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Blanco-Pérez J, Salgado-Barreira Á, Blanco-Dorado S, González Bello ME, Caldera Díaz AC, Pérez-Gonzalez A, Pallarés Sanmartín A, Fernández Villar A, Gonzalez-Barcala FJ. Clinical usefulness of serum angiotensin converting enzyme in silicosis. Pulmonology 2022:S2531-0437(22)00130-1. [PMID: 36280590 DOI: 10.1016/j.pulmoe.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Silicosis is an irreversible and incurable disease. Preventive measures to eliminate exposure are the only effective way to reduce morbidity and mortality. In such situations, having a biomarker for early diagnosis or to predict evolution would be very useful in order to improve control of the disease. The elevation of serum angiotensin-converting enzyme (sACE) in silicosis has been described in previous studies, although its relationship with severity and prognosis is not clear. AIMS To determine the levels of sACE in a cohort of patients with exposure to silica dust with and without silicosis, and to assess their impact on the prognosis of the aforementioned patients. METHOD Prospective observational study on patients treated in a silicosis clinic from 2009 to 2018. sACE levels and pulmonary function tests were performed. Radiological progression was assessed in patients who had already had 2 X-rays of the thorax and / or two CT scans with at least a 1-year interval, from the time of inclusion in the study. RESULTS A total of 413 cases of silicosis were confirmed, as well as 73 with exposure to silica dust but without silicosis. The mean sACE level for healthy subjects was 27.5±7.3U/L, for exposed patients without silicosis it was 49.6±24.2U/L, for simple silicosis it was 57.8±31,3U/L and for complicated silicosis it was 74.5±38.6U/L. Patients with a higher sACE generally progressed radiologically during follow-up (73.3±38.0 vs. 60.4±33.7; p<.001) and so the category of silicosis changed (73,9±38.1 vs. 62.5±34.6; p<.021). CONCLUSIONS sACE was elevated in patients with silicosis, and the greater its severity, the higher it was, which is associated with disease progression measured radiologically or as a category change of silicosis.
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Affiliation(s)
- J Blanco-Pérez
- Pneumology Department, University Hospital Complex of Vigo, Spain..
| | - Á Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain..
| | - S Blanco-Dorado
- Pharmacy Department, University Hospital Complex of Santiago de Compostela, Spain
| | | | - A C Caldera Díaz
- Radiology Department, University Hospital Complex of Vigo, Spain
| | - A Pérez-Gonzalez
- Internal Medicine Department, University Hospital Complex of Vigo, Spain
| | | | | | - F J Gonzalez-Barcala
- Pneumology Department, University Hospital Complex of Vigo, Spain.; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.; Pneumology Department, University Hospital Complex of Santiago de Compostela; Spanish Biomedical Research Networking Centre-CIBERES, Spain
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Tévar-Alfonso E, Belles-Medall MªD, Aumente-Rubio MªD, Blanco-Dorado S, Edo-Peñarrocha J. Mapping the clinical pharmacokinetics and pharmacogenetic units operating in Spanish hospitals. Farm Hosp 2021; 45:102-108. [PMID: 35379116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The goal of this article is to analyze the situation of harmacokinetics and pharmacogenetics units in the pharmacy departments of Spanish hospitals, evaluate their development both in the clinical and educational areas, and draw up a map reflecting their current status. Method: A 29-item survey structured in five blocks was designed with general questions about the respondents' hospital and the clinical and educational activities carried out by their pharmacy department, in the fields of both pharmacokinetics and pharmacogenetics. RESULTS Sixty-nine hospitals answered the survey. The highest response rates corresponded to Catalonia, the Valencia region and Andalusia. The drug families subject to closest monitoring were classic antibiotics (93%), digoxin (57%), classic antiepileptics (51%) and biologicals (43%). The most frequently used computer programs included PKS and NONMEM (93% and 22% of hospitals, respectively). Regarding training in pharmacokinetics, second year residents were those who most frequently rotated through the pharmacokinetics unit (40%), while 44% of those units allowed external residents. As far as pharmacogenetics is concerned, in 42% of hospitals that engaged in pharmacogenetic work, the department in charge was pharmacy. The most frequent specialties covered were hemato-oncology (72%) and psychiatry (15%). Twenty-four percent of hospitals offered rotations through their pharmacogenetics unit but only seven of them allowed external residents. CONCLUSIONS The results of the survey showed an increase in the erformance of pharmacokinetic and pharmacogenetic activities by Spanish hospital pharmacies as compared with the data from a 2009 baseline survey, with many hospitals introducing the performance of therapeutic drug monitoring of non-classical antibiotics, immunosuppressants and biologics. However, the percentage of hospitals that follow the ideal model based on analytical determinations and pharmacokinetic reporting has decreased the data obtained served as a basis to create an updated map of the harmacokinetics and pharmacogenetics units operating in Spanish hospital pharmacy departments. This map, available at http://bit.ly/mapaPKGen, will be very useful to facilitate the training of residents in these disciplines and will help promote the development of pharmacokinetic and pharmacogenetic activities among hospital pharmacists.
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Affiliation(s)
- Enrique Tévar-Alfonso
- Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife. Spain..
| | | | | | - Sara Blanco-Dorado
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña. Spain..
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Blanco-Pérez JJ, Blanco-Dorado S, Rodríguez-García J, Gonzalez-Bello ME, Salgado-Barreira Á, Caldera-Díaz AC, Pallarés-Sanmartín A, Fernandez-Villar A, González-Barcala FJ. Serum levels of inflammatory mediators as prognostic biomarker in silica exposed workers. Sci Rep 2021; 11:13348. [PMID: 34172787 PMCID: PMC8233419 DOI: 10.1038/s41598-021-92587-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Silicosis is a diffuse interstitial lung disease caused by sustained inhalation of silica and silicates. Several cytokines are activated by their inhalation and can mediate the process of pulmonary fibrosis. The identification of biomarkers could allow an early diagnosis before the development of radiological alterations and help monitor the evolution of patients. The objetive of this study was to determine the clinical significance of specific biomarkers, to estimate their association with the development, severity and/or progression of silicosis, and identify determinants of this evolution. We conducted a prospective observational study in patients attending the pulmonology clinic from 2009 to 2018. Serum levels of the following inflammatory mediators were assessed: interleukin-6 (IL-6), interleukin 2 receptor subunit alpha (IL2R) interleukin 1 beta (IL1B), interleukin-8 (IL-8), tumour necrosis factor-alpha (TNF-α), transforming growth factor-beta1 (TGF-β1), alpha-1 antitrypsin (AAT), C-reactive protein (CRP), lactate dehydrogenase (LDH) and ferritin in subjects exposed to silica, with and without silicosis. Association between those inflammatory mediators with lung function measurements and radiological severity of disease and their impact on prognosis were analysed. 337 exposed to silica (278 with silicosis) and 30 subjects in the control group were included. IL-8, α1AT, ferritin, CRP and LDH levels were higher in silicosis than in those exposed to silica without silicosis. IL-8, LDH and AAT levels were associated with progression of silicosis and IL-6, IL-8, LDH, AAT, ferritin, and CRP with vital status. The results of the ROC analysis indicated the potential of IL-8 as a biomarker in the presence of silicosis and for the prediction of mortality.
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Affiliation(s)
- José Jesús Blanco-Pérez
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain. .,IRIDIS Group (Investigation in Rheumatology and Immuno-Mediated Diseases) Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain.
| | - Sara Blanco-Dorado
- Department of Pharmacy, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Javier Rodríguez-García
- Department of Clinical Analysis, University Hospital Complex of Santiago de Compostela (CHUS)-SERGAS, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | | | - Ángel Salgado-Barreira
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain
| | | | | | | | - Francisco Javier González-Barcala
- Department of Pneumonology, University Hospital Complex of Santiago de Compostela, Spanish Biomedical Research Networking Centre-CIBERES, Santiago de Compostela, Spain
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Blanco-Dorado S, Belles Medall MD, Pascual-Marmaneu O, Campos-Toimil M, Otero-Espinar FJ, Rodríguez-Riego R, Rodríguez-Jato T, Zarra-Ferro I, Lamas MJ, Fernández-Ferreiro A. Therapeutic drug monitoring of voriconazole: validation of a high performance liquid chromatography method and comparison with an ARK immunoassay. Eur J Hosp Pharm 2021. [DOI: 10.1136/ejhpharm-2019-002155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Blanco-Dorado S, Maroñas O, Latorre-Pellicer A, Rodríguez Jato MT, López-Vizcaíno A, Gómez Márquez A, Bardán García B, Belles Medall D, Barbeito Castiñeiras G, Pérez Del Molino Bernal ML, Campos-Toimil M, Otero Espinar F, Blanco Hortas A, Durán Piñeiro G, Zarra Ferro I, Carracedo Á, Lamas MJ, Fernández-Ferreiro A. Impact of CYP2C19 Genotype and Drug Interactions on Voriconazole Plasma Concentrations: A Spain Pharmacogenetic-Pharmacokinetic Prospective Multicenter Study. Pharmacotherapy 2020; 40:17-25. [PMID: 31782536 DOI: 10.1002/phar.2351] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Voriconazole, a first-line agent for the treatment of invasive fungal infections, is mainly metabolized by cytochrome P450 (CYP) 2C19. A significant portion of patients fail to achieve therapeutic voriconazole trough concentrations, with a consequently increased risk of therapeutic failure. OBJECTIVE To show the association between subtherapeutic voriconazole concentrations and factors affecting voriconazole pharmacokinetics: CYP2C19 genotype and drug-drug interactions. METHODS Adults receiving voriconazole for antifungal treatment or prophylaxis were included in a multicenter prospective study conducted in Spain. The prevalence of subtherapeutic voriconazole troughs was analyzed in the rapid metabolizer and ultra-rapid metabolizer patients (RMs and UMs, respectively), and compared with the rest of the patients. The relationship between voriconazole concentration, CYP2C19 phenotype, adverse events (AEs), and drug-drug interactions was also assessed. RESULTS In this study 78 patients were included with a wide variability in voriconazole plasma levels with only 44.8% of patients attaining trough concentrations within the therapeutic range of 1 and 5.5 µg/ml. The allele frequency of *17 variant was found to be 29.5%. Compared with patients with other phenotypes, RMs and UMs had a lower voriconazole plasma concentration (RM/UM: 1.85 ± 0.24 µg/ml vs other phenotypes: 2.36 ± 0.26 µg/ml). Adverse events were more common in patients with higher voriconazole concentrations (p<0.05). No association between voriconazole trough concentration and other factors (age, weight, route of administration, and concomitant administration of enzyme inducer, enzyme inhibitor, glucocorticoids, or proton pump inhibitors) was found. CONCLUSION These results suggest the potential clinical utility of using CYP2C19 genotype-guided voriconazole dosing to achieve concentrations in the therapeutic range in the early course of therapy. Larger studies are needed to confirm the impact of pharmacogenetics on voriconazole pharmacokinetics.
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Affiliation(s)
- Sara Blanco-Dorado
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Olalla Maroñas
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela, Spain
| | - Ana Latorre-Pellicer
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María Teresa Rodríguez Jato
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | - Ana López-Vizcaíno
- Pharmacy Department, University Hospital Lucus Augusti (HULA), Lugo, Spain
| | | | | | | | - Gema Barbeito Castiñeiras
- Microbiology Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | | | - Manuel Campos-Toimil
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Francisco Otero Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Andrés Blanco Hortas
- Epidemiology Unit, Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), University Hospital Lucus Augusti (HULA), Lugo, Spain
| | - Goretti Durán Piñeiro
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Irene Zarra Ferro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Genomic Medicine Group, Centro Nacional de Genotipado (CEGEN-PRB3), CIBERER, CIMUS, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.,Galician Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (CHUS), Santiago de Compostela, Spain.,Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.,Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Blanco-Dorado S, Cea-Arestin C, González Carballo A, Latorre-Pellicer A, Maroñas Amigo O, Barbeito Castiñeiras G, Pérez del Molino Bernal ML, Campos-Toimil M, Fernández-Ferreiro A, Lamas MJ. An Observational Study of the Efficacy and Safety of Voriconazole in a Real-Life Clinical Setting. J Chemother 2018; 31:49-57. [DOI: 10.1080/1120009x.2018.1524085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Sara Blanco-Dorado
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
| | - Cristina Cea-Arestin
- Department of Clinical Analysis, University Hospital Vall D'Hebron, Barcelona, Spain,
| | - Alba González Carballo
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
| | - Ana Latorre-Pellicer
- Medicina Xenómica Group, CIBERER, University of Santiago de Compostela (USC), Santiago de Compostela, Spain,
| | - Olalla Maroñas Amigo
- Medicina Xenómica Group, CIBERER, University of Santiago de Compostela (USC), Santiago de Compostela, Spain,
| | - Gema Barbeito Castiñeiras
- Microbiology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
| | | | - Manuel Campos-Toimil
- Department of Pharmacology of Chronic Diseases (CD Pharma), Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
- Department of Pharmacology of Chronic Diseases (CD Pharma), Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María J. Lamas
- Department of Pharmacy, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain,
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,
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Díaz-Tomé V, Luaces-Rodríguez A, Silva-Rodríguez J, Blanco-Dorado S, García-Quintanilla L, Llovo-Taboada J, Blanco-Méndez J, García-Otero X, Varela-Fernández R, Herranz M, Gil-Martínez M, Lamas MJ, González-Barcia M, Otero-Espinar FJ, Fernández-Ferreiro A. Ophthalmic Econazole Hydrogels for the Treatment of Fungal Keratitis. J Pharm Sci 2018; 107:1342-1351. [PMID: 29305870 DOI: 10.1016/j.xphs.2017.12.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
Econazole is a feasible alternative treatment in the management of fungal keratitis. Nevertheless, its low water solubility is considered the main limitation to the incorporation into ophthalmic formulations. In this work, econazole nitrate is solubilized by using cyclodextrins to achieve an optimum therapeutic concentration. Phase solubility diagrams suggest α-cyclodextrin as the most effective cyclodextrin and later the inclusion complex formed with this one was characterized in solution by 1D, 2D-NMR, and molecular modeling. Econazole-α-cyclodextrin inclusion complex was included in 2 types of ocular hydrogels: a natural polysaccharides ion-sensitive hydrogel and a hyaluronic acid hydrogel. Both of them show no ocular irritation in the hen's egg test on chorioallantoic membrane assay and a controlled econazole release over time. Permeability studies suggest that hydrogels do not modify the econazole nitrate permeability through bovine cornea in comparison with an econazole-α-cyclodextrin inclusion complex solution. Finally, ocular biopermanence studies performed using positron emission tomography show these hydrogels present a high retention time on the eye. Results suggest the developed formulations have a high potential as vehicles for the econazole topical ocular administration as fungal keratitis treatment.
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Affiliation(s)
- Victoria Díaz-Tomé
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jesús Silva-Rodríguez
- Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Sara Blanco-Dorado
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Laura García-Quintanilla
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - José Llovo-Taboada
- Microbiology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - José Blanco-Méndez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Rubén Varela-Fernández
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Michel Herranz
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - María Jesús Lamas
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, Spain; Clinical Pharmacology Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS), Santiago de Compostela, Spain.
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