アブストラクト
Japanese
| Title | 免疫抑制剤TDM実施において考慮すべき点 |
|---|---|
| Subtitle | 総説 |
| Authors | 三浦昌朋1), 見野靖晃2), 本間真人3), 新岡丈典4), 竹内裕紀5) |
| Authors (kana) | |
| Organization | 1)秋田大学医学部附属病院薬剤部, 2)浜松医科大学医学部附属病院薬剤部, 3)筑波大学医学医療系臨床薬剤学, 4)弘前大学医学部附属病院薬剤部, 5)東京医科大学病院薬剤部 |
| Journal | 日本臨床腎移植学会雑誌 |
| Volume | 9 |
| Number | 2 |
| Page | 149-156 |
| Year/Month | 2021 / 12 |
| Article | 報告 |
| Publisher | 日本臨床腎移植学会 |
| Abstract | 「要旨」: 免疫抑制剤であるカルシニューリン阻害剤, ミコフェノール酸モフェチル, エベロリムスは, 血中濃度をモニタリング(therapeutic drug monitoring : TDM)しながら維持投与量の調節を図っている. しかし得られた血中濃度の数値の背景を正しく理解しておかなければ, 誤った薬物投与設計へとつながる. 現在, 複数の各免疫抑制剤の血中濃度を測定できる機器が存在するが, 各機器によって得られる血中濃度の値に乖離がみられる. そのため各機器の特性を十分に理解し, 血中濃度の数値と測定機器をセットにしながらTDMを実施することが求められる. また最終服薬から採血までの時間も正確に把握する必要がある. シクロスポリンベース時やタクロリムスベース時の各レジメンにおいて, 特徴的な薬物相互作用も観察されている. 組み合わせる免疫抑制剤や併用する薬剤も考慮し, 長期生着を目指して定期的にTDMを実施していく必要がある. |
| Practice | 臨床医学：外科系 |
| Keywords | therapeutic drug monitoring, シクロスポリン, タクロリムス, ミコフェノール酸モフェチル, エベロリムス, cyclosporine, tacrolimus, mycophenolic acid, everolimus |
English
| Title | Important points in applying therapeutic drug monitoring to immunosuppressive drugs |
|---|---|
| Subtitle | |
| Authors | Masatomo Miura1), Yasuaki Mino2), Masato Homma3), Takenori Niioka4), Hironori Takeuchi5) |
| Authors (kana) | |
| Organization | 1)Department of Pharmacy, Akita University Hospital, 2)Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 3)Department of Pharmaceutical Sciences, Faculty of Medicine, University of Tsukuba, 4)Department of Pharmacy, Hirosaki University Hospital, 5)Department of Hospital Pharmacy, Tokyo Medical University Hospital |
| Journal | Journal of Japanese Society for Clinical Renal Transplantation |
| Volume | 9 |
| Number | 2 |
| Page | 149-156 |
| Year/Month | 2021 / 12 |
| Article | Report |
| Publisher | Japanese Society for Clinical Renal Transplantation |
| Abstract | Immunosuppressive drugs, including cyclosporine, tacrolimus, mycophenolic acid, and everolimus, are frequently prescribed to prevent the loss or rejection of a transplanted organ. Therapeutic drug monitoring (TDM) is an important tool that is used to adjust dosages to achieve target blood or plasma concentrations, but several issues must be considered when applying TDM to these immunosuppressants. First, immunoassay methods have the potential to determine blood or plasma concentrations with high precision and accuracy, but these assays give notoriously inconsistent results when applied to immunosuppressants. Because accurate concentrations for each immunosuppressant are needed to ensure long-term survival of transplant recipients, value of blood or plasma concentration and immunoassay method calculated this value must be considered together. Second, the simulation for the prediction of pharmacokinetics of each immunosuppressive drug can have a significant impact on blood or plasma concentration at one point ; therefore, times between drug ingestion and blood sampling must be standardized. Finally, interpretation of TDM results must take into account potential interactions between immunosuppressive drugs and with concomitant drugs. Thus, while TDM serves as an important tool to optimize maintenance therapy of transplant patients, care must be taken in its implementation. |
| Practice | Clinical surgery |
| Keywords | therapeutic drug monitoring, cyclosporine, tacrolimus, mycophenolic acid, everolimus |
- 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。
参考文献
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残りの16件を表示する
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