The use of cyclodextrins as drug nano-carrier systems for drug delivery is gaining importance in the pharmaceutical industry due to the interesting pharmacokinetic properties of the resulting inclusion complexes. In the present work, complexes of the anti-cancer alkaloids camptothecin and luotonin A have been prepared with β-cyclodextrin and hydroxypropyl-β-cyclodextrin. These cyclodextrin complexes were characterized by nuclear magnetic resonance spectroscopy (NMR). The variations in the ¹H-NMR and ¹³C-NMR chemical shifts allowed to establish the inclusion modes of the compounds into the cyclodextrin cavities, which were supported by docking and molecular dynamics studies. The efficiency of the complexation was quantified by UV-Vis spectrophotometry and spectrofluorimetry, which showed that the protonation equilibria of camptothecin and luotonin A were drastically hampered upon formation of the inclusion complexes. The stabilization of camptothecin towards hydrolysis inside the cyclodextrin cavity was verified by the quantitation of the active lactone form by reverse phase liquid chromatography fluorimetric detection, both in basic conditions and in the presence of serum albumin. The antitumor activity of luotonin A and camptothecin complexes were studied in several cancer cell lines (breast, lung, hepatic carcinoma, ovarian carcinoma and human neuroblastoma) and an enhanced activity was found compared to the free alkaloids, particularly in the case of hydroxypropyl-β-cyclodextrin derivatives. This result shows that the cyclodextrin inclusion strategy has much potential towards reaching the goal of employing luotonin A or its analogues as stable analogues of camptothecin.

Dentro de las Buenas Prácticas de Farmacia, la Indicación Farmacéutica es uno de los servicios farmacéuticos más solicitados en las farmacias para resolver problemas específicos de salud en el marco de la atención farmacéutica. Este estudio tuvo como objetivo explorar la frecuencia y las características de la indicación farmacéutica (IF), también llamada Recomendación Farmacéutica (RF) en países centroamericanos, realizado en las farmacias comunitarias privadas. Estudio observacional, exploratorio y transversal, con muestreo no probabilístico por conveniencia. Se utilizó un cuestionario electrónico con 23 preguntas cerradas y una abierta, aplicado a farmacéuticos comunitarios de farmacias privadas, es decir, establecimientos de propiedad particular no estatales de esta región. Se excluyó la información de Nicaragua debido al bajo número de respuestas. Se exploraron características generales, percepción profesional y práctica asistencial. La validación se realizó con un farmacéutico por país. No se recopilaron datos personales. Entre los farmacéuticos que respondieron la encuesta, la actividad de IF/RF, en general, no ha alcanzado los principios y marcos de referencia comunes respaldados por organizaciones internacionales y guías nacionales además muestra disparidad muy amplia en cuanto a la legislación y reglamentación que cubre esta función farmacéutica en el área centroamericana. La valoración de la formación recibida sobre esta temática ofrece importantes áreas de mejora. Conclusiones: Los servicios de farmacia comunitaria en el grupo estudiado deben redefinirse dentro de un modelo más asistencial, con el objetivo de optimizar la farmacoterapia y contribuir al mantenimiento y mejoramiento de la salud de las personas.

Context: Adverse drug reactions represent one of the leading causes of hospitalization and death. Aims: To characterize adverse reactions due to antibiotics and nonsteroidal anti-inflammatory drugs in outpatients over 18 years of age. Methods: Cross-sectional descriptive observational study. It included outpatients aged 18 years or older who went to public health care centers and who presented a health problem, for which they were treated with antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs). The information was collected through an adaptation of the adverse drug reaction (ADR) report format in outpatients. Results: A sample of 4,573 participants was obtained, of which 556 (12.4%) people presented adverse drug event, 550 ADR were detected by NSAIDs and antibiotics, of which, 51.4% (291) were classified according to Naranjo’s algorithm as probable, 37.8% (214) as possible and 8.0% (45) as defined. According to the Rawlins and Thompson classification the majority were type A with 413 (75.1%). The severity was mostly mild, with 471 (85.6%) and the manifestations of the digestive system predominated with 440 (80.0%). Conclusions: It is necessary to promote and strengthen pharmacovigilance activities, as well as the training and updating of health personnel in the detection of ADR, since in many cases these can be avoided, contributing to patient safety and the reduction of public spending on health, especially in low-income countries.

Introduction: Community pharmacy across Ibero-America is characterized by conceptual, regulatory, and practice-related heterogeneity, which hinders the consistent integration of community pharmacists into healthcare systems. This study aimed to present the Ibero-American Community Pharmacy Decalogue, developed by the Ibero-American Scientific and Professional Society of Community Pharmacy (SOCFIC), and its operationalization as a preliminary tool to assess regional development, identify and prioritize gaps, establish maturity levels, and inform public policies, national action plans, and strategies to strengthen community pharmacy. Method: A methodological development study was conducted in two stages: development and validation of the Decalogue by experts representing 17 Ibero-American countries, followed by its operationalization through a matrix comprising indicators, compliance categories, and progressive maturity levels. Results: The Ibero-American Community Pharmacy Decalogue was developed together with a preliminary evaluation matrix, four maturity levels, and an implementation roadmap designed to support monitoring, cross-country comparison, and the regional strengthening of community pharmacy. Conclusions: The Decalogue and its operationalization provide a shared framework for assessing and monitoring community pharmacy development and for informing policies and strategies aimed at strengthening community pharmacy across Ibero-America.