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Chapter 4: Delivery Systems Equipment 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 Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Delivery Systems (cont’d) • Parts of a Syringe 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 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 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) 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 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 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 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 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 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 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 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 largervolume bag (250 mL, 100 mL, 50 mL) 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 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 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 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 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 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 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 Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins