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Pharmaceutics FINAL > Chapter 15 - Parenterals Part 1 > Flashcards

Chapter 15 - Parenterals Part 1 Flashcards

1
Q

name 5 types of parenteral medications

A
  1. small and large volume injectable preparations
  2. Irrigation fluid (to bathe body wounds or surgical openings)
  3. Dialysis Solutions
  4. Biological preparations (vaccines, toxoids, antitoxins)
  5. Blood replenishment products
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2
Q

name 4 disadvantages of using parenteral medications

A
  1. Difficult to make; high cost
  2. specific equipment needed
  3. hard to retrieve – once in circulation you can’t get it out
  4. causes pain
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3
Q

name 6 advantages of parenteral medications

A

-if the person is unconscious (coma), we can still give them medication through IV

-not active when taken orally - no swallowing required

-rapid acting – placed directly into body. fastest onset time of any dosage form

-if someone in hospital cant eat, we can still give parenteral medications to maintain their essential nutrients

-drug depots – releases the drug slowly over time for less frequent administration

-implantable pumps – also consistent and controlled way of delivering drug

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4
Q

name 3 requirements for injections

A

-STERILE (free from all microorganisms)
-Pyrogen-free
-administered parenterally by health professionals (with the exception of insulin)

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5
Q

explain why injections must be pyrogen free

A

a small concenteration of pyrogen is okay.

however, pyrogen is a metabolic byproduct of gram negative bacteria. they are fever-producing organic substances

come about due to microbial contamination

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6
Q

name 4 parenteral routes of administration

A

-intravenous
-intramuscular
-subcutaneous
-intradermal

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7
Q

the intravenous route of parenteral administration is delivered where into the body?

A

directly into circulation

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8
Q

differentiate between the effect of IV administration vs IM (intramuscular)

A

intramuscular provides LESS RAPID effects but last longer than IV

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9
Q

why are intramuscular injections most commonly delivered? what is an important factor to consider when determining this?

A

muscle mass is important in determining this.

for example, intramuscular injections are most commonly administered into the upper outer quadrant of the gluteus maximus for adults.

HOWEVER, in infants and young children, this area is composed primarily of fat and not muscle. Therefore, the muscles of the mid-deltoid area are preferred for younger children and infants.

IM injections must be administered into skeletal muscles and not fat. as to be as far away as possible from major nerves and blood vessels

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10
Q

between the 4 parenteral routes of administration (IV, IM, subQ, intradermal) which goes in the deepest to most superficial?

A

DEEPEST – intramuscular
intravenous
subcutaneous
MOST SUPERFICIAL – intradermal

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11
Q

where are subcutaneous injections administered?

A

in the subcutaneous tissue (LOOSE) beneath the skin layers

frequently administered in the arm or thigh

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12
Q

where are intradermal injections administered to? give an example of when intradermal injections are used

A

just beneath the most superficial layer of the skin

used during allergy tests

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13
Q

is it a good thing if blood comes out after giving an IM injection?

A

NO – VERY BAD. this means you hit a capillary. IM injections must be administered into skeletal muscles

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14
Q

name the 3 ways in which IV injections can be administered

A
  1. bolus
  2. infusion
  3. aqueous solutions
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15
Q

what is a bolus? through which parenteral route is it administered?

A

a bolus is a single, small-volume injection. given through IV

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16
Q

explain what an infusion is.

through which parenteral route is it administered?

A

infusion is a SLOW, LARGE-volume injection (opposite of bolus)
administered intravenously

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17
Q
A
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17
Q

true or false

all infusions are continuous

A

false – can be continuous or intermittent

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18
Q

which parenteral route is used for blood transfusions?

A

intravenous

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19
Q

should drugs administered intravenously be aqueous or fat emulsion?

A

aqueous is preferred because they will mix with the blood in circulation and not precipitate, leading to a blockage of blood flow

however, IV fat emulsions (fatty acids) have gained acceptance to be used as a caloric source (vs glucose)

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20
Q

why are intramuscular injections administered?
what should be avoided?

A

administered deep into skeletal muscles (gluteal or lumbar)

administered in places with a deep muscle mass to minimize hitting a nerve or a blood vessel

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21
Q

can intravenous drugs be administered as suspensions?

A

NO

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22
Q

if a drug precipitates after injection, what can it cause?

A

emboli - blockage of a blood vessel. disrupts blood flow

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23
Q

can suspensions be administered intramuscularly?

A

YES

suspensions, or aqueous or oleaginous solutions

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24
Q

which are more rapidly absorbed – drugs in solution or drugs in suspension?

A

in solution

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25
Q

rank the following according to their rate of absorption, from fastest to slowest

oleaginous solutions
aqueous solutions
suspension

A

fastest – aqueous solutions
oleaginous solutions
slowest - suspension

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26
Q

a suspension of penicillin G benzathine is given through which route of administration?
how long is the effect?

A

given IM (intramuscular)

7-10 days of effect

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27
Q

low drug solubility gives longer or shorter duration of action?

A

longer (sustained drug action)

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28
Q

parenteral drugs given via the subcutaneous route are delivered where and at what volume?

A

delivered into LOOSE SUBCUTANEOUS TISSUE of the upper arm, forearm, or thigh

very small volume –2mL or less

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29
Q

injections given via subcutaneous route can be…..

A

aqueous solutions, suspensions, and pellets

(i think non aqueous too??? not sure)

30
Q

how are subcutaneous suspensions administered?

A

through a drug depot or repository to give prolonged effects

31
Q

how are subcutaneous pellets administered?

A

via implantation

32
Q

where are intradermal injections administered?
at what volume?

A

in the corium (aka dermis) of the skin in the ARM or the BACK

VERY SMALL VOLUME —- ~0.1mL

33
Q

which parenteral route of administration is used for tuberculin testing and allergy testing?

A

intradermal route

34
Q

define Injection and give a specific example of an Injection product

A

INJECTION – liquid preparations that are drug substances or solutions thereof

Insulin Injection, USP

35
Q

define “for injection” and give an example of a specific product

A

“for injection” – dry solids that, upon the addition of suitable vehicles, yield solutions that conform, in all respects, to the requirements for injections

Cefuroxime for Injection, USP

36
Q

define Injectable Emulsion and give a specific example of a product

A

injectable emulsion = liquid preparation of a drug substance dissolved or dispersed in a suitable emulsion medium

Propofol, USP

37
Q

define injectable suspension and give an example of a specific product

A

liquid preparation of a solid suspended in a suitable liquid medium

Methylprednisolone Acetate Suspension, USP

38
Q

define “for injectable suspension” and give a specific example of a product

A

“for injectable suspension” = dry solid that, upon the addition of a suitable vehicle, yields preparation conforming in all respects to the requirements for injectable suspensions

Imipenem and Cilastatin for Injectable Suspension

39
Q

what is an emulsion?

A

2 phases – oil and water

40
Q

name the 5 OFFICIAL TYPES OF INJECTIONS

A

Injection

For injection

Injectable emulsion

Injectable suspension

For injectable suspension

41
Q

name the 5 GENERAL categories for injections

A

-solutions ready for injection

-Dry, soluble products ready to be combined with solvents

-suspensions ready for injection

-Dry, insoluble products ready to be combined with solvents

-emulsions

42
Q

differentiate between

“Sterile Dexamethasone Acetate Suspension, USP”

and

“Sterile Ampicillin for Suspension, USP”

A

the dexamethasone is READY FOR INJECTION – insoluble components are already suspended in the solvent

the ampicillin is a dry, insoluble powder that is ready to be combined with solvents

43
Q

true or false

there usually is no issue with adding coloring agents to parenteral injections

A

FALSE – it is strictly prohibited

44
Q

what can you say about the use of buffers, stabilizers, and antimicrobial preservatives in parenteral injections

A

these are added substances that fall under very specific guidelines and are restricted in certain parenteral products

45
Q

true or false

solvents/vehicles for parenteral injections must meet special purity and other standards, ensuring their safety by injection

A

TRUE

46
Q

True or false

parenteral products are always sterile, with very few exceptions

A

FALSE — ALWAYS STERILIZED AND MUST MEET STERILITY STANDARDS

47
Q

parenteral injections must not exceed allowable ____ limits

A

endotoxin limits (ELs)

48
Q

parenteral _____ must meet compendial standards for ____ matter

A

parenteral SOLUTIONS, particulate (amt of particles not dissolved)

49
Q

parenteral products must be prepared in what areas?

A

in environmentally controlled areas under STRICT SANITATION standards and by personnel that are trained and clothed to maintain these sanitation standards

50
Q

what does hermetic mean

A

airtight

51
Q

explain how parenteral products must be packaged

A

in special hermetic (airtight) containers of specific and high quality.

quality control procedures are in place to ensure the hermetic seal and sterile condition

52
Q

explain how high injection containers are filled and why

A

filled slightly higher than the labeled volume to be withdrawn

makes it easier to withdraw and administer the labeled volume

53
Q

are there specific labeling regulations that apply only to injections?

A

yes

54
Q

is there any restriction on if an injection can be contained in a single or multidose container?

A

yes

if multi-dose is allowed, there is a restricted volume. sometimes only single dose is allowed for certain injections

55
Q

STERILE POWDERS intended for solution or suspension immediately prior to being injected are packaged how?

A

they are lypophilized (AKA freeze dried) to permit ease of solution or suspension when the solvent or vehicle is added

56
Q

extemporaneously prepared (impromptu) parenteral preparations must be compounded in what kind of facility?

A

USP <797> compliant

57
Q

what is the most frequently used solvent in the large-scale manufacturer of injections

A

Water for Injection, USP

58
Q

explain how Water for Injection, USP is prepared

A

through distillation or reverse osmosis.

meets the same standards of Purified Water, USP

59
Q

what are the requirements for “Water for Injection, USP”

when is it intended to be used?

A

does NOT have to be sterile, but DOES have to be pyrogen free

meets the same standards as Purified Water, USP (not more than 1mg/100mL of total solids)

intended to be used in the manufacture of injectable products to be sterilized AFTER PREPARATION

60
Q

Name 3 water products used for solvents in injections

A

-Water for Injection, USP
-Sterile Water for Injection, USP
-Bacteriostatic Water for Injection, USP

61
Q

true or false

Sterile Water for Injection, USP is required to be antimicrobial free, while Water for Injection, USP is not

A

true

62
Q

true or false

Sterile Water for Injection, USP must be pyrogen free

A

TRUE

63
Q

Explain the difference between Bacteriostatic Water for Injection, USP and Sterile Water for Injection, USP

A

Bacteriostatic Water, USP is the same as Sterile Water, USP except that it has one or more antimicrobial agents

64
Q

is Bacteriostatic Water for Injection, USP used in large volumes? why or why not?

A

NO because of the antimicrobial agents (preservatives). toxic if administered in large amounts

65
Q

Is Sodium Chloride Injection, USP sterile?

A

yes

66
Q

Does Sodium Chloride Injection, USP have preservatives?

A

NO – it is a sterile, isotonic solution of sodium chloride in sterile water (Sterile Water for Injection, USP)

67
Q

explain the difference between Sodium Chloride, for Injection, USP and Bacteriostatic Sodium Chloride for Injection, USP

A

Bacteriostatic Sodium Chloride Injection, USP is also a sterile isotonic solution of sodium chloride, but it has 1 or more antimicrobial agents

68
Q

What is Ringer’s Injection, USP
(also state if it’s sterile or not)

A

a STERILE solution of sodium chloride, potassium chloride, and calcium chloride in water for injection

the 3 agents (NaCl, KCl, CaCl2) are present in concentrations similar to physiological fluids

69
Q

explain the difference between Ringer’s Injection, USP and Lactated Ringer’s Injection, USP

A

Lactated Ringer’s Injection, USP has different quantities of the 3 salts (NaCl, KCl, CaCl2) and also contains sodium lactate

70
Q

What is the purpose of Lactated Ringer’s Injection, USP

A

a fluid and electrolyte replenisher and systemic alkanizer

71
Q

name 4 solvents and vehicles for injections

A

water (Water for Injection, Sterile Water for Injection, Bacteriostatic Water for Injection)

Sodium Chloride (Sodium Chloride Injection, USP, Bacteriostatic Sodium Chloride Injection, USP

Ringer’s Injection, USP, Lactated Ringer’s Injection, USP

Dextrose

72
Q
A

Pharmaceutics FINAL (8 decks)

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