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Wednesday, 29 May 2013

Everything About Injection Mixing

Collected by Dr.Hossam Elgnainy
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How can I reduce the risks from mixing injections?

Injections should generally be assumed to be incompatible if there is no evidence to support their safe mixing.

From the NHS Evidence website www.evidence.nhs.uk

http://www.medicinesresources.nhs.uk/upload/documents/Evidence/Medicines%20Q%20&%20A/QA298_1_Mixing_Injectables.doc

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To mix or not to mix – compatibilities of parenteral drug solutions

Peter Murney, Deputy Director, Pharmacy Department, Concord Repatriation GeneralHospital, Sydney

Many injectable drugs cannot be mixed together in syringes or infusions. Some cannot be safely diluted in infusion bags. Incompatibility can involve precipitation, ionic
reactions, evolution of gas and denaturation of biological molecules. Knowledge of drug compatibility is needed before mixing drugs. Reference texts can provide information, but data are often
unavailable for new drugs. If drugs are mixed together, the mixture should be inspected for precipitates, turbidity or changes in colour, however not all incompatibilities are visible.

Australian Prescriber 2008;31:98-101
http://www.australianprescriber.com/magazine/31/4/98/101#.UZzqvNgpnFx

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Injectable Drugs Guide, Book

This is a beam to a critical information for protected and effective administration of injectable drugs. This is an A-Z slot beam of injectable drugs in monograph format including information on: Final thoroughness of reconstituted solutions; Stability; Periodicity of monitoring; and, Unusual electrolyte, glucose and excipients content. Each monograph includes: Pre-treatment checks, Dose, Preparation and Administration, Technical information (including compatibility), Stability, Further monitoring (blood pressure, glucose etc), and Professional information (undesirable effects, poignant interactions, overdose, counselling). The protected administration of drugs by injection is an essential activity that is achieved daily in a health caring setting. Multiple drug use and drug administration protocols make this increasingly formidable and this book aims to give evident entrance to a important/key information for protected and effective administration of injectable drugs.

http://www.book4doc.org/injectable-drugs-guide-2/

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Handbook on Injectable Drugs, 17th Edition
American Society of Health-System Pharmacists (ASHP)
http://store.ashp.org/Default.aspx?TabID=216&ProductId=44037462

and its Interactive Version;
ASHP'S Interactive Handbook on Injectable Drugs: IV Decision Support by Lawrence A. Trissel
http://store.ashp.org/ProductDetails/tabid/216/Default.aspx?ProductId=24269378
View a quick walkthrough; http://www.ashpmedia.org/video/interactivehandbook/HID%20demo%20v3.mov
http://www.interactivehandbook.com/

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