1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 4: Delivery Systems Equipment

2. 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

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Delivery Systems (cont’d) Parts of a Syringe

4. 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

5. 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

6. 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)

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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 larger- volume bag (250 mL, 100 mL, 50 mL)

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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