Physical Compatibility of Norepinephrine-Dobutamine with Common Medication in Critical Care: Visual and Microscopy Evaluation

DOI

10.2991/978-94-6463-048-0_52How to use a DOI?

Keywords

intravenous compatibility; norepinephrine-dobutamine; visual inspection; microscopy

Abstract

Intravenous (IV) incompatibility is one of the obstacles in achieving the intended therapeutic goals. Norepinephrine-dobutamine is common inotropes that often meet with other injections and somehow cause incompatibility risk. Aim: This study aims to evaluate the compatibility of norepinephrine-dobutamine with common IV medications in critical care using the naked eye, black-white background, and microscope. Methods: Inotropic solution (dobutamine and norepinephrine) was prepared in a triplicate by adding D5W to a syringe to a final concentration of 1.4 mg/mL for dobutamine in which 30 μg/mL of norepinephrine was achieved. The solution was set up as a typical y-site infusion with the three-way connector. The inotropes are infused through the infusion set, and the other medications (acyclovir, ampicillin, cefotaxime, chloramphenicol, dexamethasone, furosemide, gentamicin, meropenem, phenobarbital, phenytoin, and ranitidine) are injected through the three-way orderly. The compatibility has been investigated in the tubing with the naked eye. Then, aliquot samples are collected to see discolouration, gas, and precipitate formation under black-white background and microscope. By using the naked eye, colour changes and precipitation were seen on meropenem and phenytoin injection, respectively. Under a black and white background, a slight precipitate was observed in acyclovir injection. Incompatibility was detected on acyclovir, ampicillin, gentamicin, meropenem, phenobarbital, and phenytoin under microscopy observation. Norepinephrine-dobutamine is incompatible with acyclovir, ampicillin, gentamicin, meropenem, phenobarbital, and phenytoin. The visual inspection resulted in the detection of a small amount of incompatibility (13,3%), compared to visual inspection against black and white backgrounds and with light (20%), and optical microscopy (40%).

Copyright

© 2023 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Suci Hanifah
PY  - 2022
DA  - 2022/12/19
TI  - Physical Compatibility of Norepinephrine-Dobutamine with Common Medication in Critical Care: Visual and Microscopy Evaluation
BT  - Proceedings of the 3rd International Conference on Cardiovascular Diseases (ICCvD 2021)
PB  - Atlantis Press
SP  - 454
EP  - 461
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6463-048-0_52
DO  - 10.2991/978-94-6463-048-0_52
ID  - Hanifah2022
ER  -