Physical Compatibility of Y-site Pediatric Drug Administration: A Call for Question of US Pharmacopeia Standards.

Q2 Medicine
Emma L Ross, Kirsten Petty, Allison Salinas, Jarrett Bremmer, Cheng Her, John F Carpenter
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引用次数: 0

Abstract

Objective: To evaluate the physical intravenous Y-site compatibility of 29 combinations of medications at commonly used pediatric concentrations using both existing and novel techniques.

Methods: Medication combinations included were selected by a varied group of pediatric inpatient pharmacists, and then assessed by 3 independent reviewers for existing literature. For each combination, 2 different medications were mixed together in a 1:1 ratio and incubated at room temperature for 4 hours to simulate Y-site administration. Each sample was then analyzed using the US Pharmacopeia (USP) <788> recommended analytical technique of light obscuration (LO) in addition to novel flow imaging (FI) microscopy and backgrounded membrane imaging (BMI). Physical compatibility was determined using USP chapter <788> large volume particle count limits for all techniques.

Results: A total of 29 different medication combinations were studied. Five combinations met criteria for compatibility by all 3 techniques. The remaining 24 combinations reached the threshold to be considered incompatible by at least 1 of the 3 techniques. Light obscuration, BMI, and FI identified 14%, 59%, and 76% of combinations as incompatible, respectively. All samples deemed incompatible by LO were also incompatible by at least 1 of the other 2 techniques. Flow imaging and BMI results agreed in 69% of samples tested.

Conclusions: Most combinations tested were found to be incompatible by at least 1 of the 3 instruments used. Light obscuration appears to have reduced accuracy for identifying particulate resulting in physical medication incompatibility when compared with the novel techniques of FI and BMI.

y位点儿童用药的物理相容性:对美国药典标准的质疑。
目的:利用现有技术和新技术,评价29种常用儿科浓度药物组合的静脉y位点物理相容性。方法:由不同的儿科住院药师组选择纳入的药物组合,然后由3名独立审稿人对现有文献进行评估。在每个组合中,2种不同的药物以1:1的比例混合在一起,在室温下孵育4小时,模拟y位点给药。然后使用美国药典(USP)推荐的光遮蔽(LO)分析技术以及新型流动成像(FI)显微镜和背景膜成像(BMI)分析每个样品。使用USP章节的大体积颗粒计数限制来确定所有技术的物理相容性。结果:共研究了29种不同的用药组合。5个组合符合所有3种技术的相容性标准。其余24个组合达到了3种技术中至少1种认为不相容的阈值。光线遮挡、BMI和FI分别确定14%、59%和76%的组合不相容。所有被LO认为不相容的样品在其他两种技术中至少有一种也不相容。69%的测试样本的血流成像和BMI结果一致。结论:大多数被检测的组合在使用的3种器械中至少有1种是不相容的。与FI和BMI的新技术相比,光线遮挡似乎降低了识别导致物理药物不相容的颗粒的准确性。
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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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