1. Reconstituon of Powdered Drugs
(Mixing Powders)

2. Reconstitution of Powdered Drugs
For meds available in powdered form in a vial.
Must be reconstituted with a liquid (diluent).
Add the diluent that will give you an injectable amount in the final concentration.

3. Reconstitution Technique of adding a diluent to a powdered solution
Type and amount of diluent to use provided by manufacturer:
On vial label
Package insert
Pharmacist

4. Also may be an “Act-O-Vial” system.

5. 1. Steps for mixing Powders
1. Look at order. What is the dosage to be given?
2. Read label on powder bottle or insert
How much diluent do you instill?
What do you instill (NS or SDW)?
Resulting concentration - the ONLY part you need for figuring amount to draw out.

7. Read the entire label Is it for IM or IV administration?
What are the differences in dilutions?
Do you need more than one vial?
Always figure on paper before mixing.
Why?
Must double check your figures with another RN if Ped or IV.
Check the 5 rights.

8. Several Options?
If instructions on label give several options for reconstitution, choose the correct option based on:
Should get ordered dose in 1 injection.
Site of injection and type of injection
IM - 3 cc.
SubQ cc.
IV - no limit (usually <5cc)

9. Example #1 Instructions on label: Order: Kefzol 0.5 Gm IM qd
Available in powder/vial:
Kefzol 1 Gm
Instructions on label:
“Add 4 cc of SDW to provide a concentration of 1 Gm per 4.4 cc.”
Figure problem on paper first.

10. Figure amount to be given per dose:
Step l: 1 Gm Gm
4.4 cc = x cc
1 x = 4.4 (0.5)
x = 2.2 cc
Step 2: Add 4cc SDW to bottle.
What size syringe do you need to add the 4 cc?
5cc syringe

11. What size syringe do you need to withdraw and give the injection?
3 cc syringe
Can you give 2.2 cc in an IM injection?
yes

12. Example # 2 Order: 400,000 units Penicillin IM
Available: 500,000 u/ bottle- powdered
How many bottles do you need? 1

13. Directions on the bottle:
Use SNS for diluent
Add diluent: Concentration
a cc 50,000 u/ cc
b cc 100,000 u/cc
c cc 250,000 u/cc

14. Order: 400,000 units Available: 50,000 units / mL

15. Order: 400,000 units Available: 100,000 units / mL

16. Order: 400,000 units Available: 250,000 units / mL

17. Figure which amount of solution to add:
Option # 1
50,000 u = 400,000 u cc X cc
50,000 x = 400,000.
x = 8 cc
Is this under 3 cc?
No, too much for one injection!

18. Option # 2
100,000 u = 400,000 u
1 cc X cc
400,000 = 100,000 x
x = 4 cc
Can you give this amount?
No, still too much.

19. Option # 3
250,000 u = ,000 u
1 cc X cc
-400,000 = 250,000x
- x = cc
Can you give this amount?
Yes!!

20. Which option do you choose?
How much can you give in one IM injection
Can you give the ordered dose in 1 injection
How much diluent will you add:
1.8 cc
How much will you withdraw into syringe for the injection?
1.6 cc
Preferred option is # 3

21. Order: Cefzolin 0.3 Gm IM Supply: 500 mg powder in a Vial
Read label
How much diluent:
2 mL SDW
Concentration will be:
225 mg/mL
How much will you give?
0.3 Gm = 300 mg
225 mg = mg
1 mL X mL
225 X = X = 1.3 mL

22. Penicillin G 1,000,000 u IM Supply: PenG 5,000,000 u powder
Read Label
Which dilution will you choose?
5 million unit vial
4 options
2 answers are correct
500,000 u/mL
100,000 u/mL (Give 1 cc) or
500,000 u = ,000,000 u
1 mL x mL
X = 2 cc

23. Order: Omnipen (ampicillin sodium) 250 mg IM q 6h Supply: 500-mg vial of powder
Read label
Which dilution will you choose?
1.8 mL
Concentration will be:
250 mg/mL
How much will you give?
250 mg = mg
1 mL X mL
250 x = X = 1.0 mL

24. Order: Ancef (cefazolin sodium) 225 mg IM q6h Supply: three vials – 250 mg, 500 mg, 1 g
Read label
Which powder will you choose?
500 mg
How much diluent will you add?
2 mL SW
Concentration will be:
225 mg/mL
How much will you give?
1 mL

25. Practice makes perfect !!