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Dear All,
One of my colleague is doing a 28 day tox. study in rats and mice by
intravenous route. The pH of the solution being used is 8.5
In mice everything seems to be fine, but in rats after about 10 - 12 days
severe phlebitis is occuring and he is not able to proceed further.
Any help how to complete the exposure or how to bypass this would be
welcome.
Thanks.
Y.Chugh
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[Two replies - db]
From: "Bruce CHARLES"
Organization: School of Pharmacy
To: PharmPK.at.boomer.org
Date: Thu, 17 Feb 2000 14:39:27 +1000
Subject: Re: PharmPK Phlebitis after high pH injection in rats +++REPLY+++
X-Confirm-Reading-To: "Bruce CHARLES"
X-pmrqc: 1
Priority: normal
One possible way around is to infuse at slower rates (maybe
several hours) such as has to be done with amphotericin because
of phlebitis and thrombophlebitis.
Cheers,
BC
Bruce CHARLES, PhD
Associate Professor
Director, The Australian Centre for Paediatric Pharmacokinetics
University of Queensland, School of Pharmacy, QLD 4072
Australia
+61 7 336 53194 (TEL)
+61 7 336 51688 (FAX)
bruce.at.pharmacy.uq.edu.au
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Date: Thu, 17 Feb 2000 00:31:50 -0700 (MST)
X-Sender: ml11439.-at-.pop.goodnet.com
To: PharmPK.-at-.boomer.org
From: ml11439.aaa.goodnet.com (Michael J. Leibold)
Subject: Re: PharmPK Phlebitis after high pH injection in rats
Y.Chugh,
Parenteral phenytoin sodium has its pH adjusted to 12 to maintain
its solubility in a propylene glycol/alcohol solvent. It is very irritating
to the vein when injected IV. One method of minimizing this venous
irritation is to flush the IV line with saline after the drug is
injected. This flushes out the sodium hydroxide buffer that remains
in the IV line and causes the venous irritation/phlebitis.
Mike Leibold, PharmD, RPh
ML11439.at.goodnet.com
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Postinfusion phlebitis in humans is caused commonly caused by drugs with a
low pH or high osmolarity. Other factors are the size of the vein may be
small or the needle may be too large and may traumatise the vein. Also,
Particles in the solution can cause a mechanical phlebitis.
Suggestions to overcome phlebitis:
Alter osmolarity of infusion ( reconstitute drug in water and infuse with
water for injection)
Dilute drug in larger volume
Slower infusion rates
Use a larger vein
Rotate infusion veins
Use water for injection to reconstitute and consider using a filter to
remove particles from solution
Gail Neilson,
Senior Pharmacist, Alternative Site Infusion Service, Department of
Infectious Diseases, Princess Alexandra Hospital, Brisbane.
Secretary, Editor, AHOITA (Australian Home & Outpatient Intravenous Therapy
Association).
Masters degree student in Home Parenteral Programs, University of Queensland.
Community Pharmacy Proprietor
Email: G.Neilson.at.mailbox.uq.edu.au
Mobile: 041 23 65 294
Tel: 07 3240 5982
Fax: 07 3240 5540
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Copyright 1995-2010 David W. A. Bourne (david@boomer.org)