Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Multidisciplinary intervention for adverse events associated with ATZ + BEV therapy: a case report.","authors":"Ko Masaki, Motoyasu Miyzaki, Kota Mashima, Yasutaka Sumi, Kohei Noda, Syohei Ueno, Takashi Tanaka, Nobutaka Takahashi, Susumu Kaneshige, Hidetoshi Kamimura","doi":"10.1186/s40780-025-00448-z","DOIUrl":"https://doi.org/10.1186/s40780-025-00448-z","url":null,"abstract":"<p><strong>Background: </strong>Atezolizumab (ATZ) plus bevacizumab (BEV) combination therapy has recently been approved for the treatment of unresectable hepatocellular carcinoma. However, immune-related adverse events (irAEs), including peripheral neuropathy, have also been reported. This case report describes a multidisciplinary intervention for a patient who developed peripheral neuropathy as an irAE following ATZ+BEV combination therapy.</p><p><strong>Case presentation: </strong>The patient was a 60-year-old man with a history of hypertension. ATZ + BEV combination therapy was initiated for unresectable hepatocellular carcinoma on day 0. On day 6, he experienced a grade 2 hypertensive episode with a systolic blood pressure of 160 mmHg, despite being on amlodipine (5 mg) and azilsartan (20 mg). Based on the pharmacist's recommendations, the amlodipine dose was increased to 10 mg. However, as hypertension persisted, an additional 20 mg of azilsartan was prescribed, ultimately stabilizing the patient's blood pressure to approximately 110/60 mmHg. On day 23, the patient reported numbness in his extremities, which was later diagnosed as grade 3 peripheral neuropathy. Notably, data from the IMbrave150 trial indicated that the of peripheral neuropathy as an irAE was 1.5%. This prompted a consultation with a neurologist. Prednisolone (40 mg/day) was initiated on day 26, followed by steroid pulse therapy with methylprednisolone (1000 mg/day for three days) starting on day 37. Despite these interventions, the symptoms did not improve. Rehabilitation therapy was commenced on day 42 after steroid tapering. On day 48, the patient underwent a five-day course of high-dose intravenous immunoglobulin therapy, which also failed to yield improvement. Rehabilitation efforts subsequently shifted to enhancing activities of daily living. Initially, the patient required assistance to stand and faced significant difficulty walking. With consistent strength and mobility training, the patient progressed to walking with crutches and demonstrated increased walking distance.</p><p><strong>Conclusions: </strong>The pathophysiology of irAE-induced peripheral neuropathy associated with immune checkpoint inhibitors remains poorly understood. This case underscores the challenges of managing irAE-related neuropathy, which may exhibit limited responsiveness to conventional treatments. Early detection, timely intervention, and multidisciplinary approaches are crucial for optimizing patient outcomes and mitigating the impact of severe side effects.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"40"},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsteroidal anti-inflammatory drug use is associated with improved activities of daily living and rehabilitation in older adult patients following a fracture: a retrospective cohort study.","authors":"Eiji Kose, Hidetatsu Endo, Hiroko Hori, Shingo Hosono, Chiaki Kawamura, Yuta Kodama, Takashi Yamazaki, Toshimi Kimura, Hidetatstu Endo","doi":"10.1186/s40780-025-00445-2","DOIUrl":"https://doi.org/10.1186/s40780-025-00445-2","url":null,"abstract":"<p><strong>Background: </strong>Insufficient rehabilitation due to postfracture pain can result in muscle atrophy and joint contractures, which may affect the improvement of activities of daily living (ADL). This study investigated the impact of using nonsteroidal anti-inflammatory drugs (NSAIDs) on the improvement of ADL in older adult patients with fractures admitted to a convalescent rehabilitation unit.</p><p><strong>Methods: </strong>Of 489 older adult patients with fractures from January 2017 to June 2019, 261 fulfilled the requirements for this retrospective cohort analysis. Patients who had convalescent rehabilitation following a fracture were categorized into two groups: those who used NSAIDs and those who did not. The functional independence measure-total gain (FIM-total) score, which was used for evaluating ADL, was the main outcome measure. We ascertained the independent relationship between NSAIDs use and rehabilitation outcomes using a multiple linear regression analysis. Covariates selected to correct bias included age, sex (male), BMI, hypertension, dementia, cardiovascular disease, cerebrovascular disease, upper limb paralysis, femoral fracture, lumbar compression fracture, thoracic compression fracture, pelvic fracture, patellar fracture, FIM-total at admission, number of drugs, acetaminophen use.</p><p><strong>Results: </strong>The mean participant age was 82.3 ± 7.4 years, 69 (26.4%) of them were men, and 94 (36%) used NSAIDs. Multiple linear regression analysis revealed that NSAIDs use was independently associated with FIM-total gain during hospitalization (β=2.311, P=0.013).</p><p><strong>Conclusions: </strong>These findings suggest that the appropriate use of NSAIDs may play a beneficial role in maximizing rehabilitation outcomes. However, careful monitoring for potential adverse effects is essential, particularly in older adults.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"39"},"PeriodicalIF":1.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of dysphagia and related medications in nursing home residents using the Eating Assessment Tool (EAT-10) applied by community pharmacists: A single-center retrospective study.","authors":"Norio Watanabe, Minami Ebisujima, Takahiro Ichihara, Motozumi Ando, Masami Kawahara","doi":"10.1186/s40780-025-00447-0","DOIUrl":"https://doi.org/10.1186/s40780-025-00447-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the prevalence of dysphagia among nursing home residents and to examine the association between medication use and impaired swallowing function.</p><p><strong>Methods: </strong>Between January and December 2023, we conducted a retrospective survey across 14 nursing homes visited by community pharmacists. Swallowing function was evaluated using the Eating Assessment Tool-10 (EAT-10) questionnaire. Residents were categorized into two groups: those with reduced swallowing function (EAT-10 score ≥ 3) and those with normal swallowing function (EAT-10 score < 3). The association between medication use and swallowing function was analyzed using univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>Significant differences were observed between the reduced (n = 101, 36.9%) and normal swallowing function (n = 173, 63.1%) groups in terms of age (P = 0.022), body mass index (BMI) (P < 0.001), and nursing care level (P < 0.001). Propensity score matching was performed to adjust for confounding factors, yielding 72 matched pairs. Analysis of the matched cohort revealed a significant association between antipsychotic use and reduced swallowing function (odds ratio [OR], 2.600; 95% confidence interval [CI], 1.210-5.560; P = 0.014).</p><p><strong>Conclusions: </strong>This study identified a significant association between antipsychotic drug use and reduced swallowing function. Medication reviews incorporating assessments of swallowing function may help mitigate the risk of aspiration. Further prospective studies are warranted to validate these findings and to clarify causal relationship between medication use and swallowing dysfunction.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"38"},"PeriodicalIF":1.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right-brain utilization in pharmacists' dispensing processes: an eye-tracking analysis of efficiency and safety using error-induction models.","authors":"Toshikazu Tsuji, Kenichiro Nagata, Masayuki Tanaka, Shiori Iwane, Shigeru Hasebe, Yuto Nishiyama, Nana Yoshikawa, Hiroyuki Watanabe, Shigeru Ishida, Takeshi Hirota, Ichiro Ieiri, Mayako Uchida","doi":"10.1186/s40780-025-00443-4","DOIUrl":"https://doi.org/10.1186/s40780-025-00443-4","url":null,"abstract":"<p><strong>Background: </strong>Dispensing errors associated with \"same-name drugs\" and \"similar-name drugs\" are common, negatively affecting patients. Using two pairs of error-induction models, this study analyzed pharmacists' gaze movements while dispensing by an eye-tracking method to interpret their thought processes. Thus, we aimed to assess the efficiency and safety of dispensing processes by examining right-brain function using error-induction models.</p><p><strong>Methods: </strong>We created verification slides for display on a prescription monitor and three drug rack monitors. The prescription monitor displayed the dispensing information, including drug name, drug usage, location display, and total amount. A total of 180 drugs, including five target drugs, were displayed on the three-drug rack monitors. We measured total gaze points in the prescription area (Gaze 1), total gaze points in the drug rack area (Gaze 2), total vertical eye movements between the two areas (Passage), time required to dispense drugs (Time), and the error rate for each verification (Error). First, we defined two types of location display methods: \"numeral combination\" and \"color/symbol combination\". Then, we established two pairs of error-induction models, F₁-F₂ (same-name drugs) and G₁-G₂ (similar-name drugs), to compare the differences between the two location display methods in the designated area.</p><p><strong>Results: </strong>Significant differences in gaze movements of pharmacists between the models F₁-F₂ were observed in Gaze 2, Passage, and Time (F₁ > F₂, P < 0.001, respectively), with similar results between models G₁-G₂ (G₁ > G₂, P < 0.001, respectively). Furthermore, the error rates in models F₁ and F₂ were 10.0% (11/110) and 6.4% (7/110), as well as 13.6% (15/110) and 5.5% (6/110) in models G₁ and G₂, respectively. A significant difference in error rates was observed between the models G₁-G₂ (G₁ > G₂, P = 0.020), but not between the models F₁-F₂ (P = 0.286).</p><p><strong>Conclusions: </strong>Incorporating visual information into prescription content not only performs a series of dispensing tasks more smoothly, but also reduces the error occurrences by pharmacists. In other words, leveraging right-brain utilization in dispensing processes has led to improvements in both efficiency and safety.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"37"},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of 5-hydroxytryptamine 3 receptor antagonists versus metoclopramide for preventing nausea and vomiting during azacitidine chemotherapy in patients with myelodysplastic syndromes or acute leukemia: a retrospective observational study.","authors":"Yoshinori Wakasugi, Yoshito Ikeda, Satoshi Noda, Makoto Murata, Shin-Ya Morita","doi":"10.1186/s40780-025-00444-3","DOIUrl":"https://doi.org/10.1186/s40780-025-00444-3","url":null,"abstract":"<p><strong>Background: </strong>5-Hydroxytryptamine 3 receptor antagonists (5-HT₃RAs) and dexamethasone are recommended to prevent azacitidine-induced nausea and vomiting. In clinical practice, 5-HT₃RAs or metoclopramide is often used without dexamethasone. In this study, we aimed to determine whether 5-HT₃RAs or metoclopramide is more effective for suppressing nausea and vomiting during azacitidine-based chemotherapy.</p><p><strong>Methods: </strong>This study was a single-center retrospective observational study. Patients with myeloid malignancies receiving azacitidine-based regimens were treated with a 5-HT₃RA (ramosetron or granisetron, n = 32) or metoclopramide (n = 18) for preventing nausea and vomiting. The occurrence of nausea and vomiting was assessed using total control (TC), complete control (CC), and complete response (CR) rates (chi-squared test), and the time to the first emetic episode or rescue medication (Cox proportional hazard regression analysis).</p><p><strong>Results: </strong>The 5-HT₃RA group had significantly higher rates of TC, CC, and CR than the metoclopramide group (84% vs. 22%, 91% vs. 33%, and 91% vs. 33%, respectively). The time until the first emetic episode or rescue medication was also significantly longer in the 5-HT₃RA group than in the metoclopramide group (p < 0.001).</p><p><strong>Conclusions: </strong>5-HT₃RAs may prevent azacitidine-induced nausea and vomiting more effectively than metoclopramide.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"36"},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic assistance provided by a pharmacist for the syndrome of inappropriate antidiuretic hormone secretion caused by carboplatin plus nab-paclitaxel chemotherapy in an elderly patient with lung cancer: a case report.","authors":"Hayahide Ooi, Yuki Asai, Yasumasa Sakakura, Masaaki Takahashi","doi":"10.1186/s40780-025-00441-6","DOIUrl":"https://doi.org/10.1186/s40780-025-00441-6","url":null,"abstract":"<p><strong>Background: </strong>Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia. Although SIADH induced by carboplatin (CBDCA) plus nab-paclitaxel (nab-PTX) has been reported, there is limited evidence for SIADH being suspected by pharmacists during chemotherapy in elderly patients and contributing to early intervention through diagnostic support for physicians.</p><p><strong>Case presentation: </strong>An 84-year-old man was diagnosed with stage 3A squamous cell carcinoma of the right lung. Genetic mutations and expression of programmed cell death protein ligand 1 were < 1%. The patient was started on CBDCA area under the curve of 5 mg/mL·min on day 1 plus nab-PTX 70 mg/m² on days 1, 8 and 15 once every 3 weeks. The serum sodium level immediately before the start of chemotherapy was 141 mmol/L. On day 8, it decreased to 119 mmol/L, and the physician started oral sodium chloride (3 g/day) administration. Because the pharmacist suspected that this hyponatremia may be due to chemotherapy-induced SIADH, the pharmacist suggested an examination of plasma and urine osmolality and urinary sodium levels to the physician. The serum creatinine level, plasma osmolality, urine osmolality, and urinary sodium level were 1.06 mg/dL, 253 mOsm/kg, 355 mOsm/kg, and 59 mEq/L, respectively; furthermore, the patient was not dehydrated. Based on the findings, a diagnosis of chemotherapy-induced SIADH was made. The physician and pharmacist conferred and decided to continue chemotherapy with frequent monitoring of serum sodium levels. Subsequently, the serum sodium level improved to 139 mmol/L on day 20 without additional treatment, and oral administration of sodium chloride was discontinued on day 22. The patient completed five cycles of chemotherapy. Computed tomography revealed a partial response throughout chemotherapy. Furthermore, sodium levels did not decrease again throughout chemotherapy. The Naranjo Adverse Drug Reaction Probability Scale score was 5 points, which is categorized as \"probable.\"</p><p><strong>Conclusions: </strong>We encountered a case in which the patient developed chemotherapy-induced SIADH but was able to continue chemotherapy because of early pharmacist intervention. In elderly patients without genetic mutations and few treatment options, even if they develop SIADH, chemotherapy should be continued with monitoring of serum sodium levels by physicians and pharmacists.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"35"},"PeriodicalIF":1.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative changes in clinical records after implementation of pharmacist-led antimicrobial stewardship program: a text mining analysis.","authors":"Keisuke Sawada, Shuji Kono, Ryo Inose, Yuichi Muraki","doi":"10.1186/s40780-025-00439-0","DOIUrl":"https://doi.org/10.1186/s40780-025-00439-0","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship programs (ASPs) are essential for optimizing antimicrobial use, but many medium-sized hospitals lack infectious disease (ID) specialists. Ward pharmacists can contribute to ASPs, but the qualitative changes in their practice patterns after ASP implementation remains unclear. We aimed to explore the potential of text mining as a novel methodology to evaluate changes in ward pharmacist antimicrobial management practices after ASP implementation in a medium-sized hospital without ID physicians.</p><p><strong>Methods: </strong>We conducted a retrospective observational analysis of data documented in clinical records by ward pharmacists in a 313-bed community hospital from April 2014 to March 2022. The ASP team conducted weekly reviews of targeted patients, provided feedback to physicians, and shared recommendations with ward pharmacists who then collaborated to optimize antimicrobial therapy. Using Python-based text mining with standardized technical terms and compound word extraction, we performed morphological analysis, co-occurrence network analysis, and hierarchical clustering to evaluate documentation patterns before and after ASP implementation in April 2018. Co-occurrence relationships were assessed using Dice coefficients (threshold, ≥ 0.3), and communities were detected using the Louvain algorithm. Changes in documentation patterns were compared using Fisher's exact test.</p><p><strong>Results: </strong>The analysis included 1,353 pre-ASP and 5,155 post-ASP clinical records containing antimicrobial-related terms, which increased from 3.12 to 7.81% of the total pharmacy records. New strong co-occurrence relationships emerged in the post-ASP period for several laboratory parameters (c-reactive protein, 0.646; estimated glomerular filtration rate, 0.594; and white blood cell count, 0.582). Network analysis revealed a shift from medication-focused communities (Medication Review, Prescription Verification, and Patient Education) to infection-focused communities (Infection Assessment, Microbiological Review, and Severe Infection Management). Although Antimicrobial Management was consistently used in both periods (odds ratio [OR]: 0.70, 95% confidence interval [CI]: 0.38-1.20), cross-tabulation analysis increased significantly in Laboratory Monitoring (OR: 1.58, 95% CI: 1.39-1.78) and Infection Assessment (OR: 2.09, 95% CI: 1.85-2.36).</p><p><strong>Conclusions: </strong>This pilot application of text mining demonstrated potential as a novel methodology for objectively evaluating qualitative changes in clinical practice patterns following ASP implementation, successfully identifying shifts in pharmacists' documentation focus and providing a foundation for future multi-center validation studies across diverse healthcare settings.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"34"},"PeriodicalIF":1.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription patterns of comedications associated with drug-drug interactions risk in HCV-infected patients undergoing direct-acting antiviral treatment: an analysis of an administrative claims database in Japan.","authors":"Daisuke Nakamoto, Yi Piao, Hajime Mizutani, Ryozo Wakabayashi, Satoshi Otokita, Alice Stead, Candido Hernandez, Masahisa Jinushi","doi":"10.1186/s40780-025-00442-5","DOIUrl":"https://doi.org/10.1186/s40780-025-00442-5","url":null,"abstract":"<p><strong>Introduction: </strong>While direct-acting antivirals (DAA) are effective treatment for hepatitis C virus (HCV) patients, concerns about drug-drug interactions (DDIs) remain a significant challenge. Although there are several studies investigating the risk of DDIs associated with DAA therapy, there is limited research evaluating DDIs of DAA therapy in real-world settings in Japan. We investigated prescription patterns of comedication associated with DDIs risk in HCV patients receiving DAA therapy using a large Japanese database.</p><p><strong>Methods: </strong>This was a descriptive epidemiological study, using the Japanese administrative claims database provided by DeSC Healthcare, Inc. Patients who initiated sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB) between April 2017 and August 2023 were identified from the data. The primary outcome was DDIs associated with comedications which were assessed based on both Japanese package inserts and the Liverpool HEP Drug Interaction Checker (Liverpool HEP checker).</p><p><strong>Results: </strong>Patients included in this study were 7,338, with 467 prescribed SOF/VEL and 6,871 prescribed GLE/PIB. The mean age of the patients was 69.9 years (SD = 13.1), with 50% being male. The median number of comedications was higher in the SOF/VEL group (14.0; IQR = 14.0) than in the GLE/PIB group (9.0; IQR = 12.0) and based on package insert and Liverpool HEP checker, the DDI risk was present in 59.3% (277) of the SOF/VEL group and 51.5% (3,542) of the GLE/PIB group. DDI risk involving two or more medications in combination with a DAA was 14.1% (66) in the SOF/VEL group and 24.0% (1,648) in the GLE/PIB group. In terms of DDI severity, in the SOF/VEL group there were no patients identified under the level \"Contraindication (Red)\" category, indicating medications that do not co-administered, in contrast with the 1.7% (115) in the GLE/PIB group who were identified as \"contraindication (red)\".</p><p><strong>Conclusion: </strong>A considerable proportion of patients were prescribed medications with DDI risk during DAA treatment. A small but notable proportion of patients were on \"Contraindication (Red)\" medications. Consideration of the potential DDI risks associated with comedications by healthcare professionals is advised, referring not only to package inserts but also tools such as Liverpool HEP checker to guide safe prescribing when initiating DAA therapy for HCV patients.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"33"},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary retrospective study of the safety of Vancomycin area under the curve in patients treated with concomitant use of Vancomycin and gentamicin.","authors":"Hirokazu Nakayama, Yoshitsugu Nakamura, Masayo Tanaka","doi":"10.1186/s40780-025-00438-1","DOIUrl":"https://doi.org/10.1186/s40780-025-00438-1","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous studies on safety, acute kidney injury (AKI) caused by vancomycin and/or gentamicin remains a persistent medical issue. However, it remains unclear whether vancomycin AUC below 600 mg·h/L in combination with gentamicin trough level at least below 2 µg/mL are reliable indices to reduce the risk of AKI in patients treated with concomitant vancomycin and gentamicin.</p><p><strong>Objective: </strong>The aim was to elucidate the pharmacokinetic factors associated with AKI development in patients receiving concomitant use of vancomycin and gentamicin in the setting of therapeutic drug monitoring (TDM).</p><p><strong>Methods: </strong>A retrospective study was conducted in 15 patients treated with concomitant vancomycin and gentamicin with TDM. The patients were classified into AKI group and no-AKI group. Vancomycin area under the curve (AUC), gentamicin trough levels, and duration of concomitant duration of vancomycin and gentamicin were investigated.</p><p><strong>Results: </strong>Six (40%) of 15 patients developed AKI during the study period. In AKI group (n = 6), vancomycin AUC was significant higher [median (range) 561 (543‒712) mg·h/L compared to no-AKI group (n = 9), 380 (185‒600) mg·h/L, p = 0.026)], although no significant differences in gentamicin trough level and duration of concomitant vancomycin and gentamicin treatment were found between the two groups. Receiver operating characteristic analysis showed that the best cut-off vancomycin AUC for predicting AKI was 523 mg·h/L, with AUC of 0.852, sensitivity of 1.000 and specificity of 0.778 (p = 0.025).</p><p><strong>Conclusions: </strong>In patients treated with concomitant vancomycin and gentamicin with trough level below 1-2 µg/mL, vancomycin AUC 530 - 600 mg·h/L is associated with AKI risk.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"32"},"PeriodicalIF":1.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal metabolic alkalosis and mild diuresis resulting from torasemide self-medication by the mother: a case report.","authors":"Yumi Kitahiro, Mari Hashimoto, Yukako Sonda, Miki Yagi, Kotaro Itohara, Takumi Kido, Kazumichi Fujioka, Hitomi Imafuku, Tomohiro Omura, Ikuko Yano","doi":"10.1186/s40780-025-00436-3","DOIUrl":"https://doi.org/10.1186/s40780-025-00436-3","url":null,"abstract":"<p><strong>Background: </strong>Torasemide, a loop diuretic, is rarely used for pregnant women because of the risk of reduced placental blood flow resulting from decreased circulating plasma volume. We experienced a case of a newborn with metabolic alkalosis and mild polyuria. The mother was suspected of self-medicating as we detected torasemide in the neonatal serum by LC-MS/MS method.</p><p><strong>Case presentation: </strong>A Japanese pregnant woman in her 20s with mental illness, symptoms of panic and eating disorders, and a history of overdosing on over-the-counter medications, was referred to our hospital for birth control. She presented with vomiting following bulimia nervosa and hypokalemia. Her baby was delivered vaginally at 36 weeks and 4 days of gestation. The baby's blood gas analysis on day 0 revealed metabolic alkalosis (pH > 7.42, HCO₃^- > 28 mmHg). Up to 16 h after birth, mild polyuria and a urine output of 3.3 mL/kg/h were observed without the administration of diuretics. We suspected diuretic intake by the mother before delivery, because she had a history of taking torasemide before being referred to the hospital. As expected, torasemide was detected in the baby's serum. The serum concentration on the first day after delivery (4.80 ng/mL) gradually decreased to 0.45 ng/mL on day 5, whereas torasemide was not detected in the maternal serum. Neonatal metabolic alkalosis improved by day 3 following birth.</p><p><strong>Conclusions: </strong>This case suggests close counseling and monitoring of pregnant women before childbirth regarding their past and present use of drugs, particularly in those with mental illness.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"31"},"PeriodicalIF":1.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}