[Dose adjustment according to renal function in a polymedicated patient included in the medication reconditioning service using medication compliance aids (MCA)]. / Ajuste de dosis según función renal en una paciente polimedicada incluida en el servicio de reacondicionamiento de medicamentos utilizando sistemas personalizados de dosificación (SPD).

78-year-old patient, polymedicated and enrolled in the medication compliance aids service. When she went to pick up her medication, she informed us that for a few months she has been suffering from fatigue, weakness, dizziness and confusion. A medication review is performed, focused on the dosage of renal metabolism or elimination medications, based on the patient's estimated Glomerular Filtration Rate (eGFR). A referral was made to the Primary Care Physician (PCP) through a report, in which the dose reduction of losartan and manidipine was recommended according to the patient's eGFR. The PCP reduced the dose of antihypertensives. A follow-up of the case was carried out, which allowed to observe that the patient stopped presenting the symptoms initially described.

[Probable pharmacological interaction between sulfonylurea and beta-blocker in a patient with DM-II. A case report]. / Probable interacción farmacológica entre sulfonilurea y betabloqueante en paciente con DM-II. Un reporte de caso.

The study presents the case of a 47-year-old woman with type 2 diabetes (T2D), hypertension and anemia, treated with metformin, glyburide, metoprolol, and iron/folic acid. A drug interaction was identified between glyburide and metoprolol, causing symptoms of hypoglycemia in the afternoon. Evaluation using Horn's Drug Interaction Probability Scale (DIPS) suggested a probable interaction. Pharmacokinetic analysis revealed that the time at which the maximum concentrations of both drugs were reached coincided with the onset of symptoms. A new medication schedule was implemented which resolved the symptoms. The drug interaction was attributed to the blockade of adrenergic effects by metoprolol, compromising the ability to counteract the action of insulin released by glybenclamide. The importance of surveillance, informed decision-making and the implementation of preventive strategies is highlighted to ensure the safety and effectiveness of pharmacological treatment in patients with specific clinical conditions, such as T2D and concomitant cardiovascular diseases.

H(N3)dap (Hdap = 2,6-Diaminopurine) Recognition by Cu2(EGTA): Structure, Physical Properties, and Density Functional Theory Calculations of [Cu4(µ-EGTA)2(µ-H(N3)dap)2(H2O)2]·7H2O.

Reactions in water between the Cu2(µ-EGTA) chelate (EGTA = ethylene-bis(oxyethyleneimino)tetraacetate(4-) ion) and Hdap in molar ratios 1:1 and 1:2 yield only blue crystals of the ternary compound [Cu4(µ-EGTA)2(µ-H(N3)dap)2(H2O)2]·7H2O (1), which has been studied via single-crystal X-ray diffraction and various physical methods (thermal stability, spectral and magnetic properties), as well as DFT theoretical calculations. In the crystal, uncoordinated water is disordered. The tetranuclear complex molecule also has some irrelevant disorder in an EGTA-ethylene moiety. In the complex molecule, both bridging organic molecules act as binucleating ligands. There are two distorted five- and two six-coordinated Cu(II) centers. Each half of EGTA acts as a tripodal tetradentate Cu(II) chelator, with a mer-NO2 + O(ether, distal) conformation. Hdap exhibits the tautomer H(N3)dap, with the dissociable H-atom on its less basic N-heterocyclic atom. These features favor the efficient cooperation between Cu-N7 or Cu-N9 bonds with appropriate O-EGTA atoms, as N6-H···O or N3-H···O interligand interactions, respectively. The bridging role of both organics determines the tetranuclear dimensionality of the complex. In this crystal, such molecules associate in zig-zag chains built by alternating π-π interactions between the five- or six-atom rings of Hdap ligands of adjacent molecules. DFT theoretical calculations (using two different theoretical models and characterized by the quantum theory of "atoms in molecules") reveal the importance of these π-π interactions between Hdap ligands, as well as those corresponding to the referred hydrogen bonds in the contributed tetranuclear molecule.