parenterals Flashcards
Parenterals “injectables” are ____ and ____ preparations injected through skin into one or more layers of skin, or into internal body compartments.
sterile and pyrogen-free
Parenterals is Greek word “para = ____” and “enteron = ___”.
beside
intestine
this term means free from viable microorganisms e.g. bacteria
Sterile
Sterile and pyrogen free preparations are: (5)
parenterals irrigation solutions dialysis solutions biological preparations ophthalmics.
When are parenterals indicated? “Advantages”
emergency conditions fast onset local action for uncooperative or unconscious patient almost complete bioavailabilty Avoids GI less patient control
What are the drawbacks for parenterals?
- Require healthcare professional for drug administration, except for self-administered injectables e.g. insulin.
- pain, discomfort, and fear of needle.
- The drug cannot be retrieved or removed once administered.
- Contaminations and infections (aseptic technique is required).
- Manufacturing and preparation requirements / cost.
This route of administration requires the following:
injected into a VEIN using needles (venipuncture) or indwelling catheters (butterfly needle or catheter over needle)
IV
The sites of injection for IV are:
- Peripheral: arm (front of elbow), hand, leg, foot; for infants: scalp veins
- Central: vena cava, subclavian vein
The needle is inserted with the bevel facing ___.
The plunger of the syringe must be withdrawn before injection to ensure that the needle is inserted in the vein. The blood backflow into the syringe is the indicator.
upward
I.V. administration can be injected by:
____ or ____, or _____ (IV Push) injection
continuous or intermittent infusion, or bolus injections
Characteristics of IV dosage form:
-suitable for both small and large-volume injectable preparations.
-No drug absorption is required
-fast onset of action
-suitable for emergency and critical conditions.
-Large-volume injectables “500-1000 mL”
-containing nutrients, electrolytes, and/or
-therapeutic agents are administered by continuous infusion through indwelling catheters or needle.
-infusion rate of 42-150 mL/hour, or at a lower rate to keep the catheter open.
-Only clear, aqueous, non-precipitating, isotonic, pyrogen-free, sterile SOLUTIONS, and
EMULSIONS can be injected.
IV preparations should be free from particulate matter: USP limits are:
•Large Volume:
For particles size ≥10μm, the limit is ≤50 particles/mL
For particles size ≥25μm, the limit is ≤5 particles/mL
•Small Volume:
For particles size ≥10μm, the limit is ≤10,000 particles
For particles size ≥25μm, the limit is ≤1000 particles
Risks of IV routes of administration
–Bacterial infection
–Phlebitis due to irritation or rapid infusion
–THROMBUS “blood clot” due to the needle or catheter touching the vein wall, irritating solution, slowing of the blood circulation, altering the blood or vessel wall.
–EMBOLISM “blood vessel obstruction” due to the circulation of the formed thrombus
automated I.V. delivery system
for intermittent and self-administration of analgesics for chronic pain management.
provide constant and uniform analgesia
Patient Controlled Analgesia (PCA) Device
Patient Controlled Analgesia (PCA) Device can be used for ___, ____, and epidural administration.
IV
SC
The _____ injection technique is used for drugs that stain the skin and upper tissue, e.g. iron dextran, or irritating drugs e.g. diazepam.
Z-track
characteristis of IM injection
–Aqueous or oleaginous “oily” solutions, and suspensions can be injected.
–Absorption and elimination are slower than I.V.
–Variable absorption rates based on physiochemical properties of the drug and the formulation.
In the case of IM, drugs in solution formulation are more rapidly absorbed than in ___ or ____ formulations and less variable.
suspension
oleaginous
The type of the IM formulation depends on the _____ of the drug and the therapeutic goals.
properties
Risks of IM injections
Injuries due to incorrect administration technique that can result in neural damage “paralysis”, infection, embolism, hematoma
Injected into a skeletal muscle.
–Limited volume can be injected, up to __ ml (each side) using 20-22G, 1½” needle into the upper outer quadrate of gluteus maximus “buttock” area for adults and __ mL in the deltoid muscle “upper arm” or vastus lateralis “lateral thigh” for children and infants.
IM
5
2
Injected into the loose interstitial tissue under the skin (between the skin and the muscle tissue) of the upper arm, thigh, or abdomen.
Injection site should be rotated when frequent injections are required e.g. insulin.
If blood appears in the syringe after plunger is withdrawn, a new location should be selected.
Sub Q/hypodermic
In Sub Q, a small volume can be injected, up to ___ mL, using 24-26G, 1- ½”needle.
1.3 - 2
In Sub Q injections, irritating solutions and ___ _____ should not be injected to avoid pain and abscess.
thick suspensions
