@article{oai:gifu-pu.repo.nii.ac.jp:00013003,
 author = {木村, 美智男 and 寺町, ひとみ and キムラ, ミチオ and テラマチ, ヒトミ and KIMURA, Michio and TERAMACHI, Hitomi},
 journal = {岐阜薬科大学紀要, The annual proceedings of Gifu Pharmaceutical University},
 month = {Jun},
 note = {P(論文), 病院薬剤師は、医師と協働して、薬学的介入、すなわち、患者に最適な薬物療法を提供する必要がある。特に、が
ん化学療法においては有効で安全な治療を継続し、終末期ケアではquality of life (QOL)の維持・向上を目的とした処方設
計が、臨床上の課題である。そこで、がん薬物療法時に、病院薬剤師による薬学的介入のための指標を構築することを目
的に研究を行った。胃がん術後補助化学療法におけるtegafur・gimeracil・oteracil potassium（S-1）療法では、手術前から
S-1 服薬開始時までのbody mass index 減少量は、治療が中止・減量となった患者（2.78±1.89）より継続できた患者
（1.68±0.83）の方が小さいことを明らかにした。また、副作用によりS-1 の減量または中止に影響を及ぼす有意な因子
として、血清アルブミン値<3.5g/dL、クレアチニンクリアランス値<80mL/min が見出された。在宅用高カロリー輸液の処
方設計として、あらかじめ高カロリー輸液内にインスリンを添加したものを投薬せざるを得ない場合、溶液中の亜硫酸水
素ナトリウム1g に対する糖質のグラム数（G/g）が364.6 以下の場合、インスリンの残存率は低下を示し、466.0 以上の
場合には低下を示さないことを見出した。以上、本研究において得られた知見は、臨床に携わる薬剤師が、がん薬物療法
時に薬学的介入を実践する際の極めて有用な指標となり、副作用の予防および治療効率の向上に貢献できた。, Hospital pharmacists, in collaboration with doctors, must provide pharmaceutical interventions, namely,
pharmacotherapies optimized to the patient. Continued, effective, and safe therapies in cancer chemotherapy and pharmacotherapy
designs that aim to maintain and improve quality of life in terminal care are particularly challenging in a clinical setting. Therefore,
we aimed to establish indicators for pharmaceutical intervention during cancer pharmacotherapy for use by hospital pharmacists. For
adjuvant chemotherapy with tegafur/gimeracil/oteracil potassium (S-1) after surgery for stomach cancer, reductions in body mass
index during the time before surgery to commencing the administration of S-1 were less in the patients who were able to continue the
S-1 treatment (1.68 ± 0.83) than in the patients in whom therapy had to be ceased or reduced (2.78 ± 1.89). Additionally, significant
factors correlated with cessation or reduction of S-1 owing to adverse effects included serum albumin levels < 3.5 g/dL and creatinine
clearance rates < 80 mL/min. For total parenteral nutrition for home use, when the addition of insulin to total parenteral nutrition
could not be avoided, the residual ratio of insulin was reduced if the number of grams of carbohydrates per gram of sodium bisulfite
(G/g) was ≤364.6, but not if the number of grams was ≥466.0. Indicators of the terminal stage in patients, such as reduced food intake
and abnormalities in kidney or liver function, were used to establish a condition score. In those with scores of ≥6/11 points, steroids
had little effect on malaise. In conclusion, the findings of the present study are very useful indicators, for pharmacists, in a clinical
setting. They may help to prevent adverse effects and to improve efficacy when implementing pharmaceutical interventions during
cancer pharmacotherapy.},
 pages = {28--36},
 title = {がん薬物療法における薬学的介入の指標構築に関する研究},
 volume = {64},
 year = {2015}
}