Objective: The squeezing force and one-drop weight, suggested to directly influence adherence, were measured in 6 eye drop products containing a switch OTC drug, ketotifen fumarate, to investigate useful information for product selection.
Methods: The squeeze force, one drop weight, and pH were measured using a digital force gauge, analytical balance, and pH meter, respectively.  Information on additives contained in each product was collected from package inserts.  For the total number of drops, the number per 10 mL was calculated from the obtained value.
Results: The maximum squeeze force was 14.8 N of Irice AG Guard, and the one drop weight (33.2 mg) of Raferusa®AL was the minimum.  The total number of drops per 10 mL was 215 in Sutto eyes Z, being the minimum.  The pH was in the range of 5.2-5.7.  On comparison of additives among the products, a cooling agent was contained in only 2 products.
Discussion: Since the squeeze force was in the range of 5.3-14.8 N, it was less likely that the squeeze force reduces usability.  Since the one-drop weights of 2 products were more than 10 mg lower than the weights of the other products, the dose may be insufficient and the effect may not be attained.  The pH was within the acceptable range in all products.  Two products contain a cooling agent as an additive, and this has to be explained beforehand.  Information related to usability, actual feeling of the effect, and sense of the use of the products containing ketotifen fumarate was collected.

Objective: In this study, pharmaceutical properties were compared between the original and generic ophthalmic solutions containing betamethasone.Methods: The squeeze force, drop weight, surface tension, pH, kinematic viscosity, and total number of drops were measured. The drop volume was calculated from the drop weight and specific gravity. Information on preservatives contained in each product was collected from package inserts.Results: There was a significant difference in the squeeze force between the original and generic drugs. The pH and kinematic viscosity did not differ between the drugs. The drop volume was in the range of 30.3 to 47.2 μL, and the surface tension ranged between 33.7 and 65.2 mN/N. The total number of drops was approximately 100 in the original drug, being the lowest.Conclusion: The results of this study showed that the squeeze forces of all generic products but RINBETA PF, which was contained in a specific container, were smaller than that of the original product. The drop volumes of 2 generic products were ≥ 15-μL smaller than that of the original product, but they were within the permissible range. The maximum difference in the surface tension was approximately 33 mN/N, suggesting that drug solution relatively frequently overflows from the eyes. The total number of drops for all generic products was greater than that for the original product, suggesting that the former can be used at a higher frequency. Based on these results, pharmacists must select products in accordance with individual patients.

Objective: Glaucoma is the most frequent cause of blindness in Japan and is primarily treated using IOP-lowering ophthalmic solutions. Although the patients themselves frequently instill ophthalmic solutions, instillation by caregivers may be necessary for various reasons. Therefore, we evaluated pharmaceutical characteristics of antiglaucoma ophthalmic solutions and their usability from the caregivers' viewpoint.Methods: Five dorzolamide hydrochloride-timolol maleate ophthalmic solutions and 2 travoprost-timolol maleate ophthalmic solutions were evaluated concerning the pharmaceutical characteristics and subjective squeezability rated by adults aged 20 years or above.Results: Among the dorzolamide hydrochloride-timolol maleate compounding ophthalmic solutions, the squeeze force was the lowest in COSOPT® ophthalmic solution (11.8 N), and DORMOLOL® combination ophthalmic solution NITTEN was rated highest, with 68.2% of the subjects placing it within the top 3 levels of a 7-level scale. Of the travoprost-timolol maleate ophthalmic solutions, the squeeze force was 9.8 N, lower than the pioneer drug, in TraTimo® combination ophthalmic solution NITTO, which was also rated in the top 3 levels by 90.3% of the subjects. A strong negative correlation was observed between the squeeze force and squeezability.Conclusion: In instillation by caregivers, the squeeze force was shown to be correlated with subjective squeezability as in instillation by patients themselves. This study provided information concerning the usability of ophthalmic solutions from the caregivers' viewpoint. For the future, it is necessary to select ophthalmic solutions from the caregivers' as well as the patients' viewpoints by utilizing information obtained in this study.

Vulvodynia is defined as vulvar pain of at least three months duration without a clearly identifiable cause. Currently, there are few established treatments. We report two cases of vulvodynia treated successfully with relief of insomnia, using Japanese herbal medicine including saiko. Case 1: A 29-year-old female had been in a poor physical condition for two years. Initially, she had vulvar itching, which gradually became vulvar pain. At the first consultation, she complained of not only vulvar pain but also insomnia and feeling cold. Additional symptoms included severe fatigue, constipation, frustration, stiff shoulder, and heart palpitations. There were no abnormal findings in the genital region. We began treating the insomnia and coldness using saikokeishikankyoto. By the time of the second consultation two weeks later, her insomnia and coldness completely resolved, vulvar pain disappeared, and other symptoms improved. Case 2: A 46-year-old female experienced vulvar pain two months before the first visit to the hospital. The pain increased gradually and she awakened every 30 minutes in the night with severe vulvar pain. However, there were no abnormal findings in the genital region. We used saikokaryukotsuboreito, an antidepressant and a sleeping pill. Her insomnia improved gradually, and vulvodynia resolved two weeks after the improvement of the insomnia. These results suggest that saiko is effective on vulvodynia with insomnia.

To smoothly proceed with the national policies and projects concerning dementia measures, it is important that pharmacists who take care of patient in clinical practice sufficiently understand its contents. In this study, we conducted a questionnaire survey involving chain community pharmacists to investigate the level of awareness concerning these policies and projects. Subjects were 446 chain community pharmacists. The questionnaire consisted of 17 items (e.g. the level of awareness regarding the “Comprehensive Strategy to Accelerate Dementia Measures (New Orange Plan)”, “Dementia Supporters Caravan Program (Caravan Program)”, and “Dementia training certified pharmacist program (Certification program)”). The questionnaires were filled out anonymously. The levels of awareness concerning the “New Orange Plan” and “Caravan Program” were 34.7% and 48.9%, respectively. Sixty-one percent of subjects attended a “Dementia Supporter Training Lecture”, 30.4% of whom were wearing the “orange ring”. The levels of awareness and the hope of acquisition concerning the “Certification program” were 47.8% and 79.8%, respectively. To achieve the purpose of “contribution to early detection of dementia by pharmacist” of the “New Orange Plan”, it is necessary to conducting the workshop and to create an opportunity to come in contact with dementia patients. It is also important to recognize that it is necessary to enlighten the meaning of wearing an “orange ring” and to enlarge the circle of dementia supporters. In addition, it is thought that more dementia patients can be supported in the community by increasing the levels of awareness concerning the “Certification program” and giving appropriate advice and response.