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Drew 924 > Sterile Products for Injection > Flashcards

Sterile Products for Injection Flashcards

(91 cards)

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1
Q

What are the advantages of parenteral administration?

A

1) fast drug action
2) prolonged, high, tightly controlled [drug]
3) 1st pass avoided
4) drug poorly absorbed any other way

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2
Q

Disadvantages of parenteral administration?

A

1) sterile technique
2) professional admin
3) irritation, toxicity, pain
4) difficult to correct error

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3
Q

What is the most invasive method?

A

IV > IM > SQ

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4
Q

What method requires most skill?

A

IV > IM >SQ

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5
Q

What methods gives most rapid onset?

A

IV&raquo_space; IM, SQ

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6
Q

What method causes most pain?

A

IM > IV > SQ

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7
Q

How long for IV mixing in body?

A

4-5 minutes

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8
Q

USP requirements for parenteral admin:

A

1) sterile
2) non-pyrogenic
3) particulate matter…

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9
Q

Which routes must have isotonic products?

A

intrathecal, IV infusion

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10
Q

What is the osmolarity of blood?

A

275 - 300 mOsm/kg

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11
Q

What is particulate requirement for SVPs?

A

1) no visible particles
2) 10 um: less than 3000
3) 25 um: less than 300

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12
Q

What is particulate requirement for LVPs?

A

1) no visible particles
2) 10 um: less than 12/mL
3) 25 um: less than 2/mL

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13
Q

What USP chapter regulates particulates in IV products?

A

788

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14
Q

How is particulate matter regulated for parenterals?

A

only regulated for IV products

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15
Q

How large is capillary lumen?

A

5 - 20 um

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16
Q

What is diameter of RBC?

A

10 um

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17
Q

What are the 3 layers of blood vessels?

A

tunica intima, intermedia, adventitia

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18
Q

Body water makes up how much of TBW?

A

60 %

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19
Q

What percentage of blood is venous?

A

75%

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20
Q

What percentage of blood is arterial?

A

20%

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21
Q

What percentage of blood is in capillary system?

A

5%

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22
Q

What is pH of blood?

A

7.4 with heavy buffer

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23
Q

On what is blood volume dependent?

A

physical activity

NOT AGE

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24
Q

What percentage of TBW does blood make up in men (women)?

A

6-8% (5-7%)

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25
What is the protein concentration in blood?
65 - 80 g/L
26
What proteins are present in blood?
1) albumin (primarily) 2) a/b-globulins 3) glycoprotein 4) hormones 5) esterases 5) DNAse
27
What are the consequences of RBC crenation?
clotting; clogging of spleen
28
What interactions dictate drug-albumin binding?
H, ionic, hydrophobic interactions
29
To what proteins can drugs bind in the blood?
1) albumin 2) acidic glycoproteins 3) lipoproteins
30
What substances does albumin normally handle?
fatty acids, bilirubin
31
What is meant by "bound drug"?
fraction of drug bound by NON-COVALENT interaction in SPECIFIC TISSUE
32
What are the 2 tunnel catheter products discussed?
1) TriFusion | 2) Port-a-Cath
33
What is the care for the TriFusion tunnel cath?
saline & heparin lock rinse BID
34
How do TriFusion & Port-a-Cath differ?
TriFusion has external access port | Port-a-cath is totally implanted
35
What is the advantage of Port-a-Cath?
1) opens directly at heart for max dilution | 2) minimal infection risk
36
Describe infusion via TriFusion.
1) 3 lines = 3 drugs @ 3 different rates 2) 3 lines turn into 1 3) often used for pheresis treatments
37
How many doses to steady state for intermittent (piggy-back) infusion?
4-5
38
What muscles are used for IM injection?
1) Deltoids 2) ventrogluteal 3) dorsogluteal 4) vastus lateralis
39
Which muscle is targeted for self-IM administration?
vastus lateralis
40
What compounds are commonly injected IM?
1) hormones 2) vaccines 3) antibiotics
41
What accounts for IM blood-level variability?
1) vascularity 2) blood flow 3) fraction of mass as fat 4) fraction of mass as muscle
42
How does vascularity influence absorption in IM injection?
increased vascularity --> increased absorption
43
How does blood flow influence absorption in IM injection?
increased flow --> increased absorption
44
How can blood flow be increased?
1) irritation - - hypertonic - - extreme pH - - irritating cosolvent (acetate) 2) inflammation via muscle damage
45
How can blood flow be decreased?
vasoconstrictors (applied with local anesthetic)
46
How does fat-fraction affect absorption?
Fat less densely vascularized | -- longer tmax, lower Cmax
47
What is the volume of an LVP?
> 100mL
48
What chapter regulates LVP/SVP volume?
32
49
What are common uses for LVPs?
1) fluid replacement 2) TPN 3) IV admin vehicle
50
Advantages of plastic bag for LVP:
1) lightweight 2) hard to break 3) no venting required
51
Disadvantages of plastic bag for LVP:
1) permeability to O2, H2O 2) leaching of plasticizer 3) interaction with PVC / polyolefin
52
How are LVPs supplied?
plastic or glass
53
What are the advantages to glass bottles for LVP?
1) resistance to chemical interaction 2) impermeable to gas & microbes 3) transparent 4) easy cleaning & sterilizing
54
What are disadvantages to glass for LVP?
1) weight 2) breakage 3) light 4) venting
55
What are containers for SVP?
1) ampule 2) vial 3) pre-filled syringe
56
What is the max volume for ampule?
50 mL
57
What material is commonly used to supply pre-filled syringes?
glass
58
What are the necessary considerations for a pre-filled syringe?
1) proper storage (light, T, security) 2) abuse or injury thru disposal 3) pharmacist-provided pre-fill
59
What drugs are commonly dispensed in a pre-filled syringe?
1) insulin 2) small MW heparin (lovenox) 3) Imitrix for migraine
60
What are the types of glass?
1 - 3, NP
61
What is Type 1 glass' material?
Borosilicate
62
What is Type 2 glass' material?
Treated Soda Lime
63
What is Type 3 glass' material?
Untreated Soda Lime
64
What is Type 4 glass' material?
General Purpose Soda Lime
65
Describe Type 1 glass
borosiliate - - any pH - - steam sterilized - - most expensive
66
Describe Type 2 Glass
treated soda lime - - steam sterilized - - SO2 treated - - neutral/acidic solns
67
Describe Type 3 Glass
untreated soda lime - - non-aqueous systems - - dry-heat sterilized
68
Describe Type NP glass
General purpose soda lime - - oral products only - - cheap
69
What is defined as "light-resistant?"
no more than 10% of incident light radiation 290 - 450 nm
70
What is max capacity for single-use glass container?
1 L; slight over-fill ok
71
What is max capacity for multi-dose glass container?
30 mL unless waiver present
72
What is max capacity for irrigation glass containers?
no limit
73
What type of plastic is used for blood products?
PVC
74
What type of plastics are used for LVP?
1) PVC 2) polyesters 3) polyolefin
75
What type of plastics are used for SVP?
polycarbonate
76
What type of plastics are used for syringes?
1) polyethylene (HDPE) | 2) polypropylene
77
What type of plastics are used for administration sets?
1) tubing is PVC | 2) spike is nylon
78
What type of plastics are used for catheters?
1) teflon | 2) polypropylene
79
What types of plastics are "very flexible?"
1) PVC 2) polyesters 3) polyolefin
80
What types of plastics are "semi-rigid?"
1) teflon | 2) polypropylene
81
What types of plastics are "rigid?"
1) polyethylene 2) polypropylene 3) polycarbonate
82
What percentage of light passes thru polycarbonate?
90%
83
What percentage of light passes thru PVC & Polystyrene?
75%
84
What percentage of light passes thru polypropylene & polyethylene?
70%
85
Which plastic is most permeable?
PVC
86
Which plastic is least permeable?
Polyethylene
87
Rank plastics by permeability (PVC, polypropylene, polyethylene)
Most = PVC --- Polystyrene Least = Polyeth
88
What is Ka relating to IM injection?
partitioning into plasma
89
What types of IM solutions can act as suspensions?
Hydrophobic drug in solution w/ co-solvent | -- slow dissolution step
90
What are the sites for SQ injection?
varies sites on torso, thigh, tricep
91
Why is needle size important for SQ injection?
needle length varies by BMI & gender

Drew 924 (16 decks)

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