Powder and Crystalline Form Drugs

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Chapter 9

• Powder and Crystalline Form Drugs

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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.

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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.

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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.

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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.

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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.

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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.

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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

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• 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