Thompson D F, Stiles M L, Allen L V, Tu Y H
Drug Information Service, State of Oklahoma Teaching Hospitals, Oklahoma City.
Am J Hosp Pharm. 1988 Jan;45(1):142-5.
The compatibility of verapamil hydrochloride during simulated Y-site injection with i.v. admixtures containing 11 different penicillins was studied. Admixtures of penicillin G potassium (62.5 mg/mL), nafcillin sodium (40 mg/mL), oxacillin sodium (40 mg/mL), ampicillin sodium (40 mg/mL), carbenicillin disodium (40 mg/mL), methicillin sodium (40 mg/mL), ticarcillin sodium (40 mg/mL), azlocillin sodium (40 mg/mL), mezlocillin sodium (40 mg/mL), piperacillin sodium (40 mg/mL), and amdinocillin (20 mg/mL) were prepared in both 5% dextrose injection and 0.9% sodium chloride injection in minibags. Verapamil hydrochloride injection 4 mL (10 mg) was then added to each admixture, and the admixtures were examined macroscopically and microscopically for precipitate immediately and at 15 minutes and 24 hours after mixing. To simulate Y-site injection of verapamil, verapamil hydrochloride injection 1 mL (2.5 mg) was added to 1 mL of each penicillin admixture in a test tube. For admixtures in which precipitates formed, the pH was recorded before and after verapamil was added to the admixtures. Loss of verapamil hydrochloride when mixed with the penicillin admixtures was determined using reverse-phase high-performance liquid chromatography. Addition of verapamil hydrochloride to admixtures containing nafcillin sodium, oxacillin sodium, ampicillin sodium, and mezlocillin sodium resulted in substantial loss of verapamil hydrochloride. The results for the Y-site injection study showed visible precipitation with the same penicillin admixtures. Because a precipitate formed when verapamil hydrochloride was added to nafcillin sodium, oxacillin sodium, ampicillin sodium, or mezlocillin sodium in the diluents studied, we recommended that verapamil hydrochloride be administered separately or that the i.v. tubing be flushed thoroughly before and after this drug is administered through a Y-injection site with these penicillin admixtures.
研究了盐酸维拉帕米在模拟Y型静脉注射时与含11种不同青霉素的静脉内混合液的相容性。在微型袋中分别于5%葡萄糖注射液和0.9%氯化钠注射液中制备青霉素G钾（62.5mg/mL）、萘夫西林钠（40mg/mL）、苯唑西林钠（40mg/mL）、氨苄西林钠（40mg/mL）、羧苄西林二钠（40mg/mL）、甲氧西林钠（40mg/mL）、替卡西林钠（40mg/mL）、阿洛西林钠（40mg/mL）、美洛西林钠（40mg/mL）、哌拉西林钠（40mg/mL）和氨曲南（20mg/mL）的混合液。然后向每种混合液中加入4mL（10mg）盐酸维拉帕米注射液，并在混合后立即、15分钟和24小时对混合液进行肉眼和显微镜下的沉淀检查。为模拟维拉帕米的Y型静脉注射，将1mL（2.5mg）盐酸维拉帕米注射液加入试管中1mL的每种青霉素混合液中。对于形成沉淀的混合液，在向混合液中加入维拉帕米之前和之后记录pH值。使用反相高效液相色谱法测定盐酸维拉帕米与青霉素混合液混合时的损失。向含萘夫西林钠、苯唑西林钠、氨苄西林钠和美洛西林钠的混合液中加入盐酸维拉帕米会导致盐酸维拉帕米大量损失。Y型静脉注射研究结果显示，相同的青霉素混合液出现可见沉淀。由于在所研究的稀释剂中，当向含有萘夫西林钠、苯唑西林钠、氨苄西林钠或美洛西林钠的溶液中加入盐酸维拉帕米时会形成沉淀，我们建议盐酸维拉帕米单独给药，或者在通过Y型注射部位与这些青霉素混合液一起给药该药物之前和之后，彻底冲洗静脉输液管。
