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BackgroundThe Pharmacovigilance Risk Assessment Committee (PRAC) published restrictions on the use of ivabradine in 2014 for patients diagnosed with chronic stable angina pectoris (CSAP):begin treatment only if resting heart rate (HR) is >70 bpm, initial dose not exceeding 5 mg bid (2.5 mg bid for patients older than 75 years);maximum maintenance dose 7.5 mg bid;monitor HR before starting treatment and after changing dose;withdraw treatment in the case of atrial fibrillation (AF); anddo not use ivabradine combined with diltiazem or verapamil.PurposeTo review ivabradine prescriptions in our patients and compliance with PRAC guidelines.Material and methodsAn observational, prospective study was carried out between February and May 2015. Every patient diagnosed with CSAP and treated with ivabradine was included. Data collected: gender, age, HR, dates in which treatment was started and discontinued, diagnosis, initial and maintenance dose, diltiazem or verapamil treatment and occurrence of AF. The prescription was considered adequate if it followed every PRAC recommendation.Results34 patients were prescribed ivabradine and 17 were included in our study based on a CSAP diagnosis. At the beginning, resting HR was >70 bpm and initial dose was 5 mg bid for all patients (none was older than 75 years). Maintenance dose was never above 7.5 mg bid. In 4 patients, ivabradine was withdrawn, in 3 due to the development of AF and the other one after a pharmaceutical intervention warning the physician that a combination of diltiazem and ivabradine was prescribed.Compliance with PRAC guidelines was found in 16 of 17 patients (94%).Conclusion3 out of 17 patients (17.6%) developed AF during treatment, a higher percentage than that showed in the SIGNIFY1 study (4.6%). We strongly believe that treatment with ivabradine should be closely monitored by hospital pharmacists regarding its pharmacological and safety profile.References and/or AcknowledgementsFox K, Ford I, Steg PG, et al. Bradycardia and atrial fibrillation in patients with stable coronary artery disease treated with ivabradine: an analysis from the SIGNIFY study. Eur Heart J 2015;Sep 17:ehv451No conflict of interest.

Adults aged 18 or older, who died of an onco-haematological neoplasia between 1 April 2017 and 30 March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy (including oral targeted therapies and biotherapy). Gender, age, prescribing unit, primary malignancy, last type of treatment (chemotherapy, biotherapy or both), route of administration (parenteral, oral) and temporal interval between the last chemotherapy administration and death of the patient were collected.For descriptive analysis, the statistical program SPPS version 23.0 was used. Results A total of 298 patients died between the prespecified period in the Haematology and Oncology units, of whom 60.4% were male, with a median age of 65±13 years (range 30-87). The hospital unit of origin was Oncology for 86.9% (n=259) and Haematology for 13.1% (n=39) of the cases. Tumours with the highest number of deaths were lung (24.4%), breast (15.4%) and colon (9%).A total of 28.2% (n=11) of haematological and 25.9% (n=67) of oncological patients received chemotherapy during the last 14 days before death. Overall rate was 26.2% (n=78). In these patients, the most widely used therapeutic regimen was classic chemotherapy, administered in 79.5% of patients (67.7% intravenous treatment). Conclusion The outcomes confirm that the proportion of patients receiving chemotherapy in the last 14 days of life is high, showing excessive aggressiveness at the end-of-life care. REFERENCES AND/OR ACKNOWLEDGEMENTSNo conflict of interest.