European journal of hospital pharmacy : science and practice最新文献

{"title":"Stability study of topotecan in ophthalmic prefilled syringes for intravitreal delivery.","authors":"William Bello, Camille Hosotte, Camille Stampfli, Antoine Pierrot, Francis L Munier, Markoulina Berger-Gryllaki, Julian Pezzatti, Laurent Carrez, Farshid Sadeghipour","doi":"10.1136/ejhpharm-2024-004346","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004346","url":null,"abstract":"<p><strong>Background: </strong>Intravitreal and intracameral administration of melphalan and topotecan (TPT) has shown its efficacy in the treatment of retinoblastoma over the last few years. Due to rapid hydrolysis, melphalan must be administered within the hour following reconstitution. With improved stability at room temperature and reduced ocular toxicity, TPT seems to be a promising candidate for production of prefilled syringes in terms of safety and efficiency of preparation and treatment administration. Due to the lack of TPT stability data, the stability of TPT at 20 µg/mL and 200 µg/mL in prefilled syringes was evaluated in three different storage conditions.</p><p><strong>Methods: </strong>The stability of TPT in prefilled syringes was assessed via reversed-phase liquid chromatography coupled to a diode array detector analytical platform. The physicochemical stability of TPT in prefilled syringes in both concentrations, stored at 30±2°C with a relative humidity (RH) of 65±5%, 5±3°C, and -20±5°C, was evaluated over 12 months including visual inspection and pH measurement.</p><p><strong>Results: </strong>TPT solution in syringes at 20 µg/mL and 200 µg/mL was stable at 5±3°C and -20±5°C for up to 12 months, with no precipitate and no significant change in pH and concentration. A TPT-related degradant, 8-methoxy-TPT, was detected at <0.5% only in 30±2°C (65±5% RH) after 3 months.</p><p><strong>Conclusion: </strong>This study demonstrated that TPT solutions at 20 µg/mL and 200 µg/mL conditioned in BBraun Omnifix syringes could be stored at 5±3°C for 12 months for safe and secure administration to patients.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplants from paracetamol overdose: is it time to rethink OTC availability?","authors":"Victoria Weisbrod, Alessio Provenzani","doi":"10.1136/ejhpharm-2024-004434","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004434","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of design thinking to develop a benchmarking tool to assess documentation procedures in a hospital pharmacy aseptic compounding unit: a case study.","authors":"Noelle Murphy, Evelyn Garvey, Bernard D Naughton","doi":"10.1136/ejhpharm-2024-004178","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004178","url":null,"abstract":"<p><strong>Objectives: </strong>This paper combines the concepts of design thinking and benchmarking in an aseptic manufacturing context. Design thinking is a problem-solving approach that aims to understand user needs, generate ideas, prototypes and test solutions. There are no published examples in the Irish healthcare setting. There are also no national legislative frameworks in Ireland for compounding medicine in unlicensed hospital aseptic compounding units (ACUs). This study aims to apply design thinking principles to the development of a benchmarking process in the absence of existing frameworks.</p><p><strong>Methods: </strong>A literature review of design thinking research and international best practice guidelines regarding sterile product manufacture documentation was undertaken to develop an initial prototype benchmarking tool. Design thinking principles were implemented by recruiting and empathising with key senior stakeholders (N=5). Semistructured interviews were conducted with these stakeholders to aid the defining, ideation and optimisation of the prototype tool. The optimised tool was then prototyped and tested in practice by end users (N=11), within an Irish ACU. End users were interviewed regarding their experience of using the tool. Transcripts of interviews were coded, and thematic analysis was undertaken to generate overarching themes to support its further development.</p><p><strong>Results: </strong>The design thinking approach enabled the development of a benchmarking tool, which was optimised by empathising with key stakeholders. Through the process of empathising, defining, ideation, prototyping and testing, a useful benchmarking tool was developed which was deemed appropriate and accepted by its users.</p><p><strong>Conclusions: </strong>Design thinking provides a platform for collaboration to deliver innovation and drive quality improvement in healthcare settings. The design thinking process was successful in delivering a user-centred tool for documentation procedures in an aseptic unit, which was accepted for use by end users. When exisiting guidleines and regulations are considered, design thinking shows promise as an innovation tool in Irish aseptic units, manufacturing facilities and the wider healthcare context.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drugs associated with tachyphylaxis: results from a retrospective pharmacovigilance study using disproportionality analysis.","authors":"Kannan Sridharan","doi":"10.1136/ejhpharm-2024-004353","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004353","url":null,"abstract":"<p><strong>Background: </strong>Tachyphylaxis is the rapid development of drug tolerance following repeated administration.</p><p><strong>Objectives: </strong>To evaluate the United States Food and Drug Administration Adverse Event Reporting System (USFDA AERS) data for drugs significantly associated with tachyphylaxis using disproportionality analysis.</p><p><strong>Methods: </strong>Disproportionality analysis was used for detecting safety signals for identifying drugs associated with tachyphylaxis. Frequentist and Bayesian statistical methods were employed to detect signals, identifying anesthetics, immunosuppressants, antineoplastics, and psychoactive drugs with positive associations.</p><p><strong>Results: </strong>Data from 29,153,222 reports between 2004 and 2024 were examined, and 242 reports of tachyphylaxis included. Tachyphylaxis was observed with corticosteroids, opioids, antihistamines, psycholeptics, nitroglycerin, antineoplastics, immunosuppressants, sympathomimetics, psychoanaleptics and psycholeptics that are well documented. Tachyphylaxis was also observed with propofol, cisatracurium, oxcarbazepine, and cabergoline emphasizing the need for further investigation. Hospitalization was reported in 16.9% of cases, with 5% leading to disability and 2.5% resulting in death.</p><p><strong>Conclusion: </strong>While this study provides valuable insights into drug-related tachyphylaxis, limitations such as underreporting and lack of detailed clinical context exist. Future research should focus on understanding underlying mechanisms and developing strategies to mitigate tachyphylaxis in long-term treatments.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a 50% (w/v) aluminium chloride hexahydrate solution as haemostatic agent.","authors":"Cécile Briot, Pierre Cassier, Isabelle Fredenucci, Alicia Ehmke, François Durupt, Camille Merienne, Thomas Briot","doi":"10.1136/ejhpharm-2024-004356","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004356","url":null,"abstract":"<p><strong>Objectives: </strong>Acceleration of the haemostasis process after dermatological surgery predominantly relies on mechanical methods, such as the use of sutures or staples. To our knowledge, there is currently no commercialised haemostatic agent for this specific application. Due to the protein precipitation properties of the 50% (w/v) aluminium chloride hexahydrate solution, its physicochemical stability and maintenance of sterility over a 6 month period were assessed.</p><p><strong>Methods: </strong>Aluminium chloride hexahydrate was dissolved in sterile water to obtain a 50% (w/v) solution, which was subsequently sterilised through filtration. The solution was then placed in brown glass vials and kept at 20-25°C. The physicochemical stability and sterility of the solution were assessed at four different time points (D0, M1, M3 and M6). At each time point, pH and osmolality were measured, the chloride concentration of the sample was evaluated using the Mohr method, and aluminium identification was carried out through a precipitation method. In addition, the sterility of the solution was also assessed at each time point, according to the European Pharmacopoeia method.</p><p><strong>Results: </strong>The pH, osmolality and chloride concentration values remained stable and were concordant with the expected values throughout the study. Aluminium was identified in each sample. The sterility of the solution was maintained over the study period.</p><p><strong>Conclusions: </strong>The physicochemical stability and sterility of the 50% (w/v) aluminium chloride hexahydrate solution were maintained for 6 months. These results indicate that the solution can be prepared in advance.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialisation School of Hospital Pharmacy, Italy: advancing excellence and fostering global unity.","authors":"Andrea Falzon, Cristiana Bruno, Roberto Brunoro, Giaime Maria Corda, Luigi Fortino, Esteban Zavaleta","doi":"10.1136/ejhpharm-2024-004447","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004447","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The environmental impact of inhalers: a framework for sustainable prescription practices in Spain.","authors":"Noé Garin, Borja Zarate-Tamames, Unax Lertxundi, Ivan Martin da Silva, Gorka Orive, Astrid Crespo-Lessmann, David De la Rosa","doi":"10.1136/ejhpharm-2024-004402","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004402","url":null,"abstract":"<p><strong>Background: </strong>The healthcare sector contributes significantly to global greenhouse emissions, with inhalers being major contributors.</p><p><strong>Objective: </strong>To develop a framework for reducing the environmental footprint of inhalers in Spain by implementing greener prescription practices.</p><p><strong>Methods: </strong>A multidisciplinary working group was formed, including hospital pharmacists, pulmonologists, and environmental experts. We created a comprehensive database on the environmental impact of inhalers marketed in Spain, incorporating product specifications and environmental data from the Spanish Agency of Medicines and Medical Devices and pharmaceutical companies. We developed a decision-making algorithm integrating clinical and environmental criteria and performed scenario projections to estimate potential benefits of transitioning from pressurised metered-dose inhalers (pMDIs) to dry powder inhalers (DPIs) and other eco-friendly alternatives. Scenarios included global and individual projections, as well as comparisons between sustainable prescriptions and waste-management strategies.</p><p><strong>Results: </strong>The national database revealed significant variability in the carbon footprint across inhaler types, with pMDIs showing the highest emissions. A shift of 10% from pMDIs to DPIs could reduce CO₂ emissions by approximately 40 000 tonnes/year, and a 50% shift by up to 200 000 tonnes. The decision-making algorithm effectively combined clinical and environmental considerations, facilitating the selection of more sustainable inhalers.</p><p><strong>Conclusion: </strong>The study highlights the importance of incorporating environmental criteria into inhaler prescribing choices to reduce healthcare's carbon footprint. Transitioning from pMDIs to DPIs when clinically indicated offers considerable environmental benefits without compromising patient health. The developed decision-making algorithm provides a practical tool for healthcare professionals, balancing clinical efficacy with sustainability. Future research should refine these practices and explore their application in other medical devices.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of heparin-induced thrombocytopenia during extracorporeal membrane oxygenation support: a case of neutropenia caused by argatroban anticoagulation.","authors":"Javier Gómez-Alonso, María Martínez Martínez, Camilo Andrés Bonilla Rojas, Héctor Carlos García Díaz, Jordi Riera Del Brio, Mª Queralt Gorgas Torner, Laura Doménech-Moral","doi":"10.1136/ejhpharm-2023-003914","DOIUrl":"10.1136/ejhpharm-2023-003914","url":null,"abstract":"<p><p>We present the case of a man in his 70s admitted to the intensive care unit (ICU) after mitral valve replacement and coronary artery bypass graft surgery requiring extracorporeal membrane oxygenation support due to haemodynamic instability. He received anticoagulation therapy with heparin sodium and, after 5 days, the patient presented with thrombocytopenia and deep venous thrombosis. Heparin-induced thrombocytopenia was suspected based on a positive 4T score and confirmed by antiplatelet factor 4/heparin antibodies, so argatroban was initiated as an alternative anticoagulation therapy. In the following days the patient developed severe neutropenia requiring discontinuation of argatroban and the administration of granulocyte colony-stimulating factor. According to the Naranjo Adverse Drug Reaction Probability Scale, this event would be classified as a 'probable' argatroban-related adverse event. Argatroban should be conisdered as a possible cause of neutropenia and appropriate interventions need to be implemented due to the gravity of this adverse event in the ICU.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Losartan potassium liquid formulation for paediatric hospital use: development and stability evaluation.","authors":"Augusto César Corte, Caren Gobetti, Graciela Carlos, Sílvia Helena de Oliveira Almeida, Márcio Vinícius Ayres, Martin Steppe, Cassia Virginia Garcia","doi":"10.1136/ejhpharm-2023-004026","DOIUrl":"10.1136/ejhpharm-2023-004026","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop a liquid oral formulation containing losartan potassium, an angiotensin II receptor antagonist drug used for its antihypertensive activity, and to perform a preliminary stability assessment under different temperatures and packages to ensure paediatric therapeutic adherence and facilitate the hospital routine.</p><p><strong>Methods: </strong>A syrup containing losartan potassium (1.0 and 2.5 mg/mL) (excipients: potassium sorbate, sucrose (85%), water, citric acid and raspberry flavouring) was prepared. The packaging was carried out in amber polyethylene terephthalate (PET) and amber glass bottles (in triplicate) under the following conditions: (a) room temperature (15-30°C); (b) refrigeration (2-8°C); and (c) oven temperature (40°C) for 28 days. An analytical method by high performance liquid chromatography using a reverse-phase column was also developed and validated for quantitative determination of the drug in the formulations.</p><p><strong>Results: </strong>The analytical method showed satisfactory linearity, detection and quantification limits, precision, accuracy and robustness. Samples at room temperature maintained content values between 90% and 110% for 7 days, while those stored under refrigeration maintained a homogeneous appearance and content between 90% and 110% for a period of 21 days. Values of pH stayed in a narrow range. Viscosity results were between 40.1 and 49.2 centipoise (cp) for glass bottles and 42.4 and 54.7 cp for PET bottles.</p><p><strong>Conclusions: </strong>A simple and economical losartan potassium liquid formulation was produced and was shown to be stable under refrigeration for 21 days in both PET and glass packages.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and economic benefits of expanded access programs: should we strengthen these pharmacist-led initiatives?","authors":"Marcella Mezza, Roberto Brunoro, Girolama Iadicicco, Mariassunta Miscio, Daniele Mengato, Dario Gregori, Francesca Venturini","doi":"10.1136/ejhpharm-2024-004258","DOIUrl":"10.1136/ejhpharm-2024-004258","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}