[XIII Lección Jesús Culebras. Hospital pharmacists and nutritional support. From the beginning to the present day (1976- 2018)].

Hospital pharmacists have been, since 1970's active members in nutritional support commissions [parenteral nutrition (NP) and enteral nutrition (EN)], in our hospitals, mainly in the context of sterile preparation of NP components. This presentation tries to explain their role in this 42-year journey. Without any doubt, in quality leap, in pharmaceutical quality in PN was the step from the preparation in individual vials to the "all-in-one" admixtures", thereby reducing catheter infections due to less handling. Three events occurred in the 1990´s., First, due to increase of NP preparations, the pharmaceutical industry designed three-chamber bags. Second, studies on hospital malnutrition, were launched after verifying that malnutrition increased surgical and medical complications. Finally, the Order of June 2, 1987 regulated Home Enteral Nutrition (HEN). In the first decade of the new century, the growth of patients who were candidates for PN continued. In the last 10 years, we have intensified our work into patients with short bowel with Home Parenteral Nutrition (HPN), but above all in the control of ileostomies, after suture failure. and we placed order in the drugs that are stable in NP and in "Y" with it. We also started pharmacokinetics studies in the administration of drugs in different surgical situations: bariatric surgery, total gastrectomy... In the future we will continue to ask questions about how we can improve the nutritional support of our patients.