What scenario illustrates the danger of chemical incompatibility concerning two antibiotics in an intravenous solution over several hours?

Answer

A shift toward basic pH accelerating hydrolysis of the first drug, leading to sub-therapeutic dosing.

The scenario involving two antibiotics illustrates a classic chemical incompatibility driven by $\text{pH}$ sensitivity and hydrolysis over time. If the first antibiotic requires a slightly acidic environment to remain chemically stable, and the addition of the second drug raises the overall solution $\text{pH}$ towards the basic range, the rate of hydrolysis for the first drug dramatically increases. This chemical reaction breaks down the first antibiotic molecule. Because the IV solution is infused over several hours, this degradation occurs continuously during administration. Consequently, by the midpoint of the infusion, the patient is receiving significantly less than the prescribed dose of the necessary antibiotic, resulting in the failure of the prescribed treatment regimen.

What scenario illustrates the danger of chemical incompatibility concerning two antibiotics in an intravenous solution over several hours?

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