COMPATIBILITY AND STABILITY PROBLEMS OF INTRAVENOUS DRUG ADMINISTRATION IN INTENSIVE CARE UNIT

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

2019 | Tesis | MAGISTER FARMASI KLINIK

Intravenous drug administration is commonly used in hospitals for patients who need rapid pharmacological effects or patients who cannot take oral administration. Preparation for intravenous drug administration requires special condition because there are some risks, including incompatibility and instability. This study aims to assess the prevalence of intravenous drug incompatibility and instability in critical care patients and to investigate the risk factors that affect drug incompatibilities such as Length of stay in Intensive Care Unit, Number of IV drugs, and causes of hospitalization. This was a cross sectional, observational study. Subjects of this study were critical care patients at ICU, ICCU, and HCU who received at least one intravenous drug adminstation in two hospital (RSUP. Dr. Sardjito and UGM Hospital) in Yogyakarta Province. The data were taken from January to April 2018 by prospectively. A number of 123 patients included of this study. Potential drug incompatibility and instability were analysed based on Handbook of Injectable Drug and other references. The association between incompatibility and the risk factors were investigated using Chi-square test. Total number of incompatibility events occurred in 33 patients (26.82%) with the total events were 39 (5.6%) events. The most common type of incompatibility was potential precipitation by 33 (84.5%) events, the potential precipitation occure in simultaneously administration between phenytoin and Normal Saline (NS) 0,9%; phenytoin and dexamethasone; metronidazole and pantoprazole; phenytoin and ketorolac. There were no problems that occurred in stability of drugs during the study. There were an association between the incidence of incompatibility and cause of hospitalization (circulatory system disease and injury and certain other consequences of external causes) and there were an association between the incidence of incompatibility and the Length of stay in Intensive Care Unit of patient in intensive care (p <0.05).

Intravenous drug administration is commonly used in hospitals for patients who need rapid pharmacological effects or patients who cannot take oral administration. Preparation for intravenous drug administration requires special condition because there are some risks, including incompatibility and instability. This study aims to assess the prevalence of intravenous drug incompatibility and instability in critical care patients and to investigate the risk factors that affect drug incompatibilities such as Length of stay in Intensive Care Unit, Number of IV drugs, and causes of hospitalization. This was a cross sectional, observational study. Subjects of this study were critical care patients at ICU, ICCU, and HCU who received at least one intravenous drug adminstation in two hospital (RSUP. Dr. Sardjito and UGM Hospital) in Yogyakarta Province. The data were taken from January to April 2018 by prospectively. A number of 123 patients included of this study. Potential drug incompatibility and instability were analysed based on Handbook of Injectable Drug and other references. The association between incompatibility and the risk factors were investigated using Chi-square test. Total number of incompatibility events occurred in 33 patients (26.82%) with the total events were 39 (5.6%) events. The most common type of incompatibility was potential precipitation by 33 (84.5%) events, the potential precipitation occure in simultaneously administration between phenytoin and Normal Saline (NS) 0,9%; phenytoin and dexamethasone; metronidazole and pantoprazole; phenytoin and ketorolac. There were no problems that occurred in stability of drugs during the study. There were an association between the incidence of incompatibility and cause of hospitalization (circulatory system disease and injury and certain other consequences of external causes) and there were an association between the incidence of incompatibility and the Length of stay in Intensive Care Unit of patient in intensive care (p <0.05).

Kata Kunci : Intravenous drug administration, Incompatibility, Instability, Risk Factors, Intensive Care Unit