入院患者へのヒスタミンH_2受容体拮抗薬の適正使用 : クレアチニンクリアランス予測値に基づく補正用量と処方用量との比較

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The major elimination route for histamine H_2-receptor antagonists (H_2-antagonists), such as famotidine, ranitidine, and cimetidine, is urinary excretion. Therefore, if the dosage adjustments for renally impaired patients or elderly patients are improper, such patients will likely have adverse effects such as mental confusion and seizures due to these drugs. In the package inserts of these H_2-antagonists, methods for adjusting the dosage according to the creatinine clearance (CLcr) are provided. In this study we investigated the prescription profiles of famotidine, ranitidine, and cimetidine for inpatients during a three month period at the Kansai Rosai Hospital. The CLcr values were estimated based on the serum creatinine concentration, age, and body weight of each patient according to the equation of Cockcroft and Gault, in order to consider the appropriate usage of H_2-antagonists from the relationship between the patient's renal function and dosage. More than 70% of all patients who were prescribed the H_2-antagonists were elderly patients (more than 60 years old), and 37% were found to have their estimated CLcr to be less than 60mL/min. The dosage for 22% of patients was calculated to be excessive according to the estimated CLcr. These results indicated that prescription monitoring by hospital pharmacists according to the patient's CLcr may contribute to the appropriate dosage management of H_2-antagonists for inpatients.
日本医療薬学会の論文
2003-08-10

入院患者へのヒスタミンH_2受容体拮抗薬の適正使用 : クレアチニンクリアランス予測値に基づく補正用量と処方用量との比較

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