アブストラクト
| Title | 精神科領域のTDMと評価のポイント - クロザピンのTDMを臨床にどう生かすか - |
|---|---|
| Subtitle | 総説 |
| Authors | 古郡規雄 |
| Authors (kana) | |
| Organization | 獨協医科大学精神神経医学講座 |
| Journal | 日本病院薬剤師会雑誌 |
| Volume | 58 |
| Number | 12 |
| Page | 1389-1392 |
| Year/Month | 2022 / 12 |
| Article | 報告 |
| Publisher | 日本病院薬剤師会 |
| Abstract | 治療抵抗性統合失調症(treatment-resistant schizophrenia: 以下, TRS)に適応のあるクロザピンはほかの抗精神病薬と明らかに異なる臨床プロファイルをもつ. 4週目に目標量に達した後は, 少なくとも5日間は同一用量を維持し, 薬物血中濃度モニタリング(therapeutic drug monitoring: 以下, TDM)を測定することが重要である. 定常状態のトラフ値(1日の最低濃度)を指標としたクロザピンの血清濃度の治療基準範囲は350〜600ng/mLと狭く, 高濃度になるほど毒性およびADRの発現の可能性は高くなる. クロザピンは主にCYP1A2によって代謝され(非喫煙者女性では最低用量, 喫煙者男性では最高用量), CYP遺伝子型の違いによる代謝低下型は, クロザピン代謝阻害剤(経口避妊薬, バルプロ酸を含む)の併用, 肥満, C反応性蛋白(C-reactive protein: 以下, CRP)の上昇を伴う炎症とも関連している. |
| Practice | 薬学 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
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