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Related Experiment Videos

Visual compatibility of 30 additives with a parenteral nutrient solution.

N Athanikar, B Boyer, R Deamer

    American Journal of Hospital Pharmacy
    |April 1, 1979
    PubMed
    Summary
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    Most drug additives are visually compatible with total parenteral nutrition (TPN) solutions. However, amphotericin B and ampicillin sodium showed incompatibility, with precipitation and particulate matter exceeding standards.

    Area of Science:

    • Pharmaceutical Science
    • Clinical Pharmacy
    • Drug Compatibility Studies

    Background:

    • Total parenteral nutrition (TPN) is crucial for patients unable to consume food orally.
    • Ensuring the stability and compatibility of drug additives in TPN solutions is vital for patient safety.
    • Previous studies have indicated potential incompatibilities between certain medications and TPN formulations.

    Purpose of the Study:

    • To assess the visual compatibility of 30 common drug additives with standard TPN solutions.
    • To evaluate the impact of these additives on TPN solution appearance, particulate matter, and pH.
    • To identify specific drug additives that pose a risk of incompatibility when mixed with TPN.

    Main Methods:

    • 30 drug additives were mixed with a standard TPN solution (4.25% amino acids, 25% dextrose).

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  • Solutions were stored under specific conditions (4°C for 22 hours, then room temperature for 2 hours).
  • Visual inspection, particulate matter analysis (using microscopy and 0.8-micrometer filters), and pH measurements were performed immediately and after 25 hours.

    • Main Results:

    • Amphotericin B caused visible discoloration and precipitation in TPN solutions.
    • Ampicillin sodium and amphotericin B samples exceeded United States Pharmacopeia (USP) particulate matter limits.
    • Tetracycline hydrochloride significantly lowered the TPN solution pH, while other additives had minimal pH impact.

    Conclusions:

    • Amphotericin B and ampicillin sodium are visually incompatible with the studied TPN solutions.
    • Most other tested drug additives demonstrated visual compatibility with TPN.
    • These findings highlight the importance of careful drug-TPN compatibility assessment to prevent adverse events.