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Wade Final Thesis.pdf (820.59 KB)

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Stability of Epinephrine in a 0.9% Saline Solution

Wade, Spencer David, DDS
http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315

Abstract Details

2019, Master of Science, Ohio State University, Dentistry.
Objective: By law, pharmaceutical companies clearly label their medications with an expiration date, but the debate behind the “new expiration date” that drugs are given after being diluted is ongoing. Some medications, including epinephrine, commonly come in concentrations which are unusable for clinical anesthesiology. Epinephrine is generally used during emergency situations, making it difficult to perform an urgent dilution amidst a declining clinical scenario. Emerging evidence indicates that not only do medications remain stable past their original pharmaceutical expiration date, but their stability remains intact even after dilution. The objective of this study was to determine the stability of epinephrine over time in a 10ml normal saline pre-filled syringe stored in typical perioperative environments. Methods: All samples were prepared by diluting 1 mg/ml of epinephrine to 10mcg/ml by using normal saline pre-filled syringes. The samples were then left for 0, 15, 30, 60, and 90 day(s) prior to final analysis and stored in one of four different laboratory environments to emulate common clinical scenarios (light, dark, room temperature, and refrigerated). Capillary zonal electrophoresis was then used to measure the chemical degradation of epinephrine over time. Additionally, agar plating was used to measure bacterial growth in all samples. Results: No significant differences were detected in levels of epinephrine between the 0, 15, 30-day and 0, 60, 90-day samples in each of the four environments. Additionally, bacterial growth was not detected in any of the samples. Conclusions: Epinephrine remains stable in a normal saline pre-filled syringe for up to 90 days in common settings of lighting and temperature (i.e., sample degradation does not exceed the sample variance attributable to sample dilution). Therefore, pre-diluting epinephrine for unanticipated clinical emergencies may remain clinically useful for up to 90 days, thus improving patient safety, access to medications, and overhead costs.
Bryant Cornelius, DDS, MS, MBA (Advisor)
Courtney Jatana, DDS, MS (Committee Member)
Kelly Kennedy, DDS, MS (Committee Member)
Michelle Humeidan, MD, PhD (Committee Member)
126 p.
Analytical Chemistry; Dentistry; Pharmacology
Anesthesia; Medications

Recommended Citations

Citations

  • Wade, DDS, S. D. (2019). Stability of Epinephrine in a 0.9% Saline Solution [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315

    APA Style (7th edition)

  • Wade, DDS, Spencer. Stability of Epinephrine in a 0.9% Saline Solution. 2019. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315.

    MLA Style (8th edition)

  • Wade, DDS, Spencer. "Stability of Epinephrine in a 0.9% Saline Solution." Master's thesis, Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1561489299362315

    Chicago Manual of Style (17th edition)

osu1561489299362315
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This open access ETD is published by The Ohio State University and OhioLINK.