Compatibility of medications during multi-infusion therapy: A controlled in vitro study on a multilumen infusion device

Perez, M.; Décaudin, Bertrand; Foinard, Aurélie; Barthélémy, Christine; Debaene, B.; Lebuffe, Gilles; Odou, Pascal

doi:10.1016/j.accpm.2014.06.003

Cited by 26 publications

(11 citation statements)

References 26 publications

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“…( 4 ) The following preventive measures are recommended: nursing team guidance and training in drug preparation, administration and potential incompatibilities; implementation of standard operating procedures and distribution of flyers containing data on the most commonly used drugs in clinical practice and instructions for multi-lumen catheter manipulation. ( 1 , 13 , 16 , 17 ) Pharmacists are qualified to instruct multidisciplinary teams in drug related problem-solving scenarios; therefore, the involvement of these professionals in drug therapy decisions translates into significant benefits to healthcare services. ( 2 )…”

Section: Discussionmentioning

confidence: 99%

Potential intravenous drug incompatibilities in a pediatric unit

Leal

Leopoldino

Martins

et al. 2016

Einstein (São Paulo)

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Objective To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit.Methods A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student’s t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval.Results A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility.Conclusion Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities.

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Section: Discussionmentioning

confidence: 99%

Potential intravenous drug incompatibilities in a pediatric unit

Leal

Leopoldino

Martins

et al. 2016

Einstein (São Paulo)

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“…To enable simultaneous administration, the drugs should be physically compatible because chemical reactions require longer contact time for significant decreases in the drug concentrations to occur. ( 9 )…”

Section: Introductionmentioning

confidence: 99%

Drug incompatibilities in the adult intensive care unit of a university hospital

Marsilio¹,

Silva²,

Bueno³

2016

Revista Brasileira De Terapia Intensiva

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ObjectivesThis study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs.MethodsThis cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system. A pharmaceutical intervention was performed using the guidelines on the preparation and administration of incompatible drugs. Adherence to those guidelines was subsequently assessed among the nursing staff.ResultsA total of 100 prescriptions were analyzed; 68 were incompatible with the intravenous drugs prescribed. A total of 271 drug incompatibilities were found, averaging 4.0 ± 3.3 incompatibilities per prescription. The most commonly found drug incompatibilities were between midazolam and hydrocortisone (8.9%), between cefepime and midazolam (5.2%), and between hydrocortisone and vancomycin (5.2%). The drugs most commonly involved in incompatibilities were midazolam, hydrocortisone, and vancomycin. The most common incompatibilities occurred when a drug was administered via continuous infusion and another was administered intermittently (50%). Of the 68 prescriptions that led to pharmaceutical guidelines, 45 (66.2%) were fully adhered to by the nursing staff.ConclusionPatients under intensive care were subjected to a high rate of incompatibilities. Drug incompatibilities can be identified and eliminated by the pharmacist on the multidisciplinary team, thereby reducing undesirable effects among patients.

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“…The Edelvaiss Multilumen-8 was able to prevent the occurrence of drug incompatibilities in 49% of the tested drug combinations. [57] Nevertheless, testing different flow rates and drug combinations is still required to ensure the ability of the device to prevent various types of drug incompatibilities. [51,57] Nanocarriers as a new paradigm to overcome drug incompatibilities Nanomedicine is a rapidly evolving field that includes the applications of nanotechnology-based approaches together with the most recent advances in biomedical and pharmaceutical sciences.…”

Section: Complications Of Drug Incompatibilitiesmentioning

confidence: 99%

Nanomedicine: a new paradigm to overcome drug incompatibilities

Abdelkader

Fathi

Hamad

et al. 2020

Journal of Pharmacy and Pharmacology

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Objectives Drug incompatibilities may compromise the safety and effectiveness of combined drugs and result in mild‐to‐serious clinical complications, such as catheter obstruction, loss of drug efficacy, formation of toxic derivatives and embolism. Various preventive strategies have been implemented to overcome drug incompatibilities with limited success. This review presents an innovative approach to prevent drug incompatibilities via isolating the incompatible drugs into nanostructures. Key findings Several examples of incompatible drugs may be loaded separately into nanostructures of various types. Physicochemical characteristics and biocompatibility of the nanomaterials that are being utilized to prevent physicochemical incompatibilities should be carefully considered. Conclusions There is a new era of exploiting nanomaterials in overcoming various types of physicochemical incompatibilities, with additional benefits of further improvements in pharmacokinetic profiles and pharmacological actions of the administered drugs.

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Compatibility of medications during multi-infusion therapy: A controlled in vitro study on a multilumen infusion device

Cited by 26 publications

References 26 publications

Potential intravenous drug incompatibilities in a pediatric unit

Potential intravenous drug incompatibilities in a pediatric unit

Drug incompatibilities in the adult intensive care unit of a university hospital

Nanomedicine: a new paradigm to overcome drug incompatibilities

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