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Date of Award


Document Type


Degree Name

Master of Science (M.S.)

First Advisor

James C. King

First Committee Member

Donald Barker

Second Committee Member

M. G. Chaubal


The possibility of drug incompatibilities is a matter of serious concern when administering two or more therapeutic agents. This is especially true in the case of parenteral administration when one must be aware not only of therapeutic interactions but also chemical and physical reactions that might occur.

In order to avoid incompatibilities, drug manufacturers have suggested that parenteral solutions be used immediately after reconstitution and that admixtures of parenteral products not be administered wherever possible (1,2). Physicians have also stressed the importance in avoiding multiple drug therapy (3,4). In spite of these suggestions, the practice of multiple drug therapy is prevalent.

Because of this, there has been an increase in awareness of the number of drug admixtures administered in the hospital. At the University of Michigan Hospital over two thirds of the intravenous fluids administered contained two or more therapeutic agents (5). Holysko and Ravin (6) report that 48% of the intravenous fluids contain one additive, 30% contain two additives, and 22% contain three or more additives. The survey taken by Patterson and Nordstrom (7) showed that 24% of the solutions administered intravenously contained two drugs 1 and that 16% of the intravenous solutions contained three or more additives.

The increased awareness of the problems in admixtures of parenterals has contributed to the increased use of centralized intravenous additive programs at various hospitals. The hospital pharmacist is now becoming more responsible for the preparation of intravenous admixtures (8). The need for additional information concerning potential interactions when admixtures of therapeutic agents for intravenous use are administered is evident. The lack of information includes, in addition to incompatibilities, areas of interest such as stability, sterility, and clinical effectiveness (8,9).

This report will discuss a method to detect potential chemical interactions. The drugs under investigation are sodium ethacrynate (Edecrina) in combination with selected cardiovascular and psychotherapeutic agents when in admixture in normal saline solution. Possible therapeutic interactions and physical incompatibilities of these combinations will also be discussed.





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