title: Stability of admixture containing morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride in an implantable infusion system.
abstract: Intrathecal infusion is often performed using drug combinations. This study was conducted to evaluate the stability of the admixture of morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride when used in an implantable pump under simulated clinical use conditions. SynchroMed implantable pumps were filled with an admixture and incubated at 37 degrees C for a period of 90 days. Drug admixture stored in glass vials at 4 degrees C and at 37 degrees C served as controls. Samples which included pump reservoir and catheter delivered aliquots were collected every 30 days and analyzed for drug concentrations using a stability-indicating HPLC method. All drugs contained in the admixture were stable and the original concentrations remained greater than 96%. Over 90 days, and with the pump at the simulated body temperature of 37 degrees C, there were no evident heat catalyzed or device catalyzed reactions.
authors.affiliation: Trinity Pain Medicine Associates, PA, Fort Worth, Texas, USA.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Classen
authors.forename: Gary H
authors.initials: GH
authors.lastname: Wimbish
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kupiec
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000032:analysis; D002045:Bupivacaine / Q000008:administration & dosage / Q000032:analysis*; D003000:Clonidine / Q000008:administration & dosage / Q000032:analysis*; D045424:Complex Mixtures / Q000008:administration & dosage / Q000032:analysis; D004338:Drug Combinations; D004355:Drug Stability; D004356:Drug Storage / Q000379:methods; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods*; D009020:Morphine / Q000008:administration & dosage / Q000032:analysis*; D010146:Pain / Q000188:drug therapy; D011785:Quality Assurance, Health Care / Q000379:methods
chemical_list: D000700:Analgesics; D045424:Complex Mixtures; D004338:Drug Combinations; D009020:Morphine; D003000:Clonidine; D002045:Bupivacaine