title: The hospital pharmacist: an important contributor to improved patient safety in the hospital.
abstract: Injectable drugs are high-risk products and their reconstitution in hospital wards is a potential source of errors. Thus, in order to secure the reconstitution process and thereby improve safety, the pharmacy department of Lausanne University Hospital is focusing on developing ready-to-use  forms (CIVAS). These preparations are compounded in controlled clean rooms and are analyzed prior to release. In the intensive care unit, amiodarone 12.5 mg/mL in glucose 5% is one of the high-risk preparations, which has led the pharmacy to develop a ready-to-use solution. To this end, a  one-year stability study was initiated, and the preliminary results (after six months) are illustrated here. A stability-indicating HPLC method was developed and validated for monitoring the concentration of amiodarone. Batches were stored at 5 °C and 30 °C, which were analyzed immediately  after preparation, after one, two, four and six months of storage. The pH and osmolality values were monitored at the respective time intervals. It was observed that after six months, all the results were within specifications. However, the pH values started to decrease after two months when  amiodarone was stored at 30 °C. After six months, a degradation peak appeared on the chromatogram of these solutions, which suggested that amiodarone is more stable at 5 °C. The preliminary results obtained in this study indicated that injectable amiodarone solutions are stable for  six months under refrigerated storage conditions. The study is ongoing.
authors.affiliation: Department of Pharmacy, University Hospital Lausanne University Hospital Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Berthouzoz
authors.forename: Lina
authors.initials: L
authors.lastname: Berger
authors.forename: Pascal
authors.initials: P
authors.lastname: Bonnabry
authors.forename: André
authors.initials: A
authors.lastname: Pannatier
mesh_terms: D000638:Amiodarone / Q000008:administration & dosage* / Q000032:analysis; D002626:Chemistry, Pharmaceutical; D002851:Chromatography, High Pressure Liquid; D004349:Drug Packaging; D004355:Drug Stability; D004356:Drug Storage; D005947:Glucose; D006761:Hospitals; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007267:Injections; D008510:Medication Systems, Hospital; D009994:Osmolar Concentration; D061214:Patient Safety / Q000706:statistics & numerical data*; D019999:Pharmaceutical Solutions; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D012015:Reference Standards; D015203:Reproducibility of Results; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000032:analysis
chemical_list: D019999:Pharmaceutical Solutions; D014665:Vasodilator Agents; D005947:Glucose; D000638:Amiodarone