Drug interaction between ceftriaxone and theodrenaline/cafedrine : A case example
Adverse interactions between intravenous medications which are given simultaneously are a common problem in intensive care medicine. They are usually caused by administering a high number of medications over a limited number of intravenous lines or central venous catheters; however, this issue also...
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Published in | Die Anaesthesiologie Vol. 72; no. 2; p. 109 |
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Main Authors | , , |
Format | Journal Article |
Language | German |
Published |
Germany
01.02.2023
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Subjects | |
Online Access | Get full text |
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Summary: | Adverse interactions between intravenous medications which are given simultaneously are a common problem in intensive care medicine. They are usually caused by administering a high number of medications over a limited number of intravenous lines or central venous catheters; however, this issue also arises in routine anesthetic procedures during surgery. The following case report highlights a so far undocumented interaction between the combination of theodrenaline/cafedrine and various antibiotics.Laparoscopic cholecystectomy was performed in a female patient, classified as ASA 1. After induction of general anesthesia 2 g ceftriaxone were administered as a perioperative antibiotic prophylaxis. Simultaneously, i.e. prior to the beginning of surgery, a mild decrease in blood pressure was observed and 2 ml diluted Akrinor® (2 ml theodrenaline/cafedrine + 8 ml NaCl 0.9%) was administered. Directly following this administration a chemical precipitation reaction occurred, and large white pasty flakes were noticed in the intravenous line. The infusion was stopped immediately and all lines were replaced.In order to confirm a causal relationship between the observed precipitation and the simultaneous administration of the two drugs, an in vitro test was performed by mixing Akrinor® with other preparations of cephalosporin antibiotics. The effect observed with ceftriaxone was reproducible and cefazoline also caused a precipitation reaction. |
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ISSN: | 2731-6866 |
DOI: | 10.1007/s00101-022-01217-5 |