Osmolality of solutions, emulsions and drugs that may have a high osmolality

aspects of their use in neonatal care

L Pereira-da-Silva, G Henriques, J M Videira-Amaral, R Rodrigues, L Ribeiro, Daniel Virella

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: Administration of some hypertonic substances to neonates has been associated with a variety of adverse effects. This study was conducted to determine the osmolality of intravenous drugs and solutions used in neonates receiving intensive care.

METHODS: Osmolality was measured by freezing point depression. Vasoactive drugs, diuretics, anticonvulsants, antimicrobials, and glucose and electrolyte solutions were some of the substances analyzed.

RESULTS: The osmolalities of 90 substances were measured; the respective intra-assay and interassay coefficients of variation were always less than 5%. A few drugs were found to be extremely hypertonic (> 8000 mOsm/kg), and most of them contain propylene glycol as vehicle (e.g. digoxin, phenytoin, diazepam and phenobarbital). Other drugs, at the same concentration, evidenced a significant discrepancy of osmolality depending on the trademark.

CONCLUSIONS: The finding of some extremely hypertonic drugs highlights the need for further investigation in order to study their potential adverse effects in neonates, as well as to evaluate any advantage in diluting, infusing slowly or even avoiding such substances. Given the fact that there exists a discrepancy in osmolalities in some drugs at the same concentration depending on the trademark, the more isotonic solutions should be the preferred choice for intravenous administration.

Original languageEnglish
Pages (from-to)333-8
Number of pages6
JournalJournal Of Maternal-Fetal & Neonatal Medicine
Volume11
Issue number5
DOIs
Publication statusPublished - May 2002

Fingerprint

Emulsions
Osmolar Concentration
Pharmaceutical Preparations
Patents
Newborn Infant
Isotonic Solutions
Propylene Glycol
Digoxin
Phenytoin
Critical Care
Phenobarbital
Diazepam
Diuretics
Intravenous Administration
Anticonvulsants
Freezing
Electrolytes
Glucose

Keywords

  • Emulsions
  • Humans
  • Infant, Newborn
  • Infusions, Intravenous
  • Osmolar Concentration
  • Pharmaceutical Preparations
  • Solutions
  • Journal Article

Cite this

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title = "Osmolality of solutions, emulsions and drugs that may have a high osmolality: aspects of their use in neonatal care",
abstract = "OBJECTIVE: Administration of some hypertonic substances to neonates has been associated with a variety of adverse effects. This study was conducted to determine the osmolality of intravenous drugs and solutions used in neonates receiving intensive care.METHODS: Osmolality was measured by freezing point depression. Vasoactive drugs, diuretics, anticonvulsants, antimicrobials, and glucose and electrolyte solutions were some of the substances analyzed.RESULTS: The osmolalities of 90 substances were measured; the respective intra-assay and interassay coefficients of variation were always less than 5{\%}. A few drugs were found to be extremely hypertonic (> 8000 mOsm/kg), and most of them contain propylene glycol as vehicle (e.g. digoxin, phenytoin, diazepam and phenobarbital). Other drugs, at the same concentration, evidenced a significant discrepancy of osmolality depending on the trademark.CONCLUSIONS: The finding of some extremely hypertonic drugs highlights the need for further investigation in order to study their potential adverse effects in neonates, as well as to evaluate any advantage in diluting, infusing slowly or even avoiding such substances. Given the fact that there exists a discrepancy in osmolalities in some drugs at the same concentration depending on the trademark, the more isotonic solutions should be the preferred choice for intravenous administration.",
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Osmolality of solutions, emulsions and drugs that may have a high osmolality : aspects of their use in neonatal care. / Pereira-da-Silva, L; Henriques, G; Videira-Amaral, J M; Rodrigues, R; Ribeiro, L; Virella, Daniel.

In: Journal Of Maternal-Fetal & Neonatal Medicine, Vol. 11, No. 5, 05.2002, p. 333-8.

Research output: Contribution to journalArticle

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T1 - Osmolality of solutions, emulsions and drugs that may have a high osmolality

T2 - aspects of their use in neonatal care

AU - Pereira-da-Silva, L

AU - Henriques, G

AU - Videira-Amaral, J M

AU - Rodrigues, R

AU - Ribeiro, L

AU - Virella, Daniel

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N2 - OBJECTIVE: Administration of some hypertonic substances to neonates has been associated with a variety of adverse effects. This study was conducted to determine the osmolality of intravenous drugs and solutions used in neonates receiving intensive care.METHODS: Osmolality was measured by freezing point depression. Vasoactive drugs, diuretics, anticonvulsants, antimicrobials, and glucose and electrolyte solutions were some of the substances analyzed.RESULTS: The osmolalities of 90 substances were measured; the respective intra-assay and interassay coefficients of variation were always less than 5%. A few drugs were found to be extremely hypertonic (> 8000 mOsm/kg), and most of them contain propylene glycol as vehicle (e.g. digoxin, phenytoin, diazepam and phenobarbital). Other drugs, at the same concentration, evidenced a significant discrepancy of osmolality depending on the trademark.CONCLUSIONS: The finding of some extremely hypertonic drugs highlights the need for further investigation in order to study their potential adverse effects in neonates, as well as to evaluate any advantage in diluting, infusing slowly or even avoiding such substances. Given the fact that there exists a discrepancy in osmolalities in some drugs at the same concentration depending on the trademark, the more isotonic solutions should be the preferred choice for intravenous administration.

AB - OBJECTIVE: Administration of some hypertonic substances to neonates has been associated with a variety of adverse effects. This study was conducted to determine the osmolality of intravenous drugs and solutions used in neonates receiving intensive care.METHODS: Osmolality was measured by freezing point depression. Vasoactive drugs, diuretics, anticonvulsants, antimicrobials, and glucose and electrolyte solutions were some of the substances analyzed.RESULTS: The osmolalities of 90 substances were measured; the respective intra-assay and interassay coefficients of variation were always less than 5%. A few drugs were found to be extremely hypertonic (> 8000 mOsm/kg), and most of them contain propylene glycol as vehicle (e.g. digoxin, phenytoin, diazepam and phenobarbital). Other drugs, at the same concentration, evidenced a significant discrepancy of osmolality depending on the trademark.CONCLUSIONS: The finding of some extremely hypertonic drugs highlights the need for further investigation in order to study their potential adverse effects in neonates, as well as to evaluate any advantage in diluting, infusing slowly or even avoiding such substances. Given the fact that there exists a discrepancy in osmolalities in some drugs at the same concentration depending on the trademark, the more isotonic solutions should be the preferred choice for intravenous administration.

KW - Emulsions

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