1. Reconstitution of Solutions
Chapter 12
Reconstitution of Solutions
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2. Parts of Solutions © Cengage Learning 2013
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3. Reconstitution Process of mixing and diluting solutions Terms Solute
Substance to be dissolved or diluted; can be solid or liquid
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4. Reconstitution (Continued)
Solvent
Substance (liquid) that dissolves another substance to prepare a solution
Solution
Resulting mixture of a solute plus a solvent
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5. Caution
Before reconstituting injectable drugs, read and follow the label or package insert directions carefully
Check the drug
Check drug and diluent dates
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6. Reconstituting Injectable Medications
Determine both the type and amount of diluent to be used
Determine volume in mL of diluent to be used for the route as ordered
Reconstitute the drug and not the resulting supply dosage on the vial
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7. Parenteral Solution from a Solid Solute
Solvent or diluent
4.8 mL sterile water
5 mL reconstituted solution
Zithromax 100 mg per mL
Solid solute
Zithromax 500 mg
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8. Reconstitution Label for Zithromax
1/10/xx, 0800, reconstituted as
100 mg per mL
Expires 1/17/xx, 0800.
Keep refrigerated. G.D.P.
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9. Parenteral Solution Reconstitution Procedure
Order:
Kefzol 225 mg IM every 6 hours
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10. Parenteral Solution Reconstitution Procedure (Continued)
Withdraw 1 mL Kefzol solution for dosage of 225 mg
Inject 2 mL air into sterile water diluent vial
Make Kefzol
500 mg in 2.2 mL reconstituted solution for Kefzol 225 mg/mL
Add 2 mL sterile water to Kefzol 500 mg powder
Withdraw 2 mL sterile water
© Cengage Learning 2013

11. Rule When reconstituting multiple-dose injectable medications
Verify the length of drug potency

12. Remember Label reconstituted multiple-dose medication with
Date and time of preparation
Supply dosage prepared
Length of potency
Storage directions
Your initials

13. Math Tip
When multiple directions for diluting are given, the smaller the amount of diluent added, the greater or stronger the resulting solution concentration will be
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14. Reconstitution Drug Order
Supply:
500 mg vial of powdered Solu-Medrol for IM or IV injection
Reconstitute with 8 mL bacteriostatic water for Injection with benzyl alcohol
Methylprednisolone sodium succinate equivalent to 500 mg methylprednisolone (62.5 mg per mL)
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15. Reconstitution Dosage Calculation
What do we know?
First, to fill the order, how much and what type of diluent must you add?
Directions state to add 8 mL of bacteriostatic water for injection with benzyl alcohol
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16. Reconstitution Dosage Calculation (Continued)
Second, what is supply dosage of reconstituted Solu-Medrol?
When adding 8 mL of diluent, the supply dosage is 62.5 mg per mL
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17. Reconstitution Dosage Calculation (Continued)
Third, what is resulting total volume of this reconstituted solution?
Total volume is 8 mL
You know this because
62.5 mg per mL × 8 mL = 500 mg
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18. Reconstitution Dosage Calculation (Continued)
Finally, how many full doses of Solu-Medrol are available in this vial?
Vial contains 500 mg and order is for 200 mg
There are two full doses in the vial
Reconstitution label is needed
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19. Reconstitution Dosage Calculation (Continued)
Now you have a vial of 500 mg of Solu-Medrol
Add 8 mL of diluent
Final yield of the solution is 62.5 mg per mL, your supply dosage
Calculate one dose
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20. Reconstitution Dosage Calculation (Continued)
Step 1: Convert
No conversion is necessary
Order: Solu-Medrol 200 mg IV every 6 hours
Supply: 62.5 mg per mL
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21. Reconstitution Dosage Calculation (Continued)
Step 2: Think
You want to give more than 1 mL
You want to give more than three times 1 mL
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22. Reconstitution Dosage Calculation (Continued)
Step 3: Calculate
Given intravenously every 6 hours
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23. Solution Strength
A fraction expresses strength of a solution made from a liquid concentrate
Numerator is number of parts of solute
Denominator is number of parts of solution
Difference between denominator (final solution) and numerator (parts of solute) is number of parts of solvent
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24. Solution Strength (Continued)
Example: ⅓ strength nutritional formula
1 part concentrate
3 parts of total solution
3 - 1 = 2 parts solvent (water)
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25. D (Desired solution strength) × Q (Quantity of desired solution)
Solution Calculation
To prepare solutions
Apply formula to find amount
Quantity of desired solution
Amount of liquid solute = Amount of solvent
D (Desired solution strength) × Q (Quantity of desired solution)
= X (Amount of solute)
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26. Solution Calculation (Continued)
Example
A physician orders a patient’s wound irrigated with strength ⅔ hydrogen peroxide and normal saline solution every 4 hours while awake
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27. Solution Calculation (Continued)
60 mL per irrigation for 3 irrigations during your 12 hour shift
Prepare 60 mL × 3 irrigations = 180 mL total solution
How much stock hydrogen peroxide and normal saline will you need?
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28. Solution Calculation (Continued)
Step 1: Convert
No conversion is necessary
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29. Solution Calculation (Continued)
Step 2: Think
You want to make ⅔ strength
2 parts solute (concentrated hydrogen peroxide) to 3 total parts solution
Amount of solvent is 3 – 2 = 1 part saline
For 180 mL of solution, you will need ⅔ of it as solute (120 mL) and ⅓ of it as solvent (60 mL)
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30. Solution Calculation (Continued)
Step 3: Calculate
D (Desired solution strength) × Q (Quantity of desired solution)
= X (Amount of solute)
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