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Objectives. The implementation of dose-banding (DB) in centralised, pharmacy-based cytotoxic drug preparation units allows the preparation of standardised doses in series. The aim of this study was to evaluate the feasibility of DB for the prescribing of ganciclovir (GV) infusion solutions and to investigate the microbiological stability of dose-banded, automatically prepared ready-to-administer GV infusion bags by media-fill simulation tests and sterility tests. Methods. The frequency of prescription of GV doses was retrospectively analysed before and after implementing the DB scheme. Four dose-ranges or ‘bands’ and the corresponding standard doses (250, 300, 350, 400 mg) were identified. The maximum variance was set at ±10% of the individua.
This article focuses on the reconstitution of parenteral medicines and the work that has been carried out at the European level to improve patient safety. Reconstitution may occur in a clinical area, for example, ward, theatre and so on, or within pharmacy. The quality of reconstituted medicines should ideally be the same, regardless of where reconstitution takes place. However, in practice, risks are greater when reconstitution is carried out in clinical areas. Although ideally all reconstitutions should be carried out within pharmacy aseptic units, capacity is generally not available to allow this, so a risk assessment approach must be taken to enable the healthcare establishment to decide which products must be reconstituted in pharmacy
Haematologic side effects associated with piperacillin/tazobactam (PTZ) treatment are rare but can be fatal. The exact mechanism by which PTZ causes haemorrhages has not been determined. We report the case of a patient who received PTZ treatment and developed a coagulopathy through a vitamin K-dependent mechanism. A 70-year-old female patient was admitted to the intensive care unit because she had a severe case of pneumonia and a pulmonary thromboembolism. Empirical antibiotic treatment using PTZ was started. Her international normalised ratio (INR) was already increased and became elevated again when PTZ was restarted. Her coagulopathy was reversed by supplementation with vitamin K. We conclude that PTZ can induce coagulopathy through a vi.
Objectives. Our goal was to explore the pharmaceutical service and teaching methods of obstetric clinical pharmacists to establish standardised pharmaceutical care procedures for obstetric diseases. Methods. According to the evidence-based medicine method, the "Standard of Pharmaceutical Care" was established to standardise the procedure and content of the pharmaceutical care procedure including preface, purpose, scope of application, responsibilities, procedures, references, and appendix, with seven parts in total.
The aim of the study was to explore the involvement of interleukin 6 in SARS-CoV-2 infection, and to position the drug siltuximab in the management of severe forms of COVID-19. A bibliographic search was performed in Pubmed on the immune response to the disease, and in on clinical trials with interleukin 6 blockers. Interleukin 6 is involved in the cytokine cascade, which originates as a consequence of an excessive immune response secondary to viral infection, aggravating lung affectation. Blockers of this cytokine (tocilizumab, sarilumab and siltuximab) are being studied as a strategy for treating the disease. Siltuximab is a monoclonal antibody indicated in Castleman's disease that could be administered in a single dose.
Objectives. To analyse the results of fluorouracil (5-FU) plasma concentration monitoring in patients with advanced colorectal cancer after 5-FU treatment, and to provide a reference for the application prospect of 5-FU plasma concentration monitoring technology. Methods. A retrospective analysis was performed with advanced colorectal cancer patients treated with 5-FU from March 2015 to August 2018.
Extravasation is the leakage of intravenously administered solution into surrounding tissues, which can cause serious damage to the patient. The impact of extravasation is mostly determined by the localisation and volume of extravasation, but the physicochemical properties of the drugs are also important. In this paper a stepwise approach to managing an extravasation is described, with recommendations on the role of the pharmacist. Information on osmolality, pH, pKa and the buffering capacity of drugs is given in relation to extravasation, which is summarised in a practical crash card that can be used in clinical practice.
Objectives. Although levetiracetam presents an easy dosing and tolerability, therapeutic drug monitoring may be recommended in certain situations. Measurement of levetiracetam in serum plasma is commonly done by high performance liquid chromatography (HPLC). After ARK Diagnostics marketed an enzyme immunoassay (IA) for levetiracetam in serum or plasma, automated determinations are possible. In this study, the performance of this immunoassay and the impact of automation on the follow-up in patients treated with levetiracetam is evaluated . We also detected those subpopulations of patients who may benefit the most from this therapeutic drug monitoring. Methods. Samples from 50 outpatients diagnosed with epilepsy and treated with levetiracetam w.
Objectives. To determine the influence of different buffers, pH and meropenem concentrations on the degradation rates of meropenem in aqueous solution during storage at 32°C, with the aim of developing a formulation suitable for 24-hour infusion in an ambulatory elastomeric device, compliant with the latest National Health Service Pharmaceutical Quality Assurance Committee Yellow Cover Document (YCD) requirements. Methods. Meropenem was diluted to 6.25 mg/mL and 25 mg/mL in aqueous solutions adjusted to various pH with phosphate or citrate buffer and assessed for stability.
Objectives. In recent years, various formulations containing rapamycin, mainly petrolatum-based, have been tested on facial angiofibromas in tuberous sclerosis. They are often poorly tolerated due to irritation and bleeding. In addition, their effectiveness was insufficient in young adults. The objective of this study was to develop and characterise a hydro-alcoholic gel containing solubilised rapamycin. The stability of the product stored at 4°C was evaluated over 1 year. Methods. Two different 0.1% rapamycin gels were formulated with or without α-tocopherol and urea. Different methods were used to characterise the gels: HPLC, gas chromatography, pH, visual observation and optical microscopy. A physico-chemical and microbiological stability
Background and importance. Mitomycin C is used in different regimens for the treatment of bladder, anus and lung cancer. According to the data sheet, reconstitution of the vial should be carried out with water for preparation of injectables or with 20% dextrose. Despite this, sodium chloride solutions are commonly used for its administration. However, it is known that the stability of mitomycin C molecule is affected by the pH of the preparation as degradation increases with pH values <7. Sodium chloride solutions have an approximate pH of 5.4. There are no published data to support how pH affects mitomycin C stability in 0.9% sodium chloride solutions (NSS). Aim and objectives. To study the stability of mitomycin C in NSS under different pH
Objective. Roux-en-Y gastric bypass (RYGB) surgery induces major changes in the gastrointestinal tract that may alter the pharmacokinetics of orally administered drugs. Results from pharmacokinetic studies are sparse. This study aimed to investigate the effect of RYGB on the bioavailability of metoprolol from immediate release (IR) and controlled release (CR) tablets in female patient volunteers before and after surgery. Methods. An explorative, two-phase, single oral dose pharmacokinetic study of metoprolol in female patients undergoing RYGB was carried out. The dose was administered twice in each patient, 1 month before and 6 months after surgery. After intake of either 100 mg of metoprolol IR or CR tablet serum concentration-time profiles
Background and importance. Initially, the aim of centralisation of the management of antiblastic drugs was for the quality of preparations, workers’ protection, patient safety and reduction of the risks associated with environmental contamination. In recent years, optimisation of hospital processes has become more relevant. In 2017, a new time slot model for the delivery of cancer therapies was introduced in the galenic preparation laboratory. This type of model consists of time slots defined on the basis of fixed criteria. Aim and objectives. The aim was to optimise the management of anticancer drugs. Material and methods. A pharmacoeconomic analysis was carried out on anticancer therapies administered in two oncology departments, one of whic.

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