During surgical procedures, patients can have potentially life-threatening hypotension that requires immediate treatment with ephedrine sulfate, which requires compounding at the patient’s bedside. This study was conducted to validate and compare Nexus Pharmaceutical’s EMERPHED®, a pre-diluted ephedrine sulfate injection, with commercially used concentrated ephedrine sulfate in a simulated clinical setting. Twenty-four compounding simulations were performed in the clinical setting to simultaneously formulate EMERPHED® and concentrated ephedrine with a standardized dose of 10mg. The time to prepare the formulations, syringe volume, and the remaining contents of each vial were measured to determine compounding efficacy. Wastage reduction was theoretically discussed based on the waste disposal, and beyond use date. Inter-day variations were evaluated on different parameters. The time taken to formulate EMERPHED® was significantly faster (104.10±21.78 vs 70.63±12.45 seconds) than concentrated ephedrine (P≤0.05). The mean value for EMERPHED® was higher for the syringe accuracy, although it was not statistically significant (P=0.20) compared to concentrated ephedrine. Whereas for the remaining vial volume accuracy, EMERPHED® performed better (97.70±1.55% Vs 78.85±10.81%) than concentrated ephedrine (P≤0.05). Participants improved in the time to formulate both products between the first and second day. There was no significant difference in the percent mean accuracy of syringe dosing and remaining vial volume between days. There was no detected difference in waste reduction. EMERPHED® showed significantly greater compounding efficacy and ease of use compared to commercially available concentrated ephedrine in the clinical simulations. The results indicate that EMERPHED® could be a potential replacement option to institutions using concentrated ephedrine.
| Published in | Pharmaceutical Science and Technology (Volume 5, Issue 1) |
| DOI | 10.11648/j.pst.20210501.14 |
| Page(s) | 24-36 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Clinical Simulation, Ephedrine, Compounding, Dose Accuracy, Error Reduction, EMERPHED®
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APA Style
Alexander James Sperry, James Cruikshank, Aaron Winn, Karen Jean MacKinnon, Nashaat Zakaria Gerges, et al. (2021). Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings. Pharmaceutical Science and Technology, 5(1), 24-36. https://doi.org/10.11648/j.pst.20210501.14
ACS Style
Alexander James Sperry; James Cruikshank; Aaron Winn; Karen Jean MacKinnon; Nashaat Zakaria Gerges, et al. Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings. Pharm. Sci. Technol. 2021, 5(1), 24-36. doi: 10.11648/j.pst.20210501.14
AMA Style
Alexander James Sperry, James Cruikshank, Aaron Winn, Karen Jean MacKinnon, Nashaat Zakaria Gerges, et al. Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings. Pharm Sci Technol. 2021;5(1):24-36. doi: 10.11648/j.pst.20210501.14
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Download@article{10.11648/j.pst.20210501.14,
author = {Alexander James Sperry and James Cruikshank and Aaron Winn and Karen Jean MacKinnon and Nashaat Zakaria Gerges and George Edward MacKinnon III and Abhay Singh Chauhan},
title = {Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings},
journal = {Pharmaceutical Science and Technology},
volume = {5},
number = {1},
pages = {24-36},
doi = {10.11648/j.pst.20210501.14},
url = {https://doi.org/10.11648/j.pst.20210501.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.pst.20210501.14},
abstract = {During surgical procedures, patients can have potentially life-threatening hypotension that requires immediate treatment with ephedrine sulfate, which requires compounding at the patient’s bedside. This study was conducted to validate and compare Nexus Pharmaceutical’s EMERPHED®, a pre-diluted ephedrine sulfate injection, with commercially used concentrated ephedrine sulfate in a simulated clinical setting. Twenty-four compounding simulations were performed in the clinical setting to simultaneously formulate EMERPHED® and concentrated ephedrine with a standardized dose of 10mg. The time to prepare the formulations, syringe volume, and the remaining contents of each vial were measured to determine compounding efficacy. Wastage reduction was theoretically discussed based on the waste disposal, and beyond use date. Inter-day variations were evaluated on different parameters. The time taken to formulate EMERPHED® was significantly faster (104.10±21.78 vs 70.63±12.45 seconds) than concentrated ephedrine (P≤0.05). The mean value for EMERPHED® was higher for the syringe accuracy, although it was not statistically significant (P=0.20) compared to concentrated ephedrine. Whereas for the remaining vial volume accuracy, EMERPHED® performed better (97.70±1.55% Vs 78.85±10.81%) than concentrated ephedrine (P≤0.05). Participants improved in the time to formulate both products between the first and second day. There was no significant difference in the percent mean accuracy of syringe dosing and remaining vial volume between days. There was no detected difference in waste reduction. EMERPHED® showed significantly greater compounding efficacy and ease of use compared to commercially available concentrated ephedrine in the clinical simulations. The results indicate that EMERPHED® could be a potential replacement option to institutions using concentrated ephedrine.},
year = {2021}
}
TY - JOUR T1 - Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings AU - Alexander James Sperry AU - James Cruikshank AU - Aaron Winn AU - Karen Jean MacKinnon AU - Nashaat Zakaria Gerges AU - George Edward MacKinnon III AU - Abhay Singh Chauhan Y1 - 2021/05/31 PY - 2021 N1 - https://doi.org/10.11648/j.pst.20210501.14 DO - 10.11648/j.pst.20210501.14 T2 - Pharmaceutical Science and Technology JF - Pharmaceutical Science and Technology JO - Pharmaceutical Science and Technology SP - 24 EP - 36 PB - Science Publishing Group SN - 2640-4540 UR - https://doi.org/10.11648/j.pst.20210501.14 AB - During surgical procedures, patients can have potentially life-threatening hypotension that requires immediate treatment with ephedrine sulfate, which requires compounding at the patient’s bedside. This study was conducted to validate and compare Nexus Pharmaceutical’s EMERPHED®, a pre-diluted ephedrine sulfate injection, with commercially used concentrated ephedrine sulfate in a simulated clinical setting. Twenty-four compounding simulations were performed in the clinical setting to simultaneously formulate EMERPHED® and concentrated ephedrine with a standardized dose of 10mg. The time to prepare the formulations, syringe volume, and the remaining contents of each vial were measured to determine compounding efficacy. Wastage reduction was theoretically discussed based on the waste disposal, and beyond use date. Inter-day variations were evaluated on different parameters. The time taken to formulate EMERPHED® was significantly faster (104.10±21.78 vs 70.63±12.45 seconds) than concentrated ephedrine (P≤0.05). The mean value for EMERPHED® was higher for the syringe accuracy, although it was not statistically significant (P=0.20) compared to concentrated ephedrine. Whereas for the remaining vial volume accuracy, EMERPHED® performed better (97.70±1.55% Vs 78.85±10.81%) than concentrated ephedrine (P≤0.05). Participants improved in the time to formulate both products between the first and second day. There was no significant difference in the percent mean accuracy of syringe dosing and remaining vial volume between days. There was no detected difference in waste reduction. EMERPHED® showed significantly greater compounding efficacy and ease of use compared to commercially available concentrated ephedrine in the clinical simulations. The results indicate that EMERPHED® could be a potential replacement option to institutions using concentrated ephedrine. VL - 5 IS - 1 ER -
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