Hazardous Drugs all about

 

• Large-Volume Parenterals

• Large-volume parenteral (LVP) – is used to replenish fluids and to provide drugs, electrolytes, and nutrients such as vitamins, minerals, and glucose.

  LVPs commonly available:

    • 250 mL, 500 mL, and 1000 mL

  
  

  Potassium chloride is the most common additive.

  Lactated Ringer’s Solution – IV solution that contains a specific mixture of electrolytes.

  
  

• Small-Volume Parenterals

• Small-volume parenteral (SVP) – a CSP that is dispensed in a minibag; over a short time period 10 minutes to an hour.

  SVPs commonly available:

    • 25 mL, 50 mL, 100 mL, 150 mL, or 250 mL

  
  

  IV piggybacks (IVPBs) – majority of SVPs prepared; small volume (50 to 100 mL) of a base solution (D5W) and a medication. Special SVP solutions include frozen IV solutions, premade IVPBs, and vial-and-bag systems.
• Preparation of Labels for LVPs and SVPs

  A CSP label should contain the following:

  Patient’s name and id #

  Room number

  Medication name and dose

  Base solution and amount

  Infusion period

  Flow rate

  Beyond-use date

  Signature or initials

  Additional information

  Aseptic Preparation of IV Products

  Sterile preparations of IV medications by pharmacy personnel include single- and multi-dose vials, ampules, and other containers that must be transferred to an LVP or SVP.

  CSPs must be prepared in an ISO Class 5 laminar airflow hood.

• • Specialized Sterile Compounding Procedures

  • Vials – a sealed, sterile, plastic or glass container that has a hard plastic cap; sizes range from 1 mL to 250 mL.

    Types of vials: 
  • • Single-dose vials (SDV)
        • do not contain a preservative
        • one-time use
        • used within 1 hour or discarded
    • Multi-dose vials (MDV)
        • do contain a preservative
        • stable for 28 days

  • Withdrawing Fluid from a Vial

  • 1. First disinfect the rubber stopper with 70% isopropyl alcohol.
    2. Pierce the rubber top with a needle-and-syringe unit.
    3. Bevel up; penetrate at an angle; straightened to 90 degrees.
  • Coring – the inadvertent introduction of a small piece of rubber top into the solution.
    

    A milking technique must be used to release negative pressure within the vial.