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CHAPTER 6
Sterile Product
Preparations
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags (cont’d)
• Two types
– Intravenous piggybacks
– Continuous preparations
Large-volume IVs
Drips
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags (cont’d)
IV Piggybacks (IVPB)
• Also known as small-volume parenterals
(SVP)
• Administered over short time at specific
intervals
• Consist of base fluid (D5W or NS) &
medication
• Range in volume from 25 to 250 mL
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags (cont’d)
• Used when
– Patient cannot take another method
– Medication needs to act quickly
• Typically are antibiotic, antifungal,
antiviral, mineral replacement, or
maintenance medicine
• Add-A-Vial/Advantage systems
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Piggyback
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags (cont’d)
Continuous Preparations
• Large-volume IVs (LVIV)
– Also known as large-volume parenteral (LVP)
– Infused on a continuous rate
– For hydration & electrolyte/vitamin replacement
– 500 mL or greater (most common = 1 liter)
– Many consist of just base solution, no additive
– Also for continuous antibiotic infusions
(infections)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
IV Bags (cont’d)
Continuous Preparations
• Drips
– Infused at very slow rate
– For nitroglycerin, insulin, amiodarone,
lidocaine, nitroprusside, heparin, narcotics
– 500 mL or less
– Ordered by amount of drug to be infused over
given timeframe (mg/kg/min or mcg/hr)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Syringes
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Multi-Dose Vials (MDVS)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Multi-Dose Vials (MDVS) (cont’d)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Patient-Controlled Analgesia
• An IV pain medication
• Patient controls delivery of drug
• When patient has pain, he/she pushes
button
• Administered via various IV pumps &
devices
• Devices are calibrated to prevent
overdose
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Patient-Controlled Analgesia
(cont’d)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Epidurals
• Inserted intrathecally
• For pain control in surgery or obstetrics
• Consist of anesthetic, alone or with a
narcotic
• Common anesthetics: bupivacaine,
ropivacaine
• All medication must be preservative-free
• Preservatives in epidurals can cause
paralysis
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Neonates and Pediatric Patients
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Irrigations (cont’d)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Cytotoxic Agents
• Chemotherapy drugs
• Always compounded in biological safety
cabinet
• Vertical airflow of BSC prevents aerosols
from being blown toward technician
• Come in various forms
– Syringes
– IVPBs
– Continuous infusions
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Total Parenteral Nutrition (TPN)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Total Parenteral Nutrition (TPN)
(cont’d)
• Specific to patient’s needs & size
• IV bag size ranges from 500 to 3000 mL
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Albumin
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Albumin (cont’d)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Plasma Protein Fraction (Ppf)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Immunoglobulin (Gammar-P, IgG)
(cont’d)
• Must be reconstituted before
admininstration
• Short stability time, expensive
• Use within 24 hr of reconstitution
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Factor VIII (Alphanate)
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.
Ophthalmics
Sterile Products and Aseptic Techniques for the Pharmacy Technician, Second Edition Copyright ©2011 by Pearson Education, Inc.
Mike Johnston All rights reserved.