Small & Large Volume Parenteral Products

Fluid volume ≤100 mL

Small volume parenterals

examples of small volume parenterals

1. bags

2. vials

3. ampules

4. bottles

5. syringes

6. ready-to-mix systems

characteristics of small volume parenterals

1. Containers of 100 mL or less

2. IV, ID, IT, SUBQ

3. Administered intermittently (on and off again)

4. One-time doses or given in intervals over a 24-hour period (antibiotics)

SVPs may be used as a ____________ to a primary line

piggyback

characteristics of IVPB

1. small volume over short period of time

2. limits multiple IV sites

3. smaller bag removed once medication is infused

4. medication must be compatible

An _______________ can be administered in addition to a primary IV fluid through the injection port in the main IV fluid line by hand or using a syringe pump

IV push (IVP)

A ___________ syringe is similar in size to an IVP

flush

purpose of a flush

flush the primary IV tubing

flushing the primary IV tubing ensures

1. all drug is administered

2. incompatible medications are not present to cause a reaction

Example IV bag sizes for SVP

25, 50, 100 mL

SVP bags are made from

1. harder plastic

2. flexible PVC material

______________ have injection ports that are not flexible

Harder plastics

Often used for direct administration through parenteral route, needle used for compounding is removed from syringe and replaced with a plastic cap to maintain closure/sterility , New sterile needle applied for patient administration

syringes prepared by compounder in sterile hood

Attach directly to access catheter (needleless) or requires needle attachment. suitable for SUBQ or IM injections

Pre-filled Syringe prepared by manufacturer

advantages of pre-filled syringes

1. Minimize medication errors

2. Lower contamination risk

3. Minimize needlesticks (needleless only)

4. Convenient & easy to use

disadvantages of pre-filled syringes

1. malfunction

2. breaking

3. clogging

advantages of ready-to-mix systems

1. significant reduction of waste

2. lower potential for medication errors

3. minimize contamination, needle sticks

disadvantages of ready-to-mix systems

1. costly

2. Potential for system to not be properly activated like receiving diluent or partial drug

Plastic tool used for joining a vial with a powdered drug and an IV solution bag

Vial-Mate®

Vial-Mate® bag has two ends of attachment

1. patient IV port

2. medication vial

Keeps the drug and diluent separate until the system is activated just prior to administration

Add-Vantage System®

components of Add-Vantage System®

1. specially designed diluent container

2. drug vial

Add-Vantage System® drugs can be prepared quickly without

needles, syringes or alcohol swabs

fluid volume is > 100 mL

Large volume parenterals

Large volume parenterals packaging

1. bags

2. bottles

uses for Large Volume Parenterals

1. Administration of medications through IV route

2. Continuous infusion

3. Administration of parenteral nutrition

4. Correction of electrolyte/fluid imbalances

5. Vehicle for administering other drug substances (admixtures)

characteristics of bottles

1. Feature plastic loop that can be peeled away from the body

2. Needs an intravenous additive seal placed over the rubber stopper before leaving an ISO5 environment

2.5% dextrose in water

D2.5W

5% dextrose in water

D5W

5% dextrose and lactated Ringer's solution

D5RL or D5LR

10% dextrose in water

D10W

5% dextrose and normal saline

D5NS

2.5% dextrose and 0.45% saline

D2.51/2NS

5% dextrose and 0.45% saline

D51/2NS

Normal saline

NS

0.45% saline

0.45%NS or 1/2NS

Lactated Ringer's solution

RL or LR

Sterile water for injection

SWFI