The Interactions between  Ciprofloxacin and Parenteral Nutrition Admixtures

Gostyńska, Aleksandra; Stawny, Maciej; Dettlaff, Katarzyna; Jelińska, Anna

doi:10.3390/pharmaceutics12010027

Cited by 13 publications

(15 citation statements)

References 25 publications

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“…The most frequent interactions involved drug or PN admixture ingredient precipitation, the formation of large lipid droplets exceeding the critical acceptance limit for intravenous administration, loss of homogeneity of the oil-in-water system, or color change. Such incompatibilities were reported in previous studies [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ] ( Table 1 ). Interpretation of the results of drug–PN compatibility tests and their adaptation into clinical practice should be based not only on the conclusion whether the drug is or is not compatible with PN admixture, but also involve a detailed analysis of the pharmaceutical preparation of the drug (pH, excipients, solubilizers), the composition of the PN admixture (electrolyte content, type of lipid emulsion), and its physicochemical properties (pH, osmolarity) [ 2 , 16 , 17 , 18 ].…”

Section: Introductionsupporting

confidence: 82%

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Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

et al. 2021

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Simultaneous administration of parenteral nutrition (PN) admixtures with intravenous antibiotics is a common clinical problem. Coadministration of drugs incompatible with PN admixture may affect its stability, especially in the context of lipid droplet size, which is a crucial parameter for patient safety. In the present study, we investigate the in vitro compatibility of meropenem (Meropenem 1000, MPM) with five commercial PN admixtures used worldwide: Kabiven, Olimel N9E, Nutriflex Lipid Special, Nutriflex Omega Special, and SmofKabiven. The appropriate volumetric ratios, reflecting their clinical practice ratios, were used to prepare the MPM–PN admixture samples. Physicochemical properties of MPM–PN admixtures samples were determined upon preparation and after four hours of storage. The pH changes for all MPM–PN admixtures samples did not exceed the assumed level of acceptability and ranged from 6.41 to 7.42. After four hours of storage, the osmolarity changes were ±3%, except MPM–Olimel N9E samples, for which differences from 7% to 11% were observed. The adopted level of acceptability of changes in zeta potential after four hours of storage (±3 mV) was met for MPM–Kabiven, MPM–Nutriflex Lipid Special, and MPM–Nutriflex Omega Special. The mean droplet diameter for all samples was below 500 nm. However, only in the case of Nutriflex Lipid Special and Nutriflex Omega Special, the addition of MPM did not cause the formation of the second fraction of lipid droplets. The coadministration of MPM via Y-site with Kabiven, Olimel N9E, and Smofkabiven should be avoided due to osmolarity fluctuations (MPM–Olimel), significant differences in zeta potential (MPM–Olimel, MPM–Smofkabiven), and the presence of the second fraction of lipid droplets >1000 nm (MPM–Kabiven, MPM–Olimel, and MPM–Smofkabiven). The assumed acceptance criteria for MPM compatibility of MPM with PN admixtures were met only for Nutriflex Lipid Special and Nutriflex Omega Special in 1:1, 2:1, and 4:1 volume ratios.

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Section: Introductionsupporting

confidence: 82%

“…It was shown that lipid emulsions used in PN, due to stabilizing phospholipids, are characterized by a zeta potential of −40 to −50 mV, thus exhibiting substantial stability. Depending on the TPN admixtures’ composition, the zeta potential may even have values close to zero, in a range of −4.1 to −1.7 mV [ 5 , 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

et al. 2021

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“…This criterion was set for the US Pharmacopeia method I for the determination of the MDD of lipid injectable emulsions [ 20 ]. We established the acceptance criteria for the remaining parameters based on the work of other researchers and our own experiences [ 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The changes in measured parameters over time cannot exceed the values of ±0.2 and ±5% for the pH and osmolality, respectively.…”

Section: Methodsmentioning

confidence: 99%

All-in-One Pediatric Parenteral Nutrition Admixtures with an Extended Shelf Life—Insight in Correlations between Composition and Physicochemical Parameters

et al. 2021

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The administration of three-in-one parenteral nutrition (PN) admixtures to pediatric patients requires special consideration, specifically concerning quality and physicochemical stability. The introduction of a new parenteral amino acid solution into the market prompted us to evaluate Aminoplasmal Paed-based PN admixtures’ stability. The study aimed to determine the physicochemical parameters of the chosen variations of PN admixtures and search for a correlation between its composition and those parameters. One hundred and sixty-eight variations of PN admixtures intended for patients weighing from 10 to 25 kg and aged from 1 to 12 years and differing in the quantitative composition of electrolytes were selected for the study. The samples were prepared using each of the four intravenous lipid emulsions dedicated to pediatric patients: Intralipid 20%, Clinoleic 20%, Lipidem 20%, and Smoflipid 20%. The stability of the PN admixtures was assessed by visual inspection and determination of pH, osmolality, zeta potential, and hydrodynamic mean droplet diameter (MDD) immediately upon preparation and after seven days of storage at the temperature of 5 ± 1 °C with light protection. Pearson’s correlation was used to quantify the relationships between selected ingredients of the PN admixtures and the physicochemical parameters. The PN admixtures were characterized by pH ranging from 5.91 to 7.04, osmolality ranging from 1238 to 1678 mOsm/kg, and zeta potential ranging from −41.3 to −2.16 mV. The changes in pH and osmolality after seven days of storage did not exceed 0.2 and 4.4%, respectively. The homogeneity of the PN admixtures was confirmed by determining the polydispersity index, which ranged from 0.06 to 0.2. The MDD of the studied formulas ranged from 235 to 395 nm and from 233 to 365 nm immediately upon preparation and after the storage period, respectively. Correlations between selected components of the PN admixtures and some physicochemical parameters were found. All Aminoplasmal Paed 10%-based PN admixtures were characterized by appropriate physicochemical quality to be administered via the central veins, both immediately upon preparation and after seven days of storage at the temperature of 5 ± 1 °C with light protection. The applied electrolyte concentrations ranges and types of lipid emulsions in the selected macronutrient quantitative compositions allowed the PN admixtures to remain stable for seven days within the specified limits.

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“…HPLC was also used to determine cocarboxylase [9], vitamins A and E [10], and dehydroascorbic acid [11]. The methods of chromatographic separation and determination of vitamins B1 [12,13] and C [14] and drugs, such as ranitidine [13], linezolid [15], cefepime [16], ceftazidime [17], ampicillin [18], and ciprofloxacin [19] in PN admixtures were also described.…”

Section: Introductionmentioning

confidence: 99%

Application of the HPLC Method in Parenteral Nutrition Assessment: Stability Studies of Ondansetron

et al. 2021

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Ondansetron (OND) is a serotonin type 3 receptor antagonist that exhibits antiemetic activity. From the clinical point of view, vomiting and nausea prevention is an important task. Anticancer treatment and recovery impact the patient’s overall state by affecting appetite, well-being, and physical activity, and consequently, nutrition quality. Depending on the patient’s indication and condition, parenteral nutrition is administered to meet full nutritional requirements. In addition, antiemetic drugs can be added to the parenteral nutrition (PN) admixture to treat chemo- or radio-therapy-induced nausea and vomiting. However, adding any medication to the PN admixture can result in the instability of the composition in the overall admixture. This study aimed to develop the HPLC method of determination of OND in Lipoflex special, one of the most popular, ready-to-use PN admixtures. The proposed HPLC method and the sample preparation procedure were suitable for analyzing OND in PN admixture stored under various conditions, such as exposure to sunlight and temperature. It was found that the decomposition of OND during the seven-day storage did not exceed 5% and did not depend on external factors. Based on the conducted research, it is recommended to add OND to Lipoflex special, and it is possible to store such an admixture for seven days.

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The Interactions between Ciprofloxacin and Parenteral Nutrition Admixtures

Cited by 13 publications

References 25 publications

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures

All-in-One Pediatric Parenteral Nutrition Admixtures with an Extended Shelf Life—Insight in Correlations between Composition and Physicochemical Parameters

Application of the HPLC Method in Parenteral Nutrition Assessment: Stability Studies of Ondansetron

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