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.
The combination of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin with rituximab (DA-EPOCH-R) is used for treatment of non-Hodgkin lymphoma. Febrile neutropenia (FN) is a common complication of treatment with myelo-suppressive chemotherapy, therefore, preventing FN is important for successful treatment. The authors compared the efficacy of pegfilgrastim with that of filgrastim in patients receiving DA-EPOCH-R and showed that pegfilgrastim seems to be better than filgrastim for the primary prophylaxis, maintaining chemotherapy dosage, and reducing hospital duration.
The Science Council of Japan issued “The report: Promotion of social contributions of Research on Clinical Pharmacy and Pharmaceutical Sciences” on September 29, 2017. Research on clinical pharmacy and pharmaceutical sciences is a core research area of the 4-year doctoral course. In this symposium, several representatives from various academic societies and one research institution which have important functions for academic interchanges, will give presentations on issues and initiatives for promoting research on clinical pharmacy and pharmaceutical sciences.
To clarify the volume of water required to paste pediatric powders, we herein established a standard for the powder paste state by measuring yield values when water was added to powders. The yield value to achieve a paste state was estimated approximately 1,000 dyne/cm2 from the spreadability using a spread meter. The optimum volume of water estimated from this yield value for the amount of powder may be applied to the mixture of each pediatric power for dosage/body weight.
To clarify the associated factors for negative response to sumatriptan nasal spray (NS) in patients with cluster headache, we investigated the involvement of clinical information before commencing NS treatment. The efficacy of NS was 77.3% (n = 17) for these 22 patients. Three factors for negative response to NS, "young age of onset ", "psychiatric disorder", and "the headache is not in the orbit," were found. Therefore, these factors are considered to be useful for predicting therapy before applying NS.
We showed that a naturally occurring macrocyclic bis(bibenzyl) derivative, riccardin C (RC) and some synthetic derivatives, exhibits antibacterial activity towards MRSA, with a potency comparable to that of the clinically used drug vancomycin. The SAR results indicated that the number and positions of the phenolic hydroxyl groups are primary determinants of the anti-MRSA activity. Numerous biological studies indicated that the macrocyclic bis(bibenzyl) derivatives directly damages the gram-positive bacterial membrane, resulting in increased permeability.
Adhesive properties of 38 transdermal patches of ten different active pharmaceutical ingredients (APIs) were measured using unified methods. The adhesive properties were quite different among the patches, even for the same API, dose, and size. In the case of generic products for which the bioequivalence to a brand-name product is assured, the variation in the adhesive properties can extend the range of choices for patients. This study will help medical experts to notice the differences in adhesive properties of transdermal patches.
Similar-appearing PTP sheets (a.k.a. blister packs) that contain different medicines may result in incorrect medication due to confusion errors. To identify the factors that may lead to such errors, the authors conducted a questionnaire survey for pharmacists. Factors related to color (sheet, tablet/capsule, print) were most frequently selected as influencing the perceived similarity. The questionnaire results also indicate that patients themselves can confuse similar PTP sheets. Further quantitative studies are looked forward to clarify the key factors causing confusion errors.