Case sharing:
Nurse Xiao AA: Lonoxikan for injection needs to be dissolved with water for injection . I didn’t know before, so I used normal saline to dissolve it, which was difficult to dissolve. There are often particles in the bottle. Later, I read the instructions carefully and found out that I first used water for injection. As soon as I pushed the water for injection, it was completely dissolved.
Nursing Review:
Careful reading of the instructions for lonoxicam for injection, we can see that the redissolution of lonoxicam for injection is as follows: intramuscular or intravenous injection.
This product must be dissolved in 2 mL of water for injection before injection. During intravenous injection, it must be diluted with no less than 2 mL of 0.9% sodium chloride injection. The topic of
involves the particularity of some injection drugs.
During the patient's medication, nursing staff often encounter some special injection powder injection drugs that require redissolving with injection water. What's more, some intravenous powder injections not only need to redissolve with injection water, but also need to be redissolved after secondary dilution before the medication can be used.
Water for injection is water obtained by distillation of purified water. Its properties are colorless and clear liquid, odorless, odorless, and hypotonic, with a pH value of 5.0 to 7.0.
0.9% Sodium chloride injection (normal saline) isotonic, and water for injection and normal saline are commonly used in clinical practice powder injection diluents for subcutaneous, muscle and intravenous powder injection.
picks up several clinical medication issues to help everyone use medication correctly.
Physical saline or water for injection, which intramuscular injection is more painful?
According to observation and analysis, compared with the pain caused by intramuscular injection after diluting the drug as solvent, normal saline is better than the water for injection, and normal saline is less painful.
Why use normal saline instead of injection water during skin test?
water for injection is hypotonic, which can easily cause local edema and inflammatory reactions, and can easily cause false positive allergies. Therefore, most patients with normal saline are used and less water for injection are used.
Can water be injected intravenously?
Normal saline is an isotonic fluid and can be used intravenously. Water for injection is not used as intravenous injection due to hypotonicity.
There are so many advantages of normal saline,
Why do many injections still require the use of injection water as solvent?
1. The common saline solution is electrolyte solution containing sodium. Some high-sodium preparations are prone to homoionic effects to affect dissociation;
2. glucose solution is also an acidic environment. For example, 10% GS pH is about 3.5 to 5.5, which can easily cause damage to some drugs and may also affect dissolution (acidic, 10% GS 5% GS NS water for injection);
3. Special cases caused by special prescription design ingredients of some preparations. Therefore, for some intravenous powders, the first step of redissolution requires sterilized injection water with a pH of neutrality and no homoionic effect.
Powder injection drugs that require redissolving with water for injection
Many powder injections come with water for injection
1. Lizhi blood (hemagglutinin for injection, 1KU/bottle)
Characteristics: white loose freeze-dried powder
Classification: procoagulant and hemostatic drugs/anticoagulant thrombolysis and antiplatelet drugs
Usage: intravenous injection, intramuscular injection, and can also be used locally. Each box is equipped with 2 mL*5 injection water.
2. Injection mouse nerve growth factor (20 µg/branch)
Traits: white freeze-dried loose body. Save at 2-8°C in the dark.
Category: Neurotrophic
Usage: Dissolve with 2 mL of injection with water, intramuscular injection. Add water for injection and shake it and dissolve it completely.
3. Recombinant human interferon for injection (9µg/0.3 mL*1, 15µg/0.5 mL*6)
Characteristics: White thin shell-like loose body
Drug classification: Vaccine/antiser/ Immune preparation
Usage: Each bottle of product is dissolved with sterilized injection water, and injected subcutaneously or intramuscularly. When dissolved with water for injection, it should be injected along the wall of the bottle to avoid bubbles.
4. Freeze-dried rabies vaccine for human use (0.5 mL/bottle after redissolution)
Characteristics: White loose body
Category: Vaccine/anti-serum/immune preparation
Usage: Add the attached sterilized injection water according to the indicated amount, wait for the vaccine to redissolve and shake well before injecting.After reconstitution, 0.5 mL of each bottle, and the dose of 0.5 mL per person is 1 time. Buttock injection is prohibited, intravascular injection cannot be performed.
5. Trastuzumab (440 mg/bottle)
Characteristics: White to light yellow bulky
Category: Targeted therapeutic drug
Usage: The diluent is 20 mL sterilized injection water containing 1.1% benzyl alcohol. Patients with allergic to benzyl alcohol are known to reconstitute with water for injection during administration. 5% glucose injection cannot be used as it can accumulate proteins.
powder injection drug
that requires two-step dilution method to dissolve, that is, first redissolve with water for injection, and then dilute with normal saline or glucose solution.
1. Caspofungin acetate for injection (50 mg)
Characteristics: White or white-like drug powder
Category: Antifungal drug
Usage: The first step of drug dissolution, add 10.5 mL of sterile injection water or sterile injection water containing 0.9% benzyl alcohol under sterile conditions to make a transparent solution with a concentration of 5.2 mg/mL (50 mg per bottle) under sterile conditions.
Step 2: Prepare the solution for infusion for the patient. The diluent is a sterile normal saline or lacticated Ringer's solution for injection. It is further diluted into 250 mL of solution for infusion for the patient. The infusion solution must be injected slowly intravenously for about 1 hour.
infusion solution stored at a temperature of 25°C or below must be used within 24 hours. No dilution containing dextrose (α-D-glucan) shall be used.
2. Voriconazole for injection (0.1 g)
Characteristics: white or white loose mass or powder
Category: Antifungal drugs.
Usage: It is necessary to dissolve it with 5 mL of special solvent before intravenous infusion, and then dilute it with 5% glucose injection or normal saline to a concentration of 2 mg/mL. The fastest rate of intravenous drip should not exceed 3 mg/kg per hour and cannot be used for bolus injection.
3. Vancomycin hydrochloride for injection (500 mg/bottle)
Characteristics: White powder or lyophilized block
Category: Other antibiotics
Usage: Add 10 mL of water to a small vial containing 0.5 g of this product to dissolve it, and then dilute it with at least 100 mL of normal saline or 5% glucose injection, and the intravenous drop time is more than 60 minutes. Avoid leakage outside the blood vessels during administration.
4. Amphotericin B liposomes for injection [10 mg (10,000 units)/bottle]
Characteristics: Light yellow or yellow block
Category: Antifungal drugs
Usage: Dilute with sterilized injection water and dissolve it evenly, then add to 5% glucose injection 500 mL internal venous drip. The drip speed should not exceed 30 drops/min. Observe body temperature, pulse, breathing, and blood pressure once an hour in the first 2 hours. If there are no toxic side effects, the dose will be increased day by day to maintain the dose and infusion is avoided from light.
5. Sodium Fosfomycin for injection (4 million units)
Characteristics: White crystalline powder
Category: Other antibiotics
Usage: First dissolve with appropriate amount of sterilized injection water, then add to 250-500 mL of 5% glucose injection or sodium chloride injection diluted and then intravenously intravenously.
6. Sodium cefuroxime for injection (0.75 g)
Characteristics: white or white powder
Category: Antifungal drugs
Usage: Second generation cephalosporin antibacterial drugs.
intramuscularly, add 3 mL of water for injection and prepare an opaque suspension. Intravenous injection, dissolved in injection water. At least 6 mL of injection water is required. For a short period of intravenous infusion, dissolve 1.5 g in 50 mL of water for injection. The prepared solution can be directly used for intravenous injection; it can also be added to the intravenous infusion tube.
7. Aminotrian for injection (0.5 g)
Characteristics: white or white powder
Category: Other β-lactam antibiotics
Usage: Intravenous infusion: Every 1 g of aminotrian needs to be dissolved with at least 3 mL of injection water, and then diluted with appropriate infusion (0.9% sodium chloride injection, 5% or 10% glucose injection or Ringer's injection). The aminotrian concentration shall not exceed 2%, and the infusion time shall be 20-60 minutes.
Intravenous bolt: Dissolve each bottle with 6-10 mL of injection water and slowly inject the vein within 3-5 minutes.
8. Erythromycin lactonic acid for injection (0.25 g)
Characteristics: White or white crystals or powder
Category: Macrolide
Usage: First add 10 mL of water for injection and dissolve thoroughly, then add saline or other electrolyte solution to dilute, and slowly and continuously intravenous infusion.
9. Azithromycin for injection (0.5 g)
Characteristics: White or white powder
Category: Macrolide
Usage: 4.8 mL of sterilized water for injection must be added to each bottle first to reconstitute the solution, so that 100 mg azithromycin is contained in each milliliter of solution, and then 5 mL of 100 mg/mL azithromycin solution is diluted with common normal saline, 5% glucose solution or Ringer's lactate solution to prepare a 1.0-2.0 mg/mL azithromycin solution. It is recommended that the infusion time be no less than 60 minutes. Intravenous injection or intramuscular injection is not allowed.
10. Tekoalanin for injection (0.2 g)
Characteristics: White to light yellow lyophilized blocks and powder
Category: Other antibiotics
Usage: Use 3 mL of injection water to slowly inject it into a bottle containing tekoalanin and dissolve it, be careful not to produce foam. The configured solution can then be diluted in a common sugar or electrolyte solution.
11. Acyclovir for injection (0.25 g)
Characteristics: White loose mass or powder
Category: Antiviral drug
Usage: First, add 0.5 g of the drug to 10 mL of water for injection and dissolve it to make the concentration of 50 g/L, and then dilute it with common sugar or salt solution to at least 100 mL, so that the final drug concentration does not exceed 7 g/L, otherwise phlebitis is prone to occur.
12. Compound monoammonium glycyrrhizic acid for injection S
Characteristics: White or white-like lyophilized blocks or powder
Category: Liver-protecting medicine
Usage: After dissolving it with appropriate amount of injection water before use, add 5% glucose or 0.9% sodium chloride 250-500 mL of injection and dilute it, and then slowly instillate it. Once a day.
13. Reduced glutathione for injection (0.3 g; 0.6 g; 0.9 g; 1.0 g; 1.2 g, etc.)
Characteristics: White porous block or powder
Category: liver-protecting and antidote.
Usage: When dissolved, first dissolve in injection water, add 100 mL, 250 mL, 500 mL of normal saline or 5% glucose injection and dilute it before intravenous infusion. Or add less than 20 mL of normal saline to slowly intravenously.
14. Fat-soluble vitamins for injection
Characteristics: White to light yellow loose mass or powder
Category: Complex vitamins
Usage: Dissolve with injection water, glucose or sodium chloride injection, add it to 500 mL of fat milk injection, normal saline and glucose injection, shake gently and infusate, and use it within 6 hours.
15. Ornithine for injection (2.5 g)
Characteristics: White or white loose mass
Category: Liver treatment medicine
Usage: When using the medicine, it must be fully dissolved with an appropriate amount of injection water, and then added to normal saline or 5% or 10% glucose injection. Finally, the concentration of ornithine aspartate does not exceed 2%, and slow intravenous infusion.
16. Lonoxicam for injection (8 mg)
Characteristics: Yellow lyophilized block
Category: Nonsteroidal anti-inflammatory analgesics
Usage: Intramuscular or intravenous injection. This product must be dissolved in 2 mL of water for injection before injection. During intravenous injection, dilute at least 2 mL of 0.9% sodium chloride injection.
17. Ambroxol hydrochloride powder injection (15 mg; 30 mg)
Characteristics: White loose mass or powder
Category: Cough and sputum-relieving medicine
Usage and dosage: Dissolve with 5 mL sterile injection with water before use, and inject slowly intravenously. It can also be diluted with appropriate amount of sterile injection water and mixed with glucose, fructose, 0.9% sodium chloride injection or Ringer's solution for intravenous use.
is dissolved in water for sterile injection and cannot be mixed with other solutions with pH greater than 6.3. Because increased pH results in ambroxol free alkali precipitation.
