Paradoxical interaction between nirmatrelvir/ritonavir and voriconazole in a patient with COVID-19.

This case is based on a drug interaction between nirmatrelvir/ritonavir (approved drug for COVID-19) and voriconazole is presented, possibly derived from the bidirectional effect of ritonavir on the 2 main voriconazole metabolising enzymes (cytochrome P450 3A and 2C19) ritonavir inhibits the former and induces the latter respectively. According to the main pharmacotherapeutic information databases, in the interaction between both drugs, a decrease in the area under the curve of voriconazole is expected due to the. inducing effect of its metabolism; however, in the case we present, unexpectedly, a paradoxical effect occurs, according to what is described in literature, with the result of sustained supratherapeutic levels of voriconazole.

[Medication errors in a hospital emergency department: study of the current situation and critical points for improving patient safety].

Objectives: To determine the frequency of medication errors and incident types in a tertiary-care hospital emergency department. To quantify and classify medication errors and identify critical points where measures should be implemented to improve patient safety.

Material And Methods: Prospective direct-observation study to detect errors made in June and July 2016.

[Relationship between allogeneic blood transfusion, iron deficiency and nosocomial infection in patients with hip fracture].

Background And Objective: To know the frequency of nosocomial infection (NI) in surgical hip fracture patients and to analyze the risk factors that favor the NI development, especially its relationship with allogeneic blood transfusion (ABT) and intravenous iron administration.

Patients And Method: Unicenter prospective observational study of all hip fracture surgery patients during 8 months. The demographic, clinical and hematimetric differences between the infected and not infected patients were described.