Y-Site Compatibility Studies of Parenteral Nutrition and Other Intravenous Medications in Neonatal and Pediatric Patients: A Review of the Literature Evidence.

Background: Polytherapy in neonatal and pediatric patients requiring parenteral nutrition (PN) administration is a challenging task. Due to limited intravenous access, the Y-site administration of medication with PN admixtures is sometimes inevitable.

Aim: This review aims to summarize the evidence on the compatibility of the Y-site of intravenous medications and PN admixtures in neonatal and pediatric settings.

Electron Beam Radiation as a Safe Method for the Sterilization of Aceclofenac and Diclofenac-The Usefulness of EPR and H-NMR Methods in Determination of Molecular Structure and Dynamics.

Diclofenac (DC) [2-(2,6-Dichloroanilino)phenyl]acetic acid,) and aceclofenac (AC) 2-[2-[2-[(2,6-dichlorophenyl)amino]phenyl]acetyl]oxyacetic acid in substantia were subjected to ionizing radiation in the form of a beam of high-energy electrons from an accelerator in a standard sterilization dose of 25 kGy and higher radiation doses (50-400 kGy). We characterized non-irradiated and irradiated samples of DC and AC by using the following methods: organoleptic analysis (color, form), spectroscopic (IR, NMR, EPR), chromatographic (HPLC), and others (microscopic analysis, capillary melting point measurement, differential scanning calorimetry (DSC)). It was found that a absorbed dose of 50 kGy causes a change in the color of AC and DC from white to cream-like, which deepens with increasing radiation dose.

Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures.

Simultaneous administration of parenteral nutrition (PN) admixtures with intravenous antibiotics is a common clinical problem. Coadministration of drugs incompatible with PN admixture may affect its stability, especially in the context of lipid droplet size, which is a crucial parameter for patient safety. In the present study, we investigate the in vitro compatibility of meropenem (Meropenem 1000, MPM) with five commercial PN admixtures used worldwide: Kabiven, Olimel N9E, Nutriflex Lipid Special, Nutriflex Omega Special, and SmofKabiven.

Compatibility of intravenous metronidazole with some all-in-one parenteral nutrition regimens.

Objectives: Supplementation of parenteral nutrition (PN) admixtures with other parenteral drugs may be desired especially in the case of polypharmacy and limited vascular access. Metronidazole (MTZ) is administered in surgical and critically ill patients often requiring concomitant nutritional therapy in the form of parenteral nutrition. The aim of the study was to evaluate the possibility of the concomitant administration of MTZ with PN admixtures from one container.

Stability studies of parenteral nutrition with a high dose of vitamin C.

Background: Postoperative administration of parenteral nutrition has become routine management in patients with gastrointestinal cancer. Providing patient the complete parenteral nutrition containing not only the macronutrients and electrolytes but also adequate doses of vitamins is a significant issue of nutritional therapy. The aim of the study was to develop parenteral nutrition containing a high dose of vitamin C (500 mg) and evaluate their stability.

Modeling of the irradiation effect on some physicochemical properties of metoprolol tartrate for safe medical uses.

The effect of gamma-irradiation and ionizing radiation (high-energy electrons beam) on the physicochemical properties of metoprolol tartrate at the solid phase and aqueous solution, has been investigated in the present study to model some properties affected by absorbed doses and to reveal some interesting mutual causal correlation. The proposed some interesting models can be adapted to other experimental conditions, and the newly obtained values of the adjustable parameters could be an excellent criterion of the state quality of the metoprolol tartrate or for other additional interpretations. The peculiar behaviour of variation of physicochemical properties against dose leads us to confirm the suggested optimized doses mentioned in previous work, for sterilization and safe medical uses.

Stability of high-dose thiamine in parenteral nutrition for treatment of patients with Wernicke's encephalopathy.

Background & Aims: Wernicke's encephalopathy is associated mainly with malnourishment in alcohol-dependent patients but can be caused also by cancer, Crohn's disease, gastrointestinal surgery or prolonged parenteral nutrition (PN) without adequate supplementation of vitamins. The disorder, with a significant mortality rate of up to 20%, is often associated with the underlying disease and intensifies after administration of non-supplemented PN. Thus, it seems justified to add thiamine to PN admixtures prepared for parenterally fed patients.

Development, Validation, and Stability Assessment Application of RP-HPLC-DAD Method for Quantification of Ampicillin in Total Parenteral Nutrition Admixtures.

Background: The administration of total parenteral nutrition (TPN) is a common procedure in intensive care units, where the concomitant use of other intravenous medication is frequently needed. One of the particularly dangerous complications for neurosurgical patients is meningitis, for which high doses of ampicillin (AMP) are used. In such cases, the addition of AMP to TPN admixtures would be a desirable procedure.

Stability studies of two compounded solutions potentially used in tumor lysis syndrome.

Objective: The aim of the study was to determine the stability of two non-commercially produced solutions: 1.68% sodium bicarbonate in 5% glucose (BIC solution) and 1.6% calcium chloride in 0.

Effect of Lipid Emulsion on Stability of Ampicillin in Total Parenteral Nutrition.

Background: Ampicillin (AMP) is frequently administered parenterally in critically ill patients with meningitis or endocarditis. Many of them require parallel infusion of total parenteral nutrition (TPN) admixtures. The aim of the study was to determine the physicochemical stability of AMP in TPN admixtures.

Formulation and characterization of EGCG for the treatment of superficial bladder cancer.

In the United States, the annual incidence of bladder cancer is approximately 70,000 new cases, with a mortality rate of approximately 15,000/year. The most common subtype (70%) of bladder cancer is superficial, namely hte non-muscle invasive disease form limited to the urothelium. The rate of progression and recurrence is up to 40 and 70%, respectively.

Beta-Blockers: Current State of Knowledge and Perspectives.

It has been over half a century since propranolol, the first beta-blocker, was developed for medical treatment. Since that time a large number of compounds from this group have been synthesised and many are now in clinical use. The structure, function, pharmacokinetics, and mechanism of beta-blockers have been established.

Identification of Radiodegradation Products of Acebutolol and Alprenolol by HPLC/MS/MS.

Two therapeutically active compounds from the group of β-blockers, acebutolol (AC) and alprenolol (AL), in solid form were subjected to ionizing radiation emitted by a beam of high energy electrons from an accelerator with a standard sterilization dose of 25 kGy and in higher doses of 50-400 kGy. The effects of irradiation were detected by chromatographic methods (TLC, HPLC) and a hyphenated method (HPLC/MS/MS). No significant changes in the physicochemical properties of both compounds studied irradiated with 25 kGy were noted, but upon irradiation with the highest dose (400 kGy) the loss of AC and AL content determined by HPLC was 2.

The influence of ionizing radiation, temperature, and light on eplerenone in the solid state.

Eplerenone was subjected to the influence of ionizing radiation in the form of a high-energy electron beam (25-400 kGy), high temperature (90°C RH 0% and 60°C RH 76.4%), and light (6 mln lux h). An HPLC method was used to determine the content of eplerenone and to establish the impurity profile of all samples.

The influence of ionizing radiation on itraconazole in the solid state.

The aim of this study was to investigate the ionizing radiation effects, in the form of an electron beam, on itraconazole (ITR) in the solid phase. It was found that the ITR, under the influence of a standard 25 kGy dose of radiation used for the sterilization of drug substances, decomposed at 0.4%.

Comparative analysis of selected beta-blockers.

The suitability and effectiveness of a few spectrophotometric and chromatographic methods (UV, FT-IR, MS, TLC) for differentiating analysis of 6 beta-blockers: acebutolol, alprenolol, atenolol, metoprolol, pindolol and propranolol have been tested.

The effect of ionizing radiation on metoprolol.

The influence of ionising radiation on physico-chemical properties of metoprolol tartrate (MT) in solid phase was studied. The compound was irradiated by radiation produced by a beam of high-energy electrons in an accelerator, in doses from 25 to 400 kGy, and the possible changes in the samples were detected by organoleptic analysis (colour, forms, clarity), chromatographic and spectrometric methods. Already at the standard sterilisation dose of 25 kGy, the presence of free radicals (0.

Influence of e-beam irradiation on sulfamethoxazole in solid state.

The effects of ionizing radiation generated by a beam of electrons, in that doses varied from 25-800 kGy, on the physico-chemical properties of sulfamethoxazole (SMX) in solid state have been studied at room temperature and in the air atmosphere. The changes appearing after the irradiation were detected and evaluated by the spectroscopic methods (UV, IR, MS, EPR), chromatography (TLC and HPLC) and SEM, XRD and DSC. Already the lowest dose of 25 kGy was found to change the color of SMX from white to pale cream; such change became more intense with our increasing the irradiation dose.

Effect of radiation sterilization on alprenolol in the solid state studied by high-performance thin-layer chromatography.

The possibility of radiation sterilization of alprenolol (AL) has been studied. Irradiation of AL in solid form with a 25 kGy beam of electrons caused only an insignificant change in color that became more intense with increasing irradiation dose. Moreover, with increasing dose a decrease in pH, the content of water, and the degree of crystallinity were observed.

Thermal stability of 1,4-dihydropyridine derivatives in solid state.

The effect of temperature and air humidity on the stability of 7 derivatives of 1,4-dihydropyridine (nifedipine, nisoldipine, nitrendipine, nimodipine, nicardipine, felodipine and amlodipine) in solid state has been studied by accelerated testing. Quantitative analysis of the compounds studied was made by UV spectrophotometry, identification of the thermodegradation products and reference to the standard were made by thin layer chromatography (TLC), UV spectra and the reaction with KMnO4. Thermodegradation of the derivatives studied was found not to occur in dry air, whereas at air humidity it occurred according to the first order reaction at a similar rate for all derivatives.

Photo- and radiostability of some 1,4-dihydropyridine derivatives in the solid state.

The effect of UV (254 nm) and beta-irradiation at doses 10-100 kGy on physical and chemical properties of four 1,4-dihydropyridyne derivatives in the solid state (nifedipine, nitrendipine, felodipine and nimodipine) has been studied. It has been established that the irradiation causes the appearance of free radicals (EPR) and decomposition products (TLC, GC), a decrease in the melting point (DSC) and the content (GLC, IR) and an increase in microbiological purity. The changes appear faster under the effect of UV than by beta-irradiation and their intensity and character depend on the derivative and dose.

Sterility and antibacterial activity of some antibiotics sterilized by irradiation.

Sterility and antibacterial activity of several antibiotics (including some penicillins and their salts, gramicidin and neomycin) subjected to sterilization by irradiation has been studied. The compounds in solid phase have been exposed to gamma irradiation in air atmosphere at room temperature, with a dose of 25 kGy, and afterwards they have been subjected to tests recommended by FP V (volume I, 1990) checking their sterility and activity. The results have shown that the majority of initial compounds have been to a slight degree contaminated by bacteria from the genera Bacillus and Micrococcus, the number of bacteria did not exceed 10(2) CFU, and fungi up to 10 CFU in 1 g of the compound.