The present study demonstrated a slight evolution in self-reported provision of pharmaceutical care by community pharmacists across Europe, as measured by the BPCS. The slow progress suggests a range of barriers, which are preventing pharmacists moving beyond traditional roles. Support from professional bodies and more patient-centred community pharmacy contracts, including remuneration for pharmaceutical care services, are likely to be required if quicker progress is to be made in the future.

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Objectives The aetiology of behavioural and psychological symptoms (BPSD) could be related to inadequate treatment in patients with dementia. The aim of this study was to determine how a multifaceted intervention based on a medication review and multidisciplinary follow-up could improve treatment and minimise risk in these patients. Methods A prospective interventional study was undertaken between July 2015 and July 2016 of patients with dementia admitted to control BPSD. Patients with previous psychiatric illness or palliative care were excluded. Prescription information was obtained from Aegerus and the Catalonia clinical record HC3. The intervention was conducted by a multidisciplinary team. The Medication Appropriateness Index (MAI) was used to assess the intervention. results 65 patients (60% women, mean age 84.9±6.7 years) with mild-moderate cognitive impairment (mean 4.5±1.8), moderate-severe functional dependence (mean 43.8±23.9) and a high prevalence of geriatric syndromes and comorbidity were included in the study. 87.7% of the patients were taking ≥5 drugs (mean 9.0±3.1) and 38.5% were taking ≥10. Patients presented with BPSD values of 1.9±0.8 at admission. Common symptoms prompting admission were agitation (47.7%) and irritability (43.1%). A total of 175 drug-related problems (DRPs) were detected (2.97 per patient). Significant differences (p<0.001) were found between the MAI score at admission (4±4.6) and post-intervention (0.5±2.6). Most prevalent MAI criteria were related to interactions (40%), dosage (38.5%) and duplication (26.2%). 55 patients (84.6%) were taking anticholinergic drugs at admission (2.6±1.2 anticholinergic drugs per patient), and the post-intervention reduction was significant (p<0.016). Conclusions The balance between effective treatment and safety is complex in these patients. Medication review in interdisciplinary teams is an essential component to optimise interventions and assessment of safety. MeThOds design, setting and inclusion/exclusion criteriaThis was a one-year prospective interventional study performed in a long-term care psychogeriatric unit (21 beds) in an intermediate care hospital (HSS Mutuam Güell, 165 beds) in Barcelona, Spain.

The pharmacokinetics of cefmetazole, a new parenteral cephalosporin, administered intravenously and intramuscularly at a dose of 30 mg/kg to two groups of seven healthy volunteers were studied. Concentrations in serum were monitored over 8 h by a high-pressure liquid chromatography technique. The plasma concentration-time data were statistically fitted to a biexponential equation for both administration routes, and the data were analyzed by a two-and one-compartment kinetic model, respectively. For the dose range and the administration routes used, the pharmacokinetics of cefmetazole proved to be essentially linear, with clearances from plasma ranging between 3.8 and 12.5 liters/h. The mean maximum concentration in plasma after intramuscular administration of the drug was 90.1 ,Lg/ml at 0.7 h. The elimination half-life, about 1.3 h, did not show statistically significant differences for the two routes of administration studied.Cefmetazole sodium (7-,B-cyanomethylthioacetamide-7-amethoxy-3-[[(1-methyl-1-H-tetrazol-5-yl)-thio]methyl]-3-cephem-4-carboxylate) is a new semisynthetic derivative of cephamycin (11). This cephalosporin has a broad antimicrobial spectrum, is efficient against gram-positive and gramnegative bacteria, and shows quite high resistance to attack by several beta-lactamases (18; R. Fujii, Program Abstr. 19th Intersci. Conf. Antimicrob. Agents Chemother., abstr. no. 724, 1979). Several studies have confirmed its usefulness in the treatment of different kinds of infections, notably those due to gram-negative organisms (19; T. Tsujimoto, K. Yamada, and H. Yama, 19th ICAAC, abstr. no. 721, 1979), and in prophylactic administration after surgical wounds (3).In the present work, we established the pharmacokinetic profile of cefmetazole in healthy volunteers and determined the bioavailability of this cephalosporin after intramuscular (i.m.) administration. MATERIALS AND METHODSSubjects and study design. Seven healthy volunteers (four males and three females) aged 24 to 27 years (mean, 25.5 years), with a mean height of 1.70 m and weighing from 50 to 70 kg each (mean, 57.7 kg) were included in the study. In a sequential study, they received a 30-mg/kg dose of cefmetazole by an intravenous (i.v.) route (bolus injection) and the same dose at weekly intervals thereafter by the i.m. route.Subjects participated in the study after giving informed written consent. All were normal according to physical examination and in their hematological (leukocyte count, erythrocyte count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and platelet count) and biochemical (total protein, creatinine, blood urea nitrogen, glutamic-oxalacetic transaminase, glutamic pyruvic transaminase, alkaline phosphatase, total cholesterol, and blood glucose) profiles. None had a history of allergy to beta-lactam antibiotics. None had received any drug therapy for at least 1 week before the start of the study. Cefmetazole was administered after an overnight 10-h fast. To facilitate blood sampling,...

The efforts toward individualized medicine have constantly increased in an attempt to improve treatment options. These efforts have led to the development of small molecules which target specific molecular pathways involved in cancer progression. We have reviewed preclinical studies of sunitinib that incorporate sex as a covariate to explore possible sex-based differences in pharmacokinetics and drug–drug interactions (DDI) to attempt a relationship with published clinical outputs. We observed that covariate sex is lacking in most clinical outcome reports and suggest a series of ethic-based proposals to improve research activities and identify relevant different sex outcomes. We propose a deeper integration of preclinical, clinical, and translational research addressing statistical and clinical significance jointly; to embed specific sex-divergent endpoints to evaluate possible gender differences objectively during all stages of research; to pay greater attention to sex-divergent outcomes in polypharmacy scenarios, DDI and bioequivalence studies; the clear reporting of preclinical and clinical findings regarding sex-divergent outcomes; as well as to encourage the active role of scientists and the pharmaceutical industry to foster a new scientific culture through their research programs, practice, and participation in editorial boards and Institutional Ethics Review Boards (IRBs) and Research Ethics Committees (RECs). We establish the IRB/REC as the centerpiece for the implementation of these proposals. We suggest the expansion of its competence to follow up clinical trials to ensure that sex differences are addressed and recognized; to engage in data monitoring committees to improve clinical research cooperation and ethically address those potential clinical outcome differences between male and female patients to analyze their social and clinical implications in research and healthcare policies.