Potency and stability of extemporaneous nitroglycerin infusions

McNiff, Barbara Lenard; McNiff, Edward F.; Fung, Ho‐Leung

doi:10.1093/ajhp/36.2.173

Cited by 16 publications

(6 citation statements)

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“…Blood Samples-Disposable plastic syringes, previously determined not to cause drug loss (5), were used to draw blood samples through a peripheral vein cannula5 in the arm not used for infusion. Following blood withdrawal, the cannula was flushed with heparin (100 U/ml) in 0.9% sodium chloride.…”

Section: Methodsmentioning

confidence: 99%

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Nitroglycerin Pharmacokinetics After Intravenous Infusion in Normal Subjects

McNiff¹,

Yacobi²,

Young-Chang³

et al. 1981

Journal of Pharmaceutical Sciences

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107

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Section: Methodsmentioning

confidence: 99%

“…Nitroglycerin is known to have a high affinity for plastic materials used in intravenous infusion bags and administration sets (3)(4)(5). A significant fraction of the dose can be lost to the delivery system during intravenous nitroglycerin infusion, thus leading to significant errors in the estimation of pharmacokinetic parameters.…”

mentioning

confidence: 99%

Nitroglycerin Pharmacokinetics After Intravenous Infusion in Normal Subjects

McNiff¹,

Yacobi²,

Young-Chang³

et al. 1981

Journal of Pharmaceutical Sciences

Self Cite

107

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“…(8) formulates recommendations regarding the extemporaneous preparation of intravenous nitroglycerin solutions. The reader may be interested in knowing that the paper by McNiff el al.…”

Section: Or 25°c)mentioning

confidence: 99%

“…The reader may be interested in knowing that the paper by McNiff el al. (8) formulates recommendations regarding the extemporaneous preparation of intravenous nitroglycerin solutions. When hydrolysis of nitroglycerin occurs, it proceeds through a sequential loss of nitroxyl groups.…”

Section: Solution Stabilitymentioning

confidence: 99%

Nitroglycerin Stability: Effects on Bioavailability, Assay and Biological Distribution

Sokoloski

1981

J Clin Pharm Ther

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SUMMARY The solution, absorptive, and adsorptive properties of nitroglycerin are related to problems encountered in the intravenous use of solutions of the drug and in its assay in biological tissues. Solutions of the drug in usual intravenous fluids are quite stable to hydrolysis under neutral conditions. Loss to plastic intravenous delivery set components by rapid adsorption and slower absorption processes present a significant clinical problem. Assay of the drug and its major metabolites is complicated by problems of extraction related to the solubility of nitroglycerin, its metabolites and substances in the plasma. Loss of nitroglycerin incubated with red blood cells is a very rapid process (half‐life 4·0 min. at 10 ng/ml). The mechanism appears to be a physical process rather than an enzymatic one. The loss to blood cells and perhaps other biological materials should be considered in an analysis of the distribution of the drug.

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“…Nitroglycerin. Nitroglycerin diluted with 5% dextrose in water or normal saline was stable for at least 70 days when stored in glass containers (88). Stored in plastic bags for 24 h at room temperature, solutions of nitroglycerin in 5% dextrose were found to lose more than 50% of their potency (87).…”

Section: P G Lirndgren and L Landersjomentioning

confidence: 99%

Incompatibility and Stability Problems Associated With Intravenous Admixtures: A Survey

Lundgren

Landersjö²

1980

J Clin Pharm Ther

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In intravenous therapy the use of infusion fluids as vehicles or carriers for other parenteral drugs is now common. The extent of use of this drug administration method has been illustrated in many papers (1-8). A report from the early sixties shows that one or more drugs were added to about 10% of the infusion fluids administered (9). In the late sixties, however, the frequency of intravenous prescriptions containing additives had increased and figures of between 50 and 907; have been reported in several papers (2, 4, 5, 8). Reports over the last 5 years indicate that drugs are now less frequently administered as additives.The drugs added to infusion fluids are mainly antibiotics, electrolytes, heparin, vitamins and, to a lesser extent, several other drugs such as aminophylline and corticosteroids. Some of these drugs, for example, electrolytes, are available as sterile stock solutions designed for use as additives in infusion fluids. Usually, however, neither infusion fluids nor injections are formulated to be diluted or mixed with further drugs. The practice of adding drugs to large volume parenteral solutions may therefore result in incompatibility or stability problems.Several authors have reviewed the literature concerning addition of drugs to large volume solutions and provided references, tables and recommendations to reduce the occurrence of problems (10-16). There have been many studies on such incompatibilities; however, the literature in this area is often inconsistent and does not reflect clinically applicable situations. Several stated incompatibilities, reported in compatibility charts, are based on single observations. The influence of pH, the concentration of the drug and other factors have not been evaluated. Some are based only on the observation that no visible change has taken place in the admixture within a stated time.In some papers (6,17-27) the prediction ofcompatibility and stability ofdrugs added to infusion fluids was based on relevant physico-chemical principles. This more theoretical approach has allowed quantitative approximations to be made from kinetic data. Such a technique may be the best way to attack incompatibility problems. The success of this approach, however, depends on the available physicochemical information on the drug *Apoteksbolaget AB, (National Corporation of Swedish Pharmacies,) 105 14 Stockholm, Sweden. 29. Lebmnnn, H. (1959) uber pH-Werte von Infusionslosungen. dsterreichische Apotheker-Zeitung, 13, 30. Vogt. H. P Cklche, C. (1961) pH-Studien an den gebrauchlichsten Infusionslosungen, inbesondere die Ennittlung ihrer Pufferkapazitiit im Vergleich mit der des Blutes. Mitteilirngen der Deutschen Pharmaceutischen Gesellschaft. 31,97-107. 3 I . Cklche, G. (1966) Uber die Bedeutung de pH und Puferwertes von lnfusionslosungen fur Kombinationen mit weiteren Anneistoffen. Krankenhausact. 39.80-86. 32. hndgrm, P. P hndasj6, L. (1970) Studieson the stability and compatibility of drugs in infusion fluids. 1. pH and buffer capacity of infusion fluids. Acta Pharmacewica Sue...

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Potency and stability of extemporaneous nitroglycerin infusions

Cited by 16 publications

References 0 publications

Nitroglycerin Pharmacokinetics After Intravenous Infusion in Normal Subjects

Nitroglycerin Pharmacokinetics After Intravenous Infusion in Normal Subjects

Nitroglycerin Stability: Effects on Bioavailability, Assay and Biological Distribution

Incompatibility and Stability Problems Associated With Intravenous Admixtures: A Survey

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