ZOOM Lecture - Trissles 7 Alligaton - Jan 26

Weather Report and Snow Accumulation

  • Discussion on local snow totals in West Roxbury, Boston.
    • West Roxbury total: 21 inches.
    • Longwood Fenway area: 15 inches, reported via social media with measurements.

Transition to Lecture Topic

  • The main focus of today's discussion is on Parenteral Dose Forms and their administration.

Review of Previous Discussions

  1. Parenteral Solutions:
    • Common solutions discussed include:
      • Dextrose 5%
      • Sodium chloride 0.9%
    • Focus on how to mix and administer doses within these solutions.
  2. Administration Techniques:
    • Types of administration:
      • Bolus
      • Intermittent infusion
      • Continuous infusion
  3. Dosage Calculations:
    • Doses calculated based on patient weight (pounds/kilograms).
      • For instance, a 5 mg/kg dosage example.
  4. Labeling and Overfill Rule:
    • Discussed the importance of proper labeling and the rules regarding overfilling bags.
  5. Drug Compatibility:
    • Use of Handbook of Injectable Drugs to determine drug compatibility with solutions.

Current Lecture Focus

  1. How to Determine Volume for Drug Solutions:
    • Understanding how to establish how much solution is needed for a given dose.
  2. Formulation of Non-Commercial Solutions:
    • Importance of creating solutions not readily available, such as:
      • 20% Dextrose Solution
      • 30% Dextrose Solution
      • 3% Sodium Chloride Solution
  3. Key Reference:
    • Use the ASHP (American Society of Health-System Pharmacists) Handbook of Injectable Drugs as a primary resource.

Key Principles and Calculations

  1. Solubility of Drugs:
    • Each chemical has specific solubilities and concentration ranges.
    • Discussed how to identify low and high ranges for solubility.
  2. Dosage Calculation Example:
    • Example provided for Acyclovir dosing in a 78 kg patient:
      • Dosage: 5 mg/kg every 8 hours for 7 days.
      • Total dosage = 390 mg.
  3. Compatibility Information:
    • Method of looking up how acyclovir mixed in solutions; the concentration studies demonstrate compatibility.
    • Examples include:
      • 5 grams of acyclovir in 1 L dextrose 5% is compatible.
      • Other concentrations assessed for compatibility.
    • Establishes the compatible concentration range for acyclovir as 1-10 mg/mL.

Practical Application in Dosing

  1. Volume Calculation for Patient Appeals:
    • Dosing range established; e.g., 390 mg could fit into a volume ranging from 39 mL to 390 mL depending on concentration.

Availability of IV Solutions

  • Overview of commercially available dextrose solutions of varying sizes:
    • Example sizes: 25 mL, 50 mL, 100 mL, 150 mL, 250 mL.
  • Calculation for filling doses into each bag size was explained, ensuring concentrations remain acceptable (within the range of 1-10 mg/mL).

Laboratory Practices

  • Steps and procedures to collect data from the ASHP Handbook for practical applications in lab settings.
  • Importance of selecting familiar and commonly used solutions; e.g., using Dextrose 5% for calculations to establish appropriate ranges.

Allegation Method for Formulating Non-Commercial Solutions

  1. Concept of Allegation Method:
    • Used to prepare mixtures of different concentrations.
    • Example provided to mix dextrose 50% and dextrose 5% to make dextrose 20%:
      • Parts calculation: 50 - 20 = 30 parts of higher concentration; 20 - 5 = 15 parts of lower concentration.
  2. Final Calculations:
    • Example calculation showed how much of each solution to use to achieve a desired concentration.

Final Laboratory Instructions

  • Students will perform these calculations and prepare solutions in the lab, keeping in mind compatibility and concentration ranges.
  • Emphasis placed on teamwork and collaboration, mirroring real-life practices in pharmacy settings.

Ethical Considerations and Professional Responsibility

  • Importance of accuracy and evidence in practice.
  • Pharmacists must remain updated on drug compatibilities and thoroughly use available references.
  • Pharmacists play a critical role in patient safety and effective medication administration.

Conclusion

  • Summary of primary learning objectives and essential steps for practical applications in compounding and administration of injectable drugs.
  • Questions encouraged to clarify any procedural or informational uncertainties.