豊世武, 氏家 良人, 名倉 弘哲

    日本薬学会年会要旨集   135年会 ( 4 )   193 - 193   2015.3

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  • 救急・集中治療における敗血症性ショック患者に対する鎮静薬使用の検証

    塩瀬 麻衣, 江角 純, 平山 敬浩, 座間味 義人, 鵜川 豊世武, 氏家 良人, 名倉 弘哲

    日本薬学会年会要旨集   135年会 ( 4 )   193 - 193   2015.3

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  • 切除不能な進行・再発の結腸および直腸がんにおけるセツキシマブとパニツムマブの費用対効果分析

    永尾 香菜子, 小林 明日香, 座間味 義人, 名和 秀起, 相良 英憲, 野間 和広, 五十嵐 中, 松永 尚, 千堂 年昭, 名倉 弘哲

    Progress in Medicine   35 ( 2 )   299 - 303   2015.2

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    セツキシマブとパニツムマブは、切除不能な進行・再発の結腸・直腸がんに用いられる代表的な分子標的治療薬として同程度の無増悪生存期間の延長が認められているが、明確な使用基準は定められていない。本研究では、薬剤経済学的解析により両薬剤の優位性を明らかにすることを目的とした。はじめに、大腸がん化学療法が施行された20例と文献調査を参考にシミュレーション患者を設定し、判断樹を作成した。さらに、期待費用をシナリオごとに算出し費用対効果分析を行った。その結果、セツキシマブよりもパニツムマブの方が期待費用は48,777円安く、Quality adjusted life years(QALY)を0.022多く獲得するという結果になった。これは、明らかにパニツムマブの方がドミナントであることを意味する。しかし、投与量算出方法の違いから体重が69.6kgを超える患者ではセツキシマブの方が費用対効果において優れていることが明らかになった。このことから、投与量の算出基準に違いがある薬剤では、患者の特性が費用対効果にも影響を与えることが明らかになった。(著者抄録)

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  • 薬剤師メディカルラリーを開催した報告と今後の展望

    山口 勉, 高野 安広, 名倉 弘哲, 杉山 宏之, 磯崎 未帆, 重谷 英寿, 岡村 佳織, 伊藤 香織

    日本薬剤師会学術大会講演要旨集   47回   451 - 451   2014.10

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  • 薬学的管理に心電図を用いる意義と問題点

    尾上 洋, 名倉 弘哲

    日本薬剤師会学術大会講演要旨集   47回   296 - 296   2014.10

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  • 粉砕法による経管投与における薬剤量損失に対する簡易懸濁法の有用性についての検討

    座間味 義人, 小山 敏広, 合葉 哲也, 天野 学, 安藤 哲信, 倉田 なおみ, 名和 秀起, 名倉 弘哲, 北村 佳久, 千堂 年昭

    静脈経腸栄養   29 ( 4 )   1027 - 1033   2014.7

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    【目的】従来の薬剤経管投与法である粉砕法は薬効の減少につながる薬剤量の損失が指摘されている。そこで粉砕法による薬剤量損失に対する簡易懸濁法の有用性について検討した。【方法】頻繁に粉砕指示がなされる5種類の薬剤を用いて粉砕・分包による薬物含量減少、薬剤調製時の懸濁性および実際の経管投与を想定した薬物含量について2つの方法を比較した。【結果】薬剤を粉砕・分包するとそれぞれの薬物含量は減少した。またワーファリン錠を粉砕して水に溶解すると完全には懸濁せず、小さな塊が生じたが、簡易懸濁法では均一に懸濁した。ワーファリン錠の経管投与を想定した実験において粉砕法では薬物含量が大幅に減少したが、簡易懸濁法では、ほとんど損失が認められなかった。【結論】簡易懸濁法は粉砕法に比べて薬剤損失の面で有用性が高いことが示唆され、ワーファリン錠のように安定性が悪い薬剤では特に適正な薬物投与に貢献出来ると考えられる。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J03242&link_issn=&doc_id=20140813050011&doc_link_id=10.11244%2Fjjspen.29.1027&url=https%3A%2F%2Fdoi.org%2F10.11244%2Fjjspen.29.1027&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 薬剤のリスクマネジメント デクスメデトミジンによる低血圧発現の危険因子および予防因子解析に関する研究

    名倉 弘哲, 塩見 明日香, 座間味 義人, 平山 敬浩, 氏家 良人

    日本臨床医学リスクマネジメント学会・学術集会プログラム・抄録集   12回   62 - 62   2014.5

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  • 薬物療法の実践に重点を置いた薬学生向けの救命実技実習の開発

    座間味 義人, 今井 徹, 武本 あかね, 名倉 弘哲, 氏家 良人

    日本臨床救急医学会雑誌   17 ( 2 )   279 - 279   2014.4

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  • 救急・集中治療領域における漢方処方の使用状況(第2報)

    野田 治代, 名倉 弘哲, 千堂 年昭, 平山 敬浩, 氏家 良人, 波多野 力

    日本薬学会年会要旨集   134年会 ( 4 )   170 - 170   2014.3

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  • 本態性高血圧の初期治療における第一選択薬決定のアルゴリズム作成と有用性の検討

    萱野 由佳, 三好 智子, 水島 孝明, 花山 宜久, 黒田 真生, 尾上 洋, 相良 英憲, 座間味 義人, 大塚 文男, 名倉 弘哲

    Progress in Medicine   34 ( 3 )   527 - 536   2014.3

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    本態性高血圧症は本邦において極めて患者数の多い疾患であり、その治療は食事・運動療法に加えて薬物治療が重要である。『高血圧治療ガイドライン2009』では、本態性高血圧に対する5種類の第一選択薬であるカルシウム拮抗薬、アンジオテンシンII受容体拮抗薬、アンジオテンシン変換酵素阻害薬、β遮断薬、利尿薬が提示されている。本態性高血圧の初期治療での薬剤選択に際して医師が考慮すべき事項は極めて煩雑であり、医師の処方薬決定を困難にしている。本研究では、本態性高血圧初期治療における処方決定に役立つためのアルゴリズムの作成を試みた。さらに、調査対象となる総合内科医師と保険薬剤師にアルゴリズムを配付し、一定の試用期間後にアルゴリズムの使用感に関する有用性の評価を実施したところ、本アルゴリズムは総合内科医師、保険薬剤師それぞれから高い評価を得た。また、医師の処方決定時の思考をおおむね反映していることが検証できた。したがって、作成したアルゴリズムは医師の処方決定の理解の手助けとなる可能性が示唆された。加えて、本アルゴリズムは薬剤師が処方解析を行ううえでもその有用性は高いと考えられた。(著者抄録)

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  • 災害時医療における薬剤師の役割 東日本大震災支援活動に基づく提言 災害医療における薬剤師の役割 求められる知識とスキル

    名倉 弘哲

    薬学雑誌   134 ( 1 )   3 - 6   2014.1

  • 当センターにおけるせん妄の現状 日本語版ニーチャム混乱錯乱スケールを用いて

    高見 朋子, 米田 奈穂子, 武田 かおり, 三浦 理恵, 在本 ゆかり, 加藤 湖月, 平山 敬浩, 蟹江 一輝, 名倉 弘哲

    日本集中治療医学会雑誌   21 ( Suppl. )   [NP - 5]   2014.1

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  • 高度救命救急センターにおけるデクスメデトミジンによるせん妄発症の危険因子解析

    座間味 義人, 藤原 歩, 武本 あかね, 飯田 淳義, 鵜川 豊世武, 市場 晋吾, 名倉 弘哲, 氏家 良人

    日本集中治療医学会雑誌   21 ( Suppl. )   [DP - 6]   2014.1

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  • 2型糖尿病初期治療における経口血糖降下薬の処方選択基準に関するアルゴリズムの作成と有用性の検討

    塩見 明日香, 三好 智子, 村上 和敏, 水島 孝明, 黒田 真生, 尾上 洋, 相良 英憲, 座間味 義人, 大塚 文男, 名倉 弘哲

    Progress in Medicine   33 ( 10 )   2261 - 2268   2013.10

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    薬理作用の異なる薬剤が多数処方される2型糖尿病治療域において、ガイドラインを適切に理解し薬剤の適正使用を行うことは、臨床経験の少ない研修医や新人薬剤師にとっては困難であり、煩雑な知識を要する。そこで、2型糖尿病初期治療の選択基準となるアルゴリズムを糖尿病診療ガイドラインなどに基づき作成し、その有効性について研修医、総合内科医師、薬剤師にアンケートを実施した。アルゴリズムの有用性に関する評価では、研修医と総合内科医師の間で有意差は認められなかった。一方、薬剤師では、「本アルゴリズムの使用により、医師の処方意図や患者背景について考えるきっかけとなりましたか」との質問に対して、経験年数が6年以上の薬剤師の値に比べ、経験年数が1〜5年の薬剤師の方が有意に高い値を示した。したがって、アルゴリズムを作成し治療選択基準を図式化することで、経験年数の少ない薬剤師の迅速な理解向上に寄与できることが示唆された。(著者抄録)

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  • ECMO(膜型人工肺)回路の薬物吸着に影響する因子は何か?

    飯田 淳義, 市場 晋吾, 林 久美子, 武本 あかね, 北村 佳久, 千堂 年昭, 座間味 義人, 名倉 弘哲, 松木 範明, 氏家 良人

    日本救急医学会雑誌   24 ( 8 )   570 - 570   2013.8

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  • 岡山大学病院高度救急救命センターにおける抗MRSA薬TDMへの継続的関与の有用性

    座間味 義人, 名倉 弘哲, 武本 あかね, 森定 淳, 木浪 陽, 山内 英雄, 寺戸 通久, 鵜川 豊世武, 市場 晋吾, 氏家 良人

    日本臨床救急医学会雑誌   16 ( 3 )   407 - 407   2013.6

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  • 切除不能な進行・再発の直腸・結腸がん3次治療におけるセツキシマブとパニツムマブの費用対効果分析

    永尾 香菜子, 小林 明日香, 座間味 義人, 名和 秀起, 野間 和広, 五十嵐 中, 千堂 年昭, 名倉 弘哲

    日本薬学会年会要旨集   133年会 ( 3 )   245 - 245   2013.3

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  • 塩酸デクスメデトミジン投与患者におけるせん妄発症の危険因子解析

    名倉 弘哲, 藤原 歩, 座間味 義人, 鵜川 豊世武, 氏家 良人

    日本臨床医学リスクマネジメント学会・学術集会プログラム・抄録集   11回   81 - 81   2013.3

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  • 岡山大学病院高度救命救急センターにおける薬剤経管投与方法への薬剤師の介入症例

    座間味 義人, 名倉 弘哲, 飯田 淳義, 塚原 紘平, 寺戸 通久, 鵜川 豊世武, 芝 直基, 山内 英雄, 市場 晋吾, 氏家 良人

    日本集中治療医学会雑誌   20 ( Suppl. )   413 - 413   2013.1

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  • 岡山大学病院高度救命救急センターへの全国初となる救急薬学講座参入

    名倉 弘哲, 座間味 義人, 寺戸 通久, 芝 直基, 平山 敬浩, 森定 淳, 山内 英雄, 鵜川 豊世武, 市場 晋吾, 氏家 良人

    日本集中治療医学会雑誌   20 ( Suppl. )   442 - 442   2013.1

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  • 6年制実務実習指導体制構築におけるグループワークの有用性

    久保 和子, 岡崎 宏美, 市川 裕規, 西原 茂樹, 名和 秀起, 岡崎 昌利, 河崎 陽一, 名倉 弘哲, 松永 尚, 千堂 年昭

    薬学雑誌   132 ( 12 )   1467 - 1476   2012.12

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    6年制実務実習受け入れに向けた事前準備として、実務経験の浅い薬剤師が多く、かつコアカリの該当到達目標の多い部署である調剤室配属の薬剤師を対象に、コアカリのよりよい理解と実習指導へのモチベーションの向上を目的に、グループワークを主体とする研修会(GW)を開催し、その有用性を検討した。調剤室配属の薬剤師11例を対象とした。GWは2日間で4時間程度の内容であったが、教育評価演習の得点は有意に上昇し、実務経験年数に関係なく、コアカリの理解に有用な方法であることが示唆された。GW前後に実施したアンケートにおいて、GW後では参加者の90%以上が、今後実習に「積極的に係わりたい」又は「係わりたい」と回答した。教育評価演習の結果から、参加者はコアカリに対する事前の認識にかかわらず、GW参加により有意な知識の向上を認めた。

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  • 岡山大学に誕生した日本初の「救急薬学分野」

    名倉 弘哲

    Clinical Pharmacist   4 ( 6 )   603 - 605   2012.11

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  • デグロービング損傷により人工肛門周囲皮膚が壊死を来たし管理に難渋した小児外傷の一例

    寺戸 通久, 芝 直基, 平山 敬浩, 木浪 陽, 山内 英雄, 鵜川 豊世武, 市場 晋吾, 氏家 良人, 名倉 弘哲

    日本救急医学会雑誌   23 ( 10 )   655 - 655   2012.10

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  • Pharmacist-Physical Assessment Lab(P-PAL)活動報告 岡山大学大学院救急薬学分野との共催による卒後薬剤師教育について

    立野 朋志, 名倉 弘哲, 座間味 義人, 尾上 洋, 堀淵 浩二, 松永 るみ

    日本薬剤師会学術大会講演要旨集   45回   204 - 204   2012.10

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  • 岡山大学薬学部救急薬学分野の発足 全国初の救急薬学

    名倉 弘哲, 武本 あかね, 座間味 義人, 寺戸 通久, 芝 直基, 飯田 淳義, 木浪 陽, 山内 英雄, 鵜川 豊世武, 市場 晋吾, 氏家 良人

    日本救急医学会雑誌   23 ( 10 )   679 - 679   2012.10

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  • テイコプラニン初回投与設計における血中濃度予測の検討 性別、年齢別、血清クレアチニン値補正、体格補正、eGFR推算式による影響

    小曳 恵里子, 佐藤 智昭, 上島 智, 黒田 真生, 沖野 真季, 大西 和也, 河崎 陽一, 名倉 弘哲, 松永 尚, 千堂 年昭

    医療薬学   38 ( 7 )   461 - 470   2012.7

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    テイコプラニン(TEIC)初回投与設計におけるGFR推算式(eGFR)を用いた血中濃度予測精度について、性別、年齢別、血清クレアチニン濃度(SCr値)補正、体格補正の影響をCockcroft-Gault(CG)式と比較した。データはTEIC投与MRSA感染患者75名(男52名、女23名、平均52.5歳)を用いた。男女別・年齢別では、女性および65歳未満においてeGFR式を用いることでTEIC濃度予測精度は向上した。SCr値0.6mg/dl未満の患者に対して0.6mg/dlに補正する方法を適用した場合は、CG式、eGFR式いずれも推定クレアチニンクリアランス値が有意に減少し、これに伴い血中TEIC濃度の予測精度が向上した。肥満患者に対する体格補正については、未補正の場合はeGFR式の予測精度がCG式よりも良好で、体重を理想体重または標準体重とすることでより向上した。

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  • 東日本大震災医療支援にて経験したチーム医療

    名倉 弘哲

    岡山歯学会雑誌   31 ( 1 )   43 - 43   2012.6

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  • 薬学教育6年制における病院実習での電子ポートフォリオの活用

    岡崎 宏美, 黒田 直生, 名倉 弘哲, 松永 尚, 千堂 年昭

    日本薬学会年会要旨集   132年会 ( 4 )   345 - 345   2012.3

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  • 災害時医療における薬剤師の役割 東日本大震災支援活動に基づく提言 災害直後の医療における薬剤師役割、求められる知識とスキル

    名倉 弘哲

    日本薬学会年会要旨集   132年会 ( 1 )   269 - 269   2012.3

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  • バンコマイシン初回投与及び個別投与設計における日本人を対象とした新規GFR推算式の有用性

    黒田 真生, 上島 智, 佐藤 智昭, 小曳 恵里子, 河崎 陽一, 松永 尚, 名倉 弘哲, 千堂 年昭

    薬学雑誌   132 ( 1 )   125 - 133   2012.1

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    バンコマイシン(VCM)の初回投与設計およびベイジアン法に基づく個別投与設計時における糸球体濾過量推算式(eGFR式)の有用性を評価するため、eGFR式を用いた血中VCM濃度の予測精度をCockcroft-Gault式(CG式)と比較検討した。日本人を対象としたVCMの母集団薬物動態パラメータを用いて血中薬物濃度を予測する場合、初回投与設計においては65歳未満または体重が標準以上の患者に対して、eGFR式を用いることでVCMのトラフ濃度とピーク濃度の予測精度が改善することが明らかとなった。また個別投与設計においては65歳未満の患者に対して、eGFR式を用いることでVCMのトラフ濃度の予測精度が改善することが明らかとなった。

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  • 岡山大学薬学部創薬科学科4年制コース学生の進学意識に関する質的研究

    小林 明日香, 黒田 真生, 名倉 弘哲

    社会薬学   30 ( 2 )   32 - 33   2012.1

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  • 東日本大震災医療支援にて経験したチーム医療

    名倉 弘哲

    岡山歯学会雑誌   30 ( 2 )   90 - 91   2011.12

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  • テイコプラニン初回投与設計におけるeGFR推算式を用いた血中濃度予測精度の検討 性別、年齢、血清クレアチニン値補正およびBMI値補正による影響

    小曳 恵里子, 佐藤 智昭, 上島 智, 黒田 真生, 大西 和也, 河崎 陽一, 名倉 弘哲, 松永 尚, 千堂 年昭

    TDM研究   28 ( 3 )   s162 - s162   2011.6

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  • テイコプラニン初回投与設計における血中濃度予測の検討 血清クレアチニン値補正、体重補正、eGFR推算式による影響

    小曳 恵里子, 佐藤 智昭, 上島 智, 黒田 真生, 大西 和也, 河崎 陽一, 名倉 弘哲, 松永 尚, 千堂 年昭

    日本薬学会年会要旨集   131年会 ( 4 )   265 - 265   2011.3

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  • 肝移植患者の周術期栄養管理下におけるDiamine oxidase活性測定の有用性

    横井 尋和, 松永 尚, 小曳 恵里子, 西宮 祐輔, 内山 慶子, 内藤 稔, 八木 孝仁, 楳田 祐三, 坂本 八千代, 埴岡 伸光, 成松 鎭雄, 千堂 年昭, 名倉 弘哲

    静脈経腸栄養   26 ( 1 )   377 - 377   2011.1

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  • 地域の薬剤師に対する緩和ケア教育の必要性と有用性

    今村 牧夫, 芝崎 由美子, 岡崎 宏美, 谷川 智絵, 森 英樹, 藤原 聡子, 西崎 文祥, 稲岡 あかり, 鍛治園 誠, 槌田 大輔, 川島 理恵子, 武本 千恵, 名倉 弘哲, 松永 尚

    日本病院薬剤師会雑誌   46 ( 7 )   963 - 968   2010.7

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    地域医療における薬剤師の緩和ケア業務状況を明らかにするために、岡山県内の保険薬局に対する実態調査に引き続き、医療施設における緩和医療の実態と病院薬剤師の活動状況を調査したところ、薬剤師職能が緩和医療の充実に寄与することが示唆されたが、多くの病院薬剤師は緩和ケア業務経験に乏しいことが明らかとなった。そこで、岡山緩和ケア薬剤師研究会が地域の薬剤師の緩和ケア知識の向上と情報共有のための薬・薬連携を図る目的で、病院薬剤師と保険薬局薬剤師を対象として、模擬症例を用いて緩和的介入法を講義する緩和ケア講習会を定期的に開催した結果、約71%の受講者は緩和ケア業務に対する自信が高まったと評価した。地域における緩和ケアの普及と質の向上を図るためには、薬・薬連携の充実と緩和ケア業務経験に乏しい薬剤師の知識と自信の向上が効果的であり、そのためには模擬症例を用いて系統的な緩和的介入法を講義する合同参加型の緩和ケア講習会が有用であると考えられた。(著者抄録)

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  • eGFR推算式を用いたベイジアン法におけるバンコマイシン血中濃度の予測精度評価

    黒田 真生, 佐藤 智昭, 上島 智, 松永 尚, 名倉 弘哲, 千堂 年昭

    TDM研究   27 ( 3 )   s145 - s145   2010.6

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  • ARCHITECTアナライザーを用いた化学発光免疫測定法(CLIA法)における遊離形フェニトインの測定

    佐藤 智昭, 上島 智, 黒田 真生, 名倉 弘哲, 松永 尚, 千堂 年昭

    TDM研究   27 ( 3 )   s192 - s192   2010.6

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  • eGFR推算式を用いたテイコプラニン初回投与設計における血中薬物濃度の予測精度評価

    小曳 恵里子, 佐藤 智昭, 上島 智, 黒田 真生, 名倉 弘哲

    TDM研究   27 ( 3 )   s153 - s153   2010.6

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  • 栄養障害時における血清Diamine oxidase(DAO)活性に関する探索的検討

    西宮 祐輔, 横井 尋和, 小曳 恵里子, 坂本 八千代, 名倉 弘哲, 松永 尚, 千堂 年昭

    日本薬学会年会要旨集   130年会 ( 4 )   290 - 290   2010.3

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  • 外来がん患者に対する薬剤師外来の有用性の検討

    今村 牧夫, 名倉 弘哲, 武本 千恵

    医療薬学   36 ( 2 )   85 - 98   2010.2

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    倉敷成人病センターでは外来癌化学療法患者に対する有害事象モニタリング等のリスクマネージメントを行ってきたが、早期に症状緩和を図れないことが問題であった。そこで薬剤師外来(サポート外来)を開設し、その有用性について検討した。サポート外来開設後に外来化学療法の導入が進み、外来化学療法施行件数とサポート外来診察数との高い相関関係が明らかとなった。サポート外来での処方中止・減量提案に対する処方採用率は97%と高かった。経過中にパフォーマンスステータスの有意な低下はなく、提案剤数が多かった症状ではコントロールが良好であった。患者に対するアンケート結果でも81%がサポート外来の有用性を評価した。サポート外来の運用により入院時と同様のチーム医療の提供が可能となり、癌患者のQOLの向上、癌治療の質の向上、医療業務の負担軽減、リスクマネージメントの強化に貢献できることが明らかとなった。

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J03520&link_issn=&doc_id=20100219340004&doc_link_id=10.5649%2Fjjphcs.36.85&url=https%3A%2F%2Fdoi.org%2F10.5649%2Fjjphcs.36.85&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 寒天固形化により下痢の改善し抗てんかん薬の血中濃度が安定した症例

    坂本 八千代, 小松 仁美, 名倉 弘哲, 内藤 稔, 松永 尚

    日本病態栄養学会誌   12 ( 5 )   207 - 207   2009.12

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  • 医歯薬学合同PBLテュートリアルワークショップの報告

    吉田 登志子, 三好 智子, 名倉 弘哲, 岡崎 宏美, 片岡 仁美, 久保田 聡, 越智 浩二

    医学教育   40 ( Suppl. )   155 - 155   2009.7

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  • PBL(Problem based learning)を用いた多学部間教育の試み

    三好 智子, 越智 浩二, 名倉 弘哲, 岡本 基, 岡崎 宏美, 片岡 仁美, 中村 好男, 池田 和真, 水島 孝明, 草野 展周, 小出 典男

    医学教育   40 ( Suppl. )   70 - 70   2009.7

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  • 病院実務実習における改善項目抽出法の検討

    相良 英憲, 北村 佳久, 岡崎 宏美, 名倉 弘哲, 千堂 年昭

    医療薬学   35 ( 3 )   202 - 208   2009.3

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    ビジネス領域で一般的に使用されている統計解析手法を用いて、薬学領域においても利用しやすく汎用性の高い改善項目の抽出法に活用した。25ヵ月間の病院実習を経験した実習生8例を対象とした。実習生には14項目のSpecific Behavioral Objective(SBO)に対して、実習体験・見学進捗状況を把握するために実習体験・見学調査表と、修得度調査表を記載させた。修得度評価が最も高い項目は、「医薬品の某本的な情報を、文献、MR(医薬情報担当者)などのさまざまな情報源から収集できる」で、最も低い項目は、「医薬品・医療用具等安全性情報報告用紙に、必要事項を記載できる」であった。「要改善項目」としてあげられたSBOの項日は、「DIニュースなどを作成するために、医薬品情報の評価、加工を体験する」と「医療スタッフからの質問に対する適切な報告書の作成を体験する」であった。

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  • 薬剤師のための褥瘡教育と今後の課題 東京都病院薬剤師会主催の専門薬剤師養成の取り組みから

    奥隅 貴久美, 名倉 弘哲, 嶋田 修治, 土谷 隆紀, 中嶋 基広, 山崎 篤司, 平野 公晟, 東京都病院薬剤師会褥瘡領域薬剤師養成特別委員会

    日本褥瘡学会誌   8 ( 3 )   452 - 452   2006.8

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  • 非定型的な褥瘡症例の治療経験

    加王 文祥, 小川 恵子, 澤部 慶子, 名倉 弘哲, 和久田 和美, 保阪 善昭

    日本褥瘡学会誌   7 ( 3 )   657 - 657   2005.8

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  • 昭和大学病院褥瘡ケアチームにおける薬剤師の役割

    名倉 弘哲, 佐々木 真澄, 寺地 順子, 澤部 慶子, 大塚 尚治, 加王 文祥, 村山 純一郎, 保阪 善昭, 飯嶋 正文

    日本褥瘡学会誌   5 ( 2 )   308 - 308   2003.8

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  • 褥瘡対策未実施減算制度導入後の当院褥瘡予防対策の効果

    寺地 順子, 澤部 慶子, 名倉 弘哲, 大塚 尚治, 加王 文祥, 保阪 善昭, 飯嶋 正文

    日本褥瘡学会誌   5 ( 2 )   342 - 342   2003.8

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  • 筋・筋膜皮弁 術後筋膜上脂肪組織の経時的変化 MRIによる検索

    大塚 尚治, 上田 拓文, 加王 文祥, 澤部 慶子, 寺地 順子, 名倉 弘哲, 大久保 文雄, 保阪 善昭

    日本褥瘡学会誌   5 ( 2 )   351 - 351   2003.8

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  • 携帯型電気メスを用いたベッドサイドにおける褥瘡デブリードマン

    加王 文祥, 大塚 尚治, 澤部 慶子, 寺地 順子, 小川 恵子, 名倉 弘哲, 大久保 文雄, 飯嶋 正文, 保阪 善昭

    日本褥瘡学会誌   5 ( 2 )   374 - 374   2003.8

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  • 食物アレルギーと肝臓及び小腸(第5報) 食物アレルギーモデルマウスにおけるSuplatast tosilate(IPD)の治療効果

    飯倉 洋治, 上野 幸三, 陳 虹, 養父 佐知子, 水野 裕美子, 名倉 弘哲, 小田嶋 安平

    アレルギー   50 ( 9-10 )   1016 - 1016   2001.10

  • 食物アレルギーと肝臓及び小腸(第4報) 食物アレルギーモデルマウスにおける漢方薬(TJ-41)の画像解析手法を用いた治療効果の検討

    陳 虹, 上野 幸三, 養父 佐知子, 水野 裕美子, 名倉 弘哲, 小田嶋 安平, 飯倉 洋治

    アレルギー   50 ( 9-10 )   1016 - 1016   2001.10

  • 日本人と欧米人におけるCYP2A6遺伝子多型の解析

    宮本 昌美, 梅津 有理, 醍醐 聡, Beaune Philippe, Loriot Marie-Anne, Stucker Isabelle, 木下 盛敏, 名倉 弘哲, 立石 智則, 小林 真一

    臨床薬理   31 ( 2 )   301 - 302   2000.3

  • ラテックスビーズによるcisplatin損傷DNA結合性因子の精製

    友廣 岳則, 吉田 周平, 小高 正人, 奥野 洋明, 澤田 潤一, 澤 智華, 名倉 弘哲, 半田 宏

    日本薬学会年会要旨集   119年会 ( 3 )   114 - 114   1999.3

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  • 日本人におけるCYP2D6遺伝子診断とフェノタイピングとの関連

    千田 道洋, 有吉 範高, 名倉 弘哲, 立石 智則, 小林 真一, 溝呂木 能浩, 鎌滝 哲也

    臨床薬理   30 ( 1 )   81 - 82   1999.1

  • 日本人におけるCYP2A6遺伝子全欠損型の判定法の開発

    梅津 有理, 高橋 由紀, 有吉 範高, 木下 盛敏, 名倉 弘哲, 立石 智則, 小林 真一, 溝呂木 能浩, 清水 瓊子, 鎌滝 哲也

    薬物動態   13 ( Suppl. )   S193 - S193   1998.10

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  • 高脂血症自然発症ラットにおけるテオフィリンの体内動態

    名倉 弘哲

    臨床薬理   28 ( 1 )   225 - 226   1997.3

  • 高脂血症自然発症ラットの脂質の及ぼすストレプトゾトシンの影響

    名倉 弘哲

    日本薬理学雑誌   108 ( 4 )   81P - 81P   1996.10

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  • 高脂血症自然発症ラット肝におけるコレステロール代謝

    名倉 弘哲, 渡辺 実, 田中 政巳, 熊井 俊夫, 立石 智則, 中谷 祥子, 小林 真一, Patrick Brassil J.

    日本薬学会年会要旨集   116年会 ( 3 )   33 - 33   1996.3

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  • 高血糖合併時の高脂血症自然発症ラット肝CYP3A2の変動

    名倉 弘哲

    薬物動態   10 ( Suppl. )   340 - 340   1995.10

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  • 高脂血症自然発症ラット(HLR)肝薬物代謝酵素に関する研究 テオフィリンの体内動態について

    名倉 弘哲

    薬物動態   9 ( Suppl. )   395 - 395   1994.10

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  • 絶食によるスンクスP-4502E mRNA及び蛋白レベルの減少

    名倉 弘哲

    生化学   63 ( 8 )   838 - 838   1991.8

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  • スンクス肝チトクロームP-450のcDNAクローニング

    名倉 弘哲

    日本薬学会年会要旨集   111年会 ( 3 )   127 - 127   1991.3

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  • 肝ミクロゾームを用いたマクロライド系抗生物質の活性代謝物の検索

    名倉 弘哲

    薬物動態   5 ( 4 )   571 - 571   1990.9

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