氨磷汀与17种静脉用药物在模拟Y型输液通路中物理相容性

Physical compatibility of amifostine with 17 intravenous drugs during simulated Y-site injection

目的考察氨磷汀与临床常用静脉用药物在Y型输液通路中的物理相容性。方法模拟临床Y型输液通路,室温(25℃)、自然光环境下,用0.9%氯化钠注射液调配的氨磷汀溶液与等体积临床常用浓度的奥美拉唑钠、泮托拉唑钠、艾司奥美拉唑钠、西咪替丁、盐酸昂丹司琼、盐酸托烷司琼、盐酸甲氧氯普胺、谷胱甘肽、地塞米松磷酸钠、甲泼尼龙琥珀酸钠、利巴韦林、阿昔洛韦、硫酸庆大霉素、头孢呋辛钠、头孢哌酮钠舒巴坦钠、哌拉西林钠他唑巴坦钠、左氧氟沙星氯化钠等17种药物的溶液配伍混合,于0、0.5、1、2、4 h考察配伍液性状、丁达尔效应、浊度与pH。结果氨磷汀与阿昔洛韦配伍液15 min产生白色针状结晶,并随时间推移增加;氨磷汀与其他16种静脉用药物配伍液4 h内性状无颜色变化,未产生浑浊、结晶、沉淀或气体,未产生丁达尔效应,浊度与0 h比较,增加<0.5 NTU,pH与0 h比较,变化<1。结论氨磷汀与阿昔洛韦配伍液存在物理不相容性,不得通过Y型输液通路同时输注;氨磷汀与其他16种静脉用药物配伍液4 h内未观察到物理不相容性。

Objective To investigate the physical compatibility of amifostine with clinical commonly-used intravenous drugs in Y-site injection.Methods The clinical Y-site injection was simulated to evaluated physical compatibility.Amifostine solutions was prepared with 0.9%sodium chloride,which was mixed with seventeen common drugs including omeprazole sodium,pantoprazole sodium,esomeprazole sodium,cimetidine,ondansetron hydrochloride,tropisetron hydrochloride,metoclopramide dihydrochloride,glutathione,dexamethasone sodium phosphate,methylprednisolone sodium succinate,ribavirin,acyclovir,gentamycin sulfate,cefuroxime sodium,cefoperazone sodium and sulbactam sodium,piperacillin sodium and tazobactam sodium,and levofloxacin and sodium chloride at the clinically used concentration respectively at equal volume at room temperature(25℃)and under the natural light.The appearance characteristics,Tyndall effect,turbidity and pH of admixture solutions were observed at 0 h,0.5 h,1 h,2 h,and 4 h.Results White acicular crystals were observed at 15 min and increased with time in the admixture of amifostine with acyclovir.In other 16 admixtures,there were no color change,turbidity,crystal,precipitation or gas within 4 h;no Tyndall effect was observed within 4 h;compared to 0 h,the turbidity increased less than 0.5 NTU and the pH changed less than one unit.Conclusion Amifostine is physically incompatible with acyclovir and cannot be used simutaneously through Y-site injection,and physical incompatibility is not observed in amifostine with other 16 drugs within 4 h.