[Pharmacokinetic and molecular biological approaches to achieve the safety and effective management of drug therapies].
To prevent medical errors, especially drug-related ones, clinical pharmacists have to play an important role in multidisciplinary team care. We have investigated the pharmacokinetics, pharmacodynamics, and molecular biology of several drugs and have applied the findings obtained in our studies to therapeutic drug monitoring. The first finding is that achieving vancomycin (VCM) concentrations at an appropriate concentration contributes to a decreased incidence of VCM-induced nephrotoxicity and a decreased duration of VCM therapy. From this result, we have constructed a system to provided recommendations for VCM doses to attending medical staff as soon as possible. The second finding is that we clarified the risk factors for steroid-induced diabetes in patients with neurologic diseases, indicating a close relationship among postprandial hyperglycemia, advanced age, and hypercholesterolemia in these patients. We also determined that monitoring plasma glucose concentrations 2 hours after lunch could be useful to detect diabetes in these patients. Finally, we identified the mechanism of 3'-azido-3'-deoxythymidine and dacarbazine photogenotoxicity, including the specific site of DNA damage. These findings may provide useful information to prevent phototoxicity of drugs and to develop new photodynamic therapies.
Iwamoto
Takuya
T
Department of Hospital Pharmacy, Mie University School of Medicine, Department of Clinical Pharmacy and Biopharmaceutics, Mie University Graduate School of Medicine, Japan. taku-iwa@clin.medic.mie-u.ac.jp
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D003606:Dacarbazine / Q000633:toxicity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology; D016903:Drug Monitoring; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D009422:Nervous System Diseases / Q000150:complications; D010599:Pharmacokinetics; D011239:Prednisolone / Q000009:adverse effects; D012307:Risk Factors; D017751:Safety Management; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D001786:Blood Glucose; D014640:Vancomycin; D003606:Dacarbazine; D011239:Prednisolone