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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...

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Autores principales: Gostyńska, Aleksandra, Piwowarczyk, Ludwika, Nadolna, Malwina, Jelińska, Anna, Dettlaff, Katarzyna, Ogrodowczyk, Magdalena, Popielarz-Brzezińska, Maria, Stawny, Maciej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926682/
https://www.ncbi.nlm.nih.gov/pubmed/33671502
http://dx.doi.org/10.3390/antibiotics10020217
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author Gostyńska, Aleksandra
Piwowarczyk, Ludwika
Nadolna, Malwina
Jelińska, Anna
Dettlaff, Katarzyna
Ogrodowczyk, Magdalena
Popielarz-Brzezińska, Maria
Stawny, Maciej
author_facet Gostyńska, Aleksandra
Piwowarczyk, Ludwika
Nadolna, Malwina
Jelińska, Anna
Dettlaff, Katarzyna
Ogrodowczyk, Magdalena
Popielarz-Brzezińska, Maria
Stawny, Maciej
author_sort Gostyńska, Aleksandra
collection PubMed
description 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. The appropriate volumetric ratios, reflecting their clinical practice ratios, were used to prepare the MPM–PN admixture samples. Physicochemical properties of MPM–PN admixtures samples were determined upon preparation and after four hours of storage. The pH changes for all MPM–PN admixtures samples did not exceed the assumed level of acceptability and ranged from 6.41 to 7.42. After four hours of storage, the osmolarity changes were ±3%, except MPM–Olimel N9E samples, for which differences from 7% to 11% were observed. The adopted level of acceptability of changes in zeta potential after four hours of storage (±3 mV) was met for MPM–Kabiven, MPM–Nutriflex Lipid Special, and MPM–Nutriflex Omega Special. The mean droplet diameter for all samples was below 500 nm. However, only in the case of Nutriflex Lipid Special and Nutriflex Omega Special, the addition of MPM did not cause the formation of the second fraction of lipid droplets. The coadministration of MPM via Y-site with Kabiven, Olimel N9E, and Smofkabiven should be avoided due to osmolarity fluctuations (MPM–Olimel), significant differences in zeta potential (MPM–Olimel, MPM–Smofkabiven), and the presence of the second fraction of lipid droplets >1000 nm (MPM–Kabiven, MPM–Olimel, and MPM–Smofkabiven). The assumed acceptance criteria for MPM compatibility of MPM with PN admixtures were met only for Nutriflex Lipid Special and Nutriflex Omega Special in 1:1, 2:1, and 4:1 volume ratios.
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spelling pubmed-79266822021-03-04 Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures Gostyńska, Aleksandra Piwowarczyk, Ludwika Nadolna, Malwina Jelińska, Anna Dettlaff, Katarzyna Ogrodowczyk, Magdalena Popielarz-Brzezińska, Maria Stawny, Maciej Antibiotics (Basel) Article 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. The appropriate volumetric ratios, reflecting their clinical practice ratios, were used to prepare the MPM–PN admixture samples. Physicochemical properties of MPM–PN admixtures samples were determined upon preparation and after four hours of storage. The pH changes for all MPM–PN admixtures samples did not exceed the assumed level of acceptability and ranged from 6.41 to 7.42. After four hours of storage, the osmolarity changes were ±3%, except MPM–Olimel N9E samples, for which differences from 7% to 11% were observed. The adopted level of acceptability of changes in zeta potential after four hours of storage (±3 mV) was met for MPM–Kabiven, MPM–Nutriflex Lipid Special, and MPM–Nutriflex Omega Special. The mean droplet diameter for all samples was below 500 nm. However, only in the case of Nutriflex Lipid Special and Nutriflex Omega Special, the addition of MPM did not cause the formation of the second fraction of lipid droplets. The coadministration of MPM via Y-site with Kabiven, Olimel N9E, and Smofkabiven should be avoided due to osmolarity fluctuations (MPM–Olimel), significant differences in zeta potential (MPM–Olimel, MPM–Smofkabiven), and the presence of the second fraction of lipid droplets >1000 nm (MPM–Kabiven, MPM–Olimel, and MPM–Smofkabiven). The assumed acceptance criteria for MPM compatibility of MPM with PN admixtures were met only for Nutriflex Lipid Special and Nutriflex Omega Special in 1:1, 2:1, and 4:1 volume ratios. MDPI 2021-02-22 /pmc/articles/PMC7926682/ /pubmed/33671502 http://dx.doi.org/10.3390/antibiotics10020217 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gostyńska, Aleksandra
Piwowarczyk, Ludwika
Nadolna, Malwina
Jelińska, Anna
Dettlaff, Katarzyna
Ogrodowczyk, Magdalena
Popielarz-Brzezińska, Maria
Stawny, Maciej
Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title_full Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title_fullStr Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title_full_unstemmed Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title_short Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
title_sort toward safe pharmacotherapy: the interplay between meropenem and parenteral nutrition admixtures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926682/
https://www.ncbi.nlm.nih.gov/pubmed/33671502
http://dx.doi.org/10.3390/antibiotics10020217
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