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American Journal of Health-System Pharmacy, Vol. 62, Issue 8, 828-833
Copyright © 2005 by American Society of Health-System Pharmacists
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Compatibility and osmolality of inhaled N-acetylcysteine nebulizing solution with fenoterol and ipratropium

Tzung-Yi Lee, Chi-Ming Chen, Chun-Nin Lee, Yi-Chun Chiang and Hsiang-Yin Chen

TZUNG-YI LEE, M.S., is Pharmacist, Department of Pharmacy, Mackay Memorial Hospital (MMH), Taipei, Taiwan; at the time of this study he was M.S. degree student, School of Pharmacy, Taipei Medical University (TMU), Taipei. CHI-MING CHEN, PH.D., is Professor, School of Pharmacy, TMU. CHUN-NIN LEE, M.D., is Director, Department of Internal Medicine, TMU–Taipei Municipal Wan-Fang Hospital. YI-CHUN CHIANG, B.S., is M.S. degree student, School of Pharmacy, TMU. HSIANG-YIN CHEN, M.S., PHARM. D., is Instructor, School of Pharmacy, TMU, and Director, Department of Pharmacy, TMU–Taipei Municipal Wan-Fang Hospital.

Address correspondence to Dr. H.-Y. Chen at the Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, 250 Wu Hsing Street, Taipei, Taiwan 110 (shawn{at}tmu.edu.tw).


Purpose. The compatibility, pH, and osmolality of N-acetylcysteine (NAC) nebulizing solution in the presence of ipratropium bromide or fenoterol hydrobromide were studied.

Methods. Portions (400 µL) of each mixture were sampled immediately upon mixing and one, two, three, four, five, six, and seven hours after mixing and assayed by high-performance liquid chromatography. Osmolality was measured by sampling 100 µL from the filling cup at a five-minute interval during nebulization and by the freezing-point-depression method.

Results. Adding NAC solution to fenoterol solution raised the pH from 3.20 to 7.90 and the osmolality to a mean ± S.D. of 1400.67 ± 4.51 mOsm/kg. Fenoterol concentrations decreased to 93.71% and NAC concentrations to 92.54% of initial concentrations after seven hours. Mixing ipratropium with NAC solution raised the pH from 3.74 to 7.95 and the osmolality to a mean ± S.D. of 1413 ± 11.79 mOsm/kg. The initial ipratropium concentration declined 7.39% and 10.91% one and two hours after mixing with NAC solution, respectively.

Conclusion. NAC and ipratropium were stable in nebulizing solution within one hour of mixing. NAC and fenoterol were compatible for at least seven hours.

Index terms: Acetylcysteine; Concentration; Fenoterol hydrobromide; Hydrogen ion concentration; Incompatibilities; Ipratropium bromide; Mucolytic agents; Nebulizers; Osmolality; Parasympatholytic agents; Stability; Storage; Sympathomimetic agents

 





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