Objective: Patients treated with vinorelbine(VNR)-containing chemotherapy often suffer from injection site reactions.  VNR is a moderate vesicant that is well known to cause local venous damage.  We conducted this study to identify clinical risk factors related to the incidence of injection site reactions caused by VNR, and whether applying a hot compress was effective for preventing such reactions.
Methods: Medical records were retrospectively investigated for 48 patients treated with chemotherapy regimens containing VNR.  Injection site reactions were evaluated for every course and were graded according to the National Cancer Institute Common Toxicity Criteria (version 4.0).  Gender, age, body mass index, chemotherapy regimen, dose of VNR, and volume of fluid for flushing the vein were assessed as clinical variables.  A hot compress was applied to the vein proximal to the injection site during VNR injection.
Results: The injection site reactions occurred in 29 (60%) among 48 patients received intravenous VNR injection.  According to multivariate analysis, use of gemcitabine (GEM) in combination with VNR showed a significant independent correlation with an increased risk of injection site reactions (p=0.019).  When hot compress was applied to 21 patients, who experienced phlebitis of VNR, the injection site reaction was occurred to only three patients (p<0.001).
Conclusion: In this study, the risk factor of the injection site reaction by VNR seems to be combination of GEM.  Application of hot compresses was effective for preventing injection site reactions by VNR.

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Objective: In The Hospital of Hyogo College of Medicine, a oral rinse containing polaprezinc (PZ), a zinc-containing drug for gastric ulcers, was used as a hospital preparation to treat radiotherapy-related oral mucositis, and its efficacy was reported.  However, the dispersibility of PZ for carboxymethylcellulose sodium (CMC), which was used as the base of the oral rinse, was unfavorable, raising an issue.  In this study, we newly prepared a PZ oral rinse containing carboxyvinyl polymer (CP) as a base, and examined its usefulness.
Methods: A questionnaire survey regarding the usefulness involving 10 healthy volunteers and a pharmaceutical test were conducted.
Results: The results of the questionnaire survey showed that the optimal concentration of CP was 0.5%.  There were no serial changes in the pH, adhesiveness, or PZ content for 7 days after preparation.  Furthermore, there were no differences between CMC and CP.  The dispersibility of PZ in the oral rinse containing CP as a base was more favorable than that in the oral rinse containing CMC.
Conclusion: The results of this study suggest that the PZ oral rinse containing 0.5% CP as a base is useful, and that its stability is similar to that of the oral rinse containing CMC as a base.

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Objective: In conveying and providing drug information, it is essential to ensure correct understanding of such information at clinical practice sites.  We thus used a hospital’s drug information newsletter (DI News) to analyze factors affecting how well the drug safety information provided is understood by recipients.
Methods: Targeting nurses who work at Kushiro Red Cross Hospital, we used the DI News to provide information on changes in insulin preparations, and then implemented Questionnaire Surveys 1 and 2.  An implemented Questionnaire comparison was made among the number of years at work (6 groups), between wards of internal medicine and surgical departments (2 groups), and among various wards (12 groups), and the factors affecting the degree of understanding of information were analyzed.
Results: Compared with Survey 1, the degree of understanding improved dramatically in all groups in Survey 2.  However, no significant differences were seen among the groups in the comparison based on the number of years at work, or in the comparison between internal medicine and surgical departments.  The comparison among various hospital wards, however, showed large differences in the scores for Surveys 1 and 2, with significant differences among the groups being documented (p<0.001).
Discussion: In providing important pharmaceutical information, it was deemed necessary to gain a deeper understanding of the differences among various wards and to offer individual assistance tailored to each ward.  This study revealed the importance of meticulous, personalized information services provided by ward pharmacists.

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Objective: Pharmacy students are considered to experience various forms of stress during long-term practical training in the 6-year pharmacy education.  This study examined relationships between psychological stress responses and self-efficacy involving 77 subjects who consented to join this study in practical training conducted at Teikyo University Hospital (2010-2011FY).
Methods: This study used the Profile of Mood States (POMS) for evaluating the psychological response, and an assessment form consisted of 20 items including interpersonal relationships, contents of practical training and health/life/stress coping for self-efficacy before, during, and after the training.
Results: In the POMS, only the state of ‘vigor’ showed a significant difference in a comparison among before, during, and after the training; however, no significant change was observed in other mood states.  These results suggested that the students were under mild stress during the training.  Their self-efficacy was increased after the training in all 20 items except “contacting university instructors during the training”.  The results also showed that there was an association between self-efficacy and psychological stress responses.
Conclusions: It is considered important that instructors and pharmacy technicians involved in pharmacy practice should understand the levels of individual stress responses or interpersonal communication skills to utilize them for coaching and maintaining students’ mental health.

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Objective: The number needed to treat (NNT) is an index for determining the number of patients who need to be treated in order to prevent the occurrence of an adverse event when a new treatment instead of the standard one is used.
Methods: The properties of NNT were examined by using the geometric distribution formula as the probability for preventing the occurrence of an adverse event in the NNT.
Results: When the NNT was enlarged infinitely, the probability for the prevention of an adverse event by NNT was found to be 63.2% (=1−e⁻¹), and the number of patients who needed to show adverse event prevention at the probability of 95% was about 3 times as that of the NNT (Rule of Three).
Conclusion: When the effect of new treatment needs to be evaluated based on NNT, one should take these properties of NNT into consideration.

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