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Objective. To describe environmental contamination with hazardous drugs in a hospital pharmacy setting before and after reorganizing a hematology-oncology satellite pharmacy. Methods. This is a descriptive study of surface contamination with cyclophosphamide, ifosfamide, and methotrexate in two hematology-oncology satellite pharmacies. In order to measure surface contamination with hazardous drugs, samples from four distinct measurement sites within the pharmacy were taken in each of the two phases (pre- and postphases) using a sampling procedure and an analytical method modified from Larson et al. Results. A total of 133 samples from four measurement sites were taken and analyzed over the course of the study (specifically 60 prephase samples and 73 postphase samples). The study showed a significant increase in the number of positive samples (from 66.7% to 90.4%, p<0.001) from the pre- to the postphase. The increase, however, is only significant in terms of the location where completed preparations were placed after they had come out from under the hood (from 0/15 to 21/28, p<0.001) and the work surface (from 8/15 to 15/15, p = 0.006) and only in terms of ifosfamide. Furthermore, for the other sites studied, the number of positive samples remained unchanged between the pre- and postphase. A statistically significant difference between the pre- and postphase was observed in terms of ifosfamide for three of the four measurement sites studied and methotrexate for one of the four sites. Average concentrations were higher in the post phase in three of the four cases. Conclusion. This study describes environmental contamination with hazardous drugs in a hospital pharmacy setting before and after reorganizing a hematology-oncology satellite pharmacy. The study showed that a refitting of the hemato-oncology pharmacy is not a sufficient strategy to reduce the environmental contamination by ifosfamide because a significant increase in the number of positive samples from the pre- to the postphase have been observed. Many factors can contribute to influence the contamination of hazardous drugs such as the workflow and the training of the personal. Continuous environmental surveillance of hazardous drugs is required to document traces and help reduce risks. [ABSTRACT FROM AUTHOR]

Abstract: We first aimed to test the effect of anti-inflammatory drugs, etanercept and dexamethasone sodium phosphate (DSP), on the expression of inducible inflammatory signaling molecules (the bradykinin [BK] B1 receptor [B1R], cyclooxygenase [COX]-2) in lipopolysaccharide (LPS)-treated rabbits. Preliminary experiments mostly based on a novel cellular model, rabbit dermis fibroblasts, showed that etanercept inhibited TNF-α-induced B1R expression ([3H]Lys-des-Arg9-BK binding), but that DSP also inhibited cytokine-induced B1R upregulation with less selectivity. LPS (100 μg/kg i.v.) induced the expression of the B1R (aortic contractility ex vivo, mRNA in hearts) and COX2 (immunoblots, heart extracts). However, the function of the BK B2 receptor was unchanged (jugular vein contractility ex vivo). DSP pre-treatment profoundly reduced the induction of the B1R and COX2 whereas etanercept significantly inhibited only COX2 expression. The second aim was to verify whether chronic angiotensin converting enzyme (ACE) blockade in rabbits would induce B1R expression, as reported in other species. 14-Day enalapril oral dosing, but not treatment with the angiotensin receptor antagonist losartan, significantly increased aortic contractions mediated by B1Rs, however much less than LPS. Enalapril treatment did not increase COX2 expression but increased the ex vivo relaxation of the mesenteric artery mediated by endogenous prostaglandins. Chronic ACE inhibition recruits inflammatory signaling systems. [Copyright &y& Elsevier]

Background: Although the concept of clinical pharmacy was originally developed some time ago, in the 1960s, there is a wide variety of programs in existence, as well as great disparity between programs where the presence of a pharmacist is provided in outpatient and inpatient settings., Objective: To test a method for upgrading pharmaceutical care areas in a hospital setting., Method: This descriptive study was conducted at the Sainte-Justine university health centre, a 500-bed mother-and-child hospital. The pharmaceutical care area that was used to exemplify the upgrading method was pediatric hematology-oncology. A 3-step method was used: review of the scientific literature, creation of a profile of the targeted area, and upgrading of the practice level according to the pre- and post-upgrading profile of the pharmaceutical activities in the area., Results: A total of 108 articles were identified in a search of the PubMed database, of which 22 were retained. After a complementary manual search, a total of 36 articles were evaluated. The articles retained included 3 guidelines, 11 development studies, 1 review of scientific literature, 6 pre- and post-intervention studies, and 15 quasi-experimental studies. Although patients in the pediatric hematology-oncology area account for only 5% of admissions to this hospital, the cases are highly complex, in terms of both the codification of the care phase and the potential for pharmaceutical intervention per admission., Conclusion: There are few data to illustrate a method for upgrading practice in a pharmaceutical care area. This study tested a method for upgrading pharmaceutical care in a pediatric hematology-oncology service, with a review of the scientific literature, a profile of the area, and the pharmacists' pre- and post-upgrading job description in this area. [Publisher's translation].