Background and importance The COVID-19 pandemic has required reorganisation of our pharmacy service procedures to guarantee adequate pharmaceutical care and protect the safety of caregivers and patients.

Aim and objectives To describe the actions taken by the pharmacy service and their likely repercussions for the future.

Material and methods A retrospective analysis was conducted of the actions carried out during the 10 week period, 12 March 2020 to 21 May 2020, the period that corresponds to the first wave of the COVID-19 pandemic and its aftermath. We analysed hospital data and documentation generated in the pharmacy during the pandemic and the subsequent de-escalation and re-escalation periods.

Results During the first wave of the pandemic, the hospital treated 1088 COVID-19 patients. At the peak of the pandemic, there were 501 patients hospitalised with 57 in intensive care units.

The principal actions carried out were:

• Modification of the make–up of staff in charge of pharmacy activities with 24 hour reinforcement and work from home.

• Establishment of new internal and external communication channels with the administration, healthcare professionals and patient associations to continually communicate changes.

• Management of medications for COVID–19 and critically ill patients, establishment of stock strategies and shortages management.

• Increasing storage space and re–dimensioning the kardex system.

• Configuration of new hospital units and hospitals (including hotel hospitalisation), redesigning healthcare circuits, hospital discharges and return–to–stock procedures (quarantine).

• Preparation of new standardised intravenous mixtures and medication kits.

• Participation in protocols for COVID treatment, and incorporation of new protocols and alerts into the computerised physician order entry system.

• Design and implementation of a new virtual consultation system and home delivery of medications. During the first wave of 10 weeks, there were 3450 virtual consultations and home deliveries of medications, involving 74.8% of all outpatients. This value later went down and has remained at 60%.

• Management of clinical trials for COVID–19 treatment options.

Conclusion and relevance In retrospect, the COVID-19 pandemic presented serious challenges to our pharmacy service in terms of assuring pharmaceutical care for both COVID and non-COVID patients. Some changes have become permanent and represent innovations in pharmacy services.

Conflict of interest No conflict of interest