Injections intravenous infusions

Doxorubicin HCl liposome injection (intravenous infusion) MPEG-DSPE, fully hydrogenated soy [ os[ atidylchohne, cholesterol Treatment of AIDS-related Kaposi s sarcoma [260,261]... 

Before the development of in vivo SCE methods, attempts to use BrdUrd to sensitize tumor cells to X rays had revealed the difficulty of incorporating BrdUrd into cells in vivo. It was known that 80% of the BrdUrd was de-brominated within 1 hr of intravenous administration in rats and man. For this reason, m vivo BrdUrd-labeling methods employ either serial injections,intravenous infusion,or subcutaneous implantation of a tablet of BrdUrdto achieve sufficiently high incorporation. The amount of substitution may be further improved by injection of fluorodeoxyuridine several hours before BrdUrd administration to depress the activity of the enzyme thy-midylate synthetase. Although it has been said that the toxic effects of BrdUrd can be suppressed by simultaneous treatment with deoxycytidine, recent work suggests that this is due simply to reduced BrdUrd incorporation. 

Status epilepticus is traditionally defined as a situation where there is continuous seizure activity for a period of 30 minutes or where there are a continuous series of seizures during which the sufferer does not regain consciousness. More recently, it has been suggested that any continuous seizure period of longer than 5 minutes should be classified as status epilepticus. In these situations the treatment employed may well consist of one of the previously indicated antiepileptic dmgs such as clonazepam (Fig. 13.15), phenobarbital and phenytoin (Fig. 13.15) or alternatively diazepam, fosphenytoin (a prodrug of phenytoin), loraze-pam, midazolam and paraldehyde (Fig. 13.16) may be employed. For the drugs used in the treatment of status epilepticus, the formulation and dose differ from conventional doses due to the situation and thus many of these will be administered by intravenous injection, intravenous infusion, buccal or rectal administration. 

The principal arninoglycoside toxicides are neuromuscular paralysis, ototoxicity, and nephrotoxicity. Neuromuscular paralysis is a relatively rare complication resulting from high aminoglycoside concentrations at the neuromuscular junctions following, for example, rapid bolus intravenous injection or peritoneal instillation, rather than the normal intravenous infusion. The mechanism apparentiy involves an inhibition of both the presynaptic release of acetylcholine and the acetylcholine postsynaptic receptors (51). 

Most injections are formulated as aqueous solutions, with Water for Injections BP as the vehicle. The formulation of injections depends upon several factors, namely the aqueous solubility of the active ingredient, the dose to be employed, thermal stability of the solution, the route of injection and whether the product is to be prepared as a multidose one (i.e. with a dose or doses removed on different occasions) or in a singledose form (as the term suggests, only one dose is contained in the injection). Nowadays, most injections are prepared as single-dose forms and this is mandatory for certain routes, e.g. spinal injections such as the intrathecal route and large-volume intravenous infusions (section 2.2). Multidose injections may require the inclusion of a suitable... 

Some types of injections must be made iso-osmotic with blood serum. This applies particularly to large-volume intravenous infusions if at all possible hypotonic solutions cause lysis of red blood corpuscles and thus must not be used for this purpose. Conversely, hypertonic solutions can be employed these induce shrinkage, but not lysis, of red cells which recover their shape later. Intraspinal injections must also be isotonic, and to reduce pain at the site of injection so should intramuscular and subcutaneous injections. Adjustment to isotonicity can be determined by the following methods. 

Mallo, C., Zaidan, R., Galy, G. et al. (1990). Pharmacokinetics of melatonin in man after intravenous infusion and bolus injection. Fur. ]. Clin. Pharmacol. 38, 297-301. 

Intravenous injection, constant infusion of 0.15-0.20 mg CN/kg BW per min LD50 in about 20 min rapid progressive reduction in cerebrocortical cytochrome oxidase (cytochrome aa3) concomitant with increases up to 200% in cerebral blood flow 30... 

Bolus intravenous, intramuscular, or subcutaneous injections can be administered by a single person by securing the animal s arm through the cage bars (Mazue and Richez, 1982). For safety considerations, many investigators prefer to have the animal physically restrained by a second person before the injection is given. Arterial injections (via the femoral artery) as well as limited or continuous intravenous infusion (via catheterization of the femoral or jugular vein) are other less commonly used parenteral routes in the monkey. 

An intravenous infusion for a child weighing 55 lb is to contain 17.5 mg of vancomycin HC1 per kg of body weight in 200 mL of NaCl injection. Using a 7.5 mL vial containing 500 mg of dry vancomycin HC1 powder, explain how you would obtain the amount needed in preparing the infusion. 

A medication order for an intravenous infusion for a patient weighing 143 lbs calls for a 0.25 mEq of ammonium chloride per kilogram of body weight to be added to 500 mL of 5% dextrose injection. How many... 

There is substantial variability in the pharmacokinetics of vinblastine in patients. Evidence has been obtained that implicates altered liver function and dose-dependent elimination as contributing factors to the variable pharmacokinetics. When vinblastine was administered by a bolus injection, a mean terminal elimination half-life of 29.2 hr was estimated for a group of 24 patients, but the half-lives ranged from a low value of 16 hr to a high value of 65 hr (55). When vinblastine was administered by intravenous infusion, clearance of the drug appeared to decrease with time over a 4-month period decreases in serum albumin values were found to be correlated with decreases in the clearance of vinblastine. 

Parenteral Solution Injection Ventohn injection Ventohn intravenous infusion Non-proprietary A H A H 100 pg/mL 50 and 500 pg/mL 1 mg/mL... 

Lignocaine, originally introduced as a local anesthetic, is now widely used for the treatment and prevention of ventricular arrhythmias. When used for this purpose, it is usually administered either by intramuscular injection, or as a bolus intravenously, or, more commonly, by constant intravenous infusion. For clinical purposes, lignocaine measurements arc usually carried out on plasma collected either while the patient is receiving a constant intravenous infusion or at a specified time after the last intramuscular injection. Colorimetric methods have been used in the past (S29), but, because they lack both sensitivity and specificity, may yield false and misleading results. They have largely been replaced by GLC techniques (A3, El, K5). 

Animal experiments have shown (A3) that equilibration of lignocaine between blood and brain occurs relatively slowly. This may explain why plasma levels of lignocaine that can readily be tolerated, without cerebral side effects, after intravenous bolus injection nevertheless are associated with serious toxic symptoms when produced by constant intravenous infusion or when resulting from impaired metabolic degradation. 

Injection Slow infusion of injection is preferable to bolus administration. Rapid infusion of digitalis glycosides has been shown to cause systemic and coronary arteriolar constriction, which may be clinically undesirable. Caution is thus advised and injection probably should be administered over a period of 5 minutes or more. Mixing injection with other drugs in the same container or simultaneous administration in the same intravenous line is not recommended. 

Even if a medication is available in multiple formulations and dosage forms, the prescriber must consider the absorption and distribution differences between adult and pediatric patients. Blood supply at injection or infusion site, available blood supply for unit muscle mass, and skeletal muscle mass relative to body mass vary with patient age and size, causing drug absorption to vary, as well. A rapid intravenous bolus in a pediatric patient might result in acute toxicity a slow intravenous infusion, often required in neonates, can cause erratic, unreliable drug delivery in an older child. In addition, the volume of fluid tolerated for intravenous delivery varies significantly with the age and size of the patient. The blood supply and blood flow to and from the injection site are of prime importance since a gradual decrease in blood supply per unit muscle mass is seen with maturation. In addition, the skeletal muscle mass relative to... 

This route is generally not favoured because of variable release from injection sites. It is nevertheless common practice in patients who cannot be depended upon to take their medication and where intravenous infusion is, for one or other reason, not acceptable. 

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