• Int J Pharm Compd · May 2020

    Physical Compatibility of Medications Used in Critically Ill Patients with Balanced Fluid Solutions.

    • Alyson G Wilder, Jaime A Foushee, Laura M Fox, Jordan Navalle, Adrienne M Wright, and Megan A Greer.
    • Presbyterian College School of Pharmacy, Clinton, South Carolina.
    • Int J Pharm Compd. 2020 May 1; 24 (3): 238-241.

    AbstractUsing balanced fluids for resuscitation in patients with septic shock may lead to improved patient outcomes. However, compatibility data on co-administering balanced fluids via y-site connector with other intravenous medications is lacking. The purpose of this study was to examine the physical compatibility of frequently used intravenous medications for patients with septic shock with balanced fluids, Plasma-Lyte A, and Lactated Ringers, using a simulated y-site. Medications studied were acyclovir, amiodarone, ampicillin, aztreonam, cefepime, ceftriaxone, ciprofloxacin, heparin, hydrocortisone, gentamicin, levofloxacin, meropenem, piperacillin-tazobactam, tobramycin, and vancomycin. All medications were assessed with Plasma-Lyte A; amiodarone, ampicillin, cefepime, hydrocortisone, and levofloxacin were also assessed for compatibility with Lactated Ringers, based on missing or conflicting compatibility data. The medications were diluted to maximum concentrations used for patient administration and mixed with the balanced fluid solution in equal volumes. Physical compatibility was determined by assessing samples visually against light and dark backgrounds and using a laboratory turbidimeter. Assessments occurred at time of mixing and at 15-minute intervals up to one hour. Amiodarone demonstrated turbidimetric incompatibility when combined with Plasma- Lyte A or Lactated Ringers and should not be co-administered with either of these fluids via y-site connector. Each remaining study drug displayed visible and turbidimetric compatibility with the assessed balanced fluid. Acyclovir, ampicillin, aztreonam, cefepime, ceftriaxone, ciprofloxacin, gentamicin, heparin, hydrocortisone, levofloxacin, meropenem, piperacillin-tazobactam, tobramycin, and vancomycin exhibited physical compatibility with Plasma- Lyte A in a simulated y-site for up to one hour. Ampicillin, cefepime, hydrocortisone, and levofloxacin were also physically compatible with Lactated Ringers.Copyright© by International Journal of Pharmaceutical Compounding, Inc.

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