Exam 2 - Powerpoint 8 (Parenteral Solutions) Flashcards
Pyrogen
fever-producing organic substance arising from microbial contamination
Intradermal
Anterior of forearm, upper chest, upper back and back of upper arm
small needle, at 10-15 degree angle
TB test
Subcutaneous
Area where fat fold of at least 1’, 0.5’ peds
Insulin, heparin
Intradermal Vaccines
Polio, Rabies, Hep B and A, Measles, Flu
Intramuscular
into major muscle
the larger the volume, the more it hurts
IM vs ID
IM higher response rates for immunogenicity
ID higher incidence of swelling, pain
ID Vaccine preferred children to IM/SC
Hep A and B better IM
Central access catheter
Surgically inserted, radiographically confirmed
Used for TPNs, chemo, long term antibiotic
High risk of infection, multiple lines into one area for different drugs
For injection
powders reconstituted into liquids for injection
Injectable suspension
A solid suspended in a suitable liquid medium, methylprednisolone
For injectable suspension
Dry solid when reconstituted becomes a suspension
Water for injection
must be pyrogen free but not necessary sterile, sterilized at end of process
Used in drug production which will be sterilized
Sterile Water for Injection
SWFI
Must be pyrogen-free and an endotoxin level of not more than 0.25 USP Eu/ML
No preservatives, used to reconstitute sterile powders
Bacteriostatic Water for Injection
SWFI with an antimicrobial agent - Benzyl alcohol 0.9%
Not used if >5ml needed, use sterile water instead
DO NOT USE IN NEONATES, SUSCEPTIBLE TO TOXIC EFFECTS
Sodium Chloride Injection
Sterile isotonic solution 0.9%
Contains no antimicrobial agents, used to flush lines
Bacteriostatic sodium chloride injection
Contains benzyl Alcohol, found in multi dose vials
Not used in neonates, can cause “gasping syndrome” organ failure and death
Glycerin and Vegetable oils (non-aqueous solution)
used if drug has limited water solubility or is susceptible to hydrolysis
Challenges: Has to be given IM, some drugs have stability issues, allergic reactions to specific oils
Veggie oil need to remain Clear when cooled to ensure stability and clarity of product
Characteristics of a diluent
stability at various pH levels Viscosity Boiling point for sterilization Miscility with body fluids Low vapor pressure Ease of purification
Tonicity
Hypertonic = water leave cell, shrivel
Isotonic = equal flow in/out
Hypotonic = water into cell, burst
5 methods of Sterilization
Steam Sterilization Dry Heat Sterilization Sterilization by Filtration Gas Sterilization Sterilization by Ionizing Radiation
Steam Sterilization
Autoclave 121C (250F) for 20min, 15 PSI
Products have to be stable at this temp and to moisture
Products not appropriate:
Oils, fats, oleaginous preparations, powders
Dry Heat sterilization
Requires high temp and long time….150-170c for 2+ hrs
Used for oils, glycerin, petrolatum products, some powders
Filtration
Physical removal of micro organisms
Can only filter in one direction
Filtration size issue
Some drugs removed from solution if filter is too small, if drug is sterile and particulate matter is the issue than use a larger filter…. 1 to 5 microns
Biologics should not be filtered unless said by manufacturer
Gas sterilization
Use ethylene Oxide or Propylene Oxide gas
Requires 4-16hrs, 50-60C, 60% humidity
Products must be allowed to allow the gas to escape so doesn’t cause skin irritation
Used for medical and surgical supplies, catheters, needles, certain antibiotics, heat labile enzyme perps
