Potential Incompatibility Problem of Intravenous Drugs’ Administration among Intensive Care Unit (ICU) Patients at PKU Muhammadiyah Yogyakarta Hospital

https://doi.org/10.22146/jmpf.40930

Ardhanarishwari Umi Salamah(1), Fita Rahmawati(2), Fivy Kurniawati(3*)

(1) Fakultas Farmasi, Universitas Gadjah Mada
(2) Fakultas Farmasi, Universitas Gadjah Mada
(3) Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Drugs’ administration among hospitalized patients in ICU commonly is given intravenously. Mixing the intravenous drugs may result in incompatibility problem that might affect the drugs’ stability and bioavailability. The aim of the study was to investigate the potential incompatibility problem of  intravenous mixing drugs’ administration among ICU patients at PKU Muhammadiyah Yogyakarta Hospital. This study was a cross-sectional study in which design and data was obtained from ICU patients’ medical record retrospectively with purposive sampling in order to observe the pattern of intravenous drug’s combination. The potential incompatibility problem was analyzed using Handbook on Injectable Drugs. There were 79 out of 119 medical records which fulfilled sample inclusion criteria taken in this study. Parenteral dosage form was commonly used rather than non parenteral (62.06%) among ICUs’ patients. The potential incompatibility pattern consisted of incompatibility of intravenous drugs, electrolyte solutions/parenteral nutritions in mixture form, and the electrolyte solutions/parenteral nutritions, which are administrated simultaneously. Potential incompatibility of intravenous dosage was found in 50 events out of 79 patients (0.63 events per patients), which consisted of 8 events (8.51%) in using of drugs administrated simultaneously, 10 events (19.23%) in using of electrolyte solutions/parenteral nutritions in mixture form, and 32 events (11.72%) in using of electrolyte solutions/parenteral nutritions administrated simultaneously. Common potential incompatibilities types were precipitation of drugs and drug’s adsorption to packaging materials.


Keywords


incompatibility; intravenous; intensive care unit

Full Text:

PDF


References

1. Machotka O, Manak J, Kubena A, Vlcek J. Incidence of intravenous drug incompatibilities in intensive care units. Biomed Pap. 2015;159(4):652-656. doi:10.5507/bp.2014.057

2. Bentley J, Heard K. Mixing medicines : how to ensure patient safety Incompatibility poses a constant risk when mixing medicines but it can be avoided by understanding the chemical reactions taking. Pharm J. 2015:1-8.

3. Maharani L, Achmad A, Utami ED. Pengaruh Edukasi Apoteker Terhadap Sikap dan Pengetahuan Perawat Tentang Pencampuran Sediaan Parenteral. J Keperawatan Soedirman. 2013;8(2):87-91. doi:http://dx.doi.org/10.20884/1.jks.2013.8.2.470

4. Surahman E, Mandalas E, Kardinah EI. Evaluasi Penggunaan Sediaan. Maj Ilmu Kefarmasian. 2008;V(1):21-39.

5. Bertsche T, Mayer Y, Stahl R, Hoppe-Tichy T, Encke J, Haefeli WE. Prevention of Intravenous Drug Incomp in an Intensive Care Unit. Am JHealth Syst Pharm. 2008;65(19):1834-1840.

6. Depkes RI. Pedoman Pencampuran Obat Suntik dan Penanganan Sediaan Sitostatika. 2009:4-5.

7. Nasyiatul A. Kajian Inkompatibilitas Fisika Obat pada Pencampuran Sediaan Intravena di Instalasi Rawat Inap RSUD Prof. Margono Soekajo, Purwokerto. 2014.

8. Trissel, A L. Handbook on Injectable Drugs. 15th ed. New York: American Society of Health-System Pharmacists; 2009.

9. Foinard A, Décaudin B, Barthélémy C, Debaene B, Odou P. Impact of physical incompatibility on drug mass flow rates: Example of Furosemide-midazolam incompatibility. Ann Intensive Care. 2012;2(1):2-4. doi:10.1186/2110-5820-2-28

10. Clausen JL, Scott C, Mulherin N, et al. Adsorption/desorption measurements of nitroglycerin and dinitrotoluene in Camp Edwards, Massachusetts soil. ERDC Report TR-10-1. 2010;(February):1-164. http://www.dtic.mil/docs/citations/ADA520200.



DOI: https://doi.org/10.22146/jmpf.40930

Article Metrics

Abstract views : 4512 | views : 3155

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats