การบริหารยาและความคงตัวของยาฉีด

Administration and Stability of Injection Drugs Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Solvent Final conc Solvent Final conc Room temp 28 C Acyclovir INF 500 mg 20 ml 12 hrs vial Precipitated D5W, NSS, D5S, LR 7 mg ml >60 min Acyclovir DBL® 24 hrs dilute 0 2 mg ml Plebitis 2 5 5 mg ml renal 40 mg ml tubular damage acyclovir crystals Alteplase IV, INF Package 500 mg 50 ml 8 hrs 8 hrs D5W, NSS 30 60 min IV push Actiltyse® Only SWFI 500 mg 2 ml recon recon D5W, NSS, LR Amikacin INF renal toxicity Amikacin sulphate IV IM 24 hrs dilute 24 hrs dilute ,ototoxicity GPO® push 250mg ml 24 hrs dilute 24 hrs dilute D5W, NSS IV push IM 250mg 10ml Aminophylline INF 150mg 3ml 24 hrs dilute NA D5W 1 6 mg ml Amiodarone IV if >2mg ml Cordarone® central line push INF

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Amoxicillin IV, INF SWFI 600mg 10ml 20 mins reconstitution IV NSS, LR 12 mg ml 30 60 min IM Clavulanic acid IM SWFI 1 2g 20ml INF D5W 50 100 ml of Augmentin® Inline filter 50mg 12ml dilution degrade solvent liposome Liposomal INF 4 hrs dilute 8 hrs dilute Only D5W 1 2 mg ml adult 2 6 hrs D5W Amphottericin B Protect from light 0 2 0 5 mg ml child degrade Ambisome® 24 hrs dilute 14 days recon & dilute Ampicillin Sodium IV, INF, IM SWFI IM 250mg ml Immediately use Only NSS 3g 150ml IV10 15min Ampin Momac® 1g 3 5ml D5W degrade IV 250mg Ampicillin IV, INF, IM SWFI 3g 6 4ml hrs D5W, NSS, D5S 30 45 mg ml INF30 min Salbactam Unasyn Dose ml IV 10-15min Unasyn® reconstitution 50 100 ml of IV, IM NA solvent INF INF 15 30 Dilution 8 hrs min dilute

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Azithromycin INF SWFI 100mg ml 24 hrs recon & 7 days dilute D5W, NSS, D5S 2, LR 1 2 mg ml 60 mins IV Zithromax® 60 mins 500 mg 4 8ml dilute bolus IM 1g 2 5ml IV push 3 5 min INF 1g 4ml 60 mins 1 5g 3 2ml Cefazolin IV, INF, IM SWFI IM 1g 4ml 24 hrs recon 10 days D5W, NSS, LR 1g 50ml Zefa M H® IV 1g 10ml recon >1g 100ml 50 100 ml of IM 1g 2ml solvent INF 15 30 IV 1g 10ml min Cefoperazone IV, INF,IM SWFI,D5W, 24 hrs recon & 24 hrs recon D5W, NSS, D5S 125mg 50ml Sign of bleeding NSS IM 1g 3ml dilute & dilute Sulcef IV push 3 Sulbactam IV 1g 10ml min Do not mix with SWFI 250mg 50ml INF NaHCO3 Sulcef,Sulperazone® Sulperazone 15 60 min IV push 3 5 Cefotaxime IV, INF, IM 24 hrs dilute 5 days recon D5W, NSS 1g 50ml min Claraxim® & dilute Do not mix with >1g 100ml 50 100 ml of Cefoxitin IV, IM SWFI NA 24 hrs recon NaHCO3 solvent INF 60 mins cefoxitin M&H® & dilute IV push 3 5 D5W, NSS, D5S 2 1g 50ml min >1g 100ml INF 30 min Ceftazidime IV, INF, IM SWFI Protect from light D5W, NSS, LR 1g 50ml IV push 3 5 Cef 4® >1g 100ml min 18 hrs recon 10 days recon INF 30 min

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Ceftriaxone IV, INF, IM SWFI IM 1g 3 6ml Protect from light D5W, NSS 1 2 g 50 100 ml 30 min calcium IV Zefaxone® IV 1g 10ml 24 hrs recon 3 days recon Cef 3 48hrs Chloramphenicol IV, INF SWFI 1g 10ml 30 days recon NA D5W, NSS 2g 50ml INF 30 min >2g 100ml Ciprofloxacin INF 200mg 100ml Protect from light D5W, NSS 1 2 mg ml IV push Cifloxin® IV 14 days vial precipitated D5W Clindamycin push 600mg 4ml 14 days keep in 32 days D5W, NSS 600 mg 50ml 20 60 min IV push Dalacin C® syringe dilute D5W, NSS, D5S INF, IM Cloxacillin IV SWFI IM 24 hrs recon 48 hrs recon 0 5 40 mg ml 30 60 min Phlebitis SWFI 250mg 1 5ml NA 30 60 min >500mg push IV 1g 3 4ml 7 days recon 7 days recon IM IV, INF, IM 24 hrs dilute 5 ml drug 150mg 2ml ml solution Acute renal Colistin IV, INF, IM failure, Colistate® neuromuscular blockage Cotrimoxazole INF 400 80mg 5ml 6 hrs dilute NA D5W, NSS bacin® SMX TMP NSS D5W

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Desferoxaminwe INF, IM Only SWFI 500mg 2ml 24 hrs NA D5W, NSS, LR 100 mg ml Desferal® SC 500mcg 2ml 48 hrs dilute NA D5W, NSS 500mcg 500ml SWFI,D5W, IV Digoxin IV, INF NSS Lanoxin® Diltiazem IV, INF D5W, NSS IV 24 hrs recon & NA D5W, NSS, D5S 2 1mg ml Herbessor® push dilute NA Dimendydrinate IM 10mg 5ml D5W, NSS, SWFI Dilute with 10 ml Dimeno® IV over 2 NA of diluent only IV mins 50mg ml Dobutamine HCI INF 250mg 20ml 24 hrs dilute NA D5W, NSS, D5S 2, D5S 5mg ml Do not mixed with NaHCO3 Doripenem INF SWFI 500mg 10ml 4 hrs dilute 24 hrs dilute D5W, NSS 50 100 ml of Doribax® IV with D5W with D5W NSS solvent IV push IM 1g 3 2ml 8 hrs dilute 24 hrs dilute NSS push IV 1g 10ml with NSS with NSS 50 100 ml of IV push solvent Do not mixed Esomeprazole IV, INF NSS 12 hrs 12 hrs with D5W Nexium® recon & dilute recon & 1g 50 100ml dilute 20mg ml Ertapenem INF,IM SWFI, NSS 1hrs 30 min Invanz® IV reconstitution 24 hrs dilute push IM

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Fosphenytoin INF,IM 500mg PE 10ml INF 30 days D5W, NSS 1 5 25mg PE ml Thrombocytopen Cereneu® dilution 6 hrs dilute ia IV dilute Fosfomycin push IV push Fosmicin® 30 days dilute INF,IM Ganciclovir IV SWFI 2g 20ml 7 days recon & NA D5W, NSS 2g 100ml IV push Cymeven SWFI dilute D5W, NSS 4g 500ml 5min push D5W, NSS 50 250 ml INF 1 2hr SWFI 500mg 10ml 12 hrs recon 14 days 10mg ml INF D5W, NSS 80mg 2ml dilute with 50 250 ml 30min 2hr NSS 1mg ml 60 min Gentamicin INF,IM NA 12 hrs dilute 1mg ml IV push Gentamicin GPO® IV renal 500mg 100ml toxicity, push ototoxicity Hydrocortisone IV, INF, IM 100mg 2ml Protect from light D5W, NSS Do not mixed Solo cortef® with LR 3 days recon NA seizure, Imipenam INF 500mg 4 hrs dilute 4 hrs dilute D5W, NSS, D5S 2, D5S Cilastatin Imipenam 10ml 4 hrs dilute Thrombocytopen Tienam® ia

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Levetivacetam INF 500mg 5ml 24 hrs dilute NA D5W, NSS, 100 ml of solvent IV push Keppra® IV LR 500mg 100ml Protect from light 5mg ml 500mg IV push Levofloxacin push Ready to use 3 hrs NA D5W, NSS, >60min Do not mixed Clavit® LR 50 200 ml with NaHCO3 INF solution 50 ml 750mg IV D5W, NSS 5mg ml >90 min phlebitis 15 30 min push D5W, NSS, D5S 2 Thrombocytopen NSS ia Meropenem IV, INF SWFI 500mg 10ml 3 hrs dilute 14 hrs dilute Meronem® SWFI 1g 20ml with D5W with D5W D5W, NSS, LR 8 hrs dilute 48 hrs dilute Methylprenisolone IV, INF,IM 500mg 8ml with NSS with NSS D5W, NSS Solu medrol® 1g 16ml INF 500mg 100ml 48 hrs dilute NA Metronidazole IV Ready to use Biogly® solution Protect from light 30 60 min IV push push NA Crystal formation Moxifloxacin INF 500mg 100ml Protect from light Infusion in 60 min IV push Avelox® IV Ready to use 24 hrs dilute precipitated 50 200 ml Do not mixed with NaHCO3 push solution Netilmicin INF,IM 150mg 1 5ml NA NA Nelin® INF 4mg 4ml Until unclear NA D5W, D5S 4mg 1000ml Do not mixed Norepinephrine pinkish solution with NSS Levophed®

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Omeprazole IV, INF Package 40mg 10ml 4 hrs recon NA D5W,NSS 100ml Zefxon® 30mg 10ml 6hrs dilute with 24 hrs recon D5W, NSS D5W Pamidronate INF 12hrs dilute 100 1000ml IV push Pamosol® IV with NSS 0 06 0 36 mg ml Pantoprazole push 24 hrs recon Controloc® IV, INF Parecoxib NSS 40mg 10ml 12 hrs dilute NA D5W, NSS 100ml Dynastat® IV, IM Package 40mg 2ml D5W, NSS, D5S 2 Penicillin G sodium SWFI 5MU 3 8 ml 12 hrs recon Precipitated Do not mixed Penicillin Momac IM, INF D5W, NSS with SWFI, LR IV 3 days recon 7 days recon 2 MU 50 ml INF 24 hrs dilute 24 hrs dilute 2 1 6MU 100ml 15 30 min IV push push Continuous 10mg ml electrolyte IV 12 24hr imbalance, seizure Phenytoin sodium IV, INF 250mg 5ml Until unclear Precipitated NSS Dilantin® IV, INF 4 5g 20ml solution recommend Inline 0 22 IV, INF 24 hrs 48hrs recon D5W, NSS u filter Piperacillin 7 days dilute Tazobactam SWFI, NSS 24hrs recon D5W, NSS 50 150 ml 20 30 min sign of &dilute Tazocin® bleeding Ranitidine HCI 50mg 2ml 24 hrs dilute NA 50mg 100ml IV dilute to 20ml and slowly IV push

Generic name Reconstitution Stability after Diluent Brand name Reconstitution Dilution Route Room temp 2 8 C Solvent Final conc Solvent Final conc Sodium valproate INF Package 400mg 4ml 24hrs recon NA D5W, NSS, 50 ml of solvent IV push Depakin® IV D5W, NSS &dilute LR 50 ml of solvent SWFI, NSS NA IV push Streptokinase push 1 5MU 5ml NA 8 hrs recon NA renal Streptase® IV, INF 24 hrs dilute NA toxicity, Streptomycin 1g 1 4ml Final 50 100mg 100ml ototoxicity IM conc 1gm 2ml NA 7 days recon D5W, NSS Tigecycline IV Tygacil® 5 3 ml NSS 50mg 5ml 6 hrs dilute 24 hrs dilute push 5 3 ml D5W vial INF SWFI Vancomycin INF SWFI 500mg 10ml NA 14 days D5W, NSS, D5S,LR 500mg 100ml 60 min IV push Edicin® IV recon & >500mg 250ml red man push dilute syndrome, extravasation, acute renal failure, ototoxic Conc Concentration, Room temperature 25º 30º C, IM Intramuscular, IV Intravenous, INF Intravenous infusion, SC Subcutaneous, IT Intrathecal , Recon after Reconstitution, Dilute after Dilution, Vial after open vial Reference Lawrence AT Handbook on Injectable drugs 16th ed USA American Society of Health System Pharmacist ASHP ; 2011 Charles FL, Lora LA, Morton PG, Leonard LL Drug Information Handbook 12 cd USA Lexi comp 2004 2005 Information from drug leaflet and drug company Product Information package insert Lacy CF Armstrong LL Goldman MP Jance LL Drug Information Handbook 20 th edition Hudson Lexi Comp; 2011 2012 McEvoy GK AHFS Drug Information Bethesda ASHP 2012