Objetivo: Caracterizar la farmacoterapia de infecciones oportunistas y comorbilidades en pacientes hospitalizados con VIH y sida en el Hospital Universidad del Norte entre el año 2018 y junio de 2023. Materiales y métodos: Estudio descriptivo retrospectivo de tipo transversal, basado en la recolección de datos clínicos desde 2018 hasta junio de 2023; el enfoque de investigación fue no experimental. La recopilación de datos se realizó en el Hospital Universidad del Norte e incluyó a pacientes diagnosticados con VIH y sida como población objetivo. La muestra, compuesta por 109 pacientes, fue seleccionada a conveniencia, y cumplió con criterios de inclusión predefinidos que requerían que fueran personas mayores de 18 años y que tuvieran un periodo de hospitalización mayor a cuatro días. Los datos clínicos se recopilaron de las historias clínicas y se analizaron utilizando el software SPSS y Microsoft Excel. Resultados: La media de edad de los pacientes fue 43,6 años, mientras que la duración promedio de hospitalización fue 14,9 días por persona. El fluconazol fue el medicamento más usado en el tratamiento de infecciones oportunistas, y fue recetado al 58,5 % de la población de estudio. Para el tratamiento de las comorbilidades, el amlodipino fue el fármaco más frecuente con un 23,1 % de uso en la población estudiada. Las infecciones oportunistas más frecuentes fueron la candidiasis orofaríngea con un 15,43 %, seguida de la neumonía por Pneumocystis jirovecii (PCP) con un 12,75 %, la tuberculosis con un 11,40 % y la toxoplasmosis con un 10,73 %. Asimismo, las comorbilidades más comunes fueron la hipertensión arterial con un 28,94 % y el trastorno depresivo mayor con un 18,42 %. En cuanto al impacto económico de los problemas relacionados con medicamentos (PRM) y los resultados negativos asociados a la medicación (RNM), se registraron costos de $1 223 717 y $5 008 521, respectivamente. Conclusiones: El grupo de edad más susceptible a las infecciones oportunistas se sitúa entre los 40 y 50 años, y el sexo masculino es el más afectado. Se reportó que la mayoría de los pacientes se encontraban en la fase sida, y que sobresalieron aquellos con diagnóstico por antecedente. En el abordaje de las infecciones oportunistas, el fluconazol es el que destaca como el fármaco más utilizado en la población de estudio, seguido del trimetoprim + sulfametoxazol y la combinación de rifampicina+isoniacida+pirazinamida+etambutol. Asimismo, en el tratamiento de las comorbilidades, el amlodipino es el que sobresale entre los medicamentos más usados, seguido por el losartán, la mirtazapina, el levetiracetam y la sertralina.

Vancomycin (VCN) is a glycopeptide antibiotic widely used to treat Gram-positive infections such as those caused by methicillin-resistant Staphylococcus aureus (MRSA). Its narrow therapeutic window, high interindividual pharmacokinetic variability, and dose-dependent nephrotoxicity support the need for therapeutic drug monitoring (TDM). In this study, a UHPLC-UV method for VCN quantification in human plasma was developed and validated according to ICH M10 guidelines, using a one-step protein precipitation requiring only 100 µL of plasma. Clinical applicability was preliminarily explored in three hospitalized patients, where the area under the concentration-time curve over 24 h to minimum inhibitory concentration ratio (AUC₂₄/MIC) was estimated using PrecisePK, NextDose, and TDMx Bayesian software platforms before and after dose adjustment. The method showed linearity from 0.5 to 100 µg/mL (r² > 0.99), with accuracy within ±7% and precision below 11%. Acceptance criteria for selectivity and matrix effect were met, and stability was confirmed under multiple conditions, including clinically relevant storage and transport. Pre-adjustment AUC₂₄/MIC values were outside the target window of 400–600 in all patients, confirming the pertinence of implementing model-informed precision dosing as a routine TDM practice in Colombian health institutions.

Se presenta el caso de un paciente masculino de 46 años. Este ingresó al servicio de urgencias con un cuadro clínico de una hora de evolución caracterizado por dolor torácico opresivo de intensidad 10/10 según la escala análoga del dolor. Después de la valoración y frente a los hallazgos electrocardiográficos y de laboratorio, se diagnosticó al paciente con infarto agudo de miocardio con elevación del ST, además, se sospechó de disección aórtica y de una emergencia hipertensiva a órgano blanco corazón debido al intenso dolor precordial y las cifras tensionales de 230/120 mmHg. Dentro del esquema terapéutico, se indicaron 3 mg de morfina intravenosa diluida en 10 ml de solución salina 0,9%. Después de la administración, el paciente presentó sospecha de hipersensibilidad. Por ende, se realizó una evaluación de sospecha de evento adverso utilizando el algoritmo de Naranjo y se estableció que los efectos de morfina eran plausibles (categoría probable). The case of a 46-year-old male patient is presented. He was admitted to the emergency department with a clinical picture of oppressive chest pain of 10/10 intensity on the pain analog scale, which had been evolving for one hour. After evaluation and based on electrocardiographic and laboratory findings, the patient was diagnosed with acute myocardial infarction with st elevation. Additionally, aortic dissection and hypertensive emergency with end-organ damage to the heart were suspected due to intense precordial pain and blood pressure readings of 230/120 mmHg. As part of the therapeutic approach, 3 mg of intravenous morphine diluted in 10 ml of 0.9 % saline solution were administered. Following administration, the patient exhibited suspected hypersensitivity. Therefore, a suspected adverse event assessment was performed using the Naranjo algorithm, and it was established that the effects of morphine were plausible (category probable).

Objective: to characterize the pharmacotherapy of patients with acute ischemic stroke (ACVi) treated with recombinant tissue plasminogen activator (rt-PA) in a hospital in Soledad - Atlántico in the period 2015-2020. Materials and methods: a retrospective descriptive observational study was carried out, for the quantitative variables the Kolmogórov – Smirnov normality test was applied. The data that complied with the assumption of normality (p>0.05) were presented as means ± standard deviation, those that did not comply were presented as medians. Categorical variables were shown as frequencies or percentages. Results: 72 patients with a median age of 74 years were studied, 52.2% of the population were men, 69.4% suffered from arterial hypertension, 26.4% received platelet aggregation inhibitors, excluding heparin, and 23, 6% were administered drugs belonging to the therapeutic group of heparins. Twenty-five percent of the population developed hemorrhage: 19.4% had intracerebral hemorrhage, 4.2% developed subarachnoid hemorrhage, and 1.4% had gastrointestinal hemorrhage. Conclusion: it was possible to identify opportunities for improvement in the management of patients with stroke and in the use of alteplase. A higher percentage of bleeding complications was found compared to studies previously conducted in Colombia. Further investigations are required to corroborate the results, due to the limited number of participants and scarce data related to clinical histories.

Objective: To evaluate the pharmacotherapy of patients on anticoagulant therapy in the internal medicine department at Hospital Universidad del Norte through pharmaceutical care practice using the Dader method. Materials and methods: This study employed a quasi-experimental and ambispective descriptive methodology, which included a retrospective analysis of a study population called the reference group. This group consisted of 78 patients who were receiving anticoagulant therapy and were hospitalized for a period of three months in 2022. The patients in this group underwent a socio-demographic, clinical and pharmacological characterization, and analysis of medication-related problems (DRP) and negative results associated with medication (NOM), to determine the approach of the patient under pharmaceutical care practice who were hospitalized for a period of three months in the 2023, corresponding to the attended group with 66 patients. The activities were conducted in accordance with the Dader method, and the statistical analysis of the data was performed with the STATGRAPHICS Centurion XVI version 16.1.03 program, for both quantitative and qualitative data. Results: The DRP and NOMs most frequent reported in the attended group was drugdrug interactions, and quantitative insecurity respectively, while in the reference group was reported inadequate dose, regime and/or duration as DPR and followed by the NOM quantitative ineffectiveness. The drug associated with the occurrence of NOMs was Warfarin with 57.15% in the reference group, and a 62.5% in the attended group. Finally, through the application of statistical tests (chi-squared), it was demonstrated that patients with atrial fibrillation (AF) exhibited a 4.65 probability of presenting a DRP. Conclusion: The pharmacotherapeutic evaluation revealed potential opportunities for improvement in the management of anticoagulation in hospitalized patients. In particular, the use of warfarin was identified as a concern due to the variability in the international normalized ratio (INR), with 100% of the attended group falling outside the therapeutic window. Additionally, patients with atrial fibrillation were identified as a population that could benefit from pharmaceutical care service.