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European Journal of Hospital Pharmacy : Science and Practice (EJHP)
Journal Prestige (SJR): 0.213
Number of Followers: 5  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2047-9956 - ISSN (Online) 2047-9964
Published by BMJ Publishing Group Homepage  [62 journals]
  • SARS-CoV-2: an opportunity for hospital pharmacy

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      Authors: Claramunt Garcia, R; Munoz-Cid, C. L, Sanchez Ruiz, A.
      Keywords: COVID-19
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2021-002859
      Issue No: Vol. 29, No. 5 (2022)
       
  • EJHPs impact factor moves on up

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      Authors: Wiffen; P.
      Pages: 241 - 241
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2022-003498
      Issue No: Vol. 29, No. 5 (2022)
       
  • Lessons learnt from the COVID-19 pandemic: results of EAHP survey on the
           future crisis preparedness of hospital pharmacies

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      Authors: Leonardi Vinci, D; Polidori, P, Miljkovic, N, Batista, A, Amann, S, Makridaki, D, Kohl, S.
      Pages: 242 - 247
      Abstract: AimThe present survey aimed to collect information on the lessons learnt from the COVID-19 pandemic by hospital pharmacists. It focused on the shortages of health goods and the experiences of hospitals during the first phase of the crisis.MethodsA 17-question survey was conducted by EAHP, looking at the experiences of hospital pharmacists during the COVD-19 pandemic. The survey ran from 16 September to 23 December 2020. Statistical analysis included backward stepwise logistic regression (BSLR), Pearson’s 2 test, t-test and one-way ANOVA, as appropriate; p≤0.05 was considered statistically significant.Results1466 hospital pharmacists answered the survey fully. 58%, 63% and 69% of them experienced shortages in medicines, disinfectants and personal protective equipment (PPE), respectively. BSLR showed that being a COVID-19 dedicated hospital increased the risk of medicine shortages (OR 1.63, 95% CI 1.15 to 2.31) but the shortages of disinfectants and PPE were lower (OR 0.62, 95% CI 0.44 to 0.88; OR 0.60, 95% CI 0.42 to 0.85). Being a specialised hospital reduced the odds of medicine shortages (OR 0.59, 95% CI 0.40 to 0.88), while countries with a greater percentage of the population infected had increased odds for all three types of shortages (OR 1.16, 95% CI 1.01 to 1.23; OR 1.34, 95% CI 1.19 to 1.50; OR 1.21, 95% CI 1.09 to 1.35). The odds were also higher in answers submitted in September compared with December. The classes of medicines with highest reported shortages were anaesthetics, antibiotics and muscle relaxants. The main entities that provided support were the national competent authorities and manufacturers.ConclusionMedicine shortages affected the work of hospital pharmacists during the early stages of the pandemic. The features of the crisis and the feedback described in this survey can provide interesting insights for a more resilient healthcare framework in the future.
      Keywords: COVID-19
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2021-002944
      Issue No: Vol. 29, No. 5 (2022)
       
  • Science- and risk-based strategy to qualify prefillable autoclavable
           syringes as primary packaging material

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      Authors: Larmene-Beld, K; Wijnsma, R, Kuiper, A, van Berkel, S, Robben, H, Taxis, K, Frijlink, H.
      Pages: 248 - 254
      Abstract: ObjectivesTo develop a science and risk based strategy to qualify a prefillable autoclavable cyclic olefin polymer (COP) syringe as a container for multiple drug products in a hospital pharmacy settingMethodsDifferent extraction studies were performed with different solution characteristics: phosphate buffer batches (Na2HPO4 / NaH2PO4 in NaCl 0.9%) at different pH values, NaCl 0.9% batches, isopropyl alcohol (IPA) 5% in water and batches with Water For Injections (WFI) at different pH values. The filled syringes were terminally sterilised. The syringes were stored at room temperature (20°C±5°C).Following different monographs of the European Pharmacopoeia several tests were performed on the different batches. Analyses were performed at t=0, 1, 2, 3, 4, 5, 6, 9, 12, 18, 24 and 36 months for the general tests. For the subvisible particles, sterility and closure integrity a bracketing scheme was applied during 36 months.ResultsLow levels of extractables were measured for the different solutions. The test for subvisible particles, sterility and closure integrity all met predefined requirements. In the 5mL and 50mL syringes different concentrations of silicon were measured. Overall higher silicon concentrations were measured for the 50mL syringes.ConclusionsThe chosen strategy for the qualification program provided an adequate understanding about the extractables that could leak from the syringes. The cyclic olefin polymer syringes including stopper and tip cap were found to be suitable as primary packaging materials for the production of water based products.
      Keywords: EAHP Statement 3: Production and Compounding
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002333
      Issue No: Vol. 29, No. 5 (2022)
       
  • Evaluation of medication dose adjustments in patients with impaired renal
           function using different online drug information databases

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      Authors: Sancar, M; Altiparmak, O, Altan, A, Demirtunc, R, Izzettin, F. V, Okuyan, B.
      Pages: 255 - 258
      Abstract: ObjectivesClinical pharmacist-led medication dose adjustment is required to provide safe and effective pharmacotherapy in patients with impaired renal function. This study aimed to assess clinical pharmacist-led medication dose adjustments in hospitalised patients with impaired renal function by comparing three online drug information databases.MethodsThis retrospective observational study was conducted in an internal medicine ward between November 2016 and February 2017 among hospitalised patients with at least one estimated glomerular filtration rate (eGFR) value
      Keywords: EAHP Statement 4: Clinical Pharmacy Services
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002395
      Issue No: Vol. 29, No. 5 (2022)
       
  • Lopinavir/ritonavir, a new galenic oral formulation from commercial solid
           form, fine-tuned by nuclear magnetic resonance spectroscopy

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      Authors: Desideri, I; Martinelli, C, Ciuti, S, Uccello Barretta, G, Balzano, F.
      Pages: 259 - 263
      Abstract: ObjectivesThe lopinavir/ritonavir combination is one of the first antiretroviral drugs to be used in the treatment of COVID-19. In incapacitated patients, such as those in intensive care, an oral liquid formulation is needed. In Italy a marketed formulation is available, but only by importing it from other European countries. A galenic oral formulation prepared in the hospital pharmacy from lopinavir/ritonavir tablets was fine-tuned, evaluating the content of the active pharmaceutical ingredient (API) and stability of the formulation by using nuclear magnetic resonance (NMR) spectroscopy.MethodsTo overcome the insolubility of lopinavir/ritonavir in water, ethanol and glycerol have been used as additional excipients. To define the best excipient proportion and best preparation method, three different formulations (ethanol 7.1–7.5%, glycerol 6–15%, and water) and two different preparation procedures (two step vs one step) have been studied. Each formulation has been compared with Kaletra oral solution (lopinavir 80 mg/mL, ritonavir 20 mg/mL) by NMR spectroscopy. API content and stability were measured.ResultsThe presence of ethanol and glycerol as co-solvents is crucial both to improve solubilisation and promote the stability of the oral form. In the two-step preparation method, when crushed tablets were first dispersed in the ethanol/glycerol mixture and then in water, the content of solubilised active ingredients was equal or only slightly lower than the standard Kaletra (range 89–100%). The one-step method provided a comparable API content (65%) to that obtained by using water as the sole dispersing medium.ConclusionsThe two-step setup method with final 7.1% ethanol and 11% glycerol concentration is an efficient procedure for extemporaneous preparation of lopinavir/ritonavir liquid formulations from crushed tablets. The method combines simplicity of preparation and reconstitution in the hospital ward with good solubilisation, comparable to the commercial solution, and stability of active ingredients over time.
      Keywords: EAHP Statement 3: Production and Compounding, COVID-19
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002389
      Issue No: Vol. 29, No. 5 (2022)
       
  • Development and validation of a ready-to-use score to prioritise
           medication reconciliation at patient admission in an orthopaedic and
           trauma department

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      Authors: Vallecillo, T; Slimano, F, Moussouni, M, Ohl, X, Bonnet, M, Mensa, C, Hettler, D, Kanagaratnam, L, Mongaret, C.
      Pages: 264 - 270
      Abstract: ObjectiveMedication reconciliation (MR) is recognised as an important tool in preventing medication errors such as unintentional discrepancies (UDs). The aim of this study was to identify independent predictive factors of UDs during MR at patient admission to an orthopaedic and trauma department. The secondary objective was to build and validate a ready-to-use score to prioritise patients.MethodA retrospective study was performed on 3.5 years of pharmacist-led MR in the orthopaedic and trauma department of a large university teaching hospital. Independent predictors of UD were identified by multivariable logistic regression. A priority score to identify patients at risk of at least one UD was constructed from the odds ratios of the risk factors, and validated in a separate cohort. Performance was assessed with sensitivity, specificity, C-statistic and Hosmer-Lemeshow goodness-of-fit.ResultsIn total, 888 patients were included and 387 UDs were identified, mainly drug omissions (65.1%). Five independent predictors of UD were identified: age>75 years (OR 2.05, 95% CI 1.41 to 3.00; p
      Keywords: EAHP Statement 4: Clinical Pharmacy Services
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002283
      Issue No: Vol. 29, No. 5 (2022)
       
  • Risk factors for emergency department revisit in elderly patients with
           gastrointestinal bleeding secondary to anticoagulant therapy

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      Authors: Ruiz, J; Lopez-Vinardell, L, Juanes, A, Riera-Magallon, A, Puig, M, Mangues, M. A.
      Pages: 271 - 274
      Abstract: ObjectiveTo evaluate the frequency of emergency department (ED) revisits among elderly patients with gastrointestinal bleeding secondary to anticoagulant treatment and identify factors associated with an increased risk of ED revisits.MethodsA 3-year retrospective observational study was designed, including elderly patients (≥65 years) with atrial fibrillation and undergoing oral anticoagulation therapy who visited the ED for gastrointestinal bleeding. To evaluate the risk factors for 30-day revisit, a multivariate analysis was designed including comorbidities, concomitant treatment, change in anticoagulant treatment and prescription of direct-acting oral anticoagulants.Results80 patients were included. At discharge, anticoagulation therapy was modified in 21 (26.2%) patients; and changed from an oral anticoagulant to heparin in 17 (21.2%) patients and to another oral anticoagulant in 4 (5.0%) patients. Anticoagulant treatment was withdrawn in 5 (6.3%) patients at discharge. Eleven (13.7%) patients revisited the ED 30 days after hospital discharge for bleeding episodes. No differences in the frequency of revisit to the ED were observed in the patients who changed their anticoagulant treatment at discharge. In the multivariate analysis, chronic kidney disease was the only factor significantly associated with revisits at 30 days.ConclusionsElderly patients who experience a first episode of gastrointestinal bleeding have a high risk of revisiting the ED for a bleeding episode, with no particular differences between the types of anticoagulant prescribed at discharge.
      Keywords: EAHP Statement 4: Clinical Pharmacy Services
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002426
      Issue No: Vol. 29, No. 5 (2022)
       
  • Evaluating the effectiveness of digital communication within the National
           Medication Safety Network for England

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      Authors: Bhatti, S; Wake, N, Jani, Y.
      Pages: 275 - 279
      Abstract: ObjectivesThe medication safety officer (MSO) role was created following a patient safety alert, with an action for MSOs to be active participants in a national network in England, which included regular online webinar meetings and an online forum. The aim of the study was to assess the effectiveness of digital platforms in facilitating interaction and communication by the MSO network. The objectives were to establish the proportion of MSOs who interact through monthly webinars and the online forum. A secondary objective was to identify barriers and facilitators for engaging digitally within the MSO network.MethodsAn online survey was used alongside semistructured interviews. The online survey was disseminated to all 400 MSOs registered with the UK Department of Health Central Alerting System from December 2018 to February 2019. Interviewees were identified purposively through snowball sampling and voluntarily through the survey.Results84 MSOs responded to the survey (21% response rate) and 10 participated in the semistructured interviews. The majority of the respondents were pharmacists (79/84, 94%) from NHS large healthcare providers (44/84, 52%). MSO respondents (61/84, 73%) joined the monthly webinar and 47/84 (56%) believed the webinar was useful for networking. Ten (12%) did not attend the webinars due to technical difficulties or lack of time. The online forum was used less frequently, with a third (27/84, 32%) that had never used it.ConclusionsDigital communications through webinars and online forums were perceived by respondents as a way to facilitate networking but require a robust information technology infrastructure that can be accessed without difficulty. User-friendly platforms can help the MSO network achieve critical mass and greater interaction, allowing timely access to information.
      Keywords: EAHP Statement 5: Patient Safety and Quality Assurance
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002517
      Issue No: Vol. 29, No. 5 (2022)
       
  • Burden of enteral supplement interactions with common antimicrobial
           agents: a single-centre observational analysis

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      Authors: Hughes, S; Heard, K, Mughal, N, Moore, L. S. P.
      Pages: 280 - 283
      Abstract: IntroductionOral antimicrobials, including ciprofloxacin, levofloxacin and doxycycline, are susceptible to binding with enteral therapies such as calcium and iron therapies. Administered together, the bioavailability of these antimicrobials is expected to be reduced.MethodsA retrospective case series of patients receiving oral antimicrobials (ciprofloxacin, levofloxacin and doxycycline) was analysed at a single-centre NHS acute hospital (April 2016–September 2019). Patient demographics, including concurrent enteral therapies, were recorded using medical records. Clinically important interactions were defined as doses administered within 2 hours of antimicrobial therapy.ResultsA total of 4067 prescriptions for the study antimicrobials (ciprofloxacin, n=1905; levofloxacin, n=538; and doxycycline, n=1624) were prescribed for 3584 patients. 1918/3583 (53.5%) of the patients were female, and the median age was 67 years (range 0.5–105.0 years). 810/4067 (19.3%) prescriptions reviewed had an interacting enteral therapy (calcium or iron salt) administered within 2 hours of the study medication.ConclusionThe concomitant administration of enteral calcium and iron with oral antimicrobials is common within the acute care hospital setting. Approximately one in five patients has a clinically important interaction which may impair oral bioavailability and limit treatment efficacy. As antimicrobial stewardship teams strive for increased intravenous-to-oral de-escalation, it is important that optimum dosing administration is followed to optimise patient outcomes.
      Keywords: EAHP Statement 5: Patient Safety and Quality Assurance
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002445
      Issue No: Vol. 29, No. 5 (2022)
       
  • External contamination of antineoplastic drug vials: an occupational risk
           to consider

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      Authors: Cotteret, C; Secretan, P.-H, Gilles-Afchain, L, Rousseau, J, Vidal, F, Salguero-Hernandez, G, Batista, J, Valverde, V, Guitton, J, Cisternino, S, Schlatter, J.
      Pages: 284 - 286
      Abstract: Risk management for workers involved in the handling and preparation of cytotoxic drugs is challenging. This study aims to investigate drug contamination of the exterior surfaces of cytotoxic drug vials. Two batches of commercially available cytotoxic drugs in unprotected vials (ifosfamide, etoposide phosphate and cyclophosphamide) and plastic shrink wrap vials (doxorubicin, cytarabine and busulfan) were tested without removing the flip-off cap or the plastic wrap, and without prewashing. The results showed significant trace amounts of cytotoxic drugs on the exterior surfaces in both unprotected (eg, cyclophosphamide, ifosfamide) and protected plastic shrink wrap vials (eg, cytarabine), indicating that the secondary packaging of protected vials does not systematically prevent exposure to the handlers. These results focus on the need for guidelines to prevent cytotoxic vial contamination and safety recommendations for staff in the handling and storage of these vials.
      Keywords: Editor''s choice, EAHP Statement 3: Production and Compounding
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002440
      Issue No: Vol. 29, No. 5 (2022)
       
  • Prescription profile in patients with SARS-CoV-2 infection hospitalised in
           Aragon, Spain

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      Authors: Alvarez, A; Cabia, L, Trigo, C, Bandres, A. C, Bestue, M.
      Pages: 287 - 289
      Abstract: IntroductionOn 14 March 2020, a state of alarm was declared in Spain because of the pandemic of coronavirus disease (COVID-19). After 12 weeks from the beginning of the pandemic, the number of confirmed cases stoods at 5781 in Aragon: 46% hospitalised, 5% admitted to intensive care unit, and 15% died. The absence of controlled trials in SARS-CoV-2 infection and the fast progression of the disease has promoted the use of treatments with unproven potential benefit. The objective of this study is to define the prescription profile in patients with SARS-CoV-2 infection hospitalised in Aragon, Spain during the pandemic and its adaptation to the official recommendations.Patients and methodsDescriptive retrospective study of the consumption and inpatient dispensation of drugs in a sample of COVID-19 infected inpatients (with positive PCR test result) admitted to hospitals of Aragon, between 1 March and 8 May 2020. Data were collected by an inpatient dispensation software program.Results1482 positive COVID-19 patients were analysed: 54.9% male, median age 75 years (IQR 62–85); 12% were admitted to the intensive care unit. Median prescription: 13 active ingredients per patient (IQR 9–19). 73% (1093 patients) received hydroxychloroquine, lopinavir/ritonavir, or azithromycin, 81% as combination therapy. 4.3% (52) received other antivirals. 46% received corticosteroids (84% methylprednisolone, 8.7% dexamethasone) and 2.2% tocilizumab.DiscussionAt the time of the study period there was not enough quality evidence to issue a recommendation on any treatment. There are several clinical trials ongoing to clarify what is the best treatment for patient with SARS-CoV-2 infection.
      Keywords: EAHP Statement 1: Introductory Statements and Governance, COVID-19
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002476
      Issue No: Vol. 29, No. 5 (2022)
       
  • Elevation of transaminases associated with teriparatide treatment: a case
           report

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      Authors: Pappalardo, F; Fantini, L, Caruso, V.
      Pages: 290 - 293
      Abstract: This report describes the case of a 64-year-old Caucasian woman presenting with hypertransaminasemia during treatment with teriparatide for postmenopausal osteoporosis. The patient was also receiving food supplements containing red yeast rice (RYR) to lower her cholesterol levels. RYR has been reported to cause hepatoxicity because it contains monacolin K. According to the results of a causality assessment, carried out via several probability scales, teriparatide was defined as a ‘possible’ cause of the adverse drug reaction (ADR). Following progressive normalisation of the levels of transaminases after the teriparatide was discontinued, we therefore postulated that teriparatide was the main cause of the ADR. In addition to this, based on a literature review, we considered RYR as a concomitant agent in the aetiology of the ADR. Further post-marketing surveillance studies on teriparatide seem to be necessary.
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002293
      Issue No: Vol. 29, No. 5 (2022)
       
  • Acute onset psychosis with complex neurobehavioural symptomatology
           following the intramuscular injection of hyoscine butylbromide: a case
           report with an overview of the literature

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      Authors: Bulut, N. S; Arpacıoglu, Z. B.
      Pages: 294 - 297
      Abstract: Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of conditions, ranging from motion sickness to colic spasms and smoking cessation. In some rare conditions, the administration of scopolamine may lead to severe idiosyncratic reactions, including central anticholinergic intoxication syndrome. Here, we present a young female patient who progressively developed a series of complex neuropsychiatric symptoms including ataxia, slurred and rambling speech, stereotypic movements, vivid visual and auditory hallucinations, and self-mutilative behaviours in the days following the injection of hyoscine butylbromide in the emergency room to treat her menstrual cramps. Referred to psychiatry, detailed screening of her medical records and collateral information from the family revealed that the neurobehavioural manifestations were indeed preceded by severe peripheral anticholinergic toxicity, which were mostly overlooked during the initial evaluations. Started on olanzapine treatment, the patient’s symptoms gradually subsided over time, though it took several weeks to achieve full clinical recovery.
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2020-002583
      Issue No: Vol. 29, No. 5 (2022)
       
  • EAHPs COVID-19 Report showcases the contributions of hospital pharmacists
           and shares recommendations

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      Authors: Marzal Lopez; G.
      Pages: 298 - 299
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2022-003502
      Issue No: Vol. 29, No. 5 (2022)
       
  • Safeguarding antimicrobial medicines reserved for treating humans

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      Authors: Marzal Lopez; G.
      Pages: 299 - 300
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2022-003501
      Issue No: Vol. 29, No. 5 (2022)
       
  • Hand hygiene for healthcare workers: did we need COVID-19 to raise
           awareness of proper disinfection practice'

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      Authors: Mengato, D; Di Spazio, L.
      Pages: 302 - 302
      Keywords: COVID-19
      PubDate: 2022-08-23T01:03:23-07:00
      DOI: 10.1136/ejhpharm-2021-002812
      Issue No: Vol. 29, No. 5 (2022)
       
 
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