The functioning of health care centers is highly dependent on the quality of cooperation between medical staff - doctors, nurses, but also pharmacists. Pharmaceutical knowledge about medicines, combined with daily practice and supervision of the pharmacotherapy used, can bring a number of benefits, primarily increasing effectiveness and safety of treatment, as well as reducing the cost of treatment. Despite numerous difficulties, in some hospitals in Poland pharmacists undertake various types of clinical activities by directly joining the work of a hospital ward or remote monitoring of patient's pharmacotherapy using electronic systems. It should be emphasized that these are often tasks carried out outside the basic dimension of working time. The initiative taken in 2017 by the Director of the Provincial Specialist Hospital in Wroclaw, Research and Development Center, deserves a mention. Pharmacist (during the specialization in clinical pharmacy) was fully engaged in the work of hospital wards focusing first in the Department of Vascular Surgery, and then also General Surgery. Her daily duties include participation in medical celebrations, conducting medical history with newly admitted patients, optimization of pharmacotherapy, consultation with the medical and nursing team, control of orders and results of laboratory tests, giving advice to staff and educating patients in correct use of medicines. This kind of multidisciplinary cooperation has become a standard of care, which has been approved by the accreditation committee of the Center for Quality Monitoring in Health Care. In Poland, clinical pharmacy is constantly developing and gaining importance every year, but as of today, there are still no clear law regulations. Will the draft Act On The Pharmacy Profession adopted by the Council of Ministers introduce regulations and clearly define the place of a clinical pharmacist in the healthcare system? Undoubtedly, it would be a basic step to the further development of clinical pharmacy services.

Background and Objective Sorafenib is an oral, multikinase inhibitor with established single-agent activity in several tumor types. Sorafenib was moderately transported by P-glycoprotein (P-gp) and more efficiently by breast cancer resistance protein. The constitutive androstane receptor (CAR) is a ligand-activated transcription factor involved in P-gp regulation in the brain microvasculature. Paracetamol is a CAR activator. The purpose of this study was to investigate the effect of paracetamol on the brain uptake of sorafenib and sorafenib N-oxide. Methods The rats were assigned to two groups—rats receiving oral paracetamol 100 mg/kg and sorafenib 100 mg/kg ( n = 42, I SR+PA ) and rats receiving oral vehicle and sorafenib 100 mg/kg ( n = 42, II SR ). The sorafenib and sorafenib N-oxide concentrations in blood plasma and brain tissue were determined by a high-performance liquid chromatography method with ultraviolet detection. Brain-to-plasma partition coefficient ( K p ) was calculated as a ratio of the area under the curve from zero to 24 h (AUC) in the brain and plasma. A drug targeting index (DTI) was estimated as the group I SR+PA K p to group II SR K p ratio. Results Pharmacokinetic analysis revealed increased brain exposure to sorafenib and sorafenib N-oxide after co-administration of paracetamol. The brain maximum concentration ( C max ) and the AUC of the parent drug in the I SR+PA group compared with the II SR group were greater by 49.5 and 77.8%, respectively, and the same parameters for the metabolite were higher by 51.4 and 50.9%. However, the K p values of sorafenib and sorafenib N-oxide did not differ significantly between the two animal groups and the DTI values were close to 1. Conclusion Paracetamol increases exposure to sorafenib and sorafenib N-oxide in the brain, likely due to increased exposure in plasma.

A correction to this paper has been published: https://doi.org/10.1007/s43440-021-00278-4

Numerous studies have confirmed the influence of diabetes mellitus on the pharmacokinetics of drugs. Paracetamol (APAP) is an antipyretic that is commonly used in febrile neutropenia (FN) therapy. APAP is chiefly metabolised by glucuronidation and sulphation. This study assessed the influence of diabetes on the pharmacokinetics of paracetamol and its metabolites: glucuronide (APAP-glu) and sulfate (APAP-sulfate) in FN patients.