Dry mouth is a common complaint among elderly people; it is often associated with risks of various disorders. Maintaining oral health helps maintain general health, which is important in aging populations. In Japan, many elderly people take prescription medications and visit community pharmacies. This study investigated the prevalence of geriatric patients complaining of dry mouth and its relationship with objective oral dryness measurements. We also investigated the efficacy of a moisturizing agent on oral dryness.
The subjects were 140 geriatric patients living in their homes and visiting community pharmacies regularly. Subjective complaints of dry mouth were determined by face-to-face interview and questionnaires. Objective oral dryness was measured using an oral wetness test, KISO-WeT. The efficacy of a moisturizing agent, KINUSUI^®, was investigated in the patients who had both subjective and objective dryness.
The mean age of the patients was 75.1 years. A total of 38.6% of patients complained of dry mouth; of them, 86.0% had objective oral dryness. Most (85.7%) patients who used the moisturizing agent reported positive effects; objective oral dryness improved significantly as a result of using the agent (P < 0.05). Over 40% of users stated that they would continue using the moisturizing agent.
A substantial proportion of geriatric patients complained of dry mouth. The present results indicate that objective measurements of dryness are closely associated with subjective complaints. Pharmacists in community pharmacies are able to collect necessary information and offer moisturizing agents to benefit the oral health of geriatric patients.

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The compatibility caused by injection of Nicarpine^® 10 mg / 10 mL (Nicarpine^®) from a side tube into an intravenous line infused with Replas^® 1 Injection (Replas^® 1) and Novo-Heparin^® 10,000 units / 10 mL for Injection (Novo-Heparin^®) was investigated. We observed a mixed solution of each constituent of Replas^® 1 and Novo-Heparin^® with Nicarpine^®, and measured the IR spectrum of the precipitate and the ¹H-NMR spectrum of a saturated solution of the mixture of heparin and nicardipine. Our findings suggested that the compatibility was caused by an intermolecular interaction between heparin and nicardipine when in a 1:2 ration via the formation of a salt between the sulfate group and/or the carboxylic group of heparin and the amino group of nicardipine.

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Cyclosporin A (CyA) and azole antifungals are clinically co-administered to patients after allogeneic hematopoietic stem cell transplantation (HSCT). Since CyA is a substrate of P450 (CYP3A4) and/or P-glycoprotein in the liver and the intestine, concomitant use of CyA and azole antifungals might increase the concentration of CyA in the blood. The purpose of this study was to evaluate the effects of antifungals on the blood concentration of CyA in allogeneic HSCT recipients. When CyA was orally administered, the magnitude of drug interactions between CyA and the antifungals on CyA concentration were: oral itraconazole (ITZ) solution > voriconazole (VCZ) tablet > ITZ capsule > fluconazole (FCZ) capsule. The concentration/dose ratio of CyA increased with each antifungal but the difference from control was only significant with oral ITZ solution (P<0.001). When CyA was intravenously (iv.) administered, the magnitude of drug interactions on CyA clearance was: iv. ITZ injection and VCZ tablet > oral ITZ solution > FCZ capsule > iv. fosfluconazole injection and ITZ capsule. Significant decreases in CyA clearance versus control were seen with iv. ITZ injection (P<0.001), VCZ tablet and oral ITZ solution (P<0.05). The present study confirmed that the magnitude of the drug interactions between CyA and azole antifungals varies by dosage form as well as by the potency of the azole inhibitor. These results provide a better understanding of the drug interactions between immunosuppressants and azole antifungals. In addition, this information may contribute to the effectiveness and safety of immunosuppressant therapy.

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Kitasato University has four affiliated hospitals. Each pharmacy student practices at one of them for 11 weeks during their fifth year of school. The first 4 weeks are spent learning general practice in the Department of Pharmacy, then students participate in clinical practice for the other 7 weeks. Both the faculty functioning as institutional pharmacists and the staff pharmacists act as preceptors for students during this pharmacy practice experience in Kitasato University Hospital. We conducted a questionnaire survey for students to determine the value of the faculty in this 11-week pharmacy practice experience. Students were surveyed between April 2010 and December 2011. One-hundred-sixty students responded. Most of the responding students reported that the faculty were necessary and they valued both the faculty and staff pharmacists as preceptors. The results demonstrate that collaboration between the faculty and staff pharmacists is useful for hospital pharmacy practice experience. It reduces student anxiety, due to familiarity with the faculty, and also enhances perceived educational benefit.

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We tried to optimize the formulation for the hospital preparation of mianserin hydrochloride (MS) suppositories. MS as the raw material for the preparation was obtained from Tetramide tablets (MS-T), which were ground. The physicopharmaceutical properties of MS suppositories with bases of Witepsol H15 (H15), Witepsol W35 (W35) and Witepsol S55 (S55) were compared to choose the optimal base for the suppositories. The preparation strength correlated negatively among the three bases. The heat of fusion of MS-H15 suppositories was significantly low relative to MS-W35 and MS-S55 suppositories. The average drug release rate of MS-H15 suppositories exhibited the highest level on moment analysis. Comprehensive evaluation of the properties of MS suppositories, including the heat of fusion due to the solubility of the preparation and the drug release rate indicated that H15 was the optimal base for MS suppositories. Additionally, we examined the optimal mixing rate of ground MS-T and H15. The preparation strength positively correlated with an increased mixing rate of ground MS-T. The mean dissolution time (MDT) of suppositories was reduced with an increased mixing rate of ground MS-T. These results suggested that 0.10 g ground MS-T combined with 0.8 g H15 as the base was the optimal formulation for the hospital preparation of MS suppositories.

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Although the Japanese government is promoting the use of generic drugs in order to reduce medical costs, providing information to physicians and pharmacists on the quality, safety or utility of generic drugs compared to the original drugs is insufficient. Carboplatin is a platinum-containing antineoplastic agent that is used for the treatment of several types of cancer. Carboplatin Intravenous Infusion “NK” (GE-CBDCA) is a generic drug of Paraplatin^® Injection (OR-CBDCA). In this study, we investigated the quality and safety of OR-CBDCA and GE-CBDCA. Purity tests conducted using high performance liquid chromatography showed that there were no clear differences between the two drugs with respect to contaminant or related substances. As a result of susceptibility testing performed in vitro by using five types of tumor cells, both drug products showed similar receptivity. For comparison of adverse drug reactions, the incidence of adverse events was surveyed in 72 patients who underwent chemotherapy switched from OR-CBDCA to GE-CBDCA. No significant differences were found in seven of eight parameters. Hematological tests of hemoglobin and white blood cell counts tended to show a higher incidence of more serious adverse reactions in the group treated with GE-CBDCA, and the GE-CBDCA-treated group also showed significant higher neutrophil counts (P = 0.029). However, it was supposed that the total dosage and the administering period of the Carboplatin were factors of the adverse reaction in the GE-CBDCA-treated group, therefore, the quality and safety of the two drug products were considered to be similar.

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Linezolid (LZD), a drug used to treat methicillin-resistant Staphylococcus aureus (MRSA) infection, is not considered suitable for administration to children in Japan; hence, only a few reports describe the efficacy and safety of LZD administration in children. In our study on the safety of LZD use, we examined 17 children who were administered LZD at Hiroshima City Hospital. There were no marked differences in red blood cell or white blood cell counts and hemoglobin, aspartate aminotransferase, alanine aminotransferase, and serum creatinine levels before and after LZD administration. In 8 children, the blood platelet (PLT) levels decreased by 40% or more after LZD administration than that before LZD administration. Analysis of the factors involved in the decrease in PLT levels showed that the PLT levels tended to further decrease with cumulative and prolonged LZD administration. Further, the PLT levels improved after LZD administration was stopped, which suggests that the decrease in PLT levels due to LZD administration in children is reversible. These results also suggest that LZD may be highly tolerable by children.

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We investigated the efficacy of switching from etanercept 25 mg administered subcutaneously twice a week (ETN25 T/W) to 50 mg once a week (ETN50 O/W) in patients with active rheumatoid arthritis (RA). In the questionnaire, there were patients who reported “increased pain” by switching to ETN50O/W, but many patients reported improved convenience in terms of “reduced administration”, “convenient storage” and “easier to remember administration”. No patient requested to switch back from ETN50O/W to ETN25T/W. The evaluation of efficacy before (0 week) and after (8, 16, 24 weeks) using Disease Activity Score 28 (DAS28-CRP) showed no significant difference. Based on our findings, we suggest that the change from ETN25T/W to ETN50O/W is a clinical treatment choice with high efficacy for most patients.

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