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抗不整脈薬の薬理遺伝学的情報に基づく効果的な治療薬物モニタリング
http://hdl.handle.net/2241/00153697
http://hdl.handle.net/2241/00153697b4cb8a7a-811f-4e31-9a7b-7cd0931eef4e
名前 / ファイル | ライセンス | アクション |
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YZ_138-9 (462.7 kB)
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Item type | Journal Article(1) | |||||
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公開日 | 2018-11-15 | |||||
タイトル | ||||||
タイトル | 抗不整脈薬の薬理遺伝学的情報に基づく効果的な治療薬物モニタリング | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Use of Pharmacogenetic Information for Therapeutic Drug Monitoring of an Antiarrhythmic Drug | |||||
言語 | ||||||
言語 | jpn | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | journal article | |||||
著者 |
Doki, Kosuke
× Doki, Kosuke |
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著者別名 |
土岐, 浩介
× 土岐, 浩介 |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Antiarrhythmic drugs require therapeutic drug monitoring (TDM) to avoid adverse effects such as proarrhythmia. However, TDM is not necessarily used to adjust the dosage of antiarrhythmic drugs because there is a lack of information regarding the therapeutic range of the serum concentration and the selection of patients who require TDM. The aim of this review was to provide an overview of the pharmacogenetic information on the pharmacokinetics and drug response of flecainide, a class Ic antiarrhythmic drug with a sodium channel-blocking effect. A population pharmacokinetic analysis revealed that the CYP2D6 genotype was a determining factor of the age-related decline in flecainide clearance. Elderly patients show large interindividual variability of flecainide clearance because they have a more pronounced effect of the CYP2D6 genotype and require more frequent monitoring of serum flecainide concentrations. Carriers of an Asian-specific promoter haplotype B of the cardiac sodium channel gene (SCN5A) more frequently achieve clinically relevant flecainide efficacy even at lower concentrations. This suggests that the therapeutic range of serum flecainide concentrations is lower in SCN5A promoter haplotype B carriers than in the wild-type haplotype A homozygotes. The β1-adrenergic receptor Gly389 polymorphism decreases the antiarrhythmic efficacy of flecainide when co-administered with β-blockers. Carriers of Gly389 with co-administration of β-blockers may not achieve clinically relevant flecainide efficacy even when the serum flecainide concentrations are within the therapeutic range. These findings provide pharmacogenetic information for the effective utilization of TDM in antiarrhythmic drug therapy. | |||||
書誌情報 |
藥學雜誌 en : Yakugaku zasshi 巻 138, 号 9, p. 1145-1150, 発行日 2018-09 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 0031-6903 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AN00241525 | |||||
PubMed番号 | ||||||
識別子タイプ | PMID | |||||
関連識別子 | 30175758 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1248/yakushi.18-00114 | |||||
権利 | ||||||
権利情報 | © 2018 The Pharmaceutical Society of Japan | |||||
著者版フラグ | ||||||
値 | publisher | |||||
出版者 | ||||||
出版者 | 公益社団法人日本薬学会 | |||||
出版者別名 | ||||||
出版者 | Pharmaceutical Society of Japan |