The study was conducted to qualitatively analyze the attitudes of pharmacists working in community pharmacies toward patients with dementia to examine the status of support provided for them and related problems. Semi-structured interviews with 15 pharmacists in Aichi Prefecture were conducted, and the results were analyzed using a grounded theory approach. The opinions of pharmacists were classified into “the status of consideration for dementia patients and responses to them at the pharmacy counter,” “problems related to the status of drug administration management for patients with dementia,” and “the status of support provided for dementia treatment.” Pharmacists must play various roles at the pharmacy counter and homes of patients: they should report “changes in dementia patients that they have identified” and conduct drug administration management for them. However, the pharmacists had difficulty due to their lack of knowledge and awareness of their roles, the current system of pharmacies only focusing on drug prescription, differences in problems attributed to specific symptoms unique to dementia and the specificity of individual cases, and a lack of understanding of other people and collaboration with them. To help pharmacists provide quality services for dementia patients, it is necessary to encourage them to: undergo training to improve their awareness, learn to provide services with emphasis on the establishment of relationships between patients and their families, and closely collaborate with other pharmacists and different healthcare professionals, as well as enhance the functions of pharmacies as bases for consultation.
In a cisplatin (a highly emetogenic anti-cancer agent)-containing regimen, administrations of fluid replacement and/or of diuretic drugs are performed to relieve nephrotoxicity. Such treatments will alter the body's water balance, which may be partially responsible for chemotherapy-induced vomiting progression. We thus examined whether the body's water balance correlates with the incidence of chemotherapy-induced vomiting and/or the risk factors of chemotherapy-induced nausea and vomiting (CINV) in women (a CINV risk factor) inpatients receiving treatment with a cisplatincontaining regimen. The severity of chemotherapy-induced vomiting was significantly associated with increased body water in the patients with multiple (double), but not single CINV risk factors. Therefore, our findings suggest that the severity of chemotherapy-induced vomiting is decreased by keeping the body water balance constantly by restriction of hydration (eg short hydration) and/or consolidation of antiemetics, when the female patients with multiple (double) CINV risk factors receive treatment with a cisplatin-containing regimen.
The study was performed to evaluate the effects of pre-treated heparinoid lotion on the adhesion (peeling force), amount of stripped striatum corneum and drug release rate from of lidocaine tape in patients undergoing dialysis. The subjects consisted of 10 males and 6 females (mean age: 65.8 ± 13.6 years). The application of heparinoid lotion significantly elevated the water content of the stratum corneum. The application of lidocaine tape in hydrated skin induced by heparinoid lotion significantly reduced the amount of stripped striatum corneum without influencing peeling force. The release rate from the patch showed a tendency to increase in hydrated skin induced by heparinoid lotion. These results suggest that the usability of lidocaine tape is improved by pre-treatment of heparinoid lotion.
Cancer pain often causes a decreased quality of life in patients. Gabapentin (GBP) is recommended as a supplementary analgesic for cancer-related pain, and can be taken at all steps of the World Health Organization pain relief ladder. However, GBP treatment is limited to oral administration. Therefore, a new route of administration is required for cancer patients who are unable to take oral medications. In this study, we demonstrate the preparation method and characterize the pharmacokinetics of a suppository containing GBP in tablet form. The suppository bases polyethylene glycol (P), Witepsol H-15 (H), and Witepsol S-55 (S) were compared to find the optimal base for the suppositories. We compared intravenous (iv), per os (po), and intrarectal (ir) administration of GBP powder and tablet formulations: (GBPp and GBPt) prepared in a base of P, H, or S (GBPp/P, GBPp/H, GBPp/S, GBPt/P, GBPt/H, and GBPt/S). The hardness of the GBPt group was significantly lower than that of the GBPp group. The drug-release profiles of the GBPt suppository groups were highest, in the order H, P, and S. The drug-release profile of the GBPt/S group was significantly higher than that of the GBPp/S group. The time to maximum drug concentration of the GBPt/S group was significantly increased compared with the po, GBPt/P, and GBPt/H groups. The GBPt/H group had similar pharmacokinetic parameters to the po group. These results suggest that a suppository containing GBP tablet is better than the conventional preparation method for hospital preparation.
“Education for Medicines” was initiated in 2012, as part of health and physical education (HPE) classes in junior high schools, through the revision of school curriculum guidelines. We conducted a survey that aimed to clarify the status of the implementation of medical education in schools. A questionnaire survey that targeted junior high school teachers in Japan was conducted via mail. The response rate was 48.0% (524/1,091). HPE teachers, school nurses, and school pharmacists were in charge of Education of Medicines in 91.8%, 6.3%, and 8.4% of schools, respectively. The average duration of classes was 49.6 minutes, and 1.2 times (84.2%). On average, 1.1% of schools did not offer Education of Medicines classes, 1.7% held the “odd hour” of classes, and 1.3% held only “drug abuse” classes. The most commonly used educational material was the school textbook (84.9% of schools). With respect to the delivery of Education of Medicines classes, 84.0% of schools responded “yes” to the item, “lectures are delivered by outside lecturers,” and 72.1% responded “yes” to the item, “we hope to introduce workshop participation.” The results of the survey indicate that HPE teachers provided Education of Medicines classes in accordance with the revision of school curriculum guidelines at many junior high schools. However, some schools did not offer the classes. In Japan, it is necessary to enhance Education of Medicines activities in the pharmaceutical field by involving specialists from different areas.
On most medical drugs, bar codes in the new format “GS1 data bar” are printed on the dispensing package. However, the printing patterns of GS1 data bars vary widely. It is unclear whether bar code scanners are able to scan all types of patterns and also whether all types of scanners are able to scan these patterns. In this study, we present the experimental results of scanning tests of GS1 data bar printed on PTP sheets. As a result, it was found that certain scanners were unable to scan GS1 data bars. Moreover, it was also verified that there were certain patterns of the GS1 data bar that could not be scanned. Factors adversely affecting the quality of scanning were identified such as “existence of a frame,” “repetitive printing,” “different background color,” and “[F] ISO quality grade.” Factors advantageously influencing the scanning quality were also identified such as “cost of product is 15,000 yen or more.” The printing environment required for GS1 data bars on PTP sheets differs from that for standard bar codes on paper. In this survey, it was found that certain GS1 data bars on PTP sheets could not be scanned. For printing scannable GS1 data bars on PTP sheets, a higher printing quality is required. As GS1 data bars printed on dispensing package units contribute towards pharmaceutical safety management, ensuring accurate scanning is important. For utilizing GS1 data bars effectively, significant effort needs to be made by both the pharmaceutical industry and scanner manufactures.
Nicardipine hydrochloride injection is widely used for emergency treatment of abnormally high blood pressure. However, nicardipine hydrochloride injection often causes severe peripheral vascular injury. The goal of this study was to reduce vascular injury by nicardipine hydrochloride injection. Here, we investigated the characteristics of nicardipine hydrochloride-induced vascular injury with human dermal microvascular endothelial cells (HMVECs) in an irritability study in the rabbit ear vein. Nicardipine hydrochloride decreased cell viability and increased percentage of dead cells in a dose-dependent manner. The results from the irritability study in the rabbit ear vein suggest that the administration rate and drug concentration were related to venous and perivascular tissue injury. Thus, administration rate, drug concentration, and blood flow rate at the injection site were important factors for the reduction of nicardipine hydrochloride-induced venous irritation.
In this study, we investigated the efficacy and safety of administration of Linezolid (LZD) to pediatric febrile neutropenia (FN) patients after cancer chemotherapy. The study period was from January 2008 to June 2014, and the subjects were patients under the age of 16 receiving LZD administration (9 subjects, 16 cases, average age 9.2 ± 4.4 years). The dose of LZD was 30.7 ± 3.1 mg/kg/day, and the administration period was 12.1 ± 6.3 days. The test values were as follows: the CRP decreased from 3.9 ± 4.5 mg/dL to 0.4 ± 0.7 mg/dL (P < 0.01), the PLT increased from 7.1 ± 4.69 × 104 /μL to 14.5 ± 9.1 × 104 /μL (P < 0.01) and the WBC increased from 9.4 ± 21.6 × 102 /μL to 42.2 ± 38.5 × 102 /μL (P < 0.01); thus, statistically significant differences were obtained. The reason for the termination of LZD administration was due to the alleviation of the symptoms, which was observed in 14 cases (14/16 87.5%). Survival after 30 days was confirmed in all of the cases. The results suggest that LZD administration to FN pediatric patients is effective and safe.
Convalescent rehabilitation wards aim to prevent patients from becoming bedridden and shorten hospital stay duration through the use of intensive rehabilitation programs. Convalescence at home requires patients to self-administer medications. Cerebrovascular disease is commonly accompanied by higher order brain dysfunction and paralysis in the upper extremities. As it can often be challenging for pharmacists alone to evaluate the ability of a patient to selfadminister medications, we evaluated factors affecting the ability of patients with cerebrovascular disease to selfadminister following the use of multidisciplinary initiatives at our institution. We included 113 inpatients in this study. Significant differences in cognitive function evaluation scores and the proportion of patients discharged were found between patients that were and were not able to self-administer, with no significant difference in paralysis in the upper extremities. These results indicate that cognitive function evaluation, but not the presence of upper limb paralysis, may have utility as an index in determining the ability of cerebrovascular disease patients to self-administer medications.
The infectiousness of diseases such as: the measles, rubella, the mumps, and the chicken pox is quite strong. When people lack antibodies to these diseases, the chance for infection increases. On a university campus, a person without such antibodies can help spread such diseases. However, as vaccines are available for these diseases and people are vaccinated, the chance for infection and the spreading of these diseases will diminish. At our university, Tokyo University of Pharmacy and Life Sciences, at the start of the recent academic year, an antibody survey was taken of 2,647 students to see which students had lower levels of antibodies to help fight the spread of the aforementioned diseases. Our findings showed antibody-positive rates of 49.0% for the measles, 70.8% for rubella, 75.7% for the mumps, and 92.4% for the chicken pox. With the rate for the chicken pox being the only one meeting an acceptable standard (Fine) in terms of community immunity. On the other hand, although the vaccination rates for the measles and rubella were high, they did not meet an acceptable standard for community immunity (Fine). When the community immunity level is low, the risk of infection is increased and this could lead to an outbreak on campus and affect more than just individuals. In the future, we will encourage students to be fully vaccinated before entering school or soon after doing so in order to protect against such an outbreak from occurring.