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Albinsson E, Grönlund AB, Paulsson M, Wikström S, Ahlsson F. Unpredictable supplementation of vitamin D to infants in the neonatal intensive care unit: An experimental study. Acta Paediatr 2024. [PMID: 38972986 DOI: 10.1111/apa.17351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024]
Abstract
AIM Extremely premature infants receive nutrition and medication through nasogastric tubes. Breastmilk given accordingly is subject to fat loss. This study aimed to investigate whether this could also apply to vitamin D. METHODS A questionnaire investigated vitamin D administration at a level III neonatal intensive care unit in Sweden in 2021. Feeding simulations with breastmilk and various vitamin D mixtures were done accordingly. After administration, vitamin D3 concentration was analysed using chromatography with mass spectrometry, followed by repeated simulations with vitamin D mixtures without breastmilk in 2023. RESULTS The questionnaire was completed by 10 persons. Vitamin D was administered as drops using an enteral syringe and a nasogastric tube in conjunction with a breastmilk meal. In the feeding simulations, vitamin D3 concentration after administration was significantly higher using a syringe alone compared to standard administration. When vitamins were administered according to standard but without breastmilk, 100% of the vitamin D and 40% of the multivitamins were lost. The vitamins adhered to the material, mainly in the nasogastric tube. CONCLUSION Our findings indicate that standard vitamin D supplementation in the neonatal intensive care unit may be unpredictable when administered by enteral syringe and nasogastric tube. We suggest using direct oral administration whenever possible.
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Affiliation(s)
- Eva Albinsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research and Education, County Council of Värmland, Karlstad, Sweden
| | | | - Mattias Paulsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sverre Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research and Education, County Council of Värmland, Karlstad, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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2
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Correa-Soto CE, Sengupta R, Gonzales I, Schupp S, Bejgum B, Alvarez-Nunez F, Kiang YH. Mechanistic Insights into Propylparaben Sorption on Polyvinyl Chloride. J Pharm Sci 2024:S0022-3549(24)00124-2. [PMID: 38580143 DOI: 10.1016/j.xphs.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
The mechanism of loss of propylparaben potency from formulations when in contact with polyvinyl chloride has been determined. It is caused by the adsorption of propylparaben onto polyvinyl chloride surfaces. The adsorption kinetics is best described using a pseudo-second order model based on non-linear fit. The rate of adsorption increases with increasing bulk concentration of propylparaben. Adsorption equilibrium isotherm was fitted to three isotherm models: Langmuir, Freundlich, and Temkin, using non-linear fit. The Freundlich and Temkin models show the best fit, indicating a multi-layer adsorption. Using this case study, we present a methodology to provide mechanistic insights into the compatibility data between pharmaceutical ingredients and product contact materials when sorption is involved.
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Affiliation(s)
- Clara E Correa-Soto
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Rajarshi Sengupta
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
| | - Isaiah Gonzales
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Sydney Schupp
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Bhanu Bejgum
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
| | - Fernando Alvarez-Nunez
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Y-H Kiang
- Drug Product Technologies, Process Development, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
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3
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Schwartz C, Comet M, Lallemand B, Vince M, Ott AK, Schnell F, Bonnet B, Spitzer D. Nitroglycerin trapping in melamine matrices. Heliyon 2023; 9:e20306. [PMID: 37809411 PMCID: PMC10560045 DOI: 10.1016/j.heliyon.2023.e20306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Melamine (Mel) was used as host matrix for liquid nitroglycerin (NG), to prepare Mel/NG solid powdered compounds containing up to 45 wt% of this explosive. The two preparation processes used for this purpose consisted in evaporating a solution of both components, either in ambient conditions or under reduced pressure by the Spray Flash-Evaporation (SFE) process. In Mel/NG materials, amorphous nitroglycerin is distributed in the crystallized melamine matrix as inclusions, which were found to be smaller in size in the material prepared by the SFE process. Mel/NG materials are not stable over time: they gradually lose the nitroglycerin they contain by evaporation.
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Affiliation(s)
- Cédric Schwartz
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Marc Comet
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Bastien Lallemand
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Maxence Vince
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Anna K. Ott
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Fabien Schnell
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Benjamin Bonnet
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
| | - Denis Spitzer
- NS3E Laboratory – UMR 3208 (ISL-CNRS-UNISTRA), French-German Research Institute of Saint-Louis, BP 70034, 68301 Saint Louis Cedex, France
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4
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A proof of principle study using radiopharmaceuticals to quantify and localize container-content interactions in medical syringes. Sci Rep 2023; 13:2721. [PMID: 36792806 PMCID: PMC9932089 DOI: 10.1038/s41598-023-29923-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The sorption of drugs onto their contents is a known phenomenon that is difficult to analyse precisely. The purpose of this study was to present a non-invasive method for locating and quantifying sorption phenomena using radiopharmaceuticals. Radiopharmaceutical are medicines armed with a radionuclide enabling quantification and imaging using dedicated scanners. The sorption of nine different radiopharmaceuticals on 2- and 3-part syringes was investigated. These syringes were filled with the studied radiopharmaceutical solutions and stored immobile for 3 h. At different times ranging from 0 to 180 min, 10 µL were taken from the syringes and the radioactivity of these samples was determined by a gamma counter. 5 radiopharmaceuticals exhibited no significant sorption at any time point in both 2 and 3-parts syringes, but 4 radiopharmaceuticals exhibited sorption losses varying from 20 to 33% after 3 h contact with 3-part-syringes, but no sorption on 2-part syringes at any time point. [99mTc]Tc-tetrofosmine Single Photon Emission Computed Tomography/Computed Tomography imaging indicated clearly that the interactions were located on the rubber plunger of the 3-part-syringes. The specific nature of radiopharmaceuticals allowed their use as an innovative method to quantify and localize drug sorption phenomena.
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5
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Rodríguez Fernández MJ, Serrano Lopez DR, Torrado JJ. Effect of Primary Packaging Material on the Stability Characteristics of Diazepam and Midazolam Parenteral Formulations. Pharmaceutics 2022; 14:pharmaceutics14102061. [PMID: 36297493 PMCID: PMC9611996 DOI: 10.3390/pharmaceutics14102061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Diazepam and midazolam are formulated in autoinjectors for parenteral administration to decrease seizures in the case of emergency. However, the compatibility of these lipophilic drugs with the primary packaging material is a key part of drug formulation development. In this work, diazepam and midazolam were packaged in glass syringes as parenteral solutions using two different elastomeric sealing materials (PH 701/50 C BLACK and 4023/50 GRAY). Syringes were stored at three different storage temperatures: 4, 25, and 40 °C. At different time points over 3 years, physical appearance, benzodiazepine sorption on the sealing elastomeric materials, and drug content in solution were assayed. A detailed study on the adsorption profile of both benzodiazepines on the elastomeric gaskets was performed, indicating that the novel rubber material made of bromobutyl derivatives (4023/50 GRAY) is a better choice for manufacturing autoinjectors due to lower drug adsorption. Diazepam showed a better stability profile than midazolam, with the latter solubilised as a hydrochloride salt in an acidic pH that can affect the integrity of the elastomer over time. The amount of drug adsorbed on the surface of the elastomer was measured by NIR and correlated using chemometric models with the amount retained in the elastomeric gaskets quantified by HPLC.
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Affiliation(s)
- María José Rodríguez Fernández
- Defense Military Pharmacy Center (CEMILFARDEF), Colmenar Viejo, 28770 Madrid, Spain
- Quick Identification Laboratory, Military Emergency Unit, Torrejón de Ardoz, 28850 Madrid, Spain
| | - Dolores Remedios Serrano Lopez
- Department of Pharmaceutics, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- Institute of Industrial Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: (D.R.S.L.); (J.J.T.)
| | - Juan José Torrado
- Department of Pharmaceutics, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- Institute of Industrial Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: (D.R.S.L.); (J.J.T.)
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6
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Gopinath PM, Parvathi VD, Yoghalakshmi N, Kumar SM, Athulya PA, Mukherjee A, Chandrasekaran N. Plastic particles in medicine: A systematic review of exposure and effects to human health. CHEMOSPHERE 2022; 303:135227. [PMID: 35671817 DOI: 10.1016/j.chemosphere.2022.135227] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/15/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Single-use plastics (SUPs) have become an essential constituent of our daily life. It is being exploited in numerous pharmaceutical and healthcare applications. Despite their advantages and widespread use in the pharma and medical sectors, the potential clinical problems of plastics, especially the release of micro-nanoplastics (MNPs) and additives from medical plastics (e.g. bags, containers, and administrative sets) and sorption of drugs remain understudied. Certainly, the MNPs are multifaceted stressors that cause detrimental effects to the ecosystem and human health. The origin and persistence of MNPs in pharmaceutical products, their administration to humans, endurance and possible health implication, translocation, and excretion have not been reviewed in detail. The prime focus of this article is to conduct a systematic review on the leaching of MNPs and additives from pharmaceutical containers/administrative sets and their interaction with the pharmaceutical constituents. This review also explores the primary and secondary routes of MNPs entry from healthcare plastic products and their potential health hazards to humans. Furthermore, the fate of plastic waste generated in hospitals, their disposal, and associated MNPs release to the environment, along with preventive, and alternative measures are discussed herein.
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Affiliation(s)
| | - Venkatachalam Deepa Parvathi
- Department of Biomedical Sciences, Faculty of Biomedical Sciences, Technology and Research, SRIHER: Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra University, Chennai 600116, Tamil Nadu, India
| | - Nagarajan Yoghalakshmi
- Department of Biomedical Sciences, Faculty of Biomedical Sciences, Technology and Research, SRIHER: Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra University, Chennai 600116, Tamil Nadu, India
| | - Srinivasan Madhan Kumar
- Department of Biomedical Sciences, Faculty of Biomedical Sciences, Technology and Research, SRIHER: Sri Ramachandra Institute of Higher Education and Research, Sri Ramachandra University, Chennai 600116, Tamil Nadu, India
| | | | - Amitava Mukherjee
- Centre for Nanobiotechnology, Vellore Institute of Technology (VIT), Tamil Nadu, Vellore, 632 014, India
| | - Natarajan Chandrasekaran
- Centre for Nanobiotechnology, Vellore Institute of Technology (VIT), Tamil Nadu, Vellore, 632 014, India.
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Zuccari G, Macis S, Alfei S, Marchitto L, Russo E. The Role of the Pharmacist in Selecting the Best Choice of Medication Formulation in Dysphagic Patients. J Pers Med 2022; 12:jpm12081307. [PMID: 36013259 PMCID: PMC9410388 DOI: 10.3390/jpm12081307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Usually, the administration of drugs by feeding tube in dysphagic patients involves handling of marketing licenses outside their term, due to the lack of suitable formulations. This circumstance has put health professionals in the dilemma of choosing the formulation whose manipulation possibly does not alter the effectiveness of the drug. In this regard, a practical guide providing indications on the prescription, handling, and administration of drugs through enteral feeding tube could be of paramount utility. For this purpose, we have considered the 1047 solid oral pharmaceutical forms included in the formulary of San Paolo Hospital (Savona, Italy). From our analysis, it emerges that 95% of medicinal products are worryingly used off-label and 40% have to be managed by the hospital pharmacists without having suitable indications by either the manufacturers or by literature studies. To fill this gap, we have compiled a detailed table containing missing indications derived from pharmacist expertise and evidence-based practices, with the aim that the sharing of our procedures will contribute to make uniform pharmacological therapies from one hospital to another. This study will allow doctors to have easy access to information on drugs that can be prescribed and nurses to become familiar only with the pharmaceutical forms that can be administered.
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Affiliation(s)
- Guendalina Zuccari
- Department of Pharmacy, University of Genoa, Viale Cembrano, 16148 Genoa, Italy
- Correspondence: (G.Z.); (E.R.)
| | - Sara Macis
- Hospital Pharmacy, Department Technical Health, San Paolo Hospital, Via Genova, 17100 Savona, Italy
| | - Silvana Alfei
- Department of Pharmacy, University of Genoa, Viale Cembrano, 16148 Genoa, Italy
| | - Leonardo Marchitto
- Department of Sciences for the Quality of Life, University of Bologna, Corso D’Augusto 237, 47921 Rimini, Italy
| | - Eleonora Russo
- Department of Pharmacy, University of Genoa, Viale Cembrano, 16148 Genoa, Italy
- Correspondence: (G.Z.); (E.R.)
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8
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Boukoufi C, Boudier A, Maincent P, Vigneron J, Clarot I. Food-inspired innovations to improve the stability of active pharmaceutical ingredients. Int J Pharm 2022; 623:121881. [PMID: 35680111 DOI: 10.1016/j.ijpharm.2022.121881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 11/25/2022]
Abstract
Food-processing and pharmaceutical industries share a lot of stability issues against the same physical, chemical, and microbiological phenomena. They also share some solutions to improve the stability as the use of preservatives and packaging. Ecological concerns lead to the development of tremendous innovations in food. Some of these innovations could also be beneficial in the pharmaceutical domain. The objective of this review is to evaluate the potential application of these findings in the pharmaceutical field and the main limits in terms of toxicity, environmental, economic and regulatory issues. The principal factors influencing the shelf-life were highlighted through the description of the stability studies usually performed in the pharmaceutical industry (according to European guidelines). To counter those factors, different solutions are currently available as preservatives and specific packaging. They were described and debated with an overview of recent food innovations in each field. The limits of the current solutions in the pharmaceutical field and the innovation in the food field have inspired a critical pharmaceutical outlook. The active and intelligent packaging for active pharmaceutical ingredients of the future is imagined.
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Affiliation(s)
- Célia Boukoufi
- Université de Lorraine, CITHEFOR, F-54000 Nancy, France; Pharmacy Department, University Hospital, 54511 Vandoeuvre-lès-Nancy, France
| | | | | | - Jean Vigneron
- Pharmacy Department, University Hospital, 54511 Vandoeuvre-lès-Nancy, France
| | - Igor Clarot
- Université de Lorraine, CITHEFOR, F-54000 Nancy, France.
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Tokhadzé N, Sahnoune M, Devémy J, Dequidt A, Goujon F, Chennell P, Sautou V, Malfreyt P. Insulin Adsorption onto PE and PVC Tubings. ACS APPLIED BIO MATERIALS 2022; 5:2567-2575. [PMID: 35549028 DOI: 10.1021/acsabm.2c00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We investigate the adsorption of insulin onto PE and PVC materials by using HPLC measurements and computer simulations. We interpret the experiments by calculating the Gibbs free energy profiles during the adsorption process. The values of free energy of adsorption show a good agreement with the experimental measurements. The adsorption of insulin onto the different materials is characterized through the conformational changes with respect to its conformation in water and the interfacial regions, which are described by specific arrangements of polymer chains, water, insulin, and plasticizer molecules.
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Affiliation(s)
- Nicolas Tokhadzé
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Meriem Sahnoune
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Julien Devémy
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Alain Dequidt
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Florent Goujon
- Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont Auvergne INP, CNRS, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Philip Chennell
- Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont Auvergne INP, CNRS, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Valérie Sautou
- Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont Auvergne INP, CNRS, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Patrice Malfreyt
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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10
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Physicochemical Stability Study of the Morphine-Ropivacaine-Ziconotide Association in Implantable Pumps for Intrathecal Administration. Neuromodulation 2022:S1094-7159(21)06177-8. [PMID: 35088750 DOI: 10.1016/j.neurom.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/26/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to investigate the physicochemical stability of morphine-ropivacaine-ziconotide mixtures used in intrathecal analgesia. MATERIALS AND METHODS Eight mixtures were studied to assess their stability profiles according to the initial drug concentrations used. The solutions obtained were put in implantable pumps and stored at 37 °C over a period of 60 days. Assays were performed using ultra high-pressure liquid chromatography. Turbidity and pH were also measured throughout the study. RESULTS Results confirmed excellent physicochemical stability for morphine and ropivacaine. Concerning ziconotide, three of the eight mixtures did not show any sign of chemical instability: average concentrations remained constant throughout the 60 days. A decrease of the concentration was observed for the five other mixtures. Moreover, the appearance of a degradation product linked to oxidation confirmed the ziconotide degradation. CONCLUSIONS All these results are in favor of a physicochemical stable preparation for three of the mixture profiles when stored in implantable pumps at 37 °C up to 60 days. For the five others, the efficacy should decrease over time owing to the degradation of ziconotide. The decrease in kinetics of the ziconotide concentration depends on the mixing profile. One possibility is to adapt the filling intervals according to the profile of the mixture. Finally, the results show the period of stability ensuring maximum analgesic efficacy for the eight mixture profiles studied.
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Tokhadzé N, Chennell P, Pereira B, Mailhot-Jensen B, Sautou V. Critical Drug Loss Induced by Silicone and Polyurethane Implantable Catheters in a Simulated Infusion Setup with Three Model Drugs. Pharmaceutics 2021; 13:pharmaceutics13101709. [PMID: 34684002 PMCID: PMC8539077 DOI: 10.3390/pharmaceutics13101709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022] Open
Abstract
Silicone and polyurethane are biocompatible materials used for the manufacture of implantable catheters, but are known to induce drug loss by sorption, causing potentially important clinical consequences. Despite this, their impact on the drugs infused through them is rarely studied, or they are studied individually and not part of a complete infusion setup. The aim of this work was to experimentally investigate the drug loss that these devices can cause, on their own and within a complete infusion setup. Paracetamol, diazepam, and insulin were chosen as models to assess drug sorption. Four commonly used silicone and polyurethane catheters were studied independently and as part of two different setups composed of a syringe, an extension set, and silicone or polyurethane implantable catheter. Simulated infusion through the catheter alone or through the complete setup were tested, at flowrates of 1 mL/h and 10 mL/h. Drug concentrations were monitored by liquid chromatography, and the silicone and polyurethane materials were characterized by ATR-IR spectroscopy and Zeta surface potential measurements. The losses observed with the complete setups followed the same trend as the losses induced individually by the most sorptive device of the setup. With the complete setups, no loss of paracetamol was observed, but diazepam and insulin maximum losses were respectively of 96.4 ± 0.9% and 54.0 ± 5.6%, when using a polyurethane catheter. Overall, catheters were shown to be the cause of some extremely high drug losses that could not be countered by optimizing the extension set in the setup.
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Affiliation(s)
- Nicolas Tokhadzé
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000 Clermont-Ferrand, France; (N.T.); (V.S.)
| | - Philip Chennell
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000 Clermont-Ferrand, France; (N.T.); (V.S.)
- Correspondence:
| | - Bruno Pereira
- CHU Clermont-Ferrand, Unité de biostatistiques, DRCI, F-63000 Clermont-Ferrand, France;
| | | | - Valérie Sautou
- Université Clermont Auvergne, CHU Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, F-63000 Clermont-Ferrand, France; (N.T.); (V.S.)
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12
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[Infusion sets in neonatology: What practices in France?]. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:584-596. [PMID: 34487699 DOI: 10.1016/j.pharma.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/27/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Therapeutic management of ill newborns can require complex infusion practices using medical devices (MD). Currently, there does not exist any recommendations concerning these infusion practices. The objective of this work was to study and characterise French infusion methods neonatal and neonatal intensive care units. MATERIALS AND METHODS The study was performed in 2019, during 6 months. French hospitals possessing high (type 3) or medium (type 2B) grade maternity ward were contacted and asked to complete a 5 part online survey, to gather general information about the hospital/ward, infusion methods (overall and detailed), and detailed information about the medications and MD used. RESULTS The participation level was of 19.6 % Type 3 maternities use overall two-times more MD than those of type 2B. The vascular access device most commonly used was a single lumen catheter (80.6 % of infusion methods). 100 % of the hospitals having answered used multi-access devices (three-way tap, multiport infusion manifold, Y-extension lines) and 93.5 % used a pump-infusor. Lipidic filters for parenteral nutrition were used in 78.6 % of the hospitals. Two general standard of infusion methods were isolated: a simple version with two access points (type 2B hospitals), and a complex one with five access points (from hospitals with type 3 maternities). CONCLUSIONS Neonatal infusion practices in France are very heterogeneous, thus exposing the patients to a degree of variability during their therapeutic management. This work is a first step forwards to help analyse and anticipate the risks of content/container interactions caused by infusion practices.
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13
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Sahnoune M, Tokhadzé N, Devémy J, Dequidt A, Goujon F, Chennell P, Sautou V, Malfreyt P. Understanding and Characterizing the Drug Sorption to PVC and PE Materials. ACS APPLIED MATERIALS & INTERFACES 2021; 13:18594-18603. [PMID: 33861563 DOI: 10.1021/acsami.1c03284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Characterizing the sorption of drugs onto polyvinylchloride (PVC) and polyethylene (PE) materials in terms of thermodynamic adsorption properties and atomistic details (local arrangements, orientation, and diffusion) is fundamental for the development of alternative materials that would limit drug sorption phenomena and plasticizer release. Here, a combination of experiments and sophisticated calculations of potential of mean forces are carried out to investigate the sorption of paracetamol and diazepam to PE and PVC surfaces. The simulated Gibbs free energies of adsorption are in line with the experimental interpretations. The polymer-drug-water interface is then characterized at the molecular scale by an in-depth investigation of local properties such as density, orientation, and diffusion.
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Affiliation(s)
- Meriem Sahnoune
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Nicolas Tokhadzé
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Julien Devémy
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Alain Dequidt
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Florent Goujon
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Philip Chennell
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Valérie Sautou
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Patrice Malfreyt
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut de Chimie de Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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Maiguy‐Foinard A, Masse M, Degoutin S, Genay S, Chai F, Barthélémy C, Odou P, Blanchemain N, Décaudin B. To what extent do the storage conditions of polyether‐based polyurethane have an impact on diazepam delivery? J Appl Polym Sci 2020. [DOI: 10.1002/app.49333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aurélie Maiguy‐Foinard
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Morgane Masse
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Stéphanie Degoutin
- Université Lille, CNRS, INRA, ENSCL UMR8207, Unité Matériaux et Transformations (UMET) Lille France
| | - Stéphanie Genay
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Feng Chai
- Université Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials Lille France
| | - Christine Barthélémy
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Pascal Odou
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Nicolas Blanchemain
- Université Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials Lille France
| | - Bertrand Décaudin
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
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Falk YZ, Runnsjö A, Pettigrew A, Scherer D, Engblom J, Kocherbitov V. Interactions of Perfluorohexyloctane With Polyethylene and Polypropylene Pharmaceutical Packaging Materials. J Pharm Sci 2020; 109:2180-2188. [PMID: 32240694 DOI: 10.1016/j.xphs.2020.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 11/19/2022]
Abstract
Semifluorinated alkanes (SFAs) are aprotic solvents, which may be used as drug solvents for topical ocular applications, for instance, in dry eye syndrome. Their physical properties suggest that they might be prone to interaction with plastic materials, such as, polyethylene (PE) and polypropylene (PP), which are commonly used as packaging materials for pharmaceutical products. In this study, we investigate interactions of PE and PP with a liquid SFA perfluorohexyloctane (PFHO) using differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and cross-polarized light microscopy. Binary phase diagrams of PFHO-PE and PFHO-PP systems demonstrating interactions of PFHO with the polymeric materials were constructed based on DSC data. According to this data, PFHO tends to lower the melting temperatures of PE and PP. The equilibrium values of solubilities of the polymers in PFHO and PFHO in the polymers were obtained by extrapolation of melting enthalpy data. Absorption of PFHO by PE and PP materials at ambient conditions after 4 weeks of equilibration was also studied by TGA. From the presented results, it may be concluded that thorough studies of interactions of PE or PP with SFAs are required when these materials are used as packaging components in SFA-based formulations.
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Affiliation(s)
- Yana Znamenskaya Falk
- Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06 Malmö, Sweden
| | - Anna Runnsjö
- Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06 Malmö, Sweden
| | | | | | - Johan Engblom
- Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06 Malmö, Sweden
| | - Vitaly Kocherbitov
- Biomedical Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden; Biofilms - Research Center for Biointerfaces, Malmö University, SE-205 06 Malmö, Sweden.
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Tokhadze N, Chennell P, Bernard L, Lambert C, Pereira B, Mailhot-Jensen B, Sautou V. Impact of alternative materials to plasticized PVC infusion tubings on drug sorption and plasticizer release. Sci Rep 2019; 9:18917. [PMID: 31831771 PMCID: PMC6908714 DOI: 10.1038/s41598-019-55113-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/19/2019] [Indexed: 11/09/2022] Open
Abstract
Medical tubings in plasticized polyvinylchloride (PVC) are widely used for the infusion of medications but are known in some cases to cause content-container interactions (drug sorption and plasticizer release). The aim of this study was to assess interactions between drugs and five alternative materials to a reference plasticized PVC intravenous (IV) infusion tubing: three were PVC coextruded with polyethylene (PE), polyurethane (PU) or a thermoplastic elastomer (Styrene-EthyleneButadiene-Styrene (SEBS)) and two were SEBS or thermoplastic olefin (TPO) monolayer tubings. Diazepam and insulin were chosen as respective reference of absorption and adsorption while paracetamol acted as a negative control. The concentration of each drug was quantified with liquid chromatography to evaluate a potential loss after a static contact condition and simulated infusion at 1 mL/h and 10 mL/h dynamic condition by an electric syringe pump. A characterization of each material's surface was performed by Fourier transform infrared spectroscopy in attenuated total reflection mode (ATR-FTIR) and by measurement of surface zeta potential. Plasticizer release was quantified by gas chromatography coupled with mass spectrometry (GC-MS). For all tubings except PVC/PU, no loss of paracetamol was observed in any condition. Diazepam sorption appeared to be less important with PVC/PE, PVC/SEBS, SEBS and TPO tubings than with PVC, but was more important when using PVC/PU tubings. PVC tubings induced the least loss of insulin amongst all the studied materials. Surface analysis by ATR-FTIR highlighted the presence of a plasticizer (that could be attributed to Tris (2-Ethylhexyl) Trimellitate (TOTM)) in the coextruded SEBS layer of PVC/SEBS, which could have influenced drug sorption, probably as a consequence of a migration from the PVC layer. Coextruded PVC/SEBS and PVC/PE presented the lowest zeta potential of all studied materials with respective values of -39 mV and -36 mV and were related to the highest sorption of insulin while PVC/PU with the highest zeta potential (about -9 mV) presented the highest absorption of diazepam. Coextruded layered materials appeared to have a lower plasticizer release than PVC alone. As a conclusion, PVC/PE and thermoplastic elastomers alone or coextruded with PVC could be interesting alternatives to PVC tubings with regards to sorption phenomena and plasticizer release.
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Affiliation(s)
- N Tokhadze
- Universite Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, F-63000, Clermont-Ferrand, France
| | - P Chennell
- Universite Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, F-63000, Clermont-Ferrand, France.
| | - L Bernard
- Universite Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, F-63000, Clermont-Ferrand, France
| | - C Lambert
- Unité De Biostatistiques (Délégation à La Recherche Clinique Et à l'Innovation), CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - B Pereira
- Unité De Biostatistiques (Délégation à La Recherche Clinique Et à l'Innovation), CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - B Mailhot-Jensen
- Universite Clermont Auvergne, CNRS, SIGMA Clermont, ICCF, F-63000, Clermont-Ferrand, France
| | - V Sautou
- Universite Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, F-63000, Clermont-Ferrand, France
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Reber E, Messerli M, Stanga Z, Mühlebach S. Pharmaceutical Aspects of Artificial Nutrition. J Clin Med 2019; 8:jcm8112017. [PMID: 31752291 PMCID: PMC6912726 DOI: 10.3390/jcm8112017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022] Open
Abstract
Artificial nutrition, including enteral (EN) and parenteral (PN) nutrition, is indicated whenever adequate oral nutrition fails to sufficiently supply the necessary nutrients to the body. It is a convenient, efficacious, safe, and well-tolerated form of clinical nutrition in the hospital and home setting. EN is administered via nasogastric tube or ostomies while PN usually requires a central venous access for administration, straight into the blood stream. The infused nutrients can then be taken up directly by the different organs. PN is targeted as a single daily portion formulated as an oil-in-water emulsion providing the necessary substrates for the catabolic and anabolic metabolism including macro- and micronutrients and fluids. PN has a complex pharmaceutical composition-all-in-one admixture-and its compounding or ready-to-use preparation. The use of PN is more challenging and more expensive compare to the use of EN, commercially available as ready-to-use formulations. EN and concomitant medication is highly challenging. Upon incorrect handling and administration, PN is associated with potentially severe or even fatal complications, mostly relating to the central venous access (e.g., catheter-related sepsis) or to a metabolic intolerance (e.g., hyperglycemia, refeeding syndrome) because of inappropriate administration. A correct order of admixing, correct dosing, and administration of the artificial is crucial for safety and efficacy; clinical and biochemical monitoring of the patient and treatment regimen adaption are necessary. The high number of reactive solutes allow only limited stability of a ready-to-use PN admixture. The potential for numerous incompatibilities and interactions renders PN admixtures generally unsuitable as drug vehicle. Laboratory compatibility and stability testing and pharmaceutical expertise are a prerequisite to define the PN composition including nutrients or even drugs admixed to define the appropriate and individualized nutrition and medication regimen. The aim of this narrative review is to present the actual state-of-the-art to deliver best quality artificial nutrition with special regard on pharmaceutical aspects such as instabilities, incompatibilities, and concomitant co-medication.
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Affiliation(s)
- Emilie Reber
- Department for Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, 3010 Bern, Switzerland;
- Correspondence:
| | - Markus Messerli
- Department of Pharmaceutical Sciences, Pharmaceutical Care Research Group, University of Basel, 4050 Basel, Switzerland;
| | - Zeno Stanga
- Department for Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, 3010 Bern, Switzerland;
| | - Stefan Mühlebach
- Department of Pharmaceutical Sciences, Division of Clinical Pharmacy & Epidemiology/Hospital Pharmacy, University of Basel, 4050 Basel, Switzerland;
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Ezquer-Garin C, Ferriols-Lisart R, Alós-Almiñana M. Stability of mycophenolate mofetil in polypropylene 5% dextrose infusion bags and chemical compatibility associated with the use of the Equashield ® closed-system transfer device. Biomed Chromatogr 2019; 33:e4529. [PMID: 30845352 DOI: 10.1002/bmc.4529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 11/09/2022]
Abstract
Stability studies are necessary in healthcare settings as they facilitate fast, cost-effective and efficient work related to batch manufacturing and availability of supplies. We studied the stability of 1-10 mg/mL mycophenolate mofetil (MMF) in polypropylene 5% dextrose infusion bags prepared from Cellcept® and with a generic brand name (Micofenolato de Mofetilo Accord) at different storage temperatures. To ensure chemical compatibility during preparation, we also tested MMF sorption to the Equashield® closed-system drug transfer device used in this step. For this, a validated stability-indicating high-performance liquid chromatography method was developed for the quantification and identification of MMF in the infusion bags. The analytical selectivity of the assay was determined by subjecting an MMF sample to extreme values of pH, oxidative stress and heat conditions to force degradation. Protected from light, 1-10 mg/mL MMF in infusion polypropylene bags prepared from reconstituted Cellcept® 500 mg or Accord 500 mg in 5% dextrose was stable for at least 35 days when stored at 2-8°C or between -15 and -25°C, and for 14 days when stored at 25°C. MMF loss owing to chemical sorption to the Equashield® closed-system drug transfer device set was negligible.
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Affiliation(s)
- Carlos Ezquer-Garin
- Institute for Health Research (INCLIVA), Clinical University Hospital of Valencia, Spain
| | - Rafael Ferriols-Lisart
- Institute for Health Research (INCLIVA), Clinical University Hospital of Valencia, Spain.,Department of Pharmacy, University of Valencia, Valencia, Spain
| | - Manuel Alós-Almiñana
- Institute for Health Research (INCLIVA), Clinical University Hospital of Valencia, Spain.,Department of Pharmacy, University of Valencia, Valencia, Spain
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Zdravkovic SA. Assessment of Patient Exposure to Leachables From Lyophilized Drug Formulations Following Reconstitution, Storage, and Administration via Polymeric Packaging/Delivery Systems. J Pharm Sci 2018; 107:2837-2846. [PMID: 30005987 DOI: 10.1016/j.xphs.2018.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/04/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
It has been demonstrated that lyophilized drug formulations have an increased propensity to leach substances from the rubber stoppers comprising their primary packaging system when compared to aqueous liquid formulations stored in the same manner. Unfortunately, patient exposure to leachables originating in lyophilized drug products is not known. To that end, the goal of this study was to assess patient exposure to these leachables after reconstitution, storage, and administration of the lyophilized drug. To achieve this goal, several leachables present in 2 commercial lyophilized drug products were quantified after contact with polyvinyl chloride and non-polyvinyl chloride medication bags as well as an infusion set for durations of 15 min to 7 days at refrigerated and ambient temperature. The results obtained from this study showed that the bag's material of construction and the drugs formulation did not impact the mass of the leachables administered. Conversely, the mass of each leachable administered to the patient was reduced or eliminated as the contact duration with the intravenous bag and the temperature increased. However, for shorter contact durations, refrigerated storage, and higher molecular weight compounds, the patient would be exposed to a majority of the leachables originating from the vial.
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Affiliation(s)
- Steven A Zdravkovic
- Pharmaceutical Product Development, Inc., 8551 Research Way, Suite 90, Middleton, Wisconsin 53562.
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Kim CO, Song J, Min JY, Park SJ, Lee HM, Byon HJ. A comparison of the pharmacokinetic and pharmacodynamic properties of nitroglycerin according to the composition of the administration set: A preliminary study. Medicine (Baltimore) 2018; 97:e9829. [PMID: 29489681 PMCID: PMC5851736 DOI: 10.1097/md.0000000000009829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a risk of drug sorption into an intravenous administration set composed of polyvinyl chloride (PVC), polyurethane (PU), or polyolefin (PO). This has implications on the dose of the active ingredient the patient receives, and thus therapeutic success. This study aimed to determine the plasma concentration of nitroglycerin and the effect of nitroglycerin on patients based on the composition of the administration set. METHODS Using a randomized, open-labeled, 3 × 3 crossover method, 9 volunteers were assigned to 3 groups. In period I, nitroglycerin (100 μg/mL) was infused via a PVC- (group A), PU- (group B), or PO-based (group C) administration set. In period II, PU- (group A), PO- (group B), and PVC-based (group C) administration sets were used, and in period III, PO- (group A), PVC- (group B), and PU-based (group C) administration sets were used. The rate of drug administration in all periods was 12 mL/hour for 30 minutes using an infusion pump. Blood samples were collected, and the plasma concentrations of nitroglycerin were analyzed using validated high-performance liquid chromatography coupled with tandem mass spectrometry. Blood pressure was determined using a sphygmomanometer applied to the other upper arm at an interval of 5 minutes. RESULTS We observed that the mean plasma concentration of nitroglycerin over time when administered using a PO-based tube was higher than that when using a PU- or PVC-based tube. When the percent change of the mean arterial pressure from baseline at each time point was compared among groups, there were statistically significant differences between PU and PO or PVC at most points during nitroglycerin infusion. CONCLUSION Our results showed higher nitroglycerin plasma concentration and lower arterial pressure when a PO-based administration set was used than when a PVC- or PU-based administration set was used. PO-based administration sets may be more appropriate for nitroglycerin administration compared to those composed of PVC or PU.
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Affiliation(s)
- Choon Ok Kim
- Department of Clinical Pharmacology and Clinical Trials Center, Severance Hospital, Yonsei University Health System, Seodaemun-gu, Seoul
| | - Jeongyun Song
- Department of Anesthesiology and Pain Medicine, Yeoncheon Public Health Center, Yeoncheon-gun, Gyeonggi-do
| | - Ji Young Min
- Department of Anesthesiology and Pain Medicine
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | | | - Hye Mi Lee
- Department of Anesthesiology and Pain Medicine
| | - Hyo-Jin Byon
- Department of Anesthesiology and Pain Medicine
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
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Jin SE, Park JW, Baek H, Jeon S, Park SW, Hwang SJ. Evaluation of nitroglycerin and cyclosporin A sorption to polyvinylchloride- and non-polyvinylchloride-based tubes in administration sets. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2017. [DOI: 10.1007/s40005-017-0364-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jin SE, Jeon S, Byon HJ, Hwang SJ. Evaluation of tacrolimus sorption to PVC- and non-PVC-based tubes in administration sets: Pump method vs. drip method. Int J Pharm 2017; 528:172-179. [PMID: 28549974 DOI: 10.1016/j.ijpharm.2017.05.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/16/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
Abstract
Tacrolimus sorption to tubes was evaluated using pump and drip methods For tubes, polyvinylchloride (PVC)- and non-PVC-based (polyurethane [PU] and polyolefin [PO]) tubes were used. First, inner surface properties of tubes were analyzed using field emission scanning electron microscopy and X-ray photoelectron spectroscopy. Tacrolimus was quantitatively analyzed using high-performance liquid chromatography with UV detection. For kinetic sorption analysis, diluted tacrolimus to 10μg/mL was passed through 1-m-long tubes at 10mL/h. Samples were collected at 1-4h. The inner surface of PO-based tubes was relatively smooth and soft compared with those of PVC- and PU-based tubes. Atomic compositions of tubes matched chemical formulas of polymers excluding low-level impurity in PVC-based tubes. Tacrolimus was successfully analyzed and linearly determined at 2.5-20μg/mL. From both methods, PVC- and PO-based tubes exhibited the highest and the lowest (<10%) sorption levels to tacrolimus, respectively. Tacrolimus was stably delivered using the pump method. Results suggested that the pump method can estimate tacrolimus sorption in administration set tubes and evaluate other sorptional drugs used at low concentrations. PO-based tubes also have promising potential as an alternative for administration set tubes.
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Affiliation(s)
- Su-Eon Jin
- College of Pharmacy, Yonsei University, Incheon, 21983, Republic of Korea; College of Medicine, Yonsei University, Seoul, 03722, Republic of Korea; Yonsei Institute of Pharmaceutical Sciences, Incheon, 21983, Republic of Korea
| | - Seungho Jeon
- Polyscientech Co. Ltd, Anseong, 17508, Republic of Korea
| | - Hyo-Jin Byon
- College of Medicine, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sung-Joo Hwang
- College of Pharmacy, Yonsei University, Incheon, 21983, Republic of Korea; Yonsei Institute of Pharmaceutical Sciences, Incheon, 21983, Republic of Korea.
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Jin SE, You S, Jeon S, Byon HJ, Hwang SJ. Evaluation of Drug Sorption to PVC- and Non-PVC-based Tubes in Administration Sets Using a Pump. J Vis Exp 2017. [PMID: 28362410 DOI: 10.3791/55086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Administration sets are delivery tools for the direct application of drugs into the body and are composed of a spike, a drip chamber, tubes, Luer adapters (connectors), a needle cover for protection, and other accessories. Drug sorption to tubes of administration sets is a critical issue in terms of safety and efficacy. Although drug sorption is an important factor in the quality of an administration set, there are no standard evaluation methods for the regulation of drug sorption to the tubes. Here, we describe an evaluation protocol for drug sorption to tubes of administration sets. Tubes made of polyvinyl chloride (PVC)- and non-PVC-based polymeric materials were cut to 1 m in length. Diazepam and tacrolimus were used as model drugs. In the kinetic sorption study, we selected the drug concentration and flow rate based on the clinical usage of these drugs. After the dilution of each drug in a glass bottle, the diluted drug solution was delivered through tubes of administration sets using a pump. Samples were collected in amber vials at appropriate time points and the drugs were analyzed using high-performance liquid chromatography. Drug concentrations and sorption levels to tubes of the administration sets were calculated. Acceptable criteria to ensure the quality of administration sets are recommended.
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Affiliation(s)
- Su-Eon Jin
- College of Pharmacy, Yonsei University; College of Medicine, Yonsei University; Yonsei Institute of Pharmaceutical Sciences
| | - Siwon You
- College of Pharmacy, Yonsei University; Yonsei Institute of Pharmaceutical Sciences
| | | | | | - Sung-Joo Hwang
- College of Pharmacy, Yonsei University; Yonsei Institute of Pharmaceutical Sciences;
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Lee M, Keener J, Rodgers GM, Adachi RY. Novel polymer container systems for protein therapeutics and cell culturing. INT J POLYM MATER PO 2016. [DOI: 10.1080/00914037.2016.1149845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Manfai Lee
- School of Medicine, University of Utah, Salt Lake City, Utah
| | - Justin Keener
- School of Medicine, University of Utah, Salt Lake City, Utah
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Maiguy-Foinard A, Genay S, Lannoy D, Barthélémy C, Lebuffe G, Debaene B, Odou P, Décaudin B. Criteria for choosing an intravenous infusion line intended for multidrug infusion in anaesthesia and intensive care units. Anaesth Crit Care Pain Med 2016; 36:53-63. [PMID: 27338523 DOI: 10.1016/j.accpm.2016.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 02/25/2016] [Accepted: 02/27/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aims are to identify critical parameters influencing the drug mass flow rate of infusion delivery to patients during multidrug infusion and to discuss their clinical relevance. DATA SOURCES A review of literature was conducted in January 2016 using Medline, Google Scholar, ScienceDirect, Web of Science and Scopus online databases. DATA EXTRACTION References relating to the accuracy of fluid delivery via gravity-flow intravenous (IV) infusion systems and positive displacement pumps, components of IV administration sets, causes of flow rate variability, potential complications due to flow rate variability, IV therapies especially at low flow rates and drug compatibilities were considered relevant. DATA SYNTHESIS Several parameters impact the delivery of drugs and fluids by IV infusion. Among them are the components of infusion systems that particularly influence the flow rate of medications and fluids being delivered. By their conception, they may generate significant start-up delays and flow rate variability. Performing multidrug infusion requires taking into account two main points: the common dead volume of drugs delivered simultaneously with potential consequences on the accuracy and amount of drug delivery and the prevention of drug incompatibilities and their clinical effects. CONCLUSION To prevent the potentially serious effects of flow rate variability on patients, clinicians should receive instruction on the fluid dynamics of an IV administration set and so be able to take steps to minimise flow rate changes during IV therapy.
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Affiliation(s)
- Aurélie Maiguy-Foinard
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France; CHU Lille, Institut de Pharmacie, 59000 Lille, France
| | - Stéphanie Genay
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France
| | - Damien Lannoy
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France; CHU Lille, Institut de Pharmacie, 59000 Lille, France
| | - Christine Barthélémy
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France
| | - Gilles Lebuffe
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France; CHU Lille, Pôle d'Anesthésie Réanimation, 59000 Lille, France
| | - Bertrand Debaene
- Department of Anaesthesia and Intensive Care, University Hospital of Poitiers, Poitiers, France
| | - Pascal Odou
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France; CHU Lille, Institut de Pharmacie, 59000 Lille, France
| | - Bertrand Décaudin
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 59000 Lille, France; CHU Lille, Institut de Pharmacie, 59000 Lille, France.
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Diazepam sorption to PVC- and non-PVC-based tubes in administration sets with quantitative determination using a high-performance liquid chromatographic method. Int J Pharm 2016; 506:414-9. [DOI: 10.1016/j.ijpharm.2016.04.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 03/26/2016] [Accepted: 04/15/2016] [Indexed: 11/17/2022]
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Maiguy-Foinard A, Blanchemain N, Barthélémy C, Décaudin B, Odou P. Influence of a Double-Lumen Extension Tube on Drug Delivery: Examples of Isosorbide Dinitrate and Diazepam. PLoS One 2016; 11:e0154917. [PMID: 27153224 PMCID: PMC4859544 DOI: 10.1371/journal.pone.0154917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/21/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose Plastic materials such as polyurethane (PUR), polyethylene (PE), polypropylene (PP) and polyvinyl chloride (PVC) are widely used in double-lumen extension tubing. The purposes of our study were to 1) compare in vitro drug delivery through the double extension tubes available on the market 2) assess the plastic properties of PUR in infusion devices and their impact on drug delivery. Methods The study compared eight double-lumen extension tubes in PUR, co-extruded (PE/PVC) plastic and plasticised PVC from different manufacturers. Isosorbide dinitrate and diazepam were used as model compounds to evaluate their sorption on the internal surface of the infusion device. Control experiments were performed using norepinephrine known not to absorb to plastics. Drug concentrations delivered at the egress of extension tubes were determined over time by an analytical spectrophotometric UV-Vis method. The main characteristics of plastics were also determined. Results Significant differences in the sorption phenomenon were observed among the eight double-lumen extension tubes and between pairs of extension tubes. Mean concentrations of isosorbide dinitrate delivered at the egress of double-lumen extension tubes after a 150-minute infusion (mean values ± standard deviation in percentage of the initial concentrations in the prepared syringes) ranged between 80.53 ± 1.66 (one of the PUR tubes) and 92.84 ± 2.73 (PE/PVC tube). The same parameters measured during diazepam infusion ranged between 48.58 ± 2.88 (one of the PUR tubes) and 85.06 ± 3.94 (PE/PVC tube). The double-lumen extension tubes in PUR were either thermosetting (resin) or thermoplastic according to reference. Conclusions Clinicians must be aware of potential drug interactions with extension tube materials and so must consider their nature as well as the sterilisation method used before selecting an infusion device.
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Affiliation(s)
- Aurélie Maiguy-Foinard
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France
| | - Nicolas Blanchemain
- Univ. Lille, F-59000 Lille, France
- Inserm, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Christine Barthélémy
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Bertrand Décaudin
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France
- * E-mail:
| | - Pascal Odou
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France
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Park KH, Chung DJ. Stability study of docetaxel solution (0.9%, saline) using Non-PVC and PVC tubes for intravenous administration. Biomater Res 2015; 19:2. [PMID: 26331073 PMCID: PMC4552154 DOI: 10.1186/s40824-014-0023-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/28/2014] [Indexed: 11/19/2022] Open
Abstract
Background Di-2-ethylhexyl phthalate (DEHP) are added to poly(vinyl chloride)(PVC) infusion tubes as a plasticizer to ensure tube flexibility. In addition to previously reported disadvantages of DEHP, released DEHP molecules from PVC tubes can easily interact with surfactants in anticancer drug solutions (i.e., polysorbate 80 for Taxotere®-Inj) and reduce the solubility of docetaxel in aqueous solution during anticancer drug administration. Results In this study, we investigated the in vitro stability of docetaxel in a 0.9% saline solution under an intravenous administration condition using a PVC tube (high DEHP content) and non-PVC infused tube. Conclusion The docetaxel solution circulating through the non-PVC tube had better solution stability than through the PVC tube(high DEHP content).
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Al Salloum H, Saunier J, Aymes-Chodur C, Barakat H, Yagoubi N. Impact of the nature and concentration of plasticizers on the ability of PVC to sorb drug. Int J Pharm 2015; 496:664-75. [PMID: 26561727 DOI: 10.1016/j.ijpharm.2015.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/02/2015] [Accepted: 11/03/2015] [Indexed: 01/02/2023]
Abstract
The sorption of a drug by an infusion set may dramatically reduce the drug delivery efficiency. In this paper, we investigated how the drug sorption, in static conditions, is affected by the plasticizer's nature and ratio in the case of plasticized PVC, one of the most common material for infusion set tubing. Within the study, the drug concentration in diazepam solutions was studied after contact with PVC films containing different amounts of DEHP, DEHT, TOTM and DINCH® plasticizers. Moreover the partition coefficients between material and water were calculated. The drug sorption levels were equivalent for the different plasticizers and there was a plasticizer ratio for which the drug uptake was enhanced. As a consequence, the amount of sorbed drug might not be only linked to the amount of plasticizer in the film and to the solubility of the drug in the plasticizer alone: it must probably depend on specific interactions between plasticizer and PVC.
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Affiliation(s)
- H Al Salloum
- IFR 141, EA 401, UFR de Pharmacie, Université Paris, Sud-92290 Chatenay Malabry, France
| | - J Saunier
- IFR 141, EA 401, UFR de Pharmacie, Université Paris, Sud-92290 Chatenay Malabry, France.
| | - C Aymes-Chodur
- IFR 141, EA 401, UFR de Pharmacie, Université Paris, Sud-92290 Chatenay Malabry, France
| | - H Barakat
- IFR 141, EA 401, UFR de Pharmacie, Université Paris, Sud-92290 Chatenay Malabry, France
| | - N Yagoubi
- IFR 141, EA 401, UFR de Pharmacie, Université Paris, Sud-92290 Chatenay Malabry, France
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Park KH, Park CK, Park J, Jeon S, Bang SI, Kim JH, Chung DJ. Drug Adsorption Behavior of Polyolefin Infusion Tube Compared to PVC and PU. POLYMER KOREA 2014. [DOI: 10.7317/pk.2014.38.3.333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bernard L, Décaudin B, Lecoeur M, Richard D, Bourdeaux D, Cueff R, Sautou V. Analytical methods for the determination of DEHP plasticizer alternatives present in medical devices: a review. Talanta 2014; 129:39-54. [PMID: 25127563 DOI: 10.1016/j.talanta.2014.04.069] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 04/21/2014] [Accepted: 04/23/2014] [Indexed: 01/13/2023]
Abstract
Until 2010, diethylhexylphthalate (DEHP) was the plasticizer most commonly used to soften PVC medical devices (MDs), because of a good efficiency/cost ratio. In flexible plasticized PVC, phthalates are not chemically bound to PVC and they are released into the environment and thus may come into contact with patients. The European Directive 2007/47/CE, classified DEHP as a product with a toxicity risk and restricted its use in MDs. MD manufacturers were therefore forced to quickly find alternatives to DEHP to maintain the elasticity of PVC nutrition tubings, infusion sets and hemodialysis lines. Several replacement plasticizers, so-called "alternative to DEHP plasticizers" were incorporated into the MDs. Nowadays, the risk of exposure to these compounds for hospitalized patients, particularly in situations classified "at risk", has not yet been evaluated, because migrations studies, providing sufficient exposure and human toxicity data have not been performed. To assess the risk to patients of DEHP plasticizer alternatives, reliable analytical methods must be first developed in order to generate data that supports clinical studies being conducted in this area. After a brief introduction of the characteristics and toxicity of the selected plasticizers used currently in MDs, this review outlines recently analytical methods available to determine and quantify these plasticizers in several matrices, allowing the evaluation of potential risk and so risk management.
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Affiliation(s)
- L Bernard
- CHU Clermont-Ferrand, Pôle Pharmacie, Rue Montalembert, 63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France.
| | - B Décaudin
- Université Lille Nord de France, EA4481, GRIIOT, BP83, 59006 Lille, France; CHRU Lille, Pharmacie, Avenue Oscar Lambret, 59037 Lille, France
| | - M Lecoeur
- Université Lille Nord de France, EA4481, GRIIOT, BP83, 59006 Lille, France
| | - D Richard
- CHU Clermont-Ferrand, Service de Pharmacologie (CREPTA), Rue Montalembert, 63003 Clermont-Ferrand, France
| | - D Bourdeaux
- CHU Clermont-Ferrand, Pôle Pharmacie, Rue Montalembert, 63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
| | - R Cueff
- Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
| | - V Sautou
- CHU Clermont-Ferrand, Pôle Pharmacie, Rue Montalembert, 63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
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Zhu LL, Li W, Song P, Zhou Q. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China. Ther Clin Risk Manag 2014; 10:165-72. [PMID: 24669192 PMCID: PMC3962321 DOI: 10.2147/tcrm.s59199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People’s Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety.
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Affiliation(s)
- Ling-Ling Zhu
- Geriatric VIP Ward, Division of Nursing, People's Republic of China
| | - Wei Li
- Division of Medical Administration, People's Republic of China
| | - Ping Song
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Quan Zhou
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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Halecky M, Spackova R, Paca J, Stiborova M, Kozliak E. Biodegradation of nitroglycerin and ethylene glycol dinitrate by free and immobilized mixed cultures. WATER RESEARCH 2014; 48:529-537. [PMID: 24206758 DOI: 10.1016/j.watres.2013.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/01/2013] [Accepted: 10/02/2013] [Indexed: 06/02/2023]
Abstract
Aerobic biodegradation of nitroglycerin (NG) and ethylene glycol dinitrate (EGDN), both as individual substrates and in their mixture, was tested using batch or fed-batch cultivation with free suspended cells enriched from a soil sample subjected to a long-term contamination with explosives. EGDN was degraded only in the presence of glycerol as a co-substrate whereas NG could serve as a sole carbon, energy and nitrogen source for growth, its degradation being only slightly boosted by either glycerol or pyruvate. NG was not sufficient as a co-substrate for microbial growth on EGDN; furthermore, the presence of EGDN inhibited the NG degradation. The growth inhibition by both NG and EGDN was alleviated by the addition of glycerol. At an optimum nitroglycerin concentration of 30 mg/L, a maximum specific degradation rate of 60.9 ± 1.8 mg/gdw/h was observed. The biodegradation of both pollutants occurred with a release of nitrite. A method was developed for growing substantial amounts of NG-degrading biomass in the presence of glycerol for its immobilization on expanded slate in a pot-scale packed-bed reactor. Preliminary reactor tests were conducted in a continuous operation mode yielding a 70-90% NG biodegradation up to a load of 20 mg/L/h, with a removal rate up to 16 mg/L/h.
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Affiliation(s)
- Martin Halecky
- Institute of Chemical Technology, Department of Biotechnology, Prague 16628, Czech Republic.
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Bernard L, Cueff R, Massard C, Blavignac C, Awitor KO, Chopineau J, Sautou V. Hybrid sol gel coating: A solution to prevent interactions between plasticized poly(vinyl chloride) and injectable drugs? J Appl Polym Sci 2013. [DOI: 10.1002/app.40145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lise Bernard
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
- CHU Clermont-Ferrand, Pôle Pharmacie; F-63003 Clermont-Ferrand France
| | - Régis Cueff
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
| | - Christophe Massard
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
| | - Christelle Blavignac
- Clermont Université, Université d'Auvergne, Centre Imagerie Cellulaire Santé; BP 10448 F-63000 Clermont-Ferrand France
| | - Komla O. Awitor
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
| | - Jean Chopineau
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
- CHU Clermont-Ferrand, Pôle Pharmacie; F-63003 Clermont-Ferrand France
| | - Valérie Sautou
- Clermont Université, Université d'Auvergne; EA 4676 C-BIOSENSS, BP 10448 F-63000 Clermont-Ferrand France
- CHU Clermont-Ferrand, Pôle Pharmacie; F-63003 Clermont-Ferrand France
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Glyceryl trinitrate complements citrate and ethanol in a novel antimicrobial catheter lock solution to eradicate biofilm organisms. Antimicrob Agents Chemother 2013; 57:3555-60. [PMID: 23669393 DOI: 10.1128/aac.00229-13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antimicrobial catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous catheters. Citrate has been used clinically as an anticoagulant in heparin-free catheter locks. Ethanol has also been widely studied as an antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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Peterfreund RA, Philip JH. Critical parameters in drug delivery by intravenous infusion. Expert Opin Drug Deliv 2013; 10:1095-108. [PMID: 23565777 DOI: 10.1517/17425247.2013.785519] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Intravenous infusion is commonly used to deliver medications and fluids to patients. The duration of an infusion is short (hours) in the operating room where intravenous agents are infused to anesthetize patients and to manage circulation. Critically ill patients often receive infusions for days. Infusion technology has become increasingly sophisticated and complex. The technical advances broaden the clinical application of intravenous infusion methodology and provide safety features. AREAS COVERED This article provides an historical overview of intravenous infusion and discusses components of infusion systems. A section describes configuration of components to meet clinical needs. The article describes physical properties of infusion systems, emphasizing how critical parameters of resistance to flow, infusion pump performance and interactions between fluid flows and the dead volume influence medication and fluid delivery. The authors emphasize the use of infusions in the intensive care and operating room environments, although the general principles apply to other clinical settings. EXPERT OPINION Intravenous infusion systems contribute significantly to clinical care, but in a deceptively simple way. Several critical parameters combine to influence the performance of an infusion system, with a number of pitfalls potentially confounding utility of the technology. Safe and effective clinical application of intravenous infusion technology depends on an appreciation of this complexity which impacts the performance of infusion systems.
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Affiliation(s)
- Robert A Peterfreund
- Massachusetts General Hospital, Harvard Medical School, Department of Anesthesia, Critical Care and Pain Medicine, Jackson 439, 55 Fruit Street, Boston, MA 02114, USA.
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Feenstra P, Brunsteiner M, Khinast J. Prediction of drug-packaging interactions via molecular dynamics (MD) simulations. Int J Pharm 2012; 431:26-32. [PMID: 22521710 DOI: 10.1016/j.ijpharm.2012.03.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 03/16/2012] [Accepted: 03/26/2012] [Indexed: 11/15/2022]
Abstract
The interaction between packaging materials and drug products is an important issue for the pharmaceutical industry, since during manufacturing, processing and storage a drug product is continuously exposed to various packaging materials. The experimental investigation of a great variety of different packaging material-drug product combinations in terms of efficacy and safety can be a costly and time-consuming task. In our work we used molecular dynamics (MD) simulations in order to evaluate the applicability of such methods to pre-screening of the packaging material-solute compatibility. The solvation free energy and the free energy of adsorption of diverse solute/solvent/solid systems were estimated. The results of our simulations agree with experimental values previously published in the literature, which indicates that the methods in question can be used to semi-quantitatively reproduce the solid-liquid interactions of the investigated systems.
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Affiliation(s)
- Peter Feenstra
- Institute for Process and Particle Engineering, Graz University of Technology, Graz, Austria
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Carraretto AR, Curi EF, de Almeida CED, Abatti REM. Glass ampoules: risks and benefits. Rev Bras Anestesiol 2011; 61:513-21. [PMID: 21724014 DOI: 10.1016/s0034-7094(11)70059-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 01/24/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Glass ampoules have been widely used in packaging injection drugs. Glass has important characteristics that allow it to be widely used in fabrication of recipients for drugs and other sterile substances. However, contamination of solutions with glass microparticles on breaking open glass ampoules, the presence of metals, percutaneous injury, and biological contamination justify the need of educational materials to orient the manipulation of ampoules. CONTENTS Glass microparticles generated in the snap-opening of ampoules, as well as metals that contaminate their contents can be aspirated and injected through several routes. Exogenous contaminations by glass and metals can reach several sites in the organism. They trigger organic reactions that may give rise to injuries. Opening ampoules can expose professionals to the risk of percutaneous injuries. These lesions increase the biological risk as they are the gateway for viruses and bacteria. Ampoules opening systems (VIBRAC and OPC) have been developed to reduce the incidence of such accidents. Alternative materials to glass may represent an interesting strategy to increase safety. The use of prefilled syringes may represent an evolution regarding safety. CONCLUSIONS Team training and information provided by the pharmaceutical industry on the use of ampoules are fundamental in the prophylaxis of accidents and contaminations. The search for safer materials to replace glass is also important.
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Sáiz J, Ferrando JL, Atoche JC, Torre M, García-Ruiz C. Study of losses of volatile compounds from dynamites. Investigation of cross-contamination between dynamites stored in polyethylene bags. Forensic Sci Int 2011; 211:27-33. [DOI: 10.1016/j.forsciint.2011.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 04/05/2011] [Accepted: 04/06/2011] [Indexed: 11/15/2022]
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