Incompatibility of intravenous drugs is dangerous and therefore undesirable. The aim of this study was to identify the most commonly acquired intravenous drugs in five neonatal intensive care units and test these for compatibility.
The most frequently acquired drugs in five key hospitals in the South-Eastern district of Norway for 2019 and 2020 served as a proxy for prevalence of use. . Representatives were selected from the three most prevalent groups based on the Anatomical Therapeutic Chemical classification system. Co-administration of drug pairs was simulated using clinically relevant concentrations and infusion rates representing mixing ratios in the catheter. Particle formation was assessed by particle counting and size measurement, by visual examination using Tyndall-beam, by turbidiy, and by measuring pH of mixed samples.
The most frequently acquired drug groups were anti-infectives, neurological agents, and cardiovascular drugs. Compatibility testing revealed that both ampicillin and benzylpenicillin were incompatible with morphine. Flecainide and fluconazole showed no signs of incompatibility with morphine. No information on these combinations in a neonatal-relevant setting is available.
We recommend to abstain from co-administering ampicillin and benzylpenicillin with morphine in neonatal intensive settings. Morphine co-administered with flecainide and fluconazole in neonatal patients were evaluated as safe.
Outcome measures for trials of remyelinating agents in multiple sclerosis: retrospective longitudinal analysis of visual evoked potential latency.
2区 · 医学
作者: A Niklas ; H Sebraoui ; E Hess ; A Wagner ; F Then Bergh
Visual evoked potentials (VEP) may be suitable surrogate outcome measures in multiple sclerosis (MS) remyelination trials. The extent of spontaneous changes of subclinically delayed VEP is unknown, whereas VEP improve after acute optic neuritis (ON).
In all, 124 patients with three VEP recordings at least 3 months apart: 71 patients with MS who had never suffered clinical ON; 53 patients with ON (isolated ON or ON as an attack of MS at first recording). Latencies of P100 were analyzed by multivariate analysis of variance.
Eyes of patients with MS had a mean P100 latency of 110.2 ms, worsening mildly over time (n = 104 eyes, P = 0.022). MS patients' eyes with subclinical demyelination (delayed P100 latency at first recording >116 ms) showed no significant evidence of remyelination (n = 24 eyes, P = 0.27). By contrast, in ON patients' affected eyes, mean P100 latency decreased (P = 0.001), whereas unaffected eyes remained stable (P = 0.26). Clinically non-affected eyes from both diagnostic groups with subclinically prolonged latencies remained stable (n = 32: mean P100 at 124.8 +/- 10.7, 123.5 +/- 13.6, and 122.8 +/- 13.1 ms; P = 0.57), whereas non-affected eyes with normal latency at baseline deteriorated slightly (P = 0.001). A subgroup with more homogeneously defined follow-up periods confirmed this observation. Non-affected eyes selected for stability (difference <5 ms) between first and second recording deteriorated (normal baseline, n = 66 eyes, P = 0.013) or remained stable (prolonged baseline, n = 18 eyes, 95% confidence interval of change -5.42 to +6.89 ms, P = 0.805).
Prolonged P100 latencies in eyes never affected by clinical ON remain stable and thus can be used as surrogate outcome measure for remyelination trials.