Physical Compatibility of Reduced Glutathione for Injection With 44 Intravenous Drugs During Simulated Y-site Administration

IF 3.2 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2024-10-01 DOI:10.1016/j.clinthera.2024.08.002

Rui Wu MS , Gaochao Zhu BS , Yinghui Ju MS , Yue Zhu MS , Menglin Wang MS , Yangyu Zhao MS , Sheng Liu BS

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引用次数: 0

Abstract

Purpose

Reduced glutathione (GSH) is extensively used in clinical therapeutics due to its antioxidative and cytoprotective properties. It is essential in the management of various chronic and acute conditions and serves as an adjunct therapy in oncology. Despite its widespread use, the physical compatibility of GSH with other intravenous drugs during Y-site administration has not been thoroughly investigated, posing risks such as reduced efficacy and adverse reactions. This study fills this critical gap by examining the physical compatibility of GSH with 44 commonly used intravenous drugs in simulated Y-site administration with 0.9% sodium chloride injection (NS) and 5% dextrose injection, aiming to enhance patient safety and clinical outcomes.

Methods

Simulated Y-site administration was conducted in vitro by mixing 24 mg/mL of GSH with equal volumes of 44 diluted intravenous drugs. Physical compatibility was assessed by observing visual changes, checking for the Tyndall effect, measuring turbidity, and monitoring pH levels at 0, 0.5, 1, 2, and 4 hours post-mixing. Physical compatibility was defined as the absence of color changes, gas evolution, particulate formation, and the Tyndall effect within 4 hours, with turbidity changes of less than 0.5 nephelometric turbidity units from baseline and pH variations of less than 10% from initial values.

Findings

GSH exhibited physical incompatibility with 11 of the 44 intravenous drugs evaluated, while it remained compatible with 33 drugs over 4 hours.

Implications

This study reveals that while GSH is physically compatible with the majority of tested intravenous drugs, incompatibilities with 11 drugs under simulated Y-site conditions necessitate rigorous compatibility testing prior to co-administration in clinical settings. These findings emphasize the importance of such testing to prevent potential treatment failures and adverse effects. Further research is needed to explore chemical stability and therapeutic efficacy in clinical settings, ensuring the safe and effective use of GSH in medical treatments.

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注射用还原型谷胱甘肽与 44 种静脉注射药物在模拟 Y 位给药过程中的物理相容性。

目的：还原型谷胱甘肽（GSH还原型谷胱甘肽（GSH）具有抗氧化和细胞保护特性，因此被广泛用于临床治疗。它是治疗各种慢性和急性疾病的重要药物，也是肿瘤学的辅助疗法。尽管 GSH 被广泛使用，但其在 Y 位给药过程中与其他静脉注射药物的物理相容性尚未得到深入研究，这就带来了药效降低和不良反应等风险。本研究填补了这一重要空白，研究了 GSH 与 44 种常用静脉注射药物在 0.9% 氯化钠注射液（NS）和 5% 葡萄糖注射液的模拟 Y 位给药中的物理相容性，旨在提高患者安全性和临床疗效：将 24 毫克/毫升的 GSH 与等体积的 44 种稀释静脉注射药物混合，在体外进行模拟 Y-位点给药。通过观察视觉变化、检查廷德尔效应、测量浑浊度以及监测混合后 0、0.5、1、2 和 4 小时的 pH 值来评估物理兼容性。物理兼容性的定义是在 4 小时内没有颜色变化、气体演化、微粒形成和廷德尔效应，浊度与基线相比变化小于 0.5 尼菲尔浊度单位，pH 值与初始值相比变化小于 10%：研究结果：在所评估的 44 种静脉注射药物中，有 11 种药物与 GSH 不兼容，而在 4 小时内 GSH 仍与 33 种药物兼容：本研究表明，虽然 GSH 与大多数受测静脉注射药物具有物理兼容性，但在模拟 Y-site 条件下与 11 种药物不兼容，因此有必要在临床联合用药前进行严格的兼容性测试。这些发现强调了此类测试对于防止潜在治疗失败和不良反应的重要性。还需要进一步研究探讨在临床环境中的化学稳定性和疗效，以确保在医疗中安全有效地使用 GSH。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.