Compatibility of Intravenous N-acetylcysteine and Ondansetron

Authors' Affiliations

Sophia Sergent, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN Ben Kennard, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN Michelle Tubolino, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN Stacy Brown, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN Jim Thigpen, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN

Location

Culp Center Ballroom

Start Date

4-25-2023 9:00 AM

End Date

4-25-2023 11:00 AM

Poster Number

110

Faculty Sponsor’s Department

Pharmaceutical Sciences

Name of Project's Faculty Sponsor

Stacy Brown

Classification of First Author

Pharmacy Student

Competition Type

Competitive

Type

Poster Presentation

Project's Category

Critical Care

Abstract or Artist's Statement

Due to the need for concurrent use of N-acetylcysteine (NAC) and ondansetron in the event of acetaminophen overdose, a Y-site intravenous (IV) apparatus for these drugs would be practical. It is known that nausea and vomiting are common side effects of both acetaminophen overdose and NAC administration. Current standard patient care using NAC involves interruption of IV NAC infusion to give an IV bolus dose of ondansetron, which creates an unnecessary opportunity for healthcare staff errors and patient complications. To evaluate the IV compatibility of NAC and ondansetron, medical grade tubing was connected via a closed-circuit IV pump with separate channels. Doses of NAC were circulated in individual channels based on weight-based dosing protocols (30-kg and 100-kg patient does). Ondansetron (4 mg) was introduced into the flow of NAC using the Y-site. Samples of the circulated solutions were gathered in triplicate at time points of 10, 20, and 30 minutes after combination of ondansetron and NAC. Concentrations of NAC were quantified using a validated high performance liquid chromatography (HPLC) method with ultraviolet (UV) detection. Once the collected samples underwent HPLC-UV analysis, data was produced that showed promise for compatibility between ondansetron and NAC with Y-site infusions. Comparison of NAC concentrations for the channels with and without ondansetron yielded no statistically significant difference between the treatments (p-value of 0.05). From this experiment, we concluded that introduction of ondansetron into the flow of NAC IV would not impact NAC concentration. As mentioned before, this study was conducted using only two doses in vitro, which may be a point for further exploration of a varied number of N-acetylcysteine doses.

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Apr 25th, 9:00 AM Apr 25th, 11:00 AM

Compatibility of Intravenous N-acetylcysteine and Ondansetron

Culp Center Ballroom

Due to the need for concurrent use of N-acetylcysteine (NAC) and ondansetron in the event of acetaminophen overdose, a Y-site intravenous (IV) apparatus for these drugs would be practical. It is known that nausea and vomiting are common side effects of both acetaminophen overdose and NAC administration. Current standard patient care using NAC involves interruption of IV NAC infusion to give an IV bolus dose of ondansetron, which creates an unnecessary opportunity for healthcare staff errors and patient complications. To evaluate the IV compatibility of NAC and ondansetron, medical grade tubing was connected via a closed-circuit IV pump with separate channels. Doses of NAC were circulated in individual channels based on weight-based dosing protocols (30-kg and 100-kg patient does). Ondansetron (4 mg) was introduced into the flow of NAC using the Y-site. Samples of the circulated solutions were gathered in triplicate at time points of 10, 20, and 30 minutes after combination of ondansetron and NAC. Concentrations of NAC were quantified using a validated high performance liquid chromatography (HPLC) method with ultraviolet (UV) detection. Once the collected samples underwent HPLC-UV analysis, data was produced that showed promise for compatibility between ondansetron and NAC with Y-site infusions. Comparison of NAC concentrations for the channels with and without ondansetron yielded no statistically significant difference between the treatments (p-value of 0.05). From this experiment, we concluded that introduction of ondansetron into the flow of NAC IV would not impact NAC concentration. As mentioned before, this study was conducted using only two doses in vitro, which may be a point for further exploration of a varied number of N-acetylcysteine doses.