Investigation into the sorption of nitroglycerin and diazepam into PVC tubes and alternative tube materials during application

Treleano, Anna; Wolz, Gerd; Brandsch, Rainer; Welle, Frank

doi:10.1016/j.ijpharm.2008.10.024

Cited by 50 publications

(39 citation statements)

References 18 publications

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“…In conclusion, the GTN lock composition reported here merits further in vivo and clinical study to establish its utility in preventing catheter infection or in salvaging infected catheters, based on its reduced ethanol levels, absence of antibiotics, and safe citrate and GTN concentrations. Since some plastics are known to partially absorb GTN (33), the effect of contact with catheters on the potency of the lock needs further study. Also, the GTN lock composition studied here requires additional testing for its effect on catheter mechanical properties.…”

Section: Discussionmentioning

confidence: 99%

Glyceryl Trinitrate Complements Citrate and Ethanol in a Novel Antimicrobial Catheter Lock Solution To Eradicate Biofilm Organisms

Rosenblatt

Reitzel

Dvorak

et al. 2013

Antimicrob Agents Chemother

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Antimicrobial catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous catheters. Citrate has been used clinically as an anticoagulant in heparin-free catheter locks. Ethanol has also been widely studied as an antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected. Central line-associated bloodstream infections (CLABSIs) have declined over the past decade but remain a significant medical problem, with a substantial cost burden to the health care system. There are an estimated 250,000 CLABSIs in the United States (1), with an estimated treatment cost of $45,000 or more per infection (2). Significant portions of CLABSIs annually are associated with hemodialysis treatment (3) and treatment of critically ill patients. CLABSIs that present after the first week of catheterization tend to be associated with colonization of the catheter lumenal surfaces (4, 5) and biofilm formation on those surfaces. Colonizing organisms organize within hours into biofilm structures which can serve as a source of CLABSI and can be highly resistant to eradication by antibiotic treatments. Approaches to reducing lumenal colonization include rigorous provider hygiene and use of antimicrobial swabs when connectors are manipulated. Even with these precautions, much of the lumenal surfaces remain vulnerable to colonization. Another approach to combatting lumenal infections has been the use of antimicrobial lock therapy (ALT). Catheter lumens are hydraulically locked when not in use. Typically, lock solutions include anticoagulants to inhibit the formation of blood clots, which can occlude flow through catheters. Heparin has traditionally been used as an anticoagulant; however, there have been concerns about its purity (6), as well as its potential to promote bacterial biofilm colonization (7). Antimicrobial locks have generally fallen into the categories of antibiotic locks and nonantibiotic, antiseptic locks. Antibiotic locks have been pursued both for catheter salvage and for infection prevention. Antibiotic catheter locks have recently been reviewed (8). Significant issues limiting the use of antibiotic locks for prevention are their higher costs and potential to promote the development of antibiotic resistance. We report here on the utility of glycery...

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Section: Discussionmentioning

confidence: 99%

Glyceryl Trinitrate Complements Citrate and Ethanol in a Novel Antimicrobial Catheter Lock Solution To Eradicate Biofilm Organisms

Rosenblatt

Reitzel

Dvorak

et al. 2013

Antimicrob Agents Chemother

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“…Plasticised PVC is potentially highly interactive with drugs, whereas PE or PP materials are subject to less interaction [6][7][8].…”

Section: Methodsmentioning

confidence: 99%

“…Numerous studies have investigated drug sorption in infusion containers (IV tubing, catheters, bags, bottles) manufactured with different materials like glass, polyvinyl chloride (PVC), polyurethane (PUR) or polyethylene (PE) [7,46]. Loss of drug by sorption to IV delivery systems is potentially significant, especially after lengthy drug therapy infusion [47,48].…”

Section: Container-content Interactionmentioning

confidence: 99%

Criteria for choosing an intravenous infusion line intended for multidrug infusion in anaesthesia and intensive care units

Maiguy-Foinard

Genay²,

Lannoy

et al. 2017

Anaesthesia Critical Care & Pain Medicine

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“…Leached DEHP affects human metabolism [3,4] and can decrease the medicinal efficacy owing to drug adsorption on the inner surface of the PVC infusion tube [5]. In addition to the drug adsorption effect due to DEHP release, surfactants(such as polysorbate 80 [Tween®80] and polyethoxylated castor oil [Cremophor®EL]) which are meant enhance anticancer drug solubility in the solvent, can interact with leached DEHP from the infusion tube [6].…”

Section: Introductionmentioning

confidence: 99%

Stability study of docetaxel solution (0.9%, saline) using Non-PVC and PVC tubes for intravenous administration

Park

Chung

2015

Biomater Res

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BackgroundDi-2-ethylhexyl phthalate (DEHP) are added to poly(vinyl chloride)(PVC) infusion tubes as a plasticizer to ensure tube flexibility. In addition to previously reported disadvantages of DEHP, released DEHP molecules from PVC tubes can easily interact with surfactants in anticancer drug solutions (i.e., polysorbate 80 for Taxotere®-Inj) and reduce the solubility of docetaxel in aqueous solution during anticancer drug administration.ResultsIn this study, we investigated the in vitro stability of docetaxel in a 0.9% saline solution under an intravenous administration condition using a PVC tube (high DEHP content) and non-PVC infused tube.ConclusionThe docetaxel solution circulating through the non-PVC tube had better solution stability than through the PVC tube(high DEHP content).

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Investigation into the sorption of nitroglycerin and diazepam into PVC tubes and alternative tube materials during application

Cited by 50 publications

References 18 publications

Glyceryl Trinitrate Complements Citrate and Ethanol in a Novel Antimicrobial Catheter Lock Solution To Eradicate Biofilm Organisms

Glyceryl Trinitrate Complements Citrate and Ethanol in a Novel Antimicrobial Catheter Lock Solution To Eradicate Biofilm Organisms

Criteria for choosing an intravenous infusion line intended for multidrug infusion in anaesthesia and intensive care units

Stability study of docetaxel solution (0.9%, saline) using Non-PVC and PVC tubes for intravenous administration

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