Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
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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.
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Comparative Study
[Adverse Events after the Introduction of Quadrivalent Influenza Vaccine in Comparison with AH1pdm Vaccine (2009) in Japan].
Inactivated quadrivalent influenza vaccine (IIV4) has been used as seasonal influenza vaccine since 2016 in Japan. This study examined the safety of IIV4 in comparison with the AH1pdm monovalent vaccine used for novel influenza in 2009. Questionnaire surveillance associated with adverse events (AEs) was conducted at Chiba University Hospital, Japan. ⋯ The ratio of HCWs reporting AEs peaked at around 80% on day 1, then decreasing to less than 5% by day 7. AEs with IIV4 were reported more frequently compared with the AH1pdm monovalent vaccine. However, in consideration of the grade and duration of AEs, IIV4 was a well-tolerated, safe vaccine.
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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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Multicenter Study Observational Study
[Effects of Serum Sodium Concentrations on Nausea and Vomiting after Moderately Emetogenic Chemotherapy].
Chemotherapy-induced nausea and vomiting (CINV) is the most unbearable adverse effect of chemotherapy. The antiemesis guidelines of the National Comprehensive Cancer Network indicate that hyponatremia is a risk factor for CINV, although the relationship between the incidence of CINV and hyponatremia has not been sufficiently studied. This two-center prospective observational study evaluated whether low serum sodium concentrations were a risk factor for CINV. ⋯ The incidences of delayed nausea were 27.8% in the high Na+ group and 62.5% in the low Na+ group (p=0.042), with complete control rates (no vomiting, rescue medication, or grade 2 nausea) of 77.8% and 43.8%, respectively (p=0.042). The time to complete control failure in each group was analyzed using the Kaplan-Meier method, which revealed a significantly shorter time in the low Na+ group (p=0.03). Therefore, these results indicate that low serum sodium concentrations may increase the risk of CINV.