Formulation of Advanced or Complex Medicines 2 Flashcards
What volume of fluids can be given into a relaxed muscle?
2 ml into an arm
5 ml into a buttock
What should the rate of intramuscular injection be controlled by?
Patient pain
What is the bioavailability of intramuscular injections controlled by?
Parenteral dosage formulation
- suspensions/oil based dosage forms have delayed release rates
What are the problems with intramuscular injections?
Must avoid blood vessels
Excess volume may damage muscle tissues
What volume of fluids can be delivered subcutaneously?
Less than 1 ml
Where is a subcutaneous injection given?
Loose connective tissue below the dermis layer of the skin
What are the advantages of subcutaneous injections?
Large local response
- without large uptake of drug in blood stream
Give an example of a subcutaneous injection
Local anaesthetic
What is the rate of uptake of subcutaneous injections?
Slower than intramuscular
Faster than oral
What is important to consider when giving subcutaneous injections?
Need to rotate the site of injection
Scar tissue formation
What is an insulin pump?
Device which delivers a continuous, controlled supply of insulin subcutaneously
Give an example of an intraspinal injection
Epidural
What are the main regions of the spine?
Cervical spine
Thoracic spine
Lumbar spine
Sacrum
Coccyx
What is intrathecal chemotherapy?
Chemotherapeutic agent is injected into the subarachnoid space to prevent spread of leukaemia into CNS
What is intrathecal baclofen?
Delivery of a drug directly into the subarachnoid space surrounding a specific level of the spinal cord
What volume of fluid is given in an intrathecal injection?
Aqueous injections of not more than 20 ml
What should intrathecal injections NOT contain?
Antioxidants
Preservatives
How should intrathecal injections be presented?
Single-dose preparations with ampoule in a clear sterilised over-wrap
What conditions are critical for intrathecal injections?
Adjustment to isotonicity
What safety precautions are there regarding intraspinal injections?
Colour coded delivery equipment and administration sets
Non-compatibility with IV equipment, administration sets and syringes, specialist equipment (NRFit) connectors
What are the NPSA requirements for Vinca alkaloids?
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
