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Compounding Final > Parenterals Part 1 > Flashcards

Parenterals Part 1 Flashcards

1
Q

define parenteral drug delivery systems

A

STERILE dosage forms to be administered by injections

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2
Q

**what are the 4 S’s of parenteral drug delivery systems

A

safety
sterility
stability
solubility

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3
Q

parenteral drug delivery systems are free from what 3 things

A

microbes
pyrogens
particulates

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4
Q

3 common formulations that are parenteral drug delivery systems

A

solutions
suspensions
emulsions

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5
Q

there are small volume parenterals (SVPs) and large volume parenterals (LVPs)

what is the volume of each?

A

small volume parenterals is 100mL or less and large volume parenterals is over 100 mL

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6
Q

true or false

parenterals have the most direct access possible to the vascular system

A

true

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7
Q

true or false

parenterals have unpredictable drug levels in the blood

A

FALSE - highly predictable

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8
Q

do parenterals go through the GI route?

A

no

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9
Q

true or false

a disadvantage of parenterals is that they are a relatively high cost

A

true

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10
Q

“#1 component” of parenteral products

A

WATER (aqueous vehicle)

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11
Q

true or false

parenteral products can NOT have aqueous vehicles

A

false - they can - as cosolvents

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12
Q

name 4 potential “solutes” that may be added into a parenteral product

A

drug
antimicrobial agent (if multi dose)
tonicity adjuster
antioxidants and buffers (for stability)

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13
Q

**name the 5 types of aqueous vehicles for parenteral products

A

water for injection

sterile water for injection

bacteriostatic water for injection

sodium chloride injection

bacteriostatic sodium chloride injection

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14
Q

*true or false

water for injection is NOT required to be sterile

A

TRUE – but it MUST be pyrogen free

because it isn’t sterile, the final parenteral PRODUCT MUST be sterilized

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15
Q

water for injection must be used within ____ after collection

A

24 hours

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16
Q

*true or false

sterile water for injection is both sterile and free from pyrogens

A

true

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17
Q

*what is bacteriostatic water for injection

A

sterile water for injection that has antimicrobial agent(s)!!!!

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18
Q

*SPECIAL CONSIDERATION for bacteriostatic water for injection as well as bacteriostatic sodium chloride injection

A

USP labeling – must state NOT FOR USE IN NEONATES!!!!
due to gasping syndrome from benzyl alcohol poisoning

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19
Q

*explain what sodium chloride injection, USP is

A

STERILE and ISOTONIC solution of sodium chloride in “water for injection”

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20
Q

true or false

sodium chloride injection has no antimicrobial agents

A

TRUE

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21
Q

sodium chloride injection has no antimicrobial agents but……

A

has around 154 mEq each of Na and chloride ions/Liter

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22
Q

true or false

sodium chloride injection, USP is sterile

A

true

sterile and isotonic

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23
Q

*explain what bacteriostatic sodium chloride injection is

A

sterile and isotonic (like sodium chloride injection)

BUT also has 1 or more antimicrobial agents – must be specified on the label not for use in neonates!!!!!

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24
Q

*****true or false

water for injection is isotonic

A

FALSE

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25
Q

**true or false

water for injection is not sterile

A

true

it’s not sterile – END PRODUCT MUST BE STERILIZED!!!

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26
Q

*when adding a non-aqueous vehicle to a parenteral product, it must be both physically and chemically stable at…..

A

VARIOUS pH levels

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27
Q

*when adding a non-aqueous vehicle to a parenteral product, it is important that ___ is maintained over ____

A

fluidity is maintained over a fairly WIDE temperature range

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28
Q

*when adding a non-aqueous vehicle to a parenteral product, how is boiling point a consideration?

A

must be high enough to allow for heat sterilization

*****HIGHER THAN 170 degrees celsius!!!!

29
Q

*true or false

when adding a non-aqueous vehicle to a parenteral product, it must be miscible with the body fluids

A

true

30
Q

*when adding a non-aqueous vehicle to a parenteral product, how is vapor pressure a consideration?

A

MUST BE LOW!!!! to avoid problems during heat sterilization

(LOW tendency to evaporate when heated)

31
Q

cosolvents are added to parenteral products to increase _____ and perhaps ____

A

drug solubility and perhaps stability

32
Q

water IMMISCIBLE vehicles are generally NOT used in parenteral products

when would they be used and what might be used?

A

for TPN emulsions or IM depots

only fixed oils and their derivatives

33
Q

**true or false

a nonaqueous solvent turns viscous when the temperature decreases

is this good or bad

A

BAD

should maintain fluidity over a WIDE temperature range

34
Q

*when adding a non-aqueous solvent to a parenteral product, the boiling point must be…

A

GREATER THAN 170 DEGREES CELSIUS

35
Q

*
“(DRUG) INJECTION)

A

LIQUID – drug solution

36
Q

*
“(DRUG) FOR INJECTION

A

DRY SOLID

when you add a suitable vehicle, it will make a solution, meeting all the requirements for an injection

37
Q

*
(drug) injectable emulsion

vs

(drug) injectable suspension

A

drug injectable emulsion - LIQUID. drug is dissolved or dispersed in EMULSION medium

drug injectable suspension - LIQUID. solid is suspended in liquid medium

38
Q

**
“(drug) for injectable suspension)”

A

DRY SOLID

will become an INJECTABLE SUSPENSION when a vehicle is added

39
Q

*true or false

(drug a) for injection is supplied as a vial of injectable solution

A

FALSE - dry powder

when you add diluent it will form solution

40
Q

***** relationship between gauge number and lumen diameter

A

as the gauge number increases, the lumen diameter DECREASES

IE - 18 gauge is LARGER than 22 gauge

41
Q

rank the following according to the volume of their injection:

sub Q
IM
IV
ID

A

largest - IV
IM
SUBQ
smallest - ID (intradermal)

42
Q

intravenous preparations can be ___ or ____

A

aqueous solutions OR O/W emulsions (ie - TPN)

43
Q

max volume for a SUBQ injection

A

1mL

over 2mL can cause a painful pressure

44
Q

where is SUBQ injected

A

under the skin - between the dermis and the muscle

45
Q

**rate the following according to onset time

IM
SUBQ
IV

A

slowest - SUBQ
IM
fastest - IV

46
Q

*WHY is SUBQ injection the slowest onset

what can be done to increase the absorption rate?

A

bc blood flow is SLOW

onset of action and absorption rate are slower

can use heat or massage the site, or administer vasodilators

47
Q

administering epinephrine near the time of a SUBQ injection will increase or decrease the absorption rate of the SUBQ drug?

A

decrease – bc blood flow decreased

48
Q

explain the onset and length of duration for an IM injection

A

SLOW onset but longer lasting

ie - emulsion depot – bolus forms a depot and drug slowly releases

49
Q

common syringe and gauge needle for IM injections

A

3mL syringe
18-25 gauge needle

50
Q

the limit on the amount of IV fluid you can give to a patient in one day is determined by what?

A

the amount of fluid that the person’s body can take every day

35-50mL/kg/day

51
Q

2 risks of IV injections

A

thrombus and embolus

52
Q

IV administration can be divided into ….
(based on time)

A

continuous infusion
intermittent
bolus or IV push

53
Q

needle size for IV

A

20-22 gauge

54
Q

for continuous IV infusions, the drug is added to….
and then administered how?

A

added to a large volume parenteral solution

slowly and continuously dripped into a vein

55
Q

true or false

continuous IV infusions have an advantage over IV push/bolus because they are less irritating to the vein

A

TRUE – bc they are in dilute solutions, and IV push is highly concentrated in a small volume of solution

56
Q

IV continuous infusions are beneficial because ——- can be administered at the same time

A

drug therapy AND fluid

57
Q

which is usually cheaper - IV bolus/push or continuous infusion?

A

continuous infusion bc less units needed – and less staff

58
Q

true or false

giving drugs via continuous IV infusion can be dangerous because blood levels are unpredictable

A

FALSE — advantage that the blood levels are continuous and constant

59
Q

3 disadvantages of continuous IV infusions

A

-more monitoring bc runs continuously

-CANNOT BE USED on fluid-restricted patients

-certain unstable drugs cannot be given via continuous infusion – bc of the extended running times. ex - drug unstable in water must be given quickly

60
Q

explain how IV intermittent preparations are administered

A

given an intermediate volume in spaced intervals (ie for 15 mins - every 6 hours)

61
Q

true or false

an advantage of INTERMITTENT IV is that is requires LESS monitoring than continuous infusion

A

true

62
Q

advantage of intermittent IV over bolus/push

A

many drugs are more stable at moderate concentrations than concentrated
also, less chance of bolus toxicity

63
Q

true or false

drug levels are LESS CONSTANT with intermittent IV than for continuous IV

A

true - this is a disadvantage

64
Q

which IV administration is really the only one suitable for emergencies

A

IV bolus/push

65
Q

true or false

IV bolus/push requires monitoring

A

false - it does not

66
Q

a disadvantage of IV bolus/push is that some drugs are ____ in concentrated solutions

A

less stable

67
Q

IV bolus/push can be given as one time administration or…..

A

may be repeated in spaced intervals

disadvantage when given again bc requires more staff — 2-10 mins at bedside for each dose given

68
Q
A

Compounding Final (6 decks)

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