Cookies are small text files stored on the device you are using to access this website. However, this lack of reporting may be because the adverse effects caused by drug incompatibilities are difficult to identify in patients who are already seriously ill [2] , [3]. Jobs you might like. There is limited information available on the incidence of serious events caused by drug incompatibilities and no major incidents have ever been reported through the NHS England National Reporting and Learning System. Am J Health Syst Pharm ; American Society of Health-System Pharmacists;

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These processes incompztible be accelerated by: Am J Health Syst Pharm ;66 4: The online Medusa database for injectables is also a useful resource for injectable drug monographs. This is a weak base, but is formulated at an acidic pH of 2. Mixing must only be undertaken when it is essential to meet the needs of the patient and should never be performed at the convenience of the healthcare professional [1]. Typically, these reactions are detectable through a visual check.

Syringe Driver Drug Compatibility

Diazepam drugss insoluble in aqueous solutions and is formulated as an emulsion e. The solubility of the drug and use of an alcohol or lipid solvent can also determine how, and in what vehicle, the drug should be administered.

Adsorption — when a drug in solution incompatibke to the surface of its container, giving set or in-line filter — reduces the amount of drug available to be administered to the patient. The type of infusion vehicle used for administration of the drug can also affect the stability of the drug. Int J Pharmaceutics ; 1: Adsorption is also more likely to occur when polyvinyl chloride PVC -containing equipment is used.


Incompatibility poses a constant risk when mixing parenteral medicines but it can be avoided by understanding the chemical reactions taking place. When two or more medicines and their diluents are mixed together in the same syringe or infusion bag, or when two or more infusion lines meet at a Y-site junction, there is a risk that they may be incompatible with one another.

Mixing medicines: how to ensure patient safety

Sign In Register Subscribe pharmaceutical-journal. Syringes are generally PVC-free and are more suitable for use with drugs that are incompatigle to adsorption. Fat emulsionssuch as Intralipid, TPN and some drug formulations e.

Changes in concentration can affect the compatibility of some drug combinations i. For example, when calcium and phosphate additives are added to a TPN bag there is a potential for an insoluble calcium phosphate salt to be formed above too high a concentration for either or both additives. Commonly used solvents include polyethylene glycol, propylene glycol, ethanol and glycerine [9]. Propofol is formulated as a lipid.

Phenytoin is a weak acid and is formulated for use in intravenous preparations as a phenytoin sodium salt, with the solution adjusted to a highly basic pH of Enter email address Submit.


International Research in Healthcare Guidance for students or researchers undertaking a multi-centre research project in health services, medicines use and professional practice. These case uncompatible help you bridge the gap between theoretical medicines knowledge and practical applications.

Biologics, such as blood products and monoclonal antibodies, should never be mixed with other drug compounds and should always be administered through separate lines.

Syringe Driver Drug Compatibility | MIMS online

University College London Hospitals. However, the creation of extensive amounts of gas can be hazardous.

Cookies are small text files stored on the device you are using to access this website. Jobs you might like. It also stipulates that the mixing of medicines should:. The influence that a fluid or second drug can have on the pH of a solution depends on: According to the manufacturers, the sgringe formulation should be diluted to a concentration of at least 10mg in ml.

Since chemical reactions between the mixed drugs can result in a reduction in the incompatjble of active drug, patients should also be monitored for treatment failure. Large polymeric drugs e.