Week 3 Flashcards
Personnel Training
- Intial training–> Personnel must be trained by a qualified person and demonstrate competency
-
Initial competency must be demonstrated in —->
1. hand hygiene
2.Garbing
3.Post-garbing fingertip and thumb test
4. Aseptic processing—> media fill, gloved fingertip and thumb testing
Staff training and competency
* Visual observation of hand hygiene
1. Category 1&2 : Every 6 months
2. Category 3: Every 3 months
* Garbing and gloving technique
1.Category 1&2 : Every 6 months
2.Category 3: Every 3 months
Initial test in gloved fingertip and thumb test
- Initial test
* Completed after garbing three separate times
* Completed once after media fill test
Requalification Tests
- Category 1 &2 CSPs: Every 6 months
- Category 3 CSPs: Every 3 months
Media Fill Test
Must be passed initially, then
1. Category 1&2 CSPs: Every 6 months
2.Category 3: Every 3 months
What is active air sampling?
Measured volume of air that is drawn into a device that contains an agar plate; agar plate is incubated to detect microbial growth.
When should air sampling be done?
- Category 1&2 CSPs: Every 6 months
- Category 3: Monthly
What is surface sampling?
This is sampling of the surfaces exposed to sterile compounding with a plate containing growth media
When should surface sampling be done?
- Category 1&2: Monthly
- Category 3 : Weekly
Terminal sterilization
required for CSPs compounded using any non-sterile ingredients
Destruction of microorganisms through steam(autoclave), dry-heat(depyrogenation), gas steriliaztion and ionization.
Heat sterilization methods cannot be used on heat-sensitive drugs
Filtration sterilization
Physical removal of organisms
When is bacterial endotoxin testing required for a CSPs?
- Category 2 injectable CSPs compounded from one or more nonsterile components and assigned a BUD that requires sterility testing
- Category 3 injectables CSPs compounded from one or more nonsterile components
Drug filtration
1.This may take place
* During medication compounding(filter needle,disk filter)
* During medication administration (in-line filter)
2.Used to remove particles from solutions(particulate matter, microoraganisms, air)
Filter needles
1.TPN(dextrose/amino acids)—> 0.22micron filter
2.Lipid—> 1.2 micron fiter
3.TNA—> 1.2 micron filter
4.Particle filtration—> 5micron filter
5.Bacteria—>0.22micron filter
6.Amphotericin B liposomal—> 5-micron filter
7.Infliximab(Remicade)—> less than or 1.2 micron filter
IV Push
Rapid administration, seconds-minutes
Intermittent IV infusion
Small volumes(25-250ml) infused over a specific amount of time(minutes-hours), typically using an electronic infusion device(IV pump)
IV Piggyback (IVPB)
Medication administered via secondary IV tubing connected to the primary tubing
IV Administration
Fentanyl
rapid IV infusion may result in skeletal chest wall rigidity, impaired ventilation, respiratory arrest
IV Administration
Calcium chloride
Indication specific
Cardiac arrest : rapid bolus; Hypocalcemia: intermitttent infusion
IV Administration
Ceftriaxone
Infuse as intermittent infusion over 30 mins, IV push over 1 to 4 mins
IV Administration
IVIG(Intravenous Immune Globulin)
many monoclonal antibodies and biologic drugs
Compounding IV Push/IV Intermittent Infusions
- Reconstitution of lyophylized powder
- Reconstitution and further dilution
- “Stock Solution”—> Large dilution used to prepre multiple doses
Needles
- Compounding: needles with larger lumens will be needed for viscous solutions; smaller if rubber closure on vial can be cored easily.
- Patient care: dependent on patient age/ size, adminsitration rate, administration type (IM.IV,SQ,Intradermal)
