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In 25 cancer patients treated with slow-release oral morphine (MS Contin® in 12 patients and Kadian® in 13 patients) and in 10 cancer patients treated with continuous infusion of morphine, plasma steady-state concentrations of morphine (M), morphine-3-glucuronide (M-3-G) and morphine-6-glucuronide (M-6-G) were determined by HPLC. Blood samples were withdrawn at 0 hr, 2 hr, 6 hr after oral administration in patients treated with slow-release oral morphine and once or twice a day in patients treated with continuous infusion of morphine. In 4 cancer patients treated with continuous infusion of morphine, in order to analyze chronopharmacokinetic variability, M-3-G/M ratio was observed at 12: 00 h and 24: 00 h.No significant changes were observed in M-3-G/M ratios and M-6-G/M ratios at 0, 2, and 6 hr after administration of oral morphine. There was no difference between Kadian® and MS Contin®.The M-3-G/M ratio (38.6±25.7) in the oral morphine group was significantly higher than that (15.3±12.9) of the continuous infusion group (p

Cyclosporine A (CyA), an immunosuppressive drug, has shown a potency in pure red cell aplasia (PRCA). However, the effective blood level is not known in PRCA treatment. In a PRCA patient (53-year-old male) who responded to CyA, we carefully monitored CyA trough levels over a 4-year period. In the first 6 months, the hemoglobin level was about 11 g/dl and the CyA trough level was over 150 ng/ml ; the dose of CyA was then tapered to prevent renal toxicity. The trough level was controlled between 100 and 150 ng/ml, and he remained in continuous remission for the subsequent year. However, after that time, the hemoglobin level gradually decreased and PRCA recurred. We then increased the CyA trough level to over 150 ng/ml and his anemia improved. This case report illustrates that a CyA trough level of at least 150 ng/ml is necessary to maintain remission.

We performed a pharmacoepidemiological study on triazolam dependence with typical doses in out-patients of Fukui Medical School Hospital. We investigated the prescriptions (duration of treatment and total dose prescribed) for patients administered triazolam.The patients were classified according to the prescription pattern of this drug, Group 1: patients who had been prescribed triazolam daily, Group 2: those who had been allowed to take triazolam when they cannot sleep.Approximately 40% of all the patients had been prescribed triazolam for 8 months or longer, and were judged to be normal dose dependence. The prevalence of this dependence was apparently higher in group 1 than in group 2.

We performed a pharmacoepidemiological study on the effect of different types of questionnaires on coughing and the prevalence of this symptom in out-patients taking angiotensin converting enzyme inhibitors (ACEI) in Fukui Medical School Hospital.The following three types of quentionnaires were prepared:Type 1 ; Questionnaire asking whether the patient has a cough or no after implying that ACEI might cause this symptom.Type 2 ; Questionnaire on the general adverse effects of ACEI, including coughing.Type 3 ; Questionnaire on the general adverse effects of ACEI other than coughing.All questionnaires included a blank space in which the patients were asked to write any adverse effects. The patients were randomly divided into three groups. Each group was given one of the three questionnaires. In the type 3 questionnaire, no patient com-plained of coughing. The prevalence of cough was higher in type 1 questionnaire than in type 2 quetionnaire patients. These results indicate that the prevalence of adverse effects varies greatly depending the type of questions in the questionnaire.

In a pharmacoepidemiological study, the response to norfloxacin and ofloxacin (duration of treatment and total dose prescribed) was analyzed in order to determine whether norfloxacin and ofloxacin in combination with metal cation-containing prepara tions have an effect on the outcome of treatment.The treatment duration and total dose prescribed were significantly greater (p

We performed a pharmacoepidemiological study of the response to norfloxacin (duration of treatment and total dose prescribed) in order to determine whether norfloxacin in combination with metal cation containing preparations has an effect on the outcome of treatment. The treatment duration and total dose prescribed were significantly greater (p