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Comp 19, info sheet 1

incompatibility according to Remington's Science and Practice of Pharmacy, the term may be applied to prescriptions when certain problems arise during their compounding, dispensing, or administration
three types of incompatibility physical, chemical, and therapeutic
physical incompatibility may result in a change that can be seen such as color, solid to gas, development of hazy appearance, or the formation of solids in a liquid (precipitate) to name a few. These usually occur as a result of drug insolubility
the most obvious incompatibilities to detect physical incompatibilities *sometimes these changes are expected and are not a problem
chemical incompatibility may not be visible, many occur when a combination of chemicals are mixed together resulting in inactivation and / or destruction of the desired product
therapeutic incompatibility occur when agents antagonistic to one another are prescribed together
factors affecting compatibility and stability pH, complexation, light, dilution, time, IV solution, temperature, buffer capacity, order of mixing, plastic
pH most common cause of incompatabilities is combining two drugs that require conflicting pH values of the final solution for their own stability. Care must be taken when combining a drug with a low pH and one with a high pH i.e. combining aminophylline (pH 8.0 - 9.0) and vitamin B complex (acidic pH) results in the breakdown of the vitamin
complexation when the chemical complex formed results in reduction of desired activity i.e. combining tetracycline with a calcium containing product results in reduction of activity of the antibiotic, or a therapeutic incompatibiilty
light exposure to light may result in a breakdown of the chemical, thus reducing its potency i.e. amphotericin B
dilution the concentration of a drug in solution may be a factor in its compatibility with other drugs i.e. electrolytes
time most drugs degrade in a relatively short time when placed in a solution; it may not be instantaneous, but develop over time
IV solution some drugs require specific solutions (diluents) for reconstitution and further dilution i.e. amphotericin B must be reconstituted with SW without bacteriostatic agents
temperature degradation of drugs may be the direct result or change in temperature. This chemical reaction may result from too low to too high a temperature i.e. refrigerated items must be kept under refrigeration to maintain stability of product
buffer capacity the ability of that solution to resist change in pH when either an acidic or alkaline substance is added to it i.e. penicillin G has a buffer allowing it to be added to dextrose thus maintaining stability of the product
order of mixing the order in which drugs are added to a solution may be a factor in compatibility. Drugs that are concentrated may react to form precipitate. i.e. electrolytes added to TPN solution
plastic some drugs are incompatible in plastics. ie. nitroglylcerin must be stored in glass bottles and administered (IV) in a glassine IV Admixture set
precipitate formation of solids in a liquid
Created by: DbaileyC



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