BackgroundIn order to plan the managemenet a cytotoxic drugs preparation unit (CPDU), pharmacists used a scientific reference source1 it recommended 5 pharmacy technicians for 26,000 preparations per year. 50% of technician effective working time should be spent to preparation and 50% on associated activities (AA).PurposeWhat about in practice? The aim of this study was to assess the technicians’ work load in real life.Material and methods5 technicians were hired in a CPDU in which 60% of the production was for use outside the hospital. Over one week, the times spent on the preparation and on 15 AAs was measured. The staff had to fill in a form giving the exact start and end times of the tasks. The different data collected were analysed and expressed in percentages.Results57% of technician effective working time was allocated to preparation. 9 AAs (36%) were fully done by technicians, the main ones being: preparation of sterilisation trays (17.4%), dressings, hygiene protocols (6%), managing orders (3.4%), schedule organisation (2%). The other AAs such as taking bacterial samples, inventory management, required the help of two additional logistics staff (47% of their working time). Without the help of logistics staff, all the AAs would need 58% of effective working time.ConclusionCompared with our data, the reference source underestimates the time required for preparation and AAs, by 7.4% and 8% respectively. The additional time needed for preparation is explained by the fact that reference data are not accurate for specific preparations. Furthermore, AAs need more time because of the large amount of work outsourced to our department, which isn’t mentioned in the reference source. This study showed that 6 technicians are necessary, instead of the 5 recommended by the guidelines. Moreover, with the new national law concerning hospital organisation, the CDPUs are going to change and the outsourced work they perform will increase; the guidelines need to be reviewed.ReferenceSociété Française de Pharmacie OncologiqueNo conflict of interest.

Associated to primary percutaneous coronary intervention (pPCI), pharmacotherapy in acute ST-Segment elevation myocardial infarction (STEMI) patients have transformed the management of the acute phase. Use of glycoprotein IIb/IIIa inhibitors (GPI) remains debatable, level of guidelines has been modified in the successive editions of guidelines. In the latest European Society of Cardiology guidelines, GPI have a IIb B level in upstream use and IIa C in bail out during pPCI procedure. In front of the varying recommendations, we analysed clinical characteristics of patients with ST-Segment elevation myocardial infarction according to the use of GPI. We evaluate complications during hospitalization, particularly bleeding events. The cost of patients' management was also analysed. We conducted a retrospective, descriptive and monocentric study from January 2010 to December 2012 including all consecutive STEMI patients with symptoms evolving for less than 12 hours treated by pPCI. GPI were administered as recommended in patients with high thrombotic risk, low bleeding risk, with early presentation and more likely anterior location. Despite an initial more severe clinical presentation, no statistical difference among each group on in-hospital complications and duration of hospital stay was observed. Nevertheless patients treated with abciximab have a significant higher cost of overall management compared to HNF only (+30%) or other GPI (+37%). In selected clinical indications, in line with the European guidelines, GPI use appears safe, efficient and cost effective with regards to eptifibatide/tirofiban.