Exam 2 - Powerpoint 8 (Parenteral Solutions)

Question 1

Pyrogen

Answer 1

fever-producing organic substance arising from microbial contamination

Question 2

Intradermal

Answer 2

Anterior of forearm, upper chest, upper back and back of upper arm

small needle, at 10-15 degree angle

TB test

Question 3

Subcutaneous

Answer 3

Area where fat fold of at least 1’, 0.5’ peds

Insulin, heparin

Question 4

Intradermal Vaccines

Answer 4

Polio, Rabies, Hep B and A, Measles, Flu

Question 5

Intramuscular

Answer 5

into major muscle

the larger the volume, the more it hurts

Question 6

IM vs ID

Answer 6

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

Question 7

Central access catheter

Answer 7

Surgically inserted, radiographically confirmed

Used for TPNs, chemo, long term antibiotic

High risk of infection, multiple lines into one area for different drugs

Question 8

For injection

Answer 8

powders reconstituted into liquids for injection

Question 9

Injectable suspension

Answer 9

A solid suspended in a suitable liquid medium, methylprednisolone

Question 10

For injectable suspension

Answer 10

Dry solid when reconstituted becomes a suspension

Question 11

Water for injection

Answer 11

must be pyrogen free but not necessary sterile, sterilized at end of process

Used in drug production which will be sterilized

Question 12

Sterile Water for Injection

Answer 12

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

Question 13

Bacteriostatic Water for Injection

Answer 13

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

Question 14

Sodium Chloride Injection

Answer 14

Sterile isotonic solution 0.9%

Contains no antimicrobial agents, used to flush lines

Question 15

Bacteriostatic sodium chloride injection

Answer 15

Contains benzyl Alcohol, found in multi dose vials

Not used in neonates, can cause “gasping syndrome” organ failure and death

Question 16

Glycerin and Vegetable oils (non-aqueous solution)

Answer 16

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

Question 17

Characteristics of a diluent

Answer 17

stability at various pH levels
Viscosity
Boiling point for sterilization
Miscility with body fluids
Low vapor pressure
Ease of purification

Question 18

Tonicity

Answer 18

Hypertonic = water leave cell, shrivel

Isotonic = equal flow in/out

Hypotonic = water into cell, burst

Question 19

5 methods of Sterilization

Answer 19

Steam Sterilization 
Dry Heat Sterilization 
Sterilization by Filtration
Gas Sterilization 
Sterilization by Ionizing Radiation

Question 20

Steam Sterilization

Answer 20

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

Question 21

Dry Heat sterilization

Answer 21

Requires high temp and long time….150-170c for 2+ hrs

Used for oils, glycerin, petrolatum products, some powders

Question 22

Filtration

Answer 22

Physical removal of micro organisms

Can only filter in one direction

Question 23

Filtration size issue

Answer 23

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

Question 24

Gas sterilization

Answer 24

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

Question 25

Small volume parenterals

Answer 25

USP <1> defined as 100ml or less total volume

Insulin

Question 26

Large volume parenterals

Answer 26

Over 100ml in volume

Caloric, water, electrolyte requirement

Replacement and maintenance therapy

Question 27

Amino Acids

Answer 27

Protein source parenteral nutrition

Question 28

Dextrose and lipids

Answer 28

Caloric sources parenteral nutrition