- plain plastic - catheter over needle or catheter outside needle - catheter inside needle

Chap 15 Flashcards by zalm heheheh

Sterile, pyrogen-free preparations intended to be administered parenterally

Injections

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fever-producing organic substances arising from microbial
contamination

Pyrogens

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earliest injectable drug
to receive official recognition

Hypodermic morphine solution

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IV route is used for blood transfusions

Intravenous route

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it also serves as
the point of exit for removal of blood from patients for
diagnostic work and for donation.

Intravenous route

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used to control
the pain associated with a variety of surgical procedures,
labor, sickle cell crisis, and cancer

PCA or Patient-controlled analgesia

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provide effects that are less rapid but generally longer lasting
optimum blood levels may be achieved with accuracy and than those obtained from IV administration.

Intramuscular route

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useful for IM injections of medications that stain the upper tissue

Z-track technique

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SC route may be used for injection of small amounts of medication.

Subcutaneous route

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These substances include various agents for diagnostic
determinations, desensitiza-tion, or immunization.

Intradermal route

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are used in institutions and on an
outpatient basis for a variety of parenteral medications

Central venous catheters

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Composed of polyvinyl chloride (PVC), T eflon, and
administered
polyethylene, these should be radiopaque to ensure that
they are visible on radiographs.

Central venous catheters

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3 types of catheters

plain plastic
catheter over needle or catheter outside needle
catheter inside needle

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can be placed in a vein, cavity, artery, or the central nervous system.

Delivery catheter

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used to inject through the skin into the rubber septum of a totally implanted central vein access

Huber point needle

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Liquid preparations that are drug substances or solutions

Injections

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Liquid preparation of drug substance dissolved or dispersed in a suitable emulsion medium

Injectable emulsion

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Liquid preparation of solid suspended in a suitable liquid mediu

Injectable suspension

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most frequently used solvent in manufacture of injections

Water for injection, USP

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Solvent, vehicle, or diluent for already sterilized
and packaged injectables;

Sterile water for injection, USP

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SWI with one or more suitable antimicrobials

Bacteriostatic water for injection, USP

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NOT FOR USE IN
NEONATES (Gasping Syndrome)

0.9% benzyl alcohol

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Sterile isotonic solution of NaCI in WFI

Sodium chloride injection, USP

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Contains one or more suitable antimicrobial, and
must be indicated on the label

Bacteriostatic sodium chloride injection, USP

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Sterile solution of NaCI, KCI, and CaCI2 in WFI

Ringer’s injection, USP

Vehicle; electrolyte replenisher, plasma volume expander

Ringer’s injection

Different quantities of the chlorides + Na lactate

Lactated ringer’s injection, USP

Fluid and electrolyte replenisher; systemic alkalizer

Lactated ringer’s injection, USP

Methods of sterilization (FIGS-D)

Filtration Ionization radiation Gas Steam Dry heat

Must remain clear when cooled to 10°C; Not contain mineral oil or paraffin;

Fixed vegetable oils

conducted in an autoclave and employs steam under pressure

Steam sterilization

is applicable to pharmaceutical preparations and materials that can withstand the required temperatures and are penetrated but not adversely affected by moisture.

Steam sterilization

applicable to bulk solutions, glassware, surgical dress-ings, and instruments

Steam sterilization

usually carried out in ovens

Dry heat

less effective in killing microorganisms than in moist heat,

Dry heat

usually conducted at 150°C to 170°C for not <2 hours

Dry heat

Generally employed for substances that are not effectively sterilized by moist heat

Dry heat

effective method for sterilizing glassware and surgi-cal instruments.

Dry heat

method of choice when dry apparatus or dry containers are required

Dry heat

depends on the physical removal of microorganisms by adsorption on the filter medium or by a sieving mechanism, is used for heat-sensitive solutions

Filtration

Type of modern filter

Millipore filter

a thin plastic membrane of cellulosic esters with millions of pores per square inch

Millipore filter

used conveniently and economically in the community pharmacy to filter extemporaneously prepared solutions

Bacterial filters

the method most commonly used in hospitals

Membrane filter

this process requires specialized equipment resembling an autoclave

Gas sterilization

heat-sensitive and moisture-sensitive materials can be sterilized much better by

Gas sterilization

heat-sensitive and moisture-sensitive materials can be sterilized much better by exposure to

Ethylene oxide or propylene oxide gas

thought to sterilize by interfering with the metabolism of the bacterial cell

Ethylene oxide

Useful agent in sterilization of medical and surgical supplies and appliances

Ethylene oxide

used to sterilize certain heat-labile enzyme prepa-rations

Ethylene oxide

T echniques are available for sterilization of some types of pharmaceuticals by gamma rays and by cathode rays

Ionizing sterilization

such techniques is limited because of the highly specialized equipment Required

Ionizing sterilization

Bacillus stearothermophilus

Steam and ethylene oxide

Bacillus subtilis

Dry heat

B. pumilus, B. stearothermophilus, B. subtilis

Ionizing radiation

subset of pyrogens coming from gram(-) bacteria

Endotoxins

Natural complex of lipopolysaccharides found in the outer layer of bilayered gram(-) bacteria

Endotoxins

How many EU for parenterals

5 EU/kg

How many EU for intrathecal

0.2 EU/kg

Pyrogens are mostly removed by oxidizing with KM04

Pyrogen Test

Where is pyrogen test tested

Healthy rabbits

Extract from the blood cells of the horseshoe crab (Limulus polyphemus)

Bacterial endotoxin test USP

More sensitive than the rabbit pyrogen test

Bacterial endotoxin test USP

injections packaged in containers labeled to contain 100mL or less

Small-volume injections (USP)

From beef or pork pancreas or both

Regular insulin

Colorless to straw-colored solution; substantially free from turbidity

Regular insulin

Only insulin that can be administered IV

Regular insulin

Biosynthetic human insulin

Human insulin(humulin)

first FDA approved rDNA drug product

Human insulin (humulin)

Zinc-insulin lispro crystals dissolved in a clear aqueous fluid

Insulin lispro

Recombinant, ultra-short acting insulin produced from Saccharomyces cerevisiae (Baker's veast)

Insulin aspart

Recombinant rapid-acting insulin analog differing from human insulin by replacing 2 amino acids at B3 and B29 produced from E. coli

Insulin glulisine (apidra)

Sterile, clear, aqueous, and colorless solution; stable only in NSS

Insulin Glulisine (Apidra)

Sterile aqueous suspension prepared from zinc-insulin crystals with protamine

Isophane Insulin Suspension (NPH Insulin)

Can be 70/30 or 50/50

Isophane Insulin Suspension and Regular Insulin

Combination of insulin lispro and NPL

Humalog mix

Can be 50/50 or 75/25

Humalog mix

Long-acting basal insulin preparation intended for SC ODHS administration

Insulin glargine

Recombinant human insulin analog formulated at pH 4.0

Insulin glargine

Clear neutral solution produced by DNA in S.cerevisae

Insulin detemir

- Should not be mixed with any other insulin - Insulin Pens and Insulin Infusion Pumps

Insulin detemir

Single-dose injection intended for IV use packaged in containers of more than 100mL

Large-Volume Parenterals

Infusion of enough basic nutrients to achieve active tissue synthesis and growth

Parenteral Nutrition

Characterized by the long term feeding of protein solutions containing high concentrations of dextrose, electrolytes, vitamins, and in some, insulin.

Parenteral nutrition

Orally, via NGT , via feeding gastrostomy, or via needle-catheter jejunostomy.

Enteral nutrition

Products contain vitamins, minerals, carbohydrates, proteins, fats, and caloric requirements to meet the specific needs

Enteral nutrition

Not injected into the vein but employed outside of the circulatory system.

Irrigation and Dialysis Solutions

Bathe or wash wounds, surgical incisions, or body tissues

Irrigation Solutions

separation of substances from another in solution by taking advantage of their differing diffusibility through membranes

Dialysis Solutions

solutions are allowed to flow into the peritoneal cavity and remove toxic substances normally excreted by the kidney.

Peritoneal dialysis

is used to remove toxins in the blood.

Hemodialysis