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PP-021 Ready-to-use medicines safety?! national evaluation of standardised drug solutions in the intensive care medicine
  1. M Manske1,
  2. A Eisert2,
  3. M Baehr1,
  4. S Kluge3,
  5. H Hilgarth4,
  6. C Langebrake1
  1. 1University Medical Center Hamburg-Eppendorf, Pharmacy, Hamburg, Germany
  2. 2University Hospital Rwth Aachen, Pharmacy, Aachen, Germany
  3. 3University Medical Center Hamburg-Eppendorf, Department of Intensive Care Medicine, Hamburg, Germany
  4. 4University Medical Center Hamburg-Eppendorf, Pharmacy – Department of Intensive Care Medicine, Hamburg, Germany

Abstract

Background Ready-to-use drug-solutions for syringe pumps produced by industry or hospital pharmacies have advantages over solutions prepared manually on the ward in terms of accuracy of drug concentration and microbiological aspects. A key prerequisite for large-scale productions is to standardise concentrations, as treatment varies at the local level.

Purpose To assess the different concentrations that are being used in intensive care units nationally and the variety of ready-to-use solutions that are being manufactured by hospital pharmacists.

Material and methods Two surveys were conducted among the hospital pharmacies and intensive care units (ICU) in the national university hospitals. The answers were evaluated descriptively.

Results Overall 100 different drugs were used in 262 different locally-standardised concentrations in the responding 17 hospitals. Of those, only 21 drugs were mentioned by at least two thirds of the ICUs: e.g. catecholamines, hypnotics, insulin, heparin, hydrocortisone and amiodarone.

Among the 24 different drugs prepared by the responding 19 hospital pharmacies, the main ones reported were expensive drugs and/or preparations that are extremely prone to error (argatroban, caspofungin). There was only a little overlap (n = 6) between the standardised drugs used in the ICU and the hospital pharmacy-based manufacturing of ready-to-use preparations. Out of these only potassium chloride and heparin were being manufactured by at least five pharmacies.

Conclusion The observed gap might be due to limited manufacturing capacities of the pharmacies and/or limited stability data of the ready-to-use preparations (concentration, diluent and primary container). Standardising the drug concentrations on a national, or even European level might enable hospital pharmacies to cooperate in overcoming the lack of stability data. The capacity deficit at the hospital pharmacies could be lessened by shifting high-turnover-drugs towards pharmaceutical companies. For nationwide recommendations of standardised concentrations of drugs used in intensive care an extensive survey among ICUs is being planned.

References and/or acknowledgements No conflict of interest.

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