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Chemical Stability of Admixtures Combining Ziconotide with Fentanyl or Sufentanil During Simulated Intrathecal Administration

Author(s):  Shields David E, Aclan Jennifer, Szatkowski Aaron

Issue:  Sep/Oct 2008 - Veterinary Compounding
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Abstract:  Although the U.S. Food and Drug Administration has not approved the combined use of intrathecal medications, practitioners frequently prescribe combination intrathecal therapy for patients who do not experience adequate analgesia with a single intrathecal agent; however, the chemical stability of an analgesic combination may influence the frequency of pump refills necessary to maintain safe and effective pain control. This investigation was performed to evaluate the chemical stability of admixtures containing 25 mcg/mL ziconotide and either 1000 mcg/mL fentanyl citrate or 1000 mcg/mL sufentanil citrate during simulated intrathecal infusion under laboratory conditions at 37°C. Admixtures were prepared from commercial ziconotide (25 mcg/mL) and lyophilized powders of the opioid drugs, sparged with nitrogen to remove dissolved oxygen, and stored in implantable intrathecal pumps at 37°C. Samples obtained at various intervals over the course of 40 days were assessed for drug concentrations by using high-performanc

Related Keywords: David E. Shields, PhD, Jennifer Aclan, BSc, Aaron Szatkowski, BSc, ziconotide, fentanyl, sufentanil, nonopioid analgesics, opioid analgesics, pain relief, analgesia, intrathecal administration, intraspinal administration, spinal administration, drug admixtures, combination therapy, stability, compatibility


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