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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Comparison of Long-Term Stability of Parenteral All-in-One Admixtures Containing New Lipid Emulsions Prepared Under Hospital Pharmacy Conditions

1
Hospital Pharmacy, General University Hospital in Prague, Czech Republic
2
Department of Pharmaceutics, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
3
Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
4
Department of Medicine – Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
5
Department of Medicine – Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
6
Department of Physiology, Medical Academy, Lithuanian University of Health Sciences, Lithuania
7
Department of Pharmaceutical Technology and Social Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2011, 47(6), 46; https://doi.org/10.3390/medicina47060046
Received: 13 March 2011 / Accepted: 23 June 2011 / Published: 28 June 2011
All-in-one (AIO) admixtures for parenteral nutrition are common in hospital pharmacy practices. They are extemporaneously prepared and should be stable during preparation, storage, and administration. Lipid emulsion is a clinically important and very susceptible component of instability. The objective of study was to evaluate the long-term stability of AIO admixtures containing modern lipid emulsions.
Material and methods. AIO admixtures with two different emulsions (SMOFlipid and Lipoplus) containing the same amount of glucose and complex amino acid solution, and variable amounts of ions were prepared. Samples were evaluated at 2, 5, 8 and 30 days after preparation. The main indicator of AIO system stability was the amount of lipid globules greater than 5 μm in diameter, which is limited by pharmacopoeia. Optical microscopy was used for particle size measurement.
Results
. All prepared AIO admixtures remained stable during observation. The counts of overlimit lipid particles were within pharmacopeial limit nevertheless tended to increase in time. After 30-day storage, their value was influenced mainly by concentration of calcium ions, which at lower concentrations had a greater impact on SMOFlipid-based admixtures, whereas at the highest concentration on Lipoplus-based admixtures. The concentration of ions and osmolarity remained without changes; pH of admixtures slightly decreased.
Conclusions
. Both lipid emulsions were found to be suitable for preparation AIO admixtures with different concentrations of electrolytes. The formulations were stable even if contained high concentrations of divalent ions. The comparison of emulsions revealed the superiority of Lipoplus – electrolyte concentrations and duration of storage had a greater impact on admixtures with SMOFlipid.
Keywords: parenteral nutrition; all-in-one; lipid emulsion; stability parenteral nutrition; all-in-one; lipid emulsion; stability
MDPI and ACS Style

Janů, M.; Brodská, H.; Vecka, M.; Masteiková, R.; Kotrlíková, E.; Lažauskas, R.; Pečiūra, R.; Bernatonienė, J. Comparison of Long-Term Stability of Parenteral All-in-One Admixtures Containing New Lipid Emulsions Prepared Under Hospital Pharmacy Conditions. Medicina 2011, 47, 46.

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