Hideaki Yashima
Department of Pharmacy, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan

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Development of a quantitative method for sunitinib N-oxide Yuya Ishikawa; Takuya Araki; Miki Takenaka Sato; Hideaki Yashima; Daisuke Nagano; Koujirou Yamamoto
Indonesian Journal of Pharmaceutics Vol 3, Issue 2, May - August, 2021
Publisher : Universitas Padjadjaran (Unpad)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/idjp.v3i2.37368

Abstract

We developed a simple method for quantifying sunitinib N-oxide (SNO) in human serum using a supported liquid extraction (SLE) method and liquid chromatography/tandem mass spectrometry (LC-MS/MS) to assess the impact of SNO on adverse drug reactions (ADRs) caused by sunitinib. SNO was extracted using an SLE method and analyzed using an Xevo-TQ (Waters) LC-MS/MS system. SNO and voriconazole (internal standard; ISTD) were detected in ESI positive mode, with transitions at 415.4/326.3 for SNO and 350.1/281.1 for voriconazole. The retention times of SNO and voriconazole were 2.25 and 2.67 min, respectively, and good calibration curve was obtained from 0.1–5.0 ng/mL for SNO. The regression equation (weight = 1/x2) describing the calibration curve in human serum was y = 2.81 × 10-9 x2 + 0.000253 x – 0.00202 (R2 = 0.990), where y is the peak area ratio of SNO against the ISTD and x is the nominal concentration of SNO. The intra- and inter-assay accuracy varied between -2.4 and 15.6% and all data except the limit of quantification (LOQ) were within ±10%. The precision varied between 6.7–15.4% and all data except LOQ were under 15%. The mean recovery ratio of SNO was 90.3 ± 4.9%, and the mean matrix factor was 0.96 ± 0.031. This is the first report of a method to quantify SNO in blood. This method will help in elucidating the effects of SNO in humans, contribute to the elucidation of the ADRs expression factors associated with sunitinib, and aid in optimizing treatment with sunitinib.
Hospitalized patients on orexin receptor antagonists have a lower risk of falls Yukina Ohshima; Takuya Araki; Hideaki Yashima; Noriyuki Nakayama; Koujirou Yamamoto
Indonesian Journal of Pharmaceutics Vol 4, Issue 2, May - August, 2022
Publisher : Universitas Padjadjaran (Unpad)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/idjp.v4i2.44186

Abstract

Falls and fall-related injuries remain a major safety concern in many hospitals and nursing homes. Although many studies have examined the relationship between accidents and sedating medications, further analysis is needed of the association between falls and individual hypnotics. The aim of this study was to clarify the association between hypnotics and the risk of falls in hospital. The impact of hypnotics on fall events was retrospectively evaluated in patients aged 20 years or older who were admitted to Gunma University Hospital between January 2013 and March 2022. Logistic regression analysis was performed with age, sex, and drug prescription status as the independent variables and fall events as the dependent variable. Of the 54,019 patients included in the study, 1,460 experienced a fall during hospitalization (incidence, 2.7%). The hypnotics prescribed included orexin receptor antagonists, melatonin receptor agonists, and benzodiazepine receptor agonists. Logistic regression analysis showed that age (odds ratio [OR] 1.04), male sex (OR 1.14), estazolam (OR 2.99), flunitrazepam (OR 2.34), brotizolam (OR 1.65), diazepam (OR 3.34), lorazepam (OR 2.93), alprazolam (OR 1.91), ethyl loflazepate (OR 2.81), zolpidem (OR 1.40), eszopiclone (OR 1.87), clonazepam (OR 1.94), and ramelteon (OR 2.15) independently contributed to falls. Short-acting benzodiazepine receptor agonists tended to have smaller ORs for fall risk. Orexin receptor antagonists were not associated with falls. Therefore, orexin receptor antagonists and short-acting benzodiazepine receptor agonists are likely safer than intermediate-acting and long-acting benzodiazepines. Keywords: fall risk, hypnotics, acute care hospitals