Ottimizzazione del piano terapeutico durante la pandemia di COVID-19: uno studio esaustivo di compatibilità fisico-chimica di farmaci utilizzati in terapia intensiva.

The first wave of SARS-CoV-2 has resulted in a dramatic raise of the demand for medical devices and drugs. In this context, an important shortage of programmable syringe pumps, used to administrate different drugs in intensive care units, was seen. The opportunity of administrating combinations of five intensive care units selected drugs (Sufentanil, Clonidine, Loxapine, Midazolam and Ketamine) was considered. The medicinal chemistry profile of these drugs was delineated, and potential chemical interactions were considered. The drug mixtures were studied in a pure form or diluted in NaCl 0.9% or G5%. Twenty-six possible combinations of the five drugs were produced in glass vials or polypropylene syringes and stored at 25°C for 14 days. The LC method was implemented to study drug combinations in presence of the degradation products. The clearness and pH were also monitored. All the twenty-six possible combinations displayed adequate physicochemical stability at 25°C: at least 3 days and 7 days respectively for the dilution in 0.9% NaCl or G5%. The study provided sufficient stability results, covering the medication administration period of at least three days. The combination of more than two drugs with the same activity offers the advantage of minimizing the individual doses and reduces unwanted side-effects. Hence, this study opens up the possibility of combining the 5 drugs in one single syringe, which is useful especially under the current circumstances associated with an important shortage of programmable syringe pumps and pharmaceuticals.