Effect of Lipid Emulsion on Stability of Ampicillin in Total Parenteral Nutrition

Stawny, Maciej; Gostyńska, Aleksandra; Dettlaff, Katarzyna; Jelińska, Anna; Główka, Eliza; Ogrodowczyk, Magdalena

doi:10.3390/nu11030559

Cited by 17 publications

(19 citation statements)

References 21 publications

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“…The most frequent interactions involved drug or PN admixture ingredient precipitation, the formation of large lipid droplets exceeding the critical acceptance limit for intravenous administration, loss of homogeneity of the oil-in-water system, or color change. Such incompatibilities were reported in previous studies [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ] ( Table 1 ). Interpretation of the results of drug–PN compatibility tests and their adaptation into clinical practice should be based not only on the conclusion whether the drug is or is not compatible with PN admixture, but also involve a detailed analysis of the pharmaceutical preparation of the drug (pH, excipients, solubilizers), the composition of the PN admixture (electrolyte content, type of lipid emulsion), and its physicochemical properties (pH, osmolarity) [ 2 , 16 , 17 , 18 ].…”

Section: Introductionsupporting

confidence: 82%

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

et al. 2021

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Simultaneous administration of parenteral nutrition (PN) admixtures with intravenous antibiotics is a common clinical problem. Coadministration of drugs incompatible with PN admixture may affect its stability, especially in the context of lipid droplet size, which is a crucial parameter for patient safety. In the present study, we investigate the in vitro compatibility of meropenem (Meropenem 1000, MPM) with five commercial PN admixtures used worldwide: Kabiven, Olimel N9E, Nutriflex Lipid Special, Nutriflex Omega Special, and SmofKabiven. The appropriate volumetric ratios, reflecting their clinical practice ratios, were used to prepare the MPM–PN admixture samples. Physicochemical properties of MPM–PN admixtures samples were determined upon preparation and after four hours of storage. The pH changes for all MPM–PN admixtures samples did not exceed the assumed level of acceptability and ranged from 6.41 to 7.42. After four hours of storage, the osmolarity changes were ±3%, except MPM–Olimel N9E samples, for which differences from 7% to 11% were observed. The adopted level of acceptability of changes in zeta potential after four hours of storage (±3 mV) was met for MPM–Kabiven, MPM–Nutriflex Lipid Special, and MPM–Nutriflex Omega Special. The mean droplet diameter for all samples was below 500 nm. However, only in the case of Nutriflex Lipid Special and Nutriflex Omega Special, the addition of MPM did not cause the formation of the second fraction of lipid droplets. The coadministration of MPM via Y-site with Kabiven, Olimel N9E, and Smofkabiven should be avoided due to osmolarity fluctuations (MPM–Olimel), significant differences in zeta potential (MPM–Olimel, MPM–Smofkabiven), and the presence of the second fraction of lipid droplets >1000 nm (MPM–Kabiven, MPM–Olimel, and MPM–Smofkabiven). The assumed acceptance criteria for MPM compatibility of MPM with PN admixtures were met only for Nutriflex Lipid Special and Nutriflex Omega Special in 1:1, 2:1, and 4:1 volume ratios.

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Section: Introductionsupporting

confidence: 82%

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

et al. 2021

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“…The MDD of lipid emulsion and zeta potential (ξ) of PN admixtures were measured at 25 • C, using a Zetasizer Nano ZS (Malvern Instruments, Malvern, UK) by dynamic light scattering (DLS) and laser Doppler velocimetry respectively. The sample preparation, particles size, and zeta potential determination were performed according to the methodology described in our previous work [21]. The results of droplet diameter measurements were presented as follows: MDD (intensity weighted mean droplet diameter).…”

Section: Determination Of Mdd Of Lipid Emulsion and Zeta Potentialmentioning

confidence: 99%

The Interactions between Ciprofloxacin and Parenteral Nutrition Admixtures

et al. 2019

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Background: Co-infusion of parenteral nutrition (PN) and other drugs increases the risk of the interaction between drug and PN admixtures that can cause embolization of small blood vessels, resulting in potentially fatal consequences, including pulmonary embolism, or liver and retina vascular damage. The present study aimed to determine the compatibility between ciprofloxacin (CF) and eighteen compounded PN admixtures in order to assess the possibility of their co-administration via Y-sites. Methods: CF and PN admixtures were mixed at two volume ratios (1:1 and 2:1) and potential interactions were examined using visual inspection, and measurements of pH, osmolality particle size, and zeta potential. The analyses were conducted immediately after sample preparation and after four hours of storage. Results: The compatibility tests showed that the addition of the CF to the PN admixtures did not cause any color change or sign of destabilization in the fat emulsion. However, precipitation was observed in formulations containing higher CF concentrations and, in the case of lower CF concentrations, in formulations containing magnesium and calcium ions at a molar ratio of 2:1. Conclusions: The administration of CF and PN admixtures via the Y-site should be avoided or performed only with PN admixtures for which compatibility has been confirmed and the CF concentration in samples is 1 mg/mL at a molar ratio of magnesium to calcium ions of 1:1.

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“…The developed and described below method allowed us to perform the stability studies of AMP in three different TPN compositions: high energetic (HEN), high electrolytic (HEL), and low electrolytic (LEL). In addition, we used this method for the determination of AMP in two other TPN compositions [12].…”

Section: Introductionmentioning

confidence: 99%

Development, Validation, and Stability Assessment Application of RP-HPLC-DAD Method for Quantification of Ampicillin in Total Parenteral Nutrition Admixtures

et al. 2019

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Background: The administration of total parenteral nutrition (TPN) is a common procedure in intensive care units, where the concomitant use of other intravenous medication is frequently needed. One of the particularly dangerous complications for neurosurgical patients is meningitis, for which high doses of ampicillin (AMP) are used. In such cases, the addition of AMP to TPN admixtures would be a desirable procedure. Thus, the AMP determination method in TPN admixture was developed and validated. Methods: An isocratic HPLC analysis was performed on a LiChrospher C18 end-capped column (250 mm, 4.6 mm, 5 µm) with a C18 pre-column (LiChrospher 100, 4 mm, 5 µm). The flow rate was 1.0 mL min−1 and the detection wavelength was 230 nm. System suitability parameters, such as capacity factor, numbers of the theoretical plate, asymmetry factor, as well as validation parameters, including method precision, accuracy, linearity, selectivity, and robustness, were set up. Results: The method was shown to be linear, precise, accurate, specific, and robust, and it can be used for the quantitative analysis of AMP in TPN admixtures. Conclusions: The degradation of AMP in the TPN admixtures occurred according to first order kinetics. The degradation rate was high and dependent on the composition of the mixture and the storage conditions (t0.5 varied from 142.44 h to 300.45 h).

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Effect of Lipid Emulsion on Stability of Ampicillin in Total Parenteral Nutrition

Cited by 17 publications

References 21 publications

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

The Interactions between Ciprofloxacin and Parenteral Nutrition Admixtures

Development, Validation, and Stability Assessment Application of RP-HPLC-DAD Method for Quantification of Ampicillin in Total Parenteral Nutrition Admixtures

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