reconstituting powdered medications medications that lose potency quickly in solution –are...

Reconstituting Powdered Medications

• Medications that lose potency quickly in solution– are supplied in powdered form;

– are reconstituted using an appropriate diluent.

Reconstituting Powdered Medications (cont.)

• Determine the solvent to be used to dilute medication.– Sterile water– Saline– Bacteriostatic solution

• Some meds are packaged with the appropriate solvent.

Reconstituting Powdered Medications (cont.)

• Some medications are mixed with lidocaine.– This decreases pain on injection.

– Label or package insert indicates when lidocaine can be used.

– Must have a physician’s order to use it.

Reconstituting Powdered Medications (cont.)

Rule 14-5Rule 14-5 To reconstitute a powdered medication:

1. find the directions;

2. use a sterile syringe and aseptic technique to draw up the diluent;

Reconstituting Powdered Medications (cont.)

Rule 14-5Rule 14-5 (cont.)

3. inject the diluent into the medication vial;

4. agitate the mixture by rolling, inverting, or shaking the vial.

Reconstituting Powdered Medications (cont.)

Rule 14-5Rule 14-5 (cont.)

5.make sure the powdered medication is completely dissolved.

– The solution must be free of visible particles.

Reconstituting Powdered Medications (cont.)

• Use the specified amount of diluent.

– Too much – Dosage strength will be incorrect.

– Too little

• Powder may not dissolve completely.

• Dosage strength will be incorrect.

Reconstituting Powdered Medications (cont.)

Rule 14-6Rule 14-6 When storing a medication after reconstitution:

1. record the date, the time of expiration, and your name or initials;

2. for multiple-dose medications, also record the solution strength.

Reconstituting Powdered Medications (cont.)

Amount of diluent = 5 mL

Route = IV only

Diluent = 0.9% NaCl without preservatives

Instructions = shake to dissolve

Solution strength = 38 mg/mL

Storage = no refrigeration

Example Example

Reconstituting Powdered Medications (cont.)

Ordered: Gemcitabine HCl

125 mg IVSS

On hand: see label

H = 38 mg

Q = 1 mL

D = 125 mL

Example (cont.) Example (cont.)

Reconstituting Powdered Medications (cont.)

Step A No conversion is necessary.

Step B Calculate amount to administer using preferred method.

125 mg / 38 mg x 1 mL = A

3.29 x 1 mL = A

3.3 mL = A

Example (cont.) Example (cont.)

Reconstituting Powdered Medications (cont.)

Step C Dose ordered (125 mg) is greater than 3 time that of dose on hand (38 mg),so 3.3 mL is reasonable.

Example (cont.) Example (cont.)

Error Alert!

Select the correct instructions for the strength and route ordered.

Practice

How much diluent should you add to this vial?

What are the storage instructions?Answer: 1 mL

Answer: store between 2° and 8° C

Practice

Ordered: Synagis 75 mg IM Q8H

On hand:

What is the amount to administer?

Answer: 0.75 mL