FARMACIA HOSPITALARIA最新文献

{"title":"Sepsis y shock séptico","authors":"Carla Bastida ,&nbsp;Amaia Egües Lugea ,&nbsp;Aurora Fernández Polo ,&nbsp;Fernando Becerril Moreno ,&nbsp;Maria Martín Cerezuela ,&nbsp;Esther Domingo Chiva ,&nbsp;Tatiana Betancor García ,&nbsp;Miguel Angel Amor García ,&nbsp;Irene Aquerreta González ,&nbsp;Marta Albanell-Fernández ,&nbsp;Laura Doménech Moral ,&nbsp;Sara Ortiz Pérez ,&nbsp;Sara Cobo Sacristán","doi":"10.1016/j.farma.2025.05.009","DOIUrl":"10.1016/j.farma.2025.05.009","url":null,"abstract":"<div><div>Sepsis and septic shock are major global health issues, with significant morbidity and mortality. Early identification and appropriate management during the first few hours are crucial for improving clinical outcomes.</div><div>Sepsis treatment focuses on infection control, restoration of perfusion, and the implementation of adjunctive therapies. A thorough understanding of these approaches is essential for the clinical pharmacist in the intensive care unit to provide optimal pharmacotherapeutic validation.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"50 2","pages":"Pages 108-114"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Ethical approach to pain management in pediatric patients in a terminal situation: A systematic review","authors":"Cristina Casanova-Martínez ,&nbsp;Mónica Gayoso-Rey","doi":"10.1016/j.farma.2025.11.004","DOIUrl":"10.1016/j.farma.2025.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric palliative care aims to provide a professional, scientific, and compassionate response to the needs of terminally ill pediatric patients, with pain management being one of its fundamental pillars. This systematic review analyzes the ethical aspects involved in the management of pain in pediatric patients at the end of life, using the core principles of clinical bioethics: autonomy, beneficence, non-maleficence, and justice as a framework.</div></div><div><h3>Materials and methods</h3><div>A systematic review was conducted following the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Original qualitative or quantitative studies published between 2010 and 2024 in English or Spanish were included, provided they addressed pain management in pediatric palliative care from an ethical perspective. The databases consulted were PubMed, Scopus, and Web of Science. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).</div></div><div><h3>Results</h3><div>A total of 18 studies met the inclusion criteria. Autonomy was addressed in a limited manner, often through indirect participation of the child via their caregivers. The principles of beneficence and non-maleficence were compromised by the underuse of analgesics due to fear of adverse effects, delays in referral to palliative care, and the continuation of futile treatments. The principle of justice was reflected in structural barriers, unequal access to opioids, and limited availability of specialized care, particularly in resource-limited settings.</div></div><div><h3>Conclusions</h3><div>Bioethical principles are present in the management of terminal pediatric pain, but their application remains inconsistent. There is a clear need to enhance professional training, implement standardized clinical protocols, and promote effective communication with families.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"50 2","pages":"Pages T128-T135"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Complete resolution of rupiaceous psoriasis associated with arthropathy with guselkumab: A case report","authors":"Andrea Pinilla Rello ,&nbsp;Eva Queipo García ,&nbsp;Mª Victoria Corriol Pallas ,&nbsp;Adrián Diago Irache","doi":"10.1016/j.farma.2025.11.008","DOIUrl":"10.1016/j.farma.2025.11.008","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"50 2","pages":"Pages T136-T138"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Multidrug-resistant extra-pulmonary tuberculosis in a hemodialysis patient treated with bedaquiline and tedizolid. A case report and a literature review.","authors":"Paula Novo González, Irene Galindo Marín, Elena García Benayas, Carmen Mon Mon, Rafael Torres Perea, Sara Hernández Egido","doi":"10.1016/j.farma.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.010","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of three-compartment parenteral nutrition bags to current European guidelines for adults: a simulation study.","authors":"Marta de Antonio-Cuscó, Agustí Albalat-Torres, Javier Mateu-de Antonio","doi":"10.1016/j.farma.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.farma.2026.01.001","url":null,"abstract":"<p><strong>Introduction: </strong>The use of three-compartment parenteral nutrition bags (3CPNBs) has widely expanded due to their potential time- and cost-saving advantages compared to hospital-compounded parenteral nutrition bags (HCPNBs). However, there is limited evidence of commercial 3CPNBs to adequately meet current nutritional guidelines.</p><p><strong>Objectives: </strong>This study assessed the nutritional adequacy of all commercial 3CPNBs available in Spain, according to current European guidelines, across four clinical scenarios for adult patients.</p><p><strong>Methods: </strong>A simulation-based study was performed to evaluate the protein and caloric content of 3CPNBs commercially available in Spain. Four clinical scenarios were defined: early and late phases of intensive care (I1 and I2), surgical (Q), and medical (M) inpatients. Two sub-analyses were conducted: a 3CNPB-centered assessment of each formulation's theoretical adequacy for each scenario, and a patient-centered analysis involving 1000 simulated adult patients per scenario (total: 4000 simulations). Patients' weight was computer generated reflecting the published Spanish adult-population values (tested by the Anderson-Darling test and one-sample t-test). Nutritional requirements were calculated using ESPEN guidelines, and adequacy was defined as meeting protein and caloric targets within ±5% range. 3CPNBs were further screened for guideline-concordant composition.</p><p><strong>Results: </strong>A total of 50 commercial 3CPNBs were identified, but 15 bags (30.0%) were excluded based on predefined criteria. Then, 35 were included in the study. While 51.4% formulations met adequacy criteria across all scenarios, 34.3% were suitable for only one, and 8.6% were unsuitable for any scenario. More than half (57.1%) failed to cover even 10% of patients in any scenario. ICU scenarios, I1 and I2, showed the lowest coverage, with only around 30% of patients with an appropriate 3CPNBs. Many weight strata showed less than 50% coverage depending on the scenario. In the 64-81,99 kg strata, around the population mean, 45.9% lacked an appropriate 3CPNBs across all scenarios.</p><p><strong>Conclusions: </strong>Substantial variability existed in the adequacy of commercial 3CPNBs to ESPEN guidelines. Many formulations failed to meet the criteria or were not usable across all scenarios. Many patients with body weight around population mean had no adequate 3CPNBs. These findings supported the need for critical evaluation of 3CPNBs and still place HCPNBs as a flexible alternative, especially in complex and critically ill populations.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the development and validation of a questionnaire to evaluate user-robot interaction in the compounding of hazardous drugs in a hospital setting.","authors":"Cristina Fernández-López, María Calvo-Arbeloa, Paz Pacheco-Ramos, Carmen María Valencia-Soto, Leticia Garrido-Sánchez, Sandra Fontanals-Martínez","doi":"10.1016/j.farma.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.farma.2026.01.005","url":null,"abstract":"<p><strong>Introduction: </strong>The automation of hazardous drug preparation in hospitals using robotic systems is an effective strategy to enhance safety, quality, and process efficiency. However, its implementation introduces a novel user-robot interaction that transforms professional roles, tasks, and training needs. The acceptance of this technology depends on human, technical, and organizational factors. At present, no validated tool exists to specifically assess user-robot interaction in the preparation of hazardous drugs, whether in industrial or healthcare settings. Therefore, this study aims to develop and validate a questionnaire to evaluate such interaction in hospital settings.</p><p><strong>Methods: </strong>This multicenter study will be conducted across five Spanish hospitals equipped with robotic systems for hazardous drugs compounding. The study population will include pharmacy technicians, nurses, and other healthcare professionals who operate these systems. The questionnaire will be developed using the Delphi method, a rigorous consensus process involving a panel of experts. Data collection will be conducted using the REDCap (Research Electronic Data Capture) platform. The validation process will assess: face validity (clarity and coherence of the questionnaire), content validity (relevance of the included items), criterion validity (correlation with an established external criterion), construct validity (consistency between the items and the construct under investigation), and internal consistency (measured using Cronbach's alpha).</p><p><strong>Conclusions: </strong>This study is the first initiative to develop and validate an instrument specifically designed to evaluate human-robot interaction in the preparation of hazardous drugs. Its implementation will support the identification of barriers and facilitators to the adoption of robotic systems in clinical practice, guide the design of specific training programs, and contribute to the optimization of medication preparation workflows in hospital settings.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender perspective in medication-related problems resulting in emergency department attendance involving high-alert medications.","authors":"Concepción Marín de la Bárcena, Jesús Ruiz Ramos, Mireia Puig Campmany, María José Otero, Ana Juanes Borrego","doi":"10.1016/j.farma.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.farma.2026.01.004","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize medication-related problems resulting in emergency department attendance involving high-alert medications, paying particular attention to sex-related differences in the type of the problem and medication associated with it.</p><p><strong>Methods: </strong>Retrospective observational study (2021-2022) based on the medical history at discharge, including adult patients seeking emergency department due to medication-related problems as a primary or secondary diagnosis. Patient grouping was performed according to the class of medication implicated in the event, as defined by the reference list of high-alert drugs for chronic patients (HAMC list). Sociodemographic and clinical baseline variables were collected. To explore gender differences in the type of problem and drug involved, statistical analysis included binomial tests and binary logistic regression with odds ratio estimation.</p><p><strong>Results: </strong>Among the 1,611 adult patients admitted to the emergency department with adverse events associated with a medication problem, 1,028 (64%) involved a high-alert medication. Women with moderate- and high-risk comorbidity showed a significative greater incidence of medication-related problems. Gender differences were particularly notable for events associated with loop diuretics (136 women [70%] vs 57 men [30%], p = 0.000); antipsychotics (30 women [65%] vs 16 men [35%], p = 0.039); opioids (37 women [73%] vs 11 men [27%], p = 0.000] and digoxin (22 women [81%] vs 5 men [19%], p = 0.02). Women showed a trend toward higher odds of experiencing unintentional drug poisoning (OR = 2.5; 95% CI: 0.786-8.356; p = 0.119). In contrast, non-adherence to prescribed high-alert medications occurred with greater frequency in men (OR = 0.711, 95% CI: 0.473-1.070; p = 0.102).</p><p><strong>Conclusions: </strong>A considerable proportion of medication-related problems that lead to emergency room attendance involve high-risk medications, and the type of problem presented and the type of drug involved differ between sexes. Findings highlight that addressing gender differences, especially with regard to high-risk medicines, could be crucial in moving toward safer and more equitable healthcare.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for emergency department revisit among elderly patients with gastrointestinal bleeding secondary to oral anticoagulant therapy.","authors":"Andrea Garrido Quintero, Silvia Cercas Lobo, Jesus Ruiz Ramos, Adrián Plaza Díaz, Ane González Díez, Antonio Cañón Santos, Ana Villarejo Jiménez, María Carmenza Pérez Méndez, Mireia Puig Campmany","doi":"10.1016/j.farma.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.farma.2025.12.009","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal bleeding is a frequent cause of emergency department visits among anticoagulated patients. Antidepressants may potentiate bleeding risk by impairing platelet aggregation. The impact of concomitant antidepressant use on emergency room re-visits for gastrointestinal bleeding in anticoagulated elderly patients remains unclear.</p><p><strong>Objective: </strong>This study aimed to assess the risk factors for Emergency Department (ED) re-visit within 90 days after an initial bleeding episode in elderly patients on oral anticoagulant (OAC) therapy.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a hospital in Catalonia, including patients over 65 years treated with OACs who presented to the ED for gastrointestinal bleeding between 2018 and 2024. Data were obtained from electronic health records, including comorbidities, chronic medications, and discharge treatments. The primary outcome was ED revisit for bleeding within 90 days. Multivariate logistic regression was used to identify independent predictors.</p><p><strong>Results: </strong>Of 143 patients included [mean age 82.4 years; 51.7% women], 26.7% were on antidepressants, 8.3% on antiplatelet agents, and 77.6% on proton pump inhibitors. Over a mean follow-up of 90 days, 23,1% patients re-visited the emergency room with bleeding. Univariate analysis identified chronic kidney disease, antidepressant therapy, and antiplatelet use as significant factors. In multivariate models, independent predictors were chronic kidney disease (OR 2.50; 95% CI 1.07-5.85; p = 0.034), antidepressant use (OR 2.56; 95% CI 1.07-6.14; p = 0.034), and concomitant antiplatelet therapy (OR 4.55; 95% CI 1.27-16.28; p = 0.020).</p><p><strong>Conclusions: </strong>In elderly patients anticoagulated, the addition of antidepressants significantly increases the risk of ED re-visit for gastrointestinal bleeding within 90 days. Chronic kidney disease and concomitant antiplatelet therapy also emerge as key risk factors.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacologic and pharmacokinetic factors in blood donation: A risk-based deferral framework proposal.","authors":"Roberto Lozano, María-Esther Franco, Carina Bona","doi":"10.1016/j.farma.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.farma.2025.12.003","url":null,"abstract":"<p><strong>Objective: </strong>The presence of residual medications in blood donors can pose a risk to transfusion recipients, especially when drugs remain in plasma at clinically relevant levels. Current deferral recommendations for medicated donors are often generalized and lack pharmacokinetic rigor. This study aims to propose a pharmacologically and pharmacokinetically informed framework for assessing donor eligibility based on drug characteristics.</p><p><strong>Method: </strong>A structured literature review was conducted to evaluate key pharmacokinetic variables affecting drug persistence in blood, including half-life (t_½), time to maximum plasma concentration (t_max), maximum plasma concentration (C_max), and elimination pathways. Medications were stratified into five risk categories according to their pharmacological profile, systemic exposure, and clinical implications. Corresponding deferral periods were assigned to each category. The framework also considers the type of blood component being donated (e.g., plasma-rich vs. cellular products).</p><p><strong>Results: </strong>Medications with long half-lives, genotoxic effects, or antiplatelet activity pose higher transfusion risks and require extended deferral periods. Conversely, drugs with minimal systemic absorption, low plasma bioavailability, or that serve as physiological replacements pose minimal risk and may not warrant deferral. The proposed model aligns deferral recommendations with drug clearance data and product-specific plasma exposure.</p><p><strong>Conclusions: </strong>A pharmacokinetic approach to donor eligibility enhances transfusion safety and supports evidence-based deferral guidelines. Pharmacists and clinicians can collaborate to assess medication risk profiles and optimize donor selection. This model can reduce unnecessary deferrals and maintain blood supply integrity while protecting recipients.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and effectiveness of vutrisiran as treatment for hereditary transthyretin amyloidosis.","authors":"Javier Corazón Villanueva, Ana Andrea García Sacristán","doi":"10.1016/j.farma.2025.12.010","DOIUrl":"https://doi.org/10.1016/j.farma.2025.12.010","url":null,"abstract":"<p><strong>Objectives: </strong>To assess changes in quality of life in patients with rare disease hereditary transthyretin amyloidosis after initiating vutrisiran. Secondary objectives included evaluating effectiveness and safety.</p><p><strong>Methods: </strong>Prospective, observational study, conducted in a real-world clinical setting between November 2023 and May 2024. Quality of life was assessed using Norfolk QOL-DN questionnaire at baseline and six months after treatment initiation. Statistical analysis was performed using SPSS Statistics®, and the Wilcoxon signed-rank test was applied to compare outcomes.</p><p><strong>Results: </strong>Twenty-five patients were included. The median Norfolk QOL-DN score changed from 54 [40.5; 77.5] to 48 [32.0; 83.0] after six months (p = 0.935). NIS scores decreased from 41 [14.0; 70] to 22 [6.0; 66.5] (p = 0.177). Serum TTR levels were maintained or reduced to undetectable levels in all patients. NT-proBNP decreased from 464.0 [102.0; 827.0] to 345.0 pg/mL [146.0; 995.0] (p = 0.518). No treatment-related adverse events were reported.</p><p><strong>Conclusion: </strong>Although statistical significance was not reached, vutrisiran maintained or improved quality of life and clinical status in a real-world population that was more pretreated and had greater disease burden than the clinical trial. Combined with its favorable safety profile, subcutaneous administration, and extended dosing interval-preferred by patients-vutrisiran represents a promising therapeutic option for ATTRv amyloidosis. Long-term real-world studies are warranted to confirm these findings.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}