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PS-018 Under-dosing of oncology patients due to the overfilling with diluent of cytostatic drug solutions
  1. B Nucete Gallego1,
  2. C García Piernavieja2,
  3. E González Carrillo1,
  4. L Santos Morín1,
  5. A Díez del Pino1
  1. 1Complejo Hospitalario Universitario Insular-Materno Infantil, Pharmacy, Las Palmas de Gran Canaria, Spain
  2. 2Complejo Hospitalario Universitario Insular-Materno Infantil, Oncology, Las Palmas de Gran Canaria, Spain

Abstract

Background The solution for infusion bags prepared by the pharmacy contains an unknown and variable volume of solution in order to keep a minimum volume.

Purpose To determine the potential under-dosing of oncology patients related to the loss of cytostatic drugs in the remaining volume of the solution for infusion bags.

Material and methods Prospective observational study. We randomly assessed 50 cytostatics mixtures prepared by the Pharmacy Service.

Studied variables: total dose of cytostatic drug prescribed, total volume of the mixture and the volume remaining after the intravenous administration. The remaining volume was indicated by the infusion pump. The total volume was obtained from the cytostatics compounding program (Farmatools).

As we found from the literature, it is acceptable that up to 5% of the total dose prescribed by the oncologist may be lost in the process of IV administration.

Results Overfilling was detected in all 50 solutions (100%). In 10 cases (20%), the volume of the solution remaining after administration contained a cytostatic dose less than 5% of the total dose. In 40 cases (80%) the remaining dose was higher than 5%. In 16 of these 40 cases (40%), the non-infused dose was higher than 10% of the total dose (32% of the total of mixtures) and in 6 cases (15% of these 40 cases) was higher than 20% of the dose prescribed (10% of all the preparations).

Conclusion The solutions for infusion bags contain more fluid than that specified on the commercial label. If this is not corrected for, the total volume of the mixture will be greater than that shown on the label issued by the Pharmacy Service. The measure adopted is to program an additional volume in the infusion pump, while maintaining the speed shown on the label, so that the entire mixture is administered to the patient.

References and/or acknowledgements L. Santos

No conflict of interest.

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