CH.

15

PARENTERALS

SN 16 DANIELLE SY ENCINARES

EPORT
SCOPE OF R
First Half
Injections to
Access
Specialized
Second Half
sulin
Insulins to In
IDRA)
Glulisine (AP

CH. 15

PARENTERALS

SN 16 DANIELLE SY ENCINARES

FIRST HALF
INJECTIONS TO SPECIALIZED
ACCESS

Parenterals
DEFENITION

Injectable routes
for administration
Parenteral derived
from the Greek
word
Para; outside
Enteron;
intestine

Parenterals
WHEN

Rapid drug action is

desired
Patient is
uncooperative,
unconscious, unable
to accept or tolerate
oral medication
Drug is Ineffective
with other routes

Parenterals
MOSTLY
ADMINISTERED BY
Physicians
Physicians
assistant
Nurse
STERILITY
Free from
contaminating
microorganism
placed in indirect

Parenterals

BASED ON ROUTE OF ADMINISTRATION

Small and large

volume injectable
preparations

Irrigation fluids
to bathe body wounds or
surgical openings and
dialysis solutions

Parenterals

BASED ON ROUTE OF ADMINISTRATION

Biologic
preparations
vaccines, toxoids and anti

Opthalmic
preparations for the eye

Parenterals

BASED ON ROUTE OF ADMINISTRATION

Otic preparations
for the ear

Nasal preparations
for the nose and throat

Injections
STERILE, PYROGEN FREE
(endotoxin units EU
limited) preparation
intended to be
administered orally

PYROGEN OR BACTERIAL
ENDOTOXINS
organic metabolic
products shed from
negative bacteria

Injections
Hypodermic
morphine solution
(1874 addendum)
earliest
injectable
drug to
receive official
recognition

Injections
Employed mostly in
the hospital,
extended care
facility, clinic, and
less frequently at
home
HOME HEALTH CARE
schedule visits
to patients at
home

arenteral Routes of Administratio

Any organ or area of the body
Joint (intra- articular)
Joint fluid area (instrasynovial)
Spinal column (intraspinal)
Spinal fluid (intrathecal)
Arteries (intra-arterial)
Heart (intracardiac)
Vein ( intravenous, IV) most common

arenteral Routes of Administratio

Muscle (intramuscular, IM)
Skin (intradermal, ID;
intracutaneous)
Under the skin (subcutaneous, SC;
sub-Q, SQ; hypodermic, hypo)

arenteral Routes of Administratio

arenteral Routes of Administratio

Intravenous Route (IV)

1656; Sir Christopher Wren

Used a bladder and quill for a
syringe and needle, injected wine,
ale, opium, etc. into the veins of
dogs and studied their effects
1662; Johann Daniel Major of Kiel
IV medication first given to humans
but was abandoned due to
thrombosis and embolism
20th century
IV administration of solutions of
sodium chloride and glucose

arenteral Routes of Administratio

Intravenous Route
(IV)
Rapid actions
compared with other
routes
Life saving during
emergencies
Once administered;
cannot be retrieved
As it could
vomiting after oral
administration of

arenteral Routes of Administratio

Intravenous Route
(IV)

Suitable for
venipuncture
Superficial veins
Basilic and
cephalic veins on
the back of the
hand and dorsal
forearm (the best
for IV therapy)
Antecubital; not

arenteral Routes of Administratio

Intravenous Route
(IV)

Flow rateinfusion ;
expressed in milliliters
per hour and range
from 42 to 150 mL/h
Thrombi when the
infusion solution is
irritating to the
biologic tissues
Thrombus blood clot
formed within the

arenteral Routes of Administratio

Intravenous Route
(IV)

Embolus once such a

clot circulates
Embolismblock or
occlusion from the
lodging of the embolus
in a blood vessel.
IV fat emulsions
calories , essential fatty
acids for requiring
nutrition
Ex; intralipid, 20%,

arenteral Routes of Administratio

Intravenous Route
(IV)

IV Fat emulsion;
contains up to 30%
soybean emulsified
with egg yolk
phospholipids in a
vehicle of glycerin in
water for injection
IV route also used for
blood transfusion,
point of exit for blood

arenteral Routes of Administratio

Intravenous Route
(IV)

PCA patient controlled

analgesia; control the
pain associated with
surgical procedures,
labor, sickle cell crisis,
and cancer, chronic
malignant pain
Programmable
electromechanical unit
compact enough to be
worn on a belt or

arenteral Routes of Administratio

Intravenous Route
(IV)

PCA patient controlled

analgesia

Video Source: https://www.youtube.com/watch?

arenteral Routes of Administratio

Intramuscular Route
(IM)
Provide effect less
rapid; generally longer
lasting (parenterals can
be a suspension,
aqueous or oleaginous)
suspension is less rapid
Deep into the skeletal
muscle
Far from major nerve
Most frequent site in
adults; upper outer

arenteral Routes of Administratio

Intramuscular Route (IM)

Z-track technique creates a Z pattern

that block infiltration of medication in
the SC tissue

Ex; Iron dextran Injection (irritate

tissues)
Diazepam (by sealing in the lower
muscle)

arenteral Routes of Administratio

Subcutaneous Route
(SC)
Used for injections of
small amount of the
medication
Made in the loss
interstitial tissue of the
other upper arm, the
anterior thigh or the
lower abdomen.
Usually rooted when
injections are
frequently given like

arenteral Routes of Administratio

Subcutaneous Route
(SC)
Max amount
comfortably injected is
1.3 mL
More than that causes
painful pressure

arenteral Routes of Administratio

Intradermal route
(ID)

Injected into the corium

(more vascular layer of
the kin just beneath the
epidermis)
Agents for diagnostic
determinations,
desensitization, or
immunization.
Usual site- anterior
forearm
Narrow needle

arenteral Routes of Administratio

Intradermal route
(ID)

Injected into the corium

(more vascular layer of
the kin just beneath the
epidermis)
Agents for diagnostic
determinations,
desensitization, or
immunization.
Usual site- anterior
forearm
Narrow needle

arenteral Routes of Administratio

Specialized Access

When necessary to
administer repeated
injections over time
Several types of central
venous catheters are
used
Heparinizationmaintain
patency
Several factor on the
choice of catheterslength of time of the
infusion

arenteral Routes of Administratio

Specialized Access

3 types of catheters
Plain plastic, catheter over needle or
catheter outside needle and catheter
inside needle
Delivery catheter can be places in a
vein, cavity, artery, or the central
nervous system
Huber point needle- used to inject
through the skin into the rubber septum
of a totally implanted central vein access
device

CH. 15

PARENTERALS

SN 16 DANIELLE SY ENCINARES

SECOND HALF
INSULINS TO INSULIN
GLULISINE (APIDRA)

Insulins

Active principle of the

pancreas gland
Facilitates the cellular
uptake of glucose and
its metabolism in
liver, muscle, and
adipose tissue
To patients with
abnormal/ absent
pancreatic beta cell
function
Used in the treatment

Insulins

REGULAR INSULIN
Sterile aqueous solution of
insulin
Commercially prepared from
beef or pork pancreas or
both through biosynthetic
means (human insulin)
apH; 2.8 3.5
Contain 100 or 500 USP
Insulin Units/ mL
Not to be later than 24
months after distribution
date

*store in a cold
place
(refrigerator)

Insulins
HUMAN INSULIN

Produced by utilizing a special non diseaseforming laboratory strain of Escherichia coli and
recombinant DNA technology
Consists of two formulations
Neutral Regular Human Insulin (Humulin
R) consists of Zinc-insulin crystals in
solution for rapid onset of action and
relatively short duration of action (6 to 8
hours)
NPH Human Insulin (Humulin N)Turbid;
intermediate acting; slower onset of action
and longer duration of action (slightly less

Insulins
INSULIN LISPRO
Consists of Zinc-Insulin lispro
crystals dissolved in a clear
aqueous fluid
Created when that amino
acids at positions 28 and 29
on the Insulin B-chain are
reversed
(compared
to
regular insulin)
Peak serum levels that occur
earlier (0.5 1.5 hours) are
higher and are short acting
(6 8 hours )

Insulins
INSULIN ASPART
Recombinant, ultrashortactive insulin using
Saccharomyces cerevisiae
(bakers yeast) as the
production organism
Single substitution of the
amino acid proline by
aspartic acid in position B28.
Control postprandial glucose
concentrations when
administered 5 to 10
minutes before mealtime

*should not be
mixed with
crystalline zincinsulin
preparations;
compatibility
data are lacking

Insulins

NSULIN GLULISINE (APIDRA)

Recombinant rapid-acting insulin
analog; differs from human insulin by
the replacement of two amino acids on
the beta-chain at positions B3 and B29
Produced by recombinant DNA
technology using a nonpathogenic
strain of E. coli (K12)
(SC) route; more rapid onset of action,
shorter duration of action compared to
regular insulin

Insulins

NSULIN GLULISINE (APIDRA)

Sterile, clear, aqueous, and colorless
solution
pH- approximately 7.3
Onset of action in 0.2 0.5 hours
Reaches its peak effect in 1.6 1.8 hours
Duration of action- 3 4 hours
(SC) route; should be administered 15
minutes prior to a meal or 20 minutes after
a meal
Should be injected into thighs, arms,

Insulins

NSULIN GLULISINE (APIDRA)

Can be administered intravenously via
infusion
Used at concentrations of 0.05 to 1 U/mL
Unopened vials; should be stored in the
refrigerator (2C 8C)
Discarded if frozen/ if exposed to temp.
greater than 37C
Opened vials; stored in the refrigerator at a
room temperature of not greater than 25C
Should be discarded after 28 days since

CH. 15

PARENTERALS

SN 16 DANIELLE SY ENCINARES

END
OF
REPOR
T!