Review of Drug Storage Conditions, A Case Report.

High temperatures during the summer season are a very important factor to be considered due to their possible influence on drug stability and effectiveness. This is especially important in those patients included in clinical trials, polymedicated or with long-term pharmacological therapies.

Determination of plasma uracil as a screening for dihydropyrimidine dehydrogenase deficiency: clinical application in oncological treatments.

AIMS: Treatment with dihydropyrimidines poses a significant risk of serious adverse reactions for patients with dihydropyrimidine dehydrogenase (DPD) deficiency. This study seeks to analyse the correlation between DPD deficiency and plasmatic uracil values in patients who are candidates for a fluoropyrimidine scheme. It also studies the incidence of adverse events (AEs) in patients with DPD deficiency established with plasmatic uracil determination. METHODS: This was a retrospective observational study conducted in a tertiary level establishment from September 2020 to April 2021. Patients included were diagnosed with gastrointestinal tumours, were of good status, and were initiated into a fluoropyrimidine-based regimen. The incidence and grade of AEs, according Common Terminology Criteria for Adverse Events (CTCAE), were collected and compared in patients with and without DPD deficiency. RESULTS: 119 patients diagnosed with gastrointestinal cancer met the inclusion criteria. In 92 (77%) patients there was no DPD deficiency according to plasmatic uracil thresholds. In the group of patients without deficit, dose reductions oscillated between 10-25% (mean 17.4%). In the no DPD deficiency group, 43 (46%) patients experienced AEs. Patients who had a DPD deficiency according to plasmatic uracil measurements were started on a 5-fluorouracil (5-FU) regimen with a dose reduction of 15-50% (mean 35%). In this group, 12 patients (44%) experienced some AEs. CONCLUSION: New research is needed to clarify the correlation between plasma uracil values and DPD deficiency to achieve an optimal balance between clinical benefit and toxicity.

Guía de administración de antineoplásicos orales en pacientes con trastornos de la deglución / A guide for the administration of oral antineoplastic in patients with swallowing disorders

Objetivo: Revisar la literatura disponible sobre la administración de antineoplásicos orales en pacientes con trastornos de la deglución y realizaruna síntesis de la información hallada.Método: En el periodo septiembre 2019-junio 2020, tres farmacéuticoshospitalarios elaboraron una lista con los antineoplásicos orales disponibles en España, la cual fue repartida, y cada cual llevó a cabo labúsqueda y revisión bibliográfica de los medicamentos asignados. Serevisaron las fichas técnicas y así como Pubmed, Micromedex, Uptodate,la página web del Cancer Care Ontario, diferentes boletines farmacéuticos, guías de administración por sonda y otras fuentes terciarias deinformación. En último lugar, se contactó con la industria farmacéutica.Posteriormente cada uno sintetizó la información que había hallado ypara concluir, un médico y un cuarto farmacéutico hospitalario revisarontodo el trabajo llevado a cabo.Resultados: Se revisaron un total de 64 fármacos antineoplásicos orales.Se obtuvo información pertinente en el caso de 48, de los cuales 44 presentaban posibilidad de administración en estos pacientes (un 69% de losfármacos investigados). Se realizó una síntesis de la información hallada.Conclusiones: Pese a haber encontrado posibles métodos de preparación y administración para la mayoría de los antineoplásicos orales revisados, se constata que la información es más bien escasa y con bajo nivelde evidencia. Es necesario seguir investigando en este campo, ya que seprecisan formas farmacéuticas líquidas, o preparaciones extemporáneas,que en base a estudios farmacocinéticos y de estabilidad permitan la administración de antineoplásicos orales en este grupo de pacientes. (AU)

Objective: To review the available literature on the administration of oralantineoplastic drugs in patients with swallowing disorders and systematizethe information obtained.Method: Between September 2019 and April 2020, two hospital pharmacists drew up a list of the oral antineoplastic drugs available in Spain,which was then distributed to three hospital pharmacists, each of whomcarried out a literature search and a review. An analysis was made ofthe prescribing information and searches were performed in Pubmed,Micromedex, Uptodate, the Cancer Care Ontario website, different pharmaceutical bulletins, feeding tube administration guidelines, and tertiaryinformation sources. Lastly, the pharmaceutical industry was contacted.The group systematized the information obtained, after which a fourthhospital pharmacist and an independent physician reviewed the workcarried out.Results: A total of 64 oral antineoplastic drugs were reviewed. Relevantinformation was obtained for 48 drugs, of which 44 were amenable toadministration to these patients (69% of the investigated drugs). A systematization of the information found was carried out.Conclusions: Despite having found different methods for preparing andadministering most of the oral antineoplastic drugs reviewed, the information compiled was rather scarce and with a low level of evidence. Further studies, based on pharmacokinetic and stability studies, are necessary inthis field as there is a sore need for oral liquid pharmaceutical forms orextemporaneous preparations allowing administration of oral antineoplastic drugs to these patients. (AU)

A guide for the administration of oral antineoplastic in patients with swallowing disorders.

OBJECTIVE: To review the available literature on the administration of oral antineoplastic drugs in patients with swallowing disorders and  ystematize the information obtained. METHOD: Between September 2019 and April 2020, two hospital  harmacists drew up a list of the oral antineoplastic drugs available in  Spain, which was then distributed to three hospital pharmacists, each of  whom carried out a literature search and a review. An analysis was made  of the prescribing information and searches were performed in Pubmed, Micromedex, Uptodate, the Cancer Care Ontario website,  different pharmaceutical bulletins, feeding tube administration guidelines,  and tertiary information sources. Lastly, the pharmaceutical industry was  contacted. The group systematized the information obtained, after which a fourth hospital pharmacist and an independent physician reviewed the  work carried out. RESULTS: A total of 64 oral antineoplastic drugs were reviewed. Relevant information was obtained for 48 drugs, of which 44 were  amenable to administration to these patients (69% of the investigated  drugs). A systematization of the information found was carried out. Conclusions: Despite having found different methods for preparing and administering most of the oral antineoplastic drugs reviewed, the  information compiled was rather scarce and with a low level of evidence.  Further studies, based on pharmacokinetic and stability studies, are  necessary in this field as there is a sore need for oral liquid pharmaceutical forms or extemporaneous preparations allowing administration of oral  antineoplastic drugs to these patients.

Objetivo: Revisar la literatura disponible sobre la administración de  antineoplásicos orales en pacientes con trastornos de la deglución y  realizar una síntesis de la información hallada.Método: En el periodo septiembre 2019-junio 2020, tres farmacéuticos hospitalarios elaboraron una lista con los antineoplásicos  orales disponibles en España, la cual fue repartida, y cada cual llevó a  cabo la búsqueda y revisión bibliográfica de los medicamentos asignados.  Se revisaron las fichas técnicas y así como Pubmed, Micromedex,  Uptodate, la página web del Cancer Care Ontario, diferentes boletines  farmacéuticos, guías de administración por sonda y otras fuentes terciarias de información. En último lugar, se contactó con la industria farmacéutica. Posteriormente cada uno sintetizó la información que había  hallado y para concluir, un médico y un cuarto farmacéutico hospitalario  revisaron todo el trabajo llevado a cabo.Resultados: Se revisaron un total de 64 fármacos antineoplásicos orales. Se obtuvo información pertinente en el caso de 48, de los cuales 44  presentaban posibilidad de administración en estos pacientes (un 69% de  los fármacos investigados). Se realizó una síntesis de la información  hallada.Conclusiones: Pese a haber encontrado posibles métodos de preparación y administración para la mayoría de los antineoplásicos orales  revisados, se constata que la información es más bien escasa y con bajo  nivel  de evidencia. Es necesario seguir investigando en este campo, ya  que se precisan formas farmacéuticas líquidas, o preparaciones  extemporáneas, que en base a estudios farmacocinéticos y de estabilidad  permitan la administración de antineoplásicos orales en este grupo de  pacientes.