COMPATIBILITY AND STABILITY PROBLEMS OF INTRAVENOUS DRUG ADMINISTRATION IN HOSPITALIZED PEDIATRIC PATIENTS

REZA RAHMAWATI, Dr. Fita Rahmawati, Sp.FRS., Apt; Prof. Syed Azhar Syed Sulaiman

2018 | Tesis | MAGISTER FARMASI KLINIK

Inappropriate intravenous drug administration may cause harm to the patients. In pediatric and neonatus, intravenous drug administration is very critical because of poor venous access especially when simultaneously drug administration required which is can lead into incompatibilities occurence. Therefore, this study aims to identify combination of intravenous drug used and incidence of incompatibilitiy and instability problems and what type of drug that involved in these problems in hospitalized pediatric patients. This research design was done in cross sectional and prospective study. The location of this study were in PICU, NICU, and pediatric ward at RSUP Dr. Sardjito and Academic Hospital of UGM. A number of 167 hospitalized pediatric patient used at least 1 intravenous drug involved in this study. Compatibility and stability were analyzed using standard reference Handbook of Injectable Drugs and other references. Most of hospitalized pediatric patients got 2 intravenous drug combinations (89,0%) concomitantly . Incompatible combinations were detected in 6 (3,6%) patients with 4 different pairs of drug. There were aminophylline and ciprofloxacin (0,6%); ampicilin and D5 0,45%NS (1,2%); ampicilline and D10% (0.6%); ceftriaxone and ringerfundin (1,2%). The stability problem was found in 6 different pairs of drug that given in Y-site administration to 18 patients (10,8%). There were norephinephrine and dobutamine; norephinephrine and dopamine; morphine and fentanyl; norephinephrine and fentany (0,6%), dopamine and fentanyl (1,2%), and midazolam and fentanyl (7,2%). There were 24 from 167 (14,4%) hospitalized pediatric patients had intravenous administration problems. Incompatibility and instability still exist in pediatric patients. It is challenge for pharmacist to prevent this problem in pediatric patients.

Inappropriate intravenous drug administration may cause harm to the patients. In pediatric and neonatus, intravenous drug administration is very critical because of poor venous access especially when simultaneously drug administration required which is can lead into incompatibilities occurence. Therefore, this study aims to identify combination of intravenous drug used and incidence of incompatibilitiy and instability problems and what type of drug that involved in these problems in hospitalized pediatric patients. This research design was done in cross sectional and prospective study. The location of this study were in PICU, NICU, and pediatric ward at RSUP Dr. Sardjito and Academic Hospital of UGM. A number of 167 hospitalized pediatric patient used at least 1 intravenous drug involved in this study. Compatibility and stability were analyzed using standard reference Handbook of Injectable Drugs and other references. Most of hospitalized pediatric patients got 2 intravenous drug combinations (89,0%) concomitantly . Incompatible combinations were detected in 6 (3,6%) patients with 4 different pairs of drug. There were aminophylline and ciprofloxacin (0,6%); ampicilin and D5 0,45%NS (1,2%); ampicilline and D10% (0.6%); ceftriaxone and ringerfundin (1,2%). The stability problem was found in 6 different pairs of drug that given in Y-site administration to 18 patients (10,8%). There were norephinephrine and dobutamine; norephinephrine and dopamine; morphine and fentanyl; norephinephrine and fentany (0,6%), dopamine and fentanyl (1,2%), and midazolam and fentanyl (7,2%). There were 24 from 167 (14,4%) hospitalized pediatric patients had intravenous administration problems. Incompatibility and instability still exist in pediatric patients. It is challenge for pharmacist to prevent this problem in pediatric patients.

Kata Kunci : Pediatric, Intravenous Admininstration, Compatibility Problem, Stability Problem