Literature analysis of compatible stability of commonly used intravenous drugs in ICU

HE Xueru; FAN Liju; LI Xiao; WANG Zhi; ZHOU Xin; DONG Zhanjun

doi:10.6039/j.issn.1001-0408.2023.06.21

您当前的位置：

首页 >

文章列表页 >

Literature analysis of compatible stability of commonly used intravenous drugs in ICU

更新时间：2023-03-24

- Literature analysis of compatible stability of commonly used intravenous drugs in ICU
- ZHONGGUO YAOFANG Vol. 34, Issue 6, Pages: 752-757(2023)
- 作者机构：
  
  1.河北医科大学研究生院，石家庄　050011
  2.河北省人民医院药学部，石家庄　050057
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.06.21
  CLC： R969.3
- Published：30 March 2023，
  
  Received：12 July 2022，
  
  Revised：11 February 2023，
扫描看全文
何雪茹,范理菊,李宵等.ICU常用静脉药物配伍稳定性的文献分析 ^Δ[J].中国药房,2023,34(06):752-757.

HE Xueru,FAN Liju,LI Xiao,et al.Literature analysis of compatible stability of commonly used intravenous drugs in ICU[J].ZHONGGUO YAOFANG,2023,34(06):752-757.
何雪茹,范理菊,李宵等.ICU常用静脉药物配伍稳定性的文献分析 ^Δ[J].中国药房,2023,34(06):752-757. DOI： 10.6039/j.issn.1001-0408.2023.06.21.

HE Xueru,FAN Liju,LI Xiao,et al.Literature analysis of compatible stability of commonly used intravenous drugs in ICU[J].ZHONGGUO YAOFANG,2023,34(06):752-757. DOI： 10.6039/j.issn.1001-0408.2023.06.21.

摘要

目的

分析重症监护室（ICU）常用静脉药物的配伍稳定性，为临床用药安全提供参考。

方法

于2022年4月1－30日调研并确认河北省人民医院ICU常用静脉药物，然后以此为检索词，在PubMed、中国知网、万方数据等数据库中查询相关配伍稳定性研究文献。借助Micromedex数据库进行手动筛选，随后对纳入文献的配伍稳定性结果进行描述性分析。

结果

收集到该院ICU常用静脉药物32种，混合输注组合39种。共纳入40项研究，仅有2项研究符合所有的质量要求；18项研究对其方法进行了验证，保证了可重复性；33项研究评估了物理稳定性，包括沉淀形成、pH变化；32项研究评估了化学稳定性，主要为含量/浓度变化。共得到666种可能的两两配伍组合，其中254种组合有配伍稳定性结果，包括176种稳定、68种不稳定、10种相互矛盾；412种组合没有配伍稳定性结果。在该院ICU的两两药物组合中，42种组合稳定、14种组合不稳定、2种组合相互矛盾。

结论

pH、溶媒、辅料、配制浓度等是影响配伍稳定性的因素；该院ICU常用静脉药物存在配伍不稳定的药物组合，且稳定性研究方法有所局限，配伍稳定性数据尚无法满足临床的实际需求。

Abstract

OBJECTIVE

To analyze the compatible stability of commonly used intravenous drugs in the intensive care units （ICU）， and to provide a reference for improving medication safety in clinic.

METHODS

The commonly used intravenous drugs in the ICU of Hebei General Hospital were investigated and confirmed in April 1-30， 2022， and used as keywords to retrieve the relevant literature about compatible stability from PubMed， CNKI， Wanfang Data and other databases， and manually filtered with Micromedex database at the same time. Then， the compatible stability results of the included literature were analyzed descriptively.

RESULTS

Totally 32 commonly used intravenous drugs and 39 mixed infusion combinations were collected from ICU of this hospital. A total of 40 studies were included， only 2 studies followed all quality requirements； 18 studies validated their methods to guarantee correct reproducibility； 33 studies evaluated physical stability， including precipitate formation and pH changes； 32 studies evaluated chemical compatibility， mainly content/concentration changes. A total of 666 possible two-drug combinations were obtained from the included literature， of which 254 combinations of stability data were available， including 176 were stable， 68 were unstable， and 10 were contradictory. Totally 412 combinations had no stability results. Among two-drug combinations in ICU of this hospital， 42 combinations were stable， 14 combinations were unstable， and 2 combinations were contradictory.

CONCLUSIONS

The pH， solvent， excipients and preparation concentration are the factors that affect the stability. There are drug combinations with unstable compatibility of commonly used intravenous drugs in ICU of this hospital. The stability study methods are limited， and the stability data cannot meet the actual clinical needs.

关键词

重症监护室静脉药物混合输注配伍稳定性文献分析

Keywords

intravenous drugsmixed infusioncompatible stabilityliterature analysis

references

NÉGRIER L，MARTIN MENA A，LEBUFFE G，et al. Strategies to prevent drug incompatibility during simultaneous multi-drug infusion in intensive care units：a literature review[J]. Eur J Clin Pharmacol，2021，77（9）：1309-1321.

DOESBURG F，OELEN R，RENES M H，et al. Towards more efficient use of intravenous lumens in multi-infusion settings：development and evaluation of a multiplex infusion scheduling algorithm[J]. BMC Med Inform Decis Mak，2020，20（1）：206.

MARSILIO N R，DA SILVA D，BUENO D. Drug incompatibilities in the adult intensive care unit of a university hospital[J]. Rev Bras Ter Intensiva，2016，28（2）：147-153.

MOHAMED H B，EL-SHANAWANY S M，HAMAD M A，et al. Niosomes：a strategy toward prevention of clinically significant drug incompatibilities[J]. Sci Rep，2017，7（1）：6340.

KANJI S，LAM J，JOHANSON C，et al. Systematic review of physical and chemical compatibility of commonly used medications administered by continuous infusion in intensive care units[J]. Crit Care Med，2010，38（9）：1890-1898.

NEWTON D W. Drug incompatibility chemistry[J]. Am J Health Syst Pharm，2009，66（4）：348-357.

BARDIN C，ASTIER A，VULTO A，et al. Guidelines for the practical stability studies of anticancer drugs：a European consensus conference[J]. Ann Pharm Fr，2011，69（4）：221-231.

TRISSEL L A，GILBERT D L，MARTINEZ J F，et al. Compatibility of remifentanil hydrochloride with selected drugs during simulated Y-site administration[J]. Am J Health Syst Pharm，1997，54（19）：2192-2196.

STEWART J T，WARREN F W，MADDOX F C，et al. The stability of remifentanil hydrochloride and propofol mixtures in polypropylene syringes and polyvinylchloride bags at 22 degrees-24 degrees C[J]. Anesth Analg，2000，90（6）：1450-1451.

GERSONDE F，EISEND S，HAAKE N，et al. Physicochemical compatibility and emulsion stability of propofol with commonly used analgesics and sedatives in an intensive care unit[J]. Eur J Hosp Pharm，2017，24（5）：293-303.

FANG B X，WANG L H，LIU H M，et al. Stability study of dezocine in 0.9% sodium chloride solutions for patient-controlled analgesia administration[J]. Medicine，2017，96（35）：e7979.

刘光斌，任洁，何苗苗，等. 地佐辛注射液与常用输液的配伍稳定性研究[J]. 中国执业药师，2015，12（11）：10-15.

沈宵，冯美玲，叶甜甜，等. 酒石酸布托啡诺、地佐辛与盐酸托烷司琼在镇痛泵内配伍的稳定性考察[J]. 中国药师，2020，23（1）：161-163.

MANTONG M L，MARQUARDT E D. Visual compati-bility of midazolam hydrochloride with selected drugs during simulated Y-site injection[J]. Am J Health Syst Pharm，1995，52（22）：2567-2568.

GILLIOT S，MASSE M，FEUTRY F，et al. Long-term stability of ready-to-use 1-mg/mL midazolam solution[J]. Am J Health Syst Pharm，2020，77（9）：681-689.

陈富超，方宝霞，李鹏，等. 酒石酸布托啡诺注射液在氯化钠注射液中的稳定性考察[J]. 中国药师，2012，15（11）：1618-1620.

THOMAS B，MURRELL L，SPENDLEY P. Dexmedetomidine：admixture compatibility with palliative care drugs[J/OL].BMJ Support Palliat Care，2021[2022-06-10]. http：//spcare.bmj.am/content/early/2021/01/08/bmjspcare-2020-002583http://spcare.bmj.am/content/early/2021/01/08/bmjspcare-2020-002583.

ANDERSON C R，MACKAY M W，HOLLEY M，et al. Stability of dexmedetomidine 4 μg/mL in polypropylene syringes[J]. Am J Health Syst Pharm，2012，69（7）：595-597.

刘遂库，史海贤，门利玲，等. 右美托咪定与阿片类药物配伍稳定性的初步考察[J]. 中国药师，2015，18（6）：1063-1065.

VERMEIRE A，REMON J P. Compatibility and stability of ternary admixtures of morphine with haloperidol or midazolam and dexamethasone or methylprednisolone[J]. Int J Pharm，1999，177（1）：53-67.

D’HUART E，VIGNERON J，CLAROT I，et al. Physicochemical stability of norepinephrine bitartrate in polypropylene syringes at high concentrations for intensive care units[J]. Ann Pharm Fr，2019，77（3）：212-221.

马杰，张淑慧. 盐酸乌拉地尔（优匹敌）注射液与临床常用5种药物配伍的稳定性[J]. 河北医药，2005，27（1）：66.

马杰，张淑慧. 盐酸乌拉地尔注射液与4种常用输液配伍稳定性观察[J]. 河北医药，2005，27（4）：301.

黄永锋. 尼莫地平注射液配伍的稳定性及输液器对其吸附性观察[J]. 右江医学，2004，32（4）：370-371.

王斌，何娅，郁韫超，等. 尼卡地平与3种输液配伍的稳定性试验[J]. 中国临床药学杂志，2000，9（2）：119-120.

徐帆，冯恩富，赵星星，等. 氨茶碱与呋塞米注射液的配伍稳定性[J]. 中国药师，2009，12（1）：86-88.

WIEST D B，GARNER S S，CHILDRESS L M. Stability of esmolol hydrochloride in 5% dextrose injection[J]. Am J Health Syst Pharm，1995，52（7）：716-718.

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[J]. Pharmaceuticals（Basel），2019，12（2）：67.

梁卉，胡乔乔，谭爱萍. 盐酸胺碘酮注射液与4种临床常用输液的配伍稳定性考察[J]. 实用药物与临床，2011，14（3）：231-233.

张飞. 注射用盐酸胺碘酮与四种输液的配伍稳定性初步考察[J]. 安徽医药，2011，15（8）：1039-1040.

郭佩路，张骏. 盐酸胺碘酮注射剂与33种注射剂的临床配伍观察[J]. 山西医药杂志，2007，36（3）：277-278.

马一平，王欣. 甘露醇注射液与3种常用辅助降颅压注射液配伍的稳定性考察[J]. 安徽医药，2013，17（3）：508-510.

李昕，徐兵，张莉，等. 胰岛素与硝酸酯类药物的配伍稳定性考察[J]. 中国医院药学杂志，2008，28（14）：1219-1221.

BERGQUIST P A，MANAS D，HUNKE W A，et al. Stability and compatibility of tirofiban hydrochloride during simulated Y-site administration with other drugs[J]. Am J Health Syst Pharm，2001，58（13）：1218-1223.

SEMARK A J，VENKATESH K，MCWHINNEY B C，et al. The compatibility of a low concentration of hydrocortisone sodium succinate with selected drugs during a simulated Y-site administration[J]. Crit Care Resusc，2013，15（1）：63-66.

FOUSHEE J A，MEREDITH P，FOX L M，et al. Y-site physical compatibility of hydrocortisone continuous infusions with admixtures used in critically ill patients[J]. Am J Health Syst Pharm，2020，77（14）：1144-1148.

RASHED S M，SWEATMAN T W，THOMA L，et al. Chemical compatibility of depacon® with medications frequently administered by intravenous y-site delivery in patients with epilepsy or head trauma[J]. J Pediatr Pharmacol Ther，2004，9（2）：126-132.

张文佳，孙德清. 葡萄糖酸钙注射液与不同溶媒配伍的稳定性考察[J]. 中国药房，2021，32（10）：1230-1235.

朱培芳，张洪彬. 注射用头孢曲松钠与葡萄糖酸钙注射液在两种输液中的配伍稳定性考察[J]. 中国药学杂志，2003，38（9）：713-714.

苏雪媚，巩晓宇，黄伟东，等. 氨茶碱注射液与5种常用输液的配伍稳定性考察[J]. 中国药房，2013，24（42）：3986-3988.

KARLAGE K，EARHART Z，GREEN-BOESEN K，et al. Stability of midazolam hydrochloride injection 1-mg/mL solutions in polyvinyl chloride and polyolefin bags[J]. Am J Health Syst Pharm，2011，68（16）：1537-1540.

BEVANS-WARREN T S，CLEGG D O，Jr，SAKATA D J，et al. Remifentanil stability[J]. Anesth Analg，2018，127（3）：e51-e52.

王永，王玮，龚晓英，等. RP-HPLC法考察地佐辛和盐酸右美托咪定配伍稳定性[J]. 中国临床药理学杂志，2020，36（2）：197-199.

WALKER S E，LAW S，GARLAND J，et al. Stability of norepinephrine solutions in normal saline and 5% dextrose in water[J]. Can J Hosp Pharm，2010，63（2）：113-118.

GARABITO M J，JIMENEZ L，BAUTISTA F J，et al. Stability of tirofiban hydrochloride in 0.9% sodium chloride injection for 30 days[J]. Am J Health Syst Pharm，2001，58（19）：1850-1851.

JHUNJHUNWALA V P，BHALLA H L. Compatibility of aminophylline with hydrocortisone sodium succinate or dexamethasone sodium phosphate in 5% dextrose injection[J]. Am J Hosp Pharm，1981，38（6）：900-901.

NEMEC K，GERM E，SCHULZ-SIEGMUND M，et al. The effect of nimodipine，fentanyl and remifentanil intravenous products on the stability of propofol emulsions[J]. Pharmazie，2009，64（2）：94-97.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Renal injury caused by tenofovir disoproxil fumarate in a patient with liver cancer complicated with HBV infection： a case report and literature analysis

Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis

Literature analysis of atypical fractures associated with denosumab

Literature analysis of ocular adverse drug reactions related to dupilumab

Literature analysis of sunitinib-induced nephrotic syndrome

Related Author

CHANG Yingying

LIU Jiyong

WANG Feng

CAO Lei

HUANG Yuezhou

YIN Huanli

LUO Min

ZHANG Chenyu

Related Institution

Dept. of Pharmacy， Fudan University Shanghai Cancer Center

Dept. of Clinical Oncology， Shanghai Medical College of Fudan University

Dept. of Clinical Pharmacy， West China Hospital of Sichuan University

Dept. of Pharmacy， Zhengzhou Orthopaedic Hospital

Dept. of Pharmacy， Medical Supplies Center of PLA General Hospital

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰