lecture 5

Question 1

components of parenteral products containers

Answer 1

• Containers and closures are in direct
  contact with the product
• These are considered “ingredients” of the
  product
• Glass is arguably the most commonly used
  material for containers (gradually being
  replaced by plastic)
• There are different types of glass: Type I,
  Type II, Type III
• Use Type I to minimize problems

Question 2

basic materials used for compounding containers-vials

Answer 2

-glass or plastic
-flip off cap or metal cover protect the rubber stopper but does not guarantee sterility when first exposed (sterile wipe it)

Question 3

basic materials used for compounding containers-ampuls

Answer 3

-made out of glass
-single use containers
-provide hermetic, uniform containment

Question 4

basic material used for compounding containers- IV bags

Answer 4

-piggyback contianers
-large volume container
-roll clamp
-one-way check valve

Question 5

basic materials used for compounding syringes

Answer 5

-luer lok required for hazardous drugs
-luer tip
calibraiton marks
-barrel
-plunger piston
-top collar
-plunger
-flat end
-use the final edge of the plunger piston to read the volume
-accuracy about 1/2 of smallest division

Question 6

basic materials used for compounding needles

Answer 6

-commercially available in sterile over wrap packing
-many sizes, characterized by two numbers gauge and length
-filter needles are exist and they must be used when using ampules

Question 7

gauge

Answer 7

refers to diameter of the bore. the higher the gauge the smaller the bore diameter (13-27)

Question 8

length

Answer 8

the needle shaft from 3/8 to 3.5”

Question 9

what does it mean that IV is the least forgiving

Answer 9

• Immediate distribution - No line of defense
  if something goes wrong
• In general, if an excipient is acceptable for
  IV injection, it is acceptable for other parenteral routes of administration
• But some excipients that are acceptable for parenteral routes such as IM, for example, are totally unacceptable for IV use

Question 10

IV methods of administration

Answer 10

-bolus (push)
-infusion

Question 11

IV site of administration

Answer 11

-peripheral vein
-central vein

Question 12

IV infusion modes of administration

Answer 12

-continuous administration
-intermitted administration
-IV route is characterized by rapid onset of action because there is no absorption step

Question 13

common venous complications

Answer 13

phlebitis
thrombosis
thrombophlebitis

Question 14

thrombosis

Answer 14

-formation of a blood clot (thrombus) in the vein
-pain
-swelling
-pulmonary embolism

Question 15

phlebitis

Answer 15

-inflammation from irritation of the tunica intima of the vein
-moderate to severe discomfort
-may take days to months to subside
-limits veins available for future therapy

Question 16

intramuscular

Answer 16

• Sites of administration and typical maximum volumes of administration:
  – Deltoid muscle – about 2 mL
  – Thigh – about 5 mL
  – Gluteal muscle – about 5 mL
• IM route is characterized by an absorption step – onset of action not always faster than the oral route

Question 17

subcutaneous

Answer 17

-Similar to IM route, except that the volume
administered usually does not exceed 1.5 mL
-Absorption tends to be slower than IM because
of lower vascularization of the tissue
-Infusion by subcutaneous route is called
hypodermoclysis
- Formulation considerations similar to those for
the IM route

Question 18

what affects the rate of absorption

Answer 18

formulation and physiological factors

Question 19

intrasinal

Answer 19

intrthecal and epidural

Question 20

intrathecal

Answer 20

-into the subarachnoid space and cerebrospinal fluid
– Bolus administration directly into the CSF
– Continuous administration not recommended
– Meds have higher potency than epidural. No
membranes (dura) to cross; drug goes straight into
the CSF

Question 21

epidural

Answer 21

-into the space at the thoracic or lumbar level between the dura mater and the vertebral canal
– Bolus or continuous administration
– In neonates – at the caudal level: near the tip of the tailbone (the sacrum) into a small opening (sacral hiatus)
-gauge can matter here
-must be isotonic, have physiological pH, cannot have preservatives