Irene Zarra-Ferro

• Complejo Hospitalario Universitario de Santiago

Aripiprazole (ARI) is an atypical antipsychotic which is a substrate of P-glycoprotein (P-gp), a transmembrane glycoprotein that plays a crucial role in eliminating potentially harmful compounds from the organism. ARI once-monthly (AOM) is a long-acting injectable form which improves treatment compliance. Genetic polymorphisms in ABCB1 may lead to...

Background and Objectives: The use of artificial intelligence (AI) and, in particular, machine learning (ML) techniques is growing rapidly in the healthcare field. Their application in pharmacokinetics is of potential interest due to the need to relate enormous amounts of data and to the more efficient development of new predictive dose models. The...

Background and Objectives: The use of Artificial intelligence (AI) and, in particular, Machine Learning (ML) techniques is growing rapidly in the healthcare field. Their application in pharma-cokinetics is of potential interest due to the need to relate enormous amounts of data and to the more efficient development of new predictive dose models. Th...

Introduction Linezolid is a broadly used antibiotic to treat complicated infections caused by gram-positive bacteria. Therapeutic drug monitoring of linezolid concentrations is recommended to maximise its efficacy and safety, mainly haematological toxicity. Different pharmacokinetic/pharmacodynamic targets have been proposed to improve linezolid ex...

Ophthalmic tacrolimus compounded formulations are usually made from the commercial intravenous presentation, which contains ethanol as a solubilizer due to the low solubility of tacrolimus. The use of cyclodextrins is presented as an alternative to ethanol, an ocular irritant excipient, to avoid its long-term irritant effects. Open-label, sequentia...

The prevalence of obesity has increased considerably in the last few decades. Pathophysiological changes in obese patients lead to pharmacokinetic (PK) and pharmacodynamic (PD) alterations that can condition the correct exposure to antimicrobials if standard dosages are used. Inadequate dosing in obese patients can lead to toxicity or therapeutic f...

Background and Importance Magnesium deficiency is mainly manifested in cardiac and neuromuscular disorders. Hypomagnesaemia has been described as a frequent adverse reaction associated with the intravenous administration of liposomal amphotericin B. Aim and Objectives To compare associated hypomagnesaemia in patients with fungal infection receivin...

Background and Importance Obeticholic acid (OCA) is an orphan drug for patients with primary biliary cholangitis (PBC), a rare autoimmune disease, who do not respond adequately to treatment with ursodeoxycholic acid (UDCA) or do not tolerate it. Aim and Objectives To evaluate the efficacy and safety of OCA in patients with PBC. Material and Metho...

Background and Importance Hypothyroidism is a limiting and underestimated adverse effect of metastatic prostate cancer treatments, the impact of which in elderly patients is more significant. Apalutamide and enzalutamide are drugs with similar chemical structure, but differ in terms of adverse effect profile. Hypothyroidism is described as a common...

Background and Importance In the literature, there is an indicator of response to treatment with enzalutamide and apalutamide, defined as PSA90, for patients with metastatic castration-sensitive prostate cancer (mCSPC). However, no early response marker to abiraterone treatment in the setting of synchronous mCSPC has been described. Aim and Object...

Background and Importance Therapeutic drug monitoring in inflammatory bowel disease (IBD) is a useful tool for optimising biologic therapy. The analysis of adalimumab (ADL) concentrations in blood through enzyme-linked immunosorbent assay (ELISA) requires accumulation of samples to make it a cost-efficient technique, delaying the results for severa...

Aim The aim of the study was to define and compare persistence of infliximab and adalimumab according to the treatment line. The secondary objectives were to identify factors that influence persistence. Methods We performed an observational, retrospective, single-center study with adult patients diagnosed with Crohn’s disease between November 2001...

Therapeutic drug monitoring improves the benefit–risk balance of antipsychotic therapy. Ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) is considered the gold-standard method for measuring plasma drug concentrations; however, the Alinity C system has emerged as a promising alternative. This is the first study aim...

The introduction of point-of-care (POC) assays into clinical practice in patients with inflammatory disease enables on-demand therapeutic decision making. The aim of this study was to compare the POC test Quantum blue (Bühlmann Laboratories) for infliximab (IFX), adalimumab (ADL), and its anti-drug antibodies with the traditional ELISA assay (Promo...

Background: Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in several tissues and organs causing, among others, severe eye symptoms. The high instability of cysteamine eye drops makes it difficult to develop formulations with an acceptable shelf life to be prepared in hospital pharmacy departments. Previ...

Introduction: there is a wide variety of enteral nutrition and infant formulas preparations. When there is a need to find infomation on a product, only the infomation from industy is available. Comparison amomg products becomes then ardous. Objective: to describe the development of NEmecum as the first website that allows a directed and independent...

Introduction: The cognitive safety of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has been established in clinical trials, but not yet in real-world observational studies. We assessed the cognitive function in patients initiating PCSK9i, and differences in cognitive function domains, to analyze subgroups b...

Outpatient parenteral antimicrobial therapy (OPAT) with continuous infusion pumps is postulated as a very promising solution to treat complicated infections, such as endocarditis or osteomyelitis, that require patients to stay in hospital during extended periods of time, thus reducing their quality of life and increasing the risk of complications....

Background and Importance In patients with NSCLC and programmed death ligand-1 (PD-L1) expression ≥50%, pembrolizumab as first-line treatment has shown an increase in survival over platinum-based chemotherapy. To date, it is not known whether higher PD-L1 expression is associated with longer survival. Aim and Objectives The aim of this study is to...

Background: Inhaled ethanol in the early stages of SARS-CoV-2 infection may reduce the viral load, decreasing progression and improving prognosis. The ALCOVID-19 trial was designed to study the efficacy and safety of inhaled ethanol in older adults at initial phases of infection. Methods: Randomized, triple-blind, placebo-controlled phase II clinic...

Background and aims: Submucosal injection agents are widely used solutions in gastric polyp resection techniques. Currently, many different solutions are used in clinical practice, but most are not authorised for this use or are not biopharmaceutical characterised. The objective of this multidisciplinary work is to test the efficacy of a novel the...

Objective: To describe the implementation of a pilot Telepharmacy project (TELEA-Farmacia) in adult patients with cancer, analyze the results obtained, and identify opportunities for improvement, from a hospital pharmacy service. Method: Between October and December 2021, oncology patients, collecting their oral antineoplastic drugs at the Unit...

Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in different tissues and organs causing, among other symptoms, severe ocular manifestations. Cysteamine eye drops are prepared in hospital pharmacy departments to facilitate access to treatment, for which vehicles that provide adequate biopermanence, as well...

In recent years, many studies on population pharmacokinetics of linezolid have been conducted. This comprehensive review aimed to summarize population pharmacokinetic models of linezolid, by focusing on dosage optimization to maximize the probability of attaining a certain pharmacokinetic-pharmacodynamic parameter in special populations. We searche...

Objective: We designed a clinical study to analyze patterns of adherence to obeticholic acid, factors influencing the adherence and potential correlation with treatment efficacy by using MEMS® cap in practice daily. Method: A multicenter prospective observational study of patients with primary biliary cholangitis. Adherence will be measured by MEM...

Background and importance Inflammation is involved in the development and pathogenesis of age-related macular degeneration (n-AMD) although the roles that the inflammation-related cytokines play in it are not yet defined as some of them are pro-angiogenic. Local and systemic inflammatory molecules are being proposed as potential biomarkers of n-AMD...

Background and importance Lysosomal acid lipase (LAL) deficiency is a rare metabolic disease (0.2:10 000) characterised by lysosomal accumulation of cholesterol esters and triglycerides, with a severe and rapidly progressive form known as Wolman disease (WD), usually fatal in the first 6–12 months of life. Sebelipase alfa (SA) is a recombinant huma...

Background Low dose dexamethasone demonstrated clinical improvement in patients with coronavirus disease 2019 (COVID-19) needing oxygen therapy; however, evidence on the efficacy of high dose of dexamethasone is limited. Methods We performed a randomised, open-label, controlled trial involving hospitalised patients with confirmed COVID-19 pneumoni...

PurposeGenetic variants in genes involved in the distribution, metabolism, accumulation or repair of lesions are likely to influence the response of drugs used in the treatment of Head and Neck Cancer (HNC). We examine the effect of 36 SNPs on clinical outcomes in patients with locally advanced HNC who were receiving platinum-based chemoradiotherap...

Over the last two decades, pharmacogenetics and pharmacokinetics have been increasingly used in clinical practice in Psychiatry due to the high variability regarding response and side effects of antipsychotic drugs. Specifically, long-acting injectable (LAI) antipsychotics have different pharmacokinetic profile than oral formulations due to their s...

Vitreo‐retinal disorders constitute a significant portion of treatable ocular diseases. These pathologies often require vitreo‐retinal surgery and, as a consequence, the use of vitreous substitutes. Nowadays, the vitreous substitutes that are used in clinical practice are mainly divided into gases (air, SF6, C2F6, C3F8) and liquids (perfluorocarbon...

Inhaled administration of ethanol in the early stages of COVID-19 would favor its location on the initial replication sites, being able to reduce the progression of the disease and improving its prognosis. Before evaluating the efficacy and safety of this novel therapeutic strategy in humans, its characterization is required. The developed 65° etha...

Inhaled administration of ethanol in the early stages of COVID‐19 would favor its location on the initial replication sites, being able to reduce the progression of the disease and improving its prognosis. Before evaluating the efficacy and safety of this novel therapeutic strategy in humans, its characterization is required. The developed 65° etha...

Background and importance The gut microbiome plays a dominant role in modulating the therapeutic efficacy of immune checkpoint inhibitors (ICIs). The use of proton pump inhibitors (PPI) and antibiotics (ATB) can induce dysbacteriosis, which may attenuate the clinical outcomes of ICIs, as shown in previous publications. Aim and objectives To invest...

Background and importance Tacrolimus is an immunosuppressant with many potential uses in ophthalmic diseases. It is an inhibitor of calcineurin phosphatases, which suppress the first phase of T cell activation and leads to a decrease in inflammatory activity. There are no commercialised eye drops in Spain so its formulation as a pharmaceutical comp...

Cystinosis is a rare genetic disorder characterized by the accumulation of cystine crystals in different tissues and organs. Although renal damage prevails during initial stages, the deposition of cystine crystals in the cornea causes severe ocular manifestations. At present, cysteamine is the only topical effective treatment for ocular cystinosis....

Objective: The health crisis caused by COVID-19 required the prompt launch of research in order to generate scientific evidence pertaining to the new disease oriented to control its devastating effects and continuous spread. Therefore, it was essential to adapt the work flow of Research Ethics Committees, to prioritize and to accelerate the evalua...

Intravitreal injections are the standard procedure in the treatment of retinal pathologies, such as the administration of the anti-VEGF antibodies in age-related macular degeneration. The aim of this study is to evaluate the intraocular and blood pharmacokinetics after an intravitreal injection of ⁸⁹Zr-labelled bevacizumab and ⁸⁹Zr-labelled afliber...

For decades, topical ophthalmic drug administration through the use of eye drops has been the most widely used technique for the treatment of eye diseases. The development of galenic formulation has led to the use and commercialization of new formulations, such as suspensions, emulsions, and ophthalmic ointments that increase residence time in the...

La disección submucosa endoscópica submucosa (DSE) y la resección mucosa endoscópica mucosa (RME) o mucosec-tomía son las principales técnicas empleadas en la extirpa-ción endoscópica de pólipos del tubo digestivo. En ambas técnicas se inyecta una solución submucosa para crear un habón debajo de la lesión que separe la mucosa de la capa muscular pr...

Voriconazole is an antifungal metabolised by CYP2C19 enzyme, which can be inhibited by proton‐pump inhibitors (PPIs). A prospective observational study was carried out to determine the influence of PPIs on voriconazole pharmacokinetic. The 78 patients included were divided into 4 groups: omeprazole (n = 32), pantoprazole (n = 25), esomeprazole (n =...

Objective Voriconazole is an antifungal agent used in the treatment of aspergillosis and fluconazole-resistant Candida infections. Therapeutic drug monitoring (TDM) of voriconazole is recommended to optimise clinical results. The aim of this study was the development and validation of a high performance liquid chromatography (HPLC) method for measu...

Resumen Objetivo Analizar las características clínicas, el manejo y los resultados de los pacientes con endoftalmitis estéril asociada con el factor de crecimiento endotelial antivascular intravítreo. Métodos Serie de casos de observación retrospectiva de pacientes con endoftalmitis estéril después de inyecciones intravítreas anti-VEGF. Se han re...

Purpose Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. Methods Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravi...

Background and importance The ophthalmic formulation has for decades been postulated as the only alternative for the treatment of serious infective ocular diseases, since commercial presentations are not available. For this reason, most of these compounded formulas are made in hospital pharmacy services. Aim and objectives To summarise the current...

Background and importance Atrial fibrillation (AF) is one of the most common side effects of ibrutinib, a drug that has improved the prognosis of chronic B cell malignancies. The incidence of ibrutinib related AF (IRAF) is not well known in the ‘real life’ setting, and management is challenging, especially due to the risk of bleeding with ibrutinib...

Background and importance Long acting injectable antipsychotics have emerged to improve adherence and reduce the risk of relapse in patients with psychiatric disorders. Aim and objectives The aim was to evaluate the maintenance rate of long acting injectable antipsychotics in real life. Material and methods A retrospective observational study was...

Background and importance Terlipressin is a synthetic vasoconstrictor peptide similar to desmopressin, used to treat bleeding oesophageal varices and hepatorenal syndrome. Recent publications have shown greater efficacy via continuous infusion (CI) compared with intermittent bolus injection. This could be explained by its pharmacodynamic effect (<4...

Background and importance Cow’s milk protein allergy (CMPA) is universally the most common food allergy in the first years of life, and the incidence has increased over the past few years. The presence of CMPA has important repercussions for patients and their families as it diminishes their quality of life. Aim and objectives Our aims were to cha...

Objective: To carry out an evaluation of the impact on the number of patients in the risk situation due to safety problems with the medications after compliance with a program to improve the quality of care of the chronic patient on multiple medications in the Health Area of Santiago de Compostela. Method: The intervention program consisted of t...

Background: Voriconazole, a first-line agent for the treatment of invasive fungal infections, is mainly metabolized by cytochrome P450 (CYP) 2C19. A significant portion of patients fail to achieve therapeutic voriconazole trough concentrations, with a consequently increased risk of therapeutic failure. Objective: To show the association between...

Age-related macular degeneration is the most common cause of vision loss in elderly people in developed countries. Nowadays, in clinical practice, three anti-VEGF drugs are commonly used (bevacizumab, aflibercept and ranibizumab), requiring repeated intravitreal injections. In order to minimise the number of injections, research on intravitreal dru...

La monografía “Formulación magistral oftálmica antiinfecciosa” tiene como objetivo aportar respuestas a algunos de los múltiples problemas que se presentan en el día a día en la sección de farmacotecnia de los Servicios de Farmacia Hospitalaria. Este libro recopila toda la información, hasta la fecha disponible, sobre el método de elaboración de l...

Intravitreal administration of anti-vascular endothelial growth factor (VEGF) antibodies has become the standard treatment for Age-Related Macular Degeneration; however, the knowledge of their pharmacokinetics is limited. A comprehensive review of the preclinical and clinical pharmacokinetic data that were obtained in different studies with intravi...

Classical methodologies used in ocular pharmacokinetics studies have difficulties to obtain information about topical and intraocular distribution and clearance of drugs and formulations. This is associated with multiple factors related to ophthalmic physiology, as well as the complexity and invasiveness intrinsic to the sampling. Molecular imaging...

Background Defects in the urea cycle are genetic diseases in which nitrogen accumulates as ammonia, resulting as highly toxic, especially in paediatric patients. Sodium benzoate (SB) is conjugated with glycine, giving rise to hippurate, which is excreted in the urine. Currently there are only intravenous SB commercial presentations, but no oral pre...

Bacterial keratitis is an infectious ocular disease accompanied by inflammation that can cause severe visual impairment. Commercial eye drops are not effective in many cases, so it is necessary to develop fortified antibiotic eye drops with high drug concentrations in hospital pharmacy departments. The purpose was to develop and characterise imipen...

Background Oropharyngeal candidiasis is a common local infection usually caused by candida species. The primary treatment is usually nystatin or topical azoles but both drugs are known to be teratogenic, at least during first semester of pregnancy. Purpose The aim was to present a new buccal formulation of amphotericin and determine its effectiven...

Background In 2011, pirfenidone was the first drug to be approved for the treatment of idiopathic pulmonary fibrosis (IPF) in Europe after reduced decline in per cent predicted forced vital capacity (FVC) in two phase III trials. Purpose To describe the adverse events observed and recorded for patients receiving treatment with pirfenidone in the ph...

Background Iatrogenic long QT syndrome is an adverse effect commonly described in psychiatry. Purpose To correlate real observations from clinical practice with the predictions. Materials and methods A prospective study was performed analysing patients admitted to the psychiatric ward over two months. Exclusion criteria were: patients suffering f...

Background Innovation and new technologies help reduce the rate of medication errors and maximise efficiency in the drug administration system thus improving the safety and quality of patient care. In the market there are various automation systems, all of which are costly. Purpose To analyse two storage and dispensing automation systems in order t...