ŞULE ÖZBİLGİN, NİLAY BOZTAŞ, Mine TOSUN, Dllek ÖMÜR, SEMİH KÜÇÜKGÜÇLÜ, VOLKAN HANCI

EVALUATION OF IBUPROFEN'S PRECIPITATION CHARACTERISTICS

Amaç: Non--steroidal anti--inflamatuar ilaçlar (NSAİİ akut postoperatif ağrı yönetiminde multimodal analjezinin bir parçası olarak her zaman düşünülmelidir. İntravenöz ürünlerin uygulanması ile birlikte uyumluluk sorunlarına neden olabilir ve bu klinik olarak tehlikelidir. Bazı çalışmalarda yayımlanan raporlar ilaçların uyumsuzluk özellikleri hakkında bilgi verebilir ancak ibuprofen, yaygın olarak kullanılan bir non--steroid anti--inflamatuar ilaç olarak yeni olan formunda intavenöz uygulamaları için sınırlı veri bulunmaktadır. Bu çalışmada amaç, ibuprofen yaygın anestezi pratiğinde kullanılan diğer ilaçlarla birlikte kullanıldığında presipitasyon olup olmadığını araştırmaktır. Yöntem: Ibuprofen/serum fizyolojik (4 mg ml"), ibuprofen/ringer laktat (4 mg ml"), ibuprofen/dextroz (4 mg ml") ve ibuprofen (100 mg ml")formlarz ile presipitasyon Özelliklerinin belirlenebilmesi için sırasıyla, ilacın 0.1 ml'si ile aynı volümde (0.1 ml) test ilacı lam üzerinde üzerinde karıştırılarak presipitasyon oluşup oluşmadığı büyüteç yardımıyla gözlendi. Bulgular: Ibuprofen/serum fizyolojik (4 mg ml"); dobutamin, diltiazem, haloperidol, ketamin, vankomisin, verapamil ile, ibuprofen/ ringer laktat (4 mg ml"); dobutamin, diltiazem HCl, haloperidol, ketamin, rokuronyum, vankomisin ile, ibuprofen/dextroz (4 mg ml" )," dobutamin, diltiazem HC rokuronyum, verapamil ile ve ibuprofen (100 mg ml"); dobutamin, ditiazem HCl, gentamisin, haloperidol, kalsiyum, metoklopramid, midazolam, prilokain, protamin hidroklorid, rokuronyum, vankomisin ile ++++ presipitasyon reaksiyon verdiği tespit edildi. Sonuç: İbuprofenin çeşitli anestezi ilaçları ve antibiyotiklerle presipitasyon reaksiyonları gözlenmiştir. İbuprofenin salin ile dilüsyonunda, ringer laktat ve %5 dekstroz ile olan dilüsyon şekillerine göre daha az oranda presipitasyon reaksiyonu olduğunu gördük ve bu nedenle özellikle ardarda ilaç uygulamalarının yapıldığı durumlarda ibuprofen için salin ile dilüe etmenin daha az fiziksel uyumsuzluk ile daha az ilaç etkileşimleri olabileceği kanısındayız.

İBUPROFEN'İN PRESİPİTASYON KARAKTERİSTİKLERİNİN DEĞERLENDİRİLMESİ

Objective: Non--steroidal anti--inflammatory drugs should always be considered part of multimodal analgesia for acute postoperative pain management. Administration of intravenous products together can result in compatibility problems and this is clinically hazardous. Published reports from some studies can provide information about drugs' incompatibility characteristics but there is limited data for new drugs such as ibuprofen, commonly used non--steroidal anti--inflammatory drug. In this study, the aim was to investigate whether precipitation occurs when ibuprofen is used with other drugs commonly used in anesthesiology practice. Method: To determine the precipitation properties of ibuprofen/sf (4 mg ml"), ibuprofen/r1 (4 mg ml") ibuprofen/dextrose (4 mg ml") and ibuprofen (100 mg ml" )forms, 0.] ml of the drug was mixed on slide with the same volume of the test drug (0.] ml). Precipitation, or lack of, was observed with magnifier. Results: The presence ofprecipitation reaction (++++) was identified for the following drug combinations: ibuprofen/salin (4 mg ml") with dobutamine, diltiazem, haloperidol, ketamine, vancomycin, and verapamil; ibuprofen/ringer lactate (4 mg ml") with dobutamine, diltiazem HCl, haloperidol, ketamine, rocuronium, and vancomycin," ibuprofen/dextrose (4 mg m") with dobutamine, diltiazem HCl, rocuronium, and verapamil; and ibuprofen (100 mg ml") with dobutamine, diltiazem HCl, gentamicin, haloperidol, calcium, metoclopramide, midazolam, prilocaine, protamine hydrochloride, rocuronium, and vancomycin. Conclusion: Precipitation reactions were observed for ibuprofen mixed with variety of anesthetic medications and antibiotics. We observed lower rate ofprecipitation reactions with ibuprofen diluted with saline compared to dilution with ringer lactate and 5% dextrose. As result, we believe that in situations where drug administration occurs consecutively diluting ibuprofen with saline will cause less physical incompatibility and fewer drug interactions.

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