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Dosage Forms II > Sterile solution dosage forms > Flashcards

Sterile solution dosage forms Flashcards

Exam 2 Content (Pinal's Lectures)

1
Q

Aseptic Technique

A

Manipulation of materials in such a way as to avoid accidental introduction of microorganisms

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2
Q

What areas is aseptic technique used?

A

Surgical and Pharmacy (pharmacy is more stringent)

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3
Q

USP 797

A

used for ALL injectables

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4
Q

USP 800

A

used for HAZARDOUS drugs, if they are injectable then they also fall under USP 797

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5
Q

Three sources of aseptic technique contamination

A

-people (main source)
-equipment
-environment

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6
Q

How do we take care of contaminations?

A

-environment: control it (set standards for first air)
-equipment: sterilize it and sanitize it (disinfection)
-people: train, garb, develop good habits, test them (once a year min.)

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7
Q

Training and Knowledge

A

More experience doesn’t mean that you’re doing it right

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8
Q

PEC

A

primary engineering control/laminar flow LAFW

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9
Q

Laminar flow

A

streamline flow of a fluid in which the fluid moves in layers without turbulence

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10
Q

HEPA filtered

A

VERY CLEAN (ISO Class 5)
-has <100 particles per 0.5 microns per cubic foot

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11
Q

Horizontal flow

A

-type of laminar flow hood
-air is blowing on your face
-easier to make someone confident

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12
Q

Vertical flow

A

-type of laminar flow hood
-air is coming from ABOVE the hood
-used for HAZARDOUS drugs (so it doesn’t blow back in your face)

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13
Q

Isolators

A

closed system, nothing is exposed to the outside environment

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14
Q

Critical site

A

-a point where microorganisms are other contamination could enter a parenteral product
-ex: hole when piercing a rubber stopper

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15
Q

Direct compounding area

A

-critical area
-space between the HEPA filter and the critical site
-must keep uninterrupted laminar air flow in this area (First air)

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16
Q

Is the laminar flow hood a sterile environment?

A

No, it is VERY CLEAN but not sterile

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17
Q

First air

A

the air exiting the HEPA filter in a unidirectional air stream

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18
Q

OsmolaLity

A

the concentration of particles dissolved in solution (osmoles of solute per kg of solvent)

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19
Q

OsmolaRity

A

-number of osmoles of a solute in a LITER of solvent
-whether they dissociate
-measured by an osmometer

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20
Q

Osmosis

A

-diffusion of water
-water flows from HIGH concentration (of water) to LOW concentration (of water) to DILUTE the more solute concentrated side
-semipermeable membrane

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21
Q

Iso-osmotic

A

-maintaining and possessing a uniform tension or tone of the cellular membrane of the cell
-same m-particles and concentration of the BLOOD SERUM

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22
Q

Isotonic

A

cells will stay alive
-is something is isotonic, then the cell will be able to tolerate that concentration

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23
Q

What are the two ways that concentration equalizes?

A

Diffusion and Osmosis

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24
Q

Diffusion

A

-SOLUTE moves from HIGH to LOW
-permeable membrane

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25
Q

What kind of membrane do cell membranes have?

A

semipermeable (some things can cross, others can’t)

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26
Q

Impermeable

A

nothing goes through (cell starves)

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27
Q

Permeable

A

everything goes through (cell ends as an empty shell and dies)

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28
Q

Do cells want to fold or expand?

A

FOLD, if a HYPOtonic vehicle is administered then it can burst the cell

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29
Q

How do you measure the osmolarity and osmolality of a preparation?

A

Osmometer through the use of colligative properties

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30
Q

What are the colligative properties?

A

-freezing point depression
-lowering of vapor pressure
-OSMOTIC PRESSURE
-elevation of boiling point

31
Q

m-particle

A

molecules or ions (not the chemical nature of the dissolved materials)

32
Q

Are colligative properties integrated?

A

Yes, if you know one property then you can figure out the other properties

33
Q

When can osmolarity and osmolality be used interchangeably?

A

at LOW concentrations, dangerous if we treat them at HIGH concentrations

34
Q

What is the serum osmolality?

A

275 - 310 mOsmol/kg
275 is D5W and 310 is normal saline (demonstrating a wide range)

35
Q

Tonicity

A

refers to the effect on LIVING cells

36
Q

What is the relationship between iso-osmotic and isotonic

A

-if a solution is isotonic then it is also osmotic
-mixing iso-osmotic solutions, the solution will stay iso-osmotic
-mixing isotonic solutions you get an isotonic solutions

37
Q

Are normal saline and D5W interchangeable?

A

they are both isotonic but NOT interchangeable (check the monograph/package insert)

38
Q

What will happen if you add an iso-osmotic solution to dissolve a large amount of drug?

A

you will get a HYPERosmotic solution

39
Q

Which is better, a HYPER-osmotic solution or a HYPO-osmotic solution?

A

HYPER-osmotic solution since it will shrink cells, while HYPO-osmotic solutions will burst the cells
-iso-osmolarity is always desirable though

40
Q

Peripheral

A

-accessed through needles
-uses over the needle catheter (helps stabilize)

41
Q

Central

A

-peripherally-inserted central catheter (used for long doses of treatment or long term treatment)
-surgically implanted

42
Q

For storage uses, how are emulsions stored?

A

glass vials (haven’t figured out how to store in plastic bags)

43
Q

What are the peripheral access administration sets?

A

basic set
add-a-line set
volume-control set

44
Q

Basic administration set

A

has only ONE y-site

45
Q

Add-a-line set

A

-has TWO y-sets
-good to administer drugs that don’t mix/like to interact with other drugs

46
Q

Volume-control set

A

-characterized with a long plastic container
-used for volume control and dilution
-good for accuracy

47
Q

Benefits of ADD-vantage system

A

-characterized by a vial and bag with seals
-maintains sterility and aseptic technique when mixing drugs
-decreases the risk of contamination

48
Q

Disadvantages of ADD-vantage system

A

more expensive

49
Q

What are the two types of administration sets?

A

Macrodrip (standard)
Microdrip

50
Q

Characteristics of a macrodrip

A

-delivers large quantities
-faster rates (10, 15, 20 gtt/mL)

51
Q

Characteristics of a microdrip

A

-delivers smaller quantities
-60 gtt/mL
-used in pediatrics
-also used for patients that need a small/closely regulated amounts of IV solution

52
Q

What are the components of resistance to flow?

A

-tubing (thin diameter = tougher to go through)
-in-line filter (“a wall” might oppose the flow)
-viscosity of IV fluid (challenging to push through small tubing)
-length of tubing (longer tubing = increased friction)
-venous backpressure (position of the patient)

53
Q

Excess volumes of parenteral products

A

-the labeled mL is not the exact amount (it will contain more to ensure they can pull the exact amount)
-viscous liquids have more excess
- >50mL solutions will have a constant error

54
Q

What things influence the drop conversion factor?

A

-viscosity of the CSP
-surface tension
-density

55
Q

Uses of Central Venous Therapy

A

-infusion of LVPs (since it can be diluted quickly)
-multiple infusions
-long-term infusion therapy ((avoid being sticked more)
-infusion of irritation medications such as potassium (due to quick dilution)
-Parenteral nutrition

56
Q

PICC (peripherally inserted central catheter)

A

-inserted through the arm and is inserted into the SUBCLAVIAN VEIN
-a very complex insertion
-can also be inserted through the neck into the jugular vein

57
Q

Central vein catheter (CVC)

A

-surgically implanted
-can have multiple lumens (allowed to give multiple medications through the same line)

58
Q

What are the two common names of central lines?

A

-Hickman
-Brovaic

59
Q

Characteristics of the Hickman catheter

A

-requires surgical insertion (inserted through the chest into the subclavian vein)
-has a dacron cuff

60
Q

Dacron cuff

A

-used in Hickman catheters
-plugs the hole so bacteria can’t enter the hole
-keeps the catheter in place
-biocompatible (to avoid an immune response)

61
Q

What is a Vascular Access Port

A

-surgically implanted and goes under the skin (no exposure to the outside world)
-pay attention to the SEPTUM

62
Q

What needle is required in Vascular Access Ports

A

a NON-CORING NEEDLE (right angle?)

63
Q

Advantages of Central Venous Therapy

A

-access to central veins
-rapid infusion of LVPs
-draw blood and measure CV pressure
-reduced need for repeated vein punctures
-reduced risk of vein irritation when giving irritable drugs

64
Q

Risks of Central Venous Therapy

A

-sepsis
-thrombus formation
-perforation of vessel and adjacent organs
-air embolism

65
Q

Disadvantages of Central Venous Therapy

A

-cost
-requires more skill to insertR

66
Q

Risks of infusion

A

-stenosis (narrowing of the vein)
-thrombus (clot)
-venous occlusion
-chemical inflammation (phlebitis) and pain

67
Q

What are two instruments that are used to control flow?

A

Controllers (not used as much anymore)
Pumps (standard)

68
Q

Characteristics of infusion controllers

A

-powered by gravity
-controls the speed by opening and closing

69
Q

Characteristics of infusion pumps

A

-powered devices
-has a wide range of pressures that accounts for vein and artery (2-12 psi)
-always to check the pump, don’t set it up and leave

70
Q

Features of infusion pumps

A

-volumetric delivery (independent of vascular back pressure, infusion composition, and tubing resistance)
-has alarms (ONLY ALRMS WHEN SOMETHING IS WRONG WITH THE PUMP NOT SITE OF ADMINSTRATION)

71
Q

Syringe Pumps

A

-very useful for giving intermittent IV medications
-gives good control for small volume infusions
-useful for pediatric patients

72
Q

Patient controlled analgesia (PCA)

A

-given for cancer patients where they push the button to administer pain meds

73
Q

Ambulatory pumps

A

-for shorter use
-external pump
-used to measure sugar and administer drugs

74
Q

Implantable pumps

A

-for chronic users
-internal implantation

Dosage Forms II (8 decks)

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