Bot Detector
IJPC Seal
Download FREE Sample Issue or Article
LEARN MORE
Subscribe Today
A subscription to IJPC includes a print copy delivered by postal mail and on-line access to electronic PDF copies of your subscribed issues.

Use of Cysteine Hydrochloride Injection to Increase the Solubility of Calcium and Phosphates in FreAmine III-Containing Parenteral Nutrition Solutions

Author(s):  Trissel Lawrence A, Xu Quanyun A, Zhang Yanping, Walter William V

Issue:  Jan/Feb 2003 - Terrorism
View All Articles in Issue

Page(s):  71-77

Download in electronic PDF format for $65

Abstract:  Numerous factors (including solution pH) that influence the amount of calcium and phosphates remaining in solution or precipitating from parenteral nutrition solutions have been identified. Increased solubility of calcium and phosphates can be achieved in parenteral nutrition formulations by using a suitable acidic additive to lower the pH from the natural unadjusted level. The purpose of this study was to evaluate the use of cysteine hydrochloride injection as an additive to FreAmine III-based parenteral nutrition solutions to increase the solubility of calcium and phosphates.

In this study, five representative core parenteral nutrition formulations containing FreAmine III 1% to 5% were evaluated. Those formulations contained cysteine hydrochloride injection 0.5 mL (25 mg) per gram of amino acids from FreAmine III to lower the pH. Varying amounts of calcium and phosphates were added to samples of the core formulations to identify the points at which precipitation just began to occur. Five series of concentrations with maxima of calcium 40 mEq/L and phosphates 40 mM/L were tested. The samples were evaluated by visual observation with the unaided eye and with a Tyndall beam to accentuate the visibility of small particles and low-level turbidity. The turbidity and particle content of samples not exhibiting visible particles or haze were measured electronically. Evaluations were performed initially and after 24 and 48 hours of storage at 23°C and 37°C. Samples were also stored for 30 days at 4°C, were warmed to room temperature, and were evaluated after warming and after additional storage of 24 and 48 hours at room temperature.

The addition of cysteine hydrochloride injection 5 mL/L for each 1% of amino acids content reduced the pH of the core parenteral nutrition admixtures from 6.4 to 5.9. The solubility of calcium and phosphates was increased by approximately 30% by that reduction in pH. The compatibility-incompatibility concentration ranges for each of the five core formulations, in which calcium ranged up to 40 mEq/L and phosphates ranged up to 40 mmol/L at temperatures of 23°C and 37°C are presented in tables and figures.

The addition of cysteine hydrochloride 0.5 mL (25 mg) per gram of amino acids from FreAmine III increased the solubility of calcium and phosphates about 30% by lowering the solution pH.

Related Keywords: Cysteine hydrochloride injection, and increasing solubility of calcium and phosphates in FreAmine III-containing parenteral nutrition solutions

Related Categories: PEER-REVIEWED

Printer-Friendly Version



Related Articles from IJPC
Title/Author
(Click for Abstract / Details / Purchase)
Issue/​Page
View/Buy
Use of Cysteine Hydrochloride Injection to Increase the Solubility of Calcium and Phosphates in FreAmine III-Containing Parenteral Nutrition Solutions
Trissel Lawrence A
, Xu Quanyun A, Zhang Yanping, Walter William V
Jan/Feb 2003
Pg. 71-77

Physical Compatibility of Calcium Acetate and Potassium Phosphates in Parenteral Nutrition Solutions Containing Aminosyn II
Zhang Yanping
, Xu Quanyun, Trissel Lawrence A, Baker Mary B
Sep/Oct 1999
Pg. 415-420

L-Cysteine Hydrochloride 50-mg/mL Injection
Allen Loyd V Jr
Mar/Apr 2015
Pg. 146

Dexamethasone Sodium Phosphate Ophthalmic Solution: Equivalent to 0.1% Dexamethasone Phosphate
Allen Loyd V Jr
Nov/Dec 2015
Pg. 508

Compatibility of Baclofen, Carvedilol, Hydrochlorothiazide, Mercaptopurine, Methadone Hydrochloride, Oseltamivir Phosphate, Phenobarbital, Propranolol Hydrochloride, Pyrazinamide, Sotalol Hydrochloride, Spironolactone, Tacrolimus Monohydrate, Ursodeoxycholic Acid, and Vancomycin Hydrochloride Oral Suspensions Compounded with SyrSpend SF pH4
Polonini Hudson
, da Silva Sharlene Loures, Brandão Marcos Antônio Fernandes, Bauters Tiene, De Moerloose Barbara, Ferreira Anderson de Oliveira
Nov/Dec 2018
Pg. 516-526

Total Parenteral Nutrition for Animals
Sammarco Domenic A
Sep/Oct 2002
Pg. 328-330

Adult Peripheral Parenteral Nutrition Solution with 4.23% Amino Acids
Allen Loyd V Jr
Sep/Oct 1998
Pg. 366

Adult Peripheral Parenteral Nutrition Solution with 2.5% Amino Acids
Allen Loyd V Jr
Sep/Oct 1998
Pg. 367

Pediatric Central Parenteral Nutrition Solution
Allen Loyd V Jr
Sep/Oct 1998
Pg. 368

Pediatric Central Parenteral Nutrition Solution with Heparin
Allen Loyd V Jr
Sep/Oct 1998
Pg. 369

Particle Measuring Systems - USP <797> Environmental Monitoring Solutions