Practicum in Health Science Reconstitution Practicum in Health Science

Key Definitions Reconstitute: to change into liquid form by adding water or other fluid to a powder. Diluent: the liquid added to a powder during reconstitution.

Reconstitution Basics Solids – powders or crystals Liquids – water or sterile solutions Necessary for medications which are unstable Done according to: Physical properties of drug Route of administration Concentration may vary

Reconstitution Solids and Diluents Single or multidose containers Diluents Oral medications – distilled water only Injectable medications – sterile solutions that vary with the drug Mix-O-Vial Diluent packaged with drug (ex. Immunizations)

Reconstitution at Different Strengths Single-strength, single-dose Use diluent amount on label Multidose Use label to adjust the diluent amount Choose amount closest to achieving physician’s ordered strength

Reconstitution for Different Administration Routes Intramuscular and intravenous medications can differ Intramuscular drugs may require a variety of diluents – especially if injection is long-acting Some medications can only be administered by one route Some medications with interchangeable routes require different amounts of diluents

Equipment needed for Reconstitution Graduated cylinder or similar product Reconstitube ® - a modified graduated cylinder with two tubes attached. The upper tube connects the cylinder to a supply of water or other liquid, and the lower tube, which is open ended, enters the medication bottle.

Reconstitution Procedure Tap the container to loosen the solid in the container Read all directions on the medication label Use the manufacturer-designated diluent in the amount needed to achieve the physician-ordered medication concentration. **TIP ** Only add one-third portion of the diluent to the medication bottle at first, allowing the powder to dissolve gradually into the diluent. If you add all liquid at once, medication powder will likely stick to the bottom of the medication bottle and resist dilution. Following reconstitution, container is ready for the attachment of the prescription label. Don’t forget to affix any appropriate auxiliary labels.

Original Product Package Label Sample: for reconstitution to liquid

Check for Understanding 1. If a Reconstitube® is unavailable, what other compounding equipment would be appropriate to use for measuring the diluent? a. Mortar & pestle c. Graduated cylinder b. Amber bottle d. Oral syringe Referring to the previous sample label, once the diluent has been added to the powder medication, what is the final concentration in milligrams per milliliter? a. 25 mg/ml c. 100 mg/ml b. 50 mg/ml d. 250 mg/ml

Check for understanding Based on the concentration that was determined in question 2, how much of this medication would be needed for a 125 mg dose? a. 2 ml c. 5 ml b. 3 ml d. 10 ml If the physician orders “Augmentin 125 mg po qid,” how much of this solution would be needed for a 24- hour period? a. 5 ml c. 15 ml b. 10 ml d. 20 ml

Sources McCartney, L. & Sparks, J. Pharmacy Labs for Technicians: Building Skills in Pharmacy Practice. EMC Publishing, LLC. 2010. University of Florida College of Pharmacy: www.cop.ufl.edu/wp- content/uploads/dept/ce/pharm_tech/slidehandouts/dosa gecalc.pdf