Transcript LWW PPT Slide Template Master

Chapter 4: Delivery Systems
Equipment
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems
• Definition
–
Pieces of equipment that allow a drug to follow its designated
route of administration
• Syringes
–
Uses
• Injection
• Irrigation
• Withdrawal of fluids
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Parts of a Syringe
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Kinds of Syringes
–
Vary in size from 1 mL (1 cc) to 60 mL (60 cc)
–
Hypodermic syringes are marked with calibrations in mm
–
Two special types
• Tuberculin
• Insulin
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Kinds of Syringes
–
Tuberculin
• Narrow, with total capacity of 1 mL
• Used for:
• Newborn doses
• Pediatric doses
• Intradermal skin tests
• Small doses in adults
• Injections just beneath the skin
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Kinds of Syringes
–
Insulin
• Used only for administering insulin to diabetic patients
• Has total capacity of 1 mL
• Calibrated in units (U), representing strength of insulin per
mL
• Most insulin used today is U-100 (100 units of insulin per mL)
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Types of Syringe Tips
–
Luer-lock
• Screw-on fitting for needle that minimizes leaks
–
Slip-tip
• Allows needle to be easily slipped on; more prone to leaks
–
Catheter tip
• Long tip for cleaning out tissue, filling body cavities, attaching
a feeding tube
–
Eccentric tip
• Wide syringe tip usually used for oral applications
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Critical Surfaces of Syringes
–
Any surface that comes into contact with a sterile product,
container, or closure
–
Examples: tip & plunger
–
Hold syringe by barrel
• Syringe Calibrations
–
3-mL syringe: each tenth
–
5- & 10-mL syringes: every two tenths
–
20-, 30-, 50-, & 60-mL syringes: 1-mL increments
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Needles
–
Hypodermic needle
• Fits onto end of syringe
• Used to inject or withdraw a specific amount of fluid
–
Parts of hypodermic needle
• Hub: base that attaches to syringe
• Shaft: longest section
• Bevel: slanted, portion of needle
• Heel: edge of bevel closest to hub
• Tip: end of needle furthest from hub
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Needles
–
Gauge
• Diameter of the opening, or lumen
• Usually ranges from 28 to 16
• The larger the gauge, the smaller the opening
–
Length
• Varies depending on route of administration & body part
• Ranges from 3/8 of an inch to 3 1/2 inches
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Filters
–
Used in combination with needles or other CSP equipment to
help prevent or remove contamination
–
Sizes
• 0.22-micron: removes bacteria & particulates
• 0.45-micron: removes general particulates
• 1.2-micron: removes fungi & particulates
• 5-micron: coarse filter; removes glass shards
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Delivery Systems (cont’d)
• Filters
–
Filter needle
• Molded into hub of needle & designed for one-time use
• Removes glass shards from glass ampules
–
Filter straw
• A thin, flexible, sterile straw with a filter in hub
• Used to withdraw a single dose of fluid from glass ampule
–
Vented needles
• Used primarily for reconstituting a powdered medication
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Needleless Systems
• Allow for mixing of drug & base solution without use of
needle & syringe
• Examples:
–
Vial attached directly to IV bag for mixing
–
Drug & base solution in one bag with a barrier between them
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Intravenous Supplies
• IV Administration Set
–
Parts of an IV system that determine flow rate of fluid or drug
–
Two types
• Vented: for containers that have no venting system (IV
bottles)
• Unvented: for containers that have their own venting system
or do not require it (IV bags)
–
Large-volume IV bag: 500 mL or 1 L
–
IV piggyback: smaller volume bag piggybacked onto largervolume bag (250 mL, 100 mL, 50 mL)
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Intravenous Supplies (cont’d)
• IV Bags and Bottles
–
Sizes: 50 mL, 100 mL, 250 mL, 500 mL, 1000 mL
–
Advantages of plastic bags over glass bottles:
• Lighter
• Less expensive
• Easy to see through
• Non-breakable
• Take up less volume
–
Glass bottles used to avoid absorption of drug by plastic bag or
adsorption of drug to bag
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dosage Containers
• Ampule
–
A sealed, all-glass container containing a single dose of drug
–
Must be discarded after use
–
May shed tiny shards of glass, which mix with contents & must
be extracted using a filter needle or straw
–
Break open neck in laminar airflow workbench toward side
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dosage Containers (cont’d)
• Single-Dose Vials
–
Contain one dose of medicine
–
Are discarded after one use
–
No preservatives are added, as they are not needed
–
Top of vial has a rubber stopper, which is pierced by needle
• Multiple-Dose Vials
–
Allow you to use contents more than once
–
Rubber stopper is punctured several times, exposing CSP to air
–
Preservatives are included to keep contents stable
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Special Equipment for Sterile
Compounding
• High-Efficiency Particulate Air (HEPA) Filtration
–
HEPA filters are used in all aseptic processing areas
–
Required to satisfy USP’s guidelines for Class 5 environments
–
Can extract any particles larger than 0.5 microns
–
Filters must be tested & certified every 6 months
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Special Equipment for Sterile
Compounding (cont’d)
• Laminar Airflow Workbench (LAFW)
–
A work area that prefilters large contaminants from workspace
–
Uses HEPA-filtered air in horizontal flow to extract smaller
particles
–
Process
• Regular room air is pulled through vent by standard filter
• Air is pushed toward back of LAFW
• Air passes through HEPA filter
• HEPA-filtered air is then forced over work area at 90 ft/min
• This sweeps particulate matter away from product being
compounded
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Special Equipment for Sterile
Compounding (cont’d)
• Biological Safety Cabinet
–
HEPA-filtered air is blown vertically downward through top hood
–
Required for compounding hazardous compounds
–
Has clear glass or plastic shield that extends partially down hood
–
Shield & vertical airflow protect you from hazardous drugs
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Special Equipment for Sterile
Compounding (cont’d)
• Compounding Aseptic Isolator
–
A LAFW that is completely enclosed
–
Work surface can only be accessed through glove box openings
–
Materials & supplies for aseptic processing enter through special
air-lock boxes attached to the unit
–
Uses a HEPA filter system
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins