Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Characteristics of CYP3A4-related potential drug-drug interactions in outpatients receiving prescriptions from multiple clinical departments.","authors":"Rina Matsuoka, Shinsuke Akagi, Tomohiro Konishi, Masashi Kondo, Hideki Matsubara, Shohei Yamamoto, Keiji Izushi, Yuichi Tasaka","doi":"10.1186/s40780-024-00368-4","DOIUrl":"10.1186/s40780-024-00368-4","url":null,"abstract":"<p><strong>Background: </strong>Drug-drug interactions (DDIs) increase the incidence of adverse drug reactions (ADRs). In a previous report, we revealed that the incidence of potential DDIs due to the same CYP molecular species in one prescription exceeds 90% among patients taking six or more drugs and that CYP3A4 markedly influences the increase in the number of potential DDIs in clinical practice. However, the factors contributing to an increased number of potential DDIs in prescriptions from multiple clinical departments remain poorly clarified.</p><p><strong>Methods: </strong>This observational study was performed at five pharmacies in Okayama Prefecture, Japan. Patients who visited these pharmacies from 11 April 2022 to 24 April 2022 were included, except those who had prescriptions only from a single clinical department. A stratified analysis was performed to determine the incidence of CYP3A4-related potential DDIs according to the number of drugs taken. Additionally, factors associated with an increase in the number of drugs involved in CYP3A4-related potential DDIs were identified using multiple linear regression analysis. In this study, potential DDIs for the prescription data subdivided by clinical department, containing two or more drugs, were used as control data.</p><p><strong>Results: </strong>Overall, 372 outpatients who received prescriptions from multiple clinical departments were included in the current study. The number of drugs contributing to CYP3A4-related potential DDIs increased with an increase in the number of clinical departments. Notably, in cases taking fewer than six drugs, prescriptions from multiple clinical departments had a higher frequency of CYP3A4-related potential DDIs than those in prescriptions subdivided by clinical department. Multiple regression analysis identified \"Cardiovascular agents\", \"Agents affecting central nervous system\", and \"Urogenital and anal organ agents\" as the top three drug classes that increase CYP3A4-related potential DDIs.</p><p><strong>Conclusion: </strong>Collectively, these results highlight the importance of a unified management strategy for prescribed drugs and continuous monitoring of ADRs in outpatients receiving prescriptions from multiple clinical departments even if the number of drugs taken is less than six.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893635","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":"Hyperkalemic effect of drug-drug interaction between esaxerenone and trimethoprim in patients with hypertension: a pilot study.","authors":"Toshinori Hirai, Shun Ueda, Toru Ogura, Kan Katayama, Kaoru Dohi, Yuki Kondo, Yuka Sakazaki, Yoichi Ishitsuka, Takuya Iwamoto","doi":"10.1186/s40780-024-00366-6","DOIUrl":"10.1186/s40780-024-00366-6","url":null,"abstract":"<p><strong>Background: </strong>We examined whether the pharmacodynamic drug-drug interaction between esaxerenone and trimethoprim enhances the hyperkalemic effect.</p><p><strong>Methods: </strong>A retrospective observational study was conducted to identify patients >18 years undertaking esaxerenone alone or esaxerenone plus trimethoprim at Mie University Hospital from May 2019 to December 2022. We performed propensity score-matching (1:1) to compare between-group differences in the maximum change in serum potassium levels (ΔK) using the Mann-Whitney U test. For esaxerenone plus trimethoprim, Spearman's correlation coefficients were used to examine correlations between ΔK and variables, including changes in blood urea nitrogen (ΔBUN), serum creatinine levels (ΔCr), and weekly trimethoprim cumulative dose.</p><p><strong>Results: </strong>Out of propensity score-matched groups (n=8 each), serum potassium levels significantly increased after administration of esaxerenone alone (4.4 [4.2 to 4.7] meq/L to 5.2 [4.7 to 5.4] meq/L, p=0.008) and esaxerenone plus trimethoprim (4.2 [4.0 to 5.1] meq/L to 5.4 [4.7 to 5.5] meq/L, p=0.023). ΔK did not significantly differ between the groups (esaxerenone alone; 0.6 [0.3 to 0.9] meq/L vs. esaxerenone plus trimethoprim; 1.0 [0.4 to 1.3] meq/L, p=0.342). ΔK positively correlated with ΔBUN (r=0.988, p<0.001) or ΔCr (r=0.800, p=0.017). There was a trend of correlation of ΔK with a weekly cumulative trimethoprim dose (r=0.607, p=0.110).</p><p><strong>Conclusions: </strong>The hyperkalemic effect of the drug-drug interaction between esaxerenone and trimethoprim is not notable and related to renal function and trimethoprim dosage.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875067","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 retrospective study examining the association between polypharmacy and complications after laparoscopic surgery for colorectal cancer.","authors":"Takashi Watanabe, Shota Kashiwagura, Ryusuke Ouchi, Kensuke Usui, Chikashi Shibata, Kouji Okada","doi":"10.1186/s40780-024-00369-3","DOIUrl":"10.1186/s40780-024-00369-3","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy is an escalating public health concern across various healthcare settings worldwide. We aimed to comprehensively investigate postoperative complications after laparoscopic surgery for colorectal cancer and explore their association with polypharmacy. As laparoscopic surgery is widespread, clarifying the association between polypharmacy and postoperative complications is clinically important.</p><p><strong>Methods: </strong>We retrospectively surveyed the medical charts of adult inpatients who underwent laparoscopic surgery for colorectal cancer at Tohoku Medical and Pharmaceutical University Hospital between April 2019 and March 2023. Postoperative complications were determined using the Clavien-Dindo classification. We explored the factors related to postoperative complications and calculated the cut-off values for the number of medication ingredients.</p><p><strong>Results: </strong>Among the 236 patients, 32 (13.6%) developed postoperative complications. On multivariable logistic regression analysis, the number of regularly used medication ingredients (odds ratio = 1.160, 95% confidence interval 1.050-1.270, p = 0.002) was identified as a factor related to postoperative complications. The identified cut-off value for complications was 10 ingredients. Patients using 10 or more ingredients had approximately 3.5 times higher occurrence of postoperative complications than those using fewer than 10 ingredients (33.3% vs. 9.3%, p < 0.001, Fisher's exact test).</p><p><strong>Conclusions: </strong>Our study comprehensively investigated postoperative complications and examined their association with polypharmacy. We found that the number of regularly used medication ingredients may be linked to complications following laparoscopic surgery for colorectal cancer. These findings have important implications for perioperative management and patient care, providing valuable insights that may influence clinical practices and enhance patient outcomes.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878925","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":"Antibiotic therapy for bacterial pneumonia.","authors":"Hideo Kato","doi":"10.1186/s40780-024-00367-5","DOIUrl":"10.1186/s40780-024-00367-5","url":null,"abstract":"<p><p>Pneumonia is a common infection in patients of all ages. Determining its etiology and selecting antibiotic therapy are challenging for physicians in both private practice and hospitals. Moreover, the coronavirus disease pandemic revealed the importance of prevention and treatment of secondary bacterial pneumonia in patients hospitalized with viral respiratory infections. This review focuses on the types of bacteria that cause pneumonia and provides new insights into antibiotic therapy for bacterial pneumonia. Moreover, it also reviews the current state of knowledge regarding secondary bacterial pneumonia.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855824","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":"Chemiluminescence method for evaluating photooxidative degradation of dispensed drugs: a potential new drug information tool.","authors":"Yuriko Murai, Kasumi Kudo, Hiroyuki Suzuki, Taisuke Konno, Yasuyuki Agatsuma, Hitoshi Nakamura","doi":"10.1186/s40780-024-00365-7","DOIUrl":"10.1186/s40780-024-00365-7","url":null,"abstract":"<p><strong>Background: </strong>Dispensed drugs stored by patients are often in single-dose packages (SDPs) or are crushed and mixed after being removed from a press-through package (PTP) sheet. Information on their stability is extremely limited. To address this, we explored using chemiluminescence (CL) measurements to detect oxidative degradation.</p><p><strong>Methods: </strong>Eight amlodipine, 14 telmisartan, and two warfarin preparations were used as specimens. These preparations were stored at room temperature under various conditions, after which CL was measured. Cellopoly packaging paper was used for SDP. Three light conditions were used (Condition A: darkness, Condition B: indoor diffused light (approximately 400 lx), and Condition C: exposure to 4,000 lx). CL cumulative light output was measured every minute under nitrogen gas conduction and with a sample chamber temperature of 150 °C, for a maximum of 10 min. Luminescence images were obtained simultaneously with the CL measurements.</p><p><strong>Results: </strong>CL was observed on light-exposed tablet surfaces. For each preparation, an increase in the CL value was observed with the duration of light exposure. In the same preparation with the same exposure time, CL tended to be higher in the order of Condition A < B < C. Moreover, CL increased even when no changes in color were observed by the naked eye. A comparison between preparations with the same main ingredients showed differences in the rate of increase in CL with exposure, and each was found to show a different reactivity to light.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to visually capture the surface oxidation of tablets exposed to light using the CL method. The CL values, thought to be derived from photooxidation, increased with exposure of tablets and powders to light after SDP. This method can sensitively assess drug degradation due to photooxidation. Further research is needed to establish a CL method for assessing the stability of preparations in clinical settings.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11267834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759343","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":"Eggshell membrane and green seaweed (Ulva lactuca) micronized powders for in vivo diabetic wound healing in albino rats: a comparative study.","authors":"Moustafa H Moustafa, Mohamed S Turkey, Noha S Mohamedin, Amira A Darwish, Amira A M Elshal, Mona A H Yehia, Mohamed M El Safwany, Ehab I Mohamed","doi":"10.1186/s40780-024-00345-x","DOIUrl":"10.1186/s40780-024-00345-x","url":null,"abstract":"<p><strong>Background: </strong>Nonhealing diabetic wounds are a serious complication associated with extremely lethargic wound closure and a high risk of infection, leading to amputation or limb loss, as well as substantial health care costs and a poor quality of life for the patient. The effects of either eggshell membrane (ESM) and green seaweed (Ulva lactuca) extracts alone or in combination were evaluated for in vivo skin wound healing in a rat model of induced diabetes.</p><p><strong>Methods: </strong>Micronized powders of waste hen ESM, Ulva lactuca, and their 1:1 mixture were prepared using regular procedures. The mechanical, electrical, and surface morphology characteristics of powders were examined using direct compression, LCR-impedancemetry, and scanning electron microscopy. The effect of ESM, Ulva lactuca, and their mixture as compared to standard Dermazin treatments were evaluated on wounds inflicted on male Wistar Albino rats with induced diabetes. Quantitative wound healing rates at baseline and at 3, 7, 14, and 21 days of treatments among all rat groups were conducted using ANOVA. Qualitative histological analysis of epidermal re-epithelization, keratinocytes, basement membrane, infiltrating lymphocytes, collagen fibrines, and blood vessels at day 21 were performed using Image J processing program.</p><p><strong>Results: </strong>Compressive strength measurements of tablets showed a Young's modulus of 44.14 and 27.17 MPa for the ESM and ESM + Ulva lactuca mixture, respectively. Moreover, both samples exhibited relatively low relative permittivity values of 6.62 and 6.95 at 1 MHz, respectively, due to the porous surface morphology of ESM shown by scanning electron microscopy. On day 21, rats treated with ESM had a complete diabetic wound closure, hair regrowth, and a healing rate of 99.49%, compared to 96.79% for Dermazin, 87.05% for Ulva lactuca, 90.23% for the mixture, and only 36.44% for the negative controls. A well-formed basement membrane, well-differentiated epithelial cells, and regular thick keratinocytes lining the surface of the epidermal cells accompanied wound healing in rats treated with ESM, which was significantly better than in control rats.</p><p><strong>Conclusion: </strong>Ground hen ESM powder, a low-cost effective biomaterial, is better than Ulva lactuca or their mixture for preventing tissue damage and promoting diabetic wound healing, in addition to various biomedical applications.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752027","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":"Publisher Correction: Comparison of anticoagulation control and outcomes between usual medical care and pharmacist-led anticoagulation service in ambulatory patients taking warfarin at tertiary hospital in Ethiopia: a quasi-experimental study.","authors":"Tamrat Assefa Tadesse, Amha Gebremedhin, Dejuma Yadeta, Legese Chelkeba, Teferi Gedif Fenta","doi":"10.1186/s40780-024-00364-8","DOIUrl":"10.1186/s40780-024-00364-8","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727355","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":"Case report of pharmacokinetic analysis of continuous intravenous infusion of fentanyl in a patient with severe burn: burn shock stage complicates pain management.","authors":"Takafumi Nakano, Yasuhisa Oida, Shinichi Morimoto, Kentaro Muranishi, Soichiro Ushio, Takuya Yamashina, Masanobu Uchiyama, Kenichi Mishima, Kiyoyuki Kitaichi, Yoshihiko Nakamura, Koichi Matsuo","doi":"10.1186/s40780-024-00363-9","DOIUrl":"10.1186/s40780-024-00363-9","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl is widely used as an analgesic and sedative for patients with severe burn injuries in intensive care units. However, pharmacokinetic (PK) data for fentanyl, particularly for continuous intravenous infusion during the acute phase of burn injuries, are limited. Here, we report the clinical course and changes in blood fentanyl concentrations during the acute phase in a patient with severe burns treated with continuous intravenous infusion of fentanyl.</p><p><strong>Case presentation: </strong>A woman in her 40s, with burns caused by a gas cylinder explosion, was transported to our hospital. The patient had burn wounds on face, neck, shoulders, and all four extremities, with a total burn area of 39.0%. For pain relief, the patient received a continuous infusion of 0.01 mg/mL fentanyl (20-30 µg/h) with a target blood concentration of 1.0-1.5 ng/mL, but continued to suffer from pain due to burning during the acute phase. We measured the blood fentanyl concentrations and found that all concentrations obtained during the acute phase were subtherapeutic. Notably, during the burn shock stage, blood concentrations of fentanyl were 0.50 ng/mL on day 1 and 0.66 ng/mL on day 2, indicating that the blood concentration did not rise sufficiently for the dosage. From days 0 to 2, the patient was administered a massive fluid load for burn shock. After the burn shock stage resolved, fentanyl concentrations gradually approached the target range, and the pain rating scale improved, even though the fentanyl administration rate remained unchanged (30 µg/h).</p><p><strong>Conclusions: </strong>Major changes in the fluid volumes of body compartments that occur with large burns might increase the volume of fentanyl distribution, thereby lowering its concentration when a standard dose is administered. Our findings indicate that the PK of fentanyl in patients with severe burns can be substantially affected, especially during the shock phase, implying the importance of titrating analgesics for clinical efficacy in the acute phase.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626980","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":"Impact of once-daily versus multiple-daily dosing of gentamicin on the incidence of acute kidney injury in patients treated with synergistic combinations of antibiotics.","authors":"Kyohei Sugiyama, Keita Hirai, Yukako Suyama, Masato Tsutsumi","doi":"10.1186/s40780-024-00360-y","DOIUrl":"10.1186/s40780-024-00360-y","url":null,"abstract":"<p><strong>Background: </strong>Gentamicin is a commonly used antibiotic with synergistic effects that is administered once or multiple times daily. However, the influence of the daily administration frequency on renal function has not yet been identified. This study aimed to investigate the effect of the daily dosing frequency on worsening renal function in patients receiving gentamicin.</p><p><strong>Methods: </strong>This study included 35 patients undergoing gentamicin treatment who had at least one serum trough level measured and underwent therapeutic drug monitoring (TDM). We evaluated the influence of daily dosing frequency on gentamicin trough concentration and the risk of acute kidney injury (AKI).</p><p><strong>Results: </strong>Compared to patients who received gentamicin once-daily dosing (n = 22), patients who received multiple-daily dosing (n = 13) had significantly higher initial and minimum trough concentrations after TDM. The proportion of patients with trough concentrations lower than 1.0 µg/mL was significantly higher in the once-daily dosing group at the initial trough concentration, whereas there was no significant difference at the minimum trough concentration after TDM. AKI developed in nine patients; however, there was no significant difference in the incidence of AKI according to the frequency of daily gentamicin dosing. In contrast, a higher minimum trough concentration after TDM was found to be a risk factor for AKI development with an odds ratio of 9.2 (95% confidence intervals; 1.3-65.5).</p><p><strong>Conclusion: </strong>A higher trough concentration of gentamicin correlated with a higher incidence of AKI. The risk of developing AKI may be reduced by choosing a once-daily dosing regimen or implementing TDM.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620219","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":"Thiamylal serum concentration for refractory convulsive status epilepticus while associated decreased concentrations of concomitant antiepileptics: a case report.","authors":"Kazutaka Oda, Tomomi Katanoda, Hitomi Arakaki, Taiki Katsume, Kaho Matsuyama, Hirofumi Jono, Hideyuki Saito","doi":"10.1186/s40780-024-00362-w","DOIUrl":"10.1186/s40780-024-00362-w","url":null,"abstract":"<p><strong>Background: </strong>Treating refractory status epilepticus (RSE) remains a challenge. Thiamylal can be used as a second- or third-line treatment; however, its potential to induce cytochrome P450 (CYP) activity may reduce the concentration of antiepileptic drugs (AEDs) administered prior to thiamylal. This report details a case of RSE patient treated with thiamylal, with monitored concentrations of thiamylal and other AEDs.</p><p><strong>Case presentation: </strong>A 72-year-old healthy man developed RSE. Despite the administration of various AEDs, his seizures were not resolved. Thiamylal was then administered at an initial bolus dose of 2.1 mg/kg, followed by a continuous infusion of 4.2-5.2 mg/kg/h. The initial thiamylal concentration was observed at 7.8 μg/mL, increasing to 35.2 μg/mL before decreasing after dose reduction and cessation. Concurrently, the concentration of concomitant carbamazepine decreased from 5.59 μg/mL to 2.1 μg/mL and recovered as thiamylal concentration decreased. Lesser impacts were noted for other AEDs.</p><p><strong>Conclusions: </strong>This case report underscored the efficacy of thiamylal in treating RSE. However, it also highlighted the need for clinicians to closely monitor the concentrations of concurrent AEDs, especially carbamazepine, during thiamylal therapy.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11245824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600261","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}