Anticoagulant profile of iopamidol and meglumine amidotrizoate and their lack of thrombin

generation: an in vitro study

Gritli N; Nsiri B; Mazigh C; Ghazouani E; M'Henni H; Machghoul S; Gueddiche M

The aim of this in vitro study was to sketch the subtle anticoagulant profile of iopamidol 300 mg l
/ml (low osmolality non ionic contrast medium) and meglumine amidotrizoate 370 mg l/ml
(high osmolality ionic contrast medium) in situations where variable amounts of clotting factors
are observed and to check whether thrombin-generation significantly occurred in non
anticoagulated blood-contrast materials mixtures. In the first experiment, mixtures of deficient
plasmas with a routine plasma pool provided different ranges with variable amounts of clotting
factors II, V, VIII, X, XI and XII. For each clotting factor level studied within these ranges, an
activated partial thromboplastin time was determined with either contrast material loaded
thromboplastin (5% v/v) or glucose loaded thromboplastin (5% v/v) used as a control. In the
second experiment fibrino-peptide A (FpA) or modified antithrombin III (ATM) assays were
performed in either (9:1) non anti-coagulated blood contrast materials mixtures or blood-glucose
mixtures (control). Differing aPTT prolongation profiles were observed when clotting factors V,
VIII, XI and XII were lowered in the plasma. However, neither iopamidol nor amidotrizoate
induced an aPTT prolongation with decreasing clotting factor II. In the second experiment no
significant thrombin generation was observed as both blood-contrast materials mixtures showed
significantly lower FpA and ATM levels (p < 0.001) than glucose control after 5 minutes and 10
minutes incubation at room temperature. These findings provide evidence that the use of
iopamidol in angiographic procedures does not increase risk of clotting or hemorrhage.
Ethical observations on the choice of parenteral solvents. Choice of parenteral solvent...

Bracq Elise; Lahiani-Skiba Malika; Guerbet Michel

The parenteral administration of insoluble drugs leads to the use of biologically active solvents
inducing effects associated with ethical cause of concern including pain and pharmacological
interactions. Selected vehicles currently used were ethically and scientifically reviewed. Our
investigations allowed reinforcing the formulation decision tree with an ethical point of view. The
last generation of cyclodextrin appears to be the safest solvent. Second choice could be lipidic
emulsions, third choice being co-solvents, and finally non-ionic surfactants because of their
hypersensitivity reactions. Screening tests including pH, osmolality measurements, cytotoxicity,
and hemotoxicity, should allow to check the formulation tolerance before the animals'
administration.
Standard fortification of preterm human milk fails to meet
recommended protein intake: Bedside evaluation by Near-Infrared-
Reflectance-Analysis
Corvaglia Luigi; Aceti Arianna; Paoletti Vittoria; Mariani Elisa; Patrono Daniela; Ancora Gina;
Capretti Maria Grazia; Faldella Giacomo

BACKGROUND: Protein content of preterm human milk (HM) is relatively low and extremely
variable among mothers: thus, recommended protein intake is rarely met. OBJECTIVES: To
evaluate in a NICU setting if HM protein content after standard fortification meets the
recommended intake, and also to check the effect of fortification on the osmolality of HM, as an
index of feeding intolerance. METHODS: Protein content of 34 preterm HM samples was
evaluated by a bedside technique (Near-Infrared-Reflectance-Analysis - NIRA); osmolality was
also checked. Seventeen samples were fortified with Aptamil BMF, Milupa (Group A) and 17
with FM85, Nestle (Group B). Fortification was performed as recommended by the manufacturer
("full fortification [FF]") and also with a lower amount of fortifier ("low-dose fortification [LF]")
. After fortification, actual protein content was calculated and compared to that needed to meet
recommended intake (2.33-3g/dl), and osmolality was measured. RESULTS: After FF, protein
content was above 3g/dl in none of the samples, and below 2.33 g/dl in 16/34 samples (11 in Group
A, 5 in Group B). After LF, protein content was above 3g/dl in none of the samples and below
2.33 g/dl in 32/34 samples (15 in Group A, 17 in Group B). Osmolality exceeded 400 mOsm/kg
in 19 samples after FF (10 in Group A, 9 in Group B) and in 2/34 samples after LF (1 in each
group). CONCLUSION: HM protein content after standard fortification fails to meet the
recommended intake for preterm infants in approximately half of the cases.