CHEMICAL INCOMPATIBILITIES OF I.V ADMIXTURE COMBINATIONS IN ICU, ORTHOPEDIC AND EMERGENCY UNITS OF VARIOUS HOSPITALS AND MEDICAL CENTERS IN SANA’A, YEMEN

Mokhtar Abd Hafiz Al-Ghorafi*, Mahmoud Mahyoob Alburyhi, Fares M.S Muthanna

ABSTRACT

Background: Intravenous incompatibilities are unwanted reactions that occur when two or more drugs are administered through the same intravenous line or in the same solution. They can cause toxicity in the patient or a lack of therapeutic effect. Aims: The aim of this study was to investigate the chemical incompatibilities of IV admixture combinations in Sana'a's public and private hospitals. Methods: A cross-sectional, prospective, and quantitative study was conducted from December 2020 to July 2021. Data was collected from medical files of patients admitted to ICU, orthopedic and emergency department of public and private hospitals in Sana’a City, Yemen. Chemical drug incompatibilities were identified based on the analysis of the patient prescriptions using a PH measurement meter. Results: A total of 900 prescriptions were screened, and 100 drug combinations met the criteria for inclusion. The average number of prescribed drugs was 7 ± 4 drugs per prescription. Of these, 53% were prescribed with four or more IV drug mixtures that were analyzed at zero, one, two, and three hours. The proportion of IV admixtures contained four drugs (38%), 5 drugs (29%), 6 drugs (17%), 7 drugs (12%), 8 drugs (2%), and 9 drugs (2%). Further, Vitamin C (9.8%), Vitamin B complex (B1,B2,B3,B5,B6,B12,Biotin and folic acid (9.1%)), and Pantoprazole sodium (7.16%) were the most commonly prescribed drugs. Approximately 97 % of prescriptions had at least one potential chemical incompatibility. The most chemical incompatibilities were found in 9 IV admixtures (D.N. S+ Vit.B complex +Vancomycin + Kcl + Rabeprazole +Vit.C +Tramadol +Ceftriaxone +Dexamethasone +Furosemide), followed by 7 IV admixtures (DNS +Vit B complex +Ondansetron HCL dihydrate +KCL +Hydrocortisone +Vit), and 6 IV admixtures (N/S +Heparin + ceftriaxone +N-acetyl cysteine + Citicoline +Furosemide +Pantoprazole). Conclusion: The findings of this study suggest that the majority of IV drug admixtures indicated chemical incompatibility. The findings of this study provide the basis for drug-infusion compatibility and aid in avoiding intravenous drug incompatibilities by demonstrating that drugs with similar pH will be compatible with IV combinations.

Keywords: intravenous drug incompatibilities, chemical incompatibilities, pH, drug-infusion compatibility.