lecture 4 Flashcards

1
Q

parenteral routes for administations

A

-intravenous IV: least forgiving, rug must be dissolved
-intramuscular IM
-subcutaneous SC
-intradermal
-intraperitoneal IP
-intraspinal: very delicate

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2
Q

IV

A

-intravenous
– Very rapid
– Straight to the blood
– Good for irritant drugs
– Suitable for large volumes

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3
Q

common aqueous isotonic vehicles

A

-0.9% (w/v) NaCl Solution
AKA Normal Saline (NS) or Saline
-5% (w/v) Dextrose Solution
AKA D5W
-Bacteriostatic Sodium Chloride Injection
Normal Saline with antimicrobial preservative(s)
-Ringer’s Solution
Normal Saline with K+ and Ca2+ in approx.
physiological concentrations

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4
Q

water miscible solvents

A
  • PEG can be used IV at concentrations as
    high of 40% (v/v)
  • Ethyl alcohol can be used up to ~10% (v/v)
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4
Q

components of parenteral products vehicles

A
  • Water miscible solvents (cosolvents)
    – Ethyl alcohol
    – Polyethylene glycol (PEG)
    – Propylene glycol (PG)
  • Used to solubilize drugs
  • Can also slow down hydrolysis reactions
  • Often for intramuscular injection
  • But also used in IV preparations
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5
Q

what about oils?

A
  • Straight liquid oil injected into veins (IV) is a BIG
    NO-NO
    – It is effectively an embolus
  • Oil emulsion is OK for IV injection
    – Oil is distributed into small droplets that are even smaller than red blood cells
    – No risk of embolism
    – Solution  Emulsion
  • Oil-based solutions for IM injection are acceptable and do exist
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6
Q

do not get confused

A
  • Oil solution does not equal Oil emulsion
  • Oil solutions (oil as the solvent) must not
    be injected directly into veins
  • An emulsion contains oil, but it is not oil
  • Some emulsions (e.g., PN, parenteral nutrition)
    are administered by the IV route
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7
Q

components of parenteral products antimicrobial preservatives

A
  • Used for multiple dose preparations
  • Benzyl alcohol 0.9% is the most common preservative
  • Parabens: combination of methyl and propyl-parabens, 0.18% and 0.02%, respectively*
  • Cresol
  • Antimicrobials are not very effective in non-aqueous (oil based) formulations
  • Compatibility Issues
    – Some excipients inactivate (“sequester”) antimicrobial preservatives. Examples: Polysorbate (through micelles) and PVP (complex-like formation)
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8
Q

only preparations intended for multiple use are allowed to contains _________

A

antimicrobial preservatives

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8
Q

preparations intended for multiple use must ____-

A

contain an antimicrobial preservative

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9
Q

moral of the story about antimicrobial preservatives

A
  • If you are going to be punching holes in a
    sterile container to administer the drug
    contained in it more than once, you better
    have some antibacterial preservative in it
  • Any sterile product intended for multiple
    dose use must contain antibacterial
    preservative
  • Single dose = single use. Preparations are
    single use containers. Period
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9
Q

preservatives- remember

A
  • Benzyl alcohol 0.9% is the most commonly used
    antimicrobial preservative
  • It is generally safe to use, but
  • Some people are allergic
  • DO NOT use Benzyl alcohol in neonates. It can
    produce gasping syndrome
  • Do no use preparations containing antimicrobial
    preservatives in neonates
  • Preparations intended for the intra-spinal route of administration must be free of antimicrobial
    preservatives
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10
Q

pH buffers

A

– Why have them in a parenteral product?
– To address solubility and/or stability issues with the drug
– Use them at as low concentration as necessary
– Commonly used buffers:
– Citrates – some caution. Safe by IV, very irritating by IM or SC routes
– Acetates
– Phosphates – considerable caution. Potentially fatal danger

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11
Q

compounding sterile preparations pH buffers

A
  • Buffered vs. unbuffered formulations
  • Buffers are used to “force” the pH to
    remain at a fixed value
  • Unbuffered solutions are quickly diluted
    into physiological pH
  • That is why you want buffers as dilute as
    possible*, so the physiological pH takes
    over asap
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11
Q

antioxidants components of parenteral products

A

– Metabisulfite salts – low pH
– Bisulfite – intermediate pH
– Sulfite – high pH
– Ascorbic acid

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12
Q

_____ injected by the IM or SC routes can be very irritating but can be injected intravenously without problems

A

citrate

13
Q

______ and _______ need to be given together in PN preparations. when they are combined they have a strong tendency to precipitate and the result can be fatal

A

phosphate and calcium

14
Q

chelating agents: components of parenteral products

A

– Most common Sodium EDTA
– Enhance antioxidant’s effect
– Sequester trace metals

15
Q

components of parenteral products tonicity agents

A

-normal saline
-D5W
-glycerol
-is isotonic
-has physiological pH