Evidence map›Paper›PMID 37167030›Full record

ArticleMolecular pharmaceutics2023

Co-administration of Intravenous Drugs: Rapidly Troubleshooting the Solid Form Composition of a Precipitate in a Multi-drug Mixture Using On-Site Raman Spectroscopy.

Niklas Nilsson, Katerina Nezvalova-Henriksen, Johan P Bøtker, Niels Højmark Andersen, Bjarke Strøm Larsen, Jukka Rantanen, Ingunn Tho, Jørgen Brustugun

Open access · hybridAbstract read
In one paragraph

Article in Molecular pharmaceutics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Niklas NilssonDepartment of Pharmacy, University of Oslo, Oslo 0316, Norway.ORCID 0000-0002-2047-8058
Katerina Nezvalova-HenriksenDepartment of Pharmacy, University of Oslo, Oslo 0316, Norway.
Johan P BøtkerDepartment of Pharmacy, University of Copenhagen, Copenhagen 2100, Denmark.
Niels Højmark AndersenDepartment of Chemistry, University of Oslo, Oslo 0315, Norway.
Bjarke Strøm LarsenDepartment of Pharmacy, University of Oslo, Oslo 0316, Norway.
Jukka RantanenDepartment of Pharmacy, University of Copenhagen, Copenhagen 2100, Denmark.ORCID 0000-0002-8211-5607
Ingunn ThoDepartment of Pharmacy, University of Oslo, Oslo 0316, Norway.
Jørgen BrustugunOslo University Hospital and Oslo Hospital Pharmacy, Hospital Pharmacies Enterprise, South-Eastern Norway, Oslo 0372, Norway.
Oslo University Hospital · NOUniversity of Oslo · NOUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Intravenous drugs are often co-administrated in the same intravenous catheter line due to which compatibility issues, such as complex precipitation processes in the catheter line, may occur. A well-known example that led to several neonatal deaths is the precipitation due to co-administration of ceftriaxone- and calcium-containing solutions. The current study is exploring the applicability of Raman spectroscopy for testing intravenous drug compatibility in hospital settings. The precipitation of ceftriaxone calcium was used as a model system and explored in several multi-drug mixtures containing both structurally similar and clinically relevant drugs for co-infusion. Equal molar concentrations of solutions containing ceftriaxone and calcium chloride dihydrate were mixed with solutions of cefotaxime, ampicillin, paracetamol, and metoclopramide. The precipitate formed was collected as an "unknown" material, dried, and analyzed. Several solid-state analytical methods, including X-ray powder diffraction, Raman spectroscopy, and thermogravimetric analysis, were used to characterize the precipitate. Raman microscopy was used to investigate the identity of single sub-visual particles precipitated from a mixture of ceftriaxone, cefotaxime, and calcium chloride. X-ray powder diffraction suggested that the precipitate was partially crystalline; however, the identity of the solid form of the precipitate could not be confirmed with this standard method. Raman spectroscopy combined with multi-variate analyses (principal component analysis and soft independent modelling class analogy) enabled the correct detection and identification of the precipitate as ceftriaxone calcium. Raman microscopy enabled the identification of ceftriaxone calcium single particles of sub-visual size (around 25 μm), which is in the size range that may occlude capillaries. This study indicates that Raman spectroscopy is a promising approach for supporting clinical decisions and especially for compatibility assessments of drug infusions in hospital settings.

Indexed as

CalciumCeftriaxoneHumansInfant, NewbornInfusions, ParenteralPharmaceutical PreparationsPowdersSpectrum Analysis, RamanCalciumCeftriaxonePharmaceutical PreparationsPowdersco-infusionembolipatient safetyphysical incompatibilityprecipitate identificationsafe administration

Identifiers

PMID37167030
PMCPMC10245374
OpenAlexW4376134289

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.