Intermittently Delivered IV Medication and pH

Gorski, Lisa; Hagle, Mary; Bierman, Steve

doi:10.1097/nan.0000000000000081

Cited by 41 publications

(32 citation statements)

References 33 publications

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“…Guidelines for administration of intravenous medication (RCN, 2016) recommend that CVC should be considered for the administration of drugs such as epirubicin with a low pH (<5) which are thought to have an increased potential for causing chemical phlebitis. However, the evidence base for this guidance has been questioned by Gorski, Hagle, and Bierman (2015) who concluded that the pH of the drug cannot be used in isolation as basis for using a CVC. Yamada et al (2012) in their study of epirubicin-induced vascular injury also state that the mechanism of epirubicin-in- *p = <0.05 chi-square test: Group 2 compared with Groups 1 and 3, otherwise no significant differences were observed between groups.…”

Section: Discussionmentioning

confidence: 99%

“…However, the evidence base for this guidance has been questioned by Gorski, Hagle, and Bierman (2015) who concluded that the pH of the drug cannot be used in isolation as basis for using a CVC. However, the evidence base for this guidance has been questioned by Gorski, Hagle, and Bierman (2015) who concluded that the pH of the drug cannot be used in isolation as basis for using a CVC.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Epirubicin chemotherapy in women with breast cancer: Alternating arms for intravenous administration to reduce chemical phlebitis

et al. 2019

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Objective: To establish whether using alternating arms for peripheral intravenous epirubicin administration affects the severity or duration of epirubicin-induced phlebitis.Methods: An observational study of women with breast cancer (n = 237) in a UK Cancer Centre. Data were analysed after receiving three treatment cycles according to the arm used for epirubicin administration: same, alternating or mixed arm (two consecutive cycles in one arm and one in the alternate arm). Phlebitis severity was graded by clinical staff after each treatment; participants also self-reported symptoms during treatment and for up to 6 months after. Results:The alternating arm group experienced significantly less severe symptoms than the other arm use groups, 6% (4 of 64) compared with 34% (p < 0.001, odds ratio: 0.13 (95% CI: 0.043-0.38) alternating arm compared with same arm group). The alternating arm group reported less pain (p = 0.013), lower overall impact (p = 0.009), lower effect on function (p = 0.032) and shorter duration of symptoms (p = 0.001) than the other arm use groups.Conclusion: Using alternating arms for peripheral administration of epirubicin significantly reduces the severity and duration of chemical phlebitis and is recommended to improve patient experience and reduce the need for central venous access devices. K E Y W O R D Sbreast cancer, chemical phlebitis, chemotherapy, epirubicin, peripheral venous cannulation, phlebitis severity

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epirubicin chemotherapy in women with breast cancer: Alternating arms for intravenous administration to reduce chemical phlebitis

et al. 2019

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“…Values of pH lower than 5.5 and higher than 8.0 represent risks of complications during intravenous therapy. (17) Amiodarone has pH between 3.8 and 4.0, so it is a drug with potential risk to the impairment of the vessel. Forms of amiodarone administration, which relate to the respective variations in the vein exposure time, should be taken into consideration and may justify the non-occurrence of phlebitis in puncture groups that received exclusive bolus infusion and the occurrence of the event in the other groups analyzed.…”

Section: Discussionmentioning

confidence: 99%

Fatores relacionados à flebite em idosos com infusão intravenosa de amiodarona

et al. 2016

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Objective: To verify the incidence of phlebitis and identify factors associated with the development of phlebitis due to peripheral intravenous infusion of amiodarone in elderly patients. Methods: Prospective and observational cohort study on risk factors for the development of phlebitis in patients aged over 60 years, who received peripheral intravenous infusion of amiodarone, hospitalized in 2012 in the coronary care (22 beds) and general semi-intensive units (43 beds) of a large private hospital in São Paulo, Brazil. Results: Of the total 102 elderly people, 34 (33.3%) had phlebitis. It was more frequent in women (43.6%), in the dominant punctured member (36.2%), in the forearm basilica or cephalic veins (41.2%), in caliber 20G devices (40.0%), in IV Fix® sterile dressings (39.3%), in Intima® catheters (34.3%) and when there was device repositioning (33.3%). However, these variables were not statistically associated with phlebitis. Phlebitis absence in the exclusive bolus infusion was marginally significant (p = 0.051) compared to different types of infusion. Conclusion: One-third of the studied elderly patients presented phlebitis. There was absence of phlebitis only in exclusive bolus infusions. ResumoObjetivo: Identificar fatores associados à ocorrência de flebite decorrente da infusão intravenosa periférica de amiodarona em idosos. Métodos: Coorte prospectiva, observacional sobre fatores de risco para ocorrência de flebite em pacientes com idade acima de 60 anos que receberam infusão intravenosa periférica de amiodarona, internados, no ano de 2012, nas unidades Coronarianas (22 leitos) e Semi Intensivas Gerais (43 leitos) de um hospital privado de grande porte, localizado na cidade de São Paulo, Brasil. Resultados: Do total de 102 idosos, 34 (33,3%) apresentaram flebite. A flebite foi mais frequente em mulheres (43,6%), em membro dominante puncionado (36,2%), em veias basílica ou cefálica do antebraço (41,2%), nos dispositivos de calibre 20G (40,0%), em curativo estéril IV Fix® (39,3%), em cateter Intima® (34,3%) e quando houve reposicionamento do dispositivo (33,3%); mas essas variáveis não se associaram estatisticamente à flebite. Ausência de flebite na infusão rápida exclusiva foi marginalmente significante (p= 0,051) comparada aos diferentes tipos de infusão. Conclusão: Um terço dos idosos estudados apresentou flebite, verificou-se ausência de flebite somente nas infusões rápidas exclusivas.

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“…Pengujian pH pada sediaan perlu dilakukan karena dapat memengaruhi kelarutan dan stabilitas obat. 40 Kualitas sediaan racikan injeksi seftriakson hasil racikan RS "X" memiliki kualitas yang sama dengan yang terdapat dari literatur baik dari segi warna, pH, dan kejernihan. Sediaan parenteral harus bebas dari mikroorganime.…”

Section: Observasiunclassified

Evaluasi Peracikan Injeksi Seftriakson di Salah Satu Rumah Sakit Swasta di Semarang

Putri

Yuliani

2018

ijcp

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AbstrakInjeksi seftriakson merupakan antibiotik spektrum luas golongan sefalosporin generasi ketiga, yang dalam penggunaannya di rumah sakit memerlukan proses peracikan, yaitu rekonstitusi dan pengenceran. Sesuai dengan peraturan dan pedoman yang berlaku, peracikan sediaan steril harus dilakukan dengan fasilitas yang sesuai, proses peracikan yang aseptis, dan dilakukan oleh tenaga kefarmasian, sehingga diperoleh sediaan dengan kualitas dan stabilitas yang baik. Penelitian ini bertujuan mengamati proses peracikan dan sifat fisik hasil peracikan sediaan injeksi seftriakson yang dilakukan di salah satu rumah sakit swasta di Semarang dalam periode April-Mei 2017. Penelitian dilakukan secara observasional terhadap personel peracik, fasilitas dan proses peracikan sediaan injeksi seftriakson. Observasi dilakukan dengan bantuan check list yang disesuaikan dengan pedoman pencampuran obat suntik dan penanganan sitostatika. Sebanyak 60 proses peracikan injeksi seftriakson digunakan sebagai sampel. Hasil peracikan dengan kondisi proses paling tidak sesuai dengan pedoman diuji kualitas fisiknya meliputi pH, kejernihan dan sterilitas. Hasil penelitian menunjukkan bahwa peracikan sediaan injeksi seftriakson di rumah sakit tersebut belum memenuhi kriteria sesuai pedoman pencampuran obat suntik, terutama dari segi fasilitas dan personel peracik. Meskipun demikian, hasil uji kualitas yang dilakukan terhadap sediaan tersebut masih memenuhi kriteria bebas kuman, isohidris, dan jernih. AbstractCeftriaxone injection is a broad-spectrum antibiotic of third-generation cephalosporin. Its use in hospitals requires reconstitution and dilution to obtain the desired dose. Compounding of sterile preparations is supposed to be carried out with appropriate facilities, aseptic compounding process, and performed by a pharmacist, in accordance with regulations and guidelines, to obtain a good quality and stability of ceftriaxone injection. The aim of this study was to evaluate the compounding process of ceftriaxone injection preparation in one of a private hospital in Semarang at April-May 2017.The study was done by observing the compounding of ceftriaxone injection preparations involving the facility, process, and personnel. Observations were conducted using the checklist from Sterile Dispensing Guidelines. Sixty compounding of ceftriaxone injection were used as samples. Observation results were used to determine the process of compounding with the worst possible condition, and then pH, clarity, and sterility were tested to evaluate its physical quality. The results showed that compounding of ceftriaxone injection in the hospital do not conform the criteria according to the preparation of injectable guidelines, especially in terms of facilities and personnel. However, the results of quality tests performed still accord the criteria, i.e, free from microbe, isohydris and clear. dari segi warna, pH, kejernihan, dan bebas kuman. Perbaikan dan peningkatan saranaprasarana dan validasi proses peracikan perlu dilakukan untuk menjamin setiap sediaan inje...

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Intermittently Delivered IV Medication and pH

Cited by 41 publications

References 33 publications

Epirubicin chemotherapy in women with breast cancer: Alternating arms for intravenous administration to reduce chemical phlebitis

Epirubicin chemotherapy in women with breast cancer: Alternating arms for intravenous administration to reduce chemical phlebitis

Fatores relacionados à flebite em idosos com infusão intravenosa de amiodarona

Evaluasi Peracikan Injeksi Seftriakson di Salah Satu Rumah Sakit Swasta di Semarang

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