Physicochemical Compatibility of Amiodarone with Parenteral Nutrition.


Journal

JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134

Informations de publication

Date de publication:
02 2019
Historique:
received: 10 01 2018
accepted: 04 06 2018
pubmed: 12 7 2018
medline: 20 8 2020
entrez: 12 7 2018
Statut: ppublish

Résumé

Y-site administration of total parenteral nutrition (TPN) and drugs is frequently required in the intensive care setting. Amiodarone is commonly administered by continuous intravenous infusion and subject to be co-administered via a Y-site with TPN. The aim of this study is to determine the physicochemical stability of amiodarone Y-site administered with TPN. Two standard TPN and 2 amiodarone solutions were designed. The 2 TPN differed in the lipid source (Lipofundin MCT/LCT® 20% or SMOFlipid® 20%). The 2 amiodarone solutions were prepared at different concentrations (900 mg and 1200 mg in 250 mL of dextrose 5% in water). Each TPN and amiodarone solutions ran at a rate that simulated a 24-hour Y-site infusion to obtain different admixture samples. Each sample was then visually examined and further tested to determine the mean lipid droplet size distribution by dynamic light scattering and amiodarone concentrations by HPLC. No alterations were detected by visual inspection. Average droplet size remained below 500 nm (252.5 ± 5.9 nm for Lipofundin MCT/LCT® TPN and 327.7 ± 14.4 nm for SMOFlipid® TPN). For the samples obtained after running 900 mg and 1200 mg amiodarone solutions with TPN, the concentrations observed at 24 hours were 0.4491 ± 0.0111 mg/mL and 0.5773 ± 0.0214 mg/mL, respectively. These results represent approximately 100% of the zero-time concentrations and are within ±15% of the predicted values. No degradation products were observed in the chromatograms. Amiodarone is physicochemically compatible with standard TPN via a Y-site administration at the tested amiodarone concentrations.

Sections du résumé

BACKGROUND
Y-site administration of total parenteral nutrition (TPN) and drugs is frequently required in the intensive care setting. Amiodarone is commonly administered by continuous intravenous infusion and subject to be co-administered via a Y-site with TPN. The aim of this study is to determine the physicochemical stability of amiodarone Y-site administered with TPN.
METHODS
Two standard TPN and 2 amiodarone solutions were designed. The 2 TPN differed in the lipid source (Lipofundin MCT/LCT® 20% or SMOFlipid® 20%). The 2 amiodarone solutions were prepared at different concentrations (900 mg and 1200 mg in 250 mL of dextrose 5% in water). Each TPN and amiodarone solutions ran at a rate that simulated a 24-hour Y-site infusion to obtain different admixture samples. Each sample was then visually examined and further tested to determine the mean lipid droplet size distribution by dynamic light scattering and amiodarone concentrations by HPLC.
RESULTS
No alterations were detected by visual inspection. Average droplet size remained below 500 nm (252.5 ± 5.9 nm for Lipofundin MCT/LCT® TPN and 327.7 ± 14.4 nm for SMOFlipid® TPN). For the samples obtained after running 900 mg and 1200 mg amiodarone solutions with TPN, the concentrations observed at 24 hours were 0.4491 ± 0.0111 mg/mL and 0.5773 ± 0.0214 mg/mL, respectively. These results represent approximately 100% of the zero-time concentrations and are within ±15% of the predicted values. No degradation products were observed in the chromatograms.
CONCLUSION
Amiodarone is physicochemically compatible with standard TPN via a Y-site administration at the tested amiodarone concentrations.

Identifiants

pubmed: 29992576
doi: 10.1002/jpen.1419
doi:

Substances chimiques

Anti-Arrhythmia Agents 0
Amiodarone N3RQ532IUT

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

298-304

Informations de copyright

© 2018 American Society for Parenteral and Enteral Nutrition.

Auteurs

Marta M Mediavilla (MM)

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Andrea Molina (A)

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Lorena Navarro (L)

Pharmacology, Toxicology and Medicinal Chemistry Department, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, 08028, Barcelona, Spain.

Laura Grau (L)

Pharmacology, Toxicology and Medicinal Chemistry Department, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, 08028, Barcelona, Spain.

M Dolors Pujol (MD)

Pharmacology, Toxicology and Medicinal Chemistry Department, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, 08028, Barcelona, Spain.

Joana Cardenete (J)

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Daniel Cardona (D)

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Pau Riera (P)

Pharmacy Department, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

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Classifications MeSH