Introduction to IV Admixture

and Aseptic Technique

 Objectives
 Background and Definitions
 Equipment
 USP 797
 Technique
 Background
 Parenteral: injected through skin or other
external boundary tissue, “alongside of” “small
intestine”
 Uses:
 NPO – nothing by mouth
 Unstable in GI, 1st pass metabolism
 Immediate action needed
 Delivery to specific site
 Depot form
 Definitions
 LVP-large volume parenteral (>100 ml)
 “piggy back” – smaller volume (may be up
to 250 ml)
 D5W (5% dextrose in water)
 NS (normal saline) 0.9%NaCl
 Compounded Sterile Preparation (CSP)
 Continuous infusion vs. intermittent dosing
 Definitions
 HEPA filter- High Efficiency Particulate Air
 0.3 micron, 99.97%
 ISO: International Organization for
Standardization
 ISO 5: Clean room standards based on
particles for cubic meter by particle size
 Class 100: number of particles ≥ 5 μm per
cubic foot
 Hood types
 Horizontal Laminar
Airflow Workbench
 Hood Types
 Vertical Laminar
Airflow Workbench
(Biosafety)
 Hood Types
 Barrier Isolator
 USP 797 Risk Levels
 High (3)
 Nonsterile ingredients
 <ISO class 5
 24 hours rt, 3 days cold
 Medium (2)
 Multiple doses
 Complex manipulations
 30 hours rt, 7 days cold
 Low (1)
 Sterile components
 ISO Class 5
 <3 sterile products
 See Tables 32.1 and 32.2 in Thompson
 Clean room
 Video
 Syringes and Needles
 Parts of syringe (32.12)
 Barrel
 Plunger
 Tip
 Parts of needle (32.12)
 Bevel
 Shaft
 Hub
 Injection technique
 Critical sites
 Swabbing
 Bevel up, angle
 Equalize pressure
 IV Preparation
 Preparation
 Calculations
 Assembly
 Cleaning
 Inspection
 Expiration dates
 Quality
 Manipulation
 Inspection
 Quality
 References and Resources
 USP, Proposed Revisions to USP Chapter <797>
http://www.usp.org/healthcareInfo/pharmInfo/revisions797.html
 ASHP Self Assessment Tool for Compounding Sterile Preparations
http://www.ashpbestpracticessat.com/Print_Version_ASHP_797_Ass
essment.pdf
 Ockerman AV, U.S. Pharmacist, Compounded Sterile Preparations:
An Overview of the New Standards USP <797>
http://www.uspharmacist.com/index.asp?
show=article&page=8_1252.htm
 ASHP Guidelines on Quality Assurance for Pharmacy-Prepared
Sterile Products, Am J Health-Syst Pharm, 2000;57:1150-69