Stabilité galénique de mélanges commercialisés de nutrition parentérale en présence de médicaments. (ii) : médicaments perfusés en Y

Husson, Estelle; Crauste–Manciet, Sylvie; Hadj-Salah, Ève; Seguier, J.-C.; Brossard, Denis

doi:10.1016/s0985-0562(03)00026-8

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…Due to the short time of contact of the drug with the PN admixture in the infusion line during simultaneous administration, we did not determinate the content of the drug. This is in accordance with literature as the chemical stability of the drug, during co-administration using Y-site, is considered to be less important [8,20,33]. Thus, it is not necessary to perform chemical stability assessment in compatibility studies using Y-site.…”

Section: Discussionsupporting

confidence: 84%

Safe Practice of Y-Site Drug Administration: The Case of Colistin and Parenteral Nutrition

et al. 2020

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A serious problem in everyday clinical practice is the co-administration of drugs using the same infusion line. Potential complications of co-administration of incompatible drugs include precipitation in the infusion line or central venous catheter leading to its occlusion. Administration of precipitate and large lipid droplets into the venous system may lead to the embolization of capillaries and local or systemic inflammatory reactions, with the consequences of venous thrombosis, chronic venous insufficiency, and even pulmonary embolism. The co-administration of drugs must always be confirmed and clearly defined. The study aimed to determine the interaction between colistin (COL) in the dose used during intermittent hemodialysis and five different ready-to-use PN admixtures (PN) (Kabiven, Smofkabiven, Olimel N9E, Nutriflex Lipid Special, and Nutriflex Omega Special). COL-PN compatibilities were tested by comparing physicochemical properties (pH, zeta potential, lipid emulsion particle size) of COL and PN at three time points: immediately after sample preparation, after ten minutes, and after four hours. No changes in the visual inspection were observed. Both PN without COL and COL-PN samples remained white, homogeneous oil-in-water emulsions with no signs of phase separation, precipitation, or color change. There were no significant changes in pH, and the mean droplet diameter remained below the acceptance limit of 500 nm. The zeta potential and osmolality of COL-PN samples ranged from −21.4 to −7.22 mV and from 567 to 1304 mOsm/kg, respectively. The COL does not influence the physical stability of studied PN admixtures. The co-infusion of COL with Kabiven, Nutriflex Lipid Special, Olimel N9E, Nutriflex Omega Special, and Smofkabiven is possible in the dose used during intermittent hemodialysis.

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Section: Discussionsupporting

confidence: 84%

Safe Practice of Y-Site Drug Administration: The Case of Colistin and Parenteral Nutrition

et al. 2020

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“…The movement causes a shift in the frequency of scattered light (“Doppler shift”), which is used to determine the velocity of the movement of the droplets, the electrophoretic mobility and the zeta potential [ 49 ]. The samples were diluted 1:1000 (sample:water) in distilled water [ 25 ]. The calibration of the instrument was checked with a zeta potential transfer standard (−68 mV ± 6.8 mV) (Malvern Instruments, Worcestershire, UK).…”

Section: Methodsmentioning

confidence: 99%

“…Different studies apply different methods and the results are interpreted relatively to their test set. Some studies are based on only visual observations [ 12 , 24 ], others include a few instrumental methods in addition [ 25 – 27 ], whereas some use more extensive set-ups with a combination of several methods [ 13 , 28 ]. Assessment of possible precipitates are typically performed by one or more of the following approaches: visual examination with Tyndall light [ 11 , 12 , 24 , 29 ] or other visual examination methods [ 13 , 27 , 30 , 31 ], turbidimetric measurements [ 26 , 29 ], colorimetric measurement [ 13 ], light obscuration (LO) [ 13 , 31 ], dynamic light scattering (DLS) [ 27 ], microscopy [ 32 ] and pH-measurements [ 30 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

“…Assessment of possible precipitates are typically performed by one or more of the following approaches: visual examination with Tyndall light [ 11 , 12 , 24 , 29 ] or other visual examination methods [ 13 , 27 , 30 , 31 ], turbidimetric measurements [ 26 , 29 ], colorimetric measurement [ 13 ], light obscuration (LO) [ 13 , 31 ], dynamic light scattering (DLS) [ 27 ], microscopy [ 32 ] and pH-measurements [ 30 – 32 ]. Various methods have also been used to investigate parenteral emulsion stability: visual observation with [ 12 ] or without a centrifugation step [ 13 , 25 , 28 , 32 – 35 ], determination of zeta potential [ 25 , 28 , 34 , 36 – 38 ], measurement of dynamic surface tension [ 37 ], measurement of peroxide levels [ 28 ], pH-measurements [ 13 , 25 , 28 , 33 – 35 ] and different droplet size measurement techniques. The latter techniques are e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The latter techniques are e.g. microscopy [ 13 , 28 , 36 , 37 ], DLS [ 13 , 28 , 33 , 35 – 38 ], laser diffraction (LD) [ 25 , 35 , 36 ], flow cytometry [ 32 ], coulter counter [ 34 , 36 ] and LO [ 13 , 28 , 33 ]. The list is not complete, but illustrates the diversity in methodology.…”

Section: Introductionmentioning

confidence: 99%

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Development and evaluation of a test program for Y-site compatibility testing of total parenteral nutrition and intravenous drugs

Staven

Wang

Grønlie

et al. 2015

Nutr J

112

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BackgroundThere is no standardized procedure or consensus to which tests should be performed to judge compatibility/incompatibility of intravenous drugs. The purpose of this study was to establish and evaluate a test program of methods suitable for detection of physical incompatibility in Y-site administration of total parenteral nutrition (TPN) and drugs.MethodsEight frequently used methods (dynamic light scattering, laser diffraction, light obscuration, turbidimetry, zeta potential, light microscopy, pH-measurements and visual examination using Tyndall beams), were scrutinized to elucidate strengths and weaknesses for compatibility testing. The responses of the methods were tested with samples containing precipitation of calcium phosphate and with heat destabilized TPN emulsions. A selection of drugs (acyclovir, ampicillin, ondansetron and paracetamol) was mixed with 3-in-1 TPN admixtures (Olimel® N5E, Kabiven® and SmofKabiven®) to assess compatibility (i.e. potential precipitates and emulsion stability). The obtained compatibility data was interpreted according to theory and compared to existing compatibility literature to further check the validity of the methods.ResultsLight obscuration together with turbidimetry, visual inspection and pH-measurements were able to capture signs of precipitations. For the analysis of emulsion stability, light obscuration and estimation of percent droplets above 5 μm (PFAT5) seemed to be the most sensitive method; however laser diffraction and monitoring changes in pH might be a useful support. Samples should always be compared to unmixed controls to reveal changes induced by the mixing. General acceptance criteria are difficult to define, although some limits are suggested based on current experience. The experimental compatibility data was supported by scattered reports in literature, further confirming the suitability of the test program. However, conflicting data are common, which complicates the comparison to existing literature.ConclusionsTesting of these complex blends should be based on a combination of several methods and accompanied by theoretical considerations.

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Nutrition parentérale: Produits

Corriol¹

Traité De Nutrition Artificielle De L’adulte

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Stabilité galénique de mélanges commercialisés de nutrition parentérale en présence de médicaments. (ii) : médicaments perfusés en Y

Cited by 11 publications

References 9 publications

Safe Practice of Y-Site Drug Administration: The Case of Colistin and Parenteral Nutrition

Safe Practice of Y-Site Drug Administration: The Case of Colistin and Parenteral Nutrition

Development and evaluation of a test program for Y-site compatibility testing of total parenteral nutrition and intravenous drugs

Nutrition parentérale: Produits

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