Large volume parenterals

Types of Large volume parenterals

1. Large Volume Parenterals Dr. Swati Gokul Talele Sandip Institute of Pharmaceutical Sciences, Nasik

2. LEARNING OBJECTIVES Familiarize concept of parenteral with characteristics of LVPs. Understand t ypes of LVPs with specialised LVPs . Discuss concept of intravenous and nonintravenous LVPs.

3. Definition "Parenteral" derived from two Greek words ‘para’ beside and ‘ enteron ’ meaning intestine. Parenteral dosage forms administered directly into body tissues rather than through the intestine with the help of an injection. A ctive substances are administered using gravity, or force directly into blood vessels, organs or tissues . As per USP LVP solutions applies to a single dose injection. It is intended for intravenous use. It is packaged in containers labelled as containing more than 100 ml.

4. Characteristics of Large Volume Parenterals It should be sterile , nonpyrogenic , free from particulate matters. The volume with single units should be more than 100 ml . It should not contain any preservative. The volume does not exceed 1000ml in IV LVP’S N onintravenous LVP volume may exceed 1000 ml. ( Example: Irrigation and Dialysis solution) It should be isotonic to minimise damage to blood vessels and blood cells. Hypertonic solution may be administered efficiently . Small quantity of hypertonic solution may be administered in a peripheral vein L arge quantity of hypertonic solution are administered which inserted in a large central veins as subclavian vein or internal jugular vein.

5. REFLECTION SPOT What are the various types of large volume parenterals ? What are various specilaised LVPs?

6. Mulitiple Electrolyte Injection With 5% w/v Dextrose Lacteted Ringers Injection With 5% w/v Dextrose Sodium Chloride Mutiple Electrolyte Injection Lactated Ringers Injection ELECROLYTE SOLUTION

7. 10% invert sugar 10% fructose injection 5% dextrose injection CARBOHYDRATESOLUTION

8. Amino acid with electrolytes Amino acid injection Amino acids with 25% dextrose & electrolytes Lactated Ringers Injection Nutritional solution

9. Fat emulsion Composition Soybean oil: 10 gram Egg yolk phospholipids: 1.2 gram Glycerine: 2.25 gram Water for injection: 100 ml pH: 8.0 Osmolarity : 280mOsmol/L

10. Electrolytes Vitamins Total parenteral Nutrition Proteins Energy Trace Elements

11. 1 Hyper alimentation solution 2 Cardioplegia solution 3 Peritoneal Solution 4 Irrigation solution Specialized Large volume Parenterals

12. Hyperalimentation solutions Dextrose Amino Acids Lipids Vitamins Electrolytes Trace Elements + +

13. Calcium Chloride Dihydrate Magnesium Chloride Hexahydrate Water for Injection Potassium Chloride Sodium Chloride Cardioplegia Solution + +

14. Peritoneal Dialysis Solution Water Glucose Salt Minerals +

15. INTRA VENOUS ADMIXTURES one or more sterile dry products added to an IV fluid. Additive is SVP added to large volume parenteral It is used for drugs that intended for continuous infusion. D rugs that may cause irritation and toxicity given by direct IV injection. L aminar air flow unit with HEPA filter efficiency 99.97%.( 0.3 µm particle) Personnel handling admixtures should wear gloves and mask. The process for mixing will deviate. Totally depend on which IV fluid packaging system utilised by the hospital.

16. IRRIGATION SOLUTION T o irrigate, flush and in cleansing body cavities and wounds . Irrigating solution should not be used parentally . Irrigating solution must be sterile, pyrogen free. H andled with same care as parenteral solution . Examples: Acetic acid irrigation USP Neomycin and Polymyxin B sulfates solution for irrigation , USP Ringers Irrigation , USP Sodium Chloride Irrigation USP Sterile water for injection USP    

17. THANK YOU