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DOI: 10.1055/s-2005-836937
© Georg Thieme Verlag Stuttgart · New York
Erstellung einer Kompatibilitätstabelle für die intravenöse Pharmakotherapie auf neonatologischen und pädiatrischen Intensivstationen
Preparation of a Compatibility Chart for Intravenous Drug Therapy in Neonatal and Pediatric Intensive Care UnitsPublication History
Publication Date:
08 December 2005 (online)
Zusammenfassung
Hintergrund: Moderne Intensivtherapie in Neonatologie und Pädiatrie beinhaltet eine differenzierte Pharmakotherapie mit zahlreichen Arzneimitteln, die überwiegend intravenös verabreicht werden. Trotz des Einsatzes von mehrlumigen Zentralvenenkathetern müssen häufig weitere Venenzugänge angelegt werden. Um einerseits die Anzahl der notwendigen venösen Zugänge zu vermindern, andererseits aber mit hoher Sicherheit Komplikationen durch Inkompatibilität der infundierten Arzneimittel zu vermeiden, wurde eine Kompatibilitätstabelle erstellt, deren Spektrum über das der bisher verfügbaren Tabellen hinausgeht. Methode: Informationen zur Kompatibilität häufig verordneter Medikamente wurden durch die Auswertung der Fachinformationen der Hersteller, gebräuchlicher Handbücher sowie eine Literaturrecherche gesammelt. Ergebnis: Für 78 in der neonatologischen und pädiatrischen Intensivtherapie gebräuchliche Arzneimittel wurden die verfügbaren Daten in Form einer tabellarischen Matrix dargestellt. Neben dem pH-Wert der Substanzen wurden die getesteten Arzneimittelkombinationen entsprechend ihrer In-/Kompatibilität bei simultaner Infusion kodiert. Bei der Kodierung wurde der Schwerpunkt auf eine hohe Sicherheit in der Therapie gelegt. Schlussfolgerung: Die Kompatibilitätstabelle bietet einen schnellen Überblick über die Datenlage zu Inkompatibilitäten bei der intravenösen medikamentösen Therapie.
Abstract
Background: Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand and on the other hand to avoid complications from incompatibilities of the administered drugs, we compiled a compatibility chart, encompassing more substances than covered in previously available charts. Methods: Information on compatibility of commonly prescribed drugs was collected by analysis of manufacturers' information, medical and pharmaceutical handbooks, and a literature research. Results: Available data on compatibility of 78 drugs were displayed in a two-dimensional chart. Beside the pH of each drug, compatibility of drug combinations was encoded for simultaneous infusion. Special emphasis was on security of the therapy. Conclusion: The compatibility chart gives quick reference for Data on compatibility of intravenously administered drugs in neonatal and pediatric intensive care.
Schlüsselworte
Inkompatibilität - intravenöse Infusionen - neonatologische Intensivmedizin - pädiatrische Intensivstation
Key words
drug incompatibility - infusions - intravenous - neonatal intensive care - intensive care units - pediatric
Literatur
- 1 Akkerman S R, Zhang H, Mullins R E, Yaughn K. Stability of milrinone lactate in the presence of 29 critical care drugs and 4 i.v. solutions. Am J Health Syst Pharm. 1999; 56 63-68
- 2 Boullata J I, Gelone S P. More on usability of lorazepam admixtures for continuous infusion. Am J Health Syst Pharm. 1996; 53 2754-2755
- 3 Campbell S, Nolan P EJ, Bliss M, Wood R, Mayersohn M. Stability of amiodarone hydrochloride in admixtures with other injectable drugs. Am J Hosp Pharm. 1986; 43 917-921
- 4 Chiu M F, Schwartz M L. Visual compatibility of injectable drugs used in the intensive care unit. Am J Health Syst Pharm. 1997; 54 64-65
- 5 Colucci R D, Cobuzzi L E, Halpern N A. Visual compatibility of esmolol hydrochloride and various injectable drugs during simulated Y-site injection. Am J Hosp Pharm. 1988; 45 630-632
- 6 DeMonaco H J. Intravenous drug compatibility. Crit Care Med. 1990; 18 896
- 7 Forman J K, Souney P F. Visual compatibility of midazolam hydrochloride with common preoperative injectable medications. Am J Hosp Pharm. 1987; 44 2298-2299
- 8 Garabedian-Ruffalo S, Ruffalo R. Compatibilities and stabilities of iv preparations. Crit Care Nurse. 1989; 9 81-85
- 9 Gikic M, Di Paolo E R, Pannatier A, Cotting J. Evaluation of physicochemical incompatibilities during parenteral drug administration in a paediatric intensive care unit. Pharm World Sci. 2000; 22 88-91
- 10 Grillo J A, Gonzalez E R, Ramaiya A, Karnes H T, Wells B. Chemical compatibility of inotropic and vasoactive agents delivered via a multiple line infusion system. Crit Care Med. 1995; 23 1061-1066
- 11 Gura K M. Parenteral drug administration guidelines for the pediatric patient: one hospital's recommendations. Hosp Pharm. 1993; 28 221-228, 231
- 12 Hasegawa G R, Eder J F. Visual compatibility of dobutamine hydrochloride with other injectable drugs. Am J Hosp Pharm. 1984; 41 949-951
- 13 Hasegawa G R, Eder J F. Visual compatibility of amiodarone hydrochloride injection with other injectable drugs. Am J Hosp Pharm. 1984; 41 1379-1380
- 14 Horrow J C, Digregorio G J, Barbieri E J, Rupp E. Intravenous infusions of nitroprusside, dobutamine, and nitroglycerin are compatible. Crit Care Med. 1990; 18 858-861
- 15 Johnson C E, Bhatt-Mehta V, Mancari S C, McKown J A. Stability of midazolam hydrochloride and morphine sulfate during simulated intravenous coadministration. Am J Hosp Pharm. 1994; 51 2812-2815
- 16 Karnatz N N, Wong J, Kesler H, Baaske D M, Speicher E R. Compatibility of esmolol hydrochloride with morphine sulfate and fentanyl citrate during simulated Y-site administration. Am J Hosp Pharm. 1988; 45 368-371
- 17 Mantong M L, Marquardt E D. Visual compatibility of midazolam hydrochloride with selected drugs during simulated Y-site injection. Am J Health Syst Pharm. 1995; 52 2567-2568
- 18 Marquardt E D, Lam S S. Visual compatibility of fentanyl citrate with selected drugs during simulated Y-site injection. Am J Hosp Pharm. 1994; 51 811-812
- 19 Michaels M R, Stauffer G L, Haas D P. Propofol compatibility with other intravenous drug products: two new methods of evaluating IV emulsion compatibility. Ann Pharmacother. 1996; 30 228-232
-
20 Pecar A. Kompatibilitätstabelle. In: Nicolai T. Pädiatrische Notfall- und Intensivtherapie. 1. Aufl. Springer, Berlin, Heidelberg, New York 1999
- 21 Poirier T I, Giudici R A. Evaluation of IV compatibility microcomputer software programs. Hosp Pharm. 1991; 26 1037-1040
- 22 Pugh C B, Pabis D J, Rodriguez C. Visual compatibility of morphine sulfate and meperidine hydrochloride with other injectable drugs during simulated Y-site injection. Am J Hosp Pharm. 1991; 48 123-125
- 23 Savitsky M E. Visual compatibility of neuromuscular blocking agents with various injectable drugs during simulated Y-site injection. Am J Hosp Pharm. 1990; 47 820-821
- 24 Schröder F. Kompatibilitätsprobleme in der Intensivmedizin. Infusionsther Transfusionsmed. 1994; 21 52-58
- 25 Servais H, Tulkens P M. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients. Antimicrob Agents Chemother. 2001; 45 2643-2647
- 26 Seto W, Trope A, Carfrae L, Walker S. Visual compatibility of sodium nitroprusside with other injectable medications given to pediatric patients. Am J Health Syst Pharm. 2001; 58 1422-1426
- 27 Smythe M, Malouf E. Visual compatibility of insulin with secondary intravenous drugs in admixtures. Am J Hosp Pharm. 1991; 48 125-126
- 28 Swart E L, Mooren R A, Loenen A C. Compatibility of midazolam hydrochloride and lorazepam with selected drugs during simulated Y-site administration. Am J Health Syst Pharm. 1995; 52 2020-2022
- 29 Thompson D F, Thompson G D. Visual compatibility of esmolol hydrochloride and furosemide in 5 % dextrose or 0.9 % sodium chloride injections. Am J Hosp Pharm. 1987; 44 2740
- 30 Tounian P, Jehl F, Pauliat S, Morgant G, Ghirardi L, Selva M A. et al . Stability and compatibility of teicoplanin in parenteral nutrition solutions used in pediatrics. Clin Nutr. 1999; 18 159-165
- 31 Treadway G. Clinical safety of intravenous amrinone -a review. Am J Cardiol. 1985; 56 39 B-40 B
- 32 Trissel L A, Gilbert D L, Martinez J F. Compatibility of propofol injectable emulsion with selected drugs during simulated Y-site administration. Am J Health Syst Pharm. 1997; 54 1287-1292
-
33 Trissel L A. Handbook on Injectable Drugs. 12th ed. Nature Publishing Group, United Kingdom 2002
- 34 Vermeire A, Remon J P, Schrijvers D, Demeulenaere P. A new method to obtain and present complete information on the compatibility: study of its validity for eight binary mixtures of morphine with drugs frequently used in palliative care. Palliat Med. 2002; 16 417-424
- 35 Vogel Kahmann I, Bürki R, Denzler U, Höfler A, Schmid B, Spilsgardt H. Inkompatibilitätsreaktionen auf der Intensivstation. Anaesthesist. 2003; 52 409-412
- 36 Wedekind C A, Fidler B D. Compatibility of commonly used intravenous infusions in a pediatric intensive care unit. Crit Care Nurse. 2001; 21 45-51
- 37 Yamashita S K, Walker S E, Choudhury T, Iazzetta J. Compatibility of selected critical care drugs during simulated Y-site administration. Am J Health Syst Pharm. 1996; 53 1048-1051
- 38 Zeller F P, Anders R J. Compatibility of intravenous drugs in a coronary intensive care unit. Drug Intell Clin Pharm. 1986; 20 349-352
Dr. med. J.-H. Höpner
Interdisziplinäre pädiatrische Intensivstation · Kinderklinik und Poliklinik des Klinikum der Johannes-Gutenberg-Universität Mainz
Langenbeckstr. 1
55101 Mainz
Email: hoepner@kinder.klinik.uni-mainz.de