{
  "abstract": "Background and Importance Intensive Care Units (ICUs) manage critically ill patients, often with neurological conditions requiring anticonvulsant therapy. These patients frequently require concurrent administration of vasoactive agents to maintain haemodynamic stability. The compatibility and potential interactions between these drug classes are crucial to avoid adverse events in complex clinical settings.Aim and Objectives To define Y-site compatibilities and pharmacological interactions between anticonvulsant and vasoactive drugs, enabling their co-administration in parenteral therapy.Material and Methods A peer-reviewed literature search was conducted to evaluate Y-site compatibilities and drug interactions between anticonvulsants and vasoactive agents. For Y-site compatibility data, the web applications Stabilis and Micromedex were consulted, along with the databases PubMed, Google Scholar, and drug product information (SmPCs). Drug interaction data were retrieved from UpToDate, Drugs.com, and Micromedex, as well as PubMed and Google Scholar. Analysis was performed independently by author pairs to ensure methodological rigour and data reliability.Results A total of 63 Y-site compatibility combinations and 98 potential drug interactions were analysed between anticonvulsants (phenytoin, valproate, levetiracetam, phenobarbital, lacosamide, brivaracetam, topiramate, perampanel, tiagabine, and ethosuximide) and vasoactive drugs (adrenaline, noradrenaline, isoprenaline, dopamine, dobutamine, vasopressin, and phenylephrine).Y–site compatibility analysis revealed:28 compatible pairs (44.4%)12 incompatible pairs (19.1%)23 pairs with no available informationInteraction analysis showed:89 combinations without significant interactions2 combinations requiring specific cardiac monitoring: vasopressin–lacosamide and propofol–vasopressin7 combinations with insufficient dataDespite general compatibility, enhanced monitoring is recommended for phenytoin, valproic acid, and carbamazepine due to their enzyme induction/inhibition profiles (CYP3A4 – CYP450).Based on the project, compatibility and interaction tables were developed as an information resource for critical situations in the pharmacy service.Conclusion and Relevance Although data on Y-site compatibilities are limited, the co-administration of anticonvulsants and vasoactive agents appears to involve few clinically significant interactions. Nonetheless, a thorough pharmacological assessment is essential before parenteral co-administration. This review highlights the key role of hospital pharmacists in ICU settings to ensure the safe management of high risk medications, especially those with a narrow therapeutic index. Clinical decisions should always consider individual risk-benefit assessments.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "E Tejedor-Tejada"
    },
    {
      "affiliations": [
        "Hospital José Germain, Pharmacy, Madrid, Spain"
      ],
      "name": "A Puebla Villaescusa"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "N Nadal Portugues"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "I Cores Rodriguez"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "L Marin Ventura"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "L Garcia-Lopez"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "M Fernández González"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "S Herrero Bermejo"
    },
    {
      "affiliations": [
        "Hospital of Segovia, Pharmacy, Segovia, Spain"
      ],
      "name": "R Coloma Peral"
    }
  ],
  "title": "4CPS-118 Y-site compatibility and interaction analysis of anticonvulsants and vasoactive agents in critical care settings",
  "uid": "ce828023-9ab9-51b8-a0fe-406a23a7e8b2"
}