Extended compatibility of fentanyl and ketamine in dextrose 5. 2018

Suci Hanifah, and Ross Kennedy, and Patrick Ball
Department of Pharmacy, Faculty of Science, Universitas Islam Indonesia, Yogyakarta, Indonesia. suci.hanifah@gmail.com.

There are no published studies that report on fentanyl and ketamine compatibility in dextrose 5% solution as commonly practiced in hospital settings. This study assessed the compatibility of fentanyl and ketamine after their reconstitution in dextrose 5% under ambient temperature and humidity conditions in a hospital setting. Each sample of fentanyl and ketamine was prepared in triplicate by adding dextrose 5% to a prefilled syringe until final concentrations of 9.8 μg mL-1 for fentanyl and 192 μg mL-1 for ketamine were achieved. The solutions were stored in syringes at an ambient temperature ranging 26-28°C either under a mixture of daylight and ambient lighting. A sample was taken from the syringes at the following times: 0, 8, 24, 72, 120, and 168 hours. The samples from each solution were checked for physical changes, pH and their concentration assessed by high-performance liquid chromatography. The solutions were clear and no physical changes were seen. The pH of fentanyl and ketamine decreased dramatically after 72 hours. The concentrations of fentanyl remained 90-110% only for 24 hours, while ketamine remained 90-110% for 168 hours. Solutions of fentanyl and ketamine in dextrose 5% may be used in prefilled syringes only up to 24 hours and 72 hours after reconstitution, respectively.

UI MeSH Term Description Entries
D007649 Ketamine A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors. 2-(2-Chlorophenyl)-2-(methylamino)cyclohexanone,CI-581,Calipsol,Calypsol,Kalipsol,Ketalar,Ketamine Hydrochloride,Ketanest,Ketaset,CI 581,CI581
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D004355 Drug Stability The chemical and physical integrity of a pharmaceutical product. Drug Shelf Life,Drugs Shelf Lives,Shelf Life, Drugs,Drug Stabilities,Drugs Shelf Life,Drugs Shelf Live,Life, Drugs Shelf,Shelf Life, Drug,Shelf Live, Drugs,Shelf Lives, Drugs
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
D013594 Syringes Instruments used for injecting or withdrawing fluids. (Stedman, 25th ed) Hypodermic Syringes,Syringe, Karman,Hypodermic Syringe,Karman Syringe,Syringe,Syringe, Hypodermic,Syringes, Hypodermic

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