Poly(epsilon-caprolactone) microparticles formed by the emulsion-evaporation method: effect of the variables of the different steps of the process on their size.

In the present work the influence of the variables of the microencapsulation procedure on the size of poly (epsilon-caprolactone) microparticles (PECL-MP) obtained by the solvent evaporation method is analysed. This study will allow to choose the work conditions necessary to obtain a suitable PECL-MP size for parenteral administration. Agitation rate in the emulsion formation step, polymer concentration and organic/aqueous phase volume ratio were the variables of the microencapsulation procedure that showed a highest influence on the PECL-MP size. High polymer concentrations and low internal phase volumes had a negative effect on the microencapsulation yield. Neither the conditions of the organic solvent evaporation nor the freeze-dry process (when a cryoprotector as threalose was used) influenced on PECL-MP size. The usefulness of this study was confirmed by getting PECL-MP loaded with naloxone and with a mean diameter within 30-40 microm, suitable for parenteral administration.

[Prescription errors in patients admitted to an internal medicine department from the emergency room]. / Errores de prescripción en pacientes que ingresan en un servicio de medicina interna procedentes de urgencias.

OBJECTIVE: To identify and quantify emergency room prescription errors upon patient admission in an internal medicine unit, assess their severity and causes, and evaluate their potential clinical impact. METHOD: Discrepancies found between emergency room and internal medicine unit prescriptions were analyzed by 4th-year resident pharmacists. Prescription errors were collected and classified according to their severity and potential morbidity, and a medical analysis of service value was performed according to Overhage's method. Furthermore, pharmacist actions regarding therapeutic regimen optimization are described. RESULTS: Of 177 patients, 50 had prescription errors, for a total of 141 errors. Seven percent of prescriptions had an error. Mean errors per patient amounted to 0.8 (SD 1.51). Most commonly involved medications included anti-asthmatic and anti-infectious agents, and fluid therapy agents. On severity assessment 12.8% were considered severe, and 57.4% were considered significant. The main cause was omission of a needed therapy. Potential pharmacotherapeutic morbidity is related to adverse effects and cardiovascular disease. Medical assessment considered 12% very significant, and 52% significant. Pharmacist actions were directed towards effectiveness improvement in 57% of cases, and safety in 43.2% of cases. CONCLUSIONS: Emergency departments, as main entry points for patient admission to hospital, should be considered a priority in prescription quality improvement programs.

Errores de prescripción en pacientes que ingresan en un servicio de medicina interna procedentes de urgencias / Prescription errors in patients admitted to an internal medicine department from the emergency room

Objetivo: En este estudio se detectan y cuantifican los errores de prescripción del servicio de urgencias al ingresar los pacientes en una unidad de medicina interna, se evalúa la gravedad y las causas, así como el potencial impacto clínico de los mismos. Método: Las discrepancias encontradas en las prescripciones del servicio de urgencias y de medicina interna fueron analizadas por farmacéuticos residentes de cuarto año. Se extrajeron los errores de prescripción y se clasificaron de acuerdo a la gravedad y potencial morbilidad, se hizo un análisis médico del valor del servicio, siguiendo el método de Overhage. Se describe, además, la actuación del farmacéutico en la optimización del régimen terapéutico. Resultados: De 177 pacientes, 50 presentaron errores de prescripción, obteniéndose un total de 141 errores. El 7% de las prescripciones presentaban un error. La media de errores por paciente era de 0,8 (DE 1,51). Los medicamentos más implicados fueron antiasmáticos, antiinfecciosos y fluidoterapia. En la valoración de la gravedad fueron considerados serios el 12,8% y significativos el 57,4%. La causa principal fue la omisión de tratamiento necesario. La morbilidad farmacoterapéutica potencial se relaciona con efectos adversos y enfermedades del sistema cardiocirculatorio. La evaluación médica consideró muy significativos el 12% y significativos el 52%. La actuación farmacéutica se dirigió a la mejora de la efectividad en un 57% de los casos y a la seguridad en un 43,2%. Conclusiones: Los datos obtenidos concuerdan con otros autores en la prevalencia de errores de prescripción en el ámbito del ingreso hospitalario. Sin embargo, se pone en evidencia la dificultad de valorar la morbilidad farmacoterapéutica potencial según los diferentes resultados que se han obtenido en los estudios con los cuales se ha comparado. Pero según los resultados, los servicios de urgencias, cuando son puerta principal de entrada del paciente en el hospital, han de ser considerados como prioritarios en los programas de mejora de la calidad de la prescripción

Objective: To identify and quantify emergency room prescription errors upon patient admission in an internal medicine unit, assess their severity and causes, and evaluate their potential clinical impact. Method: Discrepancies found between emergency room and internal medicine unit prescriptions were analyzed by 4th-year resident pharmacists. Prescription errors were collected and classified according to their severity and potential morbidity, and a medical analysis of service value was performed according to Overhage’s method. Furthermore, pharmacist actions regarding therapeutic regimen optimization are described. Results: Of 177 patients, 50 had prescription errors, for atotal of 141 errors. Seven percent of prescriptions had an error. Mean errors per patient amounted to 0.8 (SD 1.51). Most commonly involved medications included anti-asthmatic and anti-infectious agents, and fluid therapy agents. On severity assessment 12.8% were considered severe, and 57.4% were considered significant.The main cause was omission of a needed therapy. Potential pharmacotherapeutic morbidity is related to adverse effects and cardiovascular disease. Medical assessment considered 12% very significant, and 52% significant. Pharmacist actions were directed towards effectiveness improvement in 57% of cases, and safety in 43.2% of cases. Conclusions: Emergency departments, as main entry points for patient admission to hospital, should be considered a priority in prescription quality improvement programs