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2.2.3: Compound sterile and nonsterile products, considering identifying the presence of, and the cause of, product incompatibilities or degradation and methods for achieving stability
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When preparing an IV formulation of amphotericin B deoxycholate (desoxycholate), the lyophilized amphotericin B powder must first be reconstituted with sterile water. What type of IV fluid must the reconstituted amphotericin B be placed in for IV administration?
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(C) Lactated Ringer's solution
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(D) 0.45% sodium chloride
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5% dextrose in water (B) will maintain the micellular distribution that is required for IV amphotericin B desoxycholate.
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0.9% sodium chloride (A), lactated Ringer's solution (C), and 0.45% sodium chloride (D) will not maintain the micellular distribution.
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Topic: Invasive Fungal Infections
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Which one of the following would be most likely to cause instability when added to a TNA?
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The correct answer is (C).
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As a multivalent cation, iron dextran has the capacity to neutralize the zeta potential on fat globules, thus destabilizing a TNA. If parenteral iron is required in a patient receiving a TNA, it can either be administered outside the PN, or it can be administered via a dextrose/amino acid solution on days when the lipid is omitted from the formulation.
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When administering drugs via enteral feeding tube:
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(A) Extended-release medications are always preferable to immediate-release dosage forms.
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(B) As long as tablets are crushed very finely they will retain their pharmacokinetic properties.
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(C) All drugs that a patient receives should be given simultaneously to minimize feeding interruptions.
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(D) Liquid medications may interact with nutritional formula and clog the feeding tube.
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The correct answer is (D).
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Some liquid medications have physical incompatibilities with enteral nutrition products, which may thicken the products or form a gel.