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Background To date, no immunological data on COVID-19 heterologous vaccination schedules in humans have been reported. We assessed the immunogenicity and reactogenicity of BNT162b2 (Comirnaty, BioNTech, Mainz, Germany) administered as second dose in participants primed with ChAdOx1-S (Vaxzevria, AstraZeneca, Oxford, UK). Methods We did a phase 2, open-label, randomised, controlled trial on adults aged 18–60 years, vaccinated with a single dose of ChAdOx1-S 8–12 weeks before screening, and no history of SARS-CoV-2 infection. Participants were randomly assigned (2:1) to receive either BNT162b2 (0·3 mL) via a single intramuscular injection (intervention group) or continue observation (control group). The primary outcome was 14-day immunogenicity, measured by immunoassays for SARS-CoV-2 trimeric spike protein and receptor binding domain (RBD). Antibody functionality was assessed using a pseudovirus neutralisation assay, and cellular immune response using an interferon-γ immunoassay. The safety outcome was 7-day reactogenicity, measured as solicited local and systemic adverse events. The primary analysis included all participants who received at least one dose of BNT162b2 and who had at least one efficacy evaluation after baseline. The safety analysis included all participants who received BNT162b2. This study is registered with EudraCT (2021-001978-37) and ClinicalTrials.gov (NCT04860739), and is ongoing. Findings Between April 24 and 30, 2021, 676 individuals were enrolled and randomly assigned to either the intervention group (n=450) or control group (n=226) at five university hospitals in Spain (mean age 44 years [SD 9]; 382 [57%] women and 294 [43%] men). 663 (98%) participants (n=441 intervention, n=222 control) completed the study up to day 14. In the intervention group, geometric mean titres of RBD antibodies increased from 71·46 BAU/mL (95% CI 59·84–85·33) at baseline to 7756·68 BAU/mL (7371·53–8161·96) at day 14 (p

In hospitals, the administration of drugs intravenous is very common and essential in cases where there is a need for rapid onset of pharmacological effect or another administration route cannot be used. The intravenous route may entail risks, such as the incompatibility between the drugs administered. Incompatibility is any unwanted physicochemical reaction that occurs when two or more drugs are mixed and where the resulting product can affect the efficacy and safety of therapy. This phenomenon is considered a medication error and a basic knowledge of this can help prevent its onset, thus reducing the risks. This article describes the types of incompatibilities, gives examples of some drugs commonly used in intravenous therapy in the management of type "Y" and examine the factors related to the occurrence of this event. We review the information on the theoretical basis that aids understanding of the mechanisms involved in their production. This article describes interventions that nursing staff can take to prevent the incompatibility, and should be incorporated in planning the pharmacological treatment of patient in nursing care. The rapid incorporation of new drugs in the therapeutic regime requires nursing professionals to constantly review and update their knowledge on the incompatibility between the drugs that are under their care. Thus, access to sources of reliable information by the nurse, is a key strategy, which will keep them updated and can prevent the risks associated with the occurrence of this unwanted event.

In hospitals, the administration of drugs intravenous is very common and essential in cases where there is a need for rapid onset of pharmacological effect or another administration route cannot be used. The intravenous route may entail risks, such as the incompatibility between the drugs administered. Incompatibility is any unwanted physicochemical reaction that occurs when two or more drugs are mixed and where the resulting product can affect the efficacy and safety of therapy. This phenomenon is considered a medication error and a basic knowledge of this can help prevent its onset, thus reducing the risks. This article describes the types of incompatibilities, gives examples of some drugs commonly used in intravenous therapy in the management of type "Y" and examine the factors related to the occurrence of this event. We review the information on the theoretical basis that aids understanding of the mechanisms involved in their production. This article describes interventions that nursing staff can take to prevent the incompatibility, and should be incorporated in planning the pharmacological treatment of patient in nursing care. The rapid incorporation of new drugs in the therapeutic regime requires nursing professionals to constantly review and update their knowledge on the incompatibility between the drugs that are under their care. Thus, access to sources of reliable information by the nurse, is a key strategy, which will keep them updated and can prevent the risks associated with the occurrence of this unwanted event.