Parenteral Products Cont.

Question 1

Components of parenteral product containers

Answer 1

In direct contact w/product,
Considered “ingredients” of product
Glass is most common (plastic becoming more common)

Question 2

What type of glass is used for parenteral products?

Answer 2

Type I

Question 3

Vials - opening

Answer 3

Does not guarantee sterility when first exposed - sterile wipe it

Question 4

Ampules

Answer 4

Made of glass
Single Use
Provide hermetic, uniform containment
Completely sealed

Question 5

Critical part of ampule

Answer 5

Neck (easy to break)

Question 6

IV bags

Answer 6

Small - 50mL
LVP - large volume
-Hydrostatic pressure - Higher level (piggyback) takes priority to go into patient)
Once switches out - the other one goes

Question 7

Drop conversion factor - drop number

Answer 7

Little number - (drop) - estimated number (15 drops ~ 1mL)
-Not exact
-Some adjustment, but it gives you a good start

Question 8

Syringes

Answer 8

Luer Lok - required for hazardous drugs
-Threads like a screw
Luer Tip - Normal

Question 9

Syringe components

Answer 9

Luer-Lok tip
Calibration marks
Barrel
Final edge of plunger piston
Plunger piston
Top collar
Plunger (rips)
Flat end (lip)

Question 10

When using the plunger pistom

Answer 10

Use the final edge of the plunger piston to read the volume
-Accuracy ~1/2 of smallest division

Question 11

Needles - Two numbers:

Answer 11

Gauge: refers to diameter of bore. The higher the gauge the smaller the bore diameter (range 13-27)
Length: of the needle shaft from 3/8 to 3.5”
Ex. 18G31/2

Question 12

Filter Needles

Answer 12

MUST be used when using ampules

Question 13

IV components

Answer 13

Very rapid
Straight to blood
Good for irritant drugs
Suitable for large volumes
“least forgiving”
Drug must be dissolved

Question 14

Syringe Needle: parts

Answer 14

Bevel heel
Bevel
Bevel tip

Question 15

Why is IV least forgiving?

Answer 15

In general, if excipient is acceptable for IV injection, it is acceptable for other parenteral routes of admin
-But some excipients that are acceptable for parenteral routes such as IM, are totally unacceptable for IV use

Question 16

Methods of admin for IV

Answer 16

Bolus (push)
Infusion

Question 17

Site of admin for IV

Answer 17

Peripheral vein
Central Vein

Question 18

Infusion modes of admin IV

Answer 18

Continuous admin
Intermittent admin

Question 19

The IV route is characterized by

Answer 19

Rapid onset of action because there is no absorption step

Question 20

Common venous complications

Answer 20

-Phlebitis:
-Thrombosis
-Thrombophlebitis

Question 21

Phlebitis

Answer 21

Inflammation from irritation of the tunica intima of the vein
-Moderate/severe discomfort
May take days to months to subside
Limits veins available for future therapy

Question 22

Thrombosis

Answer 22

Formation of blood clot (thrombus) in the vein
-Pain
-Swelling
-Pulmonary embolism

Question 23

Site of admin and max volume: IM

Answer 23

Deltoid - about 2mL
Thigh about 5mL
Gluteal - about 5mL

Question 24

IM route is characterized by

Answer 24

Absorption step - onset of action not always faster than the oral route

Question 25

Routes of admin: SubQ:

Answer 25

Similar to IM, except the volume does not usually exceed 1.5 mL
Absorption tends to be slower than IM
Infusion by subq route is called hypodermoclysis
Formulation considerations similar to those for the IM route

Question 26

Routes of admin: Intra-Spinal

Answer 26

Intrathecal
-Into the subarachnoid space and cerebrospinal fluid
Epidural
-Into the space at the thoracic or lumbar level between the dura mater and the vertebral canal (epidural space)

Question 27

Intrathecal admin

Answer 27

Bolus admin directly into the CSF
Continuous admin NOT RECOMMENDED
Meds have higher potency than epidural. No membranes (dura) to cross; drug goes straight into the CSF

Question 28

Epidural admin

Answer 28

Bolus or continuous admin
In neonates - at the caudal level: near the tip of the tailbone (sacrum) into a small opening (sacral hiatus)

Question 29

Intrathecal vs Epidural

Answer 29

Intrathecal - INto the subarachnoid space
Epidural: BETWEEN the dura mater and the vertebral canal

Question 30

Special care with Intraspinal

Answer 30

MUST be isotonic MUST have physiological pH
CANNOT have preservatives
-Even the gauge can actually matter here (contact manufacturer)

Question 31

T/F: Pressure is higher in artery vs vein

Answer 31

True