Comparison of EMERPHED® (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings Science PG
Date
12/01/2021Abstract
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.
