Administration of parenteral

Administration of parenteral glucocorticoid during an acute adrenal crisis. 

The IV or IM administration of parenteral narcotics (meperidine, morphine, fentanyl) is commonly used to treat the pain associated with labor. Compared to epidural analgesia, parenteral opioids are associated with lower rates of oxytocin augmentation, shorter stages of labor, and fewer instrumental deliveries. 

Gupta, P.K., Patel, J.P., and Hahn, K.R., Evaluation of pain and irritation following local administration of parenteral formulations using the rat paw lick model, /. Pharm. Sci. Technol., 48, 159, 1994. 

Sporadic clinical reports, without the support of data from controlled studies, repeatedly indicate the effectiveness of intratracheal administration of parenteral antimicrobial preparations in the treatment of tracheobronchitis and pneumonia in cattle. The expectation when using this route of administration is that a greater therapeutic effect will be achieved when the drug is placed as close to the infection site as possible, rather than relying on the systemic circulation for drug delivery. 

Whereas the compounding and administration of parenteral products and intravenous admixtures continues to be a vital and important component in the care of hospitalized and home health care patients, there is continued interest in easing the preparation, storage, and administration of these products with respect to controlling contamination of the finished product and protecting the health care providers from needlestick injuries. It is estimated that more than... 

Mountain R, Ferguson S, Fowler A, Hyers T. Noncardiac pulmonary edema following administration of parenteral paraldehyde. Chest 1982 82(3) 371-2. 

In some infants receiving parenteral nntrition nephro-calcinosis occnrs. Parenteral nntrition solntions contain the oxalate precnrsors ascorbate and glycine, and in one stndy of very low birth weight infants (111) administration of parenteral nntrition protein of abont 0.5 g/kg/day was associated with an increased nrinary oxalate/creatinine ratio the effect was dose-dependent. Raised nrinary oxalate concentrations may be a factor in the pathogenesis of nephrocalcinosis in these infants. 

Cephalosporin esters are widely used as intermediates in cephalosporin synthesis and as prodmgs for oral administration of parenteral cephalosporins. These esters undergo reversible base-catalysed isomerisation according to the mechanism shown in Scheme 4.8. A proton in the 2-position is abstracted by a base (B) and the resulting carbanion can be repro-tonated in the 4-postion, giving a A -ester. On hydrolysis, A -cephalosporin esters yield A -cephalosporins, which are biologically inactive. 

Antoniskis, A. Anderson, B.C. Van Volkinburg, E.J. Jackson, J.M. Gilbert, D.N. Feasibility of outpatient self-administration of parenteral antibiotics. West J. Med. 

American Society of Clinical Oncology. Criteria for facilities and personnel for the administration of parenteral systemic antineoplastic therapy. J. Clin. Oncol. 1997, 15 (11), 3416-3417. 

Table 14.1 Formulation Properties and Terms Concerning Administration of Parenteral Products Essential for the Photochemical Stability...

The choice of elastomer has the greatest effect on a formulation. The most common elastomers that can be used for closures for injectable products are given in Table 12.5. Of these elastomers, natural rubber, synthetic polyisoprene, butyl, chlorobutyl and bromobutyl rubber are typically used for the manufacture of rubber closures and stoppers used in the packaging and administration of parenterals. 

Taken in proper doses, chloroquine is an extraordinarily safe drug however, its safety margin is narrow, and a single dose of 30 mg/kg may be fatal. Acute chloroquine toxicity is encountered most frequently with too rapid administration of parenteral doses. Cardiovascular effects include hypotension, vasodilation, depressed myocardial function, cardiac arrhythmias, and cardiac arrest. Confusion, convulsions, and coma denote central nervous system (CNS) dysfunction. Chloroquine doses of >5 g given parenterally usually are fatal. Prompt treatment with mechanical ventilation, epinephrine, and diazepam may be lifesaving. 

Other routes of administration arc theoretically possible such as rectal route (rectal capsules and rectal suppositories) for drugs having systemic effects such a.s sedatives, tranquilizers, and analgesics topical route (patchs) for drug absorption (hormones or nicotine) into the systemic circulation parenteral route (administration of parenteral suspensions or implantation of compressed pellets). 

The tube consists of synthetic polymers such as fluotinated ethylene propylene (FEP) or polyurethane (PU). For infusion of viscous fluids such as blood and for rapid infusimi cannulas with diameters of 14—16 G have to be used. Smaller size diameters (18—24 G) of catheters are suitable for continuous and intermittent administration of parenteral solutions. Thorough management of the device (e.g. flushing, dressing, daily inspection) reduces complications (e.g. phlebitis) caused by a peripheral access. The need to replace the cannulas routinely is debated. 

Another sophisticated category of infusion therapy applies to the administration of parenteral medication in cancer patients. 

In the meantime various measures have been taken to improve this simation. However, in a multinational study of 2009 (27 countries on five cOTitinents) on enors in administration of parenteral drugs in Intensive Care units, 75 enors per 100 patient days were found. Nearly 15 % of them were wrong dose errors, ca. 5 % wrong medicine and ca. 5 % wrong route [38]. 

Valentin A et al (2009) Errors in administration of parenteral drugs in intensive care units multinational prospective study. BMJ 338 b814... 

Similarly, early administration of parenteral nutrition after severe injury was associated with an increased risk of nosocomial infections in a retrospective cohort study of 567 patients, of whom 95... 

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