The extent of insulin adsorption on the internal surfaces of the 2 kinds of “soft-bag type” infusion containers was investigated by using high-performance liquid chromatography. The containers were newly commercially produced from ethylene vinyl acetate and polyvinyl chloride (PVC). The results were compared with those obtained from the experiments with standard infusion containers, glass and polypropylene bottles. After addition of insulin (10-40 I. U.) to 500 ml of the isotonic saline infusion, the adsorption attained to equilibrium fairly rapidly (within 5 min) and relatively small portions of the added insulin were lost (8-19%). Adsorption on the PVC intravenous tubing was also examined. Adsorption could be prevented by adding fat-soluble vitamin injections containing some surfactants.

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Topical clindamycin is used in the treatment of acne vulgaris at this time. In hospital pharmacy, 1 % clindamycin phosphate lotion for acne vulgaris is prepared from the injectable form of clindamycin phosphate dissolved in the hydroalcoholic vehicle.
Stability of the preparation and 1% clindamycin phosphate aqueous solution was studied at 5° and 25° for 180 day. The pH of the sample was observed along with a periodical visual inspection. The amount of clindamycin phosphate in solution was determined by reversed-phase ion-pairing high-performance liquid chromatography (HPLC) with UV detector at 210 nm.
1% clindamycin phosphate lotion maintained 92% of its activity during the period of 180 days at 5°, and 88 % at 25°.1 % clindamycin phosphate aqueous solution retained 91 % of its activity over the period of 180 days at 5°, and 90% at 25°. As a primary degradation product of clindamycin phosphate in solution, lincomycin-2-phosphate was found in small amount.
1% clindamycin phosphate lotion is relatively stable and good for more than 180 days at 5°.

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For use in hypertensive emergency, 2 types of prazosin hydrochloride (PRZ) suppositories were prepared with Witepsol H-15 and polyethylene glycol (PEG) as typical lipophilic and hydrophilic bases respectively. The suppositories were used for in vitro release and in vivo bioavailability
In in vitro test, the Witepsol suppository released slowly 80% of PRZ content for 5 hr. The release rate of PRZ from the PEG suppository was rapid compared to that from the Witepsol suppository (almost 100% for 2.5 hr).
Contrary to the in vitro release, PRZ plasma concentration curves in rabbits for the Witepsol suppository showed better absorption profile than for the PEG suppository, suggesting higher clinical applicability of the Witepsol suppository. It was also emphasized that in vivo bioavailability test is essential for selection of suitable suppository base from those of which physicochemical properties widely differ.

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The effects of intravenous drip infusions with or without aerotube on the stability of ascorbic acid (AsA) were studied by determination of AsA and partial pressure of oxygen. AsA and sodium riboflavin phosphate, which promotes the photo-oxidation of AsA, were added to 14 kinds of commercial infusion solutions in consideration of practical conditions in hospital. When exposed to white fluorescent lamp (2000 lux, 3 hr), residual ratios of AsA in usual infusion solutions were 40-60% with aerotube and 11-49% without aerotube. Residual ratios of AsA (2000 lux, 6 hr) in total parenteral nutrition solutions, to which 13 kinds of vitamins and trace elements (Fe, Cu, Zn, Mn) had been added, were about 90% with aerotube and about 70% without aerotube. Partial pressure of oxygen dissolved in the solution without aerotube was increased by the bubbling of air during drip administration. Therefore, the oxidizing degradation of AsA in infusion solution without aerotube was promoted when compared with the solution with aerotube.

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Home parenteral nutrition (HPN) allows patients with gastrointestinal dysfunction to lead a nearly normal life after discharge from hospital. We prepared the total parenteral nutrition (TPN) solution bags for 7 HPN patients in our department, and instruct them in the use of the devices, while stressing their importance for home care. The TPN solution bags were usually prepared weekly under aseptic conditions according to standard or special prescriptions which meet the condition of disease in each patient. We also measured once every month the blood levels of trace elements (Zn, Cu, Fe), vitamins (A, E, B₁, B₆) and essential fatty acids in the patients. Assessment of nutritional status in each patient was made periodically according to the results of the blood level monitoring and, if necessary, the prescription was changed. No serious complications were encountered in practice of HPN in our hospital.

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A relationship between color fading and decrease of disinfectant activity of Povidone-Iodine (PVP-I) gargle was examined.
A linear correlation between the absorbance at 550 nm and the concentration of free iodine (I₂) was confirmed. Furthermore, a good correlation was observed between the bactericidal activity and the concentration of the free I₂, though only within the narrow range, 0.063-0.148 mg/ml of free I₂ concentrations.
The PVP-I gargle containing free I₂ at the concentration of 0.131 mg/ml exhibited sufficient bactericidal activity in vitro, nevertheless it was a colorless liquid to the naked eyes.
These results suggest that whether or not the disinfectant activity of PVP-I gargle still remains in the proper solution should be estimated on the basis of the exact concentration of free I₂, not on the basis of a degree of the browrlish color of the solution.

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Compatibility of acetaminophen granules with 34 drugs was investigated by sensory test, while residual activity of acetaminophen in these admixtures was measured by absorptiometry to study the relation between the compatibility and residual activity (%). The data on change in compatibility with time were analyzed by scoring and were subject to a time series analysis (by 2 mean vector). A significant change in compatibility was observed in admixture with antipyrin, Neodrin S®, ephedrine hydrochloride, Hibon fine glanules®, and Narcotin® in the wetting, and with antipyrine and sulpyrine in the discoloration under the severe conditions (30°C, RH 92%). It was also observed in admixtures with antipyrine in the wetting and discoloration under the moderate conditions (20°C, RH 75%). Residual activity of acetaminophen with time was almost stable when tested alone and in mixtures.
No evident mutual relation was observed between compatibility and residual quantity.

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Compatibility of riboflavin tetrabutyrate preparations (Modified syrup, Hibon syrup ®) with 45 medicines was investigated by sensory test, while residual potency of riboflavin tetrabutyrate was measured by absorptiometry. The data on change in compatibility with time were analyzed by time series analysis. A change of Modified syrup and Hibon syrup ® was showed in appearance, but wasn't observed in taste, odor, pH, residual potency and buffer capacity carve on every single syrup. In mixtures, a change was observed in appearance, taste, odor, but not in pH. Modified syrup, tested alone and in mixtures, was better than Hibon syrup in redispersion test. When we administer Hibon syrup ® mixture, we instruct patients to shake well before using.

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Recently, transfiguration of infections has been caused by remarkable increase in the amount of antibiotics. We investigated the amount of use and combination of antibiotics during June of 1981, 1982, 1983 and 1984 at our hospital. The results were as follows:
1) The total amount of antibiotics use decreased annually. 2) The amount of penicillins, especially carbenicillin and sulbenicillin, decreased remarkably. 3) Of the total combinations, 2-drug combinations occupied 75%-85%. 4) Combination of cephalosporins, especially those of the third generation, and aminoglycosides occurred in the largest number.

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Questionnaires on drug information activities were sent out to 820 hospital doctors of Tokyo Women's College, in order to survey their utilization of a drug information (DI) room and to use the resulting data for future reference. A total of 395 doctors responded to the questionnaires, with the recovery rate of 48.2%.
1. The number of doctors who had used the DI room with respect to the utilization and estimation of drug information was 288 (72.5%). The matter most frequently questioned was that on adverse drug reactions, followed by drug efficacy and pharmacology, and administration and dosage, in that order. 266 (79.3%) doctors were satisfied with the information supplied by the DI room.
2. 236 (59.8%) doctors read, regularly or irregularly, the monthly drug information journal published by the DI room. 200 of them replied that they could obtain useful information from the publication. The information sought most often by the doctors was on adverse reactions. Various opinions or demands as to the method of distribution or contents of the journal were sent from 36 doctors.
3. 188 (53.9%) doctors used a hospital formulary. Most of them referred to the information concerning administration and dosage or adverse reactions.
The utilization rate of DI room by hospital doctors was found to be considerably high, and DI activities in hospital were well understood. It is important to fill up the information on adverse reactions which is the subject of keen interest of doctors and to improve the hospital information journal in the future.

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Potassium canrenoate, the active ingredient of intravenous additive Soldactone®, is likely to be deposited at lower pH, and the product is known to cause a physicochemical incompatibility with many other injections. Soldactone was mixed with many kinds of intravenous (IV) fluids, and the changes in the pH and appearance of the mixture were observed.
A precipitate was produced immediately after combination with acidic IV fluids such as electrolytes fluid including dextrose or fructose and amino acid fluids. Further, since Soldactone 200 mg could be mixed with Sorbit Hartmann® or 5 % dextrose fluid, the compatibility on addition of the third intravenous additive to this intravenous (IV) admixture was examined. As a result, 30 to 40% of 188 intravenous additives studied showed a physical and chemical incompatibility upon mixing.
Thus, the pharmacists, when preparing the IV admixture, should recommend use of as few additives as possible in IV fluids, since the risk of potential problem increases in parallel with the number of additives.

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