Abstract
BackgroundAccording to several treatment guidelines, epoprostenol is an important treatment option for pulmonary arterial hypertension. However, the pharmacokinetic characteristics and poor stability of epoprostenol at room temperature make its administration challenging. We therefore studied temperature fluctuations between the drug administration cassette and atmosphere to promote the safe use of epoprostenol.Methods and FindingsFive healthy volunteers carried a portable intravenous infusion pump attached to a medication cassette containing saline in a bag during their ordinary activities over 16 days during which the mean atmospheric temperature was 29.6±1.5°C. The temperature around the medication cassette was not less than 25°C on any occasion, and the mean period over 24 h during which the temperature around the cassette exceeded 35°C and 40°C was 96.9±156.4 min and 24.4±77.3 min, respectively. Significant correlations were observed between the temperatures outside the bag and around the cassette, as well as between temperatures around the cassette and of the saline solution in the cassette (r = 0.9258 and 0.8276, respectively). There were no differences in the temperatures outside the bag or around the cassette with respect to the bag material.ConclusionsTemperatures around a medication cassette and outside the bag containing the medication increase with sunlight exposure. The temperature around cassettes used for administering epoprostenol must therefore be kept low for as long as possible during hot summer conditions to maintain the drug stability.
Highlights
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by increased pulmonary arterial pressure and pulmonary vascular resistance, which eventually results in death due to right heart failure
Epoprostenol solution is administered as a continuous intravenous infusion via a central venous catheter; it is necessary to use ice packs to keep the temperature of the epoprostenol cassette below 8uC when the reconstituted solution is used beyond 8 h [6]
Weak correlations were observed between the atmospheric temperature and temperature outside the bag (r = 0.4868 for all days, P,0.0001, Figure 2B), and atmospheric temperature and temperature around the cassette (r = 0.5243 for all days, P,0.0001, Figure 2C)
Summary
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by increased pulmonary arterial pressure and pulmonary vascular resistance, which eventually results in death due to right heart failure. Its pharmacokinetic characteristics and poor stability at room temperature make its administration challenging. Epoprostenol solution is administered as a continuous intravenous infusion via a central venous catheter; it is necessary to use ice packs to keep the temperature of the epoprostenol cassette below 8uC when the reconstituted solution is used beyond 8 h [6]. This need for icepacks for everyday use can cause considerable inconvenience and discomfort for patients. The pharmacokinetic characteristics and poor stability of epoprostenol at room temperature make its administration challenging. We studied temperature fluctuations between the drug administration cassette and atmosphere to promote the safe use of epoprostenol
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