所属 |
附属病院 薬剤部 |
研究等業績 【 表示 / 非表示 】
-
Hayato Yokota, Yumiko Akamine, Mizuki Kobayashi, Takuro Kitabayashi, Misato Horie, Tentaro Endo, Takechiyo Yamada, Masafumi Kikuchi
Journal of pharmaceutical health care and sciences ( Journal of Pharmaceutical Health Care and Sciences ) 10 ( 1 ) 2024年08月
研究論文(学術雑誌)
BACKGROUND: Naldemedine is an orally available peripherally acting μ-opioid receptor antagonist approved to treat opioid-induced constipation (OIC). It is contraindicated for patients with known or suspected gastrointestinal obstruction to protect against naldemedine-induced perforation. Here, we report a clinical case of suspected perforation of a diverticulum in the sigmoid colon associated with naldemedine. CASE PRESENTATION: The patient was a 65-year-old man with a history of oral cancer who had been prescribed oxycodone (20 mg/day) for cancer pain. On day 0, the patient started naldemedine 0.2 mg once daily before bedtime for OIC. The dose of oxycodone was increased for pain control up to 60 mg/day. On day 35 of naldemedine treatment, the patient developed fever and abdominal pain, and his frequency of defecation had decreased. Initial laboratory results showed a C-reactive protein (CRP) level of 28.5 mg/dL and white blood cell (WBC) count of 13,500/µL. On day 37, the patient still had tenderness in his lower abdomen. Abdominal computed tomography revealed free air in the abdominal cavity suggesting an intestinal perforation. A Hartmann procedure was performed. Histopathological findings showed numerous diverticula in the sigmoid colon, some of which were perforated. CONCLUSIONS: These results suggest that the effects of OIC may have compressed the intestinal tract, which was followed by naldemedine-activation of peristalsis, which led to the onset of intestinal perforation. In patients with pre-existing diverticular disease, we should monitor for increased WBC counts and CRP levels after the initiation of treatment with naldemedine, and consider performing appropriate tests early in the event of abdominal complaints.
-
Kazuma Fujita, Yumiko Akamine, Haruka Igarashi, Yayoi Fukushi, Katsuya Sasaki, Koji Fukuda, Masafumi Kikuchi, Hiroyuki Shibata
Japanese journal of clinical oncology ( Japanese Journal of Clinical Oncology ) 54 ( 11 ) 1165 - 1170 2024年06月
研究論文(学術雑誌)
BACKGROUND: The modified Glasgow Prognostic Score (mGPS) and Prognostic Nutritional Index (PNI) are indicators of nutritional status in cancer patients; however, the effects of baseline mGPS and PNI on the duration of administration of the ghrelin receptor agonist anamorelin, which is used to treat cachexia in patients with cancer, are unclear. This study aimed to clarify the association of mGPS and PNI with the duration of oral anamorelin administration for patients who did not have beneficial effects from anamorelin. METHODS: The attending physician determined the duration of oral anamorelin administration based on discontinuation due to cancer progression, poor efficacy, adverse events, or death. RESULTS: The 12-week continuation rate of oral anamorelin was 30.4%. Univariate analysis revealed that an Eastern Cooperative Oncology Group performance status (ECOG-PS) of ≥2 (P < .001), concurrent chemotherapy (P = .002), albumin level (P = .005), C-reactive protein level (P = .013), and a mGPS of 2 (P = .014) were statistically significant predictors of the 12-week continuation rate of oral anamorelin. In the multivariate analysis, a mGPS of 2 remained a significant risk factor, and the ECOG-PS and concurrent chemotherapy had no effect on the association between the mGPS and 12-week continuation rate of oral anamorelin. CONCLUSION: Patients with a mGPS of 2, compared with mGPS of 0 or 1, are less likely to maintain oral anamorelin therapy, regardless of the ECOG-PS or concurrent chemotherapy. Therefore, it is necessary to consider initiating anamorelin administration at mGPS 0 or 1.
-
Hayato Yokota, Ruriko Asahi, Yumiko Akamine, Mizuki Kobayashi, Hiyu Wakabayashi, Sho Sakamoto, Yuji Okuda, Kazuhiro Sato, Katsutoshi Nakayama, Masafumi Kikuchi
Journal of pharmaceutical health care and sciences ( Journal of Pharmaceutical Health Care and Sciences ) 10 ( 1 ) 2024年06月
研究論文(学術雑誌)
BACKGROUND: Anamorelin, a drug to treat cancer cachexia, binds to ghrelin receptors and improves body weight and appetite. In clinical trials in Japan, patients experienced a 10.7% frequency of stimulant conduction system depression as a severe side effect. Although rare, anamorelin sometimes causes fatal arrhythmias. Because patients with cancer cachexia are often underweight, data on the safety of anamorelin in obese patients are lacking. We report a case of QT interval prolongation after anamorelin administration to an obese patient with non-small cell lung cancer. CASE PRESENTATION: A female patient with a body mass index of 30 kg/m2 underwent immunotherapy for lung adenocarcinoma. She presented with severe weight loss, anorexia, and fatigue. She had no history of heart disease. On day 12, after administration of anamorelin 100 mg once daily, the patient developed nausea, diarrhea, and anorexia, which were considered cancer immunotherapy-induced immune-related adverse events, and she was admitted to the hospital. An electrocardiogram (ECG) on admission showed a QTc interval of 502 ms. On admission, her hepatic function was Child-Pugh class B, and anamorelin was discontinued the next day. On day 3 after anamorelin discontinuation, the QTc interval was prolonged by up to 557 ms, then decreased to 490 ms on day 6, and improved to 450 ms on day 16. Re-administration of anamorelin was avoided. CONCLUSIONS: When administering anamorelin to obese patients, we should be aware of the potential for stimulatory conduction system depression, as in underweight patients. Therefore, we should monitor patients by ECG from the early stages of anamorelin administration. Anamorelin is lipophilic, and its volume of distribution is increased in obese patients. Consequently, obese patients may continue to have QT interval prolongation after discontinuation of anamorelin, requiring long-term side-effect monitoring.
-
Yumiko Akamine, Miyuki Matsushita, Satoru Morikawa, Masatomo Miura
Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan ( 公益社団法人 日本薬学会 ) 143 ( 4 ) 377 - 383 2023年
研究論文(学術雑誌)
Plasma concentrations of mycophenolic acid (MPA), an immunosuppressive agent, have been measured in clinical settings using immunoassay methods or HPLC. However, immunoassay methods show cross-reactivity with metabolites of MPA glucuronide. Recently, the LM1010 high-performance liquid chromatography instrument was approved as a new general medical device. In this study, we compared the results of MPA plasma concentrations analyzed using the LM1010 method and the previously described HPLC method. Plasma samples obtained from 100 renal transplant patients (32 women and 68 men) were evaluated using both HPLC instruments. Deming regression analyses showed a very high correlation between the two instruments, with a slope of 0.9892 and an intercept of 0.0235 µg/mL (r2=0.982). Bland-Altman analysis showed an average of -0.0012 µg/mL between the LM1010 method and the previously described HPLC method. For the LM1010 method, the total run time for MPA analysis was 7 min, and the analytical time was short; however, the extraction recovery when using a spin column was extremely low for frozen plasma samples stored at -20°C for 1 month, and the volume required for the assay (150 µL) could not be collected. Thus, for the LM1010 method, analysis using fresh plasma samples was optimal. Overall, our findings showed that the LM1010 method was a rapid, accurate HPLC assay for MPA analysis and could be used in clinical practice for routine monitoring of MPA in fresh plasma samples.
-
Yayoi Fukushi, Yumiko Akamine, Miyuki Matsushita, Satoru Morikawa, Masatomo Miura
Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan ( 公益社団法人 日本薬学会 ) 143 ( 11 ) 963 - 969 2023年
研究論文(学術雑誌)
LM1010 HPLC is an emerging automated method designed for use in clinical settings. The aim of this study was to compare the analytical performance of LM1010 with the performance of traditional HPLC and LC-MS/MS in the measurement of plasma concentrations of imatinib. Seventy-eight plasma samples from 20 patients (14 men and 6 women) were collected. Plasma concentrations of imatinib in samples from the same patient were analyzed simultaneously using LM1010, HPLC and LC-MS/MS (LSI Medience Corporation). Strong correlations were seen in pairwise comparisons of results from the LM1010 and HPLC methods, the LM1010 and LC-MS/MS methods, and the LC-MS/MS and HPLC methods (Spearman's r=0.936, 0.906, and 0.953, respectively); however, the results from the LC-MS/MS method showed a positive proportional bias in comparison with the results from the LM1010 and HPLC methods, according to Deming analyses (slope=1.064 and 1.105, respectively). In Bland-Altman analyses, the LC-MS/MS method showed a positive mean bias of 98.6 and 112 ng/mL in comparison with the LM1010 and HPLC methods, respectively. Notably, results obtained using the LM1010 method were comparable to those using the HPLC method (positive mean bias=13.6 ng/mL; 95% confidence interval, -7.9-35.1 ng/mL). Biochemical parameters or drugs taken concomitantly with imatinib were not found to affect the bias of the LM1010 method. The LM1010 method can be applied to routine therapeutic drug monitoring of imatinib.
-
An update on the clinical pharmacokinetics of fexofenadine enantiomers.
Akamine Y and Miura M.
Expert Opinion on Drug Metabolism & Toxicology ( Taylor and Francis Group ) 2018年04月
総説・解説(学術雑誌) 国内共著
-
高速液体クロマトグラフィ分析装置LM1010を用いたフェニトインとカルバマゼピンの同時血中濃度定量と化学発光免疫測定法との比較
赤嶺 由美子, 松下 美由紀, 森川 悟, 三浦 昌朋
医療薬学 ( (一社)日本医療薬学会 ) 50 ( 9 ) 465 - 472 2024年09月
-
【臨床での疑問にこたえる 統計データの読み方,使い方】実践編 ケーススタディから学ぶ臨床での問題・疑問へのアプローチ もしかして,これって副作用?
赤嶺 由美子
薬事 ( (株)じほう ) 66 ( 12 ) 2341 - 2343 2024年09月
<Key Points>◎抗精神病薬の多くは,同じ薬剤を同じ投与量で使用しても治療効果や副作用発現に個人差が大きい。◎2022年度の診療報酬改定にて,抗精神病薬であるクロザピンが特定薬剤治療管理料1の対象薬剤として追加となった。治療薬物モニタリングを実施することは,臨床で経験した副作用に対して実際の血中濃度から議論することができるため,非常に有用な手段である。◎システマティックレビューは多くの論文情報が集約されており,エビデンスレベルも高く,効率的に情報を集める手段として非常に有用である。(著者抄録)
-
がん悪液質の患者におけるアナモレリン治療継続期間に影響する因子の解明
五十嵐 遥, 藤田 一馬, 福司 弥生, 赤嶺 由美子, 佐々木 克也, 柴田 浩行
日本臨床腫瘍薬学会雑誌 ( (一社)日本臨床腫瘍薬学会 ) 36 277 - 277 2024年05月
-
【血中濃度の変動要因を見極めよう 悩ましい薬物動態の諸問題】実践編 薬剤別マネジメント 向精神薬
赤嶺 由美子
薬事 ( (株)じほう ) 66 ( 3 ) 527 - 533 2024年02月
<Key Points>◎向精神薬の多くは,薬物代謝酵素や薬物輸送トランスポータの基質となるとともに,自身が阻害薬となることもあるため,考慮しなければならない薬物相互作用は非常に多い。◎向精神薬には,主消失経路が肝代謝である薬物が多くあり,肝クリアランスが全身クリアランスに大きな影響を及ぼす。そのため,肝機能障害時は,CYP活性低下に伴い血中濃度が上昇するため,慎重なモニタリングが必要となる。◎一般の方よりも,統合失調症患者においては喫煙率が高くなることが報告されており,喫煙時の相互作用にはより注意が必要である。◎バイオマーカーの少ない精神科領域にとって客観的な判断材料として,血中濃度が果たす役割は非常に大きい。(著者抄録)
◆原著論文【 表示 / 非表示 】
◆総説・解説【 表示 / 非表示 】
◆その他【 表示 / 非表示 】
産業財産権 【 表示 / 非表示 】
-
クロザピン又はその誘導体の血中薬剤濃度上昇リスク判定方法及び薬剤投与量判定方法
特許
特願 特願2016-092152 特開 特開2017-195862 特許 特許第6807094号
出願日: 2016年04月29日
公開日: 2017年11月02日
赤嶺 由美子, 三浦 昌朋
学術関係受賞 【 表示 / 非表示 】
-
日本医療薬学会奨励賞
2022年09月24日 一般社団法人日本医療薬学会 精神科領域における個別化薬物療法の開発
受賞者: 赤嶺由美子 -
女性研究者支援コンソーシアムあきた賞
2020年11月26日 秋田県 患者血液中マーカーを用いた 精神科領域の個別化薬物療法の確立
受賞者: 赤嶺由美子 -
秋田県病院薬剤師会臨床薬学賞
2020年06月06日 一般社団法人秋田県病院薬剤師会 精神科領域における 個別化薬物療法の確立
受賞者: 赤嶺由美子 -
第27回日本医療薬学会年会 優秀演題賞
2017年11月04日 一般社団法人日本医療薬学会 ACMIA, CLIA, ECLIA, LTIA法によるタクロリムス血中濃度測定値へのCYP3A5遺伝子多型の影響
受賞者: 赤嶺由美子,加賀谷英彰, 佐藤滋, 三浦 昌朋 -
日本薬学会九州支部 学術奨励賞
2013年12月07日 日本薬学会九州支部 フェキソフェナジンの立体選択的体内動態とその規定因子の解析
受賞者: 赤嶺由美子
科研費(文科省・学振)獲得実績 【 表示 / 非表示 】
-
抗精神病薬誘発性代謝異常に関するメカニズム研究
基盤研究(C)
研究期間: 2021年04月 - 2025年03月 代表者: 赤嶺 由美子
-
抗精神病薬誘発性代謝異常に関するメカニズム研究
基盤研究(C)
研究期間: 2021年04月 - 2025年03月 代表者: 赤嶺 由美子
-
抗精神病薬誘発性代謝異常に関するメカニズム研究
基盤研究(C)
研究期間: 2021年04月 - 2025年03月 代表者: 赤嶺 由美子
その他競争的資金獲得実績 【 表示 / 非表示 】
-
クロザピン活性代謝物血中濃度測定の臨床的意義に関する研究
提供機関: 民間財団等 先進医薬研究振興財団
研究期間: 2018年12月 - 2019年11月 代表者: 赤嶺由美子
資金支給機関区分:民間財団等
-
PK-PD-PGx に基づいたクロザピン個別化療法の確立
提供機関: 民間財団等 薬学研究奨励財団
研究期間: 2016年04月 - 2019年03月 代表者: 赤嶺由美子
資金支給機関区分:民間財団等
-
クロザピンの個別化治療の確立
提供機関: 民間財団等 臨床薬理研究振興財団
研究期間: 2016年04月 - 2017年10月 代表者: 赤嶺由美子
資金支給機関区分:民間財団等