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A comparison of the pharmacokinetic and pharmacodynamic properties of nitroglycerin according to the composition of the administration set: A preliminary study

 Choon Ok Kim  ;  Jeongyun Song  ;  Ji Young Min  ;  Su Jung Park  ;  Hye Mi Lee  ;  Hyo-Jin Byon 
 MEDICINE, Vol.97(9) : e9829, 2018 
Journal Title
Issue Date
Intravenous/*instrumentation/methods Administration ; Adult ; Blood Pressure ; Liquid/methods Chromatography ; Cross-Over Studies ; *Equipment Design ; Humans ; *Infusion Pumps ; Male ; Middle Aged ; Nitroglycerin/administration & dosage/blood/*pharmacokinetics ; Polyenes ; Polyurethanes ; Polyvinyl Chloride ; Tandem Mass Spectrometry ; Vasodilator Agents/administration & dosage/blood/*pharmacokinetics ; Young Adult
BACKGROUND: There is a risk of drug sorption into an intravenous administration set composed of polyvinyl chloride (PVC), polyurethane (PU), or polyolefin (PO). This has implications on the dose of the active ingredient the patient receives, and thus therapeutic success. This study aimed to determine the plasma concentration of nitroglycerin and the effect of nitroglycerin on patients based on the composition of the administration set. METHODS: Using a randomized, open-labeled, 3 x 3 crossover method, 9 volunteers were assigned to 3 groups. In period I, nitroglycerin (100 mug/mL) was infused via a PVC- (group A), PU- (group B), or PO-based (group C) administration set. In period II, PU- (group A), PO- (group B), and PVC-based (group C) administration sets were used, and in period III, PO- (group A), PVC- (group B), and PU-based (group C) administration sets were used. The rate of drug administration in all periods was 12 mL/hour for 30 minutes using an infusion pump. Blood samples were collected, and the plasma concentrations of nitroglycerin were analyzed using validated high-performance liquid chromatography coupled with tandem mass spectrometry. Blood pressure was determined using a sphygmomanometer applied to the other upper arm at an interval of 5 minutes. RESULTS: We observed that the mean plasma concentration of nitroglycerin over time when administered using a PO-based tube was higher than that when using a PU- or PVC-based tube. When the percent change of the mean arterial pressure from baseline at each time point was compared among groups, there were statistically significant differences between PU and PO or PVC at most points during nitroglycerin infusion. CONCLUSION: Our results showed higher nitroglycerin plasma concentration and lower arterial pressure when a PO-based administration set was used than when a PVC- or PU-based administration set was used. PO-based administration sets may be more appropriate for nitroglycerin administration compared to those composed of PVC or PU.
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6. Others (기타) > Dept. of Clinical Pharmacology (임상시험센터) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Choon Ok(김춘옥) ORCID logo https://orcid.org/0000-0002-2319-1108
Min, Ji Young(민지영)
Park, Sujung(박수정) ORCID logo https://orcid.org/0000-0002-2249-3286
Byon, Hyo Jin(변효진)
Lee, Hye Mi(이혜미) ORCID logo https://orcid.org/0000-0002-0432-1878
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