Analysis of extemporaneous oral liquid from commercially available drugs in hospital

ABSTRACT The objective of this study was to identify drugs that received dose adjustments (DA) and pharmaceutical alternatives (PA) that avoid DA, and calculate the economic percentage of this replacement. A descriptive, observational and cross-sectional study was performed in a second level hospital. The pharmacy and nursing services was accompanied to identify the drugs that received DA and the compounding techniques. After identifying all the drugs that received DA, was identified in the Brazilian market the corresponding pharmaceutical alternative, with the Drugs Price List of Brazilian Health Regulatory Agency. For those drugs that was not available any PA, was performed a research of studies that describe compounding techniques in international scientific databases. Was identify 88 drugs that received DA, and these, 50 do not have any PA. Were identified compounding techniques to 40 drugs. Although any drug has your own particularity of compounding, the compounding techniques can be grouped in five categories. The standardization of 29 drugs can reduce in 28% the DA procedure and cost saving of 34,85%/month. We can conclude that every three drugs prescribed, one received DA and every three DA, one can be avoided by the selection of 29 PA, saving cost as well. The use and standardization of five techniques would attend the pharmaceutics recommendations for better dissolution, bioavailability and patient safety

Variation in microbial survival and growth in intravenous fluids

The survival and growth of aerobic and anaerobic bacteria, as well as a yeast, was studied in intravenous fluids over a 3-day period. Solutions were experimentally contaminated with pathogenic strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacteroides fragilis and Candida albicans. Samples of these solutions were tested on each day up to 3 days for determining viable numbers of the organisms by a membrane filtration method. Each organism showed a different survival/growth pattern in various infusion fluids. In 5% dextrose, C. albicans multiplied but only 2-3% of the initial viable cells of E. coli, P. aeruginosa, and S. aureus were detected after 3 days. In 0.9% sodium chloride, C. albicans and S. aureus showed growth and E. coli remained viable, but P. aeruginosa was not detected after 72 h. In lactated Ringer's solution, P. aeruginosa and C. albicans grew but E. coli and S. aureus were not detected after 72 h. In the amino acid solution, C. albicans, S. aureus and E. coli grew but P. aeruginosa and B. fragilis were not detected. Results indicate that the pattern of microbial survival and growth may be substantially different in various intravenous fluids