Intravenous solution interaction

Procainamide interacts with glucose in vitro to form glu-cosylamines (63). The reaction was pH-dependent, with a maximum rate of association at a pH of 3.0 and a maximum rate of dissociation at a pH of 1.5. The authors suggested that the loss of procainamide in an intravenous solution of glucose could be marked. 

Pharmacists work in hospitals, pharmacies, clinics, research, and long-term care facilities where they are responsible for the preparation and distribution of pharmaceutical medications based on a doctor s orders. They obtain the proper medication, and also calculate, measure, and label the patient s medication. Pharmacists advise customers and health care practitioners on the selection of both prescription and over-the-counter drugs, proper dosages, and geriatric considerations, as well as possible side effects and interactions. They may also administer vaccinations, prepare sterile intravenous solutions, and advise customers about health, diet, and home medical equipment. Pharmacists also prepare insurance claims, and create and maintain patient records. 

Besides local toxicity, discussed above, there are numerous other modes of potential adverse interactions involving excipients (19,20). Many of these pose little threat provided the amounts of excipients are constrained to certain levels. Excessive amounts, however, can cause problems, particularly for patients who are intolerant of even modest levels. Commonly used phosphate buffers may cause calcium loss with formation of insoluble calcium phosphates when such buffers are administered in over-ambitious amounts (21). Calcium phosphate precipitation has been noted particularly in nutritional parenteral admixtures for neonates because of the high nutrient requirements. Similarly, renal toxicity has been associated with depletion of zinc and other trace metals caused by large parenteral doses of ethylenediaminete-traacetic acid (EDTA) (22). Excessive absorption of glycine solutions, when used as irrigants during transurethral resections, can cause hyponatremia, hypertension, and confusion (23). The use of preservatives has been associated with cardiac effects in a few patients (24). Premature neonates were found to be at risk for receiving toxic amounts of benzoic acid or benzyl alcohol in bacteriostatic solutions used to flush intravenous catheters (25). 

Talinolol, a good P-gp substrate, is eliminated from the body mainly by intestinal and renal excretion with minimal metabolism in humans. In a clinical study, a P-gp-mediated interaction between talinolol and verapamil has been reported (45). The inhibitory effect of verapamil on the intestinal secretion of talinolol was determined in six healthy volunteers by using the intestinal perfusion technique. While perfusing the small intestine with a verapamil-free solution, the mean intestinal secretion rate of talinolol was 4.0 pg/min after an intravenous dose of talinolol. The intestinal secretion rate decreased to 2.0 pg/min when a verapamil-containing solution was perfused (45). Similar to the clinical data, talinolol-verapamil interaction was also observed in rats. Coadministration of verapamil (4 mg/kg, PO) resulted in a 2.5- and 2.2-fold increase in the plasma oral AUC for S- and //-talinolol, respectively, after an oral dose of racemic talinolol in rats. On the other hand, after an intravenous dose of racemic talinolol, the inhibitory effect of verapamil on talinolol was less significant and there was only a 40% and 30% increase in AUC, respectively, for S- and //-talinolol (46). These results suggest that the larger increase in AUC of talinolol ( 2- to 2.5-fold) after oral administration was likely due to the combination of an... 

Foscamet sodium should not be mixed with any intravenous infusion drug, since it interacts with glucose- and calcium-containing solutions and sodium, ganciclovir, certain antibacterials, amphotericin, pentamidine isethionate, and trimetrexate.18 Care must be taken to avoid inhalation and exposure of the skin to zalcitabine powder. 

Ciprofloxacin intravenous infusion is a sterile solution of ciprofloxacin lactate (prepared by the interaction of ciprofloxacin and lactic acid) in sodium chloride intravenous infusion solution. 

It was always of great interest whether the very high selection criteria described above - especially the favorable low potential for interaction with other drugs -would translate into human use. Indeed, this was confirmed later in extended drug interaction studies. Pantoprazole s good solubility and very high stability in solution allowed it to become the first marketed PPI for intravenous use in critical care patients [39,40,43,44]. 

Aryl-subslituled nitrogen mustards such as chlorambucil are relatively stable to aziridinium ion fonnation because (he aromatic ring decreases the nucleophilicity of the nitni-gen atom. These mustards react according to first-order ki-netics. " The stability of chlorambucil allows it to be taken orally, whereas mechlorethamine is given by intravenous administration of freshly prepared solutions. The Kquiic-ment for fre.shly prepared solutions is bused on (he gnidml decomposition of the aziridinium ion by interaction willi water. 

Cefoxitin is a broad spectrum, semi-synthetic cephamy-cin antibiotic. The free acid form is a white, crystalline, practically insoluble solid and therefore the decision was made to use the sodium salt to provide a sterile solution for intravenous administration. It was soon evident that the sodium salt of cefoxitin would have limited stability in solution and would not lend itself to the formulation of a marketable solution product. Stability studies highlighted the advantages of sterile crystalline solid over amorphous freeze-dried product, and also the need for rubber stopper screening studies to eliminate interactions between sodium cefoxitin powder and rubber, and finally the profound effect of oxygen on the coloration rate of the product. 

V. Drug or iaboratory interactions. Intravenous infusions may be incompatible with 10% dextrose solutions, amphotericin, or hydralazine. 

V. Drug or laboratory interactions. Aqueous solutions of unithiol for intravenous injeotion should not be mixed with other drugs or minerals. Oral preparations should not be consumed simultaneously with mineral supplements. 

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