Objective : To determine how much label information on over-the-counter (OTC) medicines is contained on packaging, we investigated the items, description methods, and area of label information on packages.
Methods : We selected 75 common cold remedy products for investigation and classified the items into 3 categories (“items for use”, “items with a regulation requirement”, “items related to product image”) and measured the space given to each item in the total package area.
Results : All 75 products had “items with a regulation requirement (total 13 items),” but 8 products (only 2 manufacturers) had “consult a physician or pharmacist before use,” which was not a regulation requirement.  There were differences in description methods, especially in “caution” and “product name.”  Sixty percent of the OTC products used non-red characters with no box-frame, and 11% used red characters and box-frames.  The description order was not standardized, but “caution” was located in the lowest space on 80% of products.  Many item descriptions appeared in one place, but “product name” generally appeared in more than 4 places. While 4.5 to 8.0 points were commonly given for “items for use,” 16 to 100 points were given for “product name,” and the difference in number of points was greater than 6-fold among products.  The percentage of average area for “items related to product image” (6.1%) was 2-fold greater than for “items for use” (3.1%) and “items with a regulation requirement” (2.9%).  Almost half of the total package area was blank space.
Conclusion : Current descriptions in label information vary among items, products, and pharmaceutical companies.  Rules on describing information on OTC medicine packaging are thus necessary.

Pharmacotherapy is generally the first choice for the treatment of acute mania in bipolar disorder. Electroconvulsive therapy (ECT) is reported to be an effective treatment modality for mania; however, it is usually used as the “last resort.” Herein, we report a case of a patient with treatment-resistant severe mania in bipolar disorder who recovered with ECT without concurrent antipsychotics and mood stabilizers. Our case report showed that ECT monotherapy can be an effective treatment modality for manic state in bipolar disorder, which may lead to a shorter hospital stay and better social outcomes.

Objective: Confirmation by pharmacists of brought-in drugs is not only limited to identification of drugs, but also requires prescription design and proposals based on the background of patients and evaluation of associated information. In this study, we analyzed the content of brought-in drugs related PreAVOID reports in our hospital according to the years of pharmacist experience in order to help educate pharmacist for better brought-in drugs confirmation.Method: Various interventions regarding brought-in drugs were compared between two groups: pharmacists with >6 years of experience (group H) and those with < 5 years of experience (group L). PreAVOID reports, which related to drugs brought in by patients admitted to the Ogaki Municipal Hospital between April 1, 2018 and March 31, 2019 were assessed.Result:The PreAVOID reporting rate for the number of brought-in drugs confirmed was higher in group H (1.56%) than in group L (1.12%) (odds ratio 1.399, p = 0.023). The PreAVOID reporting rate when reporting was based solely on prescription information did not differ between these two groups, but when patient background, including disease-related information, was included with prescription information, the rate was higher in group H (0.80%) than in group L (0.30%) (odds ratio 2.725, p < 0.001). Group H provided more reports related to unnecessary drugs.Conclusion: The involvement of pharmacists in the evaluation of brought-in drugs is important when reviewing subsequent medical treatments. Our findings suggest that to improve the quality of treatment, it is necessary to provide appropriate newcomer education, such as conducting case studies using PreAVOID cases.