Stability and compatibility of histamine H2-receptor antagonists in parenteral nutrition mixtures

Puzovic, Marko; Hardy, Gil

doi:10.1097/mco.0b013e3280ebb427

Cited by 4 publications

(2 citation statements)

References 42 publications

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“…Some medications (heparin, insulin, H‐2 receptor antagonists), specific amino acids and (glutamine), or ω‐3 PUFAs, may also be added directly to the AIO admixture to make the PN regimen more efficacious. The stability of H‐2 receptor antagonists has been previously reviewed 36 but a comprehensive assessment of these or other drug stabilities is outside the remit of this review. The order in which additives are made and the mode of delivery can both influence the overall admixture stability and quality.…”

Section: Oil Content (%) In Commercially Manufactured Intravenous Lipmentioning

confidence: 99%

Formulation, Stability, and Administration of Parenteral Nutrition With New Lipid Emulsions

Hardy

Puzovic

2009

Nut in Clin Prac

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Intravenous lipid emulsions (IVLE) are an important source of energy and essential fatty acids and their incorporation into pediatric and adult parenteral nutrition (PN) regimens has revolutionized nutrition therapy. However, their clinical use has not been without risk, and will continue to remain so because of the intravenous route of administration. Pharmaceutical and microbiological concerns are centered around the methods of compounding all-in-one (AIO) admixtures, but these can be largely minimized with today's technologies and advanced understanding of aseptic principles. Modern lipid products, based on olive, coconut, and/or fish oils, have demonstrable formulation and clinical benefits over traditional soybean and safflower IVLE and, when combined in the new multi-chamber bags, can also offer improvements in stability and safety. This review outlines the rationale for different lipid formulations in PN admixtures, reviews the factors influencing stability and efficacy of lipid-based AIO regimens and evaluates some technologies for minimizing peroxidation and maximizing stability of AIO admixtures.

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Section: Oil Content (%) In Commercially Manufactured Intravenous Lipmentioning

confidence: 99%

Formulation, Stability, and Administration of Parenteral Nutrition With New Lipid Emulsions

Hardy

Puzovic

2009

Nut in Clin Prac

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“…In general, if H2 antagonist drugs are added to parenteral nutrition admixtures, the nutrition solution should be stored no longer than 24 hours in the refrigerator before administration (10). Nevertheless, failure to implement the optimal H2 antagonist therapy may occur due to temporary interruption of parenteral nutrition, and unavailability of intravenous access.…”

Section: Addition Of a Drug To The Parenteral Nutrition Solutionsmentioning

confidence: 99%

Clinical nutrition and drug interactions

Bayraktar-Ekincioglu

Demirkan

2014

UCD

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A drug's plasma level, pharmacological effects or side effects, elimination, physicochemical properties or stability could be changed by interactions of drug-drug or drug-nutrition products in patients who receive enteral or parenteral nutritional support. As a result, patients might experience ineffective outcomes or unexpected effects of therapy (such as drug toxicity, embolism). Stability or incompatibility problems between parenteral nutrition admixtures and drugs might lead to alterations in expected therapeutic responses from drug and/or parenteral nutrition, occlusion in venous catheter or symptoms or mortality due to infusion of composed particles. Compatibilities between parenteral nutrition and drugs are not always guaranteed in clinical practice. Although the list of compatibility or incompatibilities of drugs are published for the use of clinicians in their practices, factors such as composition of parenteral nutrition admixture, drug concentration, contact time in catheter, temperature of the environment and exposure to light could change the status of compatibilities between drugs and nutrition admixtures. There could be substantial clinical changes occurring in the patient's nutritional status and pharmacological effects of drugs due to interactions between enteral nutrition and drugs. Drug toxicity and ineffective nutritional support might occur as a result of those predictable interactions. Although administration of drugs via feeding tube is a complex and problematic route for drug usage, it is possible to minimise the risk of tube occlusion, decreased effects of drug and drug toxicity by using an appropriate technique. Therefore, it is important to consider pharmacological dosage forms of drugs while administering drugs via a feeding tube. In conclusion, since the pharmacists are well-experienced and more knowledgeable professionals in drugs and drug usage compared to other healthcare providers, it is suggested that provision of information and drug counselling by pharmacists in terms of detection and prevention of problems (such as interactions, stability, incompatibility) related with enteral/parenteral nutrition and drugs are invaluable in clinical practice.

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