Background In oncology, pharmacists contribute to safety and effectiveness of drug treatment, identifying, preventing and forwarding solutions to drug-related problems (DRPs). However, it is still necessary to elucidate the profile of drug-related problems in pediatric cancer treatment to contribute to guide clinical pharmacy activities. Methods A retrospective cross-sectional study was conducted. Records on Excel® spreadsheets of 2 years of pharmaceutical assistance were analyzed regarding the prescriptions of chemotherapy for hospitalized patients aged 0–19 years. Data on age, sex, cancer diagnosis, protocol and drugs prescribed were collected. Causes and types of DRPs and pharmacists’ interventions as their rate of acceptance were measured according to PCNE V 9.0. Results Drug-related problems were identified for 84 patients, in 5.3% of analyzed prescriptions. Leukemias, patients aged 0–4 years and male sex were associated with higher rates of drug-related problems. The BFM 2009 protocol for acute lymphocytic leukemia treatment had the highest frequency of prescriptions with drug-related problems. Main drug-related problems were related to effectiveness (49.2%) and safety (33.2%), with most of them due to drug selection and dose. Rate of acceptance of interventions was 92.2% and 90.6% of drug-related problems were fully resolved. Mercaptopurine and filgrastim were the drugs most associated with drug-related problems. Oral antineoplastic agents represented 36% of the prescriptions with drug-related problems. Conclusion The high rate of acceptance of pharmacist interventions demonstrates the relevance of the pharmacist participation in the care of hospitalized pediatric patients undergoing chemotherapy. Pharmacists need to take attention to cases of necessity of drug prescription, intervening with other health professionals. Special attention to oral chemotherapy is required.

PurposeThe coronavirus-2019 (COVID-19) infection is associated with a high risk of complications and death among heart transplant recipients. However, most cohorts are from high-income countries, while data from Latin America are sparse.MethodsThis is a retrospective cohort of heart transplant recipients followed at a hospital in Rio Grande do Sul, Brazil, between March 1st 2020 and October 1st 2021.ResultsOf the 62 heart transplant recipients on follow-up, 21 (34%) were infected by COVID-19, 58 (36–63) years of age, 67% male, body mass index of 26 (23-29) kg/m2, 48% with hypertension, 43% with chronic kidney disease, 5% with diabetes, within 2 (1–4) years of post-transplant follow-up. At presentation, the main symptoms were fever (62%), myalgia (33%), cough (33%), headache (33%), and dyspnea (19%). Hospitalization was required for 13 (62%) patients, with a time from first symptoms to the admission of 5 (1–12) days. In 38%, supplementary oxygen was needed, 19% required intensive care, and 10% mechanical ventilation. Three (14%) were infected after at least a first dose of COVID-19 vaccine. The main complications were bacterial pneumonia (38%), renal replacement therapy (19%), sepsis (10%) and venous thromboembolism (10%). Immunosuppression therapy was modified in 48%, with a reduction in the majority (89%). Two (10%) patients died in the hospital due to refractory hypoxemia and multiple organ dysfunction. The incidence of COVID-19 among transplant patients was comparable to the general population in the State of Rio Grande do Sul with a peak in December 2020.ConclusionHeart transplant recipients shown a high rate of COVID-19 infection in Southern Brazil, with typical symptom presentation in most cases. There was an elevated rate of hospitalization, supplementary oxygen support, and complications. In-hospital lethality among infected heart transplanted recipients was similar to previously reported data worldwide despite the high rates of infection in Latin America.

The role of clinical pharmacists as part of multidisciplinary teams of solid organ transplant programmes has been discussed worldwide, as they may provide safer and more effective care to transplant recipients, and help to support maintenance of allograft function contributing to improvement in quality of care. 1,2 Importantly, the presence of a clinical pharmacist in the multidisciplinary team has become a requirement in the accreditation process of transplant centres in the United States (U.S.). 2-6 Pharmaceutical care may be even more relevant for thoracic transplant recipients, given the greater complexity of their medication regimens. 7 In North America, the majority of transplant programmes have a well-defined set of activities performed by clinical pharmacists, which include interaction with other healthcare professionals, patient and caregivers education. 2

Este trabalho visa apresentar a caminhada do Núcleo de Extensão do Curso de Farmácia (NEF) da Universidade Federal de Santa Maria (UFSM), que durante os últimos dois anos tem encontrado nas práticas extensionistas o caminho para o desenvolvimento das habilidades do "Farmacêutico Sete Estrelas", conceito elaborado pela Organização Mundial de Saúde (OMS) voltado para o desempenho do papel do farmacêutico nos serviços de saúde (prestação de serviços em equipe de saúde, capacidade de tomar decisões, comunicação, liderança, gestão, aprendizado permanente e papel como educador). A equipe do Núcleo, formada por acadêmicos de diferentes períodos do curso, sob orientação da professora coordenadora, tem desenvolvido atividades de extensão, ferramenta de transformação social, visando integrar o conhecimento acadêmico ao da sociedade. Essas atividades representam uma alternativa para os alunos que buscam uma formação acadêmica diferenciada. Reconhecida a extensão como ferramenta ideal no desenvolvimento deste novo perfil de profissional. O NEF oportuniza, aos acadêmicos, atividades que vão além do conhecimento puramente técnicocientífico, contribuindo para uma formação profissional crítica, humanística, reflexiva e de visão global.

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