Parenteral Products Cont. Flashcards
Components of parenteral product containers
In direct contact w/product,
Considered “ingredients” of product
Glass is most common (plastic becoming more common)
What type of glass is used for parenteral products?
Type I
Vials - opening
Does not guarantee sterility when first exposed - sterile wipe it
Ampules
Made of glass
Single Use
Provide hermetic, uniform containment
Completely sealed
Critical part of ampule
Neck (easy to break)
IV bags
Small - 50mL
LVP - large volume
-Hydrostatic pressure - Higher level (piggyback) takes priority to go into patient)
Once switches out - the other one goes
Drop conversion factor - drop number
Little number - (drop) - estimated number (15 drops ~ 1mL)
-Not exact
-Some adjustment, but it gives you a good start
Syringes
Luer Lok - required for hazardous drugs
-Threads like a screw
Luer Tip - Normal
Syringe components
Luer-Lok tip
Calibration marks
Barrel
Final edge of plunger piston
Plunger piston
Top collar
Plunger (rips)
Flat end (lip)
When using the plunger pistom
Use the final edge of the plunger piston to read the volume
-Accuracy ~1/2 of smallest division
Needles - Two numbers:
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
Filter Needles
MUST be used when using ampules
IV components
Very rapid
Straight to blood
Good for irritant drugs
Suitable for large volumes
“least forgiving”
Drug must be dissolved
Syringe Needle: parts
Bevel heel
Bevel
Bevel tip
Why is IV least forgiving?
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
Methods of admin for IV
Bolus (push)
Infusion
Site of admin for IV
Peripheral vein
Central Vein
Infusion modes of admin IV
Continuous admin
Intermittent admin
The IV route is characterized by
Rapid onset of action because there is no absorption step
Common venous complications
-Phlebitis:
-Thrombosis
-Thrombophlebitis
Phlebitis
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
Thrombosis
Formation of blood clot (thrombus) in the vein
-Pain
-Swelling
-Pulmonary embolism
Site of admin and max volume: IM
Deltoid - about 2mL
Thigh about 5mL
Gluteal - about 5mL
IM route is characterized by
Absorption step - onset of action not always faster than the oral route
Routes of admin: SubQ:
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
Routes of admin: Intra-Spinal
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)
Intrathecal admin
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
Epidural admin
Bolus or continuous admin
In neonates - at the caudal level: near the tip of the tailbone (sacrum) into a small opening (sacral hiatus)
Intrathecal vs Epidural
Intrathecal - INto the subarachnoid space
Epidural: BETWEEN the dura mater and the vertebral canal
Special care with Intraspinal
MUST be isotonic MUST have physiological pH
CANNOT have preservatives
-Even the gauge can actually matter here (contact manufacturer)
T/F: Pressure is higher in artery vs vein
True
