急救药物在院前环境中使用八周后的化学稳定性

IF 1.4 4区 医学 Q3 EMERGENCY MEDICINE African Journal of Emergency Medicine Pub Date : 2023-12-13 DOI:10.1016/j.afjem.2023.11.009
Simpiwe Sobuwa , Thishana Singh , Kerusha Kalicharan
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引用次数: 0

摘要

本研究评估了四种急救药物(肾上腺素、依托咪酯、氯胺酮和罗库溴铵)在院前环境中使用八周后的稳定性。方法本研究采用纵向定量设计来评估急救药物的化学稳定性。研究在南非巴利托、德班和彼得马里茨堡的四个急救医疗服务基地进行。主要结果是四周和八周后药物浓度与标记浓度的相对降低率。高效液相色谱-质谱法(HPLC-MS)对样本进行分析,以确定药物样本中的有效成分浓度。前四周的环境温度为 18.7 至 44 °C,平均温度为 26.8 °C ± 3.0 °C。4 周和 8 周时,肾上腺素分别下降了 24.93% 和 22.73%。依托咪酯的对照品为 3.06 毫克/毫升,而不是瓶子上的 2 毫克/毫升。4 周和 8 周后,样品的活性成分分别为 3.10 毫克/毫升和 3.15 毫克/毫升。氯胺酮在四周后降解了 30% 以上,但四周后没有再降解。氯胺酮的包装上写着 10 毫克/毫升。但我们发现其含量为 17.46 毫克/毫升。对照组中的罗库溴铵浓度为 6.45 毫克/毫升,尽管生产商规定为 10 毫克/毫升。结论这项研究表明,肾上腺素和氯胺酮在院前现场使用四周内降解超过 20%,而依托咪酯和罗库溴铵在八周后仍保持稳定。
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Emergency care drugs' chemical stability after eight weeks’ deployment in the prehospital setting

Temperature conditions vary in emergency service vehicles, which may pose a risk to the integrity of the drugs on board, possibly rendering them ineffective and increasing morbidity and mortality in patients.

Aim

This study assessed the stability of four emergency care drugs (adrenaline, etomidate, ketamine, and rocuronium) after eight weeks of deployment in the prehospital context.

Methods

The study adopted a longitudinal quantitative design to evaluate the chemical stability of emergency care drugs. The study was conducted at four emergency medical service bases in Ballito, Durban and Pietermaritzburg, South Africa. The primary outcome was the relative reduction in drug concentration from the labelled concentration after four and eight weeks. High-performance liquid chromatography-mass spectrometry (HPLC-MS) analysed samples to determine the concentration of active ingredients in the drug samples.

Results

HPLC analysis was done on 176 samples. The ambient temperature ranged from 18.7 to 44 °C in the first four weeks, averaging 26.8 °C ± 3.0. At 4 and 8 weeks, Adrenaline decreased 24.93 % and 22.73 %, respectively. Etomidate's control had 3.06 mg/ml, not the 2 mg/ml on the bottle. After 4 and 8 weeks, the samples had 3.10 and 3.15 mg/ml active components, respectively. Ketamine degraded over 30 % after four weeks but not beyond that. The Ketamine package states 10 mg/ml. However, we found 17.46 mg/ml. Rocuronium was 6.45 mg/ml in the control, although the manufacturer specified 10 mg/ml. At four weeks, the concentration was 6.70 mg/ml; at eight weeks, 6.56.

Conclusion

This study suggests that adrenaline and ketamine degrade by more than 20 % within four weeks of deployment in the prehospital field, whereas etomidate and rocuronium remain stable after eight weeks.

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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
78
审稿时长
85 days
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