title: Effect of tubing on loss of clonazepam administered by continuous subcutaneous infusion.
abstract: Previous studies have reported loss of clonazepam from solutions administered intravenously from plastic infusion bags and administration sets. In palliative care, clonazepam is sometimes administered through syringe drivers using polyvinyl chloride (PVC) infusion tubing. No data currently exist to show whether use of PVC tubing affects the amount of clonazepam actually received by the patient. This study compared the use of two different types of PVC tubing with a non-PVC tubing. Solutions containing clonazepam or clonazepam and morphine were prepared with either normal saline or water for injection as diluent. Concentrations of morphine and clonazepam were determined using high-performance liquid chromatography. Significant loss of clonazepam (up to 50%) was observed in all solutions infused through PVC tubing. Solutions infused through non-PVC tubing retained greater than 90% of the initial concentration of clonazepam. It is recommended that when administering clonazepam using a syringe driver, non-PVC tubing be used.
authors.affiliation: School of Biomedical Sciences (J.J.S.), Faculty of Health, and Faculty of Medical Practice and Population Health (P.G., P.J.R.), University of Newcastle, Callaghan, Australia. Jennifer.Schneider@newcastle.edu.au
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schneider
authors.forename: Phillip
authors.initials: P
authors.lastname: Good
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ravenscroft
mesh_terms: D000327:Adsorption; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000493:pharmacokinetics; D002998:Clonazepam / Q000008:administration & dosage / Q000493:pharmacokinetics*; D004347:Drug Interactions; D018757:GABA Modulators / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D007260:Infusion Pumps; D007263:Infusions, Parenteral; D009020:Morphine / Q000008:administration & dosage / Q000493:pharmacokinetics; D011126:Polypropylenes; D011143:Polyvinyl Chloride; D013594:Syringes
chemical_list: D000701:Analgesics, Opioid; D018757:GABA Modulators; D011126:Polypropylenes; D002998:Clonazepam; D009020:Morphine; D011143:Polyvinyl Chloride