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author:("Araki, takeya")
1.  Risk of Falling and Hypnotic Drugs: Retrospective Study of Inpatients 
Drugs in R&d  2013;13(2):159-164.
Background
Falls and related injuries remain a concern for patient safety in many hospitals and nursing care facilities. In particular, reports examining the relationship between accidents and drugs with a sedative effect have been increasing; however, the analysis of correlation between the background factors of fall accidents and the detailed therapeutic category of drugs is insufficient.
Objectives
Our objective was to estimate fall risk following the administration of hypnotics in inpatients within an acute hospital. We assessed the relationship between falls and hypnotic drugs compared with other medicines.
Study Design and Setting
An inpatient population-based study was carried out at Gunma University Hospital, where all inpatients admitted between 1 October and 31 December 2007 were included. Over a 3-month follow-up period, all reports of falling accidents from ward medical staff were investigated.
Results and Discussion
Falls occurred in 1.8 % of males and 1.3 % of females in the study population (n = 3,683). The mean age of patients who experienced falls (64.7 ± 19.5 years) was significantly higher than that of patients who did not (56.2 ± 20.2 years). Multivariate analysis revealed the following drugs as high-risk factors for falling: hypnotics (odds ratio [OR] 2.17, 95 % CI 1.44–3.28), antiepileptics (OR 5.06, 95 % CI 2.70–9.46), opioids (OR 3.91, 95 % CI 2.16–7.10), anti-Alzheimer’s (OR 5.74, 95 % CI 1.62–20.3), anti-Parkinson’s (OR 5.06, 95 % CI 1.58–16.24), antidiabetics (OR 3.08, 95 % CI 1.63–5.84), antihypertensives (OR 2.24, 95 % CI 1.41–3.56), and antiarrhythmics (OR 2.82, 95 % CI 1.36–5.86). Multivariate logistic regression analysis of hypnotics, brotizolam, zopiclone, and estazolam revealed a significant association with an increased risk of inpatient falling accidents, while zolpidem, triazolam, flunitrazepam, and nitrazepam did not.
Conclusion
The present findings suggest that the risk of falling accidents in hospitals differs according to the type of hypnotic drug administered. The appropriate selection of hypnotic drugs, therefore, might be important for reducing the number of patient falls.
Electronic supplementary material
The online version of this article (doi:10.1007/s40268-013-0019-3) contains supplementary material, which is available to authorized users.
doi:10.1007/s40268-013-0019-3
PMCID: PMC3689908  PMID: 23760758
3.  Effect of Ethanol in Paclitaxel Injections on the Ethanol Concentration in Exhaled Breath 
Drugs in R&d  2012;12(3):165-170.
Background
Ethanol is included in certain injectable preparations of anticancer drugs to increase their solubility. Since the volume of ethanol in these preparations is approximately half of the total injection volume, the potential inhibitory effects of ethanol on the central nervous system cannot be disregarded, especially considering that patients may drive immediately after administration of the medication. Therefore, the concentration of ethanol was examined in exhaled breath after administration of paclitaxel, an anticancer medication containing ethanol.
Methods
The ethanol concentration in exhaled breath immediately after an intravenous infusion of paclitaxel was measured in 30 patients, using a balloon-type gas detector tube. Correlations between the concentration of ethanol in exhaled breath and the total amount of ethanol administered or the intravenous infusion speed were calculated.
Results
The mean ethanol concentration in exhaled breath was 0.028 ± 0.015 mg/L. The correlation between the ethanol concentration in exhaled breath and the total dose of ethanol was weak (R2 = 0.25; p = 0.055), while the intravenous infusion speed showed a stronger positive correlation with the concentration of ethanol in the breath (R2 = 0.49; p = 0.11). The maximum concentration of ethanol measured in exhaled breath (0.06 mg/L) was equivalent to 40% of the threshold for drunk driving, as specified in the Road Traffic Act in Japan.
Conclusion
In this study, no patient had a breath ethanol concentration exceeding the legal threshold for drunk driving. However, it is still advisable for patients to avoid driving after receiving paclitaxel injections. When driving cannot be avoided, patients should wait for a sufficient time after receiving the injection before driving.
doi:10.2165/11634690-000000000-00000
PMCID: PMC3585845  PMID: 22950523
4.  Review of the Treatment of Non-Small Cell Lung Cancer with Gefitinib 
In the past decade, molecular-targeted drugs have been focused upon for the treatment of cancer. In 2002, gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor became available in Japan for the treatment of non-small cell lung cancer (NSCLC). Over 80% of selected patients, such as EGFR mutation-positive patients, respond to gefitinib treatment; however, most patients develop acquired resistance to gefitinib within a few years. Recently, many studies have been performed to determine precisely how to select patients who will respond to gefitinib, the best timing for its administration, and how to avoid the development of acquired resistance as well as adverse drug effects. This article reviews the use of gefitinib for the treatment of NSCLC from a pharmaceutical viewpoint.
doi:10.4137/CMO.S7340
PMCID: PMC3520446  PMID: 23239933
gefitinib; EGFR; KRAS; NSCLC; lung cancer
5.  Ammonia emission from rice leaves in relation to photorespiration and genotypic differences in glutamine synthetase activity 
Annals of Botany  2011;108(7):1381-1386.
Background and Aims
Rice (Oryza sativa) plants lose significant amounts of volatile NH3 from their leaves, but it has not been shown that this is a consequence of photorespiration. Involvement of photorespiration in NH3 emission and the role of glutamine synthetase (GS) on NH3 recycling were investigated using two rice cultivars with different GS activities.
Methods
NH3 emission (AER), and gross photosynthesis (PG), transpiration (Tr) and stomatal conductance (gS) were measured on leaves of ‘Akenohoshi’, a cultivar with high GS activity, and ‘Kasalath’, a cultivar with low GS activity, under different light intensities (200, 500 and 1000 µmol m−2 s−1), leaf temperatures (27·5, 32·5 and 37·5 °C) and atmospheric O2 concentrations ([O2]: 2, 21 and 40 %, corresponding to 20, 210 and 400 mmol mol−1).
Key Results
An increase in [O2] increased AER in the two cultivars, accompanied by a decrease in PG due to enhanced photorespiration, but did not greatly influence Tr and gS. There were significant positive correlations between AER and photorespiration in both cultivars. Increasing light intensity increased AER, PG, Tr and gS in both cultivars, whereas increasing leaf temperature increased AER and Tr but slightly decreased PG and gS. ‘Kasalath’ (low GS activity) showed higher AER than ‘Akenohoshi’ (high GS activity) at high light intensity, leaf temperature and [O2].
Conclusions
Our results demonstrate that photorespiration is strongly involved in NH3 emission by rice leaves and suggest that differences in AER between cultivars result from their different GS activities, which would result in different capacities for reassimilation of photorespiratory NH3. The results also suggest that NH3 emission in rice leaves is not directly controlled by transpiration and stomatal conductance.
doi:10.1093/aob/mcr245
PMCID: PMC3197464  PMID: 21937483
Ammonia assimilation; ammonia emission; glutamine synthetase; nitrogen; Oryza sativa; photorespiration; rice cultivars

Results 1-5 (5)