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KMID : 0869620200370010064
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Journal of Korean Society of Hospital Pharmacists
2020 Volume.37 No. 1 p.64 ~ p.73
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Development of a Two-Dimensional Compatibility Table for Intravenous Y-Site Drug Administration in a Neonatal Intensive Care Unit
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Lee Sun-Min
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Abstract
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Background : The majority of drugs used in the Neonatal Intensive Care Unit (NICU) are unlicensed and off-label, exposing infants to greater risk of medication error in the intravenous drug co-administration process.
Methods : A cross-sectional analytical study was conducted in the NICU of a university hospital in Korea. Data on prescribed orders May-July 2019 were collected. Medications including intramuscular injection instruction were excluded. Prescription orders were classified in percentages according to WHO-ATC (anatomical therapeutic chemical). When two drugs were administered at the Y site at the same time, the compatibility information was investigated using the Micromedex and then classified in percentages for each drug group. A two-dimensional table with the 43 intravenous drugs prescribed was rendered based on a review of the Micromedex database.
Results : The largest drug distribution in the Neonatal Intensive Care Unit (NICU) is anti-infective for systemic use (37.2%), and the drug group with the highest incompatibility comprising the nervous system drugs (28.1%). The prescription of Phenytoin, Ampicillin sodium, and Furosemide with high incompatibility were risk factors for potential incompatibility.
Conclusion : It is expected potential drug incompatibility is common in the NICU. Clinical pharmacists thus must practice special monitoring when drugs are co-administered. The two-dimensional table can be a valuable tool for intervention. More research is needed to understand the actual drug incompatibilities and their clinical outcomes.
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KEYWORD
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Neonatal intensive care unit (NICU), Incompatibility, Two-dimensional table
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