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Abstract
Objective The primary literature was reviewed to determine the stability of drug additives in peritoneal dialysis solutions. Data Sources A MEDLINE search and retrieval, covering the period 1981 to 1994, was undertaken to identify relevant original literature. Additional references were identified from citations within the original literature. Non-English literature was excluded unless an English abstract was provided. Study Selection Forty-nine studies were identified. Of these, 24 were directly related to drug stability, 13 were related to the clinical use of the drug additives but included no stability data, and 12 examined other, nonstability aspects of in vitroactivity of antibiotics, additives, or drug adsorption in peritoneal dialysis bags and tubing. Data Extraction Data included concentrations of drug additives and dialysate solutions, duration and temperatures of storage conditions, types of assay, and whether they were stability-indicating. Results Stability was defined as the duration of time that the drug concentration remained at 90% or more of the original concentration. Stability was examined under a large variety of conditions. Thirty-one drugs were identified from 20 manuscripts as single-drug additives. Most beta-Iactams were stable for 1 –2 weeks in a refrigerator and for several days at room temperature. Aminoglycosides were stable for 1 –2 days at room temperature. Glycopeptides were stable for several weeks refrigerated or at room temperature. Prolonged storage at room temperature resulted in instability of cefotaxime, ceftazidime, ceftriaxone, and miconazole. Eleven drugs were identified from seven manuscripts as drug combination studies and showed similar stability as single agents. Dialysate concentration appeared to have minimal effect on stability. Conclusions Drug additives in peritoneal dialysate, singly or combined, should be avoided unless data are available to support their stability. Additives should be made as close as possible to the time of the exchange. Alternatively, additives should be stored refrigerated, then warmed prior to use. The practice of preparing numerous bags at one time should be avoided. Finally, stability data do not indicate sterile integrity of the dialysate.
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Affiliation(s)
- George R. Bailie
- Department of Pharmacy Practice, Albany College of Pharmacy, Albany, New York, U.S.A
| | - Michael P. Kane
- Department of Pharmacy Practice, Albany College of Pharmacy, Albany, New York, U.S.A
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Schuster L, Seifert O, Vollmer S, Kontermann RE, Schlosshauer B, Hartmann H. Immunoliposomes for Targeted Delivery of an Antifibrotic Drug. Mol Pharm 2015; 12:3146-57. [DOI: 10.1021/acs.molpharmaceut.5b00012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Liane Schuster
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Oliver Seifert
- Institute of Cell Biology and Immunology, University of Stuttgart, Allmandring 31, 70569 Stuttgart, Germany
| | - Stefanie Vollmer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Roland E. Kontermann
- Institute of Cell Biology and Immunology, University of Stuttgart, Allmandring 31, 70569 Stuttgart, Germany
| | - Burkhard Schlosshauer
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Hanna Hartmann
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
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De Vin F, Rutherford P, Faict D. Intraperitoneal Administration of Drugs in Peritoneal Dialysis Patients: A Review of Compatibility and Guidance for Clinical Use. Perit Dial Int 2009. [DOI: 10.1177/089686080902900101] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Peritoneal dialysis (PD) is an effective home-based therapy for end-stage renal failure. Intraperitoneal administration of drugs to PD patients is particularly important for the treatment of peritonitis. Clinicians need to know that the administered drug is compatible with both the PD solution and its container. A detailed literature search on drug compatibility and stability was performed and results of all published stability studies are presented for all drugs, PD solutions, and containers studied. These data will aid clinicians managing PD patients and provide a resource to demonstrate which drugs have been shown to be stable in various PD solutions and solution containers. This is important information to assist clinicians in applying effective treatments, in particular, for peritonitis.
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