TY - JOUR
T1 - Physical compatibility of lipid emulsions and intravenous medications used in neonatal intensive care settings
AU - Senarathna, S. M.D.K.Ganga
AU - Strunk, Tobias
AU - Petrovski, Michael
AU - Woodland, Sarah
AU - Martinez, Jorge
AU - Chuang, Victor T.G.
AU - Batty, Kevin T.
PY - 2023
Y1 - 2023
N2 - Objective: The purpose of this study was to investigate the physical compatibility of intravenous lipid emulsions with parenteral medications used in neonatal intensive care. Methods: Lipid emulsion and drug solutions were combined 1:1 in glass vials, inspected for physical incompatibility at 0, 1 and 2 hours, and assessed on the basis of lipid droplet size at 0 and 2 hours after mixing. Intravenous fluid controls (Water for Injection, sodium chloride 0.9% w/v, glucose 5% w/v), positive controls (gentamicin, albumin), negative controls (metronidazole, paracetamol, vancomycin) and 21 previously untested drug combinations were evaluated. Results: No phase separation, change in colour, gas production or other visible anomaly was observed. The between-run mean droplet diameter (MDD) for SMOFlipid20% alone (0.301±0.008 μm) was comparable to the lipid emulsion/intravenous fluid and lipid emulsion/drug solution combinations. In addition to gentamicin and albumin, caffeine citrate (20 mg/mL) was shown to be incompatible with the lipid emulsion. All other lipid:drug combinations were compatible, based on the MDD data. Conclusion: Intravenous lipid emulsions were found to be compatible with 20 parenteral medications, including antimicrobial agents, inotropes, anti-inflammatory drugs and caffeine base, in simulated Y-site conditions. The lipid emulsion was incompatible with caffeine citrate injection.
AB - Objective: The purpose of this study was to investigate the physical compatibility of intravenous lipid emulsions with parenteral medications used in neonatal intensive care. Methods: Lipid emulsion and drug solutions were combined 1:1 in glass vials, inspected for physical incompatibility at 0, 1 and 2 hours, and assessed on the basis of lipid droplet size at 0 and 2 hours after mixing. Intravenous fluid controls (Water for Injection, sodium chloride 0.9% w/v, glucose 5% w/v), positive controls (gentamicin, albumin), negative controls (metronidazole, paracetamol, vancomycin) and 21 previously untested drug combinations were evaluated. Results: No phase separation, change in colour, gas production or other visible anomaly was observed. The between-run mean droplet diameter (MDD) for SMOFlipid20% alone (0.301±0.008 μm) was comparable to the lipid emulsion/intravenous fluid and lipid emulsion/drug solution combinations. In addition to gentamicin and albumin, caffeine citrate (20 mg/mL) was shown to be incompatible with the lipid emulsion. All other lipid:drug combinations were compatible, based on the MDD data. Conclusion: Intravenous lipid emulsions were found to be compatible with 20 parenteral medications, including antimicrobial agents, inotropes, anti-inflammatory drugs and caffeine base, in simulated Y-site conditions. The lipid emulsion was incompatible with caffeine citrate injection.
KW - Administration, Intravenous
KW - Drug Compounding
KW - DRUG INCOMPATIBILITY
KW - NEONATOLOGY
KW - PEDIATRICS
KW - PHARMACEUTICAL PREPARATIONS
UR - http://www.scopus.com/inward/record.url?scp=85175247604&partnerID=8YFLogxK
U2 - 10.1136/ejhpharm-2023-003870
DO - 10.1136/ejhpharm-2023-003870
M3 - Article
C2 - 37875283
AN - SCOPUS:85175247604
SN - 2047-9956
JO - European Journal of Hospital Pharmacy
JF - European Journal of Hospital Pharmacy
ER -