Introduction: Anthracyclines are among the most powerful antineoplastic drugs ever developed and, even today, they are widely used according to various association schemes in the onco-hematological field. However, cardiotoxicity remains one of the most feared and characteristic side effects, both short and long term, often causing the premature interruption of therapy or irreversible effects after their suspension. In this article, we want to explain the underlying biological mechanisms, the clinical presentation characteristics and the possible strategies to prevent it. Materials and Methods: A computerized research was carried out for the articles to be inserted through use of international databases PUBMED, RESEARCHGATE and GOOGLE SCHOLAR, by typing in keywords such as “anthracyclines cardiotoxicity” and “cardioprotection strategies for anthracycline toxicity” and related articles. Discussion and Conclusions: The toxicity of these drugs on the heart represents the limiting factor both for their indications and for the success of the therapy, sometimes being the cause of premature interruption or impossibility of use in some patients. It depends especially on the cumulative dose used in the single patient and on the pre- existing risk conditions for the development of these ADRs, both in the short and long term. However, there are strategies that can avoid or reduce the damage, both related to the formulation of the compounds and to the co- administration of other drugs.

BACKGROUND AND AIMS Methadone is a well-known drug for the treatment of heroinopathy but its role as an analgesic is often forgotten, especially in primary and non-specialist medicine settings. In this article we want to describe its characteristics in this application not only for the cessation of painkillers but above all for the management of neuropathic pain and hyperalgesia induced by opioid therapy in the long term. METHODS AND RESULTS We conducted searches in PUBMED and MEDLINE for clinical trials and reviews done on the efficacy and safety of methadone used for analgesia in chronic pain and in the disassuefation from painkillers abuse. Clinical trials and the works found have overall shown that this drug has positive effects on the control of pain especially neuropathic and mixed and on some associated aspects such as the quality of life. DISCUSSION AND CONCLUSIONS Methadone remains a mysterious but at the same time fascinating drug, both for the aura of mystery around its name, frowned upon by both patients and prescribers, but at the same time unparalleled in terms of efficacy for analgesia in cancer pain and not, especially in patients who have lost sensitivity to other opioids even more potent than methadone such as fentanyl. In other words, the efficacy in the cessation of abusers of painkillers both for recreational purposes and secondary to background pain now no longer controlled makes this drug unique as a maintenance therapy.

Introduction: The use of benzodiazepines (BDZ) is notoriously associated with significant long-term problems and it is estimated that the long-term users (LTU) in Italy are over 3 million people, including many elderly people. Unfortunately, 40 to 80% of the LTUs develop dependence and many also have tolerance, with the need for a progressive increase in the daily dosage up to the point of tolerating daily megadoses. In recent years, the off-label use of continuous infusion subcutaneous flumazenil has established itself as a viable approach for rapid hospital detoxification of these sometimes very complex clinical cases. The purpose of the article is, starting from the pharmacological and biochemical bases, to describe the mechanism of action, the areas of applicability and the possible criticalities by analyzing the Italian data. Materials and Methods: A computerized research was carried out for the articles to be inserted through use of international databases PUBMED and RESEARCHGATE by typing in keywords such as “flumazenil, high dose benzodiazepine users, use of flumazenil for benzo detoxification” and related articles. We also used the PUBCHEM database to describe some chemical and pharmacological characteristics of flumazenil. Both Italian and international research articles have been selected, starting from 1980 to today. Discussion and Conclusions: The use of flumazenil in slow infusion remains off-label but, for almost 20 years, it has been in use (in Italy and beyond) to detoxify, in about a week of hospitalization, patients with equivalent daily doses of diazepam greater than 50 mg / day for more than 6 months (with a description of cases up to 350 mg / day of diazepam-equivalent). This would allow the GABA-Argic receptor resensitization in a short time and with minimal or absent withdrawal symptoms, being able to suspend megadoses of BDZ in a very short time. In Italy this approach is still used to a limited extent and it cannot be said that it is absolutely the best method but the analysis of various endpoints in published studies, such as acute withdrawal discomfort, discharge without prescription of benzodiazepines and relapses in the first 6-12 months of discharge, certainly makes us reflect on the possibility of extending this approach to various territorial hospitals.

Introduction: Therapeutic errors are among the main causes of drug-related problems, in terms of enhanced toxicological or reduced therapeutic effect, and concern all stages of the drug chain, from manufacturing to prescription, dispensing and administration. Everyone, pharmacists and doctors in all settings, should be aware of how to prevent and manage them and which drugs are at greatest risk. In this article we will focus on LASA (look alike/sound alike), on FAR (high-risk drugs) and on the guidelines especially for prevention. Methods: The article is a minireview that was written by research in paper and online on PubMed and Embase. We performed a search of any publications available in these databases between the years 1990 and 2022, using the key words: therapeutic errors, misuse / diversion of drugs, drug poisoning. After a review of the titles and abstracts, the articles chosen were considered relevant in providing evidence of the problem. We also added personal knowledge about the topic of the article and used some paper documents. Discussion and Conclusions: Most of the errors in therapy occur during administration, due to errors in doses, posology or interactions or incorrect manipulations of pharmaceutical forms, and in dispensing, due to incorrect interpretation of the prescription or confusion on the packaging in the case of LASAs. Pharmacists and doctors but also patients themselves should pay attention to the time of prescription and doctors to the drug history not only for interactions but also to avoid making mistakes in patients who take drugs with names or packages similar to the one described above. Moreover, attention must be paid in writing the prescription, in dosage, and pharmaceutical forms. Particular attention should be paid to handling by children and to avoiding any misuse of the medicines themselves.

Introduction: The presence of dysphagia is a rather common event, both physiologically in elderly people and the presence of neurological, maxillofacial, or upper digestive pathologies. Many drugs are routinely taken in solid form for the convenience of use, however, in such patients, it becomes difficult to swallow tablets or capsules and it is important to both have liquid alternatives and possibly handle the solid forms correctly. In this article, we want to describe the correct handling of solid pharmaceutical forms or the transition to liquid ones where present. Methodology: the article was written by integrating one's knowledge of pharmacology and pharmaceutical techniques with printed material and online articles extracted from databases google scholar and PubMed. Discussion and Conclusions: The liquid forms, where they exist, are important in the management of drug therapy in the dysphagia patient. In the absence of therapeutic alternatives or liquid forms of the same principle, the solid forms can be manipulated within certain limits, paying attention to the interactions with nutritional mixtures and other drugs and above all not obstructing the probe and not compromising the kinetic and dynamic characteristics of the active ingredient.