Stability of parenteral and non-parenteral medications Henderson

Things to consider for parenteral medication storage Stability Time BUD, refrigeration, sunlight exposure, heat. etc. Insulin Reconstitution of Parenteral medication DO NOT SHAKE VIGEROUSLY, gently swirl Check the Diluent when reconstituting. This vehicle could impact the stability. The vial of active ingredient will say on the side of the vial its diluent and storage requirements.

Application to Retail Pharmacy A child is prescribed a reconstituted antibiotic for an ear infection. The prescription reads: Cephalexin 250mg/5mL #200mL Sig: 5mL BID X 20 Days

Continued… Cephalexin 250mg/5mL #200mL (#2 100mL bottles) Sig: 5mL BID X 20 Days Day Supply: 20 days BUD for this reconstituted med is 14 days. If we dispense and reconstitute the entire 200mL, it will not be stable for the entire course of therapy. Now what???

Filtration of Parenteral Medications Use a Filtered device This is attached to the tip of a syringe while the original needle is still attached. This will remove up to 0.22 Microns (most microorganisms) These are pre-sterilized One time use only Run approx. $20.00 a piece!

Reference Materials Handbook on Injectable Drugs Most compounding/hospitals will have this readily available. Guide to Parenteral Admixtures These materials will have: Drug Solution Drug Compatibility Drug Dosage Drug dilution information

Reference materials continued: Contact the drug companies Contact the drug reps Google it! Drug companies HAVE SERIOUS MONEY!!! Call them and ask if you have questions about storage and stability. If the drug is a BRAND NAME drug, likely, there are drug reps hired by the company in the area who can provide you with additional information, samples, demos, etc.

Work Flow for Parenteral compounding Prescriber writes the prescription Prescription is transmitted to the pharmacy Order is checked against patient allergies, dose, compatibility and stability Prescription label and compound worksheets are prepared Prescription is compounded wither by a pharmacist or supervised technician Prescription is checked by the pharmacist Prescription is delivered to the patient Storage will be the responsibility of the patient

Other things to consider Expiration dates If a drug says its expiration is 12/15, it can be used up until 12/31/15. What if a product is left out of the refrigerator due to someone not paying attention? Vacations and travel considerations Refrigeration products may need additional care when traveling.