Formulation of Advanced or Complex Medicines 2

Question 1

What volume of fluids can be given into a relaxed muscle?

Answer 1

2 ml into an arm
5 ml into a buttock

Question 2

What should the rate of intramuscular injection be controlled by?

Answer 2

Patient pain

Question 3

What is the bioavailability of intramuscular injections controlled by?

Answer 3

Parenteral dosage formulation
- suspensions/oil based dosage forms have delayed release rates

Question 4

What are the problems with intramuscular injections?

Answer 4

Must avoid blood vessels
Excess volume may damage muscle tissues

Question 5

What volume of fluids can be delivered subcutaneously?

Answer 5

Less than 1 ml

Question 6

Where is a subcutaneous injection given?

Answer 6

Loose connective tissue below the dermis layer of the skin

Question 7

What are the advantages of subcutaneous injections?

Answer 7

Large local response
- without large uptake of drug in blood stream

Question 8

Give an example of a subcutaneous injection

Answer 8

Local anaesthetic

Question 9

What is the rate of uptake of subcutaneous injections?

Answer 9

Slower than intramuscular
Faster than oral

Question 10

What is important to consider when giving subcutaneous injections?

Answer 10

Need to rotate the site of injection
Scar tissue formation

Question 11

What is an insulin pump?

Answer 11

Device which delivers a continuous, controlled supply of insulin subcutaneously

Question 12

Give an example of an intraspinal injection

Answer 12

Epidural

Question 13

What are the main regions of the spine?

Answer 13

Cervical spine
Thoracic spine
Lumbar spine
Sacrum
Coccyx

Question 14

What is intrathecal chemotherapy?

Answer 14

Chemotherapeutic agent is injected into the subarachnoid space to prevent spread of leukaemia into CNS

Question 15

What is intrathecal baclofen?

Answer 15

Delivery of a drug directly into the subarachnoid space surrounding a specific level of the spinal cord

Question 16

What volume of fluid is given in an intrathecal injection?

Answer 16

Aqueous injections of not more than 20 ml

Question 17

What should intrathecal injections NOT contain?

Answer 17

Antioxidants
Preservatives

Question 18

How should intrathecal injections be presented?

Answer 18

Single-dose preparations with ampoule in a clear sterilised over-wrap

Question 19

What conditions are critical for intrathecal injections?

Answer 19

Adjustment to isotonicity

Question 20

What safety precautions are there regarding intraspinal injections?

Answer 20

Colour coded delivery equipment and administration sets
Non-compatibility with IV equipment, administration sets and syringes, specialist equipment (NRFit) connectors

Question 21

What are the NPSA requirements for Vinca alkaloids?

Answer 21

The labelling of vinca alkaloids should include a clear warning that reads “FOR INTRAVENEOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES”

Syringes should not be used for vinca alkaloid administration
- doses of vinca alkaloids should be prepared for use by dilution in small volume intravenous bags rather than in syringes
- the minibag technique
- protect against accidental administration via a spinal route