Tissue plasminogen activator (tPA) in the management of predominantly hemorrhagic age-related macular degeneration, milligram/milliliter or microgram/milliliter?

Niels Willem Boone, Roelof Wouter Frederik van LeeuwenMaastricht University Medical Centre, Department of Clinical Pharmacy and Toxicology, Maastricht, The NetherlandsRecently our hospital pharmacy, which serves an academic hospital with an internationally well-known department of ophthalmology, received a request for the aseptic preparation of an alteplase syringe solution for subretinal administration. Looking for dose rationale, our ophthalmology doctor came up with a concentration based on an article published by Arias and colleagues in Clinical Ophthalmology in 2010

Characteristics of potential drug-related problems among oncology patients

<p>Background Oncology patients are more at risk for drug related problems because of treatment with (combinations of) anticancer drugs, as they have a higher risk for organ failure or altered metabolism with progression of their disease. Objective The aim of this study was to characterize and to evaluate the frequency of potential drug related problems (pDRPs) among oncology patients. Setting Outpatient- and day-care centres for Internal and Pulmonary Medicine at the Deventer Hospital, Deventer, The Netherlands. Method A prospective, descriptive, observational study was carried out from March 2010 to March 2011 at the Deventer Hospital, Deventer, The Netherlands. All patients older than 18 years receiving anticancer drugs prescribed by an internal medicineoncologist or pulmonologist-oncologist were included. Main outcome measure The primary outcome was the number and type of pDRPs according to Dutch guidelines. Results Among 546 patients with cancer, 952 pDRPs were identified, of which 474 were oncology-related. These were mainly drug interactions (IA) (246 IA in 157 patients) and potential contraindications (pCI) (201 pCI in 143 patients). Conclusion Most identified pDRPs in cancer patients were IAs and pCIs and involved corticosteroids. The most frequently occurring oncology-related IAs were classified as minor or moderate levels of severity.</p>