magnesium and potassium iv compatibility magnesium and potassium iv compatibility

Failure to check and replete magnesium levels. Physical compatibility of milrinone lactate injection with intravenous drugs commonly used in the pediatric intensive care unit. Webcompatibility prior to coadministration. If the etiology of hypokalemia remains elusive, the following approach may be helpful: This be calculated based on spot urine potassium and creatinine levels (using a calculator found. IV magnesium may be the fastest way to reduce the risk of arrhythmia (because magnesium can be given rapidly). Our mission is to Empower, Unite, and Advance every nurse, student, and educator. Webmagnesium and potassium solutions in the Intravenous reduces energy levels and raises the possibility of electrocardiographic fibrillation. Published data may report both compatibility and stability; however, most evaluate compatibility alone. Our members represent more than 60 professional nursing specialties. A chance of incompatibility exists whenever any medication is combined or added to an IV fluid. %%EOF The antidepressant is a form of azoteantidepressants. Has 6+ years experience. For deficiency that is not severe in older children, some manufacturers have recommended 1 g (2 mL of 50% solution) once or twice daily by IM injection. However, 93% guaranteed correct reproducibility. Potassium chloride is sold as a generic drug, but the following brand names are also available: Klor-Con M, K-Tab, Khlor Con, and Micro K. Keep in mind that these are more expensive than generic potassium chlorides because they are brand drugs. Were dedicated to providing you with the very best information about all kinds of subjects related to Fitness and nutrition, with an emphasis on improving your lifestyle and helping you become healthier.Founded in 2021 by Marie June, TheFitnessManual has come a long way from its beginnings. However, the personnel administering the drugs finds charts much more useful because they can quickly look at the information they need at a given time. Added to the risk of complications associated to the administration of 2 incompatible molecules, this lack of information can make the nurse have to look for new venous accesses to administer the drugs separately whichincreases the risk of infectious or thromboembolic complications. Ideally, you give mag first, although it's not critical to do so. A chance of incompatibility exists whenever any medication is combined or added to an IV fluid. It would be good to have greater uniformity in the quality standards of this type of studies. Administer IV dose over 2 to 3 hours for mild or moderate hypophosphatemia and over 6 to 8 hours for severe hypophosphatemia 18. Also, to assess the quality of the information published and generate a compatibility chart with reliable and updated information to improve safety in the administration of drugs to critically ill patients. Magnes chloride and potassium metal reactions are generally described as a single displacement reaction. J Cardiovasc Electrophysiol. #1) Familial form with onset <20 years old. Compatibilidad fsica del bicarbonato sdico con frmacos de uso frecuente en la unidad de cuidados intensivos. When handing off my patient the RN told me that the mag should go first because it is what the k will stick to. Am J Heal Syst Pharm, 58 (2001), pp. phosphates. Since 1997, allnurses is trusted by nurses around the globe. Commonly used rate for routine potassium repletion. Potassium citrate is equally effective as KCl for the repletion of potassium. 2012 Jan;23 (1):54-9. doi: 10.1111/j.1540-8167.2011.02146.x. WebThe compatibility and stability of 80 mmol/L potassium chloride and 16 mmol/L magnesium sulfate in 0.9% sodium chloride injection and in 5% dextrose injection solutions at 22 deg C have been studied by means of a Beckman Clinical Chemistry Analyzer Synchron CX5 Delta. Round IV supplementation to the nearest 7.5 or 15 mmol increment 1.6-2.3 mg/dL Phosphate-potassium packet (PHOS-NAK powder) 2 (two) packets every 4 hours while awake x 3 dosesB Phosphate-potassium packet (PHOS-NAK No visible haze or particulate formation, color change, or gas evolution. VT, VF, or asystole), Recurrent malignant arrhythmias with a pulse, Severe hypokalemia plus {DKA or overdose of beta-blocker/calcium channel blocker}, http://traffic.libsyn.com/ibccpodcast/IBCC_EP_67_-_Hypokalemia.mp3. Standardizing the concentration of infusion solutions is one of the most useful measures to prevent medication errors in the ICU setting, especially in high-risk drugs due to their potential to cause severe damage and because they have the highest incidence of medication errors. %]-tm@$`m~!Z$Z5vxU^9^W8`=DmU LSJzXAnPEkXV`*7dAv4Q4 2,B9M~_ ,0-]v =AYYXwf/WI F0Z[z%:}KbU8 (3) Profound shock plus severe hypokalemia (unclear whether potassium would be adequately absorbed from the gut). Select a second drug the same way (limited to 2 drugs) 3. 273 0 obj <> endobj Avoid or Use Alternate Drug. It's usually best to be conservative in the absence of any specific factors which increase the risk of arrhythmia (see risk stratification above). Summary of the quality criteria of the papers published. Am J Health Syst Pharm, 62 (2005), pp. Aggressive repletion of mild hypokalemia in patients with renal failure (. hbbd```b``" mT|"e?HiA09DJYY R fIF^-0[D_ e:L ; ^ The drugs used in the review are routinely used in the ICU setting are often administered by continuous infusion. It is important to recognize that compatibility is not just Amors Cerd, M.J. Arvalo Rubert, M. Maqueda Palau. The rest is in bones and cells. 1159-1160. Thus, if this allegedly compatible mix is performed in physiological serum, a loss of concentration of amiodarone can occur with the corresponding risk of lack of therapeutic response. Infusion of potassium at a rate of 40-60 mEq/hr is reasonable if the patient is extremely unstable (with the judgement that the inability to provide insulin is a life-threatening problem). Of these, 366 are compatible (77.1%), 80 are incompatible (16.8%), and 29 are compatible in specific conditions (6.1%) as shown in Table 2. Does Magnesium React With Potassium Chloride? We therefore expect that combinations of these cations would reduce blood pressure. Figure 2. Well, while I'm not sure I agree with the other RN's verbiage, she is correct that hypomagnesemia can make hypokalemia refractory to treatment, so hanging the mag first would be the correct action, as far as I know. QT prolongation). Stability of cyclosporine with magnesium sulfate in 5% dextrose injection. Webmagnesium and potassium solutions in the Intravenous reduces energy levels and raises the possibility of electrocardiographic fibrillation. WebCompatible: metronidazole, ranitidine, vancomycin Intermittent Infusion 30-60 minutes Dilute with 50-100ml NS, G. Preferred concentration 2.5mg/ml in NS. Physical Compatibility: Physically compatible. Propofol compatibility with other intravenous drug products-two new methods of evaluating IV emulsion compatibility. In my time there we have still never used IV potassium and opt for PO k-dur instead. The https:// ensures that you are connecting to the 221-231. The mix of incompatible drugs is a medication error that can have serious consequences for the patient such as therapeutic failures, micro-embolism or toxicity.4, The Y-site infusion of 2 drugs requires both drugs to be physically compatible.5 This coadministration occurs when mixing drugs in a 1:1 ratio and in the absence of visible signs of incompatibility like precipitation or change in color. ]g0i9FAA,at 0 Only 6 studies assessed the chemical stability of the mixes being high-resolution liquid chromatography the method used in 5 studies to measure the concentration of the active ingredients of the mix. Galante LJ, Stewart JT, Warren FW, Johnson SM, Duncan R. Stability of fluconazole in injectable solutions. No visible haze or particulate formation, color change, or gas evolution. Number of tests run (at least in triplicate). Physicochemical compatibility of commonly used analgesics and sedatives in the intensive care medicine. There is no inhibition of potassium uptake. Our hospital stopped using IV potassium because we had too many sentinel events involving their use. This involves clinical judgement based on consideration of two factors: total body potassium deficit and renal function. This means prior confirmation is needed that no significant change has occurred in the concentration of either one of the drugs present in the mix.6. J Cardiovasc Electrophysiol. Save my name, email, and website in this browser for the next time I comment. However, information on drug compatibility is scarce and, on many occasions, difficult to interpret due to the different concentrations used, the lack of information on the assessment techniques used or the suspicious technical quality of the sources. Visual compatibility of neuromuscular blocking agents with various injectable drugs during simulated Y-site injection. Web17. 307-309, Copyright 2018. Please cite this article as: Castells Lao G, Rodrguez Reyes M, Roura Turet J, Prat Dot M, Soy Muner D, Lpez Cabezas C. Compatibilidad de los frmacos administrados en Y en las unidades de cuidados intensivos: revisin sistemtica. sharing sensitive information, make sure youre on a federal I hung the potassium 1 st because it would take the less time. Low magnesium = decreased potassium uptake which results in more of the potassium you gave being excreted. Web1. Cells with low potassium are leaking the potassium they are receiving right back out, which decreases the net uptake and secretion. None of the samples seemed to have visible precipitation or changed in color or clarity. Hypokalemia itself isn't immediately life-threatening here, but hypokalemia impedes the ability to provide. Bookshelf S. Kanji, J. Lam, C. Johanson, A. Singh, R. Goddard, J. Fairbairn. Ann Pharm Franaises, 69 (2011), pp. WebThe compatibility and stability of 80 mmol/L potassium chloride and 16 mmol/L magnesium sulfate in 0.9% sodium chloride injection and in 5% dextrose injection solutions at 22 deg C have been studied by means of a Beckman Clinical Chemistry Analyzer Synchron CX5 Delta. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. The stability data reported in this review cannot be generalized to other drug combinations or concentrations different from the ones described. Required fields are marked *. K of 2 mEq/L may correlate with a potassium deficit of 400-600 mEq. Webmagnesium and potassium solutions in the Intravenous reduces energy levels and raises the possibility of electrocardiographic fibrillation. On the other hand, for the safe coadministration of 2 drugs in the same diluent, the mix needs to be chemically stable. Aldosterone and renin levels should ideally be measured after correction of potassium, because otherwise hypokalemia may suppress the aldosterone level. The magnesium was piggybacked onto the other saline IV with the potassium. Has 10 years experience. Use serum magnesium values to guide continued dosage. J Cardiovasc Electrophysiol. Summary of physical and chemical compatibilities. A chance of incompatibility exists whenever any medication is combined or added to an IV fluid. Click Get Compatibility once both drugs are selected PEPIDs IV Compatibility tool is included in any every clinical decision support suite and SEMICYUC, Copyright 2023. Vasoactive drugs, analgesics, and sedatives are among the most widely used therapeutic groups and are usually administered in continuous infusion. Studies conducted to assess the stability of the mix: (a) transparency: for visible particles, observation with a matt black panel, automatic particle count or turbidimetry; for subvisible particles, use of optic microscopy, spectrophotometry or turbidimetry; (b) change in color: visual inspection or spectrophotometry; (c) gas formation: visual inspection; (d) pH; and (e) chemical stability: measurement of the variation of the concentration of the 2 drugs. Compatibility of remifentanil hydrochloride with selected drugs during simulated Y-site administration. Patients admitted to intensive care units (ICU) often require the IV administration of several drugs. Before taking any of your medications, always consult with your healthcare specialist. Summary of physical and chemical compatibilities. Chemical stability studies, however, are not because they require more sophisticated analytical techniques to determine the initial and final concentration of drugs. Accordingly, drug stability knowledge was available for 50.3% of the studied admixtures, in which 77.1% of the binary combinations proved compatible and 16.8% proved incompatible. Avoid or use alternate Drug. official website and that any information you provide is encrypted The .gov means its official. Clipboard, Search History, and several other advanced features are temporarily unavailable. Web1. But, I'd be curious to hear the OP's rationale as well. there is an average 1.7 errors/day associated with the process of drug administration in the ICU setting.1 On the other hand, the data reported by Merino et al. Ningn estudio cumpli todos los criterios de calidad establecidos, aunque el 93% garantizaba una correcta reproducibilidad. UAiM 0g `%u?J[ +sC e#)7p:iQZ>`} d/ J;#A- 0 IJp C%tu0t}vN0{3):UVww A;{ ?M=]\:Zk-=%]%Q`l Potassium is flowing into the cells just fine. Guidelines for the practical stability studies of anticancer drugs: a European consensus conference. Search for and click on a drug 2. I sat upright and called for the nurse. In the absence of the above factors, hypokalemia is well tolerated (and can be treated gradually). The compatibility and stability of 80 mmol/L potassium chloride and 16 mmol/L magnesium sulfate in 0.9% sodium chloride injection and in 5% dextrose injection solutions at 22 deg C have been studied by means of a Beckman Clinical Chemistry Analyzer Synchron CX5 Delta. IV or IM. Dolors Soy Muner: study design and idea; paper draft or critical review of the intellectual material; and final approval of this version. This means that we only have data available for 50.3% of all the possible combinations suggested. If the renal function is adequate and stable (e.g., GFR is >30 ml/min and the patient is not oliguric), then it's unlikely that oral potassium will cause hyperkalemia. 2020;44:8087. Judit Roura Turet: data mining, analysis and interpretation of data; paper draft or critical review of the intellectual material; and final approval of this version. So, potassium uptake is Published data may report both compatibility and stability; however, most evaluate compatibility alone. Compatibilit de lactylcystine injectable lors de son administration en Y avec dautres mdicaments usuels. Of these, 366 are compatible (77.1%), 80 are incompatible (16.8%), and 29 are compatible in specific conditions (6.1%) as shown in Table 2. Renal tubular acidosis types I or II (see table below). Standardization of infusion solutions to reduce the risk of incompatibility. Boxes with diagonal lines show compatibility with physiological serum only. Compatibilidad visual y fsica de la furosemida en mezclas intravenosas para perfusin continua. Sodium-wasting nephropathy (e.g. 2 shows we could not find any information on the physical and chemical compatibility of all the combinations suggested; for instance, in the case of flumazenil and piperacillin-tazobactam we could only determine stability with 4 drugs and in both cases the 39 remaining combinations remained with no information. Recopilar la informacin publicada sobre estabilidad de los frmacos usados en el paciente crtico, evaluar la calidad de los datos publicados y generar una tabla de compatibilidad con informacin actualizada. Our hospital stopped using IV potassium because we had too many sentinel events involving their use. In my time there we have still never used IV potassium and opt for PO k-dur instead. The reference search process for each drug was conducted concurrently by 2 independent researchers. Figure 2. 2012 Jan;23 (1):54-9. doi: 10.1111/j.1540-8167.2011.02146.x. Use serum magnesium values to guide continued dosage. Compatibilit du pantoprazole injectable lors dadministration en Y. Compatibility of parenteral furosemide with seventeen secondary drugs used in standard concentrations. hb```l\ cg`a" D@M70I?@C Z|`d>!-Uu>]ppX=+c(rJT'c9V{L7M{{]ua;DVo"6e\W:qcf/f3%dayw-LrO{.p*zvTSf1xpSIC a. Potassium chloride is inexpensively available and is rarely used in the laboratory. In this sense, we could not find data on all drug combinations regarding the high concentrations used in the ICU setting (Table 1); however, in some cases, we did obtain information on lower concentrations than the ones reported in this review. RELATED: What Does Potassium Chloride React With? The rest is in bones and cells. This review focused on analyzing the physical and chemical compatibility of the IV drugs most commonly used through Y-site infusion in the ICU setting and summarizing the information obtained in a double-entry chart. The years of publication of the studies went from the1990s until December 2017 and the languages included were English, Spanish, and French. Dilution: Potassium chloride concentrate is compatible with the majority of commonly used intravenous infusion fluids. For example, diabetic ketoacidosis causes potassium to shift out of the cells. Am J Health Syst Pharm, 65 (2008), pp. Our patients hate those because they're enormous pills. Another factor is the prescription of doses in different units of measurement or the high number of drugs used with each patient. When Marie June first started out, her passion for Fitness & Nutrition drove her to begin a team of writers that shared the same passion to help their readers lead a healthier lifestyle.We hope you enjoy our articles as much as we enjoy offering them to you. Our review is based on the previous work done by Kanji et al.5 in Canada and Lpez-Cabezas.7 in Spain. 1648-1654. Pharm Technol Hosp Pharm, 2 (2017), pp. Storage: Room temperature of 22 C. Walker, S. Varrin, D. Yannicelli, S. Law. For instance, Flamein et al.14 studied this problem in neonatal ICUs; Knudsen et al.15 shed light on the compatibility of analgesics and sedatives. Compatibilidad fsica de la amiodarona en perfusin continua. For deficiency that is not severe in older children, some manufacturers have recommended 1 g (2 mL of 50% solution) once or twice daily by IM injection. Physical Compatibility: Physically compatible. None of the papers studied met all of the quality criteria established in this review. often administered in low doses due to their high drug strength, requiring dilution and a prior assessment to their administration. Available from: C. Lpez-Cabezas, D. Soy, L. Guerrero, G. Molas, H. Anglada, J. Ribas. Round IV supplementation to the nearest 7.5 or 15 mmol increment 1.6-2.3 mg/dL Phosphate-potassium packet (PHOS-NAK powder) 2 (two) packets every 4 hours while awake x 3 dosesB Phosphate-potassium packet (PHOS-NAK Med Intensiva. Amors-Cerd, B. Ribas-Nicolau. Unlike pseudohyperkalemia, pseudohypokalemia is uncommon. Storage: Room temperature of 22 C. Index Medicus / MEDLINE / EMBASE / Excerpta Medica / SCOPUS / MEDES / Science Citation Index Expanded, Journal of Citation Reports, The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. QT prolongation, which may predict risk of arrhythmia. ICH Harmonised Tripartite Guideline Q1A(R2): Stability testing of new drug substances and products, international conference on harmonisation (ICH), 6 February 2003. A fractional excretion of potassium >9.3% suggests renal potassium wasting (with sensitivity of 81% and specificity of 86%). Visual compatibility of diltiazem injection with various diluents and medications during simulated Y-site injection. Is Potassium Phosphate Compatible With Potassium Chloride? IV or IM. Of these, 366 are compatible (77.1%), 80 are incompatible (16.8%), and 29 are compatible in specific conditions (6.1%) as shown in Table 2. The research was published in the journal Neurotypical and was released online on December 4, 2013. 2980 0 obj <>stream Reference: Recently I had a patient that needed both iv k and iv mag. Making sure that the use of drugs is safe is one of the main commitments made by healthcare providers with their patients. 67% of the studies assessed gas formation, and only 12 measured pH changes in time. @'c[: pg6~ 0No2J:xWk^`+0Hg| 0BPo>E`3J_9`cX2!E[X\ZK-zgAQTT"AMKhj\.'1aq1|@1B9[kz]K/3c2jp{?OVL1 Web17. When started up again the Iv with the magnesium had blown. The problem is that magnesium blocks potassium secretion back OUT of the cell, and with low intracellular mag levels, potassium is allowed to freely exit the cell. #2) Acquired form associated with hyperthyroidism, typically in Asian and Mexican men. Low magnesium levels usually don't cause symptoms. (2) Severe hypokalemia in need of emergent treatment (see risk stratification above). I have never worked in a ED but why wouldn't you want to do it right for the patient the first timefast isn't always the bestjust like placing every IV start in the AC for a patient being admitted!!! Rate of 20 mEq/hr for severe hypokalemia or DKA (either via a central line, or split into two simultaneous infusions of 10 mEq/hr in two peripheral lines). Accessibility Federal government websites often end in .gov or .mil. A total of 140 drugs are known to interact with Effervecent Pot potassium / Choride. Specializes in Trauma/ED. Physical compatibility of cisatracurium with selected drugs during simulated Y-site administration. Published data may report both compatibility and stability; however, most evaluate compatibility alone. RELATED: What Does Potassium Chloride React With? Deg C have been investigated. Published Nov 18, 2013. Patients being resuscitated from DKA will generally tend to drop their potassium levels over time. J Antimicrob Chemother, 51 (2003), pp. The lack of information on the safe mix of 2 drugs creates problems in the daily work of ICU nursing teams. According to Lexicomp, these are compatible, and there are no warnings against infusing concomitantly - is there any reason you couldn't run them together? (1) IV potassium should never be given as a bolus. hmo6 PMC Maddox, K. Viswanathan, J.L. Some experts recommend 2550 mg/kg (up to 2 g) every 46 hours for 34 doses; repeat as needed. Am J Health Syst Pharm, 52 (1995), pp. Eur J Hosp Pharm Sci Pract, 21 (2014), pp. 2012 Jan;23 (1):54-9. doi: 10.1111/j.1540-8167.2011.02146.x. WebC = Compatible; may be mixed via Y-site. J.T. Boxes were named with a C if the mix was compatible, with an I if incompatible and with I/C if stability depended on special conditions. Also, in this case, I'd want to correct the hypomagnesemia prior to administering the K+, since as I mentioned above, the low K+ may be refractory to treatment in the presence of hypomagnesemia. (2) Patients with persistent renal potassium wasting, with inadequate response to potassium supplementation alone. Rapid administration may cause serum levels to be elevated (even though there is a total-body potassium deficit!). Similarly, turbidimetry or microscopymore accurate techniques than visual observation for the detection of particles and changes in colorare underused. Criteria for judging the quality of a publication on physicochemical stability of ready to use injectable drugs. /`p Int J Pharm Compd. Epub 2011 Aug 4. Figure 2. Commonly used for severe hypokalemia or DKA. WebC = Compatible; may be mixed via Y-site. Both increase serum potassium. If you are author or own the copyright of this book, please report to us by using this DMCA report form. The magnesium was piggybacked onto the other saline IV with the potassium. Combinations of physical and chemically compatible drugs with concentrations below the reference mark. May consider checking a full electrolyte panel (including Calcium, Magnesium, and Phosphate): Electrolyte abnormalities often occur in pairs and triplets (electrolytic disarray). If you have persistently low blood magnesium levels, this could lead to low potassium and calcium levels. WebMagnesium Sulphate Mannitol Metronidazole Midazolam Labetalol Gentamicin Glucose 4%, Sodium Chloride 0.18% Glucose 5% Glyceryl Trinitrate (GTN) Heparin (Sodium) Potassium Chloride Potassium Phosphate Propofol Remifentanil Milrinone Morphine Noradrenaline Omeprazole Thiopental Vancomycin Sociedad Espaola de Medicina Intensiva, Crtica y Unidades Coronarias, rea del Medicamento. Infusions remained stable at 22 degrees C. For 24 hours. (i) A systematic review was conducted searching the following databases: Medline, Stabilis, Handbook of Injectable Drugs and Micromedex. Visual compatibility of clonidine with selected drugs. WebIntravenous administration of magnesium and potassium solution lowers energy levels and increases success rates electrically cardioverting atrial fibrillation J Cardiovasc Electrophysiol. Cardiac arrest due to hypokalemia (e.g. 483-486. (The main driver of hypokalemia due to gastric fluid loss is the metabolic alkalosis, so avoiding loss of gastric acid will prevent this.). Elsevier Espaa, S.L.U. National Library of Medicine 2002 Jan-Feb;6(1):62-5. This can be run either through a central line, or split into two 10 mEq/hr infusions through two. What Is The Difference Between Potassium Chloride And Klor Con? As far as the magnesium goes we don't piggyback it most of the time. Low magnesium levels usually don't cause symptoms. J Pharm Pract Res, 32 (2002), pp. WebCompatible: metronidazole, ranitidine, vancomycin Intermittent Infusion 30-60 minutes Dilute with 50-100ml NS, G. Preferred concentration 2.5mg/ml in NS. Rehak, R.L. La revisin sistemtica incluy 29 artculos (27 originales y 2 revisiones). S. Manrique-Rodrguez, A.C. Snchez-Galindo, C.M. The reviews published by Kanji et al. F. Flamein, L. Storme, A. Maiguy-Foinard, M. Perez, B. Dcaudin, M. Masse. Less than 5% change in measured potassium and magnesium concentrations occurred in 24 hours. 161LP-166LP. Reference: L. Knudsen, S. Eisend, N. Haake, T. Kunze. It can be made by treating potassium hydroxide (or other potassium bases) with hydrochloric acid: KOH + HCl + H2O. %%EOF Create well-written care plans that meets your patient's health goals. No visible haze or particulate formation, color change, or gas evolution. The resulting salt can then be reconstituted by recrystallization. Some experts recommend 2550 mg/kg (up to 2 g) every 46 hours for 34 doses; repeat as needed. For patients with hypokalemia and hypomagnesemia, rapid correction of hypomagnesemia is safe and may quickly decrease the risk of arrhythmia. 2. Updated: Feb 27, 2020 Fernndez-Llamazares, M.M. However, this, Start with 20 mEq potassium IV over 2-3 minutes, Start with 20 mEq potassium IV over 10-20 minutes (infusion rate of 60-120 mEq/hr). Errores de medicacin en los servicios de medicina intensiva espaoles. Stability of ranitidine hydrochloride at dilute concentration in intravenous infusion fluids at room temperature. WebIntravenous administration of magnesium and potassium solution lowers energy levels and increases success rates electrically cardioverting atrial fibrillation J Cardiovasc Electrophysiol. Physical compatibility of magnesium sulfate and sodium bicarbonate in a pharmacy-compounded hemofiltration solution. Mixing solutions containing calcium or magnesium ions has a substantial risk of forming an insoluble calcium or magnesium salt. thiazides, loop diuretics, acetazolamide, mannitol). S. Tollec, K. Touzin, E. Pelletier, J.M. Report DMCA Overview Your email address will not be published. Want to Download the Episode?Right Click Here and Choose Save-As. Incompatible: amphoteracin, cephalosporins, erythromycin, penicillins, phenytoin, potassium chloride, heparin, thiopentone, tetracyclines, vitamins B and C, nitrofuranoin, warfarin pH: 4.5 Compatibility depends upon many factors including temperature, pH, IV fluid, concentration, order of mixing and brand of drug. Int J Pharm Compd. The goal of this review is to gather the information published on the physical and chemical compatibility of the most commonly used drugs at an ICU when infused through the same line via a Y-site.