Background/Objective: It is not uncommon for elderly patients to experience difficulties with feeding and swallowing. In the simple suspension method, tablets are dissolved and suspended in warm water without prior crushing or decapsulation, and then administered via a tube. Despite the prevalence of this method, the pharmacokinetics of suspended tablet dosage forms remain poorly understood. Methods: Verapamil was employed in dissolution tests following both the simple suspension and crushing methods. A pharmacokinetics study was conducted on healthy adult males. Results: The resultant dissolution profiles from the two methods exhibited notable dissimilarities. Drug release from the crushed product commenced earlier than that from the simple suspension and intact tablet. Furthermore, the area under the curve for verapamil during the initial 24 h period was 1.7 and 1.3 times greater in the crushed and simple suspension groups, respectively, than in the tablet group. Conclusions: The crushing and simple suspension methods are safe techniques for administering medications to patients with dysphagia, thereby preventing aspiration. Nevertheless, the processing of medications may result in an increased frequency of adverse effects. It is recommended that the processing of medicines prior to administration be avoided.

Mutsuhiro Nakao, Hokuto Morohoshi, Yumiko Kurata, Akiou Nakamura. Clin Psychopharmacol Neurosci -0001;0:. https://doi.org/10.9758/cpn.26.1407

Hormone therapy (HT) is an effective treatment for menopausal symptoms, but its use has changed substantially since publication of the Women’s Health

BackgroundKampo medicine, the traditional Japanese system of herbal medicine, is widely integrated into contemporary medical practice in Japan. However, comprehensive evaluations of long-term prescribing patterns across multiple Kampo formulations remain limited.ObjectivesTo characterize utilization patterns of major Kampo medicines in a Japanese tertiary-care hospital using prescription- and patient-level data collected over 21 years.Materials and methodsWe conducted a retrospective database study of all Kampo prescriptions issued at a Japanese university hospital between April 2001 and March 2022. Prescription-based analyses examined prescription numbers, total prescription days, and cumulative prescribed amounts. Patient-based analyses evaluated treated patients, age, sex, initial prescribing department, inpatient status at first prescription, and prescription-to-patient ratios.ResultsKampo medicines accounted for 288,815 prescriptions (1.7% of all prescriptions) and were prescribed to 57,634 patients (4.4% of all patients). Daikenchuto ranked first in patient numbers, prescriptions, total prescription days, and cumulative prescribed amounts. Distinct prescribing patterns were observed among formulations. Based on prescription-to-patient ratios, demographics, and clinical settings, major Kampo medicines were classified into four groups: acute symptomatic medicines (Kakkonto, Bakumondoto, and Shoseiryuto), chronic management medicines (Hochuekkito, Rikkunshito, Yokukansan, and Goshajinkigan), inpatient/perioperative medicines (Daikenchuto and Shakuyakukanzoto), and women’s health medicines (Tokishakuyakusan and Kamishoyosan). Daikenchuto showed a particularly high rate of inpatient initiation.ConclusionsThis 21-year real-world analysis identified distinct functional prescribing patterns among major Kampo medicines and provides a comprehensive overview of Kampo utilization in contemporary Japanese hospital practice.