摘要
目的分析两性霉素B合适的溶媒pH值、缓冲液、终溶液浓度、输注方法等。方法测量不同规格、批号的5%葡萄糖注射液pH,测量不同pH和体积的5%葡萄糖加入缓冲液剂量pH,测量不同浓度两性霉素B输注液以及加入不同体积缓冲液溶液pH,并观察外观等。结果有61.11%批次的5%葡萄糖pH不在两性霉素B配制要求范围内,加入5%碳酸氢钠注射液0.1 mL均可将不同体积及pH的5%葡萄糖调至5.0以上;浓度4 mg/100 mL~10 mg/100 mL的两性霉素B终溶液pH值为6.00~7.60,加入5%碳酸氢钠注射液0.03 mL~0.15 mL可将不同浓度250 mL 5%的葡萄糖pH调至6.00~7.50,无沉淀、结晶现象;不管葡萄糖溶液初始pH值,配制浓度0.1 mg/mL的AMB终溶液pH值7.10~7.70,未见混浊现象。结论配制前关注5%葡萄糖注射液pH值,若pH<4.20,建议加缓冲液,若临床两性霉素B需求较大,可考虑订购pH≥4.20的5%葡萄糖注射液;建议输注液终浓度0.04~0.1 mg/mL(不超过0.1 mg/mL),该浓度下可不用调整葡萄糖注射液初始pH值;根据总剂量平衡调整输液时间(推荐4~8 h),基线肾功能不全患者、器官移植、肿瘤化疗等肾功能不全风险较大患者可适当延长,但不建议超过24 h。
Objective To analyze the appropriate solvent pH value,final solution concentration of amphotericin B(AmB).Methods Measure the pH value of 5%glucose injection with different specifications,batches.And measure the pH of AmB infusion solution with different concentrations,observe the appearance.Results The pH values of 61.11%of glucose solutions with different specifications or batches were not within the preparation requirements of AmB.The pH value of 5%glucose of different volume and pH could be adjusted to more than 5.00 by adding 0.1 mL of 5%sodium bicarbonate.The pH value of amphotericin B final solution with the concentration of 4 mg/100 mL-10 mg/100 mL was between 6.00-7.60.The pH value of 250 mL 5%glucose with different concentrations could be adjusted to 6.00-7.50 by adding 0.03-0.15 mL 5%sodium bicarbonate,and no precipitation and crystallization were been seen.Regardless of the initial pH value of glucose solution,the pH value of AmB final solution with the concentration of 10 mg/100 mL was 7.10-7.70,and no turbidity was observed.Conclusion Pay attention to the pH value of 5%glucose injection before preparation,it was recommended to add buffer if the pH value was less than 4.20.It is recommended that the final concentration of AmB infusion is 4-10 mg/100 mL(≤10 mg/100 mL),in this way,there is no need to adjust the initial pH value of glucose injection.Infusion for 4-8 h was appropriate,but it could be appropriately prolonged for the patients with baseline renal insufficiency,organ transplantation,tumor chemotherapy and other patients with high risk of renal insufficiency.
作者
张俊丽
蔡诗琪
方莉
吕芳芳
俞云松
周志慧
ZHANG Junli;CAI Shiqi;FANG Li;LÜ Fangfang;YU Yunsong;ZHOU Zhihui(Department of Infectious Diseases,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province,Hangzhou 310016,China)
出处
《中国真菌学杂志》
CSCD
2023年第6期487-492,共6页
Chinese Journal of Mycology
