تحميل برنامج لمشاهدة الافلام

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Intravenous admixtures

- I.V. admixture: Combination of parenteral dosage forms for administration as a single entity.

- I.V. fluids are used as vehicles for other parenteral drugs (additives). The number of additives can be up to 6 additives in the same I.V. fluid.


Reasons to use i.v. fluids:

1.Convenience and time saving
2. Reduction in the number of injections
3.Treating several conditions simultaneously
4. Drugs can be given in controlled increments

- I. V. Admixture incompatibility:

Refers to therapeutic, physical, and chemical problems that may arise when parenteral drugs are combined and administered with I. V. Fluids.

A)Therapeutic (pharmacological) incompatibility

1- Undesirable anatgonism: penicillin or cortisone antagonises heparin effect
2- Synergism: calcium ion enhances digoxin effect

B) Physical incompatibility

1.Precipitate formation:
- sodium salts of weakly acidic drugs such as phenobarbital sodium, or phenytoin sodium are precipitated in acidic pH I.V fluids.
- Weakly basic drugs (dramamine HCl) precipitate in alkaline pH I.V fluids.
- Calcium salts ppt. In presence of NaHCO3
- Low soluble drugs precipitate on dilution e.g. valium
 

2.Color change:

Keflin and Garamycin give yellow precipitate with I.V Fluids.

C) Chemical incompatibility

Due to instability conditions:
- Penicillins are stable at pH 6.5 for 24 hrs, but decompose at extreme pH (3.5 or in alkaline i.V. Fluids)
- Aminophylline injection added to multivitamins (B-complex and Vit. C) results in alkaline pH (unsuitable for vitamins)
- Tetracyclines are inactivated in presence of ca++ ions

Minimizing parenteral incompatibility:

1.Using fresh solutions
2.Refrigeration
3.Few additives
4.Knowledge about parenteral therapy
5.Using aseptic techniques


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