Many antibacterial agents are very bitter,which is sometimes a cause of non-compliance,especially in children.In the present study,using a taste sensor,we examined the bitterness of antibacterial agents and its suppression,and report the results together with those of related research conducted by another research group.This paper is divided into three main parts.The first is on the quantitative prediction of bitterness for several antibiotic solutions using a taste sensor,the second is on the application of the taste sensor to the prediction of bitterness of a clarithromycin dry syrup by itself and when taken together with various beverages or jellies,and the third is on the enhancement of bitterness due to dividing or crushing tablets containing antibacterial agents.Using the sensor,we could obtain a lot of quantitative information on the palatability of antibacterial agents,and we successfully demonstrated its usefulness.

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With the objective of preventing medical errors,the authors created an auditing system using a QR-code for the mixing of injections.The number of injections mixed has been increasing year by year ever since the system was introduced.Approximately 12,000 prescriptions have been audited by the system up to now and no medical errors related to the mixing of injections have occurred.We also included a function for storing auditing records in the system which as reduced our workload.
Our system not only prevents medical errors it also raises efficiency in the injection mixing process.

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The purpose of this study was to investigate the relationship between blood concentrations of tacrolimus and liver biochemical profiles in living-donor liver transplantation recipients.The results indicated that the tacrolimus blood concentration/dose ratio (C/D ratio) decreased following living-donor liver transplantation.Furthermore,the variation in the C/D ratio and tacrolimus blood concentration was greater at 1 week after surgery than at 2-4 weeks afterwards.We also noted that when the C/D ratio was high total bilirubin was also high,suggesting that a low dosage of tacrolimus is necessary for hightotal bilirubin patients.However,there was no definite correlation between AST or ALT and the C/D ratio.It is therefore necessary to control tacrolimus blood concentrations in adult living-donor liver transplantation recipients.

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In 2006,early exposure training was conducted for first-year undergraduates (six-year course) at Kyoto Pharmaceutical University.To evaluate the training,we conducted a questionnaire survey of the opinions of the students who visited hospitals and community pharmacies,the teachers who took them on the visits and the pharmacists giving them training at the hospitals and pharmacies,and then analyzed and discussed the results with the aim of improving the next year’s training.After visiting hospitals and community pharmacies,over 80% of the students were interested in the profession of pharmacist.Furthermore,students who answered that the exposure training was useful in developing an awareness of what it would be like to be a medical professional in the future,that they had a good understanding of the role of pharmacists,felt that the pharmacists were important to human life and that the early exposure was meaningful,were in the majority.The image that 69-75% of the students had of the pharmacist changed after the exposure training.The majority response among students visiting hospitals was that the pharmacist had various other jobs besides filling prescriptions (27%).Among students visiting community pharmacies,the majority opinion was that the pharmacist communicates with many patients (30%).As for the teachers,95% of them felt that the exposure enhanced students’desire for learning.The results of an aural survey of the facilities accepting the students suggested that there was no particular problem in the respective facilities carrying out the training from an independent standpoint.
In conclusion,such early exposure training for first-year undergraduates through visits to hospitals and community pharmacies increased their motivation as well as their desire for learning.

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One of the major adverse effects of Shakuyaku-kanzo-To (SKT),a herbal medicine containing licorice,is licoriceinduced pseudoaldosteronism with hypokalemia and hypertension.Owing to the risk of hypokalemia,caution should be therefore exercised when SKT is co-administered with potassium lowering drugs.In order to clarify this risk,we examined the occurrence of hypokalemia in 103 patients receiving SKT.Thirty (29.1%) of the 103 patients developed hypokalemia and SKT dosing periods tended to be longer in these patients than in those who did not develop hypokalemia (54.5 vs.23.0 days,respectively).The co-administration of potassium lowering drugs was more frequent in the patients with hypokalemia (90.0% vs.64.4% for no hypokalemia p<0.01).The occurrence rates of hypokalemia varied with drugs co-administered with SKT ; with 75.0% for glycyrrhizin preparations,47.2% for diuretics,41.9% for glucocorticoids,20.0% for sennoside preparations and 25.0% for others.
The above results confirmed that the co-administration of potassium lowering drugs enhanced SKT-induced hypokalemia.Frequent serum potassium monitoring is therefore required when potassium lowering drugs,especially glycyrrhizin preparations,diuretics and glucocorticoids,are co-administered to patients receiving SKT.

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It is an important task of the pharmacist to triage appropriate over-the-counter (OTC) drugs for patients to achieve efficacy and safety.In this study,we investigated the present situation regarding the triage of OTC drugs for patients based on pharmacists interviewing patients in a fact-finding survey which determined how pharmacists in a drugstore communicate with patients during such interviews.
We analyzed patterns of pharmacist communication with patients for the purpose of triaging OTC drugs in the drugstore and compared them with typical recommended communication patterns in the United States.In the drugstore,there were 3 patterns of initiating dialog with patients purchasing OTC drugs which were (1)“What are your symptoms?”2)“What is the name of the drug that you want?”and (3)“What disease do you have?”
Using the first pattern we conducted a role play simulating the triaging of OTC drugs by pharmacists actually working in drug stores to standardized patients.In response to the patient’s description of his or her current symptoms,pharmacists used various speech patterns to explain the suitability of drugs selected and the cautions in use.In interviews conducted by inexperienced pharmacists,time was wasted in communication and there was no logical flow in them.Afterwards,some pharmacists said that they had not been able to obtain enough information from patients for triaging OTC drugs and others thought it was necessary to set algorithms for this purpose.These opinions suggest that pharmacy education in Japan should include training that makes pharmacists realize their responsibility in triaging OTC drugs for patients.

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The School of Pharmaceutical Sciences of the International University of Health and Welfare was established in 2005.We conducted a training program with the title“Early Exposure to Pharmacy Profession”for students in their first year in which they visited hospitals,community pharmacies,pharmaceutical companies and medical and welfare institutions affiliated with our university.To evaluate the program,students were asked to complete a questionnaire before and after taking part in it.The results showed that,on a scale of 5,the degree of expectation that students had with respect to the visits,introductory lectures,presentations by students and other aspects of the program was 3.9 beforehand and that afterwards,the degree of satisfaction with it was 4.1.Almost all students considered it to be useful.Further,the percentage of students feeling that the program was necessary increased to 90% from 80% before taking part in it.These results indicate that the early exposure training increased the interest of students in medical care.

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The Teicoplanin TDM analysis software provided by Astellas Pharma Inc.was updated to Ver.2.0 and we tested it in comparison with Ver.1.0 to determine whether its predictions based on population pharmacokinetic parameters were useful in the design of initial and maintenance regimens.In addition,since renal function may be overestimated when the serum creatinine concentration is low,we determined whether correction of serum creatinine concentrations improved predictive capability with respect to initial regimens.As regards predictive performance,for initial regimens,the mean prediction error (ME) for Ver.1.0 was greater than zero and the 95% confidence interval did not include zero.These results indicate that concentrations predicted using Ver.1.0 would be significantly higher than the observed concentrations.The ME for Ver.2.0 was smaller and the 95% confidence interval included zero indicating that its predictive performance was superior to that of Ver.1.0.However,the correction of serum creatinine concentrations did not improve predictive performance for initial regimens.Using the Bayesian method,no significant correlation was observed between the observed and predicted concentrations for maintenance regimens for either Ver.1.0 or Ver.2.0 due to the small patient population used.With respect to observed concentrations at blood sampling times from 48 to 72 h from the start of administration,the predictive capabilities of both Ver.1.0 and Ver.2.0 were good.The results of this study indicated that for initial regimens,the method used for Ver.2.0 would be more useful,though the correction of serum creatinine concentrations did not improve predictive performance in this case.

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In the present study,we investigated the situation of medicines brought to an internal medicine ward by inpatients.Eighty-five percent of the inpatients brought a total of 2,072 medicines (7.3 medicines per person) to hospital and 17% of them had medicines prescribed by 2 or more hospitals.Twenty-eight percent of medicines had been packaged as unit-doses.Among 720 medicines prescribed by other hospitals,pharmacists could not determine the name for 20 of them and the dosage for 163 of them.
The results of a detailed analysis suggested that the removal of a limit on the number of prescription days,the introduction of the Diagnosis Procedure Combination (DPC) and promoting the prescription of generic drugs all influenced the bringing of medicines to hospital upon admission.
The present study also suggested the necessity of liaison between the hospital pharmacy and community pharmacy of one hospital and those of other hospitals in order to obtain detailed information on medicines brought to hospital by inpatients.
In conclusion,we feel that only pharmacists can perform the role of inspecting medicines brought to hospital by inpatients since this is a highly specialized task involving so many important issues.

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Since early morning hypertension is closely related to cardiovascular risks,the regular measurement of blood pressure is very important.In the present study,we performed a questionnaire survey of 443 patients taking depressors regarding possession of a home sphygmomanometer,explanation received when it was purchased,status of its use,and awareness of hypertension.The survey was performed at the time medicines were administered by pharmacists in the outpatient department.Of the patients surveyed,330 had a home sphygmomanometer,but only about 33% of them used it on a daily basis.Evaluation by the F test suggested that the patients who used a home sphygmomanometer daily were well informed about hypertension,while those who rarely used it knew less about hypertension.This suggests that the frequency of blood pressure measurement using a home sphygmomanometer varies with the amount of knowledge of the disease,and that it is important make patients receiving depressors more aware of the disease they have.

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