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Contamination of multidose butorphanol vials in small animal general practices
A Bell1, T T Yamaoka1, L Akil2
1School of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH.
Objectives:
To assess and quantify medetomidine contamination of butorphanol multidose vials in small animal general practices and determine if practice policies and procedures regarding drug handling, as determined by questionnaire, impact upon contamination level.
Methods:
Samples of butorphanol were withdrawn from in-use vials in participating practices in June and July 2013. Samples were analysed using high-performance liquid chromatography and mass spectrometry.
Results:
Forty-one samples were obtained from 31 practices. Contamination was detected in 29 samples from 10 mL vials. The mean (αsd) contamination was 0 · 275 (α0 · 393) µg/mL; maximum contamination in any vial was 2 · 034 µg/mL. There was no correlation between volume of the vial used and the level of contamination. None of the survey factors predicted contamination levels of the vials.
Clinical Significance:
Contamination of butorphanol multidose vials with medetomidine was common but the level of contamination was insufficient to cause detrimental effects in dogs if butorphanol were to be administered alone. The potential for sporadic higher levels of contamination must be taken into account, especially when using 50 mL vials when sedating critically ill cases, because there is a risk of clinical side effects.
Insights
Medetomidine contamination in butorphanol multidose vials is common in veterinary practices. While generally at low levels, higher contamination risks exist, especially in larger vials, potentially causing side effects in sedated animals.
Area of Science:
- Veterinary Pharmacology
- Small Animal Medicine
- Drug Safety
Background:
- Multidose vials are frequently used in veterinary practice.
- Accidental contamination between drugs can occur during vial access.
- Medetomidine and butorphanol are commonly used analgesics and sedatives in small animals.
Purpose of the Study:
- To quantify medetomidine contamination in butorphanol multidose vials.
- To investigate the impact of practice policies on contamination levels.
- To assess the risk of adverse events due to contamination.
Main Methods:
- Butorphanol samples were collected from in-use multidose vials.
- High-performance liquid chromatography and mass spectrometry were used for analysis.
- A questionnaire assessed drug handling policies in participating practices.
Main Results:
- Medetomidine contamination was detected in 29 out of 41 samples (70.7%).
- Mean contamination was 0.275 µg/mL, with a maximum of 2.034 µg/mL.
- No correlation was found between vial volume or survey factors and contamination levels.
Conclusions:
- Butorphanol vials frequently show medetomidine contamination, but levels are typically sub-clinical in dogs.
- Higher contamination levels in larger vials pose a risk for critically ill patients.
- Awareness and careful handling are crucial to minimize contamination risks.
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