Hajime Kagaya

Characterization of the Adverse Effects Induced by Acetaminophen and Non-steroidal Anti-Inflammatory Drugs based on the Analysis of the Japanese Adverse Drug Event Report Database.

Objectives: Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are antipyretic analgesics with established adverse effects (AEs); however, only a few studies have compared their AEs simultaneously. We aimed to compare the AEs of these medications to confirm the respective frequencies of both rare and major AEs. Methods: We used a high-quality database for spontaneous adverse drug event reporting in Japan. Data were extracted regarding the AEs of acetaminophen and NSAIDs to compare the tendency of the appearance of those AEs between the drugs. We also performed a principal component analysis using the AE data to assess the characteristics of major AEs. Results: Cutaneous disorders and hepatic disorders were the most common AEs induced by acetaminophen and NSAIDs, with gastrointestinal tract disorders also common with NSAID use. Principal component analysis quantitatively showed the tendencies of specific AEs, and it helped demonstrate the characteristics of AEs. Acetaminophen and NSAIDs showed different tendencies in the occurrence of AEs. Each NSAID was plotted based on the tendency of the appearance of major AEs, and AEs were classified by their likelihood of being pharmacological or idiosyncratic. Conclusions: These findings may help clinicians select an appropriate drug for patients considering their backgrounds, instead of choosing merely based on the class of the drug, for example, cyclooxygenase selectivity. This selection, based on the characteristic information on AEs occurring in clinical settings, might be more suitable for patients.

Antacid attenuates the laxative action of magnesia in cancer patients receiving opioid analgesic

This study was designed to investigate pharmacological interaction between magnesium laxative and antacid in patients receiving opioid analgesic.

Cytotoxicity, apoptosis, and QSAR studies of phenothiazine derived methoxylated chalcones as anticancer drug candidates

In the present study, chalcones “(E)-1-(10H-phenothiazine-2-yl)-3-aryl-prop-2-en-1-ones, FS1-11” were successfully synthesized via base-catalyzed Claisen–Schmidt condensation. Chemical structures of the compounds were confirmed by 1H NMR, 13C NMR, and HRMS techniques. Aryl part of the chalcone was changed as mono, di, and trimethoxylated phenyls. Cytotoxicities of the phenothiazine derivatives were evaluated against four human oral squamous cell carcinoma (OSCC) cell lines (Ca9-22, HSC-2, HSC-3, and HSC-4) and three human normal oral cells (HGF, HPLF, and HPC) by MTT test. The CC50 values of the compounds were calculated in the range of 0.9–109.8 µM towards OSCC malign cell lines. Trimethoxylated compound FS6, (E)-1-(10H-phenothiazine-2-yl)-3-(2,4,5-trimethoxyphenyl)-prop-2-en-1-one, was found the most selective cytotoxic compound among the series with the highest selectivity index (SI) (SI = 76.5) and potency-selectivity expression (PSE) (PSE = >1285; > 1602) values. Western blot analysis demonstrated that FS6 (8–64 μM) induced the production of cleaved product of PARP and the activation of caspase-3 in HSC-2 cells, suggesting the induction of apoptosis by FS6. QSAR analysis suggested that the tumor specificity of the chalcones correlated with their molecular shape, volume, and electrostatic properties.

Analysis of factors associated with hiccups based on the Japanese Adverse Drug Event Report database

Hiccups are occasionally experienced by most individuals. Although hiccups are not life-threatening, they may lead to a decline in quality of life. Previous studies showed that hiccups may occur as an adverse effect of certain medicines during chemotherapy. Furthermore, a male dominance in hiccups has been reported. However, due to the limited number of studies conducted on this phenomenon, debate still surrounds the few factors influencing hiccups. The present study aimed to investigate the influence of medicines and patient characteristics on hiccups using a large-sized adverse drug event report database and, specifically, the Japanese Adverse Drug Event Report (JADER) database. Cases of adverse effects associated with medications were extracted from JADER, and Fisher’s exact test was performed to assess the presence or absence of hiccups for each medication. In a multivariate analysis, we conducted a multiple logistic regression analysis using medication and patient characteristic variables exhibiting significance. We also examined the role of dexamethasone in inducing hiccups during chemotherapy. Medicines associated with hiccups included dexamethasone, levofolinate, fluorouracil, oxaliplatin, carboplatin, and irinotecan. Patient characteristics associated with hiccups included a male gender and greater height. The combination of anti-cancer agent and dexamethasone use was noted in more than 95% of patients in the dexamethasone-use group. Hiccups also occurred in patients in the anti-cancer agent-use group who did not use dexamethasone. Most of the medications that induce hiccups are used in chemotherapy. The results of the present study suggest that it is possible to predict a high risk of hiccups using patient characteristics. We confirmed that dexamethasone was the drug that has the strongest influence on the induction of hiccups. However, the influence of anti-cancer agents on the induction of hiccups cannot be denied. We consider the results of the present study to be helpful for the prevention and treatment of hiccups.

Development of a double-stranded siRNA labelling method by using 99mTc and single photon emission computed tomography imaging

Abstract In vivo biodistribution of small interfering RNAs (siRNAs) is important to develop them for medical use. Therefore, novel single photon emitter-labelled siRNA was prepared by using diethylenetriamine-N,N,N′,N″,N″-pentaacetic acid (DTPA) and poly(A) polymerase, and subsequently, real-time analysis of siRNA trafficking was performed by using single photon emission computed tomography (SPECT). This study aimed at assessing the use of 99mTc-radiolabelled siRNA targeting lacZ to detect lacZ expression in vivo. siRNA targeting lacZ was radiolabelled with 99mTc by using the bifunctional chelator DTPA, and the labelling efficiency and specific activity were determined. The probe stability in RNaseA was assessed. SPECT imaging was performed in mice overexpressing the lacZ gene in the liver. Radiolabelled siRNA remained highly stable in RNaseA solution at 37 °C. In SPECT imaging, significant 99mTc accumulation in the liver was observed in mice overexpressing the lacZ gene. 99mTc-labelled lacZ siRNA shows β-galactosidase-specific accumulation and appears promising for the visualisation of lacZ expression in vivo. Our labelled siRNA should be deliverable to specific regions overexpressing the target gene.

Expected Duties of Pharmacists and Potential Needs of Physicians and Nurses on a Kaifukuki Rehabilitation Ward

This study investigated the required duties of pharmacists in a kaifukuki rehabilitation ward from the viewpoint of the ward physicians and nurses. A questionnaire survey was distributed to 27 facilities with kaifukuki rehabilitation wards. The questionnaire examined which duties the physicians and nurses expected from pharmacists while on the ward (4 areas, 10 items), as well as the time required for pharmacists to carry out those duties. Multivariate analysis was used to investigate which types of work took the most time for pharmacists on kaifukuki rehabilitation wards. Responses were received from 43 physicians and 184 nurses who worked on the kaifukuki rehabilitation wards of 19 facilities. The results revealed that the essential duties performed by pharmacists were the management of medical supplies, instruction on the use of self-medicating drugs at the time of introduction, and monitoring drug side effects. Furthermore, some duties, such as the distribution of medicines and changing or suggesting new drugs, required pharmacists to spend extended time on the ward. The responses indicated that physicians and nurses recognized the necessity for pharmacists to perform ward duties along with their routine work. This study shows that physicians and nurses working in kaifukuki rehabilitation wards demand proactive participation from pharmacists in appropriate medical therapy, such as instruction in the administration of medications and assessment at the time of prescription changes.