Parenteral Medications - NAPLEX

$\text{mL/hr} = \frac{\text{mL}}{\text{hr}}$. The formula derives the rate by dividing total volume by infusion time for consistent delivery.

Neurotoxicity; neuraxial products should be preservative-free. Preservatives in neuraxial medications can irritate neural tissues, leading to inflammation or damage in the spinal area.

It must not be given IM, SC, intrathecal, or epidural. The label restricts administration to IV to prevent adverse effects like tissue irritation or inefficacy associated with other routes.

Preservative-free 0.9% sodium chloride (or preservative-free SWFI if specified). Preservatives can cause neurotoxicity in the CSF, so preservative-free diluents ensure safety for intrathecal routes.

$2\ \text{mg/mL}$. Dividing total drug amount by final volume gives concentration for dosing calculations.

$5\ \text{mL/hr}$. Dividing dose rate by concentration ensures the infusion delivers the ordered amount per hour.

Risk of benzyl alcohol toxicity (gasping syndrome). Benzyl alcohol in bacteriostatic water can cause metabolic acidosis and respiratory distress in neonates due to immature liver function.

$50\ \text{gtt/min}$. Multiplying volume by drop factor and dividing by minutes provides the precise manual adjustment rate.

Approximately $900\ \text{mOsm/L}$ (institution-specific limits may vary). Osmolarity limits for PPN prevent vein irritation and phlebitis, with ~900 mOsm/L as a common threshold based on institutional protocols.

IM. IM route allows slow absorption of oil-based formulations, providing sustained release unlike rapid IV dispersion.

A CSP prepared for immediate administration with minimal delay. USP <797> defines immediate-use CSPs as those prepared aseptically outside controlled environments for administration starting within 4 hours to reduce microbial contamination risk.

$\text{gtt/min} = \frac{\text{mL} \times \text{gtt/mL}}{\text{min}}$. The formula accounts for drop factor to convert volume over time into countable drops per minute.

$125\ \text{mL/hr}$. Dividing volume by time yields the rate, ensuring accurate delivery over the specified period.

Central venous access. Central access reduces extravasation risk by diluting vesicants in larger blood volumes, unlike peripheral veins.

Can cause tissue necrosis and severe local injury. Vesicants damage tissues upon extravasation due to their irritant properties, leading to blistering and potential long-term injury.

5 g per 100 mL. D5W provides 5% dextrose by weight, equating to 5 grams per 100 mL for caloric support in parenteral nutrition.

0.9% sodium chloride (normal saline). 0.9% sodium chloride matches plasma osmolarity at approximately 308 mOsm/L, minimizing cellular damage during infusion unlike hypotonic 0.45%.

Container that allows repeated entries and usually contains a preservative. USP <797> allows multiple-dose containers for repeated access due to preservatives that inhibit microbial growth, extending usability beyond single entry.

$\text{mL/hr} = \frac{\text{mg/hr}}{\text{mg/mL}}$. The formula determines volume rate by dividing desired dose rate by solution concentration for therapeutic accuracy.

To remove particulates (and sometimes air/microprecipitates) from the infusion. In-line filters capture contaminants to ensure infusion safety, particularly for solutions prone to particle formation.

$0.22\ \mu m$. The $0.22\ \mu m$ size effectively removes bacteria and small particles from aqueous solutions without impeding flow.

$1.2\ \mu m$. Lipids require larger pores like $1.2\ \mu m$ to pass through without being trapped, unlike smaller filters for aqueous solutions.

28 days after initial entry (unless manufacturer states otherwise). The 28-day BUD balances preservative efficacy against contamination risk, aligning with USP <797> guidelines unless shorter stability is indicated by the manufacturer.

Sterile water for injection (SWFI). SWFI lacks preservatives like benzyl alcohol, reducing toxicity risks in vulnerable patients compared to bacteriostatic water.