Infusion packaging

To allow the IV fluid to infuse over a specified period, the IV flow rate must be determined. Before using one of the methods below, the drop factor must be known. Drip chambers on the various types of IV fluid administration sets vary. Some deliver 15 drops/mL and others deliver more or less than this number. This is called the drop factor. The drop factor (number of drops/mL) is given on the package containing the drip chamber and IV tubing. Three methods for determining the IV infusion rate follow. Methods 1 and 2 can be used when the known factors are the total amount of solution, the drop factor, and the number of hours over which the solution is to be infused. 

Nesiritide—2 mcg/kg IV bolus followed by a continuous IV infusion of 0.01 mcg/kg/min. Doses above the initial infusion rate should be limited to carefully selected patients. High-alert medication—read package insert before use... 

One issue related to supporting a metabolic stability assay with HPLC/MS/MS is the need to set up an MS/MS method for each compound. While it may only take 10 min to infuse a compound solution and find the corresponding precursor and product ions (along with minimal optimization of the collision energy), the processes of MS/MS development would require 4 hr per day if one wanted to assay 25 compounds per day. MS vendors have responded to this need by providing software tools that can perform the MS/MS method development step in an automated fashion. Chovan et al.68 described the use of the Automaton software package supplied by PE Sciex (Toronto, Canada) as a tool for the automated MS/MS method development for a series of compounds. The Automaton software was able to select the correct precursor and product ions for the various compounds and optimize the collision energy used for the MS/MS assays of each compound. They found that the Automaton software provided similar sensitivity to methods that would have been developed by manual MS/MS procedures. Chovan et al. also reported that the MS/MS method development for 25 compounds could be performed in about an hour with the Automaton software and required minimal human intervention. 

Driscoll, D. F., Ling, P. R., and Bistrian, B. R. (2007), Physical stability of 20% lipid injectable emulsions via simulated syringe infusion effects of glass versus plastic product packaging, J. Parenteral Enteral Nutr., 31(2), 148-153. 

Further, they can be used for medical purposes, such as press-through packages, disposable syringes, liquid medicine vials, and infusion bags. They are suitable for electric or electronic materials, such as wire coating. In addition, packaging films, such as wrapping films, stretch films, shrink films, and blister packs can be produced. 

UHT milk differs from pasteurized milk mainly in the heat treatment employed for sterilization. Usually UHT milk is heated at 130° to 150°C for 2 to 8 seconds and is then aseptically packaged. In the final heating stage, steam is injected directly into the milk, or the milk is infused into a steam chamber, followed by flash evaporation to remove added water (steam). An alternative procedure, the indirect method, involves heating milk across a stainless steel barrier, using high-pressure steam as the heating medium (Mehta 1980). 

Investigators from the Department of Pediatrics in Johns Hopkins Hospital, after seeing a neonate who had marked leukocytosis temporally related to alprostadil, conducted a retrospective study of neonatal leukocytosis induced by alprostadil in 45 neonates (5). They concluded that alprostadil infusion is a predictable cause of leukocytosis in neonates with congenital heart disease. Alprostadil-induced leukocytosis was especially prominent in three patients with splenic disorders associated with the hetero-taxy syndrome. Many of the other adverse effects of alprostadil, including respiratory depression, hypotension, fever, and lethargy, were also associated with sepsis. The authors considered that it is reasonable to look for sepsis in infants receiving alprostadil, but that it is equally reasonable to withdraw empirical therapy once infection has been ruled out. Leukocytosis associated with alprostadil infusion has not been previously reported and is not listed in the alprostadil package insert. 

The earliest available preparations, made as infusions and concentrated to a syrup by the native people, were designated as calabash (gourd), tubo- (bamboo), or pot (clay pot) curare depending upon the containers in which the drug was packaged. Curare is obtained from the upper regions of the Amazon river, the Orinoco basin, and the eastern slopes of the Ecuadorian plateau. The term curare is derived from the Indian name (woorari, urari) for poison (Grollman, 1962). 

Bleomycin sulfate should not be diluted in 5% glucose-infusion solutions. Loss of activity of bleomycin was reported with different packaging materials.205 Patients under treatment with bleomycin must avoid driving 206... 

Fluorouracil was relatively stable in PVC containers compared with glass, but this depends on concentration and storage temperature. Fluorouracil solutions are incompatible with synthetic elastomers containing packaging and infusion materials.218,219... 

The packaging material must not interact with the product either to adsorb substances from the product or to leach chemicals into the product. Plastics contain additives to enhance polymer performance. PVC may contain phthalate diester plasticizer, which can leach into infusion fluids from packaging. Antimicrobial preservatives such as phenylmercuric acetate are known to partition into rubbers and plastics during storage, thus reducing the formulation concentration below effective antimicrobial levels. 

For infusion liquids, no completely UV-VIS photon impermeable immediate package can be used. These products require dilution and the inspection for particulates before use both processes hindered by such packaging. To guarantee safe application/dosing additional photostabilizing packaging is applied for extremely photosensitive drug preparations. 

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