Antipsychotics are widely used to manage mental illnesses. They have, however, been reported to cause various adverse events. Two studies were conducted to resolve clinical questions related to adverse events caused by antipsychotic medications in clinical practice. The first adverse event studied was clozapine-induced sialorrhea (CIS), a common adverse event. There is no established standard treatment for CIS because the underlying mechanism remains unclear. Therefore, this study aimed to identify the cause of CIS. Results of clinical and basic studies suggest that N-desmethylclozapine (NDMC), the active metabolite of clozapine, is the causative agent of CIS. Furthermore, the action of NDMC on salivary gland cells via muscarinic receptors is one of the proposed mechanisms of CIS. The second adverse event was hyperglycemia. Antipsychotics increase the incidence of hyperglycemia. However, the incidence of antipsychotic-induced hyperglycemia is difficult to predict because many factors are involved. This study aimed to examine the effect of antipsychotic treatment-associated factors on hyperglycemic progression after adjustment for the effect of background factors suggested to be associated with hyperglycemic progression. A national multicenter prospective observational study of 631 newly initiated patients showed that initiation of clozapine and zotepine treatment significantly increased the incidence of hyperglycemia. In addition, obesity has been shown to significantly increase the incidence of antipsychotic-induced hyperglycemia. Because these studies were conducted to resolve questions that arose in actual clinical practice, the study results obtained are considered to have clinical applicability.

Theranostics, a new medical term that combines therapeutics and diagnostics is considered an ideal system for medical care. Ultrasound is considered one of the most reasonable energies for the development of theranostics. Additionally, microbubbles, which are ultrasound contrast agents, have received considerable attention for their effectiveness in diagnosis and therapy. Microbubbles are composed of an inner gas and an outer shell composed of proteins or phospholipids. Under ultrasound exposure, the oscillation or collapse of microbubbles is induced depending on the intensity of the ultrasound. These mechanical effects are important for imaging, drug delivery, and ablation therapies. Therefore, it is essential that microbubbles reach the targeted site and induce mechanical effects to achieve effective and efficient diagnosis and therapy. We have previously developed novel microbubbles with high stability by optimizing the outer shell composition. Recently, microbubbles containing distearoylphosphatidyl glycerol showed high stability and prolonged circulation in the blood. These novel microbubbles may be useful for diagnosis and therapy. The combination of microbubbles and ultrasound has received considerable attention for brain-targeted drug delivery applications. We examined whether microbubbles can be used for brain-targeted drug delivery and evaluated the effect of the encapsulated gas on drug delivery. Thus, novel microbubbles combined with ultrasound can deliver molecules to the brain. Microbubbles containing perfluoropropane or perfluorobutane could efficiently deliver molecules to the brain. The novel microbubbles have long-circulating properties in the blood and could deliver molecules to the brain. The combination of novel microbubbles and ultrasound would contribute to the development of efficient thranostic systems.

Pharmacy schools in Japan started to offer the 6-year undergraduate program in 2006. Currently, students are eligible for the national licensing examination to become a pharmacist only after completing the six-year program and receiving a bachelor’s degree. Meanwhile, pharmacy schools offer the four-year graduate program in the United States of America (U.S.A.). In addition to the length of the program, there are several significant differences between pharmacy schools in Japan and the U.S.A. In the U.S., students receive a professional doctoral degree in pharmacy, doctor of pharmacy (Pharm.D.), after completion of the program. Fourth-year pharmacy students in the U.S. spend 1600 h in their clinical rotations, which is considerably longer than those in Japanese programs. It is also unique that pharmacists and pharmacy students are authorized to administer vaccines in the U.S. upon completion of immunization training. This symposium review aims to introduce the pharmaceutical education and the Pharm.D. program offered in the U.S.

Based on its founding spirit of “Strong, Correct and Clear” Gifu Pharmaceutical University (hereinafter referred to as “the University”) has adopted the human and environmentally friendly Pharmacy (Green Pharmacy) as its basic philosophy. As the University fulfills its social mission to enrich and strengthen education, research, and social activities, it faces many challenges. These include incorporation, fostering academia–industry–government collaboration, life-science center development and expanding the role of the affiliated pharmacy. The University will continually strive to recognize trends in the social environment and make the effort to respond to challenges when they arise. This effort will allow the University faculty and staff to maintain a sustainable institution that can respond to social challenges while continuing to share the benefits of education, research, and drug discovery/development with the community. The University is committed to train world class Pharmacist–Scientist. This review explains the rationale for the University’s transition to a single six-year program. It also gives an update on the current status of education, research, and the mobile pharmacy (MP) since its introduction. Furthermore, it highlights advancements in academic–industry–government collaboration.

Almost 20 years have passed since the six-year pharmaceutical education started as the standard educational course for pharmacists. The six-year pharmaceutical education was originally proposed to nurture the pharmacists who can play important roles in advanced medical care as part of the medical team. Importantly, recent advances in life science are providing additional scientific advantages for the graduates from the six-year pharmaceutical education system. In the new era of life science, clinical training in the six-year education will be beneficial not only for the clinical pharmacists but also for the pharmaceutical scientists. For example, in drug discovery research, numerous studies have been making efforts to identify therapeutic targets based on basic sciences so far. However, as a result of the innovation in life science, such as multi-omics analyses and molecular imaging, we can now perform patient-/disease-oriented research on molecular basis using clinical materials and information. Nowadays, with the help of data science, we can understand the pathophysiological status of individual patients and optimize pharmacotherapy from viewpoint of molecular biology in clinical setting. Moreover, in drug discovery research, we can explore and identify the drug targets by analyzing clinical samples and medical records. Thus, learning from the bedside in detail will develop future leaders, including pharmacists, scientists and pharmacist-scientists, who will pave the way for pharmaceutical sciences in the next generation.

The Faculty of Pharmaceutical Sciences at Tokushima University, which had a two-department system, was unified into a six-year system in 2021. Based on our experience with the two-department system, we have continued to provide our original courses to foster a research mindset, and we have established new courses to nurture leading pharmacists. We believe that the faculty’s passion for research and education is the key to the success of the six-year system.

The environment surrounding pharmaceutical education in Japan has changed significantly with the establishment of many new pharmacy schools and the transition to six-year pharmacist education. Under these circumstances, various issues have been revealed in recent years. In particular, the decrease in the number of doctoral students responsible for future pharmaceutical education and research in drug discovery and life science is a concern. To address this issue, we at Kanazawa University have revised the human resource development policy of the Faculty of Pharmaceutical Sciences to “fostering leaders who are active in a variety of professions in pharmaceutical sciences” and have made various efforts toward the realization of this policy. Among the topics introduced at the symposium, this paper focuses on reforming the educational system and reorganizing the School of Pharmacy and Pharmaceutical Sciences at Kanazawa University.

To empower the next generation of students to become leaders that play active roles in various fields in society, research universities must offer attractive and meaningful doctor of philosophy (PhD) programs in their graduate schools. The Graduate School of Pharmaceutical Sciences, at Kyoto University has trained a large number of researchers who are leading drug discovery science and clinical pharmacy in academia as well as in the pharmaceutical industry, in medical organization and in government. However, due to changes in the trends of students and the evolving skill requirements of future PhD holders to handle the challenges of a changing society, it is necessary to revise the curriculum of our graduate school. Thus, we will reform the graduate and undergraduate school programs by implementing a so-called late specialization program and a double mentoring system and aim to nurture emergent researchers who will explore uncharted areas in pharmaceutical sciences. Toward this goal, we established the Division of Medical Frontier Sciences in April 2022 to replace the former Division of Bioinformatics and Chemical Genomics. This program is Japan’s first five-year integrated doctoral course in the field of pharmaceutical sciences. In this review, I will introduce the background leading to its development construction and provide an overview of the characteristics of this five-year integrated doctoral program.

To overcome the decline in the number of students advancing to doctor of philosophy (PhD) courses in graduate schools in Japan, the government of Japan launched a new five-year program in 2021: Support for Pioneering Research Initiated by the Next Generation (SPRING). SPRING is overseen by the Japan Science and Technology Agency (JST) as an integrated program that provides outstanding PhD course students financial support in an amount equivalent to their living expenses and research expenses, as well as career development and human development courses and support. The proposed advanced doctoral program for medical innovators at Tokyo University of Pharmacy and Life Sciences was selected for SPRING support under the theme of “Beef Up Toyaku talents TO go BEyond the borders” (BUTTOBE). This report describes the purpose and current activities of the BUTTOBE program.

In recent years, the role of pharmacists has changed dramatically due to a combination of rapid developments in medicine, science and technology, along with a rapidly aging population and declining birthrate. Especially since the 1980s, these changes have been remarkable. Accordingly, in order to best prepare pharmacists, the duration of pharmacy education has been extended to six years. Further, the core curricula of all three medical faculties (medicine, dentistry, and pharmacy) will be revised concurrently, in a coordinated manner, in 2024. Pharmaceutical education should thus place more emphasis on clinical education to “know clinical practice, link what you have learned in clinical practice to drug discovery, and important to know the roles of each medical provider including patients and contribute to drug treatment and post-marketing drug development. We should be aware that pharmacy and medical care cannot be achieved through lectures alone.” In designing a new pharmaceutical curriculum to meet these coming needs, it is important to have a vision looking 10 or 20 years into the future. It is necessary to know the world in which we live, as well as the role that should be played by pharmacists, to set a clear educational philosophy that includes goals to be achieved, and then to develop a curriculum to reach these, and a plan for steadily putting these goals into practice.

In 2006, Japan’s pharmaceutical science education was revised to a 6-year enrollment course, placing greater emphasis on cultivating practical clinical ability. Quality Assurance (QA) measures have been implemented including offering education based on a model core curriculum and third-party assessments. In August 2021, Ministry of Education, Culture, Sports, Science and Technology (MEXT) launched an investigative commission to review the above. For QA, the commission summarized a comprehensive report in August 2022 for items including: modality of selecting entrants; revising enrollment limits; securing education management; information disclosure; corresponding to pharmaceutical education assessments. For revising the model core curriculum, the commission is reviewing correspondence to: demographic changes due to decreasing birthrates, an ageing population, changes in the structure of diseases; rising and emerging infectious diseases; utilizing Big Data and artificial intelligence (AI). As Japan’s ageing population is forecast to peak in 2040s, pharmacists must be fostered to provide safe and quality medicine towards a drastically changing future. Medical care is provided through the collaboration of various professions. In such changing demographics, team medicine is crucial to provide quality medical care. Moreover, towards all medical professions sharing the same vision, revisions to the model core curricula for medical and dental education are also being reviewed. The commission is now reviewing detailed curricula to foster pharmacists with competencies to: comprehensively assess patients and ordinary citizens; utilize information science and technology; professionalism. Towards securing quality pharmaceutical education, pharmaceutical departments at universities must also organize and implement an educational curriculum based on the Model Core Curriculum for Pharmaceutical Education. This paper will introduce the investigative commission’s review.

When vancomycin hydrochloride (VCM) powder mixes with xanthan gum-based thickening agents in food, lumps or other property-related changes may occur. Previous studies have reported delayed disintegration and elution of the drug and its adsorption on to xanthan gum, which is the main ingredient of thickened food products. If the addition of thickening agents can affect the antimicrobial activity of VCM powder as previously reported, it might interfere with the treatment of Clostridioides difficile infection (CDI). In this study, we investigated the effect of the addition of xanthan gum-based thickening agents on the antibacterial activity of VCM against Clostridioides difficile in vitro. The VCM concentration at 0 min after adding 3% Tsururinko Quickly (Clinico, Tokyo) to VCM powders (Shionogi, Osaka and Meiji Seika Pharma, Tokyo) was lower than that of the control [Shionogi: 65.15±35.57%, Meiji Seika Pharma: 77.00±15.81% (mean±standard deviation), ** p<0.01, Dunnet’s test]. However, the VCM concentration at 30 min after the addition recovered to the control level. The drug susceptibility tests for C. difficile and Staphylococcus aureus using the disk diffusion method showed no effect of addition of 3% Tsururinko Quickly. Our in vitro evaluations showed that the addition of xanthan gum-based thickeners to VCM powders had a negligible effect on the treatment of CDI.

Insulin therapy is one of the central treatments for diabetes mellitus. Insulin-derived localized amyloidosis (IDLA) is a known skin-related complication of insulin injection. This is one of the causes of poor glycemic control in diabetic patients on insulin therapy. The aim of this study was to review and update the findings on the extent and mechanism of reduced insulin absorption in IDLA. A literature search was conducted on decreased insulin absorption and its mechanisms, and nine references were selected, with seven of these on decreased insulin absorption and four on mechanisms. Insulin absorption at IDLA sites was reported to be 27–94% lower compared with normal sites. In addition, a comparison between nonpalpable and palpable IDLA sites revealed a significant decrease in insulin absorption at the palpable IDLA site. The mechanism of insulin malabsorption was found to be a reduction in insulin absorption at the palpable IDLA sites. Four mechanisms of decreased insulin absorption were identified: decreased subcutaneous blood flow, adsorption of administered insulin onto insulin amyloid fibers, impaired diffusion of insulin subcutaneously, and physical factors such as shaking of the insulin preparation. These mechanisms should be investigated in vivo in the future.

Diabetes is a chronic disease requiring long-term management. Poorly controlled diabetes is associated with reduced quality of life and micro- and macro-vascular complications. Community pharmacists have a role in supporting people with diabetes to better address their condition and reduce their risk of diabetes-related illness. The purpose of this study was to examine and compare the attitudes, practices, and confidence of community pharmacists in Japan and Ireland on the care of people with diabetes. A cross-sectional survey of community pharmacists in Ireland (388 respondents) and Japan (144 respondents) was conducted to assess their attitudes, practices, confidence, and other characteristics linked to diabetes management. A Likert scale was utilized, with a range of strongly agree to strongly disagree. The study reported that Japanese pharmacists have lower levels of practice (p<0.004), confidence, trust by patients, job satisfaction, concern with patients, and knowledge (all p<0.001) regarding diabetes management than Irish pharmacists. Although there was no significant difference in the attitude of pharmacists in both countries, the results show almost similar attitudes toward diabetes management, indicating their willingness to support people with diabetes. These results demonstrated less confidence in diabetes management and less practice of diabetes management care among Japanese pharmacists than Irish pharmacists. The results can be used to identify pharmacist education needs and develop training programs in diabetes management for pharmacists in Japan and Ireland.