[Second-Generation Antihistamines for Preventing Hypersensitivity Reactions during Anticancer Therapy-A Retrospective Study].

Hypersensitivity reactions are an adverse effect of anticancer drug therapy. Prophylactic administration of antiallergic drugs and steroids is recommended when administering drugs associated with a high hypersensitivity reaction incidence. First-generation antihistamines are generally used in this setting. These medications, however, induce drowsiness and sedation due to their inhibitory effects on the central nervous system. They are contraindicated in patients with angle-closure glaucoma and prostatic hyperplasia. Second-generation antihistamines are used as alternative drugs for such cases in our hospital. This study investigated the use of second-generation antihistamines at our hospital and examined their efficacy and safety. A total of 7 second-generation antihistamines were used at our hospital. Approximately 90% of the target patients were shifted from first-generation antihistamines to bilastine or desloratadine. The most frequent reasons for changing to second- generation antihistamines were drowsiness(32.3%)and car driving(24.2%). No central inhibitory side effects were observed upon consumption of second-generation antihistamines. Only 2 patients(3.2%)developed hypersensitivity reactions after changing to second-generation antihistamines. Our findings suggest that second-generation antihistamines are effective in preventing hypersensitivity reactions. These medications may be used in patients who have concerns regarding the central inhibitory side effects of first-generation antihistamines or their potential to exacerbate comorbidities. Their use can help improve the safety of anticancer drug therapy.

[The Department of Pharmacy at Fukuoka University Hospital's Role in Preventing Hepatitis B Virus Reactivation in Patients Taking Oral Anticancer Drugs].

At the Department of Pharmacy of Fukuoka University Hospital, hepatitis B virus(HBV)screening tests, and HBV-DNA quantitative monitoring, are conducted before starting chemotherapy with injectable anticancer drugs. If certain tests have not been performed, the pharmacists order them as part of the protocol based pharmacotherapy management(PBPM)system. However, the status of HBV-related testing among patients taking oral anticancer drugs is unclear. Therefore, we surveyed the status of HBV-related testing in patients, who were prescribed oral anticancer drugs with a label warning regarding HBV reactivation, at our hospital between August 1 and September 30, 2021. We examined the effect of pharmacist support for HBV reactivation measures based on the PBPM. During the study, 247 patients were prescribed oral anticancer drugs, and 36% did not undergo HBV screening or HBV-DNA quantitative monitoring. Screening or monitoring was performed in most cases after they were ordered by the pharmacists or after informing the physicians. These results suggest that HBV-related testing in patients taking oral anticancer drugs is inadequate, and pharmacist support based on the PBPM may help prevent the development of hepatitis and facilitate the continuation of anticancer drug treatment for underlying diseases.

[Comparative Study of the Efficacy and Safety of Caffeine and Aminophylline for the Treatment of Apnea in Preterm Infants].

　Methylxanthine is widely administered for the treatment of apnea of prematurity in many countries, and previous reports have clearly established that caffeine is effective for the treatment of apnea of prematurity. In Japan, caffeine has been available since December 2014. Thus, we compared the efficacy and safety of caffeine with that of aminophylline in our hospital. There was no significant difference between the caffeine group and aminophylline group regarding the characteristics of the study patients. The mean efficacy rate from day 1 to day 10 was 89.5% in the caffeine group, and 81.9% in the aminophylline group, although the rate of improvement in apnea episodes each day from day 1 to day 10 was not significantly different between the two groups. On the other hand, the adverse event rates in the caffeine group and the aminophylline group were 70.6% and 75.0%, respectively. No significant difference was observed in the adverse event rates between the two groups. Moreover, suspected abdominal distension due to the drug administration was more frequently observed with the aminophylline group. Our findings indicate that caffeine is as effective as aminophylline, while it is superior to aminophylline regarding its overall safety.