Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"A systematic review of sodium-glucose cotransporter 2 inhibitors and renal profiles among Japanese patients with type 2 diabetes mellitus.","authors":"Junichi Mukai, Nakaba Okamura, Yuki Saito, Rie Kubota","doi":"10.1186/s40780-023-00305-x","DOIUrl":"10.1186/s40780-023-00305-x","url":null,"abstract":"<p><strong>Background: </strong>We conducted a systematic review and meta-analysis to summarize the available literature and comprehensively appraise the renal profiles of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in Japanese patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>The electronic databases MEDLINE, Ichushi-web, and ClinicalTrials.gov were searched for studies without language restrictions from their inception until 20 July 2023 and CENTRAL until 21 September 2021. Studies were included if they were double-masked randomized controlled trials (RCTs) (1) including Japanese patients with T2DM aged > 18 years who received SGLT2i or a placebo, (2) reporting at least one renal outcome of serum creatinine or the estimated glomerular filtration rate (eGFR), and (3) with a follow-up of > 12 weeks. Cross-over and open label trials were excluded. The risk of bias based on the Cochrane risk-of-bias tool for randomized trials (RoB 2) was appraised. We computed the weighed mean difference with 95%CI for each renal outcome and used a random-effects model (inverse variance method).</p><p><strong>Results: </strong>We ultimately retrieved 13 RCTs including 2687 individuals in our review. The durations of RCTs ranged between 12 and 104 weeks. Only one trial had a longer duration of more than one year. Ten out of 13 RCTs reported serum creatinine, while nine included eGFR. Serum creatinine and eGFR were slightly worse with SGLT2i than with a placebo [mean difference 0.01 (95%CI 0.00 to 0.02) mg/dL, p = 0.002, mean difference - 1.30 (95%CI -2.23 to -0.37) mL/min/1.73 m², p = 0.006, respectively]. Merged results revealed insignificant heterogeneity (I² < 30%).</p><p><strong>Conclusion: </strong>These results suggest that SGLT2i slightly worsens serum creatinine and eGFR in Japanese patients with T2DM. However, since the durations of most RCTs were short, the effects of eGFR in particular may be transient. Further evidence is needed from rigorous studies that focus on renal outcomes with a longer duration to confirm the present results.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10310482","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":"Significance of pharmacist intervention to oral antithrombotic therapy in the pharmaceutical outpatient clinic of cardiovascular internal medicine: a retrospective cohort study.","authors":"Tomoko Kurimura,&nbsp;Kazuhiro Yamamoto,&nbsp;Hidekazu Tanaka,&nbsp;Takayoshi Toba,&nbsp;Takeshi Kimura,&nbsp;Yasushi Habu,&nbsp;Kotaro Itohara,&nbsp;Yumi Kitahiro,&nbsp;Tomohiro Omura,&nbsp;Ikuko Yano","doi":"10.1186/s40780-023-00296-9","DOIUrl":"https://doi.org/10.1186/s40780-023-00296-9","url":null,"abstract":"<p><strong>Background: </strong>Optimised antithrombotic therapy requires clinical experience and an understanding of the current guidelines. This retrospective study aimed to evaluate whether pharmacist interviews and interventions with patients taking oral antithrombotic drugs in the pharmaceutical outpatient cardiology clinic had favourable clinical outcomes including decreased bleeding.</p><p><strong>Methods: </strong>The participants included patients visiting the outpatient clinic of cardiovascular internal medicine at the Kobe University Hospital from January-December 2017, and were taking oral antithrombotic medication. The observation period was from the first visit to the outpatient clinic to October 2021 or death. Patients who received pharmacist intervention more than twice were defined as the pharmacist intervention group. Two control patients per one pharmacist intervention group individual were selected from the non-intervention pool matched for age, gender and antithrombotic medication type.</p><p><strong>Results: </strong>Of the 895 eligible patients, 132 were in the pharmacist intervention group and 264 were selected for the matched non-intervention group. Bleeding events according to the Bleeding Academic Research Consortium criteria over type 2 were significantly lower in the pharmacist intervention group compared with the non-intervention group (17.4% versus 28.4%, P = 0.019). There were no significant differences in mortality and heart failure hospitalisation frequency, stroke, or cardiovascular events between the groups. Multivariate analysis identified age (≥ 65 years) and pharmacist intervention as factors associated with bleeding (odds ratio = 2.29 and 0.51, respectively).</p><p><strong>Conclusion: </strong>Pharmacist intervention in the outpatient clinic of cardiovascular internal medicine was effective in reducing the risk of bleeding in patients undergoing antithrombotic therapy.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166428","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":"Differences in the growth of microorganisms depends on the type of semi-solid enteral nutritional supplements.","authors":"Sachiko Omotani,&nbsp;Kanaha Murakami,&nbsp;Arisa Naka,&nbsp;Yasutoshi Hatsuda,&nbsp;Michiaki Myotoku","doi":"10.1186/s40780-023-00297-8","DOIUrl":"https://doi.org/10.1186/s40780-023-00297-8","url":null,"abstract":"<p><strong>Background: </strong>Enteral nutritional supplements are used in many medical facilities and home care, but require appropriate management because they are nutrient-rich products. Recently, infection control methods for Ready To Hang (RTH) preparations, which are widely used and are expected to reduce the risk of infection, have not been established in Japan and are dependent on caregivers. Therefore, we evaluated the difference in the growth of microorganisms depending on the type of enteral nutrients following contamination with microorganisms.</p><p><strong>Methods: </strong>Nine types of enteral nutrition were used. Escherichia coli (E. coli) W3110, Serratia marcescens (S. marcescens) NBRC3046, and Candida albicans (C. albicans) IFM61197 were used as test bacteria. The bacterial solution was added to the enteral nutritional supplement, adjusted, and the number of bacteria was measured at 0, 4, 8, and 24 h after the addition of the bacterial solution at 25 °C and in the dark.</p><p><strong>Results: </strong>E. coli and S. marcescens grew in RACOL^®-NF SemiSolid for Enteral Use, Hine_® Jerry AQUA, and Mermed Plus_® over a 24-h period; however, a decrease was observed for other enteral nutrition products. In contrast, C. albicans grew in all enteral nutrition products.</p><p><strong>Conclusion: </strong>Because the viscosity and calorie content vary among enteral nutrition preparations in which growth was observed, we found that pH had the greatest effect on the differences in bacterial growth. Nonetheless, C. albicans growth occurred in all nine types of enteral nutrients, indicating that unlike bacteria, its growth was independent of pH. If semi-solid enteral nutrients are contaminated with microorganisms for any reason, microorganisms will grow, so appropriate infection control is necessary to prevent infection.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10145761","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":"Simple and validated method to quantify lacosamide in human breast milk and plasma using UPLC/MS/MS and its application to estimate drug transfer into breast milk.","authors":"Ayako Furugen,&nbsp;Ayako Nishimura,&nbsp;Takeshi Umazume,&nbsp;Hina Ishikawa,&nbsp;Katsuya Narumi,&nbsp;Masaki Kobayashi","doi":"10.1186/s40780-023-00295-w","DOIUrl":"https://doi.org/10.1186/s40780-023-00295-w","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a common neurological disorder. Lacosamide is a third-generation antiepileptic drug used to treat partial-onset seizures. Limited information is currently available on the transfer of lacosamide to breast milk. To facilitate studies on the safety of lacosamide use during breastfeeding, we aimed to develop a method to quantify lacosamide in human breast milk and plasma using ultra-performance liquid chromatography/tandem mass spectrometry.</p><p><strong>Methods: </strong>Fifty microliters of breast milk or plasma was used, and samples were prepared by protein precipitation using methanol containing lacosamide-d₃ as an internal standard (IS). Chromatography was performed using an ACQUITY HSS T3 column with an isocratic flow of 10 mM ammonium acetate solution/methanol (70:30, v/v). Lacosamide and IS were detected by multiple reaction monitoring in positive ion electrospray mode. The run time was 3.5 min.</p><p><strong>Results: </strong>Calibration curves were linear and in the range of 0.5 to 100 ng/mL both in breast milk and plasma. The validation assessment indicated that precision, accuracy, matrix effects, selectivity, dilution integrity, and stability were acceptable. The developed method was successfully applied to quantify lacosamide in breast milk and plasma obtained from a volunteer who had been orally administered lacosamide twice a day (100 mg × 2). Relative infant dose of lacosamide was estimated to be 14.6% in breast milk at five time points.</p><p><strong>Conclusions: </strong>We developed a simple and robust method to quantify of lacosamide in human breast milk and plasma. This method could be useful for in future studies investigating the safety of lacosamide use during breastfeeding.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10201018","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 study on the chemical stability of cholesterol-lowering drugs in concomitant simple suspensions with magnesium oxide.","authors":"Ginjiro Kato, Hidemichi Mitome, Yusura Miyauchi, Syu Takeda, Yoshito Toyota, Noriaki Hidaka, Mamoru Tanaka, Kazuki Akira","doi":"10.1186/s40780-023-00301-1","DOIUrl":"10.1186/s40780-023-00301-1","url":null,"abstract":"<p><strong>Background: </strong>Difficulty in taking solid medicines is a common issue particularly for the elderly because of a decline in swallowing function, also known as dysphagia. For patients with such a dysfunction, a simple suspension method, in which solid medicines are disintegrated and suspended using warm water, has been developed and widely used in Japanese clinical settings. However, there is little information on drug stability in the simple co-suspension of multiple formulations especially including acidic or alkaline ones. In this study, the chemical stability of typical cholesterol-lowering drugs was investigated in a simple co-suspension with alkaline magnesium oxide (MgO) which is frequently used as a laxative or antacid in Japan.</p><p><strong>Methods: </strong>A cholesterol-lowering drug (one tablet) was soaked with or without MgO in warm water (55°C), and the vessel was left at room temperature for 10 min or 5 h. The suspensions prepared were then analyzed by high-performance liquid chromatography. Degradation products were analyzed by nuclear magnetic resonance spectroscopy and mass spectrometry for the structural elucidation.</p><p><strong>Results: </strong>In the simple co-suspension with MgO, no significant degradation was observed for atorvastatin or pravastatin, while a significant decrease of the recovery from the co-suspension was observed for rosuvastatin after 5 h. On the other hand, simvastatin and ezetimibe co-suspended with MgO were partially degraded to simvastatin acid and a pyran compound, respectively.</p><p><strong>Conclusions: </strong>A simple co-suspension with MgO is feasible for atorvastatin, pravastatin, and rosuvastatin, although the rosuvastatin tablet should not be left soaking for a long time. Further it is inadvisable to suspend simvastatin or ezetimibe together with MgO because of their partial degradation.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10120530","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":"Knowledge about stem cell sources and obstacles in donation of bone marrow and peripheral blood stem cells: a cross-sectional survey from Ha'il city to track the prospects of regenerative medicine in Saudi Arabia.","authors":"Asma Ayyed Al-Shammary, Sehar Un-Nisa Hassan","doi":"10.1186/s40780-023-00299-6","DOIUrl":"10.1186/s40780-023-00299-6","url":null,"abstract":"<p><strong>Background: </strong>Promoting stem cell donation behaviors could be crucial in advancing stem cell-based treatment, research and improving public health in Saudi Arabia. Donation of stem cells can be considered an act of social welfare just like blood donation because stem-cell-based therapies are emerging as a hope for those suffering from chronic health conditions and/or terminal illnesses.</p><p><strong>Aim: </strong>This study aims at assessing levels of awareness about sources of stem-cells, donor organizations and predictors of stem cell donation behavior in target population.</p><p><strong>Methods: </strong>The study employed a cross-sectional online survey method. The study sample comprises 1325 educated Saudi people living in Ha'il city. The survey questionnaire collected data about respondents' demographic background, awareness about various sources of stem cells and stem-cell donor registries, willingness to donate stem cells, registration status and obstacles in stem cell donation registration. Percentages, Chi-square analysis and Odd Ratios were computed to analyze the data.</p><p><strong>Results: </strong>In this sample, (n = 696; 52%) were males and (n = 629; 48%) were females. Although (n = 1308; 98%) percent of respondents reported willingness to donate stem cell, less than one percent (n = 6; 0.5) were registered with Saudi Stem Cell Registry. Over 50% of respondents hold inaccurate perceptions about sources of stem cell. Odd Ratio (OR) values from binary logistic regression model identified four factors as significant predictors of non-registration status. These included (i) unaware about donor agencies and procedures (OR = 10.07; p < 0.05), (ii) unaware about possibility to donate stem cells (OR = 8.08; p < 0.05) (iii) concerns about impact on health (OR = 10.01; p < 0.05) and (iv) have health issues that does not permit donation (OR = 10.50; p < 0.05).</p><p><strong>Conclusion: </strong>Stem cell registrations can be enhanced through appropriate health education programs that focus on increasing awareness about donation procedures, trustworthy donor organizations and reducing people apprehensions related to donation.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10006221","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":"Tazobactam/ceftolozane and tobramycin combination therapy in extensively drug-resistant Pseudomonas aeruginosa infections in severe burn injury: a case report.","authors":"Yuta Ibe,&nbsp;Ryuichiro Kakizaki,&nbsp;Hirotoshi Inamura,&nbsp;Tomoyuki Ishigo,&nbsp;Yoshihiro Fujiya,&nbsp;Hiroyuki Inoue,&nbsp;Shuji Uemura,&nbsp;Satoshi Fujii,&nbsp;Satoshi Takahashi,&nbsp;Eichi Narimatsu,&nbsp;Masahide Fukudo","doi":"10.1186/s40780-023-00294-x","DOIUrl":"https://doi.org/10.1186/s40780-023-00294-x","url":null,"abstract":"<p><strong>Background: </strong>Combination therapy with tazobactam/ceftolozane (TAZ/CTLZ) and high-dose aminoglycosides has been reported to be efficacious in extensively drug-resistant (XDR)-Pseudomonas aeruginosa infection. However, there are no reports of efficacy in XDR-P. aeruginosa infection for combination therapy with low-dose aminoglycosides and TAZ/CTLZ. Herein, we describe a rare case of severe burn injury patients with persistent bacteremia due to XDR-P. aeruginosa, which was successfully treated with TAZ/CTLZ and low-dose tobramycin (TOB).</p><p><strong>Case presentation: </strong>A 31-year-old man was admitted to the intensive care unit with severe burn injury involving 52% of the total body surface area and a prognostic burn index of 79.5. The patient had recurrent bacterial infections since admission, and blood cultures collected on the 37th day of admission revealed the presence of P. aeruginosa strains that were resistant to all β-lactams and amikacin (AMK). The results of the antimicrobial synergistic study showed no synergistic effect of low-dose meropenem (MEPM) and AMK combination therapy. The patient had acute renal failure, and it was difficult to increase the dose of MEPM and AMK, respectively. Thus, we initiated TAZ/CTLZ 1.5 g/8 h instead of the AMK and MEPM combination therapy on the 43rd day of hospitalization. Low-dose TAZ/CTLZ was continued because of prolonged renal dysfunction and resulted in a transient clinical improvement. However, the dosage of TAZ/CTLZ could be increased as the renal function improved, but despite an increased TAZ/CTLZ dose, bacteremia persisted, and the blood cultures remained positive. Thus, TOB was added to TAZ/CTLZ at low doses for synergistic effect against Gram-negative bacteria. Blood cultures collected after initiation of combination therapy with TAZ/CTLZ and low-dose TOB were negative on two consecutive follow-up evaluations. Thereafter, although the patient had several episodes of fever and increased inflammatory response, blood cultures consistently tested negative, and all of the wounds healed. On the 93rd day, due to the good healing progress, the patient was transferred to another hospital.</p><p><strong>Conclusions: </strong>TAZ/CTLZ and low-dose TOB combination therapy showed the potential for synergistic effects. Our present report suggests a novel synergistic treatment strategy for rare cases that are refractory to the treatment of infections, such as XDR-P. aeruginosa infection.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965442","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":"Olanzapine treatment effectively relieves breakthrough chemotherapy-induced nausea and vomiting: a real-world experience.","authors":"Akihiro Uchiike,&nbsp;Haruka Kono,&nbsp;Katsuhiro Miura,&nbsp;Tatsuya Hayama,&nbsp;Daisuke Tsutsumi,&nbsp;Shinya Tsuboi,&nbsp;Susumu Ohtsuka,&nbsp;Shinji Hidaka","doi":"10.1186/s40780-023-00293-y","DOIUrl":"https://doi.org/10.1186/s40780-023-00293-y","url":null,"abstract":"<p><strong>Background: </strong>Olanzapine treatment prevents chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC). However, its role in the secondary prevention of breakthrough CINV in real-world cancer care should be further evaluated.</p><p><strong>Method: </strong>We conducted a retrospective study on patients receiving olanzapine to prevent breakthrough CINV refractory to standard antiemetic therapy. The major outcome was improvement in CINV, defined as any downgrade in CINV symptoms, according to the Common Terminology Criteria for Adverse Events. Comprete response was defined as no symptoms in CINV, i.e., Grade 0. These outcomes were compared in the HEC versus non-HEC groups and the standard- (5 or 10 mg/day) versus low- (2.5 mg/day) dose groups. The other outcome measurement was adverse events (AEs).</p><p><strong>Results: </strong>We analyzed 127 patients, including 92 women, with a median age of 50 years (range: 19-89 years). Baseline CINV severity was grade 1, 2, and 3 in 18%, 69%, and 13% of the patients, respectively. After prophylaxis with olanzapine at doses of 2.5, 5, or 10 mg/day, improvement was observed in 105 (83%) patients, with a complete response in 42 patients (33%). The improvement and complete remission rates for the HEC (n = 96) and non-HEC (n = 31) groups were 86% and 71% (p = 0.048) versus 38% and 19% (p = 0.062), respectively. The rates for the standard- (n = 98) and low- (n = 29) dose groups were 86% and 82% (p = 0.568) versus 28% and 52% (p = 0.015), respectively. Thirty-four patients (27%) experienced olanzapine-related AEs, mainly somnolence (n = 28). Grade 3 or higher AEs were not observed.</p><p><strong>Conclusion: </strong>Our study results support the clinical application of olanzapine for the secondary prevention of breakthrough CINV.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925708","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":"Adrenaline-resistant anaphylactic shock caused by contrast medium in a patient after risperidone overdose: a case report.","authors":"Takafumi Nakano,&nbsp;Yoshihiko Nakamura,&nbsp;Keisuke Sato,&nbsp;Yoshito Izutani,&nbsp;Hiroto Iyota,&nbsp;Misaki Aoyagi,&nbsp;Taisuke Kitamura,&nbsp;Toshinobu Hayashi,&nbsp;Koichi Matsuo,&nbsp;Kenichi Mishima,&nbsp;Hidetoshi Kamimura,&nbsp;Hiroyasu Ishikura,&nbsp;Takashi Egawa","doi":"10.1186/s40780-023-00292-z","DOIUrl":"https://doi.org/10.1186/s40780-023-00292-z","url":null,"abstract":"<p><strong>Background: </strong>In Japan, the use of risperidone in combination with adrenaline is contraindicated, except in cases of anaphylaxis. Therefore, there is limited clinical evidence regarding the interaction of these two drugs. Here, we report the clinical course of a case of adrenaline-resistant anaphylactic shock induced by a contrast medium injection after a risperidone overdose.</p><p><strong>Case presentation: </strong>A man in his 30s was transported to our hospital after attempting suicide by taking 10 mg of risperidone and jumping from a height of 10 m. To determine the location and severity of his injuries, he was injected with an iodinated contrast medium, after which he developed generalized erythema and hypotension and was diagnosed with anaphylactic shock. A 0.5 mg dose of adrenaline was administered with no improvement, followed by another 0.5 mg dose that did not change his blood pressure. After infusion of a sodium bicarbonate solution (8.4%), administration of fresh frozen plasma, and additional administration of adrenaline (0.6-1.2 µg/min), his blood pressure improved, and he recovered from the anaphylactic shock.</p><p><strong>Conclusions: </strong>This was a rare case of a risperidone overdose followed by adrenaline-resistant anaphylactic shock. The resistance is likely associated with the high blood concentration of risperidone. Our findings indicate that the potential for decreased adrenergic responsiveness should be considered in patients undergoing risperidone treatment in the event of anaphylactic shock.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190718","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":"Risk factors for thromboembolism during first-line treatment of patients with unresectable advanced or recurrent colorectal cancer: a retrospective short study.","authors":"Ryo Takada,&nbsp;Miki Fujiwara,&nbsp;Masatoshi Maki,&nbsp;Yoko Takahashi,&nbsp;Koji Tamura","doi":"10.1186/s40780-023-00291-0","DOIUrl":"https://doi.org/10.1186/s40780-023-00291-0","url":null,"abstract":"<p><strong>Background: </strong>While cancer is a risk factor for developing thromboembolism, so is the use of molecularly targeted therapies. This study aimed to determine whether thromboembolism incidence differed between vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibitor use in patients with unresectable advanced or recurrent colorectal cancer, and to compare the risk of thromboembolism caused by cancer and the use of molecular targeted therapy drugs.</p><p><strong>Main body: </strong>We retrospectively evaluated patients with unresectable advanced or recurrent colorectal cancer who were treated with a cytotoxic anticancer drug and a VEGF or EGFR inhibitor combination between April 2016 and October 2021. Patients were compared in terms of the regimen administered, thromboembolism occurrence during the first-line treatment period, patient background, and clinical laboratory values. Of the 179 included patients, 12 of 134 (8.9%) in the VEGF-inhibitor group and 8 of 45 (17.8%) in the EGFR-inhibitor group developed thromboembolism, with no significant difference between the groups (P = 0.11). There was no significant difference in time to thromboembolism between patients in the VEGF- inhibitor group and patients in the EGFR-inhibitor group (P = 0.206). The cutoff value determined by a receiver operating characteristic analysis for the occurrence of thromboembolism was one point. Multivariate analysis using the occurrence of thromboembolism as the response variable identified at least one risk factor for thromboembolism (odds ratio = 4.17, P = 0.006, 95% confidence interval = 1.51-11.50). Molecular targeted therapies were not identified as a risk factor.</p><p><strong>Conclusions: </strong>Although the small sample size, there was no difference in the incidence of thromboembolism between the two molecular-targeted therapies in first-line treatment of patients with unresectable advanced or recurrent colorectal cancer. Our results suggest that risk factors for thromboembolism may be more strongly influenced by cancer itself than by the use of molecularly targeted therapies.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127423","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}