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compatibility
Comp 19, info sheet 1
| Question | Answer |
|---|---|
| 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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