Physical stability of highly concentrated injectable drugs solutions used in intensive care units

Closset, Mélanie; Hecq, Jean-Daniel; Soumoy, Laura; Simar, J; González, Elena Álvarez; Charlet, Laurent; Declave, C; Gillet, Patricia; Galanti, Laurence

doi:10.1016/j.pharma.2016.12.004

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…The high prevalence in prescribing drugs for cardiac therapy was attributed to norepinephrine, specifically due to the type and volume of the diluents used when administering the drug. The stability of concentrated norepinephrine preparations in saline and glucose solutions is well documented in literature, as there is a great interest in developing strategies to reduce excess fluid infusion in critically ill patients (Closset et al, 2017;Walker et al, 2010). Fluid overload is associated with increased morbidity and mortality, and a possible way to prevent this is to use more concentrated solutions, which are considered off-label (Ogbu et al, 2015;Besen et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Off-label drug use in an adult intensive care unit of a Brazilian hospital

Chaves

Neto

Moreira

et al. 2022

Braz. J. Pharm. Sci.

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The objective of this study was to determine the prevalence and describe the factors associated with off-label drug use in an adult intensive care unit (ICU) of a Brazilian hospital. An analytical, crosssectional, prospective study was conducted in the adult ICU population from March 2018 to May 2018. Off-label use of medication was classified by indication, dosage, route of administration, type and volume of diluent, and duration of administration. Most patients were female (57.89%), nonelderly (56.14%), and had a mean age of 54.44 ± 17.15 years. The prevalence of off-label drug use was 70.31%, but was not associated with the clinical severity of the patients. A statistically significant association was observed between label use of drugs and prescribing potentially inappropriate medicines (PIM). The most common reasons for off-label drug use were therapeutic indication (19.58%) and volume of diluent (23.30%). Drug administration by enteral tubes accounted for the largest number of off-label uses due to route of administration (90.85%). There was a higher prevalence of off-label use of systemic antimicrobials (14.44%) and norepinephrine (9.28%). Our study provided a broad characterization of off-label drug use in an adult ICU and showed why it is important for health professionals to evaluate the specific risks and benefits of this practice.

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