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Parenterals > Midterm > Flashcards

Midterm Flashcards

1
Q

What is a parenteral product?

A

a preparation administered to the body other than through the intestinal tract

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2
Q

parenteral routes

A

IV, SQ, IM, intradermal (ID), intrathecal (IT), epidural, intra-articular, intra-arterial, intraperitoneal

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3
Q

parenteral pros

A
  • patient is unable to take drug by mouth
  • drug inactive when taken orally
  • immediate onset of action
  • direct delivery to an organ, lesion, muscle or nerve
  • depots of drug into muscle for long-acting drug delivery
  • implantable pump advantages
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4
Q

parenteral cons

A
  • parental products are more costly
  • special training, devices & equipment
  • once administered, can’t be removed
  • contaminated products can cause serious harm or death
  • pain & tissue damage upon administration
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5
Q

NS is given

A

IV

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6
Q

influenza vaccine is given

A

IM

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7
Q

insulin is given

A

SQ

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8
Q

what goes in the sharps

A

needles, open ampules, broken glass

** NOT empty vials unless broken**

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9
Q

any needlestick injuries should be reported to

A

a course instructor immediately

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10
Q

efficiency is secondary to

A

accuracy & good technique

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11
Q

factors influencing sterility

A
  • environmental quality
  • proper hand washing
  • proper hand hygiene
  • use of PPE
  • primary & secondary engineering controls
  • maintenance of equipment & environment
  • ASEPTIC TECHNIQUE
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12
Q

transient hand flora

A

15% of all flora

removed with hand washing

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13
Q

resident hand flora

A

85% of all flora

NOT removed by hand washing

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14
Q

spores

A
  • requires physical removal with hand washing

- NOT removed with hand sanitizers or alcohol

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15
Q

proper hand washing is key to

A

preventing contamination

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16
Q

personal protective equipment (PPE)

A 
shoe covers
beard covers
hair covers
jacket/gown
gloves- sterile & powder-free
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17
Q

Donning PPE

A
  • aka “garbing”
  • protect preparation from the operator
  • protect the operator from the preparation
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18
Q

wash hands prior to donning gloves

A
  • hands can contaminate gloves when donned

- hands can transport particles onto gloves when donned

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19
Q

disinfecting gloves

A
  • immediately after being donned
  • prior to & after cleaning LAFW
  • prior to each preparation
  • prior to re-entering ISO class % environment
  • if suspected or known contamination
  • periodically during prolonged durations of compounding in the PEC
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20
Q

critical sites are at greatest risk of contamination

A

tough, moisture, contact with unclean air

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21
Q

critical sites

A
  • needle: hub, tip & shaft of needle
  • syringe: tip of syringe & ribs of plunger
  • vials & ampules- rubber closer when penetrated, opening of ampule
  • additive bag- injection port
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22
Q

steps of aseptic technique

A
  • gather supplies
  • disinfect vials, ampules, & injection port
  • prepare syringe & needle
  • enter vial
  • withdraw contents
  • inject into diluent/solution
  • mix & check final admixture
  • cover & label admixture
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23
Q

when disinfecting vials, ampules & injection ports, allow to remain wet for at least

A

10 seconds

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24
Q

mix & check preparation against light & contrasting background for

A

incompatibilities, particulate matter, coring

25
Q

steps for reconstitution

A
  • determine diluent
  • determine concentration of reconstituted drug
  • remove vial cover
  • disinfect additive port of bag
  • removed desired diluent volume
  • stabilize vial on workbench, insert needle into vial. Do not invert vial
  • using milking technique to add contents of syringe
  • allow contents to completely dissolve
  • inspect solution in vial
  • determine the volume of drug to be removed
  • re-insert needle into vial avoiding original puncture site
  • withdraw volume
26
Q

syringes should be capped when

A

medications will be administered directly from the syringe

27
Q

positive pressure

A
  • if air added > volume of solution withdrawn

- results in spraying or dripping of solution from vial

28
Q

negative pressure

A
  • if air removed >volume of solution removed

- results in difficulty removing volume needed from vial

29
Q

auxiliary label examples

A 
storage conditions
administration alerts
high-risk meds
nonstandard concentrations
hazardous agents
30
Q

batch compounding

A

involves the compounding of multiple preparations containing the same ingredients
- requires specific documentation

31
Q

quality of final preparation dependent upon

A

compatibility & stability parameters

32
Q

stability

A

retention of properties & characteristics throughout the storage & use periods

33
Q

instability results when

A

a change or degradation of the active ingredients occurs

34
Q

stability parameters established

A

secondary to exposure testing by the manufacturer

35
Q

types of stability

A 
chemical
physical
toxicological
therapeutic 
microbiological
36
Q

expiration date

A
  • assigned by the manufacturer

- determined using extensive analytical testing

37
Q

BUD

A
  • assigned by a pharmacist

- determined based on available scientific evidence or per manufacturer recommendations

38
Q

MDV BUD

A

28 days from entering/opening the vial

39
Q

single-dose vials exposed to ISO class 5 or cleaner

A

6 hours from entering/opening the vial

40
Q

any equipment of vial exposed to air quality worse than ISO class 5

A

1 hour from enter/open

must be discarded after 1 hour

41
Q

commercially prepared products (ready use product)

A

as indicated y the manufacturer label until entered/opened

BUD should not be extrapolated to extemporaneous preparations

42
Q

vial systems

A

as indicated by the manufacturers until entered/open

43
Q

RT

A

20-25C, 68-77F

44
Q

fridge

A

2-8C, 36-46F

45
Q

frozen

A

-25 to -10C, -13 to 14F

46
Q

3 types of incompatibility

A

therapeutic
physical
chemical

47
Q

therapeutic influences

A
  • chemical or physical incompatibilities can result in influences in therapeutic efficacy of drugs
  • loss of efficacy of one or more of active ingredients when administered together
  • can administer separately or with adequate time between drugs
48
Q

chemical

A

result from a chemical reaction between two or more components of a mixture, which affects molecular structure or activity of product

49
Q

physical

A

results in changes in the physical properties of the product in term of appearance, palatability, uniformity, dissolution, & susceptibility
- most physical incompatibilities are the result of chemical rxns

50
Q

evidence of incompatibility

A 
color change
precipitate
phase separation
bubbles
heat/cold
crystallization
51
Q

factors affecting affecting stability & campatibility

A 
pH
temp
light
mixing sequence
time
concentration
52
Q

calcium phosphate

A
  • formed when calcium salts are added to electrolytes containing phosphate
  • chemical rxn physically manifested as formation of precipitates or haze in preparation
53
Q

calcium & potassium are

A

physically incompatible

54
Q

parenteral nutrition

A
  • common source of incompatibilities resulting in calcium phosphate
  • nutrition preparations for neonates at high risk
55
Q

preventing calcium phosphate

A 
utilize Ca gluconate over CaCl
maintain low pH of final admixture 
increased amino acid conc
decreased dextrose conc
store compound at lower temp
avoid higher temp during admin
do not add Ca & P salts in close sequence
Calc solubility of Ca
use slower infusion rates
56
Q

preventing incompatibilities

A

verify solubilities
determine risk of precipitation
determine chemical form of drug
determine storage & handling conditions

57
Q

visual inspection

A 
look for:
hazy/cloudy appearance
precipitates
color change
formation of gas
separation of contents
temp changes
crystallization
58
Q

compatible

A

physical or visual compatibility reported

stability for at least 24 hours

59
Q

incompatible

A

physical or visual incompatibility

greater than 10% decomposition of one or more components in 24 hours or less

Parenterals (4 decks)

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