模拟 Y 型部位给药时，黏菌素与镇痛药的物理相容性。

Physical compatibility of colistin with analgesics during simulated Y-site administration.

机构信息

Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, Poznań, Poland.

出版信息

Am J Health Syst Pharm. 2024 Jun 24;81(13):e365-e371. doi: 10.1093/ajhp/zxae035.

DOI:10.1093/ajhp/zxae035

PMID:38358317

Abstract

PURPOSE

Special consideration is needed when intravenous drugs are administered simultaneously using a Y-site connector. This study aimed to investigate the physical compatibility of colistin with 6 analgesics at concentrations commonly used in clinical practice.

METHODS

A pharmaceutical preparation of colistin was dissolved according to the manufacturer's instructions and diluted to a concentration of 1.5 mg/mL or 0.67 mg/mL (of colistin base). Simulated administration via Y-site infusion set was performed by mixing 5 mL of colistin solution with an equal volume of a solution of one of 6 intravenous analgesics. Infusion solutions of ibuprofen, ketoprofen, metamizole sodium, morphine sulfate, paracetamol, and tramadol hydrochloride were studied. For each analgesic tested, concentrates for injection were diluted with 2 solvents, resulting in 11 different combinations with each concentration of the colistin solution. The mixtures were visually inspected, and their turbidity was measured directly after mixing and at 3 consecutive time points (30, 60, and 120 minutes). Additionally, the pH of the mixtures was measured after 120 minutes and compared with the pH of the analgesic and the colistin solutions.

RESULTS

During visual inspection with the unaided eye, no precipitate formation or gas evolution was observed in any of the tested analgesics except for sodium metamizole, where the yellow color of the solutions was observed. For samples containing the mixture of ibuprofen and colistin, the turbidity measurements revealed the presence of turbidity in the studied mixtures. The greatest change in pH relative to the value immediately after preparation was noted for combinations of ketoprofen and morphine sulfate with the tested antibiotic.

CONCLUSION

Colistin was found to be incompatible with ibuprofen and metamizole sodium formulations. It should also not be combined with morphine sulfate due to the significant differences in the pH value of the preparations. The colistin 0.67 mg/mL and 1.5 mg/mL infusion solutions were physically compatible with ketoprofen, tramadol hydrochloride, and paracetamol.

摘要

目的

当通过 Y 型管连接器同时给予静脉内药物时，需要特别考虑。本研究旨在调查在临床实践中常用浓度下黏菌素与 6 种镇痛药的物理相容性。

方法

根据制造商的说明溶解黏菌素制剂，并将其稀释至 1.5mg/mL 或 0.67mg/mL（黏菌素碱）的浓度。通过将 5mL 黏菌素溶液与 6 种静脉内镇痛药之一的等体积溶液混合，模拟 Y 型管输注装置给药。研究了布洛芬、酮洛芬、盐酸曲马多、硫酸吗啡、对乙酰氨基酚和盐酸曲马多的输注溶液。对于每种测试的镇痛药，用 2 种溶剂稀释注射液，导致与每种黏菌素溶液浓度的 11 种不同组合。目视检查混合物，并在混合后和 3 个连续时间点（30、60 和 120 分钟）直接测量其浊度。此外，在 120 分钟后测量混合物的 pH 值，并与镇痛药和黏菌素溶液的 pH 值进行比较。