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Gilliot S, Martin Mena A, Genay S, Masse M, Thibaut M, Carta N, Lannoy D, Négrier L, Barthélémy C, Décaudin B, Odou P. Factors influencing accuracy when preparing injectable drug concentrations in appliance with clinical practice: a norepinephrine case study. Eur J Hosp Pharm 2024; 31:168-170. [PMID: 35882533 PMCID: PMC10895172 DOI: 10.1136/ejhpharm-2022-003358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 11/04/2022] Open
Abstract
Errors in injectable preparations with high-risk drugs can be fatal. This study aimed to identify the factors influencing the accuracy of high-risk injectable drug concentrations in appliances used for intensive care unit preparation practices. Norepinephrine (NE) was chosen as an example of a high-risk medication drug. The concentration (0.2 and 0.5 mg/mL), the diluent (sodium chloride 0.9% and 5% dextrose), and the container type (prefilled- and empty-infusion bag and syringe) were tested as potential variability factors. An ultraviolet spectrophotometric method was used for NE dosage. 108 NE solutions were prepared by five individuals (pharmacists or laboratory technicians) with clinical experience as well as experience in the aseptic preparation of solutions. The container type was found to be the only factor influencing the accuracy of NE concentration. NE solutions in syringes proved to be the most accurate while preparations in prefilled bags tended to underdose NE.
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Affiliation(s)
- Sixtine Gilliot
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Anthony Martin Mena
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Stéphanie Genay
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Morgane Masse
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Manon Thibaut
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Natacha Carta
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Damien Lannoy
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Laura Négrier
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Christine Barthélémy
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Bertrand Décaudin
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
| | - Pascal Odou
- Institute of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, Hauts-de-France, France
- ULR-7365 Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, Lille, Hauts-de-France, France
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2
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Masse M, Jimenez M, Genay S, Pettinari A, Bellayer S, Barthélémy C, Décaudin B, Blanchemain N, Odou P. Limitation of the migration of plasticizers from medical devices through treatment with low-pressure cold plasma, polydopamine coating, and annealing. Int J Pharm 2023; 646:123422. [PMID: 37722492 DOI: 10.1016/j.ijpharm.2023.123422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
Poly(vinyl chloride) (PVC) is widely used in the manufacture of medical devices. The plasticizers added to PVC are potentially toxic for humans, likely to migrate, and thus unintentionally administered to patients. The objective of the present study was to reduce the migration of plasticizer (1,2-cyclohexanedicarboxylic acid, diisononylester (DINCH) or trioctyltrimellitate (TOTM)) from PVC by implementing a three-step surface treatment process: (i) pretreatment with low-pressure argon cold plasma, (ii) polydopamine coating, and (iii) post-treatment with cold plasma exposure or thermal treatment at 140 °C. Samples were then characterized in terms of the water contact angle (WCA) and the aspect in scanning electron microscopy. Plasticizer migration (n = 5) was measured using an HPLC technique with ultraviolet detection and found to depend on the treatment and the plasticizer. Plasticized PVC was hydrophobic, with a measured mean ± standard deviation WCA of 96.7 ± 3.6° for PVC-DINCH and 110.2 ± 5.8° for PVC-TOTM. Plasma post-treatment and thermal post-treatment were respectively associated with a mean decrease in migration of 38.3 ± 1.9% for DINCH and 61.5 ± 4.4% for TOTM. Our results are promising with regard to limiting the migration of plasticizers into the patient's blood and thus enabling the development of safer medical devices.
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Affiliation(s)
- Morgane Masse
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
| | - Maude Jimenez
- Univ. Lille, CNRS, INRA, ENSCL UMR8207, UMET - Unité Matériaux et Transformations, F-59000 Lille, France; Institut Universitaire de France, 1 rue Descartes, F-75005 Paris, France
| | - Stéphanie Genay
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Alice Pettinari
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Séverine Bellayer
- Univ. Lille, CNRS, INRA, ENSCL UMR8207, UMET - Unité Matériaux et Transformations, F-59000 Lille, France
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Nicolas Blanchemain
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Pascal Odou
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
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Gilliot S, Henry H, Carta N, Genay S, Barthélémy C, Décaudin B, Odou P. Long-term stability of 10 mg/mL dobutamine injectable solutions in 5% dextrose and normal saline solution stored in polypropylene syringes and cyclic-oleofin-copolymer vials. Eur J Hosp Pharm 2023; 30:153-159. [PMID: 34011556 PMCID: PMC10176992 DOI: 10.1136/ejhpharm-2021-002748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/23/2021] [Accepted: 05/04/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Dobutamine is an inotropic agent given to patients with low cardiac output or undergoing cardiac surgery in intensive care units. Routine clinical care protocols recommend a target dilution concentration of 10 mg/mL dobutamine from the 250 mg/20 mL commercial solution.This study aimed to assess the 1-year stability of ready-to-use 10 mg/mL diluted dobutamine solutions. Two types of 50 mL conditioning, polypropylene (PP) syringes or cyclic-oleofin-copolymer (COC) vials and two diluents (5% dextrose (D5W) and normal saline (NS)) were tested. METHODS Reversed-phase liquid chromatography coupled with an ultraviolet detection stability-indicating method was developed for dobutamine and validated according to selectivity, linearity, sensitivity, accuracy and precision. Chemical stability was considered to have been maintained if the measured concentrations were >90% of the initial concentration with no colour change. Physical stability was assessed through sterility tests, pH and osmolality monitoring, and subvisible particle counting. Containers were stored at -20±5°C, +5±3°C and +25±2°C with 60%±5% relative humidity in a dark, closed environment. RESULTS According to this study, the physicochemical stability of 10 mg/mL dobutamine solutions prepared with D5W or NS is constant throughout a 365-day period when stored in COC vials, at all the aforementioned temperatures, whereas solutions in PP syringes required a refrigerated temperature and should not be administered after 21 days or 3 months when prepared with D5W or NS, respectively, or after 1 month at ambient temperature whatever the diluent. CONCLUSION Our results argue in favour of adopting the compounding of ready-to-use 10 mg/mL dobutamine solutions in COC vials in centralised intravenous additive services.
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Affiliation(s)
- Sixtine Gilliot
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
| | - Héloïse Henry
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
| | - Natacha Carta
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
| | - Stéphanie Genay
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
- Institut of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, France
| | - Christine Barthélémy
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
| | - Bertrand Décaudin
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
- Institut of Pharmacy, CHRU Lille Pôle Spécialités Médicochirurgicales, Lille, France
| | - Pascal Odou
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
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Bonnet-Brilhault F, Roux S, Blanc R, Gomot M, Dansart P, Rouvre O, Houy-Durand E, Malvy J, Barthélémy C. [The BSE2 scale : A new clinical tool for the diagnostic of ASD within NDDs]. Encephale 2023; 49:57-64. [PMID: 34857368 DOI: 10.1016/j.encep.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The behavioral summarized evaluation scales, the BSE and its revised version the BSE-R, were developed and validated in the 1980-1990s. The BSE-R is still used daily by clinical teams in France and foreign countries, and it is recommended by the French Health Authority (2018). Having taken into account knowledge improvement in neurodevelopment and autism spectrum disorder (ASD) and the importance of observation by relatives in ecological context, the second version of the BSE was developed. This paper presents the construction and the validation study of the second version of the behavioral summarized evaluation scale, the BSE2 and the BSE2-P rated by parents. METHODS Construct validity of the BSE2 scale has been studied in a population of 244 children and adolescents with ASD according to DSM-5 criteria, aged from 30 months to 18 years. Discriminant validity has been analyzed using a population of 86 patients of the same age, with neurodevelopmental disorder (NDD) without comorbidity of ASD. RESULTS BSE2 comprises 30 items and is a two-dimensional scale as was BSE-R. Both dimensions, labelled "Interaction" (11 items) and "Modulation" (11 items), accounted for 41.7 % of the total variance. They describe autism severity and are in accordance with the two DSM-5 dimensions. Internal consistency (0.927 and 0.850 respectively) and inter-rater reliability (0.932 and 0.897 respectively) are good or excellent for both dimensions. Sensibility and specificity (0.758 and 0.767 respectively) range BSE2 among the tools with good psychometric properties. The parent version, BSE2-P, dedicated to ecological context is easily rated by parents. CONCLUSIONS BSE2 scale for children and adolescents is a clinical tool with good psychometric properties. Its two-dimensional structure is in accordance with DSM-5 criteria. This scale covers all spectrum of ASD clinical forms in both children and adolescents. It can be used to identify ASD in complex neurodevelopmental disorders with several comorbidities and can help to distinguish autism symptomatology from other neurodevelopmental diagnoses. Furthermore, this scale allows to expand the rating context, involving parents to define and adjust the individualized therapeutic project. Thus the BSE2 is a valuable clinical tool for practitioners for both diagnosis and follow-up.
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Affiliation(s)
- F Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
| | - S Roux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - R Blanc
- ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - M Gomot
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - P Dansart
- ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - O Rouvre
- ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - E Houy-Durand
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - J Malvy
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; ExAC-T, Centre d'Excellence Autisme et Troubles du Neurodéveloppement, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - C Barthélémy
- Université de Tours, Faculté de Médecine, 10, boulevard Tonnellé, 37032 Tours cedex 1, France
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Masse M, Henry H, Cuvelier E, Pinçon C, Pavy M, Beeuwsaert A, Barthélémy C, Cuny D, Gautier S, Kambia N, Lefebvre JM, Mascaut D, Mitoumba F, Puisieux F, Standaert A, Wierre P, Beuscart JB, Roche J, Décaudin B. Sleep Medication in Older Adults: Identifying the Need for Support by a Community Pharmacist. Healthcare (Basel) 2022; 10:healthcare10010147. [PMID: 35052310 PMCID: PMC8775744 DOI: 10.3390/healthcare10010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/23/2022] Open
Abstract
Many older adults take benzodiazepines and sedative-hypnotics for the treatment of sleep disorders. With a view to considering the possible discontinuation of hypnotics, the objectives of the present study were to describe bedtime habits and sleep patterns in older adults and to identify the sleep medications taken. An expert group developed a structured interview guide for assessing the patients’ bedtime habits, sleep patterns, and medications. During an internship in a community pharmacy, 103 sixth-year pharmacy students conducted around 10 interviews each with older adults (aged 65 or over) complaining of sleep disorders and taking at least one of the following medications: benzodiazepines, benzodiazepine derivatives (“Z-drugs”), antihistamines, and melatonin. A prospective, observational study was carried out from 4 January to 30 June 2016. The pharmacy students performed 960 interviews (with 330 men and 630 women; mean ± standard deviation age: 75.1 ± 8.8). The most commonly taken hypnotics were the Z-drugs zolpidem (n = 465, 48%) and zopiclone (n = 259, 27%). The vast majority of patients (n = 768, 80%) had only ever taken a single hypnotic medication. The median [interquartile range] prescription duration was 120 (48–180) months. About 75% (n = 696) of the patients had at least 1 poor sleep habit, and over 41% (n = 374) had 2 or more poor sleep habits. A total of 742 of the patients (77%) reported getting up at night—mainly due to nycturia (n = 481, 51%). Further, 330 of the patients (35%) stated that they were keen to discontinue their medication, of which 96 (29%) authorized the pharmacist to contact their family physician and discuss discontinuation. In France, pharmacy students and supervising community pharmacists can identify problems related to sleep disorders by asking simple questions about the patient’s sleep patterns. Together with family physicians, community pharmacists can encourage patients to discuss their hypnotic medications.
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Affiliation(s)
- Morgane Masse
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
- Correspondence:
| | - Héloïse Henry
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
| | - Elodie Cuvelier
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
| | - Claire Pinçon
- Univ. Lille, CHU Lille, ULR2694-METRICS, Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France; (C.P.); (J.-B.B.)
| | - Margot Pavy
- Faculté de Pharmacie, Université de Lille, F-59000 Lille, France; (M.P.); (A.B.)
| | - Audrey Beeuwsaert
- Faculté de Pharmacie, Université de Lille, F-59000 Lille, France; (M.P.); (A.B.)
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
| | - Damien Cuny
- Univ. Lille, ULR 4515-LGCgE, Laboratoire de Génie Civil et Géo-Environnement, F-59000 Lille, France;
| | - Sophie Gautier
- Inserm, UMR-S1172, Center for Pharmacovigilance, CHU de Lille, University Lille, F-59037 Lille, France;
| | - Nicolas Kambia
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
| | - Jean-Marc Lefebvre
- Department of General Practice, University of Lille, F-50045 Lille, France;
| | - Daniel Mascaut
- Association des Conseillers et des Pharmaciens Agréés Maîtres de Stage du Nord—Pas-de-Calais, 21 Rue du Pont-Neuf, F-59000 Lille, France; (D.M.); (P.W.)
| | - Fabrice Mitoumba
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
| | - François Puisieux
- Hôpital Gériatrique Les Bateliers, Pôle de Gérontologie, CHRU de Lille, F-59000 Lille, France;
| | - Annie Standaert
- Univ. Lille, Inserm, CHU Lille, U1286-INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
| | - Patrick Wierre
- Association des Conseillers et des Pharmaciens Agréés Maîtres de Stage du Nord—Pas-de-Calais, 21 Rue du Pont-Neuf, F-59000 Lille, France; (D.M.); (P.W.)
| | - Jean-Baptiste Beuscart
- Univ. Lille, CHU Lille, ULR2694-METRICS, Evaluation des Technologies de Santé et des Pratiques Médicales, F-59000 Lille, France; (C.P.); (J.-B.B.)
| | - Jean Roche
- CHU de Lille, Unité de Psychogériatrie, Pôle de Gérontologie, F-59037 Lille, France;
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, ULR 7365-GRITA—Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000 Lille, France; (H.H.); (E.C.); (C.B.); (N.K.); (F.M.); (B.D.)
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Fernández-Rodríguez B, Dupouy J, Harroch E, Fabre-Delcros MH, Barthélémy C, Loubière P, Barange K, Brefel-Courbon C, Rascol O, Ory-Magne F. Body mass index variations in patients with Parkinson's disease treated with levodopa-carbidopa intestinal gel infusion: A case control study versus standard of care and subthalamic nucleus deep brain stimulation. Rev Neurol (Paris) 2021; 177:919-923. [PMID: 34154827 DOI: 10.1016/j.neurol.2020.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 11/27/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND Levodopa-carbidopa intestinal gel (LCIG) is an advanced therapy for patients with Parkinson Disease (PD). Weight loss has been pointed out as an adverse event of LCIG infusion. AIMS OF THE STUDY To compare weight changes between three groups of PD patients: patients treated with LCIG, patients within the first year of subthalamic deep brain stimulation (STN-DBS) and patients treated exclusively with oral treatment during 1 year of follow up. METHODS Patients treated with LCIG were retrospectively matched by age, gender, disease duration and Hoehn and Yahr to patients undergoing STN-DBS and to patients both receiving the standard of care treatment and unwilling advanced therapies (SOC). Clinical features and weight were collected at baseline, and 12 months after introducing the treatment (LCIG and STN-DBS groups) or for one year of treatment (SOC). RESULTS Eighteen patients were included in each group. They had no differences in clinical and demographic features, except for cognitive impairment. There was a mean weight (-5.8kg ±6.8) and BMI (-2.1kg/m2±2.6) reduction in the LCIG group after 12 months, while there was a slight weight loss in the SOC (-1.4kg ±3.1) and a weight increase in the STN-DBS group (5.4kg ±4.7). Differences of weight were statistically different between, LCIG and STN-DBS (P<0.001), LCIG and SOC (P=0.002) and STN-DBS and SOC (P<0.001). CONCLUSIONS The study shows a significant weight reduction after starting LCIG infusion compared to the other groups. Weight loss should be closely monitored in patients treated with LCIG.
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Affiliation(s)
| | - J Dupouy
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France
| | - E Harroch
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France
| | - M-H Fabre-Delcros
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France
| | - C Barthélémy
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France
| | - P Loubière
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France
| | - K Barange
- Service de Gastroentérologie centre Hospitalier Universitaire Toulouse, France
| | - C Brefel-Courbon
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France; NS-Park/FCRIN network, Inserm UMR1214, ToNIC (Toulouse NeuroImaging Center), Université Paul Sabatier, Toulouse, France
| | - O Rascol
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France; NS-Park/FCRIN network, Inserm UMR1214, ToNIC (Toulouse NeuroImaging Center), Université Paul Sabatier, Toulouse, France; Service de Pharmacologie Clinique, Centre de Pharmacovigilance, Pharmacoépidemiologie and Informations sur le médicament, CIC Inserm 1436, NeuroToul Centre of Excellence in Neurodegeneration, Université de Toulouse, CHU de Toulouse, France
| | - F Ory-Magne
- Service de Neurologie, centre Hospitalier Universitaire, Toulouse, France; NS-Park/FCRIN network, Inserm UMR1214, ToNIC (Toulouse NeuroImaging Center), Université Paul Sabatier, Toulouse, France.
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7
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Préta LH, Henry H, Masse M, Barthélémy C, Carta N, Foulon C, Goossens JF, Kouach M, Lannoy D, Storme L, Décaudin B, Genay S, Odou P. Instability of Insulin Aspart Diluted in Dextrose. Diabetes Care 2020; 43:e77-e78. [PMID: 32381586 DOI: 10.2337/dc19-2462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 04/01/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Laure-Hélène Préta
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, France
| | - Héloïse Henry
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, France
| | - Morgane Masse
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, France
| | - Christine Barthélémy
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France
| | - Natacha Carta
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France
| | - Catherine Foulon
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France
| | - Jean-François Goossens
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France
| | - Mostafa Kouach
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France
| | - Damien Lannoy
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, France
| | - Laurent Storme
- ULR 4489 - Environnement Périnatal et Santé, Université de Lille, Lille, France.,Réanimation néonatale, CHU Lille, Lille, France
| | - Bertrand Décaudin
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, France
| | - Stéphanie Genay
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France .,Institut de Pharmacie, CHU Lille, Lille, France
| | - Pascal Odou
- ULR 7365 - Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Université de Lille, Lille, France.,Institut de Pharmacie, CHU Lille, Lille, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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9
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Gilliot S, Masse M, Feutry F, Barthélémy C, Décaudin B, Genay S, Odou P. Long-term stability of ready-to-use 1-mg/mL midazolam solution. Am J Health Syst Pharm 2020; 77:681-689. [DOI: 10.1093/ajhp/zxaa040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
Midazolam is a benzodiazepine derivative commonly used in intensive care units to control sedation. Its use requires dilution of a 5-mg/mL commercial solution to a target concentration of 1 mg/mL. A study was conducted to evaluate the stability of diluted ready-to-use 1-mg/mL midazolam solutions over 365 days when stored in cyclic olefin copolymer vials or polypropylene syringes.
Methods
A specific stability-indicating high-performance liquid chromatography coupled with UV detection method was developed for midazolam hydrochloride and validated for selectivity, linearity, sensitivity, precision, and accuracy. Three storage conditions were tested: –20°C ± 5°C, 5°C ± 3°C, and 25°C ± 2°C at 60% ± 5% relative humidity. Half of the vials were stored upside down to test for the absence of interaction between midazolam and the stopper. Particle contamination, sterility, and pH were assessed.
Results
The limit of stability was set at 90% of the initial concentration. After 1 year’s storage at –20°C and 5°C, concentrations remained superior to 90% under all storage conditions. At 25°C, stability was maintained up to day 90 in syringes (mean [SD], 92.71% [1.43%]) and to day 180 in upright and upside-down vials (92.12% [0.15%] and 91.57% [0.15%], respectively). No degradation products were apparent, no variations in pH values were detected, and containers retained their sterility and conformity with regard to any specific contamination during the study.
Conclusion
The evaluated 1-mg/mL midazolam solution was stable over a 1-year period when stored at a refrigerated (5°C) or frozen (–20°C) temperature in both vials and syringes; with storage at 25°C, the stability duration was lower. The preparation of ready-to-use midazolam solutions by a hospital pharmacy is compatible with clinical practice and could help to decrease risks inherent in dilution in care units.
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Affiliation(s)
- Sixtine Gilliot
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Morgane Masse
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Christine Barthélémy
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Bertrand Décaudin
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Stéphanie Genay
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Pascal Odou
- Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA), Centre Hospitalier Universitaire de Lille, Lille, France
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10
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Gilliot S, Masse M, Genay S, Lannoy D, Barthélémy C, Décaudin B, Odou P. Long-term stability of ready-to-use norepinephrine solution at 0.2 and 0.5 mg/mL. Eur J Hosp Pharm 2020; 27:e93-e98. [PMID: 32296514 DOI: 10.1136/ejhpharm-2019-002146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives Norepinephrine is a vasopressor frequently administered after dilution to treat hypotension and shocks in intensive care units. The stability of norepinephrine is known to be highly sensitive to storage conditions. Moreover, medication errors linked to the dilution step are frequent and may be deleterious for critically-ill patients, especially in intensive care units. This study aimed to evaluate the stability of ready-to-use diluted norepinephrine solutions prepared at two target concentrations (0.2 and 0.5 mg/mL), according to the summary of product characteristics, and stored for 365 days in two containers: AT-closed cyclic olefin copolymer vials, and polypropylene syringes. Methods A fast reversed-phase liquid chromatography method coupled with an ultra-violet detector was developed to assess the chemical stability of norepinephrine solutions. Validation was conducted according to the linearity of the calibration ranges, selectivity, sensitivity, accuracy and precision. Dosage, sub-visible particle contamination, pH monitoring and sterility assays were performed. Chemical stability was maintained if the measured concentration respected the lower limit of 90% of the initial concentration. Containers were stored at -20±5°C, +5±3°C and +25±2°C with 60±5% relative humidity in a dark closed enclosure. Results Stability was successfully maintained for every concentration and container tested when stored at -20±5°C and +5±3°C. In these storage conditions, particle contamination, pH monitoring and sterility assay respected the required criteria. Chemical degradation and colouring of solutions appeared before the end of the 1 year study period for most norepinephrine solutions stored at room temperature. Conclusions Ready-to-use solutions containing 0.2 and 0.5 mg/mL norepinephrine in polypropylene syringes or cyclic olefin copolymer vials must be stored at refrigerated or frozen temperatures to obtain acceptable 1 year shelf-stability. Exposure to higher temperatures significantly decreases shelf-stability. Our study protocol for compounding polypropylene syringes and cyclic olefin copolymer vials containing norepinephrine is adapted to implementation in centralised intravenous additive services.
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Affiliation(s)
- Sixtine Gilliot
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Morgane Masse
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Stéphanie Genay
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Damien Lannoy
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Christine Barthélémy
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Bertrand Décaudin
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
| | - Pascal Odou
- EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU Lille, F-59000 Lille, France
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11
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Masse M, Genay S, Martin Mena A, Carta N, Lannoy D, Barthélémy C, Décaudin B, Odou P. Evaluation of the stability of vancomycin solutions at concentrations used in clinical services. Eur J Hosp Pharm 2020; 27:e87-e92. [PMID: 32296513 DOI: 10.1136/ejhpharm-2019-002076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/25/2019] [Accepted: 12/31/2019] [Indexed: 01/27/2023] Open
Affiliation(s)
- Morgane Masse
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Stéphanie Genay
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Anthony Martin Mena
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Natacha Carta
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Damien Lannoy
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Pascal Odou
- Univ. Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
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12
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Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, Kambia N, Bertoux E, Mascaut D, Barthélémy C, Cuny D, Puisieux F, Décaudin B. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr 2019; 19:277. [PMID: 31638909 PMCID: PMC6802481 DOI: 10.1186/s12877-019-1276-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The community pharmacist is a key player in medication reviews of older outpatients. However, it is not always clear which individuals require a medication review. The objective of the present study was to identify high-priority older patients for intervention by a community pharmacist. METHODS As part of their final-year placement in a community pharmacy, pharmacy students conducted 10 interviews each with older adults (aged 65 or over) taking at least five medications daily. The student interviewer also offered to examine the patient's home medicine cabinet. An interview guide was developed by an expert group to assess the difficulties in managing and taking medications encountered by older patients. RESULTS The 141 students interviewed a total of 1370 patients (mean age: 81.5; mean number of medications taken daily: 9.3). Of the 1370 interviews, 743 (54.2%) were performed in the patient's home, and thus also included an examination of the home medicine cabinet. Adverse events were reported by 566 (42.0%) patients. A total of 378 patients (27.6%) reported difficulties in preparing, administering and/or swallowing medications. The inspections of medicine cabinets identified a variety of shortcomings: poorly located cabinets (in 15.0% of inspections), medication storage problems (21.7%), expired medications (40.7%), potentially inappropriate medications (15.0%), several different generic versions of the same drug (19.9%), and redundant medications (20.4%). CONCLUSIONS In a community pharmacy setting, high-priority older patients for intervention by a community pharmacist can be identified by asking simple questions about difficulties in managing, administering, taking or storing medications.
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Affiliation(s)
- Jean-Baptiste Beuscart
- University of Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France. .,Department of Geriatrics, CHU Lille, F-59000, Lille, France.
| | - Ségolène Petit
- Department of Pharmacy, CHU Lille, F-59000, Lille, France
| | - Sophie Gautier
- Department of Pharmacology, CHU Lille, F-59000, Lille, France
| | - Patrick Wierre
- Association des Conseillers et des Pharmaciens Agréés Maîtres de stage du Nord Pas de Calais, Lille, France
| | - Thibaut Balcaen
- University of Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France.,Department of Public Health, CHU Lille, F-59000, Lille, France
| | - Jean-Marc Lefebvre
- Department of General Practice, University of Lille, F-50045, Lille Cedex, France
| | - Nicolas Kambia
- University of Lille, EA 7365 - Groupe de recherche sur les injectables et les technologies associées, F-59000, Lille, France
| | - Elisabeth Bertoux
- Association des Conseillers et des Pharmaciens Agréés Maîtres de stage du Nord Pas de Calais, Lille, France
| | - Daniel Mascaut
- Association des Conseillers et des Pharmaciens Agréés Maîtres de stage du Nord Pas de Calais, Lille, France
| | - Christine Barthélémy
- University of Lille, EA 7365 - Groupe de recherche sur les injectables et les technologies associées, F-59000, Lille, France
| | - Damien Cuny
- University of Lille, EA 4483, Impacts de l'environnement chimique sur la santé humaine (IMPECS), F- 59000, Lille, France
| | - François Puisieux
- University of Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France.,Department of Geriatrics, CHU Lille, F-59000, Lille, France
| | - Bertrand Décaudin
- Department of Pharmacy, CHU Lille, F-59000, Lille, France.,University of Lille, EA 7365 - Groupe de recherche sur les injectables et les technologies associées, F-59000, Lille, France
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13
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Adès J, Agid Y, Bach JF, Barthélémy C, Bégué P, Berthoz A, Dubertret L, Falissard B, Le Moal M, Léna P, Tisseron S. Rapport 19-04. L’enfant, l’adolescent, la famille et les écrans : appel à une vigilance raisonnée sur les technologies numériques. Bulletin de l'Académie Nationale de Médecine 2019. [DOI: 10.1016/j.banm.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Morschhauser F, Dekyndt B, Baillet C, Barthélémy C, Malek E, Fulcrand J, Bigot P, Huglo D, Décaudin B, Simon N, Odou P. A new pharmacokinetic model for 90Y-ibritumomab tiuxetan based on 3-dimensional dosimetry. Sci Rep 2018; 8:14860. [PMID: 30291297 PMCID: PMC6173718 DOI: 10.1038/s41598-018-33160-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/07/2018] [Indexed: 02/01/2023] Open
Abstract
Monoclonal antibodies (mAbs) are key components in several therapies for cancer and inflammatory diseases but current knowledge of their clinical pharmacokinetics and distribution in human tissues remains incomplete. Consequently, optimal dosing and scheduling in clinics are affected. With sequential radiolabeled mAb-based imaging, radiation dosing in tissues/organs can be calculated to provide a better assessment of mAb concentrations in tissues. This is the first pharmacokinetic model of 90Y-Ibritumomab tiuxetan (90Y-IT) in humans to be described, based on three-dimensional (3D) dosimetry using single-photon emission computed-tomography coupled with computed-tomography. 19 patients with follicular lymphoma were treated initially with 90Y-IT in the FIZZ trial. Based on a compartmental approach individualising the vascular compartment within studied organs, this study proposes a reliable pharmacokinetic (PK) five-compartment model replacing the currently used two-compartment model and constitutes a new direction for further research. This model provides exchange constants between the different tissues, Area Under the Curve of 111In-IT in blood (AUC) and Mean Residence Time (MRT) that have not been reported so far for IT. Finally, the elimination process appears to occur in a compartment other than the liver or the spleen and suggests the metabolism of mAbs may take place mainly on the vascular compartment level.
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Affiliation(s)
- F Morschhauser
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France. .,Haematology Department, Hôpital Claude Huriez, CHU Lille, F-59000, Lille, France.
| | - B Dekyndt
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France.,Pharmacy Institute, CHU Lille, F-59000, Lille, France
| | - C Baillet
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France.,Nuclear Medicine department, Hôpital Claude Huriez, CHU Lille, F-59000, Lille, France
| | - C Barthélémy
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France
| | - E Malek
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France
| | - J Fulcrand
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France
| | - P Bigot
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France
| | - D Huglo
- Nuclear Medicine department, Hôpital Claude Huriez, CHU Lille, F-59000, Lille, France
| | - B Décaudin
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France.,Pharmacy Institute, CHU Lille, F-59000, Lille, France
| | - N Simon
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France.,Pharmacy Institute, CHU Lille, F-59000, Lille, France
| | - P Odou
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associees, Lille, France.,Pharmacy Institute, CHU Lille, F-59000, Lille, France
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15
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Masse M, Maton M, Genay S, Blanchemain N, Barthélémy C, Décaudin B, Odou P. In vitro assessment of the influence of intravenous extension set materials on insulin aspart drug delivery. PLoS One 2018; 13:e0201623. [PMID: 30114258 PMCID: PMC6095494 DOI: 10.1371/journal.pone.0201623] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/18/2018] [Indexed: 12/16/2022] Open
Abstract
Insulin is a frequently prescribed drug in hospitals and is usually administered by syringe pumps with an extension line which can be made of various materials. Two insulin solutions were studied: an insulin analogue, Novorapid® which contains insulin aspart and two phenolic preservatives (e.g. phenol and metacresol) and Umuline rapide® with human insulin and metacresol as preservative. Some studies have indicated interactions between insulin, polyvinyl chloride (PVC) and polyethylene (PE). The aim of this work was to study such interactions between Novorapid® or Umuline rapide® and infusion extension line materials (PVC, PE and coextruded (PE/PVC)). Insulin solution at 1 IU/mL was infused at 2 mL/h over 24 hours with 16 different extension lines (8 in PVC, 3 in PE and 5 in PE/PVC). Ultra-Fast Liquid Chromatography with diode array detection (UFLC-DAD) was performed to quantify insulin (human and aspart) and preservatives (metacresol and phenol). Limited human insulin sorption was observed thirty minutes after the onset of infusion: 24.3 ± 12.9%, 3.1 ± 1.6% and 18.6 ± 10.0% for PVC, PE and PE/PVC respectively. With insulin aspart, sorption of about 5% was observed at the onset of infusion for all materials. However, there were interactions between phenol and especially metacresol with PVC, but no interactions with PE and PE/PVC. This study shows that insulin interacts with PVC, PE and PE/PVC at the onset of infusion. It also demonstrates that insulin preservatives interact with PVC, which may result in problems of insulin conservation and conformation. Some more studies are required to understand the clinical impact of the latter during infusion.
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Affiliation(s)
- Morgane Masse
- Univ. Lille, EA 7365 – GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
| | - Mickael Maton
- Univ. Lille, CHU Lille, Inserm, U1008 – Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Stéphanie Genay
- Univ. Lille, EA 7365 – GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
- * E-mail:
| | - Nicolas Blanchemain
- Univ. Lille, CHU Lille, Inserm, U1008 – Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Christine Barthélémy
- Univ. Lille, EA 7365 – GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
| | - Bertrand Décaudin
- Univ. Lille, EA 7365 – GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
| | - Pascal Odou
- Univ. Lille, EA 7365 – GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
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Vasseur M, Simon N, Picher C, Richeval C, Soichot M, Humbert L, Barthélémy C, Fleury-Souverain S, Bonnabry P, Décaudin B, Allorge D, Odou P. A decontamination process adding a tensioactive agent and isopropanol to a closed-system drug transfer device for better control of isolator contamination. A prospective, parallel study. PLoS One 2018; 13:e0201335. [PMID: 30089139 PMCID: PMC6082556 DOI: 10.1371/journal.pone.0201335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/13/2018] [Indexed: 11/29/2022] Open
Abstract
Background Despite the use of closed system drug transfer devices (CSTD), residual contamination from antineoplastic drugs is still detected inside isolators. The aim of this study was to compare the decontamination level obtained using a CSTD + standard cleaning procedure with a CSTD + standard cleaning procedure + specific decontamination procedure. Methods and findings A comparative and prospective study was carried out in a newly opened compounding unit. Compounding was performed with a CSTD (BD-Phaseal, Becton-Dickinson). In the Control isolator (C), the cleaning process was completed daily with a standard biocide solution (AnioxysprayTM, Anios, France). In the Intervention isolator (I), weekly decontamination with a homemade admixture of sodium dodecyl sulfate 10−2 M/70% isopropanol (80/20, v/v) was added. Monitoring was performed via a validated LC-MS/MS method. Eight drugs (cyclophosphamide, cytarabine, dacarbazine, fluorouracile, gemcitabine, ifosfamide, irinotecan and methotrexate) were monitored daily over 14 consecutive weeks on three sites inside the isolators: gloves, workbench and window. Results are presented as the odds-ratio (OR) of contamination and as overall decontamination efficiency (EffQ, %). The proportion of EffQ ≥ 90% was assessed by a Fisher’s exact test (p<0.05). Overall contamination rates (CR, %) were significantly different from one isolator to the other (CRC = 25.3% vs. CRI = 10.4%; OR = 0.341; p<0.0001). Overall EffQ values (median; 1st and 3rd quartiles) were higher in the intervention isolator (I: 78.3% [34.6%;92.6%] vs. C: 59.5% [-5.5%;72.6%]; p = 0.0015) as well as the proportion of days with an EffQ ≥ 90% (I: 42.9% vs. C: 7.1%; p = 0.077) but very variable depending on drugs. Conclusion Adding a decontamination protocol with a tensioactive agent to a CSTD leads to better control of chemical contamination inside isolators. Improving decontamination by increasing decontamination frequency or modifying the protocol will be further studied.
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Affiliation(s)
- Michèle Vasseur
- Univ. Lille, EA 7365—GRITA—Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
| | - Nicolas Simon
- Univ. Lille, EA 7365—GRITA—Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
- * E-mail:
| | - Chloé Picher
- Univ. Lille, EA 4483 –IMPECS–IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France
- CHU Lille, Pôle de Biologie-Pathologie-Génétique, Unité Fonctionnelle de Toxicologie, Lille, France
| | - Camille Richeval
- Univ. Lille, EA 4483 –IMPECS–IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France
- CHU Lille, Pôle de Biologie-Pathologie-Génétique, Unité Fonctionnelle de Toxicologie, Lille, France
| | - Marion Soichot
- Laboratoire de Toxicologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Luc Humbert
- Univ. Lille, EA 4483 –IMPECS–IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France
- CHU Lille, Pôle de Biologie-Pathologie-Génétique, Unité Fonctionnelle de Toxicologie, Lille, France
| | - Christine Barthélémy
- Univ. Lille, EA 7365—GRITA—Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
| | - Sandrine Fleury-Souverain
- Pharmacy, Geneva University Hospitals and School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Pascal Bonnabry
- Pharmacy, Geneva University Hospitals and School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Bertrand Décaudin
- Univ. Lille, EA 7365—GRITA—Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
| | - Delphine Allorge
- Univ. Lille, EA 4483 –IMPECS–IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France
- CHU Lille, Pôle de Biologie-Pathologie-Génétique, Unité Fonctionnelle de Toxicologie, Lille, France
| | - Pascal Odou
- Univ. Lille, EA 7365—GRITA—Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France
- CHU Lille, Institut de Pharmacie, Lille, France
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Barnoud D, Pinçon C, Bruno B, Béné J, Gautier S, Lahoche A, Petitpain N, Vasseur M, Barthélémy C, Décaudin B, Simon N, Odou P. Acute kidney injury after high dose etoposide phosphate: A retrospective study in children receiving an allogeneic hematopoetic stem cell transplantation. Pediatr Blood Cancer 2018. [PMID: 29528179 DOI: 10.1002/pbc.27038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Etoposide phosphate (EP; single injection, 60 mg/kg) followed by total body irradiation (TBI) at 12 Gy has been used as an allogeneic stem cell transplantation (allo-SCT) conditioning regimen for children since 2010. In our institution, EP has been suspected of leading to acute nephrotoxicity. The aim of this study was to assess the potential renal toxicity of EP in this context. MATERIALS AND METHODS A retrospective study was carried out on children hospitalized between 2007 and 2015 for allo-SCT with TBI-based myeloablative conditioning associated with cyclophosphamide (CY, 60 mg/kg/day × 2 days) or EP. The primary endpoint of the study was the occurrence of acute kidney injury (AKI). Additional endpoints were time to recovery for children with AKI, survival, and treatment-related mortality. RESULTS Thirty-five patients were analyzed (CY: 22 vs. EP: 13). AKI occurred more frequently in the EP group than in the CY one (69% vs. 27%, adjusted odds ratio 6.0, 95% confidence interval [CI] [1.145; 31.445], P = 0.03). The median time to recovery was estimated at 3 days, 95% CI (2; 17), with CY and 11 days 95% CI (5; 18) with EP (adjusted hazard ratio of recovery for EP vs. CY 0.262, 95% CI [0.071; 0.969], P = 0.04). No significant difference was highlighted between the two treatments for survival or for treatment-related mortality. DISCUSSION This study shows that EP at high dosage or one of its excipients is probably responsible for AKI, as compared to CY. Further studies are required to explore the origin of this adverse effect.
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Affiliation(s)
| | - Claire Pinçon
- EA 2694-Santé publique: épidémiologie et qualité des soins, Université de Lille, Lille, France
| | - Bénédicte Bruno
- Service d'Hématologie Pédiatrique, Centre Hospitalier Regional Universitaire de Lille, Lille, France
| | - Johana Béné
- Centre Régional de Pharmacovigilance, Centre Hospitalier Regional Universitaire de Lille, Lille, France.,U1171-Degenerative & Vascular Cognitive Disorders, Université de Lille, Lille, France
| | - Sophie Gautier
- Centre Régional de Pharmacovigilance, Centre Hospitalier Regional Universitaire de Lille, Lille, France.,U1171-Degenerative & Vascular Cognitive Disorders, Université de Lille, Lille, France
| | - Annie Lahoche
- Service de Néphrologie Pédiatrique, Centre Hospitalier Regional Universitaire de Lille, Lille, France
| | - Nadine Petitpain
- Laboratoire de pharmacologie clinique et toxicologie, centre régional de pharmacovigilance de Lorraine, hôpital Central, Centre Hospitalier Regional Universitaire de Nancy, Nancy, France
| | - Michèle Vasseur
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, 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
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Nicolas Simon
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Pascal Odou
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
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18
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Benlabed M, Perez M, Gaudy R, Genay S, Lannoy D, Barthélémy C, Odou P, Lebuffe G, Décaudin B. Clinical implications of intravenous drug incompatibilities in critically ill patients. Anaesth Crit Care Pain Med 2018; 38:173-180. [PMID: 29680262 DOI: 10.1016/j.accpm.2018.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 01/06/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this review is to analyse the clinical consequences of intravenous drug incompatibilities in critically ill patients, especially the incidence of organ dysfunctions and mortality. METHODS A review of literature was conducted according to the PRISMA statement in June 2017, using Medline, ISI Web of Science and Clinicaltrials.gov. DATA EXTRACTION Eligible studies were case reports and randomised controlled trials (RCTs) that assessed the effects of drug incompatibilities in critically ill patients on morbidity or mortality as primary or secondary outcomes, or adverse events. Two investigators independently reviewed the eligibility of the study from abstracts or manuscript data. DATA SYNTHESIS Twelve articles met the selection criteria. The six articles reporting RCTs concern only four RCTs. RCTs were single-centre studies comparing infusion with or without filter. One of them included adult patients. The others included paediatric and neonatal intensive care unit patients. Primary endpoints were SIRS, organ failure, overall complication rate, bacteraemia, sepsis, phlebitis and length of stay. The results are mixed with one RCT reporting a reduction in SIRS, organ failure and overall complication rate, two studies in disagreement over the occurrence of sepsis and one study reporting no impact on length of hospital stay. The six articles on case reports show different drug incompatibility situations. They report pulmonary toxicity. CONCLUSION Little data is available on this topic. Infused particles may induce organ failure, in particular pulmonary toxicity and SIRS. Further studies are needed to establish a link between the level of exposure to drug incompatibilities and clinical implication.
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Affiliation(s)
- Malik Benlabed
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Maxime Perez
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Romain Gaudy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Stéphanie Genay
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Damien Lannoy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Christine Barthélémy
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France
| | - Pascal Odou
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France
| | - Gilles Lebuffe
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pôle d'anesthésie-réanimation, CHU de Lille, 59000 Lille, France
| | - Bertrand Décaudin
- Groupe de recherche sur les formes injectables et les technologies associées (GRITA), University Lille, EA 7365, 59000 Lille, France; Pharmacie, CHU de Lille, 59000 Lille, France.
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19
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Haybrard J, Simon N, Danel C, Pinçon C, Barthélémy C, Tessier FJ, Décaudin B, Boulanger E, Odou P. Factors Generating Glucose Degradation Products In Sterile Glucose Solutions For Infusion: Statistical Relevance Determination Of Their Impacts. Sci Rep 2017; 7:11932. [PMID: 28931894 PMCID: PMC5607278 DOI: 10.1038/s41598-017-12296-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Sterilising glucose solutions by heat promotes the generation of a large number of glucose degradation products (GDPs). It has been shown that high levels of GDPs may result in Advanced Glycation End products that have an impact on cellular homeostasis and health in general. If data is available for peritoneal dialysis solutions, little has been published for glucose infusion fluids. It is essential to identify the parameters causing the formation of GDPs and so limit the risk of exposing patients to them. After quantifying both 5-hydroxymethyl-2-furfural, considered as an important indicator of degradation, and 2-furaldehyde, an ultimate GDP of one degradation pathway, in marketed solutions, the aim of this work is to build a model integrating all the parameters involved in the formation rates of these two GDPs: supplier, glucose amount, container material, oxygen permeability coefficient and time-lapse since manufacture. Our results show a good logarithmic relationship between GDP formation rates and time-lapse since manufacture for both GDPs. The amount of GDPs in the glucose solutions for infusion depends on the initial glucose amount, the polymer of the container, the time elapsed since manufacturing and the supplier.
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Affiliation(s)
- J Haybrard
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - N Simon
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France. .,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France.
| | - C Danel
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - C Pinçon
- Univ. Lille, EA 2694, 59000, Lille, Cedex, France
| | - C Barthélémy
- Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - F J Tessier
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, F-59000, Lille, France
| | - B Décaudin
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - E Boulanger
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, F-59000, Lille, France
| | - P Odou
- CHU Lille, Institut de Pharmacie, F-59000, Lille, France.,Univ. Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
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20
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Perez M, Décaudin B, Maiguy-Foinard A, Barthélémy C, Lebuffe G, Storme L, Odou P. Dynamic Image Analysis To Evaluate Subvisible Particles During Continuous Drug Infusion In a Neonatal Intensive Care Unit. Sci Rep 2017; 7:9404. [PMID: 28839243 PMCID: PMC5571216 DOI: 10.1038/s41598-017-10073-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 08/04/2017] [Indexed: 11/24/2022] Open
Abstract
Studies have shown that infused particles lead to numerous complications such as inflammation or organ dysfunctions in critically ill children. Nevertheless, there is very little data available to evaluate the amount of particulate matter potentially administered to patients, and none with regard to infants. We have investigated the quantity received by these patients during multidrug IV therapies. Two different protocols commonly used in our neonatal intensive care unit (NICU) to manage excessively preterm infants were reproduced in the laboratory and directly connected to a dynamic particle analyser. The particulate matter of infused therapies was measured over 24 h, so that both overall particulate contamination and particle sizes could be determined. No visible particles were observed during drug infusions. Particulate analyses showed a significant number of particles that can reach 85,000 per day, with peaks during discontinuous drug infusions. Moreover, we showed that very large particles of about 60 µm were infused to infants. This study showed that despite very low infusion flow rates, infants may receive a large number of particles during drug infusion, especially in NICUs. Particulate contamination of IV fluids is not without consequences for fragile infants. Preventive solutions could be effective, such as the use of in-line filters.
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Affiliation(s)
- Maxime Perez
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France. .,CHU Lille, Pharmacie, F-59000, Lille, France.
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France.,CHU Lille, Pharmacie, F-59000, Lille, France
| | - Aurélie Maiguy-Foinard
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France.,CHU Lille, Pharmacie, F-59000, Lille, France
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Gilles Lebuffe
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France.,CHU Lille, Clinique d'Anesthésie-Réanimation, F-59000, Lille, France
| | - Laurent Storme
- CHU Lille, Clinique de Néonatalogie, F-59000, Lille, France.,Univ. Lille, CHU Lille, EA 4489 - Environnement Périnatal et Santé, F-59000, Lille, France
| | - Pascal Odou
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les Formes Injectables et les Technologies Associées, F-59000, Lille, France.,CHU Lille, Pharmacie, F-59000, Lille, France
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21
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Lefebvre M, Simon N, Vasseur M, Sidikou O, Barthélémy C, Décaudin B, Odou P. Evaluation of Specific Administering Devices for Antineoplastic Drugs Compounded in Syringes in Paediatry: Methodology Proposal. J Oncol Pharm Pract 2017; 25:1078155217733323. [PMID: 28975864 DOI: 10.1177/1078155217733323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The aims of this study were to propose a simple methodology to assess the rinsing volume of syringe extension sets and to compare several marketed devices. Methods A UV-spectrophotometry assay using quinine hydrochloride as drug substitute was developed. Quinine concentration ranged from 20 to 200 µg/ml. The assay was validated with the accuracy profile method and tested on five different assemblies (device+extension sets) with different dead-space volumes (1.28-2.80 ml) and at two different quinine concentrations (0.3 and 8.0 mg/ml). Rinsing was performed stepwise with water for injection until reaching an undetectable quinine concentration. After fitting the data with a Weibull model, assemblies were compared with an ANOVA performed on ranks (GraphPad, La Jolla, USA). Results The within-day and between-day precision ranges were 0.39-0.81 and 0.48-0.84%, respectively. The lower limit of quantification was 4.26 µg/ml. The volume required to completely rinse the infusion line was different according to the initial drug concentration and to the device assessed: from 6 to 10 ml for a low quinine concentration and from 7 to 17 ml for a high quinine concentration. Conclusion This study shows that a simple, cheap and easy-to-use methodology may be used to assess the rinsing volume of syringe extension sets. The rinsing volume is different according to the tested device.
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Affiliation(s)
| | - Nicolas Simon
- 1 CHU Lille, Institut de Pharmacie, F-59000 Lille, France
- 2 Univ. Lille, EA 7365 GRITA Groupe de Recherche sur les formes Injectables et les Technologies AssociÕes, F-59000 Lille, France
| | - Michèle Vasseur
- 1 CHU Lille, Institut de Pharmacie, F-59000 Lille, France
- 2 Univ. Lille, EA 7365 GRITA Groupe de Recherche sur les formes Injectables et les Technologies AssociÕes, F-59000 Lille, France
| | | | - Christine Barthélémy
- 2 Univ. Lille, EA 7365 GRITA Groupe de Recherche sur les formes Injectables et les Technologies AssociÕes, F-59000 Lille, France
| | - Bertrand Décaudin
- 1 CHU Lille, Institut de Pharmacie, F-59000 Lille, France
- 2 Univ. Lille, EA 7365 GRITA Groupe de Recherche sur les formes Injectables et les Technologies AssociÕes, F-59000 Lille, France
| | - Pascal Odou
- 1 CHU Lille, Institut de Pharmacie, F-59000 Lille, France
- 2 Univ. Lille, EA 7365 GRITA Groupe de Recherche sur les formes Injectables et les Technologies AssociÕes, F-59000 Lille, France
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Feutry F, Genay S, Velghe C, Barthélémy C, Décaudin B, Odou P. Stability of midazolam and noradrenaline stored in cyclic olefin copolymer AT-Closed Vials® and polypropylene syringes during 365 days. Pharmaceutical Technology in Hospital Pharmacy 2017. [DOI: 10.1515/pthp-2017-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Genay S, Feutry F, Masse M, Barthélémy C, Sautou V, Odou P, Décaudin B, Azaroual N. Identification and quantification by 1H nuclear magnetic resonance spectroscopy of seven plasticizers in PVC medical devices. Anal Bioanal Chem 2016; 409:1271-1280. [PMID: 27822646 DOI: 10.1007/s00216-016-0053-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/12/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
Medical devices are generally made of polyvinyl chloride plasticized by six authorized plasticizers as alternatives to di-(2-ethylhexyl)-phthalate (DEHP) classified as reprotoxic class 1b. These are acetyl tri-n-butyl citrate (ATBC), di-(2-ethylhexy) adipate (DEHA), di-(2-ethylhexyl) terephthalate (DEHT), di-isononyl cyclohexane-1,2-dicarboxylate (DINCH), di-isononyl phthalate (DINP), and tri-octyl trimellitate (TOTM). The main objective of this study was to propose a new method using 1H NMR spectroscopy to determine and quantify these seven plasticizers in PVC sheets, standard infusion tubings, and commercially available medical devices. Two techniques were compared: dissolution in deuterated tetrahydrofuran and extraction by deuterated chloroform. Plasticizer 1H NMR spectra were very similar in both deuterated solvents; dissolution and extraction provided similar results. The sensitivity of this method enabled us to detect and quantify the presence of minor plasticizers in PVC. In nine commercially available samples, the major plasticizer was identified and quantified by 1H NMR. In six samples, one, two, or three minor plasticizers were identified and also quantified. DEHP was detected in only one tubing. NMR is therefore very convenient for studying plasticizers contained in medical devices. Only small quantities of solvents and sample are required. It is not necessary to dilute samples to enter a quantification range, and it is sufficiently sensitive to detect contaminants.
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Affiliation(s)
- Stéphanie Genay
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Frédéric Feutry
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Morgane Masse
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Valérie Sautou
- Clermont Université, Université d'Auvergne, CHU Clermont-Ferrand, EA 4676, C-BIOSENSS, BP 10448, F-63000, Clermont-Ferrand, France
| | - Pascal Odou
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France.
| | - Nathalie Azaroual
- Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
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Bernard L, Bourdeaux D, Pereira B, Azaroual N, Barthélémy C, Breysse C, Chennell P, Cueff R, Dine T, Eljezi T, Feutry F, Genay S, Kambia N, Lecoeur M, Masse M, Odou P, Radaniel T, Simon N, Vaccher C, Verlhac C, Yessad M, Décaudin B, Sautou V. Analysis of plasticizers in PVC medical devices: Performance comparison of eight analytical methods. Talanta 2016; 162:604-611. [PMID: 27837878 DOI: 10.1016/j.talanta.2016.10.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/30/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
A wide variety of medical devices (MDs) used in hospitals are made of flexible plasticized polyvinylchloride (PVC). Different plasticizers are present in variable amounts in the PVC matrix of the devices and can leach out into the infused solutions and may enter into contact with the patients. The ARMED1 project aims to assess the migration of these plasticizers from medical devices and therefore the level of exposure in patients. For the first task of the project, eight methods were developed to directly detect and quantify the plasticizers in the PVC matrix of the MDs. We compared the overall performances of the analytical methods using standardized and validated criteria in order to provide the scientific community with the guidance and the technical specifications of each method for the intended application. We have shown that routine rapid screening could be performed directly on the MDs using the FTIR technique, with cost-effective analyses. LC techniques may also be used, but with limits and only with individual quantification of the main plasticizers expected in the PVC matrix. GC techniques, especially GC-MS, are both more specific and more sensitive than other techniques. NMR is a robust and specific technique to precisely discriminate all plasticizers in a MD but is limited by its cost and its low ability to detect and quantify plasticizer contamination, e.g. by DEHP. All these results have been confirmed by a real test, called the " blind test " carried out on 10 MD samples.
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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.
| | - 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
| | - B Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques, Délégation Recherche Clinique & Innovation, F-63000 Clermont-Ferrand, France
| | - N Azaroual
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - C Barthélémy
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - C Breysse
- Centre de Ressources Technologiques 3s'Inpack, 63173 Aubière cedex, France
| | - P Chennell
- 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
| | - T Dine
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - T Eljezi
- Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
| | - F Feutry
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - S Genay
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - N Kambia
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - M Lecoeur
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - M Masse
- University 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
| | - P Odou
- University 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
| | - T Radaniel
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - N Simon
- University 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
| | - C Vaccher
- University Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - C Verlhac
- Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
| | - M Yessad
- Clermont Université, Université d'Auvergne, EA 4676 C-BIOSENSS, BP 10448, F-63000 Clermont-Ferrand, France
| | - B Décaudin
- University 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
| | - 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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Hreich EK, Messarra C, Roux S, Barthélémy C, Richa S. [Validation in Arabic of the Revised Autistic Behavior Summarized Evaluation Scale (BSE-R)]. Encephale 2016; 43:451-456. [PMID: 27637874 DOI: 10.1016/j.encep.2016.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 04/20/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
The Behavioral Summarized Evaluation is a rating scale specifically related to the assessment of autistic behaviors in children and young teenagers with Autism Spectrum Disorder, such as communication, social interaction and interests. It also facilitates progressive recording of the evolution of children with ASD involved in short-term therapeutical studies. In the absence of standardized tools to assess autistic behaviors and effects of therapeutics in Lebanon, the BSE-R validation is an urgent need. The purpose of this study is to validate the BSE-R to the Lebanese population. METHOD Specialized translators and clinicians ensured forward and backward translation of the scale into Arabic. The participants consisted of 100 children with ASD, diagnosed upon DSMIV-TR criterion (age range: 35 to 153 months, DS: 28.0). Fifty-eight had intellectual disability (ID). Scores of autism severity as measured by CARS1 (Schopler et al., 1980) varied from 20-58.5. Trained raters on recorded individual and group situations performed BSE-R ratings. RESULTS BSE-R for Lebanese was found to have excellent inter-rater reliability. The internal validity highlighted a main factor which describes the severity of core autistic behaviors related to social interactions and communication, and behavioral specificities and particular interests with an internal consistency of 0.91 in a one-to-one setting and 0.92 in group settings. External validity of the scale as measured by correlations with CARS and the age of the children showed that this main factor is essentially determined by ASD severity, not by the severity of ID. It was named "relational deficiency" according to the initial paper of Barthélémy et al. (1997). CONCLUSION BSE-R in Arabic is a practical tool, useful to all team members working with ASD children in Lebanon and the Arab countries. It will also allow future research based on reliable tools at an international level.
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Affiliation(s)
- E K Hreich
- Institut supérieur d'orthophonie, faculté de médecine, université Saint-Joseph, Beyrouth, Liban
| | - C Messarra
- Institut supérieur d'orthophonie, faculté de médecine, université Saint-Joseph, Beyrouth, Liban
| | - S Roux
- UMR Inserm 930, université François-Rabelais de Tours, 2, boulevard Tonnelle, 37044 Tours cedex, France
| | - C Barthélémy
- UMR Inserm 930, université François-Rabelais de Tours, 2, boulevard Tonnelle, 37044 Tours cedex, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, 37044 Tours cedex 9, France
| | - S Richa
- Département de psychiatrie, faculté de médecine, université Saint-Joseph, Beyrouth, Liban; Service de psychiatrie, CHU Hôtel-Dieu de France, BP 166830, boulevard Alfred Naccache, Achrafieh, Beyrouth, Liban.
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Abstract
We hypothesized that the difficulties of the child with autism originate from disorders of organization and regulation of actions according to environmental changes. Autism impoverishes general mental representation skills, which are the basis of symbolic play and the development of communication. Twenty-one children with autism were compared with 14 children with global intellectual impairment and 15 matched typically developing children, on both regulation of play activities and communication development. Regulation of play was very disordered in children with autism, with breaking off, dissociation and instability of actions. However, in directed play their actions were more structured and corresponded to a better developmental level. In addition, dysregulation was associated with delayed, heterogeneous development of communication skills. The results of this study are in line with our hypotheses and emphasize the role of symbolic play in differential diagnosis and the value of therapies based on regulation processes and symbolic play.
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Affiliation(s)
- R Blanc
- Université René Descartes, Boulogne-Billancourt, France.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Perez M, Maiguy-Foinard A, Barthélémy C, Décaudin B, Odou P. Particulate Matter in Injectable Drugs: Evaluation of Risks to Patients. Pharmaceutical Technology in Hospital Pharmacy 2016. [DOI: 10.1515/pthp-2016-0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AbstractOne of the fundamental principles guiding the pharmaceutical quality of parenteral products is to prevent injecting contaminants from microbiological, chemical or physical sources. It is just as difficult to ensure the absence of chemical and particulate contaminants in injectable products as it is to weigh up the microbiological risk. The problem of particulate matter is mainly related to the preparing and administrating of injectable drugs rather than through the contamination of marketed products. Particulate contamination also arises
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Mazzocco P, Barthélémy C, Kaloshi G, Lavielle M, Ricard D, Idbaih A, Psimaras D, Renard MA, Alentorn A, Honnorat J, Delattre JY, Ducray F, Ribba B. Prediction of Response to Temozolomide in Low-Grade Glioma Patients Based on Tumor Size Dynamics and Genetic Characteristics. CPT Pharmacometrics Syst Pharmacol 2015; 4:728-37. [PMID: 26904387 PMCID: PMC4759703 DOI: 10.1002/psp4.54] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/23/2015] [Accepted: 05/04/2015] [Indexed: 01/27/2023]
Abstract
Both molecular profiling of tumors and longitudinal tumor size data modeling are relevant strategies to predict cancer patients' response to treatment. Herein we propose a model of tumor growth inhibition integrating a tumor's genetic characteristics (p53 mutation and 1p/19q codeletion) that successfully describes the time course of tumor size in patients with low‐grade gliomas treated with first‐line temozolomide chemotherapy. The model captures potential tumor progression under chemotherapy by accounting for the emergence of tissue resistance to treatment following prolonged exposure to temozolomide. Using information on individual tumors' genetic characteristics, in addition to early tumor size measurements, the model was able to predict the duration and magnitude of response, especially in those patients in whom repeated assessment of tumor response was obtained during the first 3 months of treatment. Combining longitudinal tumor size quantitative modeling with a tumor''s genetic characterization appears as a promising strategy to personalize treatments in patients with low‐grade gliomas.
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Affiliation(s)
- P Mazzocco
- Inria, project-team Numed, Ecole Normale Supérieure de Lyon Lyon France
| | - C Barthélémy
- Inria, project-team Popix, Université Paris-Sud Orsay France
| | - G Kaloshi
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - M Lavielle
- Inria, project-team Popix, Université Paris-Sud Orsay France
| | - D Ricard
- Hôpital d'instruction des Armées du Val-de-Grâce Paris France
| | - A Idbaih
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - D Psimaras
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - M-A Renard
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - A Alentorn
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - J Honnorat
- Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncologie; Université de Lyon, Claude Bernard Lyon 1, Lyon Neuroscience Research Center INSERM U1028/CNRS UMR Lyon France
| | - J-Y Delattre
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie Mazarin; INSERM, U975, Centre de Recherche de l'Institut du Cerveau et de la Moelle, Université Pierre & Marie Curie Paris VI, Faculté de Médecine Pitié-Salpêtrière, CNRS UMR 7225 and UMR-S975 Paris France
| | - F Ducray
- Hospices Civils de Lyon, Hôpital Neurologique, Neuro-oncologie; Université de Lyon, Claude Bernard Lyon 1, Lyon Neuroscience Research Center INSERM U1028/CNRS UMR Lyon France
| | - B Ribba
- Inria, project-team Numed, Ecole Normale Supérieure de Lyon Lyon France
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Simon N, Romano O, Michel P, Pinçon C, Vasseur M, Lemahieu N, Barthélémy C, Hebbar M, Décaudin B, Odou P. Influence of infusion method on gemcitabine pharmacokinetics: a controlled randomized multicenter trial. Cancer Chemother Pharmacol 2015; 76:865-71. [DOI: 10.1007/s00280-015-2819-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
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Perez M, Décaudin B, Abou Chahla W, Nelken B, Barthélémy C, Lebuffe G, Odou P. In vitro analysis of overall particulate contamination exposure during multidrug IV therapy: impact of infusion sets. Pediatr Blood Cancer 2015; 62:1042-7. [PMID: 25755136 DOI: 10.1002/pbc.25442] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/02/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Drug incompatibilities, recognizable through precipitate, may have clinical consequences for patients, especially during multidrug IV therapies, where vancomycin and piperacillin are present. Drug concentration and infusion set influence the overall particulate contamination of pediatric infusion protocols. The use of multi-lumen infusion sets could prevent such incompatibilities. Our goal was to define and assess a new way to infuse these drugs during leukemia treatment in children. PROCEDURES This in vitro study focused on a pediatric multidrug protocol for patients diagnosed with lymphoblastic leukemia and receiving allogeneic transplantation. Different vancomycin concentrations were tested to infuse incompatible drugs simultaneously without any particle formation (optimized multidrug protocol). A dynamic particle count test was used over 24 hr to evaluate the overall particulate contamination of our standard and optimized multidrug protocols, using both a standard and a multi-lumen infusion set. RESULTS No visible particles were detected on a decreased vancomycin concentration compared to the standard dose. For the optimized multidrug protocol, the use of a multi-lumen infusion set reduced overall particulate contamination by 68%, compared to the standard infusion set (P = 0.002). Large-sized particles were significantly reduced when using the multi-lumen infusion set approximately 60% (P = 0.027) and 90% (P = 0.009) for particle sizes ≥10 μm and 25 μm, respectively. CONCLUSIONS This study demonstrates that a large number of particles can be administered during parenteral multidrug infusion. The choice of drug concentration and/or the type of infusion set may reduce this. Further studies are required to evaluate adverse clinical effects.
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Affiliation(s)
- Maxime Perez
- EA GRITA, University Lille Nord de France, Lille, France; Institute of Pharmacy, Lille University Hospital, Lille, France
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Feutry F, Simon N, Genay S, Lannoy D, Barthélémy C, Décaudin B, Labalette P, Odou P. Stability of 10 mg/mL cefuroxime solution for intracameral injection in commonly used polypropylene syringes and new ready-to-use cyclic olefin copolymer sterile vials using the LC-UV stability-indicating method. Drug Dev Ind Pharm 2015; 42:166-174. [DOI: 10.3109/03639045.2015.1038273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Frédéric Feutry
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Nicolas Simon
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Stéphanie Genay
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Damien Lannoy
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Christine Barthélémy
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Bertrand Décaudin
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
| | - Pierre Labalette
- Department of Ophthalmology, University Hospital Center, Lille, France
| | - Pascal Odou
- Pharmacy Institute, University Hospital Center, Lille, France,
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, UFR Pharmacie, Lille, France, and
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Foinard A, Perez M, Barthélémy C, Lannoy D, Flamein F, Storme L, Tournoys A, Décaudin B, Odou P. Assessment of anti-factor Xa activity of heparin in binary parenteral nutrition admixtures for premature neonates. Ann Pharm Fr 2015; 73:277-80. [PMID: 25863599 DOI: 10.1016/j.pharma.2015.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 11/30/2022]
Abstract
An in vitro study was carried out to determine the anti-Xa activity of heparin in binary parenteral nutrition (BPN) admixtures for premature neonates in our neonatal intensive care unit (NICU) after a 24-hour infusion, as well as to assess drug interaction with a 50% glucose solution. Two types of bags were prepared: (1) BPN admixtures (composition defined in the NICU) including sodium heparin at 77 UI/mL and (2) bags containing only G50% with sodium heparin at 193 UI/mL. The anti-Xa activity of heparin was measured in bags at T0, after the 24-hour infusion and in eluates at the outlet of the infusion line after 24hours, using a validated chromogenic anti-Xa method. Comparisons of the mean concentration observed with the theoretical value for anti-Xa activity were performed with the Student t-test. Mean values of anti-Xa activity do not differ significantly from the values expected for all conditions. We found a slight variation in anti-Xa activity when infused over 24hours for both types of bags, with and without in-line filtration, showing that heparin remains stable during this infusion period in both BPN admixtures and G50%.
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Affiliation(s)
- A Foinard
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France; Institut de pharmacie, CHRU de Lille, rue Philippe-Marache, 59037 Lille cedex, France
| | - M Perez
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France; Institut de pharmacie, CHRU de Lille, rue Philippe-Marache, 59037 Lille cedex, France
| | - C Barthélémy
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France
| | - D Lannoy
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France; Institut de pharmacie, CHRU de Lille, rue Philippe-Marache, 59037 Lille cedex, France
| | - F Flamein
- Service de néonatalogie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2 avenue Oscar-Lambret, 59037 Lille cedex, France
| | - L Storme
- Service de néonatalogie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2 avenue Oscar-Lambret, 59037 Lille cedex, France; EA4489, laboratoire environnement périnatal et santé, université Lille Nord de France, 1, place de Verdun, 59045 Lille cedex, France
| | - A Tournoys
- Laboratoire d'hématologie, centre de biologie pathologie, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille cedex, France
| | - B Décaudin
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France; Institut de pharmacie, CHRU de Lille, rue Philippe-Marache, 59037 Lille cedex, France.
| | - P Odou
- EA GRITA, laboratoire de biopharmacie, pharmacie galénique et hospitalière, université Lille Nord de France, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France; Institut de pharmacie, CHRU de Lille, rue Philippe-Marache, 59037 Lille cedex, France
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Perez M, Décaudin B, Foinard A, Barthélémy C, Debaene B, Lebuffe G, Odou P. Compatibility of medications during multi-infusion therapy: A controlled in vitro study on a multilumen infusion device. Anaesth Crit Care Pain Med 2015; 34:83-8. [PMID: 25858619 DOI: 10.1016/j.accpm.2014.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 06/02/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Drug incompatibilities can jeopardize the safety and effectiveness of intravenous drug therapies, especially in the field of anaesthesia and intensive care. Patients receive many drugs simultaneously through limited venous accesses. This study was designed to confirm the impact of a multilumen infusion device on the occurrence of known physical drug incompatibilities. STUDY DESIGN In vitro laboratory work. METHODS Two infusion devices were studied: a standard single-lumen set and a multilumen infusion access device (Edelvaiss Multiline-8, Doran International). Up to six drugs were infused simultaneously: three acidic solutions of midazolam, amiodarone and dobutamine, and three alkaline solutions of furosemide, pantoprazole and amoxicillin/clavulanate. Saline, Ringer' solution and 5% dextrose were used as hydration vehicles with an infusion rate initially set at 100 mL/h and with stepwise decreases of 10 mL/h until precipitation. Two methods were used to highlight physical drug compatibility according to the European Pharmacopoeia: visual inspection of the extension set and an obscured-light sub-visible particle count test of infusions. The lowest infusion rate value for vehicle infusion to satisfy the two tests in all trials is reported for each infusion device. RESULTS The standard set did not satisfy the test in 82% of the assessed drug combinations. The Edelvaiss Multiline-8 was able to prevent the occurrence of drug incompatibilities in 49% of the drug combinations tested. This device is therefore advantageous, especially when simultaneously infusing two or four incompatible drugs. CONCLUSIONS Infusion device characteristics have an impact on physical drug incompatibilities. Our results confirm that the Edelvaiss Multiline-8 device prevents physical drug incompatibilities under specified conditions.
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Affiliation(s)
- Maxime Perez
- Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France
| | - Bertrand Décaudin
- Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France.
| | - Aurélie Foinard
- Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France
| | - Christine Barthélémy
- Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France
| | - Bertrand Debaene
- Department of Anesthesia and Intensive Care, Poitiers University Hospital, Inserm U1070, 86021 Poitiers, France
| | - Gilles Lebuffe
- Department of Anesthesia and Intensive Care Medicine, Lille University Hospital, EA 1046, IFR 114, 59037 Lille, France
| | - Pascal Odou
- Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France
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Perez M, Décaudin B, Abou Chahla W, Nelken B, Barthélémy C, Lebuffe G, Odou P. GM-010 Reducing the overall particulate contamination exposure in paediatric patients: the advantage of using multilumen infusion sets. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lebecque M, Simon N, Legrand JF, Pinturaud M, Vasseur M, Barthélémy C, Décaudin B, Odou P. OHP-017 Ability of infusion devices to deliver the expected volume of antineoplastic drug in solution: an in vitroassessment: Abstract OHP-017 Table 1. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Foinard A, Perez M, Barthélémy C, Lannoy D, Flamein F, Storme L, Addad A, Bout MA, Décaudin B, Odou P. In Vitro Assessment of Interaction Between Amino Acids and Copper in Neonatal Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2015; 40:827-34. [PMID: 25712958 DOI: 10.1177/0148607115571967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/18/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The repeated blackening of in-line filters has been observed during the infusion of parenteral nutrition 2-in-1 mixtures (binary parenteral nutrition [BPN]) delivered in a neonatal intensive care unit. This study aimed to examine the elemental content of precipitates isolated from infused BPN bags and determine the main physicochemical interactions occurring in these bags. MATERIALS AND METHODS The infusion of BPN mixtures was simulated in vitro following hospital practices. Filter membranes were examined by scanning electron microscopy and energy dispersion spectroscopy (EDS). Amino acid (AA) profiles were obtained from BPN mixtures to determine the concentrations of each AA. RESULTS Analyzed filter membranes revealed conglomerates of particles on filter surfaces. An EDS analysis generated spectra from isolated particles, identifying copper and sulfur as the major chemical elements. AA mean concentrations were relatively close to the expected value for each AA, except cysteine. Cysteine concentrations were very significantly lower than the expected values. CONCLUSION A specific interaction was identified between 1 AA (cysteine) and a trace element (copper) in our BPN mixtures.
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Affiliation(s)
- Aurélie Foinard
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France
| | - Maxime Perez
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France
| | - Christine Barthélémy
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France
| | - Damien Lannoy
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France Institute of Pharmacy, University Hospital of Lille, Lille, France
| | - Florence Flamein
- Department of Neonatology, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France
| | - Laurent Storme
- Department of Neonatology, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France Department of Perinatal Environment and Health, University of Lille Nord de France, Lille, France
| | - Ahmed Addad
- Department of "Unité Matériaux et Transformations," University of Lille 1, Villeneuve d'Ascq, France
| | - Marie-Adélaïde Bout
- Laboratory of Hormonology, Metabolism-Nutrition & Oncology, Center of Biology and Pathology, University Hospital of Lille, Lille, France
| | - Bertrand Décaudin
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France Institute of Pharmacy, University Hospital of Lille, Lille, France
| | - Pascal Odou
- Department of Biopharmacy, Galenic and Hospital Pharmacy, EA GRITA, University of Lille Nord de France, Lille, France Institute of Pharmacy, University Hospital of Lille, Lille, France
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Radaniel T, Genay S, Simon N, Feutry F, Quagliozzi F, Barthélémy C, Lecoeur M, Sautou V, Décaudin B, Odou P. Quantification of five plasticizers used in PVC tubing through high performance liquid chromatographic-UV detection. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 965:158-63. [DOI: 10.1016/j.jchromb.2014.06.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 06/07/2014] [Accepted: 06/25/2014] [Indexed: 11/27/2022]
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Genay S, Feutry F, Santoni A, Décaudin B, Barthélémy C, Simon N, Odou P. PS-031 Insulin infusion: the right equipment for good care! Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Foinard A, Décaudin B, Simon N, Barthélémy C, Storme L, Odou P. Vancomycin syringe study shows significant reduction in dosing variability after introducing a revised protocol. Acta Paediatr 2014; 103:e93-4. [PMID: 24164676 DOI: 10.1111/apa.12484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aurélie Foinard
- Laboratoire de Biopharmacie; Pharmacie Galénique et Hospitalière, EA4481; Université Lille Nord de France; Lille France
| | - Bertrand Décaudin
- Laboratoire de Biopharmacie; Pharmacie Galénique et Hospitalière, EA4481; Université Lille Nord de France; Lille France
- Institut de Pharmacie; CHRU Lille; Lille France
| | - Nicolas Simon
- Laboratoire de Biopharmacie; Pharmacie Galénique et Hospitalière, EA4481; Université Lille Nord de France; Lille France
- Institut de Pharmacie; CHRU Lille; Lille France
| | - Christine Barthélémy
- Laboratoire de Biopharmacie; Pharmacie Galénique et Hospitalière, EA4481; Université Lille Nord de France; Lille France
| | - Laurent Storme
- Clinique de Médecine Néonatale; CHRU Lille; Lille France
- EA4489, Environnement Périnatal et Croissance; Université Lille Nord de France; Lille France
| | - Pascal Odou
- Laboratoire de Biopharmacie; Pharmacie Galénique et Hospitalière, EA4481; Université Lille Nord de France; Lille France
- Institut de Pharmacie; CHRU Lille; Lille France
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Dubourg C, Bonnet-Brilhault F, Toutain A, Mignot C, Jacquette A, Dieux A, Gérard M, Beaumont-Epinette MP, Julia S, Isidor B, Rossi M, Odent S, Bendavid C, Barthélémy C, Verloes A, David V. Identification of Nine New RAI1-Truncating Mutations in Smith-Magenis Syndrome Patients without 17p11.2 Deletions. Mol Syndromol 2014; 5:57-64. [PMID: 24715852 DOI: 10.1159/000357359] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/19/2022] Open
Abstract
Smith-Magenis syndrome (SMS) is an intellectual disability syndrome with sleep disturbance, self-injurious behaviors and dysmorphic features. It is estimated to occur in 1/25,000 births, and in 90% of cases it is associated with interstitial deletions of chromosome 17p11.2. RAI1 (retinoic acid induced 1; OMIM 607642) mutations are the second most frequent molecular etiology, with this gene being located in the SMS locus at 17p11.2. Here, we report 9 new RAI1-truncating mutations in nonrelated individuals referred for molecular analysis due to a possible SMS diagnosis. None of these patients carried a 17p11.2 deletion. The 9 mutations include 2 nonsense mutations and 7 heterozygous frameshift mutations leading to protein truncation. All mutations map in exon 3 of RAI1 which codes for more than 98% of the protein. RAI1 regulates gene transcription, and its targets are themselves involved in transcriptional regulation, cell growth and cell cycle regulation, bone and skeletal development, lipid and glucide metabolisms, neurological development, behavioral functions, and circadian activity. We report the clinical features of the patients carrying these deleterious mutations in comparison with those of patients carrying 17p11.2 deletions.
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Affiliation(s)
- C Dubourg
- Laboratoire de Génétique Moléculaire, CHU Pontchaillou, France ; CNRS UMR 6290, IFR140, Université de Rennes 1, France
| | | | - A Toutain
- Génétique, CHRU Bretonneau, Tours, France
| | - C Mignot
- Service de Génétique Clinique, CHU La Pitié Salpêtrière, France ; Service de Neuropédiatrie, APHP, Hôpital Armand Trousseau, France
| | - A Jacquette
- Service de Génétique Clinique, CHU La Pitié Salpêtrière, France
| | - A Dieux
- Service de Génétique Clinique, CHU, Lille, France
| | - M Gérard
- Service de Génétique, CHR Clémenceau, Caen, France
| | | | - S Julia
- Service de Génétique Médicale, CHU Purpan, Toulouse, France
| | - B Isidor
- Service de Génétique Médicale, CHU, Nantes, France
| | - M Rossi
- Service de Génétique Clinique, CHU, Lyon-Bron, France
| | - S Odent
- CNRS UMR 6290, IFR140, Université de Rennes 1, France ; Service de Génétique Médicale, CHU Hôpital Sud, Rennes, Services de, France
| | - C Bendavid
- CNRS UMR 6290, IFR140, Université de Rennes 1, France
| | | | - A Verloes
- Service de Génétique Clinique, CHU Robert Debré, Paris, France
| | - V David
- Laboratoire de Génétique Moléculaire, CHU Pontchaillou, France ; CNRS UMR 6290, IFR140, Université de Rennes 1, France
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Foinard A, Décaudin B, Barthélémy C, Lebuffe G, Debaene B, Odou P. Impact of infusion set characteristics on the accuracy of patient-controlled morphine administration: a controlled in-vitro study. Anaesthesia 2014; 69:131-6. [DOI: 10.1111/anae.12523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Foinard
- Department of Biopharmacy, Galenic and Hospital Pharmacy; Lille 2 University; UDSL; EA GRIIOT; UFR Pharmacie; Lille France
| | - B. Décaudin
- Department of Biopharmacy, Galenic and Hospital Pharmacy; Lille 2 University; UDSL; EA GRIIOT; UFR Pharmacie; Lille France
- Pharmacy; Lille University Hospital; CHU Lille; Lille France
| | - C. Barthélémy
- Department of Biopharmacy, Galenic and Hospital Pharmacy; Lille 2 University; UDSL; EA GRIIOT; UFR Pharmacie; Lille France
| | - G. Lebuffe
- Department of Anaesthesia and Intensive Care Department; Lille University Hospital; EA1046 Lille France
| | - B. Debaene
- Department of Anaesthesia and Intensive Care Department; Poitiers University Hospital; INSERM U1070; Poitiers France
| | - P. Odou
- Department of Biopharmacy, Galenic and Hospital Pharmacy; Lille 2 University; UDSL; EA GRIIOT; UFR Pharmacie; Lille France
- Pharmacy; Lille University Hospital; CHU Lille; Lille France
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Genay S, Décaudin B, Ethgen S, Barthélémy C, Odou P, Lebuffe G. Impact of noradrenaline infusion set on mean arterial pressure: a retrospective clinical study. ACTA ACUST UNITED AC 2013; 32:e159-62. [PMID: 24138772 DOI: 10.1016/j.annfar.2013.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 08/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Noradrenaline (NA) can be infused through various systems including single or double syringe pumps. The aim of this study was to define the best and most efficient infusion system in an emergency context. STUDY DESIGN This was a retrospective clinical study based on the analysis of patients' hemodynamic data. PATIENTS AND METHOD Three infusion lines used presently in our postoperative ICU were compared through a retrospective clinical study: an NA syringe pump at 2mL/h and a saline carrier solution syringe pump at 8mL/h (infusion system 1- IS1) or 5mL/h (IS2), both connected to a very low dead-space volume set (V=0.046mL); IS3 with the same NA syringe at 2mL/h directly connected to the central venous catheter. Mean arterial pressure (MAP) was obtained from retrospective data analysis of ICU patients with postoperative septic shock criteria. Infusion systems were compared according to the time required to reach an MAP greater than 65mmHg after the onset of infusion. RESULTS Data from 37 patients was analysed. The MAP objective was attained in 14:00 minutes (9:20 - 26:10, n=15) with IS1, in 19:10 minutes (12:20 - 27:20, n=13) with IS2 and in 34:10 minutes (23:10 - 62:30, n=9) with IS3 (P=0.00032). CONCLUSION The use of a double syringe pump system associated with a very low dead-space volume infusion set appears to be the most appropriate system for NA infusion.
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Affiliation(s)
- S Genay
- Department of biopharmacy, Galenic and hospital pharmacy, Lille 2 university, UDSL, EA GRIIOT 4481, UFR pharmacie, 3, rue du Professeur-Laguesse, BP 83, 59006 Lille cedex, France
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Blanc R, Malvy J, Dansart P, Bataille M, Bonnet-Brilhault F, Barthélémy C. La thérapie d’échange et de développement, une rééducation neurofonctionnelle de la communication sociale. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.neurenf.2013.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Genay S, Décaudin B, Ethgen S, Scoccia S, Pinturaud M, Barthélémy C, Lebuffe G, Odou P. Improving noradrenaline infusion technique. Anaesthesia 2013; 68:647-8. [DOI: 10.1111/anae.12273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Genay
- Lille University Hospital; Lille; France
| | | | - S. Ethgen
- Lille University Hospital; Lille; France
| | - S. Scoccia
- Lille University Hospital; Lille; France
| | | | | | - G. Lebuffe
- Lille University Hospital; Lille; France
| | - P. Odou
- Lille University Hospital; Lille; France
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Perez M, Foinard A, Barthélémy C, Debaene B, Décaudin B, Odou P. OHP-046 Impact of Multi-Lumen Infusion Devices on the Occurrence of Physical Drug Incompatibilities: A Controlled in Vitro Study. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Foinard A, Décaudin B, Barthélémy C, Debaene B, Odou P. The Impact of Multilumen Infusion Devices on the Occurrence of Known Physical Drug Incompatibility. Anesth Analg 2013; 116:101-6. [DOI: 10.1213/ane.0b013e31826f5e02] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Foinard A, Décaudin B, Barthélémy C, Debaene B, Odou P. Impact of physical incompatibility on drug mass flow rates: example of furosemide-midazolam incompatibility. Ann Intensive Care 2012; 2:28. [PMID: 22794308 PMCID: PMC3407719 DOI: 10.1186/2110-5820-2-28] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 07/13/2012] [Indexed: 11/17/2022] Open
Abstract
Background Patients in intensive care units receive many drugs simultaneously but through limited venous accesses. Several intravenous therapies have to be administered through the same catheter, thus increasing the risk of physicochemical incompatibility. The purpose of this work was to assess and to quantify the impact of physical incompatibility on the mass flow rates of drugs infused simultaneously to the patient, through an in vitro study. Methods Furosemide-midazolam incompatibility was used to assess the impact of physical incompatibility on drug mass flow rates. Furosemide, midazolam, and saline were simultaneously infused. A filter was added at the end of the infusion line to retain visible particles. Two infusion conditions were tested with and without visible particles. A partial least square method on UV spectra was used to determine simultaneously the concentrations of the two drugs at the egress of the terminal extension line. The drug mass flow rate (expressed as mg/h) was calculated as the product of drug concentration versus total flow rate. Observed/theoretical mass flow rate ratios for each drug (%) were determined per infusion condition. Results Even in the absence of visible particles, precipitation of furosemide led to a drug loss estimated at between 10% and 15%. Furosemide is more impacted by interaction because the pH of the mixture is acid and this form is poorly soluble in an aqueous solution. Conclusions Physical incompatibility between furosemide and midazolam leads to a significant reduction in drug delivered to the patient and may result in treatment failure.
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Affiliation(s)
- Aurélie Foinard
- Laboratoire de Biopharmacie, Pharmacie Galénique et Hospitalière, EA 4481, IFR114, Université Lille Nord de France, 3 rue du Professeur Laguesse, BP83, 59006, Lille, France.
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Splingart C, Frapsauce C, Veau S, Barthélémy C, Royère D, Guérif F. Semen variation in a population of fertile donors: evaluation in a French centre over a 34-year period. ACTA ACUST UNITED AC 2011; 35:467-74. [PMID: 22150270 DOI: 10.1111/j.1365-2605.2011.01229.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although it has been suspected that there is a decrease in semen quality over time, the results reported to date remain debatable because of methodological issues. The aim of the study reported here was to investigate the evolution of semen quality over time in a population of 1114 fertile candidates for sperm donation at CECOS, Tours, between 1976 and 2009. We investigated semen volume, sperm concentration, progressive motility, vitality, percentage of normal forms and multiple abnormalities index of the first ejaculate in this population. We did not find a decline in semen volume, whereas we observed a significant decrease in total sperm count (from 443.2 million in 1976 to 300.2 million in 2009), motility (from 64% in 1976 to 49% in 2009) and vitality (from 88% to 80%). Moreover, a significant decline in the percentage of normal forms was noted between 1976 and 1997 (from 67% to 26%) with a steady rise in the multiple abnormalities index between 1998 and 2009 (from 1.19 to 1.65). This study involving a population of fertile men from a restricted area revealed various degrees of decline in semen parameters over a period of 34 years. These findings will have to be compared with findings in other geographical areas.
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Affiliation(s)
- C Splingart
- Service de Médecine et Biologie de la Reproduction CHRU de Tours, Tours, France
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