The compatibility results are presented in a chart or list view, with the default chart view displaying all methods within the fields for the selected drugs and solutions. ^P}M%@586:vaX-KF\6c:Zj;C8r8&}+MDU_M iVg 6qiv |fZ~d,NDF+ mTI\uPxuPh)":H"3&"Xz M9|AqouXOKX3ZuJ&!q\&`1 ,5 &l5@`,[%h6agz6SM0@ &cuu Each sample was prepared in duplicate and performed at room temperature. You can click on the compatibility icons in the list view to see the same study list and details. In this update we added a new monograph for TOCILIZUMAB. About this app. i\ M, u=UZ"UiCjJ; &0tOQsy pj/N&]W&/iqh&hIiM7DwZYm- j{jA[;N`9T`xk`U MM>)y@ofS5Nk5zv|\\)y9 ?;~20CLw}tb,G"5nDWyQ(EKQ}L%IzoJO*@z. Get in touch with us. 1. 574 0 obj <> endobj 610 0 obj <>/Encrypt 575 0 R/Filter/FlateDecode/ID[<7C5275BC3D5C496FB588ACDF9629EDDA>]/Index[574 66]/Info 573 0 R/Length 145/Prev 963922/Root 576 0 R/Size 640/Type/XRef/W[1 2 1]>>stream All drug components in the test samples were found to be chemically stable (less than 10% loss of intact drug) for at least 24 hours under the conditions being tested. Use the free Micromedex IV Compatibility app. No data for administration methods chosen. Two syringes taped together sounds like a recipe for disaster' date=' either for the patient or for the nurse - particularly with regard to increased risk for needle sticks. Fig. [/quote'] Flushing after IV medication administration with compatible IV solution is recommended as per the guidelines in Checklists 60, Checklist 61, and Checklist 62 to ensure that medication left in the extension tubing is administered at the appropriate rate. Aminophylline IV Push IV Push IV Push IV Push IV bolus infuse over 20 -30 minutes not to exceed 25 mg/min; max concentration 25 mg/ml. PARENTERAL NUTRITION (PN) AND DRUG COMPATIBILITY The co-infusion of drugs and PN should be avoided. How tax and accounting firms supercharge efficiency with a digital workflow, Tax pros and taxpayers take note farmers and fisherman face March 1 tax deadline, IRS provides tax relief for GA, CA and AL storm victims; filing and payment dates extended, 3 steps to achieve a successful software implementation, 2023 tax season is going more smoothly than anticipated; IRS increases number of returns processed, How small firms can be more competitive by adopting a larger firm mindset, OneSumX for Finance, Risk and Regulatory Reporting, BECRIS 2.0 How to prepare for next-level granular data reporting, Implementing Basel 3.1: Your guide to manage reforms. Numerous factors affect stability and compatibility including salt, strength, diluents, order of drawing up, temperature and infusion periods. Click Get Compatibility once both drugs are selected. A cost evaluation of the risk can be done by assigning costs to their related clinical treatment and resulting extended length of stay. Incompatibility is an undesirable reaction that occurs between the drug and the solution, container or another drug. %%EOF Combinations of two, three or more of these drugs occasionally need to be co-administered via syringe driver. The IV drug compatibility chart is based on information from the, ThisIVDrugCompatibilityChartisprovidedasaquickr, itisadvisedthatyoucheckwithapharmacistforr. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. Such circumstances include: The decision to mix drugs should not be made without knowledge of their compatibility. Incompatibility between infusion-bolus was . In other cases, care needs to be taken to ensure that if the injection solution is diluted, the dilution is adequate to ensure continuing solubility over the duration of the infusion. In one study, incompatibility was investigated in a pediatric intensive care ward showing that 3.4% of drug combinations were incompatible and thus potentially dangerous.7A life threatening nature was found for 26% of incompatibilities in an intensive care unit (ICU).8, Another survey collected 78 different medication regimes and found 15% with incompatibility reactions.9Taxis and Barber10reported that in the ICU clinical incompatibilities can contribute to 25% of medication errors. Definitions for the following types of compatibility testing are as follows: The compatibility information presented is based on one of four (4) ratings: In the chart display, find detailed information about a specific pair of drugs and administration route by clicking on the compatibility type link within the table. Alfentanil. View the full Trissels monograph for more information on the physical and chemical characteristics of the drug. IV medication must be cleared by flushing at the same rate of administration to avoid the . Australian Prescription Products Guide. You can return to the Chart display by toggling back to Chart View. Find the product you are looking for. The antibiotics are listed on the Y-axis and along the X-axis are the most commonly used IV solutions. Drug Name Dose &/or Ranges Administration Compatibility Precautions Adenosine (adenocard) First dose 6mg, repeat within 1-2 minutes at . Apply judgment in using these results. Better business continuity for Nelnet now! medication compatibility chart I.v. Refer to drug manufacturer's labeling and use instructions for recommendations, USP <797>, and applicable institution policy for shelf life and sterility information of reconstituted product and admixture device compatibility. Fig. An independent peer-reviewed journal providing critical commentary on drugs and therapeutics. Incompatibility problems are more likely to arise when small concentrated volumes are mixed in a syringe rather than in the larger volume of an infusion bag. %%EOF To add drugs to be compared, the user only has to . The two types of incompatibilities associated with intravenous administration are physical and chemical.1,2, A drug interaction describes the alteration of a drug effect due to the influence of another substance (i.e. Midazolam (Versed) YES Midazolam (Versed) YES Midazolam (Versed) ** View Text Version Copyright Report Compatibility of a drug(s) is dependent on the manufacturer(s) of the products and/or the use of specific product formulations. 7db. Many institutions and schools subscribe to Micromedex products, which translates into free access for you. Checklist: Top 25 software capabilities for planning, profitability and risk in the banking industry, Optimizing balance sheets and leveraging risk to improve financial performance, How the EU Foreign Subsidies Regulation affects companies operating in the single market, Understanding why companies have to register to do business in another state, Industry experts anticipate less legislation, more regulation for 2023. This table was compiled for the convenience of . Qual Saf Health Care; 14(3): 190-195, 12 Riemann T, Schrder F. (2005) More effective prevention of incompatibility reactions through the use of four lumen central venous catheters in critically ill patients. q.pD&abjlurtMh""?7u9 eo:jWCIY#%E;%;ZgqvPWy{d&pk0k;%s*%@=)e cI2mJ2(zTv$5hu -d0)&2`\ I9d. Independent peer-reviewed journal providing critical commentary on drugs and therapeutics for health professionals, Provides health professionals with timely, independent and evidence-based information, Our new and ongoing programs for healthcare professionals. Cookies help us to ensure that we give you the best experience on our website. Dilution of injectable phenytoin by adding it to an infusion bag lowers its pH and therefore reduces its solubility resulting in precipitation of the drug. 1994-Present PEPID, LLC. King Guide to Parenteral Admixtures Online Edition. Drug combinations are tested for compatibility in solution. It is a list of 33 antibiotics and their given stability in several different solutions. Reasonable care is taken to provide accurate information at the time of creation. 2. hb```,Q ea8p3$H``h Murney P. To mix or not to mix compatibilities of parenteral drug solutions. Special Sections on Stability and Storage, Boxed Warning and Hazardous Drugs List and Identification, Proprietary and Generic Drug Names Included. The most prominent example of a pH-related reduction in solubility is dilution of phenytoin sodium injection. A green C means the drugs are compatible. /Feature/WoltersKluwer/OneWeb/SearchHeader/Search, The worlds most trusted medical research platform, Evidence-based drug referential solutions, Targeting infection prevention, pharmacy and sepsis management, Cloud-based tax preparation and compliance, workflow management and audit solution, Integrated tax, accounting and audit, and workflow software tools, Tax Preparation Software for Tax Preparers, Integrated regulatory compliance and reporting solution suite, Market leader in UCC filing, searches, and management, eOriginal securely digitizes the lending process from the close to the secondary market, Software solutions for risk & compliance, engineering & operations, and EHSQ & sustainability, Registered agent & business license solutions, The world's unrivalled and indispensable online resource for international arbitration research, Market-leading legal spend and matter management, contract lifecycle management, and analytics solutions, The master resource for Intellectual Property rights and registration. Many injectable drugs cannot be mixed together in syringes or infusions. Addition of an acidic drug solution to a solution containing a carbonate or bicarbonate may result in production of carbon dioxide gas. Timely, independent, evidence-based information on new drugs and medical tests, and changes to the PBS and MBS. 9787 0 obj <> endobj Integrate our IV compatibility tool into any. Source: hqinstitute.org Clinical Resource: Toolkit Pharm World Sci; 22(3): 88-91, 8 Tissot E, Cornette C, Demoly P, Jacquet M, Barale F, Capellier G. (1999) Medication errors at the administration stage in an intensive care unit. Albumin ? User Interface: Upon launching the app, the user is brought to a simple to use screen where there is an alphabetical list of IV medications. 9. New items will appear in the "Selected Items" field. FETROJA (cefiderocol) for injection, for intravenous use Initial U.S. Approval: 2019 -----INDICATIONS AND USAGE----- l indicated in patients 18 years of age or older who have limited or no alternative treatment options, for the . Use the reset filter button to go back to the default view. Reference texts can provide information, but data are often unavailable for new drugs. hWk0W=tlPIl-sYZ%fl~:YR|]6p|;HRIDP* C=9J)90EqL$1%re8E {.#s%&Z)g*b]TCD|y4WSDq6Dq6UcZq!Jxz #,4J. Among repeat test samples, microparticulate formation was electronically determined to have formed in some samples but not others. Truven Health Analytics, the makers of Micromedex, have released multiple standalone apps, and one of them happens to be an IV compatibility checker. http://www.ncbi.nlm.nih.gov/pubmed/17937330, drugs and inappropriate IV solutions as diluent, two drugs (drug-drug incompatibility) when they are, drugs and adjuvants (preservative, buffer, stabilizer, solvent). Antibiotic Compatibility Chart. The problem is frequently observed when diazepam injection is diluted. This is because of higher mutual drug concentrations and potentially greater pH changes in the more concentrated solution. Click on "Trissel's IV Compatibility" to open the module. 1986 Jul-Aug;6(4):82-3. Ketorolac Tromethamine IV Drug Compatibility Chart L Alteplase (Activase, rTPA) Amiodarone (Cordarone) Argatroban Atropine Calcium chloride Diltiazem (Cardizem) Dobutamine (Dobutrex) Dopamine Epinephrine (Adrenalin) Esmolol (Brevibloc) Furosemide (Lasix) Heparin Insulin (regular) Lidocaine (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate To view all solution and drug compatibility results for a single drug, enter the IV Drug and Click "View Compatibility". (2014) A clinical study on drug-related problems associated with intravenous drug administration. administration of intravenous (IV) medication to neonates. .1-.15mg/kg repeat q15 mins : Max .3mg/kg or 50mg . The King Guide to Parenteral Admixtures is designed to help practitioners decide which alternative administration strategy is best. With this app you will have access to the largest, most comprehensive IV compatibility resource which: Includes drug-solution compatibility results as well as drug-drug compatibility results when creating an admixture or administering via Y-Site. COMPATIBILITY OF DRUGS COMBINED IN A SYRINGE. BMJ Qual Saf; 20(12): 1027-34, 6 Hpner JH, Schulte A, Thiessen J, Knuf M, Huth RG. 3 Emami S, Hamishehkar H, Mahmoodpoor A, Mashayekhi S, Asgharian P. (2012) Errors of oral medication administration in a patient with enteral feeding tube. BHz8DOGvcPoHH~` iNJ2)uIarvCmWp(l 6%{k`7;I;B+ H& 4T "!U=/p aQ]N{iT2,&dOK.~;.u;Oyem~/Q_s(d;;HMYE -"bpVghUmM01@#nS|x5213$qHfd6hAH%icIsI5sR%> `$`S_?) When two drug solutions are mixed together the absence of a visible reaction does not exclude degradation of either drug. Y-Site, Syringe, and other sets/container specific information. What makes a difference? drug, chemical substance, nutrition) resulting in a solution that is no longer optimal for the patient after the substances are mixed.1,3, (1) Taxis K, Barber N. (2004) Incidence and severity of intravenous drug errors in a German hospital. 194 0 obj <>stream 2015-05-04. For research results that do not fit these conventional guidelines, the research results are designated as Uncertain or Variable. Click "Get Compatibility" once both drugs are selected PEPID's IV Compatibility tool is included in any every clinical decision support suite New compatibility information was added to the existing drug monograph for AMPHOTERICIN B, BUMETANIDE, FOSFOMYCIN DISODIUM, PLAZOMICIN, SCOPOLAMINE HYDROBROMIDE, and IMIPENEM, CILASTATIN AND RELEBACTAM with 28 other drugs. We start 2023 with the following list of 603 injectable drugs currently found in the King Guide to Parenteral Admixtures Loose-Leaf, and Internet Editions. Critical Care Intravenous Drug Administration Guide For Use on ICU, HDU & CTCCU Page 1 of 44 April 2008 (For review April 2009) . IV Medication Safety: The right rate While your IV infusions will be programmed on your pump or by drops per minute, your IV push medications are given at the rate you push them. The ongoing shortage of drugs, and especially small volume parenteral solutions, is causing changes in methods of drug administration. A change in visible or electronically (even if not visible) particulates, haziness, or turbidity, frank precipitation, color or gas evolution occurred. AN\=l93 eJ .Dv;wahf*|7Qq''BCLr_D]psG1W0 Sodium bicarbonate and mannitol solutions should not be used as diluent for intravenous drug administration. In these formulations, dilution of the non-aqueous injection vehicle with water or saline may precipitate the drug. A method to determine hospital costs associated with nosocomial infections (transl), Ann Ig 2007; 19(4): 381-392http://www.ncbi.nlm.nih.gov/pubmed/17937330. This application provides the healthcare profession with a method of quickly checking the compatibility of any two of the following intravenous drugs at the Y-site: Acetylcysteine. This was the third project that I was assigned at Oconee Medical center. Corporations and LLCs doing business in another state? Handbook on injectable drugs. Practical information, tools and resources for health professionals and staff to help improve the quality of health care and safety for patients. This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Copyright 2021 GlobalRPH - Web Development by, IV Dilutions Medication Reference and Infusion Guidelines, Renal dosing for healthcare professionals, HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Jonathan Petersen. IV Drug Compatibility 12+ ITDCS Ltd Designed for iPad 1.3 16 Ratings $2.99 Screenshots iPad iPhone This application provides the healthcare profession with a method of quickly checking the compatibility of any two of the following intravenous drugs at the Y-site: Acetylcysteine Adrenaline Alfentanil Aminophylline Amiodarone Aprotinin The Australian recommendations for the use of antibiotics in the prevention of endocarditis have been revised by Therapeutic Guidelines. The link displays the drug concentrations used in the studies, additional information on the vehicle used, and each studys findings. Empowering physicians with fast, accurate clinical answers, Beyond the call: How to differentiate your telehealth experience post-visit, Implementing 2023 updates to your Antimicrobial Stewardship Program. Possible drug/solution selections will be displayed as you continue to type. Copyright 1993-2021 6-Methylmercaptopurine (MMPR) A Abciximab Acetaminophen Acetazolamide Sodium Acetylcysteine ACTH Acyclovir Sodium Adenosine Alatrofloxacin Mesylate Albumin, Serum Human Alcohol, Ethyl Anaesthesist; 52(5): 409-12, 10 Taxis K, Barber N. (2004) Incidence and severity of intravenous drug errors in a German hospital. hXmo8+UEw'EUBJRmwNBRb8x0_N%p F9)c'R&(a&LH*$("A7(P&|I#\(NU?ANI"4R`2DVT@0AX|N4nE`] 4IV,\;{^Q8q9bcFO>C@Do\#+Uhju}4wQTLG/| {0pR(7%?$sM7kB(h9hY* ^?r37HE2hHGp0JE~fqpyzlFE'&abRoXIPoTD L ExUoib:"nt/x]q>=YZ+Bc#,%3}~(qYKjs@x' ? Incompatibility can involve precipitation, ionic reactions, evolution of gas and denaturation of biological molecules. Fortunately, King Guide, the oldest continuously published reference on parenteral drug stability and compatibility, is designed to provide practitioners with the timely information they need in this era of drug shortages. However, a small number of injection solutions are formulated in non-aqueous solvents to allow dissolution of a poorly water soluble substance in a small volume. To determine the physical intravenous Y-site compatibility of 19 commonly used medications at pediatric concentrations with 3 different types o . 3. Trissel LA. 4. The compatibility or incompatibility of IV medication is an important consideration in drug administration, especially since it is not unusual for multiple drugs to be administered through y-site connectors on continuous infusion administration sets. Over 600 IV drugs with at-a-glance view of compatibility in 12 fluids. X^P7&+5 Fig. The booklet versions of Therapeutic Guidelines: Antibiotic and Therapeutic Guidelines: Oral and Dental will be updated when new editions are published. 1. Mixing solutions containing calcium or magnesium ions has a substantial risk of forming an insoluble calcium or magnesium salt. When both drugs are present in the "Drug List" on the left, click the "Run Report" button. You can use the IV Drugs/Solutions search bars on the left at any time to enter new drugs to be screened. The majority of sources cited define compatibility by physical compatibility rather than chemical compatibility This table is a guide only. Disclaimer: This IV Drug Compatibility Chart is provided as a quick reference, however since information is . Specialist references dealing with their mutual compatibilities need to be consulted.3,4. Making safe and wise decisions for biological disease-modifying antirheumatic drugs (bDMARDs) and other specialised medicines. %PDF-1.6 % Purpose/objectives: To examine the cause(s) and types of IV incompatibilities that can occur in the oncology population, to present information on commonly used oncologic medications, to identify resources available to nurses, and to provide specific interventions designed to prevent incompatibilities in various oncology settings. Read our privacy policy. Do Not Copy, Distribute or otherwise Disseminate without express permission. We would be pleased to provide you with more information. within the same infusion line (simultaneous infusion) and/or IV container - administered one after the other, but within the same infusion line Drug pairs with conflicting compatibility results may often have different concentrations used or other differences to account for the variability. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . The single user license allows access from any computer or device from any location and limits access to one person at a time while the site license allows access from an unlimited number of computers or devices. The more medicines you take, the more difficult it can be to remember important information about them. Only 212/820 (26%) co-infusions of drugs were compatible. Some incompatibilities are eminently predictable from simple chemical knowledge, but most compatibilities and incompatibilities are not so easily predicted. Search for and click on a drug 2. Adverse effects of drug incompatibilities extend periods of patients hospitalization and the total costs for hospitals. A visual check for precipitation, turbidity or colour change should be carried out before administering the mixture, but does not guarantee compatibility. While some general principles can be applied to the mixing of injection solutions, they are fraught with exception and applicability varies with circumstance. Fig. When in contact with other fluids it precipitates as well. (2005) Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France. The most obvious case of pH reduction in solubility is the dilution of sodium phenytoin injection. Step 2 Select a second drug the same way, 3. Of the 196 co-infusions, 110 had additional restrictions on time in solution. Definitions for the following types of compatibility testing are as follows: Y-site Compatibility - A single drug that is administered simultaneously at a Y-site connection with another drug in a solution Solution Compatibility - A single drug in a solution Admixture Compatibility - Two drugs in a solution Standards for Infusion Therapy. Administer with a 0.22 micron filter. "d @7. Incompatibility between infusion-bolus was found to be 26.6%. Mixing magnesium sulfate 50% and calcium chloride 10% results in precipitation of insoluble calcium sulfate. Thyroid disease: challenges in primary care, To mix or not to mix compatibilities of parenteral drug solutions, difficulties with venous access limiting the number of intravenous lines available for continuous administration of multiple drugs, multiple drugs requiring parenteral administration within a short time frame such as in a home visit by a general practitioner. Some cannot be safely diluted in infusion bags. Nursing: March 2008 - Volume 38 - Issue 3 - p 15. doi: 10.1097/01.NURSE.0000312600.67772.13. Enter one drug and click View compatibility. The default compatibility result will display the solution compatibilities for the IV Drug searched. For this reason, the decision to mix any two injection solutions whether in a syringe, in an infusion bag or at a Y-site should be based on a reliable reference. When this occurred, "incompatible" was used. Other drugs which demonstrate solubility problems and which are formulated in injection vehicles other than simple aqueous solutions include digoxin, clonazepam, phenytoin, amiodarone and phytomenadione. The Vial2Bag Advanced 20mm admixture device is not compatible for use with all drug products. All subscriptions provide for access from any computer, tablet or phone. To view compatibility results for a list of drugs, enter multiple IV drugs and/or solutions then click "Analyze". Five years after the implementation of a simple "colour code system". medication compatibility chart Crit Care Nurse. The mixing of drug salts of calcium, and to a lesser extent magnesium, with phosphates, carbonates, bicarbonates, tartrates or sulfates should also be avoided. e^QHv` % Lexicomp Trissels IV Compatibility Databases. With workflows optimized by technology and guided by deep domain expertise, we help organizations grow, manage, and protect their businesses and their clients businesses. Micromedex IV Compatability is a reliable resource for on-the-go access to the industry's most trusted clinical reference information, providing users with more informed treatment decisions at the point of care. &2dG&SGi`B N PraWp#ZNkb}s&,V T8=L cUATj8c? Intravenous rehydration is a simple, safe and common procedure with a low risk of complications. Learn more about our innovation hub and present your idea. endstream endobj startxref 140 0 obj <> endobj One or more drug components in the test samples exhibited a loss of intact drug greater than 10% within 24 hours under the conditions being tested. View answers to our most frequently asked question. !k> Y = compatible for at least 30 minutes P = provisionally compatible; give within 15 minutes P(5) = provisionally compatible; give within 5 minutes . medication compatibility chart I.v. Prescription and OTC drugs (over 100,000 drug products), 900+ nutraceuticals, including herbal medicines, Presented in prescriptive, immediately actionable bullet points for busy clinicians and students. Consistently checking alternative modes of administration and/or using multi-lumen catheters. Visit our global site, or select a location. The salts of monovalent cations, such as sodium and potassium, are generally more soluble than those of divalent cations, such as calcium and magnesium. Call your doctor for medical advice about serious . Incompatibility can also occur between medications or fluids and certain types of container materials. Consequences of physicochemical drug incompatibilities are particularly severe in neonate and pediatric patients.1,4,6, There is little published scientific information about the frequency of drug incompatibility reactions. Premium IV-Administration Set with AirStop andPrimestop, Antimicrobial modified four-lumen catheter sets for catheterization of the vena cava according to the Seldinger method with the possibility of ECG based Central Venous Catheter tip placement and position control, 0.2 m infusion filter with positively charged membrane, Stopcock system for infusion therapy and monitoring. J Res Pharm Pract; (1): 37-40, 4 Vijayakumar A, Sharon EV, Teena J, Nobil S, Nazeer I. To remove an individual drug or solution, click on the X next to the name. With no software to install and no updates to apply practitioners are assured of having the latest and most up-to-date information available. A separate license is required for each facility location and we offer discounts for multiple licenses. A number of references, in addition to the manufacturer's product information, are available. These include the Australian Injectable Drugs Handbook.2 Table 1 shows some of the compatibility and incompatibility data currently available. Get full access to PEPID for 2 weeks with a free trial, or contact us to learn more about integrating the IV Compatibility Checker and the PEPID Knowledgebase into your health IT system. 0 The King Guide has been updated quarterly since 1971 and is an excellent addition to any drug information library with complete monographs for over 600 injectable drugs. We streamline legal and regulatory research, analysis, and workflows to drive value to organizations, ensuring more transparent, just and safe societies. The King Guide to Parenteral Admixtures exceeds TJC requirements for updated references, is NABP endorsed and listed by name by many state pharmacy boards as a required reference. Biological substances including blood products and insulin are prone to denaturation when exposed to variations in pH and osmolality. Don't let the courthouse door close on you. Meropenem (infusion) and pantoprazole (bolus) constituted 16.6%. J Basic Clin Pharm; 5(2): 49-53, 5 Westbrook JI, Rob MI, Woods A, Parry D. (2011) Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. Full information can be obtained from your pharmacy department Key References Adrenaline 18 1 Compatible (Reference 1) 1 "Handbook of Injectable Drugs" Lawrence Trissel available on www.medicinescomplete.com The online edition started as a direct replacement for the original loose-leaf King Guide. (2007) Preparation of a compatibility chart for intravenous drug therapy in neonatal and pediatric intensive care units. On$a }; Special Sections on Stability and Storage 2. If drugs are mixed together, the mixture should be inspected for precipitates, turbidity or changes in colour, however not all incompatibilities are visible.