Stability of Epinephrine in a 0.9% Saline Solution

Bibliographic Details
Main Author: Wade, Spencer David, DDS
Language:English
Published: The Ohio State University / OhioLINK 2019
Subjects:
Online Access:http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315
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spelling ndltd-OhioLink-oai-etd.ohiolink.edu-osu15614892993623152021-08-03T07:11:32Z Stability of Epinephrine in a 0.9% Saline Solution Wade, Spencer David, DDS Analytical Chemistry Dentistry Pharmacology Anesthesia Medications Objective: By law, pharmaceutical companies clearly label their medications with an expiration date, but the debate behind the “new expiration date” that drugs are given after being diluted is ongoing. Some medications, including epinephrine, commonly come in concentrations which are unusable for clinical anesthesiology. Epinephrine is generally used during emergency situations, making it difficult to perform an urgent dilution amidst a declining clinical scenario. Emerging evidence indicates that not only do medications remain stable past their original pharmaceutical expiration date, but their stability remains intact even after dilution. The objective of this study was to determine the stability of epinephrine over time in a 10ml normal saline pre-filled syringe stored in typical perioperative environments.Methods: All samples were prepared by diluting 1 mg/ml of epinephrine to 10mcg/ml by using normal saline pre-filled syringes. The samples were then left for 0, 15, 30, 60, and 90 day(s) prior to final analysis and stored in one of four different laboratory environments to emulate common clinical scenarios (light, dark, room temperature, and refrigerated). Capillary zonal electrophoresis was then used to measure the chemical degradation of epinephrine over time. Additionally, agar plating was used to measure bacterial growth in all samples.Results: No significant differences were detected in levels of epinephrine between the 0, 15, 30-day and 0, 60, 90-day samples in each of the four environments. Additionally, bacterial growth was not detected in any of the samples. Conclusions: Epinephrine remains stable in a normal saline pre-filled syringe for up to 90 days in common settings of lighting and temperature (i.e., sample degradation does not exceed the sample variance attributable to sample dilution). Therefore, pre-diluting epinephrine for unanticipated clinical emergencies may remain clinically useful for up to 90 days, thus improving patient safety, access to medications, and overhead costs. 2019-10-24 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315 http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection NDLTD
language English
sources NDLTD
topic Analytical Chemistry
Dentistry
Pharmacology
Anesthesia
Medications
spellingShingle Analytical Chemistry
Dentistry
Pharmacology
Anesthesia
Medications
Wade, Spencer David, DDS
Stability of Epinephrine in a 0.9% Saline Solution
author Wade, Spencer David, DDS
author_facet Wade, Spencer David, DDS
author_sort Wade, Spencer David, DDS
title Stability of Epinephrine in a 0.9% Saline Solution
title_short Stability of Epinephrine in a 0.9% Saline Solution
title_full Stability of Epinephrine in a 0.9% Saline Solution
title_fullStr Stability of Epinephrine in a 0.9% Saline Solution
title_full_unstemmed Stability of Epinephrine in a 0.9% Saline Solution
title_sort stability of epinephrine in a 0.9% saline solution
publisher The Ohio State University / OhioLINK
publishDate 2019
url http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315
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