Extended Stability for Parenteral Drugs

Get the support you need to safely extend dating of parenteral drugs beyond the usual 24-hour limit—minimizing waste, lowering medication costs, and enabling optimal patient administration schedules at alternate infusion sites. 

ASHP’s sixth edition of Extended Stability for Parenteral Drugs, by Caryn Dellamorte Bing, RPh, MS, FASHP and Anna Nowobilski-Vasilios, PharmD, MBA, FASHP, BCNSP, covers all aspects of determining stability, including the changing elastomeric landscape and the ongoing variability in stability data.

New in this edition:

• Nearly all 165 stability monographs completely updated
• Including 11 new stability monographs
• Updated chapters on applying stability data in patient care and parenteral nutrition
• Previously unpublished data for specific types of infusion devices and containers
• Direct communications from drug and device manufacturers, and a focused review of previously published data from practitioners

With its expanded coverage, many updates, and new information, Extended Stability provides even more support, making it a “must have” for any practice in which pharmaceutical solutions are prepared and administered.

Caryn Dellamorte Bing, RPh, MS, FASHP

Caryn Dellamorte Bing is Senior Manager Clinical Services and PGY1 Residency Program Director for Critical Care Systems (CCS), Inc., a national home and specialty infusion provider. Her corporate responsibilities at CCS have included development of clinical standards of practice, clinician training and professional development, and leadership and management of CCS PGY1 pharmacy residency program at five locations. Ms. Bing’s 30-year career includes corporate leadership, general management, operations, clinical management, accreditation surveyor, consulting, training, and pharmacy practice roles in home/specialty infusion and other alternate site and acute care practice settings. She holds a BS from University of Illinois College of Pharmacy and MS in Health Systems Management from Rush University. Ms. Bing completed her pharmacy residency at Rush-Presbyterian-St. Luke’s Medical Center. She is a Rho Chi Scholar and Fellow of the American Society of Health-System Pharmacists.

Bing has been active in professional association leadership throughout her career, including terms as a presidential officer for the Illinois and Nevada ASHP state affiliates, and as an ASHP Delegate and Alternate Delegate numerous times. She served on the ASHP Home Care Section Executive Committee and was Chairperson for the ASHP Continuity of Care Task Force. She received the first Distinguished Service Award from the ASHP Home Care Section. Ms. Bing served on editorial boards for AJHP, the Journal of Pharmacy Practice, and Perspectives in Pharmacy; has published a number of articles and book chapters; and has presented at many state and national meetings. Bing has been editor of Extended Stability for Parenteral Drugs since its inception.

Anna Nowobilski-Vasilios, PharmD, MBA, FASHP, CNSC, BSNCP

Dr. Nowobilski-Vasilios is Principal at her consulting firm, Anovation Care Management Innovation. As a home infusion and specialty pharmacy industry veteran, she has held various clinical and management positions within healthcare organizations ranging from hospitals to home health agencies and home infusion providers. Her clients have included home infusion pharmacies, specialty pharmacies, ambulatory infusion clinics, accrediting organizations, colleges of pharmacy, professional associations, and medical education providers. She received her BSc in Pharmacy from the University of Illinois, MBA from the Keller Graduate School of Management, and PharmD from Midwestern University. In 2009, she received the University of Illinois College of Pharmacy Alumni of the Year Award.

She is an active member of several national and state professional associations (ASHP, ICHP, NHIA, ASPEN, INS) and the Polish American Pharmacists’ Association (PAPA), which named her Member of the Year in 2012. Dr. Nowobilski-Vasilios delivered numerous presentations, and has published articles on the subjects of home infusion therapy, specialty pharmacy, nutrition support, sterile preparation, new drugs, and interdisciplinary collaboration. She authored the Home Infusion chapter within the 22nd edition of Remington: The Science and Practice of Pharmacy and has been a contributing writer and co-editor of Caryn Dellamorte Bing's Extended Stability for Parenteral Drugs.

WRITERS

Gene Bernieri

Stanley N. Chamallas

Donald J. Filibeck

Crystin Gloude

Brenda L. Gray

Annemarie Hocking

Barbara Limburg-Mancini

Kevn M. McNamara

Diane Nitzki-George

Shamir K. Patel

Kevin L. Ross

Lisa L. Siefert

Paula Zelle

“This is considered to be the foundation book for extended stability.”

Lawrence P. Carey, BS, PharmD, Doody's Review Service, 2017

The Pharmaceutical Journal, 2 February 2018

[REVIEWER'S EXPERT OPINION]

Laurence A. Goldberg (Pharmaceutical Consultant from Bury, Lancashire)

Stability data for many parenteral drugs beyond 24 hours are often difficult to find in the published literature. This has been a complicating factor in the care of patients being treated outside the hospital environment. When home infusion therapy emerged and grew in the 1980s and 1990s, accurate information on extended stability of compounded injections was very limited. Pharmacists were challenged to find drug stability data that supported realistic and cost-effective compounding and delivery schedules to patients’ homes.

Some commercial infusion companies put considerable resources into the task of compiling drug stability information to support their own operational and patient care services by employing full-time drug information specialists to support clinicians in the field. The highly competitive nature of the home infusion industry also led to the development of unpublished drug stability data, based on independent studies undertaken by large home infusion companies. More recently, high-cost parenteral drugs and drug shortages have forced practitioners to consider the need for extended beyond-use dating in order to limit wastage of these expensive or ‘short supply’ drugs.

This book comprises 165 monographs, including 11 new to this edition. Each monograph represents a drug for which some extended stability information for the compounded injection is available. The monographs selected include most of the anti-infective agents, several monoclonal antibodies and other parenteral drugs for which useful extended stability data are available. They cite most extended stability data available at the time of publication. Many of the monographs are referenced by well-known sources, such as the Handbook on Injectable Drugs. Additional references and sources include previously unpublished data for specific types of infusion devices and containers, direct communications from drug and device manufacturers, and a focused review of previously published data from practitioners.

The monographs are presented alphabetically by generic name. Stability data for the drugs in various containers, solutions, concentrations, temperature, storage and administration conditions are included.

Practitioners who are unfamiliar with this book and the principles of extended stability should begin by reading the first chapter, ‘Applying stability data in patient care.’ This introduction covers a wide range of topics including duration of therapy, vascular access, administration methods, infusion devices and drug delivery systems, together with basic information on osmolarity, pH and temperature.

Primary: home and ambulatory care pharmacies; alternate site infusion companies (National Home Infusion Association)

Secondary: directors of pharmacy