Stabiliteit van meropenem in een draagbare medicatiecassette omgeven door koelelementen

Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground Meropenem is a parenteral β-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground: Meropenem is a parenteral P-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective: The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods: Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results: All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion: The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.</p

Stabiliteit van meropenem in een draagbare medicatiecassette omgeven door koelelementen

Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground Meropenem is a parenteral β-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground: Meropenem is a parenteral P-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective: The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods: Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results: All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion: The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.</p

Stabiliteit van meropenem in een draagbare medicatiecassette omgeven door koelelementen

Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground Meropenem is a parenteral β-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground: Meropenem is a parenteral P-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective: The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods: Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results: All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion: The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.</p

Stabiliteit van meropenem in een draagbare medicatiecassette omgeven door koelelementen

Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground Meropenem is a parenteral β-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground: Meropenem is a parenteral P-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective: The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods: Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results: All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion: The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.</p

Het effect van geïnhaleerde glycopyrroniumbromide op ernstige speekselvloed en kwijlen bij patienten met de ziekte van Parkinson

OBJECTIVE: To investigate the safety and tolerability of glycopyrronium inhalation powder using different dosing regimens and to determine the decrease of drooling in patients with Parkinson's disease. DESIGN: We conducted a 5-week safety study. METHODS: Following a baseline week, each participant used glycopyrronium inhalations during four weeks, with weekly changing dosing regimes. The safety and tolerability was determined by monitoring side effects and the experience of participants. The decrease in drooling was determined by comparing the mean sialorrhea scores obtained every week. An interim analysis was performed after including seven participants. RESULTS: Side effects occurred in 71.4% of participants, which led to discontinuation of the study in three out of seven participants. The most common side effects were coughing and headache. Side effects that caused discontinuation were a swollen tongue, dry mouth, and gastro-enteritis. No unknown side effects of glycopyrronium led to discontinuation. Four participants experienced improvement in sialorrhea and three participants continued inhalation treatment after completion of the study. Two participants mentioned an instant effect after inhalation of glycopyrronium. CONCLUSION: Despite the reported side effects and the fact that we performed an interim analysis, we believe that glycopyrronium inhalations could be considered after failing of oral therapy

The association between concomitant use of serotonergic antidepressants and lithium-induced polyuria. A multicenter medical chart review study

Background: A previous Study aimed at revealing the prevalence and determinants Of lithium induced polyuria Suggested an increased risk of polyuria (urine volume >= 3L/24h) in those using serotonergic antidepressants next to lithium. Objective: The objective of our study was to re-evaluate this secondary finding in another study population. Methods: We performed a multicenter medical chart review study in patients using lithium in whom a 24-hour urine volume had been determined. Results: We included 116 patients, twelve (26 %) of the 46 patients with polyuria used serotonergic antidepressants compared to ten (14%) of the 70 patients without polyuria. We found an increased risk of polyuria in lithium users concurrently using serotonergic antidepressants (odds ratio 2.86; 95 % confidence interval 1.00-8.21), adjusted for age, gender, use of antiepileptics and thyreomimetics. Conclusion: Our results Confirm the previous secondary finding of an increased risk of polyuria in patients using serotonergic antidepressants next to lithium. Physicians should take this into account when evaluating polytiria in patients using lithium and when choosing an antidepressant in patients using lithium

Stabiliteit van meropenem in een draagbare medicatiecassette omgeven door koelelementen

Stability of meropenem infusions in a portable medication cassette stored in a bag enclosed by cooling elementsBackground: Meropenem is a parenteral P-lactamase resistant broad spectrum carbapenem antibiotic. After dissolution, it is relatively unstable. Therefore, in the outpatient setting, it cannot be stored nor given as prolonged (continuous) infusion at room temperature.Objective: The aim of this study was to investigate the chemical stability of meropenem solutions in a medication cassette packed in a bag enclosed by cooling elements (changed every 12 hours), stored at room temperature for 24 hours.Design and methods: Meropenem was reconstituted and diluted with cold 0.9% sodium chloride (4.3 °C) to obtain solutions with concentrations of 12 mg/mL (n = 3) and 24 mg/mL (n = 3) in portable 250 mL CADD medication cassettes. Cassettes were individually enclosed by two frozen cooling elements and stored at room temperature for 24 hours. Cooling elements were changed every 12 hours. Samples were taken at t = 0 followed by a sample every 3 hours during 24 hours. Samples were analysed using a validated stability indicating high performance liquid chromatography with diode array detection method. Solutions retaining &gt; 90% of the initial concentration were considered stable.Results: All tested samples showed a meropenem concentration &gt; 90% of the initial concentration. No degradation products were found.Conclusion: The results demonstrate that meropenem continuous infusion can be used in outpatient setting when above-mentioned conditions are met.</p

Dopaminergic drugs and the risk of hip or femur fracture: a population-based case-control study.

SUMMARY: The effect of dopaminergic medication on the risk of hip/femur fractures is not clear. Our results showed a nearly twofold increased risk of hip/femur fractures in current dopaminergic drug users. Concomitant use of antidepressants further increased this risk. Fracture risk assessment may be warranted in elderly users of dopaminergic drugs. INTRODUCTION: Dopaminergic drugs, often used in the treatment of Parkinson's disease, have several pharmacological effects that may increase or decrease the risk of falling and fractures. Thus, the effect of dopaminergic medication on the risk of hip/femur fractures is not clear. The objective of the study was to examine the effect of dopaminergic medication and concomitant use of psychotropics on the risk of hip/femur fractures taking into account the timing of dopaminergic drug use. METHODS: A population-based case-control study in the PHARMO database was conducted for the period 1991 to 2002. Cases were patients aged 18 years and older with a first hip or femur fracture and matched to four control patients by year of birth, sex and geographical region. RESULTS: The study population included 6,763 cases and 26,341 controls. Current use of dopaminergic drugs (1-30 days before the index date) was associated with an increased risk of hip/femur fractures compared to never use (OR(adj) 1.76, 95% CI = 1.39-2.22), but this excess risk rapidly dropped to baseline levels when treatment had been discontinued &gt;1 year ago. Concomitant use of antidepressants among current dopaminergic drug users further increased the risk of hip/femur fractures (OR(adj) 3.51, 95% CI = 2.10-5.87) while there was no additional risk with concomitant use of other psychotropics. CONCLUSIONS: Although the observed association between dopaminergic drugs and fracture risk may not be entirely causal, due to absence of information on the (severity of the) underlying disease, fracture risk assessment may be warranted in elderly users of dopaminergic drugs