The authors formulated a “Rubric assessment for pharmacotherapy” to continuously assess students’ ability to perform pharmacotherapy and provide patients with proper pharmacotherapy during student clinical rotations, and evaluated its usefulness. The rubric consists of three domains with 31 subdomains. Students were able to continuously self-assess their performance using the rubric, while continuously improving their achievement level. The rubric assessments may be useful for students to assess and improve their ability to practice pharmacotherapy.
The authors investigated the connection between differences in argatroban administration and worsening of symptoms after day 3 in ischemic stroke patients. Worsening of symptoms was not related to either intravenous or continuous infusion group. Bleeding was also not associated with either group. They suggest that the differences in the mode of argatroban administration were not related to the worsening of symptoms in ischemic stroke patients. They also found that safety was equivalent regardless of the administration route.
The authors investigated the drug–drug interactions between warfarin and tolvaptan by measuring drug blood concentrations in clinical patients and conducting in vitro albumin-binding experiments. They indicated that tolvaptan causes the free warfarin concentration to increase within 2 weeks of starting the combined treatment and the mechanism was albumin-binding substitution. This study shows that investigating and demonstrating various phenomena from the bedside enable pharmacists to provide better pharmaceutical care for patients.
The authors have reported that diclofenac etalhyaluronate (SI-613) exerted a long-lasting analgesic effect in experimental arthritis models. In this study, they evaluated the properties of residual SI-613 in the knee joint. The results suggested that intra-articularly administered SI-613 remained for a longer time in the joint as hyaluronic acid (HA) linked with diclofenac than intra-articularly administered HA. Therefore, SI-613 was considered to prolong the pharmacological effects of both HA and diclofenac by remaining in the joint as HA linked with diclofenac.
The authors evaluated the effect of prescription suggestions by pharmacists to show the need for ward pharmacists’ services beyond 8 weeks for inpatients in the psychiatric ward. The pharmacists supported pharmacotherapy without exacerbating patient outcomes, decreased in benzodiazepine doses, and reduced healthcare expenditures were obtained for inpatients > 8 weeks of admission. This study showed that ward pharmacists’ services were necessary not only for the inpatients hospitalized for < 9 weeks, but also for those hospitalized for > 8 weeks.
Riluzole is a drug used to manage amyotrophic lateral sclerosis (ALS). Previous reports indicate a high incidence of liver injury in patients taking riluzole. Therefore, this study aimed to determine the risk factors for liver injury among patients who were prescribed riluzole from 1999 to 2015. As a result, concurrent use of CYP1A2 inhibitors, and history of smoking are independent risk factors associated with the development of liver injury in ALS patients who are prescribed riluzole.
The author hypothesized that an investigation of inhaler hygiene in relation to inhaler cleaning practices might help lower the risk of infection by determining the prevalence of improper cleaning methods in elderly asthma patients. This study showed that the hygiene of steroid drug inhalers used by those who did not perform any cleaning action after inhalation was poor, and suggested that a guidance on how to clean the inhaler would be important for the infection control.
This study investigated attribution of each anticholinergic (AC) drug type to total AC burden in large elderly data in 2015-2016 using Anticholinergic Cognitive Burden (ACB) scale, Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Beers criteria. AC use and burden increased with age with ACB and ADS but decreased with ARS and Beers criteria. Antihypertensives were the most attributable AC in ACB and ADS while antihistamines attributed the most in ARS.
The prevalence of home parenteral nutrition (HPN)
continues to increase. Elneopa NF No. 1
and No. 2 infusions have been used for HPN, with insulin injected into the bags
for patients with hyperglycemia. In this study, the authors studied the stability
of insulin in the bags. It was revealed that the concentration of insulin
injected into the bags decreases, especially in No. 2 bags. In addition, decreases
in insulin levels were observed as the solutions passed through infusion sets.
The liposome suspension and the hydrophobically-modified hydroxypropylmethylcellulose (HM-HPMC) aqueous solution each had low viscosities, but the viscosity increased rapidly when they were mixed. This is thought to be due to the formation of a 3D network structure caused by the hydrophobic group of HM-HPMC penetrating into the liposomal membrane, crosslinking the liposomes together. The viscosity of the liposome/HM-HPMC mixed solution decreased rapidly when a shear was applied, but immediately returned to the original gel state when the shear was removed.
Much less education has been done on literature evaluation in the Japanese education of pharmaceutical sciences. The authors adopted team-based learning (TBL) to educate undergraduate students on the practical evaluation of literature and the understanding of evidence-based medicine (EBM) concepts. The mean scores on the post-test significantly improved from 4.34 to 6.42 out of 10 total points. These results suggested that TBL was effective in EBM education for providing knowledge of literature evaluation and the understanding of fundamental concepts.
In patients being treated with bisphosphonates (anti-bone-resorptive drugs), bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious concern. The authors demonstrate that nitrogen-containing bisphosphonates (N-BPs) are transported into soft-tissue cells via phosphate transporters and therein exhibit cytotoxicity, while non-nitrogen-containing bisphosphonates (non-N-BPs) inhibit this transportation. Based on results from animal and clinical studies, they propose that the non-N-BPs etidronate and clodronate may be useful for preventing and/or treating BRONJ. They also demonstrate that N-BP-induced toxicity is augmented by infection.
Paclitaxel (PTX)-associated acute pain syndrome (P-APS) is characterized by disabling but transient arthralgia and myalgia in up to 80% of patients administered with PTX. In this study, it was revealed that clinical condition that needs non-steroidal anti-inflammatory drugs (NSAIDs) and previously administered NSAIDs prior to PTX injection do not affect the incidence, severity, and duration of P-APS. These results will help in educating patients about their medications and will contribute to the management of P-APS.
The authors on the liaison team have
been applying digital labels with recommendations for the reduction of use and
changes in the medication orders and prescriptions of BZDs on electronic
medical records. This study showed that the medication orders for BZDs were
reduced after the implementation of digital labels and that the reduction effect was maintained for a certain period of
time, and suggest that the liaison team pharmacist-led approach can contribute
to the proper use of BZDs.
Different serum creatinine (Scr) levels are reported depending on the analytical methods utilized such as the Scr level determined by the enzyme method being lower than that by the Jaffe method. This study investigated whether assessment of renal function with or without Scr adjustment affects cisplatin-based chemotherapy in cervical cancer patients. The results suggest that evaluation of renal function using the adjusted Scr is important for an appropriate dose adjustment of cisplatin in clinical practice.
This retrospective study investigated whether a collaboration between cardiologists and pharmacists would improve the quality of ambulatory anticoagulation therapy with warfarin in patients with non-valvular atrial fibrillation (NVAF). The quality of the anticoagulation therapy was assessed by percent time within therapeutic range (%TTR) of international normalized ratio of prothrombin time (PT-INR). The study demonstrated that a multi-disciplinary ambulatory anticoagulation service (MAAS) improved the median %TTR significantly (p<0.05) from 57% during the pre-MAAS period to 77% during the MAAS period.
We have developed a new SNP typing method, reducing the experiment time by simplifying the conventional DNA extraction and purification process. Furthermore, the risk of human error, such as sample contamination was reduced, and significant cost reduction was achieved. We aim to utilize genotyping of alcohol metabolism-related genes in health education, preventing drinking accidents for university freshmen, as well as promoting appropriate drinking habits in the community. By identifying genotypes for genes related to drug metabolisms, personalized medicine will be achieved.
We reviewed systematic reviews (SRs) subjected for breast cancer patients who used complementary and alternative medicine (CAM); that is, (1) which CAM was used, (2) how much evidence was contained. Thirty-four SRs met a set of criteria. Among interventions, yoga (9), acupuncture (6), and herbal medicines (5) were mainly used. Evaluation of quality of SRs using AMSTAR revealed that 9 out of 34 reviews were of high quality and 3 reviews were deemed to be of low quality.
The pharmacist needs to understand the characteristics of each drug and work on optimizing prescriptions, such as considering dosage and usage schedules to avoid various risks and problems. In this study, multidisciplinary clinical team meetings where pharmacists can effectively share information on the current status of benzodiazepine receptor agonist (BZRA) use and their prescription recommendations with other clinical team members can lead to reduced BZRA dosages. Therefore, this study will be a guide to the intervention of Japanese pharmacists.
In the 2016 Kumamoto earthquake, medical supply vehicles (mobile pharmacies) were dispatched from Oita, Wakayama, and Hiroshima and contributed to medical treatment in the disaster area. In this qualitative research, authors conducted a semi-structured interview of 21 pharmacists. The modified grounded theory approach was used for data collection and analysis to generate 36 concepts and 13 categories. The support pharmacists maintained mobile pharmacies as a method for cooperation among multiple occupations, and talked about further collaboration of mobile pharmacies.