IV Infusion

It is a presentation on IV infusion chapter in Biopharmaceutics and Pharmacokinetics course.

1. Presentation on “ I V I n f u s i o n ” Welcome

2. Presented by Presented by A. N. M. SHARIF Student, University of Asia Pacific, Bangladesh. E-mail: [email protected]

3. Intravenous Infusion I ntravenous is the term means “into the vein”

4. What is IV infusion? An IV infusion is a slow drip of medication into the vein over a set period of time to deliver a constant volume of therapy

5. History of IV infusion Intravenous technology started from studies on cholera treatment in 1831 It was further developed in 1930s but was not widely available until the 1950s

6. Intra Venous Infusion Procedure & Equipment's Equipment's Containers Drip chamber Tubing Filters Spikes Needle Adhesive tape Constricting band Antiseptic and 2 x 2 gauze

7. IV Infusion Procedure Select a suitable vein for venipuncture . b. Prepare the venipuncture site.  Apply a constricting band two inches above the venipuncture site. The constricting band should be tight enough to occlude venous flow, but not so tight that distal pulses are lost . ( 2) Select and palpate a prominent vein. (3) Cleanse the skin with an alcohol swab .Allow the site to dry . c. Don gloves. d. Perform the venipuncture. (1) With the dominant hand, position the distal bevel of the needle up and insert the cannula into the vein at approximately a 30 degree angle (figure 1-10).

8. (2) continue inserting the needle until blood is observed in the flash chamber of the catheter. (3) decrease the angle to 15 to 20 degrees and carefully advance the cannula approximately 0.5 centimeter farther (figure 1-11).

9. (4) Place a finger over the vein at the catheter tip and put pressure on the vein to prevent blood from flowing out the catheter (5) Remove the needle while maintaining firm catheter control. IV Infusion Procedure

10. IV Infusion Procedure E. Remove the constricting band. F. Obtain venous blood samples as required. G. Attach the administration tubing to the cannula hub while maintaining stabilization of the hub with the non-dominant hand.

11. H. Open the flow-regulator clamp and observe for drips in the drip chamber. Allow the fluid to run freely for several seconds. Adjust to the desired flow rate. J. Clean the area of blood, if necessary, and secure the hub of catheter with tape, leaving the hub and tubing connection visible. Make a small loop in the iv tubing and place a second piece of tape over the first to secure the loop

12. IV Infusion Procedure K. Apply a 2×2 or a transparent dressing tegaderm over the venipuncture site L. Label a piece of tape with date and time the IV was initiated, the catheter size, and your initials. Secure the tape over the dressing. M. Monitor the casualty and continues to observe the venipuncture site for signs of infiltration . N. Remove your gloves and disposes of them appropriately. O. Document the procedure on the appropriate medical form.

13. Plasma drug concentration for IV infusion following one compartment model The pharmacokinetics of a drug given by constant IV infusion follows zero order input process in which the drug is infused directly into the systemic blood circulation . CpD B V D R K

14. For most drugs elimination of drug from the plasma is first order process. Therefore in the one compartment model infused drug follows zero order input and first order .

15. Here, = rate in – rate out D B = amount of drug in the body = R- K.D B R= infusion rate  dD B =  (R-K.D B ) dt K = Elimination rate constant D B = (1 – e - kt ) Cp.V D = (1- e - kt ) Cp = (1- e - kt ) [D B = Cp.V D ] When, t = ∞ at he study state concentration the equation will be C ss =  

16. Calculation the elimination rate constant for a drug given through IV infusion   In case of IV infusion , plasma drug concentration at any time is : C p = R/K .V D (1 –e - kt ) At steady state ,t= α time , C SS = = R/K .V D So , C p = C SS (1 –e - kt ) → C p - C SS = C SS .e - kt → C p - C SS / C SS = e - kt → - kt = ln (C p - C SS / C SS ) → - kt / 2.303 = log (C p - C SS / C SS ) → K = -2.303/t . log (C p - C SS / C SS )

17. Loading Dose Loading dose is the minimum effective dose which is given initially at a time to obtain the steady state plasma drug concentration as early as possible.

18. we use a loading dose to rapidly achieve therapeutic concentration of a drug

19. IV Infusion with loading dose D L

20. Time required for achieving 99% of steady state level in terms of t1/2   An infinite long period of time is required to reach steady state drug levels. In practice, it is quite acceptable to reach 99% steady state level. We know that, C ss =R/ K.V d 99% steady state level is: 99% r/ k.V d

21. In case of IV infusion, plasma drug concentration at any time, C p = R/ K.V D (1-e -kt ) → 99% r/ k.V d = r/ k.V D (1-e -kt ) [as c ss = c p ] → 99% = (1-e -kt ) → 1-(99/100) = e - kt → e - kt = 0.01 → - kt = ln(0.01) → - Kt = -4.61 → 0.693/ t 1/2 × t = 4.61 → T = (4.61/ 0.693) × t 1/2 So, t 99%ss = 6.65 t 1/2

22. C p =C ss IV infusion Loading dose IV bolus dose Steady state Plasma drug concentration

23. Loading dose + IV infusion

24. For loading dose: For IV infusion : D L plus IV infusion : Loading dose plus IV infusion :

25. Loading dose plus IV infusion cont … DL is used to reach ss rapidly:

26. Loading dose plus IV infusion cont … Let , D L = C ss V d But, C ss V d = R/ k el Therefore, if a D L = R/ k el is given SS will and

27. Loading dose plus IV infusion cont … D L = R/ k el

28. Main reason for giving a drug by slow iv infusion In case of IV infusion ,When drug is administered rapidly , it tends to increase the volume of the blood . As a result, hypervolemia may occur, thereby slowly infused. Slow IV infusion may be used to avoid side effects due to rapid drug administration . eg : Intravenous immune globulin may cause a rapid fall in blood pressure when infused rapidly.

29. Main reason for giving a drug by slow iv infusion Some antisense drug injected rapidly by IV to the body, it cause a rapid fall in blood pressure. The rate of infusion is particularly important in administering anti- arrythmic agents in patients. The rapid IV bolus injection of many drugs that follow the pharmacokinetic of multi-compartmental models, may cause an adverse response due to the initial high drug conc.eg: If heparin is injected or infused at a faster rate, cardiac arrest may arise.

30. Advantages

31. Advantage Body Temperatur e

32. IV nutrient therapy

33. Disadvantage Painful & Fearful Supervisor required to administer Infection

34. Disadvantage Irreversible Coagulation

35. CATEGORIES

36. Function includes Deliver medications Replace lost fluids

37. If you have any question, Please feel free to ask us!!!!!!!