This study investigated the effects of fenofibrate and bezafibrate on risk of diabetic retinopathy (DR) in Japanese working age patients with type 2 diabetes and dyslipidemia using electronic medical records. Although these fibrates did not affect development of DR, poor control of hemoglobin A1c (HbA1c) and low-density lipoprotein cholesterol (LDL-C) within the follow-up period increased the risk of DR. Thus, controlling HbA1c and LDL-C levels under coexistence type 2 diabetes and dyslipidemia is more important than the selection of fibrate.
The author introduced three methods to characterize the blood-brain barrier (BBB) transport function. It was shown that the BBB plays an important role in protecting the brain by transporting small molecules such as neurotransmitters, uremic toxins and xenobiotics together with proteins. Significant species differences were shown in the expression amounts of various BBB transporter proteins. Moreover, in vivo BBB efflux transport activity was predicted from in vitro study and transporter protein concentration.
The authors report on pharmacists’ work that is unique to surgical departments. Pharmacists prepare drug solutions utilizing anesthesia recording systems, which they were involved in developing. Anesthesiologists request pharmacists to prepare drug solutions after estimating the degree of postoperative pain in the surgical field during surgery. Pharmacists then prepare specific solutions after consultation and discussion with anesthesiologists. In this study, the authors investigated the evaluation of pharmacists’ practices by anesthesiologists and found that pharmacists received favorable evaluations.
Distigmine is a cholinesterase inhibitor, which is used in Japan for the treatment for underactive bladder. Although the effectiveness of distigmine for underactive bladder treatment has been confirmed by many clinical reports, the pharmacological effects of distigmine on urinary bladder (UB) motility have not been well studied. In this review, the authors discuss the long-lasting potentiating effect of distigmine on guinea pig UB motility and the mechanism of these effects in guinea pig UB smooth muscle and recombinant human acetylcholinesterase.
In this review, the authors first discuss the mechanisms of phototoxicity and how they can be evaluated. They then discuss the state of the art and challenges now faced in photosafety evaluation of pharmaceuticals and cosmetics. Additionally, they describe the latest developments in OECD test guidelines for assessing photosafety, including revisions to the 3T3 NRU phototoxicity test (TG 432) and the newly adopted ROS assay (TG 495).
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.