Background: Hematocrit is usually measured from venous blood collected by invasive venipuncture. This study was performed to determine hematocrit accurately and precisely using minimally invasive volumetric absorptive microsampling (VAMS) technique.Such technique is to be applied to determining hematocrit in various clinical settings for the care, including therapeutic drug monitoring, of neonatal or epileptic patients, or patients with high risk of infection or bleeding. Methods: The study was performed using 31 VAMS samples obtained from 21 pancreatic cancer patients. Hematocrit was determined using the values of potassium concentrations obtained from blood in VAMS tips (HctVAMS ). HctVAMS was compared with hematocrit measured from blood collected by venipuncture (HctVP ). The accuracy and precision of HctVAMS in comparison to HctVP were evaluated using BlandAltman plot, Deming regression and mountain plot. Results: Bland-Altman plot displayed a random scattering pattern of the differences between HctVAMS and HctVP with the mean bias of −0.010 and the 95% limit of agreement ranging from −0.063 to 0.044.Deming regression for HctVAMS and HctVP line demonstrated very small proportional and constant biases of 1.04 and −0.003, respectively. Mountain plot exhibited a narrow and symmetrical distribution of the differences with their median of −0.011 and central 95% range from −0.049 to 0.033. Conclusion Hematocrit was accurately and precisely determined using less invasive VAMS technique. Such technique appears to be applicable to determining hematocrit in situations that venipuncture is not favorable or possible.

OBJECTIVE: This study was performed to compare the changes in the blood concentrations of tacrolimus when either itraconazole or voriconazole is together with tacrolimus to prevent or treat invasive aspergillus pneumonia (IAP) in patients with lung transplants. Therefore we can compare the degree of drug-drug interactions between tacrolimus and itraconazole against tacrolimus and voriconazole. METHODS: Patients who were admitted and had lung transplants in a territory referral hospital from September 2012 to May 2015 were analyzed retrospectively. The effects of itraconazole and voriconazole on the plasma concentrations of tacrolimus were analyzed. RESULTS: Mean tacrolimus concentrations was 10.49±2.35 ng/mL vs. 10.95±2.98 ng/mL (p=0.722), and mean concentration of tacrolimus over the dose of tacrolimus per day was 8.510±5.890 (ng/mL)/(mg/d) vs. 15.45±28.47 (ng/mL)/(mg/d) (p=0.947) in itraconazole vs. voriconazole group each. The ratio of the number of the results out of target tacrolimus concentrations to the total number of tacrolimus concentration results was 18.0±13.3% vs. 24.4±18.5% (p=0.185). CONCLUSION: There were no significant differences between itraconzaole and voriconazole to have influences on mean concentrations of tacrolimus over tacrolimus dose per weight per day. However voriconazole tended to raise tacrolimus plasma concentrations more than itraconazole. Safer and more effective drug management to prevent and treat fungal infections should be done by therapeutic drug monitoring not only of tacrolimus but of itraconazole and voriconazole in lung transplant patients.
Aspergillus ; Drug Interactions ; Drug Monitoring ; Humans ; Itraconazole* ; Lung* ; Plasma* ; Pneumonia ; Referral and Consultation ; Retrospective Studies ; Tacrolimus* ; Transplant Recipients* ; Voriconazole*

BACKGROUNDS: Patient counseling has been forced since June. 19, 2014. Prior to this, there was no study to try to standardize medication counseling to improve quality. PURPOSE: This study was to investigate satisfaction level and comprehension level between the pharmacist group and the patient group about standardized medication counseling sheet. METHODS: Questionnaires to assess standardized patient counseling sheet were posted at online survey software (Qualtrics) to pharmacists who worked at community pharmacy and patients who had visited community pharmacy before. RESULTS: Three hundred thirty five patients and three hundred nineteen pharmacists were responded to the questionnaire (Response rate: 72.9%). More than half of each group were satisfied with standardized medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged' and patient group were more satisfied than pharmacist group. Similarly, more than half of each group comprehended with the medication counseling sheets 'for the general public', 'for the pregnant women and nursing mothers', 'for the chronic patient', and 'for the aged'. Patient group tended to expect longer patient counseling time per one drug than pharmacist group. Also, the majority of both groups wanted to provide standardized medication counseling sheets constantly and extend for all drugs. CONCLUSION: Both groups were satisfied and comprehended standardized medication counseling sheets, and agreed to expand standardized medication counseling sheets to all drugs. So, it is necessary to build the standardized medication counseling of all drugs.
Comprehension* ; Counseling* ; Female ; Humans ; Nursing ; Pharmacies ; Pharmacists* ; Pregnant Women