Stability and Compatibility Aspects of Drugs: The Case of Selected Cephalosporins

Intravenous drug incompatibilities are a common cause of medical errors, contributing to ineffective therapy and even life-threatening events. The co-administration of drugs must always be supported by studies confirming compatibility and thus guarantee the therapy’s safety. Particular attention should be paid to the possible incompatibilities or degradation of intravenous cephalosporins in different infusion regimens since the administration of drugs with inadequate quality may cause treatment failure. Therefore, an appropriate stability test should be performed. The study aimed to present various aspects of the stability and compatibility of five cephalosporins: cefepime (CFE), cefuroxime (CFU), ceftriaxone (CFX), ceftazidime (CFZ), and cefazoline (CFL). The degradation studies in parenteral infusion fluids and PN admixtures were conducted for CFE and CFU. The interactions between CFX or CFZ and PN admixtures, as well as the compatibility of CFL with five commercial parenteral nutrition (PN) admixtures, were investigated. The content of CFX and CFZ in PN admixture after 24 h was >90%. CFL administered simultaneously with PN admixture by the same infusion set using Y-site was compatible only with Nutriflex Lipid Special. CFE and CFU were stable in all tested infusion fluids for a minimum of 48 h and decomposed in PN admixtures during storage.

Monitoring Cairan Infus Secara Realtime

At present, many are found in a hospital, the number of inpatients is not balanced with the number of medical staff, especially in the nursing service on duty 24 hours to monitor the patient's condition one by one. As a result of these limitations, the possibility of negligence of the guard officer is very possible, especially in monitoring the condition of infusion fluids in patients. In the task of monitoring the condition of the patient's intravenous fluids, nurses usually have to go back and forth and check the condition of the infusion manually at any time that has been previously estimated. On the basis of this reality, in this final assignment a monitoring system for intravenous fluids was made in real time and centrally that can control the infusion fluid volume of patients based on ATMEGA32 microcontroller with proportional-derivative control method and can provide information about the condition of the patient's actual infusion fluid to medical personnel or guard officers centrally using cables that reconnected and function as a means of communication between the microcontroller and the computer. This tool uses a light sensor to detect the height of the infusion fluid and convert it to liquid volume at ATMEGA 32. If the liquid reaches the minimum volume, then the information from the sensor running or detecting infusion fluid will be processed through a microcontroller and sent to a computer that functions as a monitor or LCD.

Control of body temperature and immune function in patients undergoing open surgery for gastric cancer

The influence of mild perioperative hypothermia on the immune function and incidence of postoperative wound infections has been suggested, but the specific mechanism is unclear. This study aimed to analyze the body temperature, immune function, and wound infection rates in patients receiving open surgery for gastric cancer. Body temperature was controlled in each patient using one of four different methods: wrapping limbs, head and neck; insulated blankets; warming infusion fluids and insulated blankets; and warming fluids without insulated blankets. One hundred patients were randomly divided into four groups of 25 patients each, and every group received a different intraoperative treatment for maintaining normal body temperature. Nasopharyngeal and rectal temperatures, transforming growth factor beta (TGF-β), interleukin 10 (IL-10) levels, and cluster of differentiation (CD)3+T and CD4+/CD25+ regulatory T cell (Treg) counts were measured before surgery and at 2 and 4 hours postoperatively. Patients were evaluated at one week after surgery for signs of infection. Intraoperative body temperature and measures of immune function varied significantly between the four groups, with the largest temperature changes observed in the group in which only the limbs were wrapped in cotton pads to control the body temperature. The lowest temperature change (i.e., close to normal temperature) and cytokine response after surgery were observed in the group in which infusion fluids and transfused blood (if needed) were heated to 37℃, peritoneal irrigation fluid was heated to 37℃, and an insulation blanket was heated to 39℃ and placed under the patient. No intergroup differences were found in the infection rates at one week after surgery. In conclusion, body temperature variation during surgery affects the immune function of patients, and maintaining body temperature close to normal results in the least variation of immune function.

Use of ozone in medicine and veterinary practice

Ozone is a triatomic allotrope of oxygen that can be produced in specially designed machines: ozone generators (ozonators). It breaks down to dioxygen (O2) and active atomic oxygen (O), which is a very strong oxidant. Due to the fact that its bactericidal, virucidal and fungicidal activities are 50 times more powerful than those of chlorine, ozone could be used in a wide range of applications, including disinfection, disinfestation and deodorization. Biochemical properties of ozone make it useful in both human and animal medicine. Ozone therapy has been applied in the treatment of cardiovascular and gastrointestinal tract diseases, many viral, bacterial and fungal infections, corneal diseases, skin disorders, as well as in inflammatory and degenerative joint diseases. Various forms of ozone are utilized for medical purposes, for example, ozone/oxygene mixture, dressing covered with ozonated water or oil, ozonated infusion fluids and ozonated autohemotherapy (AHT). Medical ozone appeared to be successful in the treatment of antibiotic-resistant infections, infected and nonhealing wounds. When properly conducted, ozone therapy is safe and non-toxic, and should therefore be widely used in veterinary and human medicine practice..

Rancang Bangun Sistem Pemantauan Infus dan Tekanan Darah pada Pasien Rawat Inap secara Real Time

The problems that often arise in inpatients, especially those that need special handling such as infusion fluids should be given is often the occurrence of negligence in the infusion bottle examination is good condition of fluids in infusion bottles and the number of droplets per minute that is not appropriate. In addition, the patient will also be disrupted when the nurse should take care of the patient's blood pressure periodically. To overcome these problems need to be made a system that can monitor all of it in real time.This system design process requires a hardware and software that is integrated in such a way that it can be used to monitor the infusion and blood pressure of the patient. The main hardware required is the infrared sensor and the pressure sensor where the sensor will be controlled by the microcontroller device which the results can be sent to the monitoring computer wirelessly. From the overall testing of the design that has been made, it can generally be applied but there are still shortcomings that occur in measuring instruments, especially blood pressure gauges where the average error occurred in the measurement of systolic pressure of 8.42% and the average error that Occurs in diastolic measurements of 4.90% and on data delivery there is a significant delay spike when given a barrier.

Intravenous fluids in anaesthetic practice

Infusion fluids may be regarded as drugs in the perioperative setting. The therapeutic effects of crystalloid solutions are strongly related to the administered volume, while fluids of the colloid type may also improve microcirculation and have anti-inflammatory properties. The anaesthetist should be able to handle all available infusion fluids and be aware of their benefits, limitations, and risks. Fluid administration programmes for surgery are traditionally based on a balance method in which perceived and measured losses are continuously replaced. Two outcome-guided approaches—restrictive and goal-directed fluid therapy—have been added in recent years. The latter places all patients on the top of the Frank–Starling curve by titrating repeated bolus infusions of colloid fluid while observing the stroke volume response. Areas where special consideration should be given to fluid therapy include burn injury, children, day surgery, endoscopic surgery, neurosurgery, induction of spinal and epidural anaesthesia, and in septic and trauma-related shock. As volume is the key component of infusion fluids, kinetic analysis of their disposition is based on their dilution effect on components already present in the blood, usually haemoglobin.