The purpose of this research was to clarify the effect of repeated administration of 2 kinds of energy drink,1 containing vitamins,taurine and caffeine (simple-type),and the other containing vitamins,taurine,caffeine and several botanical herb extracts (herb-type),on work performance using cognitively subjective and objective indicators. The simple-type and herb-type drinks were given to 14 healthy young adults in a consecutive double-blind,randomized,2-period cross-over clinical trial.Participants took each energy drink once a day for five days during separate periods.Motivation,feeling of drowsiness,and general fatigue were evaluated on a subjective scale using a self-reported questionnaire both before and after administration.Other subjective evaluations were those based on the fatigue-visual analog scale (Fatigue-VAS) and multi-dimensional fatigue inventory-20 (MFI-20).As an objective measure,work performance was examined using the Kreapelin mental work test. Compared to the simple-type drink,the herb-type drink achieved a significant reduction in drowsiness and significantly increased motivation based on the self-reported questionnaire results for the post-administration assessment.In the Kreapelin mental work test,the mean amount of work was significantly increased by both drinks.MFI-20 revealed significant decreases in 2 categories of physical fatigue and general fatigue due to the 2 drinks.The fatigue-VAS also indicated decreases but they were not statistically significant. Both types of energy drink appeared to be effective in terms of subjective and objective indicators.Though the herb-type drink was found to be superior to the simple-type drink regarding subjective measures,there was no significant difference between the 2 regarding the objective measure.
Recently,the number of patients with colorectal cancer has been increasing.Many patients are not aware of any symptoms until the disease is advanced.It is important to select effective regimens for colorectal cancer therapy and combination therapy with a molecular-targeted agent has recently been used for this purpose.However,the effects of anticancer drugs on epidermal growth factor receptor (EGFR),a molecular-targeted protein,have not been clarified.We therefore evaluated the effects of folinic acid/5-fluorouracil/irinotecan (FOLFIRI) and folinic acid/5-fluorouracil/oxaliplatin (mFOLFOX citation=6)treatments,using the 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay,as well as the effects of these treatments on EGFR expression in LoVo cells. The results suggested that 5-fluorouracil and irinotecan have a stronger antiproliferative effect than oxaliplatin.The reduction in viability for LoVo cells treated with FOLFIRI was greater than that for Lovo cells treated with mFOLFOX 6 on day 22.Moreover,EGFR mRNA and protein levels were increased more by mFOLFOX 6 than by FOLFIRI.These results suggest that FOLFIRI therapy may be more effective than mFOLFOX 6 therapy against LoVo cells in consideration of EGFR expression.
Benzodiazepines (BZDs) are frequently prescribed for the treatment of sleep disturbances,depression,anxiety syndromes and various somatoform disorders in the elderly.The daily doses of BZDs for elderly patients should be low enough to avoid the adverse effects.However,the actual situation of prescribing BZDs in Japan has not been fully elucidated.We,therefore.,analyzed 56,192 prescriptions including BZDs (23 BZDs including the non-BZD hypnotics,zolpidem and zopiclone) for 6,777 patients at Tsukuba University Hospital using Data Warehouse,a knowledge base technology. Fifty-four percent of prescriptions including BZDs were from departments other than psychiatry,and 33.8% were for patients over 65 years old.Prescriptions for elderly patients from the psychiatry department were less frequent than those from other departments (18.4 vs.47.2%).While 83% of BZDs prescribed for elderly patients were short-acting BZDs,longacting BZDs were prescribed more frequently by the psychiatry department than others (41.2 vs.16.7%).Intentional dose reduction of BZDs for elderly patients was observed only for etizolam.Our results suggested that BZDs except for etizolam were prescribed without dose reduction to elderly patients in the departments other than psychiatry.
We investigated the role of pharmacists in the treatment of multiple sclerosis (MS) patients (37 cases) based on data obtained during pharmaceutical care services provided to patients regarding self-injection of interferon -β (IFNβ) at the beginning of such treatment,when we provided continuous training in the injection of IFNβ until all patients could inject themselves.We also explained the adverse reactions,and provided further support after they had left hospital.However,at the beginning,all patients had difficulty in mastering the injection technique and were anxious about adverse effects.These problems hindered self-injection.As adverse effects,fever,lassitude and skin lesions developed.The skin lesions tended to become worse with long-term outpatient treatment and this was thought to be due to non-compliance in IFNβ treatment. Continuous treatment with IFNβ is indispensable in preventing recurrence of MS and maintaining good ADL for patients and we feel that appropriate supportive care provided by pharmacists at the start of IFNβ treatment is effective in ensuring that it is continued.Thus the positive involvement of pharmacists in MS treatment is thought to be necessary and we hope that our efforts will lead to the establishment of standardized pharmaceutical care services for such intractable diseases with relatively few cases.
In the present study,we examined whether distilled water or tap water affects the release of the major component from the tablet in the simple suspension method.We first analyzed hospital tap water for the presence of 22 different elements and 11 of them (B,Na,Mg,Ca,Ni,Fe,Cu,Zn,Ba,Mn and Cd) were detected.However,the concentrations of all these elements were below the limits prescribed by the water quality standards for drinking water specified in the Waterworks Law of Japan.We then studied the release of amlodipine besilate from the originator product containing it as the active ingredient and 5 generic versions using the simple suspension method.The amlodipine contents of the originator product and generics were 98.2-101.7%,within the range specified in the Japanese Pharmacopoeia.After suspending in distilled water for 30 and 120 min,the amounts of amlodipine released from the originator drug were 15 and 38%,respectively.Those for generics at 30 and 120 min were similar to the originator except for one generic which was designed to release the active ingredient in the mouth.In conclusion,for the simple suspension method,the amounts of amlodipine released from originator drug with time into water were similar to those for generics.
In cancer chemotherapy,there has recently been a paradigm shift from inpatient to outpatient treatment.Since the outpatient oncology room opened at the National Hospital Organization Fukui Hospital in November 2004,pharmacists have been providing pharmaceutical care for patients receiving outpatient chemotherapy.Between April 2008 and March 2010,there were 1,344 instances of outpatient chemotherapy and we provided pharmaceutical care in 1,218 instances.Further,for 28 of 112 patients who received pharmaceutical care in the outpatient oncology room,prescriptions were added to or changed based on pharmacists’advice.In 30 instances,prescriptions were added to and regimens,dosages,and schedules changed as recommended by pharmacists in consideration of adverse effects due to cancer chemotherapy.Reductions in adverse effects were observed in 22 instances. Under the current medical fee system,though no additional fee is charged by pharmacists for pharmaceutical care,it is important for them to use their knowledge to the maximum by providing pharmaceutical care in addition to performing their routine work of mixing anticancer agents and checking regimens.
Increasing numbers of patients are receiving medical care at home and as a result,pharmacists are involved in the collection and disposal of more infectious medical waste from patients’homes than ever before.This puts them at risk of needlestick injuries.In this study,we evaluated the current practices of community pharmacies for collecting and disposing of infectious medical waste as well as the current rates of pharmacist needle-stick injuries due to improper separation of infectious medical waste. We conducted a questionnaire-based survey of 1,111 pharmacists working in community pharmacies in Hiroshima Prefecture and 482 provided responses.Infectious medical waste was collected in original sterile containers by 183 pharmacies,whereas it was not by 12 pharmacies.More than 70% of the pharmacists indicated that instructions regarding proper methods of collecting and disposing of such waste were needed.Respondents also said that instructions on first aid for needlestick injuries were needed but such instructions were only provided in 5 pharmacies. To prevent needle-stick injuries and the related infections,detailed instructions regarding the handling of infectious medical waste and needle-stick injuries should be immediately provided and they should be complied with.In addition,patients and their caregivers should be instructed on how to deal with infectious medical waste properly and prevent needle-stick injuries.
The use of six types of simple blood glucose meter,finger-stick blood collection devices,glucose monitoring test strips,and needles currently on the market was evaluated.Sixty-three participants in a training workshop on diabetes mellitus answered questions about the use of the devices on a six-point scale.All six models of simple blood glucose meter received a score of 4.0 or better for all questions.However,the assessment of use by the participants did not necessarily agree with the information provided with the individual meters.In addition,glucose monitoring test strips were criticized regarding procedures for dealing with monitoring errors,and the use of some of them was criticized for being affected by the user’s eyesight or manual dexterity.Needles were criticized for being more difficult to prepare for use than to dispose of. Though participants gave high marks to the six types of meter for use,glucose meters should not be selected based only on the data the meter provides but also on actual use.In addition,in the future,glucose monitoring test strips and needles should be made safer and easier to prepare for use.
The aim of the present study was to evaluate the mechanisms responsible for our previous finding that the uptake of mizoribine by human intestinal epithelial LS 180 cells is considerably lower than that of the structurally-related compound ribavirin.We confirmed that the uptake of 400μM mizoribine by the cells in 30 min was significantly lower than that of 400μM ribavirin.In addition,the steady-state cell/medium (C/M) ratio for mizoribine under low (1 mM) extracellular Na+ conditions was far below 1.0 (approximately 0.1),whereas that of ribavirin was approximately 0.6.Furthermore,the steadystate C/M ratio of mizoribine under high (126 mM) extracellular Na+ conditions was still much lower than 1.0 (approximately 0.2),whereas that of ribavirin was higher than 1.0 (approximately 1.4).These findings indicate that the transport activity of the unidentified efflux transporter for mizoribine (but not ribavirin) in LS 180 cells is much higher than that of the Na+-independent (equilibrative) and/or Na+-coupled (active) uptake nucleoside transporters under the experimental conditions used,and that the relatively higher affinity of mizoribine for the efflux transporter is at least partly responsible for its lower uptake.
The use of closed systems is recommended to prevent occupational exposure to anti-cancer agents during preparation.The PhaSeal closed-system consists of an“Injector”and a“Protector”.Named“SOLUS”,the Protector can be used with reconstitution drug vials as well as drug solution vials.We therefore studied the compatibility of SOLUS and 41 kinds of reconstitution drug,as well as durability. After attaching SOLUS to the vials,needle insertion was performed 10 times by the Injector.Thereafter,they were injected with a mixture of distilled water and sodium fluorescein (FL-Dw) under pressurization.Immediately afterwards,after 1 hour and 24 hours,the vials were examined under UV light to determine whether there was any liquid leakage following injection of FL-Dw,and then the same test was performed without pressurization.Next,“Protector P 21”or SOLUS was attached to the vials and FL-Dw was injected into them.Needle insertion was then performed 30 times under both pressurized and unpressurized conditions and vials were examined under UV. The surface or membrane of SOLUS was determined to be fluorescent for 10 kinds of vial tested.Five types of vial were excluded because their diameter did not match the apparatus.Under unpressurized conditions,the apparatus could be used safely for needle insertion by P 21 or SOLUS up to 30 times.However,when vials required pressurization,inserting the needle 5 times caused leakage. Twenty-six kinds of reconstitution drug vial could be used safely with SOLUS.However,there is still the possibility of exposure to anti-cancer drugs due to leakage and SOLUS should therefore be operated carefully.