Identifying over-the-counter information to prioritize for the purpose of reducing adverse drug reactions in older adults: A national survey of pharmacists.

BACKGROUND: Over-the-counter (OTC) medication use is associated with risks of adverse drug reactions (ADRs), particularly among older adults. The Drug Facts Label (DFL) is supposed to provide consumers with information that would avoid ADRs, yet research suggests that consumers frequently fail to interact with this critical information. We postulate that emphasizing critical information by placing it on the front of the package may increase its usage. Before doing so, the most critical information from the DFL needs to be identified. OBJECTIVES: This study aimed to determine which information from the DFL is most critical in reducing ADRs at the time of purchase or use by older adults. METHODS: A national survey of practicing pharmacists knowledgeable about OTC medication use by older adults asked participants to rank order the importance of the DFL sections to reduce ADRs in older adults. Open-ended questions focused on identifying ways of improving OTC medication labeling. Quantitative rankings were used to calculate the content validity ratio and analyzed using Wilcoxon signed rank tests. Qualitative results were categorized into themes. RESULTS: A total of 318 responses (12% response rate) were analyzed. There was high consensus that uses and purpose, active ingredient, warnings, and directions for use were the most important sections of the DFL. Within the warning section, 2 specific warnings, "Do not use" and "Ask a doctor or pharmacist," were deemed most important. Similarly, qualitative themes focused on seeking health care provider assistance or were specific to age-related precautions. CONCLUSIONS: Prioritizing warnings that highlight the importance of possible drug-drug and drug-disease precautions and the need to seek medical advice before taking OTC medications were deemed most critical. Moving this type of information to the front of the package may help reduce ADRs among older adults.

Spatial reorganization of the endoplasmic reticulum during mitosis relies on mitotic kinase cyclin A in the early Drosophila embryo.

Mitotic cyclin-dependent kinase with their cyclin partners (cyclin:Cdks) are the master regulators of cell cycle progression responsible for regulating a host of activities during mitosis. Nuclear mitotic events, including chromosome condensation and segregation have been directly linked to Cdk activity. However, the regulation and timing of cytoplasmic mitotic events by cyclin:Cdks is poorly understood. In order to examine these mitotic cytoplasmic events, we looked at the dramatic changes in the endoplasmic reticulum (ER) during mitosis in the early Drosophila embryo. The dynamic changes of the ER can be arrested in an interphase state by inhibition of either DNA or protein synthesis. Here we show that this block can be alleviated by micro-injection of Cyclin A (CycA) in which defined mitotic ER clusters gathered at the spindle poles. Conversely, micro-injection of Cyclin B (CycB) did not affect spatial reorganization of the ER, suggesting CycA possesses the ability to initiate mitotic ER events in the cytoplasm. Additionally, RNAi-mediated simultaneous inhibition of all 3 mitotic cyclins (A, B and B3) blocked spatial reorganization of the ER. Our results suggest that mitotic ER reorganization events rely on CycA and that control and timing of nuclear and cytoplasmic events during mitosis may be defined by release of CycA from the nucleus as a consequence of breakdown of the nuclear envelope.

Effects of bacterial lipopolysachharide on peripheral leukocytes in the American alligator (Alligator mississippiensis).

Alligators were injected intraperitoneally with four different doses (10, 1.0, 0.1, and 0.01 mg/kg body weight) of a mixture of bacterial lipopolysaccharides (LPS) derived from three different types of bacteria (Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae). Injection of the alligators with the LPS mixture resulted in a dose- and time-dependent increase in total peripheral leukocytes Lymphocytes increased at days 3 and 4 post-injection, and decreased back to baseline levels at day 7 for all doses. Alligators that were not treated, and those injected with pyrogen-free saline, did not exhibit statistically significant changes in total leukocytes during the course of the study. Injection of alligators with 0.5 mg LPS/kg body weight derived from one of three bacterial species revealed that the leukocyte increases observed were not statistically different for all three types of LPS. The animals displayed the same increases in total counts and the levels of all circulating leukocyte types were not different between animals treated with a combination of LPS from all three bacterial species.