Parenteral Chapter 8

1. ParenteralChapter 8 The Pharmacy Technician

2. Parenterals • situated or occurring outside the intestine • parenteral drug administration by intravenous, intramuscular, or subcutaneous injection

3. 2 general types of packaging • Large volume parenteral (LVP) solutions • Typically bags or bottles containing large volume of IV solutions • Uses: electrolye balance, nutrition, fluid balance • Small volume parenteral (SVP) solutions • Generally contained in ampules, pigglyback bags, prefilled syringes and vials. • Can be added by LVP solution or injected directly into the patient

4. Inspections • Inspect after compounding • Visually inspect before use • Visual inspections are generally performed against a brightly lit white background

5. Characteristics • Pg. 172-173 • Solutions for injection but be sterile • Solutions must be free of all visual particulate material • All parenteral solutions must be pyrogen-free • The solution must be stable for its intended use • The pH of an intravenous solution should not vary significantly from the physiological pH, about 7.4 • IV solutions should be formulated to have an osmotic pressure similar to that of blood

6. Osmotic pressure-a characteristic of a solution determined by the number of dissolved particles in it • Isotonic-when a solution had an osmolarityequivalent to blood • Hypertonic-when a solution has a greaterosmolarity than that of blood • Hypotonic-when a solution has a lesserosmolarity than that of blood

7. Parenteral Routes • Intravenous • Intramuscular • Intradermal • Subcutaneous • Epidural • Intrathecal • Intranasal • Inhalation • opthalmic

8. Administration Devices • Administration set • Heparin lock • Piggyback • Positive Pressure Infusion Devices • Combination controllers & pumps • Peristaltic Pumps • Cassette Pumps • Syringe Pumps • Elastomeric Reserviors

9. Syringes & Needles • Basic Parts of Syringe • Barrel, plunger & tip • Syringes come in sizes ranging from 1 to 60 m • Basic Parts of a Needle • Bug, shaft & bevel • Lumen-hollow bore of the need shaft • Needles are classified by length & gauge

12. Filters • Used to remove particulate materials or microorganisms from solutions • Depth filters-filter that can filter solutions being drawn into or expelled from a syringe, but not both ways in the same procedure • Membrane filters-a filter that filters solution as the solution is expelled from the syringe • Final filters-filter that filters solution immediately before it enters a patient’s vein

13. Laminar Flow Hoods, Biological Safety Cabinets, Clean Rooms • Laminar Flow Hoods • Establishes and maintains an ultra clean work area • Used to prevent contamination • Biological Safety Cabinets • Take air into the cabinet through te work surface and recycle it through a HEPA filter • Clean Rooms • House laminar flow hoods and biological safety cabinets • Regulations are established to maintain class 100 environment

14. Aseptic Techniques • Aseptic techniques maintain the sterility of all sterile items and are used in preparing admixtures. • Clothing & barriers • Collect supplies • Wash hands • Position supplies in hood • Sterilize puncture surfaces **Sterile supplies often have instructions for use as well as expiration dates. Always follow such instructions along with any facility or manufacture instructions.

15. Vials & Ampules • 2 types of parenteral vials • Vials Containing Solution • Vials Containing Lypholized Powder • Ampules-sealed glass containers with an elongated neck with a colored stripe **potential for coring vials

16. Special Solutions • Parenteral nutrition solutions are complex admixtures compose of dextrose, fat, protein, electrolytes, vitamins and trace elements used to meet patient nutritional needs. • Total parenteral nutrition solutions (TPN) • Dialysis solutions • Irrigation solutions • Surgical & urological