P17 Pharmco-stability of plasma-lyte 148 and plasma-lyte 148% glucose 5% with frequently used infused therapeutic agents

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Abstract

Aims

Plasma-Lyte148 is a balanced, crystalloid fluid which has been shown to circumvent the hyperchloraemic metabolicacidosis associated with 0.9% Saline. There is limited compatibility data available to support the co-administration of this fluid with commonly infused medications. Such data is essential to support the safe introduction of this fluid, especially in children where intravenous access is often limited. This study aimed to expandon knowledge in this area by assessing the chemical and physical compatibility of Plasma-Lyte with a range of medicines.

Methods

Adrenaline, Dobutamine, Dopamine, Furosemide, Midazolam, Milrinone and Morphine were mixed with Plasma-Lyte, Plasma-Lyte with 5% Glucose, and the two control solutions 0.9% Saline and 5% Glucose. Chemical compatibility was assessed by High Performance Liquid Chromatography using the Thermo Scientific UltiMate 3000 system. Physical compatibility was assessed by checking for colour changes and precipitate formation. pH of the admixtures was recorded using a Fisherbrand Hydrus 3000 pH metre. 6 repeats were carried out for HPLC and 2 for physical compatibility checks and pH measurements, with all admixtures assayed at 0, 2 and 24 hours. Chemical stability was defined as <5% change in concentration and pH was considered acceptable for peripheral administration if it was between 5 and 9 at all time points.

Results

Adrenaline, Dobutamine, Dopamine, Morphine and Milrinone were chemically and physically stable when diluted with Plasma-Lyte 148 and Plasma-Lyte 148 with 5% Glucose. Furosemide was compatible with Plasma-Lyte 148, but not Plasma-Lyte 148 with 5% glucose. Midazolam was not compatible with Plasma-Lyte 148 or Plasma-Lyte 148%–5% glucose at the tested concentration of 3 mg/mL. Only Dobutamine, Dopamine, Furosemide and Morphine remained within the pH range 5–9 when mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose.

Conclusion

Adrenaline, Dobutamine, Dopamine, Morphine and Milrinone can be mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose in clinical practice. Furosemide can beco-administered with Plasma-Lyte 148, but not Plasma-Lyte 148 with 5% glucose. Midazolam should not be mixed with Plasma-Lyte 148 and Plasma-Lyte 148 with glucose at a concentration of 3 mg/mL.

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