Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 91
Filtrar
1.
Farm. comunitarios (Internet) ; 16(2): 37-42, Abr. 2024. tab
Artigo em Espanhol | IBECS | ID: ibc-232406

RESUMO

Paciente de 78 años, polimedicada e incluida en el servicio de Sistema Personalizado de Dosificación de Medicamentos (SPD). Al acudir a retirar su medicación nos informa que desde hace unos meses sufre cansancio, debilidad, mareos y confusión. Se realiza una revisión de la medicación, centrada en la dosificación de los medicamentos de metabolismo o eliminación renal, en función del valor de Filtrado Glomerular estimado de la paciente (FGe). Se realiza derivación al Médico de Atención Primaria (MAP) mediante un informe, en el que se recomienda la reducción de dosis de losartán y manidipino según el valor de FGe de la paciente. El MAP redujo la dosis de los antihipertensivos. Se efectuó seguimiento del caso, que permitió observar que la paciente dejó de presentar los síntomas descritos inicialmente.(AU)


Assuntos
Humanos , Feminino , Idoso , Polimedicação , Dosagem , Insuficiência Renal/tratamento farmacológico , Formas de Dosagem , Drogas Desenhadas , Exame Físico , Confusão , Tontura , Pacientes Internados , Debilidade Muscular
2.
Farm. comunitarios (Internet) ; 16(1): 61-64, Ene. 2024. tab
Artigo em Espanhol | IBECS | ID: ibc-229282

RESUMO

Los Sistemas Personalizados de Dosificación (SPD) son una herramienta eficaz, segura y homologada para el reacondicionamiento de fármacos en farmacia comunitaria. Estos implican la revisión del uso del medicamento (RUM) y la colaboración con el médico de atención primaria (MAP). En el presente artículo se describe el caso de una paciente de 57 años intervenida de lumbociatalgia en 2021 y 2022, con dolor crónico mal controlado y aturdimiento derivado del olvido y/o duplicidad de las tomas. Durante la dispensación habitual se detectan estos problemas relacionados con el medicamento (PRM) y se deriva a la paciente al servicio SPD. Tras la implantación del mismo, la paciente mejora a nivel cognitivo, eliminando el aturdimiento y controlando el dolor, lo que supuso un aumento en su calidad de vida. En conclusión, se destaca la importancia de los diferentes servicios disponibles en la farmacia para mejorar la calidad de vida del paciente, la adherencia al tratamiento y la detección de PRM. (AU)


Monitored Dosage Systems (MDS) are an efficient, reliable and approved device for drug reconditioning in pharmacy. These systems imply a review on proper drug use and the collaboration between primary health care and pharmacists. The case study describes a female patient with a surgical intervention due to lumbosciatica in 2021 and 2022. Patient describes uncontrolled chronic pain and confusion related to improper drug use. During regular dispensing of her medication, these medicine-related problems (MRP) were detected and the patient was referred to the MDS service. After its implementation, the patient’s confusion was eliminated and pain management was achieved, increasing her quality of life. As a conclusion, the different health services provided by the pharmacy can improve a patient’s quality of life, treatment adherence and MRP detection. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cooperação e Adesão ao Tratamento , Polimedicação , Formas de Dosagem , Qualidade de Vida , Cálculos da Dosagem de Medicamento
3.
Pharm. care Esp ; 25(1): 19-36, 16-02-2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-216144

RESUMO

Introducción: el aumento de patologías crónicas en edades avanzadas conlleva un elevado grado de polimedicación, entendido como el consumo simul-táneo de cinco o más medicamentos. La polimedi-cación aumenta el riesgo de problemas relaciona-dos con los medicamentos (PRM). Puede provocar la aparición de resultados negativos asociados a la medicación y una disminución en la adherencia terapéutica, que se acentúa en el ámbito rural don-de la población está especialmente envejecida. Los sistemas personalizados de dosificación (SPD) son una buena herramienta para solventar esta situa-ción. Su preparación se basa en procedimientos normalizados de trabajo (PNT) y documentos de buenas prácticas.Método: hemos realizado una adaptación de un PNT incidiendo en puntos clave como el estudio detallado de la farmacoterapia y la posibilidad de fraccionamiento y reacondicionamiento, incluyendo una revisión del uso de la medicación y la realiza-ción de un estado de situación. Con la información obtenida, hemos valorado la existencia de PRM.Resultados: de los pacientes adscritos al servicio, la mayoría eran mujeres mayores de 75 años y polimedicadas. Las patologías más prevalentes fueron hipertensión arterial, hipercolesterolemia y diabetes. Casi el 80% de los pacientes tenían al menos una pauta irregular en sus tratamientos. Menos del 5% de formas farmacéuticas no pudie-ron ser finalmente reacondicionadas. Se detectaron 77 PRM, destacando el aumento de probabilidad de efectos adversos por asociación de fármacos. La adherencia se incrementó del 28.2% al 79.5% después de seis meses.Conclusiones: la preparación de SPD es un servi-cio complejo, sistemático e individualizado que ha permitido una mejora sustancial en la adherencia. (AU)


Introduction: the high prevalence of chronic di-seases in older ages frequently leads to the simul-taneous intake of five or more drugs, a condition known as polymedication. This results in a higher risk of drug-related problems, which can cause negative outcomes associated with medication and a decrease in therapeutic adherence. This fact is noteworthy in rural areas where the population is particularly aged. Compliance aids system, elabo-rated according to specific working protocols and standards, can be a suitable tool to address this issue.Method: we have adapted our regional working pro-tocol by focusing on the analysis of the pharmaco-therapy, pharmaceutical dosage form splitting and stability, including and initial medication review and assessment of the patient. Medication and drug-re-lated problems were also assessed according to this procedure.Results: most of the ascribed patients were poly-medicated women over 75 years of age. Hyper-tension, hypercholesterolemia, and diabetes were found to be the most prevalent pathologies, while 80% of the patients were taking, at least, one drug at irregular dosing intervals. Less than 5% of the prescribed dosage forms were not suitable for reconditioning in compliance aids systems. We detected 77 drug-related problems, adverse drug reactions being the most frequently recorded. The-rapeutic adherence increased from 28.2% to 79.5% after six months.Conclusions: compliance aids system elaboration is a complex process, which should be individuali-zed for each patient. These devices may be useful to improve therapeutic adherence in polymedicated aged patients. (AU)


Assuntos
Humanos , Cooperação e Adesão ao Tratamento , Assistência Farmacêutica , População Rural , Formas de Dosagem
4.
Hosp. domic ; 6(4)oct./dic. 2022.
Artigo em Espanhol | IBECS | ID: ibc-212862

RESUMO

Paciente de 87 años incluido en el Servicio de Sistema Personalizado de Dosificación (SPD) a petición de su esposa. Tras seguir el Protocolo Normalizado de Trabajo de la Farmacia, se prepara la medicación del paciente en dichos dispositivos.Ante la falta de adherencia a los tratamientos, se decide proponer al médico un cambio de posología al que accede. A partir de este momento, el paciente tiene una adherencia a los tratamientos del 100%.El uso del SPD es una excelente herramienta para ayudar a los pacientes en el manejo de la medicación y además permitir observar la adherencia a la misma y en su defecto realizar propuestas de modificación para aumentarla. Así pues, un seguimiento multidisplinar del paciente aumenta el cumplimiento terapéutico, mejorando su calidad de vida y suponiendo un ahorro al Sistema Nacional de Salud. (AU)


An 87-year-old patient included in the Personalized Dosage System Service (PDS) at the request of his wife. After following the Standard Work Protocol of the Marta Mayor Pharmacy, the patient's medication is prepared in these devices.Given the lack of adherence to the treatments, it was decided to propose a change in dosage to the doctor to which he would agree. From this moment on, the patient has 100% adherence to treatment.The use of the SPD is an excellent tool to help patients in the management of medication and also allows adherence to it to be observed and, failing that, to make modification proposals to increase it. Thus, a multidisciplinary follow-up of the patient increases therapeutic compliance, improving their quality of life and assuming savings for the National Health System. (AU)


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Cooperação e Adesão ao Tratamento , Formas de Dosagem , Assistência Domiciliar/métodos , Cálculos da Dosagem de Medicamento , Qualidade de Vida
5.
Hosp. domic ; 6(2)abr./jun. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-209264

RESUMO

El paciente domiciliario de 76 años acude a la farmacia sita en Alfaz del Pi (Alicante) a retirar su medicación. Durante el acto de dispensación y tras observar la amplia farmacoterapia, se le ofrece formar parte del Servicio de Sistema Personalizado de Dosificación (SPD).Durante los 11 meses que el paciente domiciliario forma parte del Servicio, el médico le modifica 38 veces el tratamiento. Con la ayuda del SPD, el paciente ha aumentado la adherencia a su amplia polifarmacia y consecuentemente ha mejorado su calidad de vida y disminuir el número de comprimidos diarios.Con la participación del farmacéutico en el Sistema de Salud a través de los SPD, se consigue por un lado evitar los posibles problemas relacionados con la medicación, evitar los resultados negativos asociados a la misma, mejorar la salud del paciente al aumentar la adherencia a los tratamientos y consecuentemente suponer un ahorro económico a la Sanidad Nacional. (AU)


The 76-year-old home-care patient goes to the pharmacy located in Alfaz del Pi (Alicante) to pick up his medication. During the act of dispensing and after observing the extensive pharmacotherapy, pharmacist offered him to be part of the Personalized Dosing System Service (SPD).During the 11 months that the home-care patient is part of the Service, the doctor modifies the treatment 38 times. With the help of the SPD, the home-care patient has increased adherence to his extensive polypharmacy and consequently has improved his quality of life and decreased the number of daily tablets.With the participation of the pharmacist in the Health System through the SPD, it is possible, on the one hand, to avoid possible problems related to the medication, avoid the negative results associated with it, improve the patient's health by increasing adherence to treatments and consequently suppose an economic saving to the National Health. (AU)


Assuntos
Humanos , Masculino , Idoso , Qualidade de Vida , Serviços de Assistência Domiciliar , Serviços Comunitários de Farmácia , Polimedicação , Cooperação e Adesão ao Tratamento , Formas de Dosagem
7.
Pharm. care Esp ; 23(5): 42-48, Oct 15, 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-216137

RESUMO

C. es una paciente polimedicada frágil de 83 años incluida en nuestro servicio de sistemas personali-zados de dosificación (SPD). Su control glucémico no es adecuado, por lo que su endocrino modifica el tratamiento antidiabético oral e inicia insulinote-rapia. Se consigue mejorar el control de su gluce-mia gracias al nuevo tratamiento. Días después, a causa de una infección respiratoria, su médico de atención primaria (MAP) le prescribe Dextrome-torfano (Romilar®) 3 mg/ml jarabe y Cefuroxima (Zinnat®) 500 mg granulado para suspensión oral. Debido al reciente problema del control glucémico decidimos revisar el contenido en azúcares simples de ambas presentaciones en el momento de la dis-pensación. Según la posología prescrita, la paciente podría llegar a ingerir 50 g de sacarosa al día con este tratamiento. Se opta por intervenir proponien-do un cambio en la forma farmacéutica del anti-biótico prescrito. En el caso del antitusivo, que no precisa prescripción médica, se aplica el protocolo de indicación farmacéutica: dispensamos en su lugar Dextrometorfano (Normotus®) 2mg/ml jarabe (cuya formulación no incluye sacarosa) y realiza-mos el correspondiente ajuste en la posología. El servicio SPD no solo mejora la adherencia terapéu-tica, sino que nos aporta conocimientos relevantes de la situación clínica del paciente y constituye una valiosa herramienta para la detección y el abordaje de problemas relacionados con los medicamentos (PRM).(AU)


C. is a 83-year-old fragile patient included in our monitored dosage system (MDS) service. Due to an inappropriate glycemic control, her oral antidia-betic medication was recently modified and insulin therapy was started. Two weeks later, glycemic control showed a notorious improvement. Today, she has been prescribed new medication for treat-ing a respiratory infection: an antitussive solution and an antibiotic powder for oral suspension. Since we are aware of the recent hyperglycemic issue, we decided to check the simple sugars content of the new prescriptions before dispensation. According to technical information, C. would take 50 g of sac-charose per day with both medicines. We conduct-ed an intervention proposing her doctor a pharma-ceutical dosage form change, recommending the prescription of coated tablets instead of powder. As far as the antitussive is concerned, we selected a sugar free dextromethorphan solution following our standard indication service algorithms. MDS service provides important information regarding patient therapy and it is a valuable tool to detect drugs related problems (DRP).(AU)


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Excipientes , Pacientes Internados , Exame Físico , Polimedicação , Diabetes Mellitus , Assistência Farmacêutica , Formas de Dosagem
8.
An. R. Acad. Nac. Farm. (Internet) ; 87(1): 105-108, ene.-mar. 2021.
Artigo em Espanhol | IBECS | ID: ibc-201636

RESUMO

Intento acercar la oficina de farmacia desde su legislación hasta su ejercicio profesional centrándonos en puntos menos conocido como la atención farmacéutica y calidad de vida el perfil psiquiátrico que acompaña a la no adherencia al tratamiento médico. Quisiera sacar la Conclusión de que he conseguido interesar para que se conozca la misión de los farmacéuticos y técnicos en farmacia que las integran


I try to bring the pharmacy office closer from its legislation to its professional practice, focusing on less known points such as pharmaceutical care and quality of life, the psychiatric profile that accompanies non-adherence to medical therapy. I would like to draw the conclusion that I have managed to interest so that the mission of the pharmacists and pharmacy technicians who are part of them is known


Assuntos
Humanos , Assistência Farmacêutica/legislação & jurisprudência , Formas de Dosagem , Comercialização de Produtos , Adesão à Medicação , Qualidade de Vida , Espanha , Satisfação do Paciente
9.
An Real Acad Farm ; 86(3): 157-172, jul.-sept. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-201313

RESUMO

La industria farmacéutica está en continua búsqueda de nuevas tecnologías que permitan mejorar las formas de dosificación de las que se dispone, siendo uno de los objetivos el aumento de la adherencia a los tratamientos por parte de los pacientes. En este sentido, la impresión en 3 dimensiones (3DP) es una emergente técnica de fabricación aditiva que ha comenzado a abarcar muchos sectores industriales e influir directa e indirectamente en la calidad de vida de los individuos. Tanto es así, que la 3DP se postula como una de las técnicas que podría contribuir a que se produzca un gran cambio en el sector farmacéutico, permitiendo la personalización de los tratamientos de los pacientes, mejorando la biodisponibilidad de fármacos que presentan problemas de disolución o combinando toda la medicación de un paciente en una sola forma farmacéutica de toma diaria (polypill), entre otros. Esta nueva técnica de producción va a diferir enormemente de las clásicas formas de fabricación farmacéuticas y, en los próximos años puede suponer una transformación revolucionaria en la práctica farmacéutica


The pharmaceutical industry is continually searching for new technologies to improve the characteristics of current medicines. One of the objectives is the increase of adherence to the treatments by patients. Simultaneously, 3-dimensional printing (3DP) is an emerging additive technique that is reaching many sectors of industry and influencing directly and indirectly the quality of life of patients. In this sense, 3DP postulates to be one of the technologies that contribute to the pharmaceutical development, allowing the personalized medicine in patients, improving the bioavailability of drugs with dissolution problems or combining all the medication of the patients in a single tablet (polypill), among others. This new technique will differ greatly from the traditional pharmaceutical manufacturing and in the coming years it may involve a revolutionary transformation in pharmaceutical practice


Assuntos
Humanos , Indústria Farmacêutica/métodos , Impressão Tridimensional/normas , Preparações Farmacêuticas/síntese química , Tecnologia Farmacêutica/métodos , Impressão Tridimensional/provisão & distribuição , Preparações Farmacêuticas/provisão & distribuição , Formas de Dosagem/normas
10.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194199

RESUMO

BACKGROUND: Area under the curve to minimum inhibitory concentration (AUC/MIC) has been recommended by the 2020 updated vancomycin guidelines for dosing vancomycin for both efficacy and safety. Previously, AUC/MIC has been cumbersome to calculate so surrogate trough concentrations of 15-20 mg/dL were utilized. However, trough-based dosing is not a sufficient surrogate as AUC/MIC targets of 400-600 can usually be reached without achieving troughs of 15-20 mg/dL. Targeting higher trough levels may also lead to adverse events including acute kidney injury (AKI) and nephrotoxicity. OBJECTIVE: To compare the mean total first day vancomycin dose in traditional trough-based dosing versus dosing recommended by an AUC/MIC dosing program. METHODS: Adult inpatients who received at least 24 hours of IV vancomycin treatment were included in this single-center, retrospective cohort study. The primary endpoint was difference in mean total first day vancomycin dose in milligrams (mg) received between patients' traditional trough-based dosing and recommended dose via AUC/MIC electronic dosing calculator. Patients served as their own control by analyzing both actual dose received and dose recommended by the electronic AUC/MIC program. Rates of vancomycin induced adverse events, including acute kidney injury, elevated steady-state trough concentrations, and Red Man's syndrome were also compared between patients who received doses consistent with the AUC/MIC dosing recommendation versus those who did not. RESULTS: 264 patients were included in this study. Initial 24-hour vancomycin exposure was significantly lower with the recommended AUC/MIC dose versus the dose received (2380.7; SD 966.6 mg vs 2649.6; SD 831.8 mg, [95% CI 114.7:423.1] p = 0.0007). CONCLUSIONS: Utilizing an electronic AUC/MIC vancomycin dosing calculator would result in lower total first day vancomycin doses


No disponible


Assuntos
Humanos , Vancomicina/classificação , Formas de Dosagem/normas , Vancomicina/administração & dosagem , Estudos de Coortes , Testes de Sensibilidade Microbiana/métodos , Estudos Retrospectivos , Insuficiência Renal/tratamento farmacológico
11.
Allergol. immunopatol ; 48(2): 124-129, mar.-abr. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-191814

RESUMO

OBJECTIVE: This study aimed to assess the regular use of long-term asthma-control medication and to determine inhaler techniques in asthmatic children. METHODS: The study was conducted on asthmatic children aged 6-18 years. Information on rescue and controller medications was given and the proper inhalation technique was demonstrated. One month later, patients and parents were asked to answer a questionnaire on drug use and to demonstrate their inhaler techniques. RESULTS: One hundred children and/or their parents were interviewed for the study. All of the patients identified long-term asthma-control medications while quick-relief asthma medications were identified by 93% of the patients. Of the patients, 34% described the dose of their quick-relief medication correctly. All steps in the inhalation technique were correctly carried out by 60.6% of patients using a metered-dose inhaler (MDI), 80% of patients using a Turbuhaler, and 58% of patients using a capsule-based dry-powder inhaler (DPI). Of the participants, 73% reported regular use of long-term asthma-control medications. While the mean age of the patients regularly using long-term asthma medications was 9.05 ± 2.5 years, that of patients not compliant with the regular treatment was 10.29 ± 3.26 years (p = 0.04). The most common reason for irregular drug use was forgetting to take the drug. CONCLUSION: Adherence to long-term asthma-control medications tends to be better in younger patients. Since the most common cause of irregular drug use is forgetting to take the drug, repeated training is necessary to ensure asthma control and the successful treatment of asthmatic children


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Asma/tratamento farmacológico , Administração por Inalação , Antiasmáticos/administração & dosagem , Assistência de Longa Duração , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento , Asma/diagnóstico , Estudos Prospectivos , Formas de Dosagem , Inaladores Dosimetrados
12.
Pharm. care Esp ; 22(6): 438-446, 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-199935

RESUMO

ANTECEDENTES: Paciente varón de 60 años, fumador y de bajo estrato social y cultural. Dependiente para todas sus actividades de la vida diaria, es atendido por su madre, una anciana de 86 años. El paciente presenta un cuadro pluripatológico antes de la intervención farmacéutica, destacando: infección crónica por VIH, combinación de medicamentos de uso hospitalario con medicamentos dispensados en la farmacia comunitaria y continuas incidencias en la dispensación en receta electrónica por no ajustarse a las pautas posológicas establecidas por su médico. La evaluación del paciente por el equipo multidisciplinar lo considera un paciente de riesgo y que precisa ayuda en la toma de la medicación; el paciente es no adherente según el test Morisky Green Levine reducido. La intervención farmacéutica consiste en la elaboración de SPD para el paciente. RESULTADOS: Tras 12 meses utilizando los SPD, dejaron de producirse desajustes en la dispensación en receta electrónica y los SPD que devuelve a la farmacia comunitaria muestran que ha tomado toda la medicación. El cálculo de la tasa Proportion of Days Covered (PDC) indica que es cumplidor para la mayoría de los tratamientos. CONCLUSIÓN: La elaboración de SPD a un paciente con patologías crónicas complejas resultó ser una intervención farmacéutica eficaz para mejorar su adherencia farmacológica


BACKGROUND: 60 years old male patient, smoker and of low social and cultural stratum. He is dependent for all his activities of daily life, he is cared for by his mother, an 86 year old women. The patient presents a multiple pathological picture before the pharmaceutical intervention, highlighting: chronic HIV infection, a mixture of hospital use drugs and community pharmacy dispensed drugs apart from continuous incidents in the dispensing by electronic prescription due to lack of adherence to his doctor dosage guidelines. The evaluation of the patient by the multidisciplinary team reveals a risk patient who needs help in taking medication; the patient is not adherent to his treatments according to Morisky Green Levine reduced test. The pharmaceutical intervention consists on the elaboration of unit dose drug distribution system to the patient. RESULTS: After 12 months using the dose drug distribution system, misalignments in electronic prescription dispensing stopped and the dose drug distribution systems that the patient brought back to the community pharmacy showed that the patient has taken the medication. The Proportion of Days Covered (PDC) ratio showed that the patient was compliant with most of the treatments. CONCLUSION: The elaboration of dose drug distribution system to a patient with complex chronic pathologies was an effective pharmaceutical intervention to improve his treatment adherence


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Adesão à Medicação , Formas de Dosagem , Doença Crônica/tratamento farmacológico , Polimedicação , Farmácias , Fatores de Tempo , Resultado do Tratamento , Prescrição Eletrônica
13.
Rev. esp. quimioter ; 32(supl.2): 35-37, sept. 2019.
Artigo em Inglês | IBECS | ID: ibc-188737

RESUMO

In the past, the dose of an antibiotic was chosen, always from among those that were well tolerated, by considering those with the ability to exceed the MIC of bacteria in plasma. This approach, which has still not widely changed, is contrasted with the pharmacokinetic and pharmacodynamic (PK/PD) relationships, which indicate that the efficacy of antibiotics is directly related to parameters that relate the sequence of concentrations over time with a parameter of the MIC effect in vitro. Until now, three types of PK/PD relationships have been established for antibiotics: the inhibitory coefficient (Cmax/MIC), the efficacy time (T>CMI) and the relationship between the exposure of the drug and the MIC (AUC/MIC)


No disponible


Assuntos
Humanos , Antibacterianos/farmacologia , Antibacterianos/farmacocinética , Prescrições de Medicamentos , Antibacterianos/administração & dosagem , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Formas de Dosagem , Testes de Sensibilidade Microbiana
15.
Pharm. pract. (Granada, Internet) ; 16(3): 0-0, jul.-sept. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-174798

RESUMO

Background: There remains variability in both practice and evidence related to optimal initial empiric dosing strategies for vancomycin. Objective: Our primary objective was to describe the percentage of obese patients receiving vancomycin doses consistent with nomogram recommendations achieving targeted initial steady-state serum vancomycin concentrations. Secondary objectives were to describe the primary endpoint in subgroups based on patient weight and estimated creatinine clearance, to describe the rate of supratherapeutic vancomycin accumulation following an initial therapeutic trough concentration, and to describe the rate of vancomycin-related adverse events. Methods: This single-center, IRB-approved, retrospective cohort included adult patients ≥ 100 kilograms total body weight with a body mass index (BMI) >30 kilograms/m2 who received a stable nomogram-based vancomycin regimen and had at least one steady-state vancomycin trough concentration. Data collected included vancomycin regimens and concentrations, vancomycin indication, serum creatinine, and vancomycin-related adverse events. Patients were divided into two cohorts by goal trough concentration: 10-15 mcg/mL and 15-20 mcg/mL. Results: Of 325 patients screened, 85 were included. Goal steady-state concentrations were reached in 42/85 (49.4%) of total patients. Conclusions: Achievement of initial steady-state vancomycin serum concentrations in the present study (approximately 50%) was consistent with the use of published vancomycin dosing nomograms


No disponible


Assuntos
Humanos , Vancomicina/administração & dosagem , Obesidade/complicações , Formas de Dosagem/normas , Nomogramas , Pesos e Medidas Corporais/estatística & dados numéricos , Estudos Retrospectivos , Doenças Transmissíveis/tratamento farmacológico
16.
Rev. lab. clín ; 11(2): 64-72, abr.-jun. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-174357

RESUMO

Introducción. La monitorización terapéutica de metotrexato (MTX) es una práctica indicada en el seguimiento del tratamiento de la leucemia linfoblástica aguda para ajustar las dosis de rescate con leucovorina y evitar toxicidad. El objetivo de nuestro trabajo fue evaluar el desempeño de un método bioanalítico por cromatografía líquida en el control de tratamientos pediátricos de leucemia linfoblástica aguda. Materiales y métodos. Se analizó la evolución de la concentración plasmática del fármaco en 61 pacientes, divididos en 2 grupos según el tipo de tratamiento con MTX: infusión de 24h e infusión de 36h. Alícuotas de 250μL de plasma pretratado se analizaron utilizando un método analítico validado, en un cromatógrafo Agilent 1260 con una columna Zorbax Eclipse XDB-C18 (4,6×150mm, 5μm) y fase móvil compuesta por acetonitrilo y solución reguladora de acetato de sodio 0,05mol/L a pH 3,5. La detección se efectuó a 305nm. Resultados. El método no presentó interferencias por metabolitos ni otros fármacos. El límite inferior de cuantificación fue de 0,05μmol/L, la precisión y la exactitud inter e intraensayo fueron aceptables en el rango (0,05-5,0μmol/L), verificándose un comportamiento lineal. El 29,4% de los pacientes con infusión de 24h y el 60% de aquellos con infusión de 36h presentaron niveles plasmáticos tóxicos de MTX, por lo que debieron adelantarse y/o reforzarse los rescates con leucovorina. Conclusiones. El método cromatográfico resultó eficiente y accesible para la monitorización terapéutica de MTX en pacientes pediátricos, permitiendo la toma de decisiones médicas pertinentes en un corto tiempo de análisis


Introduction. Therapeutic drug monitoring of methotrexate (MTX) is a practice used during acute lymphoblastic leukaemias treatments in order to adjust the leucovorin rescue dose and avoid toxicity. The aim of this work was to evaluate the performance of a bioanalytical method based on liquid chromatography in the control of paediatric acute lymphoblastic leukaemia treatments. Materials and methods. MTX plasma concentrations were evaluated in a total of 61 patients, divided in 2 groups according to the treatment: 24h infusion and 36h infusion. The method used 250μL aliquots of pre-processed plasma, using a validated analytical method, in an Agilent 1260 chromatograph with a 5μm Zorbax Eclipse XDB-C18 column (4.6×150mm) and a mobile phase composed of acetonitrile and 0.05mol/L of a sodium acetate buffer solution at pH 3.5. The detection was performed at 305nm. Results. The method did not show interferences by metabolites or other drugs. The lower limit of quantitation was 0.05μmol/L. Inter- and intra-assay precision and accuracy were acceptable in the working range (0.05-5.0μmol/L), and linear behaviour was observed. Toxic plasma levels of MTX were observed in 29.4% and 60% of the patients from 24h infusion and 36h infusion, respectively. Therefore, leucovorin rescue treatment was either applied earlier or reinforced. Conclusions. The chromatography method was efficient and accessible for the therapeutic drug monitoring of MTX in paediatric patients, allowing appropriate medical decision making within a short time of analysis


Assuntos
Humanos , Criança , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Metotrexato/uso terapêutico , Cromatografia Líquida de Alta Pressão/métodos , Leucovorina/uso terapêutico , Terapia Combinada/métodos , Quimioterapia Combinada/métodos , Monitoramento de Medicamentos/métodos , Estudos Retrospectivos , Formas de Dosagem
19.
Rev. esp. quimioter ; 30(3): 183-194, jun. 2017. graf, tab
Artigo em Inglês | IBECS | ID: ibc-163231

RESUMO

Introduction. A rapid, simple and sensitive high-performance liquid chromatography (HPLC) method with ultraviolet detection has been developed for quantification of darunavir and raltegravir in their pharmaceutical dosage form. Material and methods. The assay enables the measurement of both drugs with a linear calibration curve (R2= 0.999) over the concentration range 5-100 mg/L. The determination was performed on an analytical Tracer Excel 120 ODSB (15x0.4.6 cm) column at 35ºC. The selected wavelength was 254 nm. The mobile phase was a mixture of 0.037 M sodium dihydrogen phosphate buffer, acetonitrile and methanol (40:50:10, v/v/v) at a flow rate of 2.0 mL/min Nevirapine (50 mg/L) was used as internal standard. Results. Accuracy, intraday repeatability (n = 5), and inter-day precision (n = 3) were found to be satisfactory, being the accuracy from -4.33 to 3.88% and precisions were intra-day and interday, 0.25% and 4.42% respectively in case of darunavir. Raltegravir intraday and interday precisions lower of 1.01 and 2.36%, respectively and accuracy values bet from -4.02 to 1.06%. Conclusions. Determination of the darunavir and raltegravir in their dosage form was done with a maximum deviation of 4%. This analytical method is rapid, easily implantable and offers good results (AU)


Introducción. Un método rápido, sencillo y sensible de cromatografía líquida de alto rendimiento (HPLC) con detección ultravioleta ha sido desarrollado para la cuantificación simultánea de darunavir y raltegravir en su forma farmacéutica. Material y métodos. La determinación se llevó a cabo empleando una columna Tracer Excel 120 ODSB (15x0.4.6 cm) C18 a 35 ºC. La longitud de onda empleada fue de 254 nm. La fase móvil fue una mezcla de una disolución tampón dihidrógeno fosfato de sodio 0,037 M, acetonitrilo y metanol (40:50:10, v/v/v) con un flujo de 2,0 mL/min. El fármaco nevirapina (50 mg/L) fue usado como patrón interno. Resultados. El ensayo realiza la medida de ambos fármacos con una curva de calibración lineal (R2= 0,999) en un rango de concentración de 5 a 100 mg/L. Los valores de exactitud, repetibilidad intradía (n = 5) e interdía (n = 3) han resultado satisfactorios, encontrándose los valores de exactitud entre -4.33 y 3.88%, y las precisiones intradía e interdía, 0,25% y 4,42%, respectivamente en caso de darunavir. En el caso del raltegravir, las precisiones intradía e interdía fueron de 1,01 y 2,36%, respectivamente y para la exactitud se obtuvieron valores entre -4,02 y 1,06%. Conclusiones. La determinación de darunavir y raltegravir en su forma farmacéutica fue llevada a cabo observándose una desviación máxima del 4%. El método es rápido, fácilmente implantable y ofrece buenos resultados (AU)


Assuntos
Humanos , Antirretrovirais/análise , Antirretrovirais/farmacologia , Darunavir/farmacologia , Raltegravir Potássico/farmacologia , Formas de Dosagem/normas , Sensibilidade e Especificidade , Cromatografia/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA