ABSTRACT
Objectives: The long treatment duration of glaucoma and multiple drug use have decreased patient adherence to anti-glaucoma drugs. This has prompted the recent marketing of a combination drug, Xalacom ® Combination Eye Drops (hereinafter referred to as the original drug), and its generic drugs (3 generics). In this study, we compared these eye drops from a pharmaceutical viewpoint,conducted research on usability, and evaluated the selection criteria for generics.Methods: The viscosity and pH of the original drug and its generics were measured. The total number of drops per container, mean mass per drop, and the squeeze force needed for one drop of individual eye drops were measured using a digital force gauge. In addition, a questionnaire survey on the usability of each eye drop was conducted in patients.Results: The total number of drops in the contain of the original drug and generics tested almost the same. The mean mass per drop of generics from two companies was significantly lower than that of the original drug, and the squeeze force of the generic from one company was significantly lower than that of the original drug. The usability of the containers some generics was significantly higher than that of the original drug.Conclusion: No difference was observed in the total number of available drops between the original drug and generics. However,differences in squeeze force and usability were observed between the original drug and generics and among the generics. This information should preferably be described in the interview form, patient instruction manual, etc. for providing medication instructions to pharmacists. All products investigated in this study contained more than 100 drops in the containers. The expiration date of tested eye drops after opening is about one month. Reducing the volume of filling into a container may be contribute to the medical economy and avoid the risk of microbial contamination.
ABSTRACT
Objective: We conducted a survey on drug information accumulated by pharmaceutical companies about the adequacy of administration of crushed or simply suspended internal medicines through enteral feeding tube, examination methods to confirm adequacy and inquiries from medical institutions to pharmaceutical companies about the adequacy of these methods.Methods: We sent a questionnaire to 162 pharmaceutical companies that sell internal medicines to collect information. The survey was conducted from May 1, 2016 to March 31, 2017.Results: The questionnaire response rate was 61% (99 companies responded). Eighty and 90 percent of the companies possessed information about the drug crushing methods and simple suspension methods used for administration of internal medicines,respectively. The type of information and examination methods used varied among the companies, was very limited, and was often limited to new drugs. The information acquisition rate about crushing methods was 69.3% in original examination methods of pharmaceutical companies. On the other hand, 90.3% of the information about simple suspension methods was obtained by the unified method of Hand Book of Simple Suspension Method.Conclusions: In the future, medical practice and patients will benefit if examination methods to confirm the adequacy of crushing and administration through feeding tubes are commonly and consistently obtained by pharmaceutical companies. Furthermore, it would be very useful for information of crushing methods and simple suspension methods to be included in package inserts and interview forms.
ABSTRACT
Objective: In this study, we surveyed the attitudes of community pharmacists regarding oral antidiabetic drugs that need to be continuously administered, focusing especially on recently available oral‐combination antidiabetic drugs, in terms of their positioning and medication adherence. In addition, we identified relevant problems from the survey results and discussed the proper use of the combination drugs.Methods: We conducted a questionnaire‐based survey on health insurance‐covered dispensing pharmacies belonging to Kanazawa, Koga, Takasaki, Hitachi, and Hitachinaka Pharmaceutical Associations via fax or post from September 1, 2017 to November 30, 2017.Results: The overall response rate to the survey was 29.8%. Although combination drugs were considered useful in terms of improved motivation to take medication, i.e., medication adherence, there were also opinions claiming that combination drugs are not particularly useful due to the following reasons: there are problems in discarding residual drugs, they are less economical than individual drugs, it is difficult to ingest tablets of combination drugs because of their large size, it is difficult to adjust doses of combination drugs, and medication adherence does not change because of concomitant drug use.Conclusion: Based on the results there was the opinion that a combination oral diabetes drug improves medication adherence but problems such as the generation of leftover unused drugs due to switching and an increase in the risk of overuse when taking medication was pointed out. It is necessary for pharmacists to give advice in recognition of the risks with each active ingredient of the oral diabetes combination drug and to continuously monitor any development of side effects. Furthermore, as with other diabetes remedies, pharmacists need to advise regarding the patient's lifestyle as well as monitor laboratory test results such as kidney function. The patient's swallowing ability is also an important consideration at the time of medication instruction.