The anticancer drug, paclitaxel, is widely used for ovarian, breast, non-small cell lung, and gastric cancers; however, it induces peripheral neuropathy as a side effect. There is insufficient evidence-based prophylaxis, and new prophylaxis and treatment methods are required. We examined the effect of α1-receptor antagonists on paclitaxel-induced peripheral neuropathy using Sprague-Dawley rats and a large adverse event database. The repeated administration of doxazosin or tamsulosin significantly reduced the response threshold to paclitaxel administration in animal models. In the sciatic nerve tissue, axonal degeneration and myelopathy were significantly suppressed. Furthermore, an analysis of the Food and Drug Administration Adverse Event Reporting System (FAERS) database suggested that the group using α1 inhibitors showed a lower reporting rate for paclitaxel-related peripheral neuropathy than the group that did not use these inhibitors (odds ratio (95% confidence interval): tamsulosin 0.21 (0.08–0.56), p < 0.01, doxazosin 0.41 (0.10–1.65), p = 0.195; any α1 receptor antagonist 0.54 (0.38–0.76), p < 0.01). Thus, doxazosin and tamsulosin may inhibit the development of paclitaxel-induced peripheral neuropathy by suppressing neurodegeneration, particularly axonal degeneration and myelopathy.

Medical expenses are increasing year by year in Japan. However, the quantity of disposed medical opioids is not well known. In this study, we assessed disposed medical opioids in community pharmacies of Fukuoka city and in all of medical organizations of Kumamoto cities for 3 and 2 years, respectively. We collected official opioid disposal reports in Kumamoto city and Fukuoka City Pharmaceutical Association disposal information sheet in Fukuoka city. The total amount of disposed opioids was worth 7.1 million ¥ from 2017 to 2019 in Fukuoka city, and 8.9 million ¥ in for 2 years (2018 and 2019) in Kumamoto city. In Fukuoka city, the most disposed opioid was 20 mg Oxycontin^®, worth approximately 940,000 ¥. In Kumamoto city we assessed data in different organizations. The most disposed opioid was 5 mg Oxinorm^® at a cost of 600,000 ¥ at the medical institutions over the 2-year study period. The most disposed opioid was 40 mg Oxycontin^®, at a cost of 640,000 ¥ in community pharmacies. Two hundred µg E-fen^® buccal tablet was the most disposed of opioid, was amounting to 960,000 ¥ in wholesalers. On the whole in Kumamoto city, non-dispensing was the most common reason of disposal. These results indicate that the amount of disposed opioids is huge. Small package simulation studies suggest that smaller package units of MS-Contin^®, Anpec^® suppository, and Abstral^® sublingual tablet may be able to reduce the amount of disposed opioids.

Freshwater clams (Corbicula spp.), commonly known as shijimi in East Asia, have long been valued for their functional and nutritional properties. In this review, we summarise the physiological effects of hot water extracts derived from Taiwanese freshwater clams (FCE), particularly in relation to metabolic syndrome and other lifestyle-related disorders. Traditionally, shijimi has been used to alleviate hepatic dysfunction and symptoms associated with alcohol consumption. FCE significantly suppresses galactosamine-induced increases in serum aspartate aminotransferase and alanine aminotransferase. In addition, FCE reduces alcohol-induced hepatic lipid accumulation and lowers hepatic cholesterol levels. FCE also influences alcohol metabolism: animals receiving FCE exhibit lower blood alcohol concentrations and a faster rate of alcohol clearance following ethanol administration. These findings suggest that shijimi may protect against alcohol- or drug-induced liver damage, potentially by enhancing alcohol metabolism. Beyond its role in liver protection, shijimi has been associated with the alleviation of jaundice, possibly through increased bile secretion linked to improved cholesterol homeostasis. Supporting this, studies using models of exogenous hypercholesterolemia show that FCE lowers both serum and hepatic cholesterol levels in a dose-dependent manner. Overall, traditional claims regarding the hepatoprotective effects of shijimi are increasingly supported by mechanistic and molecular evidence. This is the first clarified review of the various effects of shijimi.