ANTIBIOTICOS COMPATIBILIDADES

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FARMACIA

Transcript of ANTIBIOTICOS COMPATIBILIDADES

INSTITUTO NACIONAL DE PEDIATRALABORATORIO DE FARMACOLOGAFRMACO: PIPERACILINA / TAZOBACTAN

Piperacilina-Tazobactam (PIP-TZ) es un frmaco compuesto por un antibitico betalactmico (PIP) y un inhibidor de betalactamasa (TZ) para tratamiento de infecciones graves producidas por grmenes Gram positivos, Gram negativos y anaerobios. Ejerce su actividad bactericida mediante la inhibicin de la sntesis de la pared celular bacteriana.El tazobactam, una sulfona cida triazolimetil penicilnica, es un inhibidor potente de muchas -lactamasas, incluyendo las enzimas mediadas por plasmidios y cromosomales que comnmente causan resistencia a las penicilinas y cefalosporinas, incluyendo las cefalosporinas de tercera generacin.

Cada gramo de piperacilina debe reconstituirse con al menos 5 ml de agua estril para inyeccin , cloruro sdico al 0,9 %, agua bacteriosttica para inyeccin o cloruro de sodio bacteriosttico 0,9 % (conservada con alcohol benclico o parabenos ) o dextrosa al 5 % y se agita bien hasta diluir .

pH :Viales : de 4.5 a 6.8Solucin premezclada congelada: de 5,5 a 6.Biodisponibilidad: 71 %

Administracin: debe administrarse por infusin intravenosa durante al menos 30 minutos despus de la dilucin con al menos 50 ml en un diluyente compatible. Tambin se puede infundir usando bombas de infusin ambulatorias Compatibilidad con antibiticos y otros frmacos: - Puede disminuir la concentracin plasmtica de aminoglucsidos. - Puede disminuir la aclaracin renal de Metotrexate (controlar nivles de MTx)- Anticoagulantes orales: Se puede producir un aumento del efecto anticoagulante, con un aumento del riesgo hemorrgico. Puede disminuir el efecto terapetico de la vacuna BCG, y la respuesta inmunolgica de la vacuna de fiebre tifoidea atenuada (Ty21a).

Estabilidad : Polvo liofilizado de color blanquecino en viales intactos que deben almacenarse a temperatura ambiente. Viales de una sola dosis de la solucin deben utilizarse inmediatamente despus de la reconstitucin. Cualquier porcin restante debe desecharse despus de 24 horas a temperatura ambiente o 48 horas bajo refrigeracin a 2 a 8 C.En las soluciones de infusin compatible, el frmaco es estable durante 24 horas a temperatura ambiente o una semana bajo refrigeracin. Vidrio y plstico (incluyendo jeringas, bolsas de solucin por va intravenosa, y tubera) no afectan estabilidad. Soluciones CongeladasLas inyecciones congeladas disponibles comercialmente se deben almacenar en 0 por debajo de -20 C . Descongelar a temperatura ambiente o bajo refrigeracin, pero no en un bao de agua caliente o por radiacin de microondas. Soluciones descongeladas no deben volver a congelarse. Despus de la descongelacin, las soluciones son estables durante 24 horas a temperatura ambiente o 14 das en refrigeracin. Bombas AmbulatoriaEl producto mostr ser estable hasta 12 horas en una bomba de infusin ambulatoria.

Solucin Observaciones Drogas en jeringa

Dextrosa al 5%Compatible Dimenhydrinate 10mg/1mlCompatible, solucin clara

Dextrosa al 5% con 20- 80 g Concentracion/LVisualmente compatible. Pequea prdida de cualquiera de los frmacos en 28 das a 5 C y luego 72 horas a 23 C a la luz

pantoprazol sdico4mg/1 mL No compatible, formacin de precipitado despus de 1 h.

Inyeccin de Ringer lactato

Compatible si se usa la formulacin con Edetato Disdico.Compatibilidad Inyeccin Y- Site

Cloruro de Sodio al 0.9%compatible

Cloruro de Sodio al 0.9%Con 40g C/L de base de drogaprdida del 10 % en 5,8 das a 7 C y 3,8 das a temperatura ambiente.

Cloruro de Sodio al 0.9%Con 40 g C /L de base de droga prdida del 10 % en 5,8 das a 7 C y 3,8 das a temperatura ambiente.

Cloruro de Sodio al 0.9%con 20- 80 g C/L de base de droga Visualmente compatible. 5 % tazobactam y 2 % de prdida de piperacilina en 28 das a 5 C y luego 72 horas a 23 C a la luz.

http://www.interactivehandbook.com/monographs/

http://www.interactivehandbook.com/monographs/a591011.htmErtapenem SodiumAHFS Class: 8:12.07.08 - CarbapenemsTradenames: InvanzProductsErtapenem is available as a lyophilized powder in 1-g vials as the sodium salt with sodium bicarbonate 175 mg and sodium hydroxide to adjust the pH. For intravenous administration, reconstitute the 1-g vial with 10 mL of sterile water for injection, bacteriostatic water for injection, or sodium chloride 0.9% and shake well, yielding a 100-mg/mL concentration. Upon dissolution, immediately transfer the reconstituted solution to 50 mL of sodium chloride 0.9% for adults. For pediatric patients, the dose of reconstituted ertapenem should be transferred to a volume of sodium chloride 0.9% to yield a final concentration of 20 mg/mL or less.1(2/08) For intramuscular injection, reconstitute the 1-g vial with 3.2 mL of lidocaine hydrochloride 1% (without epinephrine) and shake well, yielding a 280-mg/mL concentration. Upon dissolution, administer within one hour. Do NOT administer the reconstituted intramuscular injection intravenously.1(2/08) pH7.5.1(2/08) Sodium ContentApproximately 137 mg or 6 mEq.1(2/08) AdministrationErtapenem sodium diluted in sodium chloride 0.9% may be administered by intravenous infusion over 30 minutes or by deep intramuscular injection into a large muscle mass such as the gluteal muscle or the lateral part of the thigh.1(2/08) StabilityIntact vials of ertapenem sodium should be stored at controlled room temperature not exceeding 25 C. The reconstituted drug solution for intravenous administration should be diluted immediately in sodium chloride 0.9%. Dextrose-containing solutions should NOT be used to dilute ertapenem.1(2/08) 2723 . The drug diluted for infusion may be stored and used within six hours at room temperature or may be stored for 24 hours under refrigeration and used within four hours after removal from refrigeration. The drug prepared for intramuscular administration should be used within one hour. Solutions of ertapenem sodium should not be frozen.1(2/08) Compatibility Solution CompatibilityErtapenem (as sodium salt)

Test Soln NameTest Soln MfrBase Drug MfrBase Drug Conc/LRemarksRefsCompat

Dextrose 5% in sodium chloride 0.225%ABME10 and 20 gVisually compatible. 10% loss in 6 hr at 25 C. 8% loss in 32 hr and 11% loss in 48 hr at 4 C2487 I

Dextrose 5% in sodium chloride 0.9%ABME10 and 20 gVisually compatible. 11% loss in 6 hr at 25 C and 10% loss in 32 hr at 4 C2487 I

Dextrose 5%ABME10 and 20 gVisually compatible. 10% loss in 6 hr at 25 C and 5 to 8% loss in 24 hr at 4 C2487 I

Ringer's injectionABME10 and 20 gVisually compatible. 10 to 12% ertapenem loss in 20 hr at 25 C and 11% loss in 5 days at 4 C2487 Ia

Ringer's injection lactatedABME10 and 20 gVisually compatible. 18% loss in 20 hr at 25 C and 9% loss in 3 days at 4 C2487 I

Sodium chloride 0.225%ABME10 and 20 gVisually compatible. 9 to 12% loss in 20 hr at 25 C and 8 to 11% loss in 5 days at 4 C2487 Ia

Sodium chloride 0.9%ABME10 and 20 gVisually compatible. 9 to 11% loss in 20 hr at 25 C and 8 to 11% loss in 5 days at 4 C2487 Ia

Sodium chloride 0.9%b ME10 gPhysically compatible with less than 10% drug loss in 24 hr at 25 C and 7 days at 5 C2723 C

Sodium chloride 0.9%c ME10 gPhysically compatible with less than 10% drug loss in 30 hr at 25 C and 8 days at 5 C2723 C

Sodium chloride 0.9%b ME20 gPhysically compatible with less than 10% drug loss in 18 hr at 25 C and 5 days at 5 C2723 C

Sodium chloride 0.9%c ME20 gPhysically compatible with less than 10% drug loss in 24 hr at 25 C and 7 days at 5 C2723 C

Sodium lactate (1/6) MABME10 and 20 gVisually compatible. 7 to 9% loss in 6 hr at 25 C and 8 to 11% loss in 2 days at 4 C2487 I

a Incompatible by conventional standards but recommended for dilution of ertapenem with use in shorter periods of time. b Tested in the Homepump Eclipse elastomeric pump reservoirs. c Tested in Intermate elastomeric pump reservoirs.

Additive CompatibilityErtapenem (as sodium salt)

Test DrugTest Drug MfrTest Drug Conc/LBase Drug MfrBase Drug Conc/LSolutionRemarksRefsCompat

MannitolAB5%ME10 and 20 gPrecipitate in 90 min may be required if Redman syndrome develops.

a Chemical degradation was dependent on the diluent. This is the shortest time in which the drug degraded 10%. b Stable for 48 h warmed to room temperature after refrigeration. c Frozen expiration date per manufacturer's label. Do not extrapolate commercial premix stability data to extemporaneously compounded solutions. Thaw at room temperature or under refrigeration. Do not force thaw. Do not refreeze. d Manufacturers extrapolated data from other sources. e pH of the undiluted solution is 3.8-6. pH of reconstituted preparation in W or NS is 3.9. pH of a 5% solution in W is 2.5-4.5.1 f Following 17 d refrigerated storage.

Compatibility Solution CompatibilityVancomycin HCl

Test Soln NameTest Soln MfrBase Drug MfrBase Drug Conc/LRemarksRefsCompat

Dextrose 5% in Ringer's injection lactated5 gStable for 96 hr refrigerated1(10/08) C

Dextrose 5% in sodium chloride 0.9%5 gStable for 96 hr refrigerated1(10/08) C

Dextrose 5% in sodium chloride 0.9%LI1 gPhysically compatible74 C

Dextrose 5%5 gStable for 14 days refrigerated1(10/08) C

Dextrose 5%LI1 gPhysically compatible74 C

Dextrose 5%LI5 gStable for 7 days at 5 and 25 C141 C

Dextrose 5%TRa LI5 gPhysically compatible and stability for 24 hr at room temperature518 C

Dextrose 5%TRb LI5 gPhysically compatible with no loss in 7 days and 5% loss in 17 days at 24 C. In glass containers, no loss in 63 days at 5 C1134 C

Dextrose 5%TRLI4 and 5 gPhysically compatible with 8% loss in 17 days at 23 C and 11% loss in 30 days at 4 C1354 C

Dextrose 5%ABe AB20 and 40 gLittle loss in 96 hr at 25 C and in 30 days at 5 C2097 C

Dextrose