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Physicochemical Compatibility of Amiodarone with Parenteral Nutrition
Author(s) -
Mediavilla Marta M.,
Molina Andrea,
Navarro Lorena,
Grau Laura,
Pujol M. Dolors,
Cardenete Joana,
Cardona Daniel,
Riera Pau
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1419
Subject(s) - amiodarone , parenteral nutrition , medicine , antiarrhythmic agent , chemistry , high performance liquid chromatography , dosage form , chromatography , anesthesia , pharmacology , heart disease , atrial fibrillation
Background Y‐site administration of total parenteral nutrition (TPN) and drugs is frequently required in the intensive care setting. Amiodarone is commonly administered by continuous intravenous infusion and subject to be co‐administered via a Y‐site with TPN. The aim of this study is to determine the physicochemical stability of amiodarone Y‐site administered with TPN. Methods Two standard TPN and 2 amiodarone solutions were designed. The 2 TPN differed in the lipid source (Lipofundin MCT/LCT® 20% or SMOFlipid® 20%). The 2 amiodarone solutions were prepared at different concentrations (900 mg and 1200 mg in 250 mL of dextrose 5% in water). Each TPN and amiodarone solutions ran at a rate that simulated a 24‐hour Y‐site infusion to obtain different admixture samples. Each sample was then visually examined and further tested to determine the mean lipid droplet size distribution by dynamic light scattering and amiodarone concentrations by HPLC. Results No alterations were detected by visual inspection. Average droplet size remained below 500 nm (252.5 ± 5.9 nm for Lipofundin MCT/LCT® TPN and 327.7 ± 14.4 nm for SMOFlipid® TPN). For the samples obtained after running 900 mg and 1200 mg amiodarone solutions with TPN, the concentrations observed at 24 hours were 0.4491 ± 0.0111 mg/mL and 0.5773 ± 0.0214 mg/mL, respectively. These results represent approximately 100% of the zero‐time concentrations and are within ±15% of the predicted values. No degradation products were observed in the chromatograms. Conclusion Amiodarone is physicochemically compatible with standard TPN via a Y‐site administration at the tested amiodarone concentrations.