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Stability of Epinephrine in a Normal Saline Solution
Caroline M. SawickiDDS, PhD,
Daniel B. McKimPhD,
Hongrui WangMS,
Morgan VasasBS,
Joshua J. BlakesleePhD,
Courtney A. JatanaDDS, MS,
Patrick DibPhD,
Bryant W. CorneliusDDS, MS, and
Spencer D. WadeDDS, MS
Article Category: Research Article
Volume/Issue: Volume 71: Issue 3
Online Publication Date: Sep 09, 2024
DOI: 10.2344/998301
Page Range: 109 – 114

Administration (FDA) guidelines for storage. 6 – 11 However, a gap in knowledge exists regarding epinephrine stability in common hospital conditions for up to 90 days. Such information could potentially encourage manufacturers to create a prefilled low-dose (10 µg/mL) epinephrine product that meets FDA standards for storage. Currently, a 10 µg/mL epinephrine product is not commonly available and would require a double serial dilution of the 1 mg/mL solution or single dilution of the 100 µg/mL solution. The primary objective of this study was to determine the stability of 1

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Figure 4.; Sterility Testing Colony-forming units (CFUs) represent contamination as a function of the number of microbial cells present in the indicated samples. Samples 1 to 60 and the negative control sample did not show evidence of contamination (n.d. = no difference) due to absence of microbial cells. Positive controls showed evidence of contamination as expected.
Caroline M. Sawicki,
Daniel B. McKim,
Hongrui Wang,
Morgan Vasas,
Joshua J. Blakeslee,
Courtney A. Jatana,
Patrick Dib,
Bryant W. Cornelius, and
Spencer D. Wade
Figure 4.
Figure 4.

Sterility Testing

Colony-forming units (CFUs) represent contamination as a function of the number of microbial cells present in the indicated samples. Samples 1 to 60 and the negative control sample did not show evidence of contamination (n.d. = no difference) due to absence of microbial cells. Positive controls showed evidence of contamination as expected.


Caroline M. Sawicki,
Daniel B. McKim,
Hongrui Wang,
Morgan Vasas,
Joshua J. Blakeslee,
Courtney A. Jatana,
Patrick Dib,
Bryant W. Cornelius, and
Spencer D. Wade
Figure 3.
Figure 3.

Epinephrine Concentration Between 0 and 90 Days

The relatively uniform concentrations of epinephrine observed in samples across all day, light, and temperature treatments indicate that little or no degradation of epinephrine occurred in samples, regardless of the storage conditions. Bars represent average ± SD.


Caroline M. Sawicki,
Daniel B. McKim,
Hongrui Wang,
Morgan Vasas,
Joshua J. Blakeslee,
Courtney A. Jatana,
Patrick Dib,
Bryant W. Cornelius, and
Spencer D. Wade
Figure 2.
Figure 2.

Epinephrine Concentration Between 0 and 30 Days

The relatively uniform concentrations of epinephrine observed in samples across all day, light, and temperature treatments indicate that little or no degradation of epinephrine occurred in samples, regardless of the storage conditions. Bars represent average ± SD.


Caroline M. Sawicki,
Daniel B. McKim,
Hongrui Wang,
Morgan Vasas,
Joshua J. Blakeslee,
Courtney A. Jatana,
Patrick Dib,
Bryant W. Cornelius, and
Spencer D. Wade
Figure 1.
Figure 1.

CZE Concentration Response Curve

Representative concentration-response curve for CZE analysis of epinephrine. Epinephrine levels were quantified using diode array detection (DAD) at a wavelength of 205 nm. A stock solution of epinephrine was used to generate an 8-point standard curve, and the results of this concentration curve are shown here. Linearity of response, which is critical for quantification of epinephrine in solution, was demonstrated to be achievable across the range of epinephrine concentrations encountered in this study. The best-fit line for the standard curve shown here had an r2 value of 0.9962, indicating a high degree of linearity and a strong correlation between concentration and absorbance unit response (peak area) across the concentrations of epinephrine used in subsequent experiments. The limit of detection (LOD) for epinephrine solutions used in this study was 1 µg/mL, and the maximum concentration on the standard curve was 50 µg/mL.


Masahiro HeimaRDT, DDS, PhD and
Kelsey StehliDDS
Article Category: Research Article
Volume/Issue: Volume 69: Issue 3
Online Publication Date: Oct 06, 2022
Page Range: 13 – 19

analysis has never been performed on such tests given to children. Based on our systematic literature review, we found no articles studying the reliability and validity of the DAQ administered to children. Although there is no research to determine which single-item survey is the best for children, the DAQ seems to be used more frequently in research projects compared with other single-item questions or surveys. The primary aim of this research was to assess the psychometric properties, specifically the test-retest (ie, stability) reliability, criterion validity

Kyle J. KramerDDS, MS,
Steven GanzbergDMD, MS,
Simon PriorBDS, PhD, MS, and
Robert G. RashidDDS, MAS
Article Category: Other
Volume/Issue: Volume 59: Issue 3
Online Publication Date: Jan 01, 2012
Page Range: 107 – 117

, number of propofol rescue boluses required, or the number of participants who required additional local anesthetic ( Table 2 ). The total dose of propofol administered was statistically significantly different, with the ketamine group receiving 432.1 ± 155.0 mg and the remifentanil group receiving 321.2 ± 122.7 mg, a difference of 110.9 mg ( P = .029). Table 2. Infusion Dosages Hemodynamic Stability The measures of hemodynamic

Austen L. WeeksDDS, MA,
John SotosDDS,
Bryce WoolseyDDS,
William M. JohnstonMS, PhD, and
Bryant W. CorneliusDDS, MBA, MPH
Article Category: Research Article
Volume/Issue: Volume 70: Issue 2
Online Publication Date: Jun 28, 2023
Page Range: 53 – 57

salivation, bradycardia) independently warrants an anticholinergic like IV glycopyrrolate at the time rocuronium is administered, unintended mixture may occur. Although coadministration is possible, the current literature is devoid of any discussion regarding the compatibility and stability of glycopyrrolate and rocuronium combined. The objective of this study was to determine if glycopyrrolate and rocuronium are physically compatible when combined for up to 60 minutes. While these drugs are not usually mixed in the same syringe, residual drug present in the IV

Yoshiki ShionoyaDDS, PhD,
Kaoru HirayamaDDS,
Kaho SaitoDDS,
Eriko KawasakiDDS,
Yoko KantakeDDS,
Hazuki OkamotoDDS, PhD,
Takahiro GoiDDS,
Katsuhisa SunadaDDS, PhD, and
Kiminari NakamuraDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
Page Range: 24 – 29

, decreasing the risk of ventricular tachycardia, and could be an additional option. 20 CONCLUSION CPVT is characterized by catecholamine-induced fatal arrhythmias, which lead to syncope and sudden death. Because invasive surgical procedures can induce emotional stress in patients with CPVT, there is a need for anesthetic management. DEX-based IV sedation has a centrally acting sympatholytic effect, minimally impacts respiratory stability, and was successfully used in combination with midazolam for oral surgery in a patient with CPVT. Use of DEX

Yoshio HayakawaDDS, PhD,
Keiko Fujii-AbeDDS, PhD,
Sayaka AkitomiDDS,
Shihomi NiwaDDS,
Michiru AbeDDS,
Manami OtsukaDDS, PhD,
Maho IkedaDDS,
Takumi IshikawaDDS, PhD,
Manami YajimaDDS, PhD, and
Hiroshi KawaharaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 70: Issue 4
Online Publication Date: Jan 15, 2024
Page Range: 159 – 167

, potential for significant cardiovascular depression, vascular pain during injection, and high fat content, and it is not water-soluble. This study compared the use of remimazolam or propofol as the general anesthetic agent in oral surgical operations for up to approximately 2 hours. The main objective of this study was to compare remimazolam and propofol used for general anesthesia by assessing cardiovascular stability and anesthetic depth as determined by EEG. Secondary objectives included time to loss of consciousness, time to extubation, administered opioid