Original articleIdentification of potentially irritating intravenous medicationsIdentificación de medicamentos intravenosos potencialmente irritantes
Section snippets
What is known
Chemically induced phlebitis is an inflammatory response of the vascular endothelium to the intravenous administration of irritating drug solutions. It is a common complication in hospitalised patients receiving intravenous therapy via peripheral catheters.
What it contributes
Knowing the physicochemical properties of intravenous drugs, such as pH and osmolarity, helps in the assessment of their capacity to cause venous irritation or endothelial damage.
Implications of the study
The creation of comprehensive tables based on the physicochemical properties of drugs may be a useful tool which, together with the assessment of other factors, can help prevent chemically induced phlebitis by taking appropriate measures for vascular access care.
Design, sample, and scope of the study
An experimental in vitro study was conducted in an independent laboratory at the University of the Basque Country.
The researchers selected a sample of 62 medicines commonly used in hospitals. The drugs were selected by consensus between the researchers and three nurses from a tertiary hospital, ensuring a representative and equitable sample of serotherapy drugs, antibiotics, and other drugs administered most commonly in emergency departments or hospitalisation units. The drugs studied were
Results
Samples from 19 commercial solutions for fluid therapy, 21 antibiotics and 22 intravenous drugs commonly used in emergency and inpatient departments were analysed in the laboratory.
The analytical data of commonly used fluid therapy solutions are shown in Table 1. All the glucose solutions analysed showed an acidic pH (below 4.5). Glucose solutions above 5%, glucosaline, 10% mannitol and 1M bicarbonate showed a high capacity to cause venous irritation due to their hypertonic properties.
In the
Discussion
This study made it possible to identify the capacity of some of the most common peripheral intravenous drugs administered in the hospital setting to cause irritation and/or endothelial damage. In addition to the clinical condition of the patient and the indications for treatment, determining the pH and osmolarity values of these drugs provides useful information for deciding the form of administration or the most appropriate venous access device, with the aim of reducing the risk of chemically
Conclusion
In light of the results of our study, we can conclude that there is a need to determine the physicochemical properties of intravenous drugs, such as pH and osmolarity, to identify drug presentations with the potential to cause endothelial damage. The creation of comprehensive tables based on the chemical properties of drugs may, together with the assessment of other factors, be a useful tool to help prevent chemically induced phlebitis by taking appropriate measures for vascular access care.
Funding
No funding was received for this paper.
Conflict of interests
The authors have no conflict of interests to declare.
Acknowledgements
We would like to thank Victoria Armenteros Yeguas, for her review and contributions to this text.
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