Handling injectable medications: mixing drugs.

This article discusses the practice of mixing injectable medications in anesthesia, which is not covered in recent guidelines on safe administration. The authors highlight the increasing prevalence of mixing medications, such as the components of total intravenous anesthesia (TIVA), antibiotics, anti-emetics, and analgesics. While guidelines do not endorse the mixing of propofol and remifentanil, there is emerging discourse within the anesthesia community on its acceptability. The article emphasizes the need for a stronger consensus on mixing injectable medications, considering factors like chemical compatibility and pharmacokinetic properties. The authors also mention the lack of a validated pharmacokinetic model for propofol and remifentanil admixtures, leading to complexities in dosing recommendations. The article suggests that separate guidance may be needed for adult and pediatric anesthesia, and highlights the risks and responsibilities associated with using unlicensed ad-hoc admixtures. [Extracted from the article]