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Parenterals

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Injections

Sterile, pyrogen-free preparations intended to be

administered parenterally.

Greek words parao!tside" and enteron

intestine" and denotes ro!tes of administrationot#er t#an t#e oral ro!te injectable ro!te".

Pyrogens$ %e&er-prod!cing organic s!bstances

arising from microbial contamination, are

responsible for many of t#e febrile reactions in

patients following intra&eno!s injection.

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Parenteral ro!tes are !sed w#en$( )apid dr!g action is re*!ired as in emergencies.( +#en t#e patient is !ncooperati&e, !nconscio!s, or

!nable to accept or tolerate oral medication.( #e dr!g itself is ineffecti&e by ot#er ro!tes.

ost injections are administered by t#ep#ysician, p#ysicians assistant, or n!rse e/cept

for ins!lin injections w#ic# are commonly self-administered by t#e diabetic patients. Injections are employed mostly in t#e #ospital,

e/tended care facility, and clinic and lessfre*!ently at #ome. 0n e/ception is #ome #ealt#care programs.

#e p#armacist s!pplies injectable preparationsto t#e p#ysician and n!rse as re*!ired for !se int#e instit!tional setting, clinic, office, or #ome

#ealt# care program.

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Parenteral ro!tes of administration$

r!gs may be injected into almost any organ or

area of t#e body, incl!ding$( 3oints Intra-artic!lar".

( 3oint-fl!id area Intra syno&ial".

( Spinal col!mn Intra spinal".

( Spinal fl!id Intrat#ecal".

(0rteries Intra-arterial".

( 4eart Intracardiac".

( 5ein Intra&eno!s, I5".( !scle Intram!sc!lar, I".

( Skin Intra dermal, I, intrac!taneo!s".

( 6nder t#e skin S!bc!taneo!s, S7".

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Intra&eno!s )o!te

)ecogni9ed dangers associated wit# t#e I5 ro!te$( #romb!s blood clot" and embol!s formation may be ind!ced

by I5 needles and cat#eters.( Possibility of partic!late matter in parenteral sol!tions poses a

concern.

0d&antages as compared wit# ot#er ro!tes ofadministration$( I5 dr!gs pro&ide rapid action life sa&ing in emergencies".

( :ptim!m dr!g le&els may be ac#ie&ed wit# acc!racy andimmediately dr!g absorption is not a factor".

isad&antages$( :nce a dr!g is administered I5, it cannot be retrie&ed after oral

administration, &omiting can be ind!ced".

( I5 dose may differ greatly from t#e oral dose. Great care m!stbe taken to pre&ent o&erdosing or !nder dosing.

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ost s!perficial &eins are s!itable for &enip!nct!re, t#e&eins of t#e antic!bital area in t#e front of t#e elbow" are!s!ally selected beca!se t#ey large, s!perficial and easyto see and enter.

Strict aseptic preca!tions m!st be taken specially site ofinjection to a&oid risk of infection.

#e injectable sol!tion, t#e syringe and needles and t#epoint of entrance m!st be also sterile to a&oid carryingbacteria from t#e skin to t#e blood by t#e needle".

Small and large &ol!mes 1

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Intram!sc!lar )o!te

I injections pro&ide less rapid effects b!t

generally longer lasting t#an I5 administration. 0*!eo!s or oleagino!s sol!tions or s!spensions

of dr!g s!bstances may be administered I.

#e point of injection m!st be as far as possiblefrom major ner&es and blood &essels.

Inj!ries are related to t#e point at w#ic# t#e

needle entered and were t#e medication was

deposited. #ese incl!de paralysis, abscess, cyst,

embolism, #ematoma, slo!g#ing of t#e skin and

scarring.

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Site for I injection$( In ad!lts

#e most fre*!ently !sed site is t#e !pper o!ter *!adrant of

t#e gl!te!s m!scle. #e deltoid may be also !sed b!t t#e pain is more

noticeable.

( In infants and yo!ng c#ildren$ #e gl!teal area is small and composed of fat and not

m!scles. 0n injection in t#is area can be dangero!s to t#e

sciatic ner&e. #e deltoid m!scle of t#e !pper arm !pper or lower portion

away from t#e radial ner&e" or t#e midlateral m!scle of t#et#ig# are preferred.

If series of injections are gi&en, t#e injection site

is !s!ally &aried. 5ol!me administered con&eniently is to a

ma/im!m of 8 ml in t#e gl!teal region and 2 mlin t#e deltoid region.

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S!bc!taneo!s )o!te

It is !sed for injection of small amo!nts of medicationma/im!m amo!nt is abo!t 1.' ml and amo!nts greater

t#an 2 ml will ca!se painf!l press!re". Injection of t#e dr!g beneat# t#e skin is made in t#e

loose interstitial tiss!e of t#e o!ter !pper arm, t#eanterior t#ig#, or t#e lower abdomen.

#e site of injection s#o!ld be rotated w#en injectionsare fre*!ently gi&en as wit# daily ins!lin injections !poninsertion if blood appears in t#e syringe".

Syringes wit# !p to ' ml capacities and 28-'< ga!ge are!sed.

Irritating dr!gs and t#ick s!spensions may prod!ceind!ration, slo!g#ing, or abscess and may be painf!l.Aot s!itable for s!bc!taneo!s injection.

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#e 6SP specifies restriction on t#e fi/ed

&egetable oils in parenteral prod!cts$

( #ey m!st remain clear w#en cooled to 1.

#ey are !s!ally administered by I5 inf!sion toreplenis# fl!ids or electrolytes or to pro&ide

n!trition. 0dministered in &ol!mes of 1

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Dlectrolytes, &itamins, and antineoplastics arefre*!ently incorporated into large-&ol!meparenterals.

P#ysical and c#emical compatibility of t#eadditi&e in sol!tion in w#ic# it is placed.

It is also to be &igilant for incompatibilitiesassociated wit# m!ltiple inf!sions

coadministered to a patient. Barge-&ol!me parenteral sol!tions are employedin maintenance t#erapy for t#e patient enteringor reco&ering from s!rgery and for t#e patientw#o is !nconscio!s and !nable to take fl!ids,

electrolytes, and n!trition orally. #e sol!tions may also be !sed in replacement

t#erapy for patients w#o s!ffered #ea&y loss offl!ids and electrolytes.

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:t#er Injectable Prod!cts$

Pellets or Implants Pellets or implants are sterile, small, !s!ally

cylindrical solid objects abo!t '.2 mm indiameter and ? mm long, prepared bycompression and intended to be implanted

s!bc!taneo!sly to pro&ide contin!o!s release ofmedication o&er time.

#ey are !s!ally !sed for potent #ormones.

0d&antages$( Pro&ide t#e patient wit# an economical means of

obtaining long-lasting effects !p to many mont#s".

( :b&iates fre*!ent parenteral or oral #ormone t#erapy.

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#e implant w#ic# may contain 1

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