title: Considerations on prevention of phlebitis and venous pain from intravenous prostaglandin E(1) administration by adjusting solution pH: in vitro manipulations affecting pH.
abstract: Prostaglandin E(1) (PGE(1); Alprostadil Alfadex) is a potent vasodilator and inhibitor of platelet aggregation used to treat patients with peripheral vascular disease. The main adverse effects of intravenous PGE(1) administration, phlebitis and venous pain, arise from the unphysiologically low pH of infusion solutions. When PGE(1) infusion solutions with a pH value greater then 6 are used, phlebitis and venous pain are considered to be avoidable. Beginning with a PGE(1) infusion solution with pH greater than 6, we add the amount of 7% sodium bicarbonate needed to bring the solution to pH 7.4 if phlebitis or venous pain develops. In the present study we established a convenient nomogram showing the relationship between the titratable acidity of various infusion solutions and the volume of 7% sodium bicarbonate required to attain pH 7.4 for preventing the phlebitis and venous pain associated with PGE(1) infusion.
authors.affiliation: Department of Pharmacy, Kansai Medical University Takii Hospital, Fumizono-cho, Moriguchi, Osaka, Japan. kohnoe@takii.kmu.ac.jp
authors.forename: Emiko
authors.initials: E
authors.lastname: Kohno
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nishikata
authors.forename: Noboru
authors.initials: N
authors.lastname: Okamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsuyama
mesh_terms: D000527:Alprostadil / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D010146:Pain / Q000517:prevention & control*; D010689:Phlebitis / Q000517:prevention & control*; D017693:Sodium Bicarbonate; D012996:Solutions
chemical_list: D012996:Solutions; D017693:Sodium Bicarbonate; D000527:Alprostadil