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4CPS-100 Intradialytic parenteral nutrition effects on albumin levels in malnourished haemodialysis patients 营养不良血液透析患者分析性肠外营养对白蛋白水平的影响
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.392
K. Álvarez Tosco, C. Fraile Clemente, C. Pérez Martín, I. González García, CL Díaz Díaz, P. Joy Carmona, A. Martín López, J. Merino Alonso
Malnutrition is one of the stron-gest predictors of mortality and morbidity in haemodialysis patients. Albumin levels are used as an indicator of its severity and concentrations under 3.8 g/dL indicate severe malnutrition. As first-line treatment, guidelines recommend nutritional counselling and oral nutrition supplements. Furthermore, parenteral nutrition during regular haemodialysis sessions, known as intradialytic parenteral nutrition (IDPN), is an option for patients who can nottolerate oral or enteral routes for nutrition supplements.
营养不良是血液透析患者死亡率和发病率的最强预测因素之一。白蛋白水平被用作其严重程度的指标,浓度低于3.8 g/dL表示严重营养不良。作为一线治疗,指南建议进行营养咨询和口服营养补充剂。此外,在常规血液透析期间进行肠外营养,即分析性肠外营养(IDPN),是不能耐受口服或肠内营养补充剂的患者的一种选择。
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引用次数: 0
4CPS-237 Measuring adherence to antiretroviral treatment: correlation and concordance between two indirect methods 4CPS-237衡量抗逆转录病毒治疗依从性:两种间接方法的相关性和一致性
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.407
A. López-García, N. Herranz-Muñoz, I. Salvador-Llana, P. Sanmartín-Fenollera, M. Vélez-Díaz-Pallarés, JA Peña-Pedrosa, C. Martínez-Nieto, A. Onteniente-González, LM Bedoya-del-Olmo, I. Iglesias-Peinado, J. Sánchez-Rubio-Ferrández
Á López-García*, N Herranz-Muñoz, I Salvador-Llana, P Sanmartín-Fenollera, M VélezDíaz-Pallarés, JA Peña-Pedrosa, C Martínez-Nieto, A Onteniente-González, LM BedoyaDel-Olmo, I Iglesias-Peinado, J Sánchez-Rubio-Ferrández. Hospital Universitario de Getafe, Pharmacy Department, Getafe, Spain; Hospital Universitario Fundación Alcorcón, Pharmacy Department, Alcorcón, Spain; Hospital Universitario Ramón y Cajal, Pharmacy Department, Madrid, Spain; Hospital Clínico San Carlos, Pharmacy Department, Madrid, Spain; Hospital Universitario de La Princesa, Pharmacy Department, Madrid, Spain; Universidad Complutense de Madrid, Facultad de Farmacia, Madrid, Spain
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引用次数: 0
4CPS-027 Desensitisation protocol for liposomal amphothericin B: a case report 两性霉素B脂质体脱敏方案:1例报告
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.382
E. Wilhelmi, C. Salazar, R. Farré, M. Duero, A. Machinena, M. Gómez
Background and importance Liposomal amphotericin B (ANBL) is an effective and safe treatment, however non-IgE-mediated hypersensitivity reactions have been described. Aim and objectives To describe the ANBL desensitisation protocol in a patient with leishmaniasis who developed a demonstrated hypersensitivity reaction to the drug. Material and methods A 16-year-old male, 85 kg, with severe corticodependent eosinophilic asthma, was admitted for prolonged fever, cholestatic hepatitis, splenomegaly and thrombocytopenia. Visceral leishmaniasis was diagnosed and ANBL treatment was started at 3 mg/kg intravenously (IV) to be administered over 2 hours. During the perfusion the patient presented back pain and headache, which subsided when the perfusion was interrupted. Later, the perfusion was restarted at a slower rate; however, he developed erythematous plaques, discomfort, tachycardia and fever, as a result of which the perfusion was stopped. The ANBL prick test was negative. It has been described that in non-IgE reactions there is a release of cytokines that trigger the symptoms of fever, hypotension, etc. Desensitisation to the antigen produced by the initial cytokine cascade is possible. Second-line alternatives for leishmaniasis were not considered adequate, so it was decided to restart ANBL with a desensitisation protocol, which consisted of administering the drug in three steps, progressively increasing the infusion rate and concentration until administration of the full dose was reached. Low initial doses of antigen produce progressive depletion of activating signals and inhibition of mediator release, thus reducing clinical reactivity. Results In our case, desensitisation consisted of only two steps: 1/10 dilution at a concentration of 0.2 mg/mL (25 mg/ 125mL) and the full dose at 1 mg/mL (250 mg/250mL) of ANBL in 5% glucose serum because there are no stability data for a more dilute preparation of ANBL (1/100). The first dilution was administered in five perfusion rhythms starting at 2.5 mL/hour in 15 min, given good tolerance, the speed was progressively increased every 15 min: 5 mL/hour, 10 mL/hour, 20 mL/hour up to 40 mL/hour. Subsequently, the full dose of ANBL was administered in four rhythms, starting at 10 mL/hour, and increasing to 20 mL/hour, 40 mL/hour to 60 mL/hour, which was maintained until the full dose was reached. Premedication with paracetamol plus IV dexchlorpheniramine was necessary. Conclusion and relevance The use of an ANBL desensitisation protocol has proven to be a safe option, which has allowed the administration of treatment without the appearance of adverse effects.
背景和重要性脂质体两性霉素B (ANBL)是一种有效和安全的治疗方法,然而非ige介导的超敏反应已被描述。目的和目的描述一名利什曼病患者的ANBL脱敏方案,该患者对该药表现出超敏反应。材料与方法16岁男性,85公斤,患有严重的皮质依赖性嗜酸性粒细胞性哮喘,因长期发热、胆汁淤积性肝炎、脾肿大和血小板减少而入院。诊断为内脏利什曼病,并开始以3mg /kg静脉注射(IV) ANBL治疗,持续2小时。灌注过程中患者出现腰痛和头痛,灌注中断后症状消退。随后,以较慢的速度重新开始灌注;但患者出现红斑斑块、不适、心动过速及发热,并停止灌注。ANBL点刺试验为阴性。据描述,在非ige反应中,有细胞因子的释放,引发发烧、低血压等症状。对最初细胞因子级联反应产生的抗原脱敏是可能的。利什曼病的二线替代方案被认为不够,因此决定用脱敏方案重新启动ANBL,该方案包括分三步给药,逐步增加输注速度和浓度,直到达到全剂量。低初始剂量抗原产生的激活信号的逐渐消耗和抑制介质释放,从而降低临床反应性。在我们的病例中,脱敏只包括两个步骤:1/10稀释浓度为0.2 mg/mL (25 mg/ 125mL)和1 mg/mL (250 mg/250mL) ANBL在5%葡萄糖血清中的全剂量,因为没有更稀释的ANBL制备(1/100)的稳定性数据。第一次稀释在15分钟内以2.5 mL/小时开始的5个灌注节律进行,给予良好的耐受性,每15分钟逐渐增加速度:5ml /小时,10ml /小时,20ml /小时直到40ml /小时。随后,以4个节律给药ANBL全剂量,从10 mL/小时开始,逐渐增加到20 mL/小时、40 mL/小时至60 mL/小时,一直维持到达到全剂量。前用药对乙酰氨基酚加静脉注射右氯苯那敏是必要的。结论和相关性使用ANBL脱敏方案已被证明是一种安全的选择,它允许在没有出现不良反应的情况下进行治疗。
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引用次数: 0
4CPS-136 Persistence of first-line biological therapy in patients with Crohn’s disease 克罗恩病患者一线生物治疗的持久性
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.397
A. Corderi Sierra, D. Javier, Bonato Marc, GJ Begonya, SU Azhara, PC Laia, MM Raquel, AJ Veronica, L. David, CB Lluis, Grimes Teresa
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引用次数: 0
5PSQ-150 Implementation of a program for optimising the use of antibiotics (PROA) in the paediatrics emergency care unit of a third-level hospital 5PSQ-150在一家三级医院的儿科急诊病房实施优化抗生素使用方案
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.428
I. Garcia del Valle, G. Morla Clavero, P. Marcos Pacua, N. Joaqui Lopez, M. Garcia Pelaez, G. Baronet Jordana, M. Sanmartín Suñer, L. Val Prat
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引用次数: 0
4CPS-239 Impact of knowledge about human immunodeficiency virus (HIV) transmission on the qualiy of life of people living with HIV 人类免疫缺陷病毒(HIV)传播知识对HIV感染者生活质量的影响
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.408
A. López-García, N. Herranz-Muñoz, I. Salvador-Llana, P. Sanmartín-Fenollera, M. Vélez-Díaz-Pallarés, JA Peña-Pedrosa, C. Martínez-Nieto, A. Onteniente-González, LM Bedoya-del-Olmo, I. Iglesias-Peinado, J. Sánchez-Rubio-Ferrández
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引用次数: 0
4CPS-036 Is our protocol for the use of tocilizumab in COVID patients adequate? 我们在COVID患者中使用tocilizumab的方案是否足够?
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.385
A. Dominguez Barahona, S. Gonzalez Suarez, MA Toledo Davia, C. Blázquez Romero, L. Torralba Fernández, R. López Álvarez, C. Jiménez Méndez, P. Moya Gómez
Background and importanceTocilizumab (TCZ) has been a key pillar in the management of pulmonary hyperinflammation in patients with SARS-CoV-2 pneumonia. The incessant publication of new studies assessing its effectiveness and the ideal time of use means that in-hospital protocols are constantly being reviewed and updated.Aim and objectivesTo describe the clinical characteristics of hospitalised patients with SARS-CoV-2 pneumonia treated with TCZ and their evolution, and to compare our results with those of the primary endpoint (28-day mortality) of the RECOVERY study.Material and methodsRetrospective observational study of patients administered TCZ between October 2020 and February 2021 in a tertiary hospital. Criteria for TCZ use were PAFI <300 and meeting two of the following three criteria: C-reactive protein (CRP) >150 mg/L, D-dimer >1500 ng/mL and ferritin >2000 ng/mL, and not having contraindications for its use.Each patient received a single dose of 400 mg if weight <75 kg and 600 mg if weight >75 kg.Demographic data, comorbidities and days from symptom onset to TCZ administration were collected. Follow-up of analytical data (CRP, D-dimer and ferritin pre- and post- (15 days) TCZ administration). Clinical evolution was evaluated by mortality rate at 28 days.Statistical analysis: Stata/MP v16.0. Student’s t-test was used for comparison of quantitative variables.Results39 patients were included, 25 (64.1%) were male, median age 74 (IQR 61–80) years. 61.5% had hypertension, 33.3% obesity, 41% diabetes mellitus, 17.9% chronic kidney disease, 12.8% heart disease. The median time from symptom onset to TCZ administration was 10 (IQR 7–15) days.The medians prior to and at 15 days of TCZ administration were, respectively: 152.5 mg/L (IQR 89–220.8) and 1.7 mg/L (IQR 0.65–4.2) CRP (p<0.001);2300 ng/mL (IQR 11 959–4889) and 1124 ng/mL (IQR 567–1439) D-dimer (p=0.1726);1242 ng/mL (IQR 647–2705) and 851 ng/mL (IQR 268–1384) ferritin (p=0.1294). Mortality at 28 days was 64.1%.Conclusion and relevanceOur sample size is smaller than that of the RECOVERY study;however, the days of symptoms until TCZ administration (10 vs 9) and the median CRP prior to TCZ (143 vs 152.5 mg/L) in both studies are very similar. Our mortality is much higher (64.1% vs 29%). We found a statistically significant difference between our pre- and post-CRP data.With this result, the in-hospital protocol was modified and new criteria for TCZ administration in COVID patients became oxygen saturation <92% or PAFI >300 and CRP >75 mg/L, with no contraindications for use.In subsequent studies we will test whether this update helps to improve mortality outcomes.References and/or acknowledgementsConflict of interestNo conflict of interest
背景和重要性tocilizumab (TCZ)已成为管理SARS-CoV-2肺炎患者肺部高炎症的关键支柱。评估其有效性和理想使用时间的新研究的不断发表意味着医院内的协议不断被审查和更新。目的和目的描述使用TCZ治疗的SARS-CoV-2肺炎住院患者的临床特征及其演变,并将我们的结果与RECOVERY研究的主要终点(28天死亡率)进行比较。材料与方法回顾性观察研究某三级医院2020年10月至2021年2月接受TCZ治疗的患者。TCZ的使用标准为PAFI 150 mg/L, d -二聚体>1500 ng/mL,铁蛋白>2000 ng/mL,无使用禁忌症。如果体重为75公斤,每位患者接受单次剂量400毫克。收集人口统计数据、合并症和从症状出现到服用TCZ的天数。随访分析数据(TCZ给药前后(15天)CRP、d -二聚体、铁蛋白)。以28天死亡率评价临床进展。统计分析:Stata/MP v16.0。定量变量比较采用学生t检验。结果纳入39例患者,男性25例(64.1%),中位年龄74岁(IQR 61 ~ 80)。61.5%患有高血压,33.3%患有肥胖症,41%患有糖尿病,17.9%患有慢性肾病,12.8%患有心脏病。从症状出现到服用TCZ的中位时间为10 (IQR 7-15)天。TCZ给药前和15天的中位数分别为:152.5 mg/L (IQR 89-220.8)和1.7 mg/L (IQR 0.65-4.2) CRP (p300和CRP >75 mg/L,无使用禁忌症。在随后的研究中,我们将测试这一更新是否有助于改善死亡率结果。参考文献和/或致谢利益冲突无利益冲突
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引用次数: 0
4CPS-095 Appropriateness of empirical antibiotic therapy for cervicitis and urethritis prescribed at the emergency department 急诊对宫颈炎和尿道炎经验性抗生素治疗的适宜性
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.391
A. de Lorenzo-Pinto, C. Ortega-Navararo, B. Torroba-Sanz, C. Fernandez-Llamazares, I. Taladriz-Sender, A. Herranz-Alonso, M. Sanjurjo-Sáez
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引用次数: 0
4CPS-199 Evaluation of fremanezumab response in migraine prophylaxis 4CPS-199评估fremanezumab在偏头痛预防中的反应
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.404
M. Gutiérrez Lorenzo, M. F. Fernández Gonzalez, P. Ciudad Gutiérrez, P. del Valle Moreno
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引用次数: 0
5PSQ-148 TANDEM project: transitions of care and medication reconciliation in high-risk patients 5PSQ-148 TANDEM项目:高危患者的护理转变与用药和解
Pub Date : 2022-03-01 DOI: 10.1136/ejhpharm-2022-eahp.427
C. Ortega Navarro, A. de Lorenzo Pinto, R. García Sánchez, B. Torroba Sanz, A. Herranz Alonso, M. Sanjurjo Sáez
{"title":"5PSQ-148 TANDEM project: transitions of care and medication reconciliation in high-risk patients","authors":"C. Ortega Navarro, A. de Lorenzo Pinto, R. García Sánchez, B. Torroba Sanz, A. Herranz Alonso, M. Sanjurjo Sáez","doi":"10.1136/ejhpharm-2022-eahp.427","DOIUrl":"https://doi.org/10.1136/ejhpharm-2022-eahp.427","url":null,"abstract":"","PeriodicalId":393937,"journal":{"name":"Section 7: Post Congress additions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131135170","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}
引用次数: 0
期刊
Section 7: Post Congress additions
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