Securing extemporaneous oral liquid preparations at CHU Grenoble Alpes
11 October 2019C. Ruiz (1), R. Mazet (1-2), J. Leenhardt(1), S. Chanoine(1-2), M-D. Desruet (1), P. Bedouch (1-2)
(1) Département pharmacie, Centre Hospitalier Universitaire Grenoble Alpes, France
(2) Université Grenoble Alpes, Faculté de sciences pharmaceutiques, Grenoble, France
Currently, oral liquid preparations are packaged in a type II amber glass bottle and sealed with a tamper-evident cap. This cap secures the preparation until the vial is opened but the nurse may be exposed to a chemical risk and the preparation for biological contamination.
The goal of this work is to secure the administration of oral liquid preparations before and after opening and at each administration.
We looked for caps or inserts that would fit on our current 28 mm diameter vials and be compatible with the ENFit®oral syringes used for administration in the care units.
The main criteria evaluated were ease of use, no leakage, low dead volume, compatibility of materials and finally their low cost.
We selected 2 caps which 2 are screw top from CAIR LGL® (NCE302C) and FAGRON®, 2 conical inserts from ASEPT INMED® (202342) and ETS LEROY® (11619830) laboratories and 1 straight insert from ASEPT INMED® laboratory (202346).
No cap leaks after turning
The FAGRON®’s screw cap is not compatible with ENFit® syringe.
Conical plugs were less convenient to use because they are easy to remove.
The ETS LEROY®’s conical plug had a dead volume of 12,5ml while others had a dead volume under 3ml.
All materials were used in the packaging of other drugs.
Finally, the cost of ETS LEROY®’s conical plug was higher (7, 37€) than others caps which ranged from 0.36€ to 1,52€.
Discussion and conclusion
We eliminated the FAGRON®’s screw cap because it is not compatible with ENFit® oral syringe used in the care units.
Conical plugs can be easily removed and ETS LEROY®’s conical plug is extremely expensive. Therefore, they were discarded.
The screw cap CAIR LGL® requires an additional handling by the nurse.
After evaluation by the user service, we jointly selected ASEPT INMED®’s straight insert. It’s easy to use, compatible with oral ENFit® syringe, leak-free, with a low dead volume and a reasonable price (0,36€). It can be inserted into the bottle before dispensing and t allows the current cap with tamper-evident stoppering to be kept. The preparations are now secured before and after opening and at each administration.