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通过使用旨在防止容器破裂的药用玻璃瓶提高患者安全。

Enhancing Patient Safety through the Use of a Pharmaceutical Glass Designed To Prevent Cracked Containers.

作者信息

Schaut Robert A, Hoff Kyle C, Demartino Steven E, Denson William K, Verkleeren Ronald L

机构信息

Corning Incorporated, Corning, NY 14831

Corning Incorporated, Corning, NY 14831.

出版信息

PDA J Pharm Sci Technol. 2017 Nov-Dec;71(6):511-528. doi: 10.5731/pdajpst.2017.007807. Epub 2017 Sep 19.

DOI:10.5731/pdajpst.2017.007807
PMID:28928290
Abstract

An essential role of packaging material for the storage and delivery of drug products is to provide adequate protection against contamination and loss of sterility. This is especially important for parenteral containers, as lack of sterility or contamination can result in serious adverse events including death. Nonetheless, cracked parenteral containers are an important source of container integrity failures for injectable drugs and pose a serious risk for patients. Despite significant investments in inspection technology, each year many injectable drugs are investigated and recalled for sterility risks associated with cracked borosilicate containers. Multiple studies and the many difficulties in detection of cracked containers suggest that the magnitude of the public health risk is even larger than the recall rate would suggest. Here we show that the root cause of cracked parenteral containers (low internal energy following annealing) is inherent to the glasses currently used for primary packaging of the majority of injectable drugs. We also describe a strengthened aluminosilicate glass that has been designed to prevent cracks in parenteral containers through the use of an engineered stress profile in the glass. Laboratory tests that simulate common filling line damage events show that the strengthened aluminosilicate glass is highly effective at preventing cracks. Significant safety benefits have been demonstrated in other industries from the use of special stress profiles in glass components to mitigate failure modes that may result in harm to humans. Those examples combined with the results described here suggest that a significant improvement in patient safety can be achieved through the use of strengthened aluminosilicate glass for parenteral containers. Cracks are small cuts or gaps in a container which provide a pathway for liquid, gas, or microbes through a glass container. When these defects are introduced to conventional glass containers holding injectable medicines, the affected drug can pose serious risks to the patient receiving that medication. Specifically, the drug product may become less effective or even non-sterile, which could lead to bloodstream infections and, in some cases, death. This article presents a review of some previously documented cases of cracked glass containers that led to patient infections and deaths. Following a survey of common crack locations in glass vials, lab-based methods for replicating these cracks are presented. These methods are then used to compare the fracture response of vials made from conventional borosilicate glass and strengthened aluminosilicate glass. The results show that stable cracks are essentially prevented (at least 31 times less likely to occur) in the strengthened aluminosilicate glass containers (relative to conventional borosilicate glass). This improvement in safety is similar to improvements already engineered into other glass product designs by utilizing stored strain energy to mitigate certain failure modes.

摘要

药品储存和运输包装材料的一个重要作用是提供充分的保护,防止污染和无菌性丧失。这对于注射用容器尤为重要,因为缺乏无菌性或受到污染可能导致包括死亡在内的严重不良事件。尽管如此,破裂的注射用容器仍是注射剂容器完整性失效的一个重要原因,对患者构成严重风险。尽管在检测技术方面投入巨大,但每年仍有许多注射剂因与破裂的硼硅酸盐容器相关的无菌风险而接受调查和召回。多项研究以及检测破裂容器的诸多困难表明,公共卫生风险的严重程度甚至比召回率所显示的还要高。在此我们表明,破裂的注射用容器的根本原因(退火后内部能量低)是目前大多数注射剂主要包装所用玻璃所固有的。我们还描述了一种强化铝硅酸盐玻璃,其设计目的是通过在玻璃中采用工程应力分布来防止注射用容器出现裂缝。模拟常见灌装线损坏事件的实验室测试表明,强化铝硅酸盐玻璃在防止裂缝方面非常有效。在其他行业中,通过在玻璃部件中采用特殊应力分布来减轻可能对人类造成伤害的失效模式,已证明具有显著的安全效益。这些例子与本文所述结果相结合表明,通过将强化铝硅酸盐玻璃用于注射用容器,可显著提高患者安全性。裂缝是容器上的小切口或缝隙,为液体、气体或微生物提供了穿过玻璃容器的通道。当这些缺陷出现在装有注射用药品的传统玻璃容器中时,受影响的药品可能会给接受该药物治疗的患者带来严重风险。具体而言,药品可能会失效甚至失去无菌性,这可能导致血液感染,在某些情况下还会导致死亡。本文回顾了一些先前记录的因玻璃容器破裂导致患者感染和死亡的案例。在对玻璃瓶常见裂缝位置进行调查之后,介绍了基于实验室的复制这些裂缝的方法。然后使用这些方法比较由传统硼硅酸盐玻璃和强化铝硅酸盐玻璃制成的瓶子的断裂响应。结果表明,强化铝硅酸盐玻璃容器基本上可以防止出现稳定裂缝(发生可能性至少降低31倍)(相对于传统硼硅酸盐玻璃)。这种安全性的提高类似于通过利用储存的应变能来减轻某些失效模式而在其他玻璃产品设计中已经实现的改进。

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