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Identification of potentially irritating intravenous medications.
Enferm Intensiva (Engl Ed). 2022 Jul-Sep; 33(3):132-140.EI

Abstract

AIMS

To identify commonly used intravenous drugs that may produce endothelial damage.

METHODS

An experimental research study was performed using a sample of 62 intravenous drugs commonly used in emergency care, pH and osmolarity were measured. Subsequently, based on these values, the theoretical capacity to cause irritation or endovascular damage was determined and classified as high, moderate, and low.

RESULTS

Samples from 19 drugs for fluid therapy, 21 antibiotics and 22 drugs for intravenous use were studied. Glucose solutions, sodium bicarbonate 1M and mannitol 10% showed a high capacity to cause venous irritation. Vancomycin, ciprofloxacin, amiodarone, haloperidol, and labetalol solution presented a high capacity for irritation based on their acidic pH. The antibiotics, dexketoprofen, diazepam, digoxin, etomidate, phenytoin, levetiracetam and metamizole also showed high osmotic values in their reconstituted or undiluted presentations. Moreover, osmolarity of diazepam, digoxin and phenytoin remained high despite being diluted in 100 ml of saline.

CONCLUSIONS

Knowing the pH and osmolarity of intravenous drugs allows their capacity to cause endothelial damage to be assessed. The use of comprehensive tables based on the chemical properties of the drugs can be a useful tool to help prevent chemically-induced phlebitis.

Authors+Show Affiliations

Osakidetza, Organización Sanitaria Integrada Bilbao-Basurto, Bilbao, Spain. Electronic address: sendoa.ballesteros@ehu.eus.Biocruces Bizkaia Health Research Institute, Barakaldo, Vizcaya, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Spain.Biocruces Bizkaia Health Research Institute, Barakaldo, Vizcaya, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Spain; Osakidetza, Organización Sanitaria Integrada Barrualde-Galdakao, Galdakao, Bizkaia, Spain.Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Spain; Achucarro Basque Center for Neuroscience, Leioa, Bizkaia, Spain.Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Bizkaia, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35941074

Citation

Ballesteros-Peña, S, et al. "Identification of Potentially Irritating Intravenous Medications." Enfermeria Intensiva, vol. 33, no. 3, 2022, pp. 132-140.
Ballesteros-Peña S, Fernández-Aedo I, Vallejo-De la Hoz G, et al. Identification of potentially irritating intravenous medications. Enferm Intensiva (Engl Ed). 2022;33(3):132-140.
Ballesteros-Peña, S., Fernández-Aedo, I., Vallejo-De la Hoz, G., Tønnesen, J., & Miguelez, C. (2022). Identification of potentially irritating intravenous medications. Enfermeria Intensiva, 33(3), 132-140. https://doi.org/10.1016/j.enfie.2021.05.003
Ballesteros-Peña S, et al. Identification of Potentially Irritating Intravenous Medications. Enferm Intensiva (Engl Ed). 2022 Jul-Sep;33(3):132-140. PubMed PMID: 35941074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of potentially irritating intravenous medications. AU - Ballesteros-Peña,S, AU - Fernández-Aedo,I, AU - Vallejo-De la Hoz,G, AU - Tønnesen,J, AU - Miguelez,C, Y1 - 2022/08/05/ PY - 2021/02/19/received PY - 2021/05/28/accepted PY - 2022/8/9/pubmed PY - 2022/9/14/medline PY - 2022/8/8/entrez KW - Concentración osmolar KW - Endotelio vascular KW - Flebitis KW - Irritantes KW - Irritants KW - Osmolar concentration KW - Phlebitis KW - Vascular endothelium SP - 132 EP - 140 JF - Enfermeria intensiva JO - Enferm Intensiva (Engl Ed) VL - 33 IS - 3 N2 - AIMS: To identify commonly used intravenous drugs that may produce endothelial damage. METHODS: An experimental research study was performed using a sample of 62 intravenous drugs commonly used in emergency care, pH and osmolarity were measured. Subsequently, based on these values, the theoretical capacity to cause irritation or endovascular damage was determined and classified as high, moderate, and low. RESULTS: Samples from 19 drugs for fluid therapy, 21 antibiotics and 22 drugs for intravenous use were studied. Glucose solutions, sodium bicarbonate 1M and mannitol 10% showed a high capacity to cause venous irritation. Vancomycin, ciprofloxacin, amiodarone, haloperidol, and labetalol solution presented a high capacity for irritation based on their acidic pH. The antibiotics, dexketoprofen, diazepam, digoxin, etomidate, phenytoin, levetiracetam and metamizole also showed high osmotic values in their reconstituted or undiluted presentations. Moreover, osmolarity of diazepam, digoxin and phenytoin remained high despite being diluted in 100 ml of saline. CONCLUSIONS: Knowing the pH and osmolarity of intravenous drugs allows their capacity to cause endothelial damage to be assessed. The use of comprehensive tables based on the chemical properties of the drugs can be a useful tool to help prevent chemically-induced phlebitis. SN - 2529-9840 UR - https://www.unboundmedicine.com/medline/citation/35941074/Identification_of_potentially_irritating_intravenous_medications. DB - PRIME DP - Unbound Medicine ER -