Powder and Crystalline Form Drugs

1. Chapter 9 Powder and Crystalline Form Drugs

2. Why powdered drugs? Drug may be unstable in reconstituted form. Shelf life can be much longer in dry form Drug must be reconstituted prior to administration Specific type and amount of fluid for reconstitution will be listed on label or in drug insert packaging. May also be found in drug reference books.

3. What is used for reconstitution? Most drugs will be reconstituted with sterile water for injection, bacteriostatic water for injection or sodium chloride injection. Some medications require specific fluids for reconstitution. A vial of this fluid will be packaged with the vial of dry drug. Be sure you use the correct diluent.

4. How to reconstitute Always read the instructions very carefully. Adding different amounts of fluid will drastically change the dose strength of the medication and may cause an error. Different routes of administration may also require different volumes of diluent.

5. Displacement In some cases, the amount of fluid in the vial after reconstitution will be larger than the amount of fluid used to reconstitute. The amount of additional volume may be very small to insignificant or may be as a large amount. Read the instructions on the vial/packaging to see how much displacement to expect.

6. Points to remember Read to find out what kind of diluent to use Read to find out how much diluent to use Generally, after injecting the diluent into the vial roll the vial between the palms of your hands or shake to mix. (Some medications require more vigorous shaking. Some medications should not be shaken. See package inserts for more information.) Do not draw up the medication until all powder is dissolved and bubbles have dissipated.

7. Multidose vials Upon reconstituting multidose vials, mark with Date mixed Date and time to discard (how long the medication is good will be written in the package insert) Dosage in a specific volume Initials of RN who prepared the drug.

8. Common situations Dosage strength ordered is equivalent to the total strength of the drug in the vial or ampule. Examples The information available does not indicate how much total volume will be in the reconstituted vial. Examples

9. The information available indicates that various amounts of diluent can be added to the powder to arrive at different dosage strengths per mL. Examples The dosage strength may be indicated as dose per specific volume once the instructions for reconstitution are followed. Examples