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Investigations of Physical Compatibilities of Commonly Used Intravenous Medications with and without Parenteral Nutrition in Pediatric Cardiovascular Intensive Care Unit Patients

McWhorter School of Pharmacy, Samford University, Birmingham city, AL 35229, USA
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Pharmaceuticals 2019, 12(2), 67; https://doi.org/10.3390/ph12020067
Received: 12 April 2019 / Revised: 29 April 2019 / Accepted: 1 May 2019 / Published: 4 May 2019
Many pediatric intensive care patients require numerous specialized intravenous (IV) medications at various dosages in multiple fluids often with nutritional support. This requires several venous access points due to lack of Y-site compatibility data for combinations of two or more drugs. This project investigated physical compatibilities of intravenous medications: alprostadil, calcium gluconate, dexmedetomidine, epinephrine, norepinephrine, esmolol, furosemide, vasopressin, and milrinone with and without lipid-free total parenteral nutrition (TPN) commonly used in a pediatric cardiovascular intensive care unit (CVICU) patient. Actual drug combinations were evaluated using a simulated Y-site study design. Compatibility was determined based on observational data: odor (change/appearance), evolution of gas, and visual appearance combined with physical or chemical endpoints with predefined acceptance criteria: change in pH (± 1 unit), and turbidity (>0.5 NTU) at eight time points between 0 and 240 min. All binary drug combinations along with the four drug plus TPN combination were found to be physically compatible up to 240 min. The three drug combinations were determined to be incompatible and were not evaluated with TPN. This study demonstrates the utility of simulated Y-site study design to multi-drug combinations and increases the scientific body of knowledge related to medications used in a pediatric CVICU. View Full-Text
Keywords: Y-site; drug compatibility; pediatric; cardiovascular Y-site; drug compatibility; pediatric; cardiovascular
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MDPI and ACS Style

Greenhill, K.; Hornsby, E.; Gorman, G. Investigations of Physical Compatibilities of Commonly Used Intravenous Medications with and without Parenteral Nutrition in Pediatric Cardiovascular Intensive Care Unit Patients. Pharmaceuticals 2019, 12, 67. https://doi.org/10.3390/ph12020067

AMA Style

Greenhill K, Hornsby E, Gorman G. Investigations of Physical Compatibilities of Commonly Used Intravenous Medications with and without Parenteral Nutrition in Pediatric Cardiovascular Intensive Care Unit Patients. Pharmaceuticals. 2019; 12(2):67. https://doi.org/10.3390/ph12020067

Chicago/Turabian Style

Greenhill, Katherine, Erin Hornsby, and Greg Gorman. 2019. "Investigations of Physical Compatibilities of Commonly Used Intravenous Medications with and without Parenteral Nutrition in Pediatric Cardiovascular Intensive Care Unit Patients" Pharmaceuticals 12, no. 2: 67. https://doi.org/10.3390/ph12020067

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