[Recent Social Background and Consumer Views on Over-the-counter Drugs and Self-medication].

Recently, because the marked rise in medical expenses in Japan has become a major social problem, self-medication using OTC drugs in cases of minor health problems has attracted increasing attention. When people use OTC drugs for self-medication, they need support and/or advice from pharmacists on their proper use. This paper outlines recent revisions in the legal sales system of OTC drugs, the social background of self-medication, characteristics of OTC drugs and role of the pharmacists in providing consultation on OTC preparations. Next, consumers' views of self-medication and the OTC drug sales system are described based on the results of surveys performed after they attended an educational event on the proper use of OTC drugs. The survey of consumer views on the legal sales system of OTC drugs revealed that they were the most concerned about safety and convenience. From the survey of consumer views on self-medication, a significant percentage of the group who understood the meaning of the term "self-medication" practiced it in cases of minor health problems. Although no significant difference was seen between the groups who understood the term "self-medication" and those who did not in regard to the reading the drug package label and/or insert, a significant difference was found in their understanding of "The System for Sufferers from Adverse Drug Reactions". Therefore, it was clear that the consumers familiar with "self-medication" not only practiced it, but also understood the contents of drug package labels and/or inserts.

Isolation and identification of a potent antimalarial and antibacterial polyacetylene from Bidens pilosa.

Diseases caused by malaria parasites and pathogenic bacteria were thought to be on the brink of eradication in the 1950-1960s, but they have once again become a serious threat to mankind as a result of the appearance of multidrug resistant strains. The spread of these multidrug resistant organisms has prompted a worldwide search for new classes of effective antimalarial and antibacterial drugs. Natural products have been recognized as highly important candidates for this purpose. Our attention has focused on the herbal plant Bidens pilosa, a weed common throughout the world, as one of the target plants in the search for new active compounds, owing to its empirical use in the treatment of infectious diseases and to pharmaco-chemical studies of its crude extract. We report the isolation of two new compounds of B. pilosa, the linear polyacetylenic diol 1 and its glucoside 2 which have previously been isolated from different plants. Compound 1 exhibited highly potent antimalarial and antibacterial properties in vitro as well as potent antimalarial activity by way of intravenous injection in vivo, thereby representing a promising new class of drugs potentially effective in the treatment of malarial and bacterial diseases. We suspect that discovery of these compounds in B. pilosa in appreciable quantity is because the Fijian tradition of using the fresh plant for extraction rather than the Asian tradition of using dried plants (1 is unstable in the dried state) was followed.

Nine acetylenic alcohols isolated from the Okinawan marine sponge of the genus Petrosia (Strongylophora).

Nine new acetylenic alcohols 1-9 were isolated from a marine sponge belonging to the genus Petrosia (Strongylophora). The structures were elucidated mainly based on the analysis of one-and two-dimensional NMR spectral data. To determine the position of the central double bonds in 1-8, each compound was cleaved with OsO(4) and HIO(4), and the resulting aldehyde was converted to the corresponding 2,4-dinitrophenylhydrazone. Analysis of the high-resolution mass and (13)C NMR spectral data of each 2,4-dinitrophenylhydrazone clarified the position of the central double bonds in 1-8.

Non-prescription Drugs and Self-medication: Features and Subjects in Pharmaceutical Education.

At the time of consultation with a patient regarding OTC drugs, a pharmacist goes through the following five steps. In Step 1 information is collected, including the patient's gender, age, health condition, living situation, etc. In Step 2, upon analyzing and evaluating this collected information, the pharmacist decides whether to recommend that the patient see a medical doctor or whether an OTC drug is sufficient. In Step 3, when an OTC drug is required, the pharmacist suggests the most suitable OTC drug. In Step 4, the pharmacist provides the patient recommendations and information about the selected OTC. In Step 5, sales record entry and aftercare are performed. In these five steps, the pharmacist is making a decision on whether the consultation recommendation is required or optional; the step of making an optimal selection of an OTC drug is distinct from prescription dispensing. In many cases, at the time of OTC drug consultation, since the patient is not consulting a medical doctor, a pharmacist becomes a "first access" health professional. In this instance, the advice of a pharmacist may have a great influence on a patient's prognosis regarding the particular health challenge. Therefore, pharmacists who perform patient consultations regarding OTC drugs are required to have broad medical knowledge and communication skills. The features of consultation and information dissemination about OTC drugs by a pharmacist, and the practice and study of this subject in present-day pharmaceutical education, are described herein.

Systematic Education of Self-Medication at Tokyo University of Pharmacy and Life Sciences.

The promotion of self-medication by pharmacies, with the aim of encouraging a patient's self-selection of proper OTC drug, is written about in the national action plan "Japan is Back". The subject of self-medication has been improved in the 2013 revised edition of "Model Core Curriculum for Pharmaceutical Education". At Tokyo University of Pharmacy and Life Sciences, the systematic education of self-medication was started from the onset of the six-year course in the third, fourth and fifth grade. We introduce here a new approach in our systematic education of self-medication. In the practice of the fourth grade, groups of around 5-6 students are formed. The pharmacy students assume various roles-of pharmacist, rater, observer, and chairman-and perform role-playing. We prepared a standardized patient (SP) showing various symptoms. The student of the role of pharmacist asks about the SP's symptoms, chooses an OTC drug suitable for the SP, and explains the OTC drug to the SP. After the role-playing, those in the roles of rater, observer, SP, and faculty give feedback to the student who played the role of pharmacist. Because we conduct this role-playing using SPs with a variety of symptoms, we can create a situation similar to a real drugstore.

Molecular phylogenetic relationships between prostanoid-containing Okinawan soft coral ( Clavularia viridis) and nonprostanoid-containing Clavularia species based on ribosomal ITS sequence.

To study phylogenetic relationships among Okinawan soft corals of the genus Clavularia, the ribosomal internal transcribed spacer sequences of host corals and the 18S rDNA sequences of symbiotic algae were analyzed. The molecular phylogenetic trees of hosts showed that a prostanoid-containing species, Clavularia viridis, is deeply diverged from other species of Clavularia which do not biosynthesize the prostanoids as the main secondary metabolites. Comparison of their trees suggested poor phylogenetic concordance between hosts and symbionts.

Localization of clavulones, prostanoids with antitumor activity, within the Okinawan soft coral Clavularia viridis (Alcyonacea, Clavulariidae): preparation of a high-purity Symbiodinium fraction using a protease and a detergent.

To investigate the localization of clavulones (CV), prostanoids with antitumor activity, in the Okinawan soft coral Clavularia viridis, we developed a method for the isolation of Symbiodinium cells from the coral, i.e., treatment of a coral homogenate with a protease, pronase E, and a detergent, Nonidet P-40. The conditions for the treatment were optimized by monitoring the morphology microscopically and the amount of chlorophyll in the Symbiodinium fraction (SymF) optically. To evaluate the purity of SymF and a Symbiodinium-free coral fraction (CorF), we analyzed them for proteins and lipids using cultivated Symbiodinium as a reference. TLC of lipids revealed that SymF contained a greater amount of glycolipids, whereas CorF comprised mostly phospholipids. SDS-PAGE of proteins in SymF and CorF revealed their distinct profiles. Thus, we could obtain each fraction with high purity; we reached the conclusion that CV and arachidonic acid, their possible precursor, are localized exclusively in the insoluble fraction of host coral cells.

Structure of an unsaturated fatty acid with unique vicinal dimethyl branches isolated from the Okinawan soft coral of the genus Sinularia.

A new unsaturated fatty acid with unique vicinal dimethyl branches was isolated from the Okinawan soft coral of the genus Sinularia. The structure of the compound was determined based on the results of spectroscopic analysis and chemical conversion. The absolute configuration was deduced by applying the Ohrui-Akasaka method.

Structure of cymbidine A, a monomeric peptidoglycan-related compound with hypotensive and diuretic activities, isolated from a higher plant, Cymbidium goeringii (Orchidaceae).

The structure of a new monomeric peptidoglycan-related compound with hypotensive and diuretic activities, cymbidine A (1) isolated from the orchid Cymbidium goeringii, was elucidated mainly by spectroscopic analysis. The structure of 1 was shown to involve four amino acids (D-alanin, meso-diaminopimelic acid, D-gultamic acid, and L-valine) and two amino sugars (N-acetylglucosamine and 1,6-anhydro-N-acetylmuramic acid). The sequence of the amino acids and amino sugars was determined by the analysis of 2D NMR data. The absolute stereochemistries of the three amino acids (D-Ala, D-Glu and L-Val) were determined by the modified Marfey's method, and the (6S,10R) configurations of meso-diaminopimelic acid in 1 were indicated on the basis of the CD analysis. The absolute stereochemistry of 1,6-anhydro-N-acetylmuramic acid was also determined by CD data.

Acetylenic strongylodiols from a Petrosia (Strongylophora) Okinawan marine sponge.

Seven new long-chain acetylenic alcohols, strongylodiols D-J, were isolated from an Okinawan marine sponge of the genus Petrosia (Strongylophora). The structures of these compounds were elucidated on the basis of the results of spectroscopic analysis and chemical reaction. Analysis of the MNA esters of the acetylenic alcohols disclosed that these compounds were each an enantiomeric mixture in a different ratio.

Isolation of three marine prostanoids, possible biosynthetic intermediates for clavulones, from the Okinawan soft coral Clavularia viridis.

Three marine prostanoids, 1, 2, and 3, were isolated from the extract of the Okinawan soft coral Clavularia viridis. The structures of these compounds were assigned based on the results of spectroscopic analysis. Compound 1 was shown to be preclavulone-A methyl ester, and this is the first isolation of the ester of preclavulone-A as a natural product. Preclavulone-A is proposed to be the key intermediate in the biosynthesis of marine prostanoids exemplified by clavulones in C. viridis. The new prostanoid 3 was suggested to be a biosynthetic intermediate from preclavulone-A to clavulones, and a possible biogenetic pathway via 3 is proposed.

Isolation and structures of new halogenated prostanoids from the Okinawan soft coral Clavularia viridis.

Fifteen new halogenated prostanoids 9-23 were isolated as minor constituents from the Okinawan soft coral Clavularia viridis. Compounds 9-11 were new members of iodovulone, and compounds 12-18 were 12-O-acetyliodovulones, 12-O-acetylbromovulones, and 12-O-acetylchlorovulones. Compounds 19-23 were 10,11-epoxy congeners of iodovulone, bromovulone, and chlorovulone. The structures of these compounds were determined on the basis of spectroscopic analysis and chemical conversion.

New marine sesquiterpenoids and diterpenoids from the Okinawan soft coral Clavularia koellikeri.

Six new terpenoids (two maaliane-type sesquiterpenoids, 1 and 2, one aromadendrane-type sesquiterpenoid, 3, one noraromadendrane-type sesquiterpenoid, 4, and two neodolabellane-type diterpenoids, 5 and 6) were isolated from the Okinawan soft coral Clavularia koellikeri. The structures of these compounds were determined on the basis of the results of spectroscopic analysis, chemical conversion, and X-ray crystallographic analysis. Compound 6 exhibited modest growth-inhibition effect in vitro toward tumor cells.

Stolonilactone, a novel terpenoid-related compound, isolated from the Okinawan soft coral Clavularia koellikeri.

A novel terpenoid-related compound, stolonilactone (1), was isolated from the Okinawan soft coral Clavularia koellikeri. The structure of 1 was elucidated on the basis of spectroscopic analysis. A possible biogenesis of 1 through the [4 + 2]-cycloaddition of a trisnorsesquiterpenoid-type diene and a cembranolide-type dienophile is proposed.

Isolation of peridinin-related norcarotenoids with cell growth-inhibitory activity from the cultured dinoflagellate of Symbiodinium sp., a symbiont of the Okinawan soft coral Clavularia viridis, and analysis of fatty acids of the dinoflagellate.

Two norcarotenoids, 1 and 2, related to peridinin (3) were isolated from the cultured dinoflagellate of the genus Symbiodinium, a symbiont of the Okinawan soft coral Clavularia viridis, which contains in abundance antitumor marine prostanoids such as clavulones. The structures of 1 and 2 were elucidated on the basis of spectroscopic analysis. These compounds showed significant growth-inhibitory activity in vitro toward cancer cells. Analysis of fatty acids of the dinoflagellate was also carried out, suggesting that the marine prostanoids are produced by the host soft coral itself.