Physical Compatibility of Y-site Pediatric Drug Administration : A Call for Question of US Pharmacopeia Standards
Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membershippediatricpharmacy.org 2023..
OBJECTIVE: To evaluate the physical intravenous Y-site compatibility of 29 combinations of medications at commonly used pediatric concentrations using both existing and novel techniques.
METHODS: Medication combinations included were selected by a varied group of pediatric inpatient pharmacists, and then assessed by 3 independent reviewers for existing literature. For each combination, 2 different medications were mixed together in a 1:1 ratio and incubated at room temperature for 4 hours to simulate Y-site administration. Each sample was then analyzed using the US Pharmacopeia (USP) <788> recommended analytical technique of light obscuration (LO) in addition to novel flow imaging (FI) microscopy and backgrounded membrane imaging (BMI). Physical compatibility was determined using USP chapter <788> large volume particle count limits for all techniques.
RESULTS: A total of 29 different medication combinations were studied. Five combinations met criteria for compatibility by all 3 techniques. The remaining 24 combinations reached the threshold to be considered incompatible by at least 1 of the 3 techniques. Light obscuration, BMI, and FI identified 14%, 59%, and 76% of combinations as incompatible, respectively. All samples deemed incompatible by LO were also incompatible by at least 1 of the other 2 techniques. Flow imaging and BMI results agreed in 69% of samples tested.
CONCLUSIONS: Most combinations tested were found to be incompatible by at least 1 of the 3 instruments used. Light obscuration appears to have reduced accuracy for identifying particulate resulting in physical medication incompatibility when compared with the novel techniques of FI and BMI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG - 28(2023), 1 vom: 06., Seite 84-92 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ross, Emma L [VerfasserIn] |
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| Links: |
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| Themen: |
Drug stability |
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| Anmerkungen: |
Date Revised 14.02.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5863/1551-6776-28.1.84 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352873752 |
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| 500 | |a Date Revised 14.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membershippediatricpharmacy.org 2023. | ||
| 520 | |a OBJECTIVE: To evaluate the physical intravenous Y-site compatibility of 29 combinations of medications at commonly used pediatric concentrations using both existing and novel techniques | ||
| 520 | |a METHODS: Medication combinations included were selected by a varied group of pediatric inpatient pharmacists, and then assessed by 3 independent reviewers for existing literature. For each combination, 2 different medications were mixed together in a 1:1 ratio and incubated at room temperature for 4 hours to simulate Y-site administration. Each sample was then analyzed using the US Pharmacopeia (USP) <788> recommended analytical technique of light obscuration (LO) in addition to novel flow imaging (FI) microscopy and backgrounded membrane imaging (BMI). Physical compatibility was determined using USP chapter <788> large volume particle count limits for all techniques | ||
| 520 | |a RESULTS: A total of 29 different medication combinations were studied. Five combinations met criteria for compatibility by all 3 techniques. The remaining 24 combinations reached the threshold to be considered incompatible by at least 1 of the 3 techniques. Light obscuration, BMI, and FI identified 14%, 59%, and 76% of combinations as incompatible, respectively. All samples deemed incompatible by LO were also incompatible by at least 1 of the other 2 techniques. Flow imaging and BMI results agreed in 69% of samples tested | ||
| 520 | |a CONCLUSIONS: Most combinations tested were found to be incompatible by at least 1 of the 3 instruments used. Light obscuration appears to have reduced accuracy for identifying particulate resulting in physical medication incompatibility when compared with the novel techniques of FI and BMI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a drug stability | |
| 650 | 4 | |a intravenous administration | |
| 650 | 4 | |a intravenous infusion | |
| 650 | 4 | |a particulate matter | |
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| 700 | 1 | |a Salinas, Allison |e verfasserin |4 aut | |
| 700 | 1 | |a Bremmer, Jarrett |e verfasserin |4 aut | |
| 700 | 1 | |a Her, Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Carpenter, John F |e verfasserin |4 aut | |
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