Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
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The number of patients with chronic liver diseases is expected to decline due to progress in antivirus therapy, including direct-acting antivirals for hepatitis C and nucleot(s)ide analogues for hepatitis B. On the other hand, the number of patients with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) in the setting of metabolic syndrome has been increasing worldwide. Hepatocellular carcinoma (HCC) arises in the setting of chronic hepatic inflammation and liver cirrhosis associated with NAFLD/NASH. ⋯ A number of new drugs for NAFLD/NASH patients have been under trial. Additional larger-scale studies are required to elucidate fully the clinical and basic landscape of NAFLD-HCC. This paper gives an overview of NAFLD/NASH management based on the most recent findings.
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We have conducted health promotion workshops in Kobe City, beginning in June 2016, to promote the view of pharmacies as community health centers that provide not only medicine but also offer support for maintaining and enhancing a person's health. To this end, we collaborated with Kobe Women's University (KWU). Our health promotion workshops included: 1. ⋯ This suggests that our health promotion workshops brought about positive changes in people with regard to awareness of health and a healthy lifestyle. To further explore how pharmacies might contribute to healthy life expectancy, we will continue to investigate the relationship between changes in exercise and diet and people's awareness of health. As a group exercise, from now on we have decided to expand the role of pharmacies as community health promotion centers with the slogan "Extend healthy life expectancy by having fun".
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Case Reports
[Risk of Euglycemic Diabetic Ketoacidosis Due to Low-carbohydrate Diet While Taking Empagliflozin: a Case Report].
Empagliflozin reduces blood glucose levels independently of insulin secretion by reducing glucose reabsorption in the proximal renal tubules through inhibition of sodium-glucose cotransporter 2 (SGLT2). Because SGLT2 inhibitors have a different mechanism of action to conventional antidiabetic drugs, recommendations have been issued about the management of specific side effect such as ketoacidosis, urinary tract infection, and genital infection. There have been some reports of SGLT2 inhibitor-associated euglycemic diabetic ketoacidosis (euDKA), but there have been few reports about euDKA in patients with type 2 diabetes using SGLT2 inhibitors while on a low-carbohydrate diet. ⋯ The patient improved after infusion of acetated Ringer's solution with 5% glucose and administration of regular insulin. It is necessary for physicians and pharmacists to thoroughly inform patients about the side effects of SGLT2 inhibitors such as ketoacidosis, urinary tract infection, and genital infection. Patients should also be advised about the higher risk of euDKA associated with a low-carbohydrate diet while taking SGLT2 inhibitors.
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Case Reports
[Effectiveness of Steroid Rotation in a Japanese Patient with Hiccups Caused by Dexamethasone: a Case Report].
The effectiveness of steroid rotation from dexamethasone to prednisolone for hiccups caused by dexamethasone for antiemetic chemotherapy has been reported overseas, but has not been reported in Japan. The effectiveness of steroid rotation in Japanese individuals is unclear because ethnic differences and variations in glucocorticoid receptors affect sensitivity to dexamethasone. We report a case of the effectiveness of steroid rotation in a Japanese patient with hiccups caused by dexamethasone for antiemetic chemotherapy. ⋯ Steroid rotation from dexamethasone to prednisolone completely controlled the hiccups, with no further recurrence. No emetic episodes occurred during chemotherapy. Therefore, this demonstrates the effectiveness of steroid rotation in a Japanese patient with hiccups caused by dexamethasone for antiemetic chemotherapy.
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The "Choosing Wisely" campaign is an activity to promote conversations between patients and doctors about unnecessary examinations, treatments, or procedures. A "Top five list" published by a number of specialty societies consists of five evidence-based recommendations in their own fields. ⋯ The purpose of this campaign is not only to publish recommendations to reduce waste in health care resources but also to disseminate and implement the recommendations contents. To put them into practice, it is necessary to think about interprofessional and interdisciplinary approaches.