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Nitroglycerin delivery through a polyethylene-lined intravenous administration set.

T S Tracy¹, L Bowman, C D Black

¹Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis.

American Journal of Hospital Pharmacy

|October 1, 1989

Summary

A new polyethylene-lined (PEL) intravenous (IV) administration set significantly reduces nitroglycerin loss compared to traditional polyvinyl chloride (PVC) sets, ensuring more consistent drug delivery.

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Area of Science:

Pharmacology
Materials Science
Clinical Pharmacy

Background:

Intravenous (IV) nitroglycerin is a critical medication for various cardiovascular conditions.
Adsorption of nitroglycerin by IV administration sets can lead to underdosing and reduced therapeutic efficacy.
Polyvinyl chloride (PVC) tubing is commonly used but known to adsorb nitroglycerin.

Purpose of the Study:

To compare the adsorption and delivery of nitroglycerin using a novel polyethylene-lined (PEL) IV administration set versus a standard PVC set.
To evaluate the impact of different nitroglycerin concentrations, flow rates, and sampling times on drug loss.

Main Methods:

Nitroglycerin solutions (50, 125, 200 µg/mL in 0.9% NaCl) were infused through PEL and PVC sets at 12 and 60 mL/hr.
Drug concentrations were measured at multiple time points (0-8 hours) and sites using high-performance liquid chromatography (HPLC).

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Comparison of nitroglycerin loss between the two administration set materials.

Main Results:

The PEL set demonstrated a minimal average nitroglycerin loss of 2.3% at the distal end.
The PVC set exhibited a substantial average nitroglycerin loss of 39.7% at the distal end.
Nitroglycerin loss with the PEL set was independent of concentration, flow rate, or time, unlike the PVC set.

Conclusions:

The new polyethylene-lined (PEL) IV administration set significantly minimizes nitroglycerin adsorption compared to PVC sets.
PEL sets offer a more reliable and consistent delivery of intravenous nitroglycerin, potentially improving patient outcomes.
Further investigation is needed to understand the observed nitroglycerin loss from the admixture bottle itself.