117: Parenteral Products and Administration

objectives

• Be familiar with the different administration devices

• Know the different types of containers and advantages/disadvantages.

• Know the different types of catheters and advantages and disadvantages of each

Small Volume Parenterals (SVPs)

Intravenous solutions, 100 ml or less

pH and tonicity can be physiologically incompatible

Large Volume Parenterals (LVPs)

Intravenous solutions more than 100 ml

pH and tonicity should be physiologically compatible

different small volume parenterals

 Multi-Dose Vials

 Single Dose Vials

 Ampules

 Sterile lyophilized powders

 IV Piggybacks

 Prefilled Syringes

 Add-Vantage IV System

 Mini Bag Plus

multi-dose vial

• vial of liquid med, has more than one dose of med

• max 30 ml

• has rubber stopper

  • can be punctured multiple times

  • reseals when needle withdrawn to protect from contamination

• has preservatives —> sterile

  • once punctured, vial should be dated & discarded within 28 days (unless manu dated dif)

  • discard by manu exp date if not opened

single dose vial

• vial of liquid med, single use for a single case, procedure, injection

• 1-100ml

• has rubber stopper

  • penetrate once and discard vial

• no preservatives

ampule

• sealed glass container w. elongated neck

• must be snapped off before use

• do not reseal, discard remaining solution

how to use ampule since can be contaminated w. glass shards when opened

• use a filter needle to withdraw solution

• replace filter needle w/ new one before adding to another container or give to pt

filter needle

has filter in needle

pred-filled syringe

• prepackaged pre-filled syringes

• ready for immediate use

• use in cartridge for pump

large volume

 Fluid Administration

 Total Parenteral Nutrition (TPN)

 Dialysis Solutions

 Irrigation Solutions

containers

• Must be able to maintain the integrity of the product as a sterile, pyrogen-free, high

  purity preparation

• 2 types

  • glass

  • plastic

glass containers

• usually has a vacuum

• rubber stopper

• graduation marks

• require venting

Advantages of glass

 Rigid

 Fluid levels easier to read

 Relatively nonreactive

 Protects against vapor

 Withstands steam sterilization*

Disadvantages of glass

Fragile

Takes up space

Venting can lead to contamination

2 types of plastic containers

Polyvinyl Chloride (PVC)

Polyethylene (polyolefin)

Advantages of plastic

 Lightweight

 Flexible

 Easier to store

 Will not break

 No air venting needed because they collapse when emptying

Disadvantages of plastic

• Permeable to vapors and other molecules in either direction through wall of plastic container

• Leaching of constituents of plastic into product

• Adsorption of drug onto sides of plastic container

permeation

Problem solved by using overwrap to retard water loss from container

administration set

 Deliver IV fluids and regulate flow

 Plastic spike to pierce the IV container

 Drip chamber to trap air and allow for flow rate adjustment

 Adjustable clamp

 PVC tubing with injection port

 Can inject additional medication through this port if needed

 Needle or catheter adapter

 Flashball*

tubing

Tubing without venting for use with plastic IV containers

types of tubing

macro drip

• 10 drops/ml

• 15 drops/ml

• 20 drops/ml

microdrip

• 60 drops/ml

ex: problem

• 1000 ml D5/0.45 NaCl + 30 meq potassium chloride to run continuously @ 100ml/hr

• if tubing used to admin IV is labeled as 15 drops/ml

• QueSTION: how fast should IV run in drops/minute\

answer: 25 gtt/min

admin devices

Manual Flow Regulator

Used with gravity infusion to set infusion rate

2 types of Controlled Rate Infusion Pumps

Cassette Pumps

Syringe Pumps

Cassette Pumps

• Small in size, useful as ambulatory pumps

• Cassette acts as reservoir, tubing connects the cassette to the patient

Syringe Pumps

• Syringe attached to a pump expels solution from the syringe by advancing the

plunger or barrel at a predetermined rate

• for intermittent drug administration

• Useful for neonatal, infants, critical care

  • small volumes need to be given over extended periods of time

• use to deliver IV push more controlled

Controlled Rate Infusion Pumps

• Elastomeric Reservoirs/Pumps

• aka home ball or ball pump

• balloon like reservoirs, filled w. medication that is forced out thru a flow restrictor

• intermittent or slow

• continuous infusions

Volume Control Chamber

• for ped pts

• Purpose: Prevents accidental infusion of too much IV fluid.