Intravenous nitroglycerin delivery: dynamics and cost considerations.

Area of Science:

• Pharmacology and Pharmaceutics
• Intravenous Drug Delivery Systems

Background:

• Nitroglycerin (NTG) is a critical vasodilator used in various clinical settings.
• The material of intravenous (IV) administration sets can affect drug stability and delivery.
• Previous studies suggest potential adsorption of drugs to polyvinylchloride (PVC) IV sets.

Purpose of the Study:

• To evaluate the impact of PVC versus polyethylene IV administration sets on nitroglycerin (NTG) delivery accuracy.
• To determine the relative availability of NTG when infused through different IV set materials at varying rates.
• To assess the cost-effectiveness of using polyethylene IV sets for NTG infusions.

Main Methods:

• Nitroglycerin solutions were infused through PVC and polyethylene IV sets at 6, 12, and 24 ml/hour.
• Delivered NTG concentrations were quantified using high-performance liquid chromatography over 24-hour infusions.
• Relative NTG availability was calculated by comparing delivered to initial concentrations.

Main Results:

• Polyethylene IV sets demonstrated high NTG relative availability (96.3–97.3%) across all infusion rates.
• PVC IV sets showed significantly lower NTG relative availability (41.5–76.0%), varying with infusion rate.
• NTG concentration delivered through PVC sets varied considerably over time and with infusion rate.

Conclusions:

• Polyethylene IV administration sets provide accurate and consistent delivery of nitroglycerin.
• PVC IV sets lead to substantial under-delivery of nitroglycerin, impacting therapeutic efficacy.
• Polyethylene IV sets are recommended for nitroglycerin infusions to ensure accurate dosing and cost-effectiveness.