Effect of retrograde aminophylline administration on calcium and phosphate solubility in neonatal total parenteral nutrient solutions

• Published in: American journal of hospital pharmacy Vol. 46; no. 12; p. 2496
• Main Authors: Kirkpatrick, A E, Holcombe, B J, Sawyer, W T
• Format: Journal Article
• Language: English
• Published: United States 01-12-1989
• Subjects: Aminophylline - analysis; Calcium - analysis; Chemistry, Pharmaceutical; Drug Incompatibility; Food, Formulated - analysis; Humans; Infant, Newborn; Infusion Pumps; Parenteral Nutrition, Total; Phosphates - analysis
• ISSN: 0002-9289
• DOI: 10.1093/ajhp/46.12.2496

The effect of retrograde administration of aminophylline injection on calcium and phosphate solubility in neonatal total parenteral nutrient (TPN) solutions was studied. Neonatal TPN solutions containing two amino acids solutions in three concentrations (Travasol 1% and 2% and TrophAmine 2%) were formulated. Calcium and phosphate salts were added to achieve calcium concentrations of 10, 15, 20, 25, 30, or 40 meq/L and phosphorus concentrations of 10, 15, 20, 25, 30, or 40 mmol/L. Samples were inspected visually after 18-24 hours; solutions free of precipitation were then infused through two parallel syringe-pump systems designed to simulate clinical conditions for TPN solution administration to a 1-kg neonate. To one system, a 7.5-mg aminophylline dose was added as a manual retrograde injection; sterile water for injection was added as a manual retrograde injection to the other system. The solutions were inspected throughout a one-hour infusion period for precipitate formation in the i.v. apparatus, and the pH of the effluents was determined. Concurrent aminophylline administration resulted in visible precipitate in all but a few of the solutions tested. The solution containing Travasol 2%, calcium 10 meq/L, and phosphorus 10 mmol/L remained clear, as did the solutions containing TrophAmine 2% and the following concentrations of calcium and phosphorus: calcium 10 meq/L and phosphorus 10, 15, or 20 mmol/L; calcium 15 meq/L and phosphorus 10 or 15 mmol/L; and calcium 20 meq/L and phosphorus 10 or 15 mmol/L. An average increase in pH of 0.63 unit was noted in all solutions.