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Drug dosing of cytotoxic intravenous drugs, such as anticancer drugs or certain antivirals, has historically been based on the body surface area (BSA) or the weight of the patient being treated. This entails the individual preparation of each treatment and, consequently, it results in increased demand on pharmacy compounding area, often causing delays for patients awaiting treatment. 1 Elaboration by dose banding is one of the strategies proposed in order to optimize the processing at compounding units without reducing safety. 2 According to the definition by the NECN (North of England Cancer Network), dose banding is a system whereby, through

Background Chronic kidney disease (CKD) is a highly prevalent disease worldwide. A basic pillar for the management of a patient with CKD is the safe use of drugs. Inadequate dosing of medication or contraindicated drugs in renal impairment can lead to negative outcomes. The primary objective was to analyse the drug prescriptions of patients with CKD from two primary care centres to see if they were optimally adapted to the patient's estimated glomerular filtration rate (eGFR). Methods A retrospective observational study was conducted in two urban primary care centres. The study period was between September–October 2019. Patients over 18 years of age, with established CKD and with an eGFR less than 60 mL/min/1.73m2 for at least three months were included. Their demographic data (age and sex) and clinical variables such as associated comorbidities, eGFR value were retrospectively registered. Finally, their medication plans were reviewed in order to detect: inappropriate prescribing (IP), defined as an incorrect dose/frequency or contraindicated drug according to the renal function of the patient; nephrotoxic drugs and drugs with a high sodium content. Results A total of 273 patients were included. The most common patient profile was an elderly woman, polymedicated, with other concomitant diseases and with mild CKD. Two hundred and one IPs were detected, 13.9% of which were contraindicated drugs. Of all patients, 49.1% had been prescribed at least one IP on their medication plan, 93.8% had some potentially nephrotoxic drug and 8.4% had drugs with a high sodium content prescribed. Conclusions Patients with CKD are at increased risk of medication-related problems. It is necessary to implement measures to improve the safety in the prescription of drugs in patients with CKD.

Mitomycin C as a treatment for superficial bladder carcinomas and upper urinary tract tumours has been linked to local adverse events. Systemic toxicity has been documented for just a very few cases. This report presents a case of interstitial pneumonitis accompanied by myelosuppression in a 74-year-old patient after receiving the fifth administration of mitomycin C through a ureteral catheter as a treatment for left kidney pyelocaliceal urothelial carcinoma. Therefore, suspecting mitomycin C toxicity, urinary tract instillations were discontinued, and intravenous filgrastim and methylprednisolone were initiated. Currently, after five months since the last mitomycin C urinary tract instillation, the patient is still receiving filgrastim and corticosteroids. A moderate effort dyspnoea persists despite interstitial pulmonary infiltrates have presented a very important reduction. Pancytopenia has also persisted. Blood count and lung function monitoring would be appropriate in patients undergoing mitomycin C instillations, especially in those with established prior lung disease.

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with all the patients, regardless of the levels of CD4 lymphocytes and the symptomatology. Purpose Persistence: time a patient remains with a treatment frome the beginning until the interruption, regardless of the reason. Aim of this research: comparison between the patients' persistence who different ART. Material and methods Descriptive, transversal and retrospective research that includes all the patients who have started an ART for HIV, 2013-10 October 2018, and who have suffered a change in the therapy.Variables: starting date, initial treatment, changing date and reason for the change. Analysis: SPSS Statistics. Results Six-hundred and sixteen patients have started ART and 186 (30.2%) of them have changed it.Fifty-one (27.4%) patients started ART with single tablet regimens (STRs), 40 (78.4%) started with Tenofovir/Emtricitabine (TDF o TAF/FTC) and 11 (21,6%) Abacavir/Lamivudine (ABC/3TC). Thirty-two 62.7%) were with an integrase inhibitor (INI) as a third drug, and 19 (37.3%) with no analogous (ITINN).One-hundred and thirty-five (72.6%) patients started with multiple tablet regimens (MTRs), 115 (85.2%) TDF/FTC and 16 (11.8%) ABC/3TC. Seventy-two (53.7%) were with protease inhibitor (IP) as a third drug, 34 (25.4%) ITINN and 28 (20.9%) INI.The median survival for STRs was 229 days (95% CI 146.0 to 311.9) and 164 for MTRs (95% CI 87.8 to 240.2), no statistically significant differences. Regarding the third drug, the median survival with INI was 103 days (95% CI 65.0 to 140.9), 241 days with IP (95% CI 162.1 to 319.9) and 265 days with ITINN (95% CI 162.1 to 367.9). Between INI-IP and INI-ITNN, there were statistically significant differences.One-hundred and five (56.5%) patients changed their treatment because of toxicity, 48 (25.8%) patients simplification, 19 (10.2%) patients virologic failure, seven (3.8%) patients due to interaction with their home treatment and seven (3.7%) other causes. One-hundred and five patients changed ART by toxicity ( 39of them (37.1%) had as a third drug IP, 37 (35.2%) ITINN and 29 (27.6%) INI) In 2013-2015, 20 (16.8%) patients started STRs and in 2016-2018, 31 (46.3%) patients started STRs. Conclusion ART combinations with STRs have a longer survival in the treatment and in patients with IP as a third drug, a greater survival is observed. The main cause of ART in naïve patients is toxicity. There was a gradual rise in the use of STRs throughout the years studied.

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