Ground mixtures of Florae^®, RE (FR) (porous calcium silicate) and acetaminophen (ACTA) were prepared in order to improve the dissolution and compression characteristics of ACTA. No diffraction peaks due to ACTA crystals were observed in the powder X-ray diffraction pattern of the ground mixture with FR (FR: ACTA=9: 1), which showed amorphization of ACTA crystals caused by grinding. The ground mixture produced an improved dissolution of ACTA in comparison with the ACTA crystals, and the tablets prepared from the ground mixture showed faster dissolution behaviour of ACTA than the tablets prepared from a physical mixture.
Tablets of ternary ground mixture containing FR, ACTA and polyethylene glycol 6000 (PEG 6000) were prepared. The dissolution profile of ACTA from the tablet was found to be controlled by the PEG6000 content and compression pressure.

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We have frequently experienced that actual serum concentrations were higher than those predicted during vancomycin therapy. In the present study, we investigated retrospectivelyto find out the characteristics of the patients whose elimination rate distinctly decreased. In elderly patients, renal dysfunctional patients and patients with low elimination rate constant, and mean prediction error induced by the difference of predicted concentrations to actual concentrations showed great values. No correlation was noted between the data of hepatic function and elimination rate constants, although mean prediction error significantly corralated with the serum albumin and cholinesterase concentrations. The patients who had to change the dose interval did not show the data of abnormal renal function. These findings suggest that the dosage requirements of vancomycin and dose interval could not be determined only by the renal function data.

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As intravenous hyperalimentation (IVH) prepared from IVH basic solution and amino acid solution has become popular, lactic acidosis is receiving attention as a serious adverse reaction. Therefore, thiamine is added to IVH in order to prevent this adverse reaction. However, sodium sulfite (SS), added as a stabilizer to many IVH basic solutions and most amino acid solutions, degrades thiamine. Recently, since an amino acid solution without SS has been developed, it is now possible to prepare IVH without SS.
In this study, we measured the time courses of the residual concentrations of both SS and thiamine in the 12 kinds of IVH containing multivitamin and investigated the relationship between the SS concentration and the stability of thiamine from the viewpoint of degradation kinetics.
From the kinetic analysis results, the degradation rate of SS in the IVH stored in a bag was faster than that stored in a glass bottle. The degradation rate of SS in the IVH was very fast when SS is not included in the IVH basic solution.
The degradation of thiamine in IVH was regarded as the apparent first-order degradation process and the degradation rate as being proportional to the SS concentration. The secondorder degradation rate constant of thiamine by SS was not affected by the pH of IVH. Stabilization of thiamine by glucose was inferred by comparing the degradation rate of thiamine caused by SS in IVH and that in buffered solution without glucose.

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Intravenous hyperalimentation (IVH) treatment has been used in Japan since 1970, many hospitals applying this treatment to patients and receiving good results. Since the introduction of IVH treatment, its prescription and technique of this treatment have improved as a result of the many experiments and clinical reasearch conducted.
In this study on the pharmacist's safety while adjusting IVH, it was forcused mainly on the amount and the size of the scattering glass fragments and the distance they traveled when an ampoule is opened.
The results of the experiment were follows.(1) The number of glass fragments for those larger than 30μm only Scattered was from a minimum of 2 to a maximum of 33. The largest glass fragment found in each of the three samples used was 182.7μm, 238.3μm, and 126.1μm for Ohtsuka MV^® Sohvita^®, and distilled water, respectively.(2) Many fragment were from 30μm to 40μm in size, with fragments of this size were contained in each sample as follows: 53.50%, 46.30%, and 57.95% in Ohtsuka MV^®, SohvitaR, and distilled water, respectively.(3) It was found that glass fragments could scatter up to 80cm in distance away from the ampoule.

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Beads-Rotatory cell method was investigated as a new release test method for suppositories. A progesterone suppository of Witepsol-W35 and an indomethacin suppository of polyethyleneglycol were employed as model suppositories. After a membrane filter was attached on the bottom of a stainless steel cylindrical cell, a suppository was put into the cell with glass and nylon beads. Release tests were carried out under different conditions on a basis of composite experimental design consisted of two factors: rotation speed of the cell and the glass-to-nylon bead addition ratio. The release parameters of suppositories were predicted by multiple regression analysis.
For the progesterone suppository, a minimum value of area under the dissolution-time curve for 8 hours (ADT_0-8) was obtained on the center of the experimental area. It was possible to predict ADT_0-8, MDT and T16% using the two factors. For the indomethacin suppository, a tendency was observed for ADT_0-8 to vary proportionally to the rotating speed.
The optimum condition producing excellent agreement between the in vitro and in vivo data was then sought for each suppository by multiple regression analysis.
The Beads-Rotatory cell method could be easily executed utilizing the JP dissolution test apparatus and it was possible to establish a condition which correlates well with the in vivo state.

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The crushing of tablets and opening of capsules should not be done without proper care because these may adversely affect the pharmaceutical release mechanism. However, these tasks must naturally be performed for various clinical reasons. Since few descriptions on crushing and opening appear on package inserts and instructions, we investigated by means of a questionnaire sent to pharmaceutical companies whether or not the tablets and capsules in our hospital formulary are suitable for crushing and opening. The tabulated results showed that 51.0% of 468 tablets and capsules are suitable for crushing and opening and that 49.0% of them are not.
Considering the existence of different dosage forms with the same ingredients such as powders, liquid and external preparations which have been adopted in our hospital formulary and the physicochemical stability of the original drugs, we classified drugs, based on our findings, into the three groups of: suitable, unsuitable and conditionally suitable on the basis of the investigation and the current literature on this subject. On classification poduced 243 suitable (51.9%), 82 unsuitable articles (17.5%), and 143 conditionally suitable (30.6%) tablets and capsules.
According to the results of this investigation, few materials are available for giving useful information in reference to rational pharmacotherapy following crushing and opening. We believe that requests for the crushing of tablets and opening of capsules tend to rise with the increase in elderly patients and with advances in medical treatment. Consequently, pharmaceutical companies should refine and provide their reference materials including clinical data such as the pharmacokinetic data upon crushing and opening of the preparations.

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One-hundred strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated from hospitals located in different areas in Japan were tested for antiseptic-resistance and the possession of transferrable antiseptic-resistant plasmid. The coagullase types of MRSA strains were type II (74%), type IV (11%), type VII (8%), type III (2%) and non-type (5%). Sixtyone strains were penicillinase-producing and 39 were non-producing. Antiseptic-resistant MRSA strains were isolated from 50 hospitals in different areas in Japan. The transferrable gentamicin-resistant plasmids were detected from 23 of the harboured strains. The antiseptic-resistant determinant was located on the transferrable gentamicin-resistant plasmid in 12 of the 23 strains. These 12 strains harbouring the transferrable antiseptic-resistant plasmid were isolated from all areas of Japan except for Hokkaido and Okinawa. The antiseptic-resistant strain and the strains harbouring the transferrable antiseptic-resistant plasmid were found not to exist in any specific hospital or area in Japan.

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The drug information database (DB) system of Akita University Hospial was established by the introduction of MEDIS-DC from JAPIC in MS-DOS personal computer system. The hospital formulary directed to desk top publishing (DTP) was also published according to this DB system. We extracted the data of several items by the introduction of the color-specific modification and converted them into the specific font style format. The formulary which has a purposive layout style could be introduced after the conversion process of the information data from the textual expession. Although this method requires the additional work of include the colorful attributes into the data, it is capable of introducing a free style format and multiple fonts. In addition, this method may also be very useful for showing an easily understandable form of the information contents and for pasting them into the application software. This system is possible to provide the information data suitable for our purpose when DB system is usually supported.

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The differences between the usage directions (storage, preparation and administration) found in the package inserts of Japanese and American biotechnological drugs were examined. In general, American description were found to provide more detailed information on all issues, especially aggregate formation due to the nature of protein molecules. Aggregation was caused by excessive agitation of interferon α 2a, dilution with saline of filgrastim and unusual handling of insulin. These drugs should be carefully checked for the aggregates formed, which might exhibit immuno-or neurotoxic properties. The insufficient information provided on the usage of the biotechnological drugs in Japan should be reconsidered, and pharmacists must take the responsibility for ensuring the proper use of drugs until just before administration.

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We describe a presumed case of drug-induced gastric perforation arising during treatment of rheumatoid arthritis in an outpatient. A 48-year-old male was given diclofenac sodium and misoprostol at the University Hospital. However, the patient also took two non-prescription drugs produced in Taiwan without the consent of his doctors or pharmacists for about three months. The patient was then admitted to another hospital due to upper abdominal pain. A diagnosis of peritonitis due to perforation of the digestive tract was made by thoracic and abdominal radiography, and extended gastrectomy was carried out. We detected indometacin and prednisolone from one non-prescription drug. From the findings, it was considered that the perforated gastric ulcer in this patient was induced by the concomitant use of a corticosteroid and NSAIDs. In this case, the adverse reaction might have been prevented by sufficient patient counseling about the medication. For high-quality and appropriate pharmaceutical care, the pharmacist must provide patient counseling about non-prescription as well as prescrintion drugs

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For the effective use of the ON-LINE MEDLINE (Silver Platter) and CD-ROM MEDLINE (JOIS-III) systems to obtain certain drug information, the time-lags between the publication or the arrival date of journals and their appearance in the MEDLINE systems were examined using the 1993 CD-ROM MEDLINE files. The time-lag between the arrival date at our library and the update for 11 international and 10 domestic journals in these MEDLINE systems was 3-6 months. Since the ON-LINE and CD-ROM MEDLINE systems are updated weekly and monthly, respectively, the time-lag was shorter in the former by almost one month. However, when these systems were used at the beginning (January) and end (December) of the year, the timelag was not differ. The variation in time-lags for journals was relatively large. which may be attributed to several factors such as 1) frequency of publication, 2) country of publication, 3) language used, 4) evaluation by National Library of Medicine, U. S.A. and other factors. We should know the time-lag between the arrival date of journals and the appearance in the database to avoid miss-searching the ON-LINE and CD-ROM MEDLINE systems.

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We have developed a new checking system for dispensing of powder drugs employing two--dimensional barcode symbology (2D-barcode). The 2D-barcode has high density and high capacity of encoding over kilobyte of data per label. This capability is superior to the commercially based system using a linear barcode at the followings:(1) The 2D-barcode can hold all of the necessary dispensing data; drug name, generic name, usual dosage and usual prescribing limits.(2) No database files are required for necessary item data which can be carried on the 2D-barcode.(3) The 2D-barcode is an error-correcting symbology designed for the hospital applications where portions of labels can make handling useless. It performs error corrections by making cal culations, if necessary, to reconstruct undecoded or corrup ted portions of the symbol.

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A Windows drug information system was constructed at Osaka University Hospital. The MSDOS text file of drug information described in the package inserts was obtained in the form of Magnet Optical Disk. Essential information of the drugs used in the hospital were extracted from the text file and the data were edited so as to make the drug information system most efficient for physicians wishing to refer to it when prescribing drugs for patients.

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We have developed a combined Kampo medicine information database system. The database system comprises contains Kampo medicine products information database and a crude drugs information database. In the former, information on component crude drugs and their contents and safety is unified in a relational database for each product and compared with each other within a given Kampo formula by display scrolling. In the latter, information on application, indications, constituents, dosage and other data, is separately obtained for each crude drugs.

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