Medication errors in cancer therapy: Reports from German hospital pharmacists between 2008 and 2019.

Objective: Since medication errors can have severe consequences, the development of methods to improve patient safety is becoming increasingly important. The aim of this evaluation was to identify frequent medication errors in oncology as well as characteristic correlations in the various error patterns. In addition, the implementation rate of the proposed pharmaceutical intervention was determined in order to assess the benefit of a clinical pharmacist in the field of oncology.

Clinical pharmacists' interventions across German hospitals: results from a repetitive cross-sectional study.

Background Pharmacists' interventions (PI) are suitable to improve medication safety and optimise patient outcome. However, in Germany, clinical pharmacy services are not yet available nationwide. Aim To gain prospective data on the extent and the composition of routine PI with special focus on intervention rates among German hospital pharmacists during two intervention weeks.

[Polypharmacy - Solutions for Enhanced Drug Safety].

Polypharmacy (≥ 5 drugs) is common among older people and may lead to falls, ADEs and delirium. Adherence is an important part in the medication management. Simple questions (i.

[Therapy of a common otitis media in the infancy].

The therapy of an acute otitis media has been questioned due to increasing bacterial resistance during the last years. Two recent studies dealing with efficiency of the antibiotic treatment regarding diseased children younger tha 2 or 3 years are recommending antibiotic drugs compared to the use of placebo. How are the results of the studies to be interpreted?

[Hepatitis A vaccination three days before departure to Eastern Europe?].

Vaccination against hepatitis A is indicated for travellers who visit areas with a high exposure to this type of virus. Beside tropical areas an active vaccination is indicated for the whole Mediterranean Area and Eastern Europe. This active vaccination is effective even short before departure due to the long incubation period of hepatitis A.

[SSRI-associated bleeding risk].

Secondary to their antidepressive effect, selective serotonin reuptake inhibitors (SSRI) also lead to a diminished platelet aggregation, which results in an increased risk of bleeding. This adverse effect is added to the therapeutic effects of antiplatelet drugs. Furthermore, combination with nonsteroidal antirheumatic drugs (NSAID) increases the risk of bleeding, particularly in the gastrointestinal tract.

[Allergic reaction after intravenous application of vitamin B12].

Allergic reactions of parenteral vitamin B12 (cobalamin) for therapy of pernicious anaemia are very rare, but repeatedly described in the literature. In case of allergic reactions oral instead of intravenous substitution of vitamin B12 is tolerated. Very high dosages of vitamin B12 (1,000-2,000 microg per day) are necessary due to the underlying vitamin B12 malabsorption.

[Gingival hyperplasia].

Gingival hyperplasia is a typical adverse reaction of certain drugs (phenytoin, calcium antagonists and cyclosporine). Also oral contraceptives and presumably hormone replacement therapy may rarely lead to gingival hyperplasia. By differential diagnosis a paraneoplastic syndrome has to be taken into account.

[Lactose-containing tablets for patients with lactose intolerance?].

Lactose is often used as an excipient in tablets because of its ideal characteristics. Most patients with lactose intolerance tolerate small amounts of lactose. However, the nocebo effect must be considered.

[Protective use of calcium in case of osteoporosis versus calcium oxalate stones].

In patients with calcium-containing kidney stones calcium supplements are officially contraindicated. Recent studies showed a protective effect by calcium-supplementation when taken with meals, analogous to the decreased risk of kidney stones by dietary calcium due to binding of oxalate. However, because of the poor compliance, costs and the official contraindication for calcium supplements in patients with kidney stones, dietary calcium intake should be preferred whenever feasible.

[Creatine kinase increase under simvastatin--therapeutic consequences?].

Myopathy is the most serious, dose dependent adverse reaction of statins and may lead to rhabdomyolysis and death. Clinical symptoms are muscle pain, weakness and muscle cramps, main laboratory finding is an increase in serum creatine kinase (CK). If myopathy symptoms are present or CK levels are greater than 5 times the upper limits of normal, statin therapy should be discontinued.

[Prescription of rimonabant in the early stage of pregnancy?].

Rimonabant should not be prescribed in pregnancy because no sufficient data on the teratogenic/ embryotoxic risk are available. A preventive termination of pregnancy is not indicated. Women in childbearing age should take only low-risk drugs.

[Are AT1 receptor antagonists an alternative to ACE inhibitors in angioedema?].

History of angioedema is a contraindication for ACE-inhibitors. Angioedema is caused by: 1. a decreased degradation of bradykinin, 2.

[Splitting of tablets: small pieces a risk].

For economic reasons physicians prescribe more and more multiunit tablets. Splitting of multiunit tablets depends on the physical-chemical properties of the agents, the galenic of the dosage form, the size and contour of the tablet and the shape of the score. Tablets with one or more scores are prepared to be divided for a single/multiple dose.