Addition of drugs to infusion fluids: pharmaceutical considerations on preparation and use

In most hospitals, the addition of drugs to infusion fluids is carried out by nurses. The preparation involves certain hazards both microbiologically and pharmaceutically. Incompatibilities between drug and fluid or between drugs may result in admixtures which have reduced therapeutic activity or which are even hazardous to the patient. The all-in-one total parenteral nutrition mixtures represent a new way of administering nutrition and has achieved increased popularity both for in- and outpatients. During preparation, which takes place in the pharmacy, several precautions have to be taken to assure a product with acceptable stability. Some of the important incompatibilities are mentioned.