Interactions of drugs in injectable solutions (in a single infusion system or a syringe)

In medical practice it is very often necessary in the simultaneous use of a plurality of injection solutions. Thus the most optimal and appropriate their administration is in a single infusion system or a syringe. However, the person must always remember, drugs that can have different physico-chemical properties, eliminating the possibility of simultaneous administration of solutions referring unforeseen or undesirable interactions.

Due to the interaction of drugs with mixing of solutions can occur physicochemical reaction (redox, hydrolysis, complexation or salting), leading to a change in appearance (color, precipitation, etc.. d.), or reactions with no visible external changes. Such interactions can not only lead to a change in the expected therapeutic effect, disruption of the dosage of drugs, but also the most unpredictable consequences, which makes it impossible to parenteral administration.

From a practical point of view, two aspects are noteworthy combination therapy when administered in the form of injection solutions:

• drug interactions when administered several solutions in an infusion system or a syringe;
• interaction, arising between the drug and a solvent.

Do not mix in the same syringe infusion system or with other drugs: adrenomimetiki, ampicillin sodium salt, amphotericin B, ascorbic acid, B vitamins, phytomenadione, dipiridamol (kurantil), oksiferriskorbon sodium, phenothiazines (Chlorpromazine and others.), furosemid, etamzilat, eufillin (aminofillin). These substances have a pronounced reactivity. Their interaction with other substances leads to inactivation or precipitation formation. Worthy of attention are also information about the interaction of drugs in infusion solutions.

In the treatment of asthma, purulent bronchitis need arises in a number of combined antibiotics (gentamicin sulfate, benzilpenicillin, Streptomycin sulfate, tetracyclines) with aminophylline, having alkaline properties. With this combination of inactivation of antibiotics. Penicillins and cephalosporins decompose when combined in one syringe of acetylcysteine (ACC, FLUIMUCIL) and other mucolytics.

If you fall in blood pressure in septic shock simultaneously administered agonists and antibiotics. In combination with penicillin adrenaline hydrochloride (epinephrine), fenilafrinom or ephedrine hydrochloride in the same syringe possible inactivation of the antibiotic and its solubility violation.

In allergic complications, asthma, infectious-toxic shock and other pathological states combined with corticosteroids Antibiotics. When administered in the same syringe penitsildinov, cephalosporins, chloramphenicol with gidrokortizona gemisuktsinatom for infringements rastvorimosti vozmozhno education osadka.

You can not enter into the same syringe benailpenitsilliny gentamicin sulfate and heparin, having alkaline properties. With their combination of a precipitate.

For the treatment of systemic fungal infections using a freshly prepared solution of amphotericin B. High lability and reactivity of antibiotic cause a number of special precautions and the use of its solutions (prepared by Method, specified in the summary). Antibiotics should not be mixed in a single system with benzylpenicillin, dimedrolom (difengidraminom) and other substances.

Antibiotics are very sensitive to external factors (light, temperature, pH of the medium and others.), can form immiscible blends with other drugs, as well as in combination with each other. When the need for combination therapy antibiotics should be administered in different ways and to avoid lengthy (more than 2-3 hours) infusions. The following table provides information about the incompatible combinations of antibiotics in the same solution for injection.

Particularly noteworthy combined use of vitamins, which is widely used in treating many diseases. Thus it is necessary to consider some features of interactions of this class of compounds: vitamins in the native state do not interact, and the joint administration of the "clean" materials exhibit different kinds of interactions. So, ascorbic acid is not recommended to be combined in the same syringe with sodium barbitalom, geksametilentetraminom, geparinom, Caffeine-sodium benzoate, kordiaminom (nikethamide), aminophylline and other substances schelochnoreagiruyuschimi. Ascorbic acid promotes the decomposition of low stability of antibiotics with β-lactam group and pyridoxine.

Thiamine bromide (chloride) It destroyed when introduced into a solution for injection pyridoxine, causes an acidic environment. The combination of these vitamins is an example of classical pharmacological incompatibility, as pyridoxine body brakes transition thiamine biologically active (phosphorylated) form. For this reason it is not recommended to introduce these two vitamins, not only in the same syringe at the same time, but even in one day. Rationally their turn to enter on different days and hours of the day. Considering, vitamins easily interact with each other and with other drugs, they are not recommended to be added to infusion solutions.

The interaction of vitamin preparations, while injected,