» Articles » PMID: 31892212

The Interactions Between Ciprofloxacin and Parenteral Nutrition Admixtures

Overview
Journal Pharmaceutics
Publisher MDPI
Date 2020 Jan 2
PMID 31892212
Citations 11
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Co-infusion of parenteral nutrition (PN) and other drugs increases the risk of the interaction between drug and PN admixtures that can cause embolization of small blood vessels, resulting in potentially fatal consequences, including pulmonary embolism, or liver and retina vascular damage. The present study aimed to determine the compatibility between ciprofloxacin (CF) and eighteen compounded PN admixtures in order to assess the possibility of their co-administration via Y-sites.

Methods: CF and PN admixtures were mixed at two volume ratios (1:1 and 2:1) and potential interactions were examined using visual inspection, and measurements of pH, osmolality particle size, and zeta potential. The analyses were conducted immediately after sample preparation and after four hours of storage.

Results: The compatibility tests showed that the addition of the CF to the PN admixtures did not cause any color change or sign of destabilization in the fat emulsion. However, precipitation was observed in formulations containing higher CF concentrations and, in the case of lower CF concentrations, in formulations containing magnesium and calcium ions at a molar ratio of 2:1.

Conclusions: The administration of CF and PN admixtures via the Y-site should be avoided or performed only with PN admixtures for which compatibility has been confirmed and the CF concentration in samples is 1 mg/mL at a molar ratio of magnesium to calcium ions of 1:1.

Citing Articles

Potential Use of Common Administration of Emulsion for Parenteral Nutrition and Vinpocetine: Compatibility Study and Prospect.

Tomczak S, Kaszuba K, Szkudlarek J, Piwowarczyk L, Jelinska A Metabolites. 2024; 14(8).

PMID: 39195535 PMC: 11356329. DOI: 10.3390/metabo14080439.


Physicochemical Compatibility of Ceftolozane-Tazobactam with Parenteral Nutrition.

de Pourcq J, Riera A, Gras L, Garin N, Busquets M, Cardenete J Pharmaceuticals (Basel). 2024; 17(7).

PMID: 39065746 PMC: 11279994. DOI: 10.3390/ph17070896.


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

Gostynska A, Przybylski T, Ogrodowczyk M Pharmaceutics. 2024; 16(2).

PMID: 38399318 PMC: 10892144. DOI: 10.3390/pharmaceutics16020264.


Honokiol-Loaded Nanoemulsion for Glioblastoma Treatment: Statistical Optimization, Physicochemical Characterization, and an In Vitro Toxicity Assay.

Gostynska A, Czerniel J, Kuzminska J, Brzozowski J, Majchrzak-Celinska A, Krajka-Kuzniak V Pharmaceutics. 2023; 15(2).

PMID: 36839769 PMC: 9959519. DOI: 10.3390/pharmaceutics15020448.


Y-Site Compatibility Studies of Ketoprofen with Parenteral Nutrition Admixtures for Central and Peripheral Administration.

Dettlaff K, Gostynska A, Ziolkowska N, Stawny M Pharmaceutics. 2022; 14(12).

PMID: 36559064 PMC: 9781255. DOI: 10.3390/pharmaceutics14122570.


References
1.
Hill S, Heldman L, Goo E, Whippo P, Perkinson J . Fatal microvascular pulmonary emboli from precipitation of a total nutrient admixture solution. JPEN J Parenter Enteral Nutr. 1996; 20(1):81-7. DOI: 10.1177/014860719602000181. View

2.
WATSON D . Piggyback compatibility of antibiotics with pediatric parenteral nutrition solutions. JPEN J Parenter Enteral Nutr. 1985; 9(2):220-4. DOI: 10.1177/0148607185009002220. View

3.
Stojkovic A, Tajber L, Paluch K, Djuric Z, Parojcic J, Corrigan O . Biopharmaceutical characterisation of ciprofloxacin-metallic ion interactions: comparative study into the effect of aluminium, calcium, zinc and iron on drug solubility and dissolution. Acta Pharm. 2014; 64(1):77-88. DOI: 10.2478/acph-2014-0007. View

4.
Driscoll D, Ling P, Bistrian B . Pathological consequences to reticuloendothelial system organs following infusion of unstable all-in-one mixtures in rats. Clin Nutr. 2006; 25(5):842-50. DOI: 10.1016/j.clnu.2006.02.009. View

5.
Stawny M, Olijarczyk R, Jaroszkiewicz E, Jelinska A . Pharmaceutical point of view on parenteral nutrition. ScientificWorldJournal. 2014; 2013:415310. PMC: 3885274. DOI: 10.1155/2013/415310. View