Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences)
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
Volume 44, Issue 10
Displaying 1-7 of 7 articles from this issue
Review Article
  • Noriaki Nagai
    2018 Volume 44 Issue 10 Pages 481-490
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    Eye drops are the primary route of administration for therapy in the ophthalmic field; however, the continuous application of eye drops causes corneal damage. Moreover, in traditional formulations, only small amounts of the administered drug penetrate the cornea to reach the desired intraocular tissue due to corneal barriers, and thus eye drops are not a suitable therapy for cataracts. To resolve these problems, we evaluated the corneal toxicity caused by commercially available anti-glaucoma eye drops (1), and investigated the development of a preservative system comprising benzalkonium chloride and sericin (2). In addition, we demonstrated the optimal drug particle size in the ophthalmic suspension (rebamipide) to promote corneal wound healing (3), and researched the novel factor of cataract development (Aβ accumulation) in the lens epithelium of Japanese patients with cortical opacification (4). Furthermore, we designed a novel ocular drug delivery system using drug nanoparticles (5). This review summarizes our research described above (1-5), and these findings expand their usage for therapy in the ophthalmologic field.

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Notes
  • ~ Hospital Preparation of Aseptic Preparation Using Commercial Preparations ~
    Rena Kamioka, Hisashi Mimoto, Masayuki Hashimoto, Yuka Tsutsui, Hiroyu ...
    2018 Volume 44 Issue 10 Pages 491-495
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    Cardioplegia plays an important role in cardiac surgery. Various cardioplegia solutions have been utilized at different hospitals worldwide; however, Miotecter® is the only commercially available solution in Japan. The del Nido solution is a cardioplegia solution that has been applied to adult patients owing to its advantage in achieving a relatively long duration of cardiac arrest with a single dose. However, the del Nido solution is not available in Japan, and there is no report of del Nido solution use in Japan. Thus, we decided to formulate a cardioplegia solution with the function of the del Nido solution at our hospital (Chikamori Hospital, Chikamori Health Care Group). Although the available preparation equipment was limited, we successfully designed a safe formulation using a commercially available product; the preparation was conducted at a clean bench. The prepared “del Nido Chikamori Modification” extended the redosing interval from its original 20 min to the current 45 min with one administration. We expect the redosing interval to be extended even further in the future. In addition, other reasons for the preferred usage of the del Nido Chikamori are likely to include its advantages in easy blood glucose control and its inexpensiveness.

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  • Takuya Sato, Ryohei Goto, Aya Matsushita, Yoshihiro Kataoka, Madoka Ts ...
    2018 Volume 44 Issue 10 Pages 496-502
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    To allocate limited medical resources efficiently in the aging society, promotion of self-medication is an urgent matter. To solve this problem, appropriate recommendations for consultation by pharmacists are necessary. The pharmacist should be able to determine which patients require consultation. However, pharmacist education in clinical reasoning is insufficient and its efficacy has not been clarified. Therefore, we developed an educational program for improving pharmacist clinical reasoning skills, such as history-taking and physical assessment. This study aimed to evaluate the efficacy of the educational program. The subjects were pharmacists working for a pharmacy chain. A questionnaire was distributed to the participants before and after the educational program. The questionnaire asked about learning achievement (12 questions) and recommendation for consultation in the practice (9 questions). Questions about learning achievement consisted of clinical reasoning and physical assessment skills. Questions about recommendation for consultation consisted of frequency of the recommendation and impression about the recommendation. As a result, 43 pharmacists participated, and there were 36 respondents (84%). The number of pharmacists who were unsure whether they should recommend consultation decreased significantly after the program (25 pharmacists [69%] before vs. 13 pharmacists [36%] after, P = 0.002). Pharmacists gained confidence in conducting clinical reasoning by participating in this educational program. In addition, it is suggested that the pharmacistʼs desire to convey the results of the work to the customer may increase.

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  • Hiroyuki Suzuki, Tatsuya Nakamura, Seiji Miyaura, Kyoko Inooka, Tomomi ...
    2018 Volume 44 Issue 10 Pages 503-509
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    Panvitan® powder for prescription (PP) administrated in combination with pemetrexed sodium hydrate (PEM) for the purposes of folic acid supplementation is significantly degraded by exposure to humidity or light. Hence, we investigated the influence of humidity and light on the color of the powder and concentration of folic acid in PP. We prepared samples by placing 1 g of PP into separate bags and stored them for 28 d under normal delivery conditions, intermediate humidity, high humidity, and light exposure. The amount of folic acid was quantified by high-performance liquid chromatography, where the percentage was calculated assuming the initial amount was 100%. Under normal delivery conditions (room temperature, 50% RH, shielded light) and intermediate humidity conditions (25℃, 75% RH, shielded light), no significant changes in appearance or folic acid content were observed. The sample stored under high humidity conditions (25℃, 91% RH, shielded light) changed in color from yellow to brown. The decrease in folic acid content was time dependent, and decreased to 47.1% after 28 d. Under light exposure (room temperature, 50% RH, 5,000 lux, 0.56 W/m2), the yellow color of PP becomes thin with time, while the folic acid content decreased to 73.2% after 28 d. The amount of folic acid may have decreased without any concomitant visible changes in the powder. The results of this study are expected to facilitate the management of adverse effects of PEM.

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  • Kazunari Iwao, Yuichi Ichimura, Hiroyuki Naraoka, Masanori Tsunemi, Hi ...
    2018 Volume 44 Issue 10 Pages 510-515
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    A ghost tablet (GT) was observed in a patient immediately after the switching of potassium chloride sustained release tablets from a brand-name formulation (Slow-K® tablets 600 mg) to a generic one (K-SUPPLY® tablet 600 mg). GT is a phenomenon in which the shell of a tablet is excreted in the feces without disintegration after releasing its active ingredient in the gastrointestinal tract. The objective of this study was to access factors leading to this phenomenon when using the generic formulation. A dissolution test based on the Japanese Pharmacopoeia (JP) 17th edition was performed using the paddle method under three sets of experimental conditions (ultra-pure water, ultra-pure water (pH 6.8), JP dissolution test 1st fluid (pH 1.2)). The concentration of potassium eluted in the medium was determined using an ion electrode method. The dissolution of the potassium was almost the same between the brand-name and generic formulations. The brand-name formulation disintegrated within 6 hr under all three sets of experimental conditions. On the other hand, despite the fact that the release of potassium from the generic formulation was comparable to that of brand-name formulation, it showed little disintegration; that is, the shell of tablet remained intact even after 6 hr. It is considered that differences in the change in appearance between the brand-name and generic formulations during the dissolution test led to the GT when using the generic formulation, and the pharmaceutical additives in the generic formulation were responsible for the GT.

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  • Aiko Fukui, Manako Hanya, Akira Yoshimi, Yukihiro Noda, Hiroyuki Kamei
    2018 Volume 44 Issue 10 Pages 516-525
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    We investigated the educational effects of fourth-year pharmacy studentsʼ participation in the case presentation performed by senior students during clinical practice. Two hundred eight fourth-year students participated in the case presentation using Meijo Distance Education System (MDES), and a total number of 509 fourth-year students was administered questionnaires. Of the total number of students, 93.7% answered “watching the case presentation was useful,” 91.2% answered “question-and-answer was useful,” 86.6% answered “I gained useful knowledge,” and 79.7% answered “I was satisfied with the content.” Joining the case presentation is an opportunity for fourth-year students to think about how to apply basic knowledge and appropriate interventions for individual patients. It is useful for junior students to consider senior students as role models to gain further understanding of clinical practice and to improve their motivation to study.

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  • Youhei Usami, Yuki Hirayama, Masumi Koyama, Yukiya Hashimoto
    2018 Volume 44 Issue 10 Pages 526-532
    Published: October 10, 2018
    Released on J-STAGE: October 10, 2019
    JOURNAL FREE ACCESS

    We recently found the H+/quinidine (QND) antiport system in canine kidney MDCK and porcine kidney LLC-PK1 cells. The aims of the present study were to confirm the presence of the H+/QND antiport system in human embryonic kidney (HEK) 293 cells, and to investigate the substrate specificity of the system. The cellular uptake of 100 µM QND into HEK293 cells was decreased by acidification of extracellular pH and by NH4Cl-induced alkalization of intracellular pH. In addition, a lipophilic cationic drug, diphenhydramine (DPH), significantly decreased the QND uptake in HEK293 cells. In order to evaluate the substrate specificity of the renal H+/QND antiport system, we investigated the DPH-sensitive uptake (Δuptake) of 12 cationic compounds (celiprolol, acebutolol, procainamide, pindolol, bisoprolol, metoprolol, flecainide, clonidine, pyrilamine, QND, propranolol, and verapamil). The Δuptake positively correlated with their lipophilicity (Log D) values, and negatively correlated with their polar surface area (Log PSA) values. In contrast, the Δuptake did not correlate with their molar volume (MV), molar refractivity (MR), or polarization (PO). These findings indicate that an H+/QND antiport system is present in HEK293 cells, and that the Log D and Log PSA of drugs are important factors responsible for the transport activity of the postulated H+/lipophilic cation antiporter in the kidney.

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