Stability of parenteral drugs in hospital circuit

Abstract

Introduction- Drug stability in healthcare establishments is a recurring problem in practice
of hospital pharmacists. Apart from the expired drugs, instabilities are often confirmed by
changes in appearance or color observed during drug’s period of validity. The objective of
this work was to evaluate the stability and hospital practices likely to induce instabilities of
valid parenteral drugs.
Materials and methods- Firstly, a cross-sectional descriptive study was carried out over
three months in three hospital in western of Algeria. Bad conditions of storage, preparation
and administration as well as instabilities have been identified on parenteral drugs with
long expiry dates. Secondary, photostability test was carried out under normal conditions of
administration after exposure to daylight of both ascorbic acid solution in slow infusion and
amoxicillin solution for injection after reconstitution.
Results- About 546 parenteral drugs examined, 131 non compliances were identified, including
43% related to poor storage at the pharmacy, 33% related to administration and 24%
related to preparation or reconstitution. Among the non-conformities related to storage and
those related to administration, exposure to light for photosensitive drugs was predominant
at 54% and 53.8% respectively.In addition, photostability study showed reduction of 10% of
ascorbic acid content from the 30th minute of infusion and a yellowing of amoxicillin solution
after one hour of daylight exposition.
Conclusion- These studies showed the importance of having a quality assurance system within
the hospital, which will ensure the application of good hospital pharmacy practices and
thus guarantee the drug’s stability and efficacy, particularly for liquid parenteral forms.