1. Stability of parenteral and non-parenteral medications
Henderson

2. Things to consider for parenteral medication storage
Stability Time
BUD, refrigeration, sunlight exposure, heat. etc.
Insulin
Reconstitution of Parenteral medication
DO NOT SHAKE VIGEROUSLY, gently swirl
Check the Diluent when reconstituting. This vehicle could impact the stability. The vial of active ingredient will say on the side of the vial its diluent and storage requirements.

3. Application to Retail Pharmacy
A child is prescribed a reconstituted antibiotic for an ear infection. The prescription reads:
Cephalexin 250mg/5mL
#200mL
Sig: 5mL BID X 20 Days

4. Continued… Cephalexin 250mg/5mL #200mL (#2 100mL bottles)
Sig: 5mL BID X 20 Days
Day Supply: 20 days
BUD for this reconstituted med is 14 days.
If we dispense and reconstitute the entire 200mL, it will not be stable for the entire course of therapy.
Now what???

5. Filtration of Parenteral Medications
Use a Filtered device
This is attached to the tip of a syringe while the original needle is still attached.
This will remove up to 0.22 Microns (most microorganisms)
These are pre-sterilized
One time use only
Run approx. $20.00 a piece!

6. Reference Materials Handbook on Injectable Drugs
Most compounding/hospitals will have this readily available.
Guide to Parenteral Admixtures
These materials will have:
Drug Solution
Drug Compatibility
Drug Dosage
Drug dilution information

7. Reference materials continued:
Contact the drug companies
Contact the drug reps
Google it!
Drug companies HAVE SERIOUS MONEY!!! Call them and ask if you have questions about storage and stability. If the drug is a BRAND NAME drug, likely, there are drug reps hired by the company in the area who can provide you with additional information, samples, demos, etc.

8. Work Flow for Parenteral compounding
Prescriber writes the prescription
Prescription is transmitted to the pharmacy
Order is checked against patient allergies, dose, compatibility and stability
Prescription label and compound worksheets are prepared
Prescription is compounded wither by a pharmacist or supervised technician
Prescription is checked by the pharmacist
Prescription is delivered to the patient
Storage will be the responsibility of the patient

9. Other things to consider
Expiration dates
If a drug says its expiration is 12/15, it can be used up until 12/31/15.
What if a product is left out of the refrigerator due to someone not paying attention?
Vacations and travel considerations
Refrigeration products may need additional care when traveling.