Many medicines for parenteral administration are provided as concentrates or lyophilised powders. These require reconstitution and/or dilution followed by transfer to a device (such as a syringe or infusion bag) for administration to the patient.
Intravenous additives
Many medicines for
parenteral administration are provided as concentrates or lyophilised powders.
These require reconstitution and/or dilution followed by transfer to a device
(such as a syringe or infusion bag) for administration to the patient. The need
for pharmacy-based IV additive services was recognised in the Breckenridge
report of 1976. However, studies in the north-west of England have shown that
only 35% of medicines requiring aseptic manipulation are prepared by the
hospital pharmacy department. Most CIVAS departments target high-risk areas for
their services. These include the provision of various doses for paediatric
patients, analgesics and antibiotics and also anaesthetic analgesic
combinations for epidural infusion. Many hospitals also provide subcutaneous
infusions of drug combinations used in palliative care, as well as prefilled
syringes to support patient-controlled analgesia. They also provide antibiotic
infusions in disposable infusion devices for domiciliary patients with cystic
fibrosis or osteomyelitis. A Department of Health survey placed infusions of
morphine, bupivacaine, desferrioxamine and three antibiotics into the top 10
aseptic products pro-duced by hospitals.
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