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LVP stands for Large Volume Parenteral. A large volume parenteral (LVP) is a unit dose container of greater than or equal to 100ml that is terminally sterilized by heat.
LVP are Parenterals designed to provide :
Requirements for LVP :
Generally, sterilization is done at 121°C & it is a standard temperature for sterilization. If we want to sterilize the material at the temperature other than 121°C then we must change the time of sterilization.
Some materials are heat sensitive & can’t be sterilized at 121°C. F0 value is used to determine the exposure time of material for sterilization at a particular temperature. F0 value is the time in minute for the specified temperature that gives the same thermal lethality as at 121°C in one minute.
It explains that temperature is not an important factor in thermal sterilization but lethlity is important. Time of sterilization can be changed (decrease or increase) according to the lethality of the temperature.
F0 = Δt x 10 (T-121/z)
where, T = Temperature of sterilization | Δt = 60 Sec. = 1 min | z = temperature coefficient (assumed as 10°C)
For Example: If we want to sterilize any material at 115°C then we have to calculate F0 value.
F0=1×10(115-121/10)
F0=1×10(-6/10)
F0=1×10(-0.6)
F0=3.98 Minutes
It shows that the thermal lethality of 1 minute at 121°C is equal to the lethality of 3.98 minutes at 115°C.
An injection refers to the administration of medication using a needle & syringe. For example, if you’ve been given a flu shot or a vaccine, it was an injection.
An infusion is when fluids, medication, or blood is given through a catheter directly into a vein. A medical professional does this by using a needle to guide the catheter into a vein. The needle is then removed leaving the plastic catheter behind in the vein. A lot of patients think that there’s a needle in their arm throughout the whole infusion but just the plastic catheter remains.
The big difference between an infusion & injection is the period of administration. Injections are often done within minutes whereas infusions can take anywhere between 30 minutes to several hours.
The different routes of parenteral administration are as follows:
Though all routes have their place, intravenous (“within vein”) therapy is fast & has 100 percent bioavailability, meaning the drug is unchanged by absorption or metabolism when it reaches systemic circulation.
If you can’t eat or drink normally, or have swallowing difficulties, IV fluids can be crucial for your survival. After falling seriously ill or undergoing an operation, it’s more important than ever to remain hydrated & get the right nutrients.
We all need water, salt & other essential nutrients for our bodies to function & stay healthy. So we may need Intravenous fluids, more commonly referred to as IV fluids.
Intravenous fluids, also known as intravenous solutions, are supplemental fluids used in intravenous therapy to restore or maintain normal fluid volume & electrolyte balance when the oral route is not possible. The basic function of I.V. fluids is to replenish the body fluids. IV fluid therapy is an efficient & effective way of supplying fluids directly into the intravascular fluid compartment, in replacing electrolyte losses, & in administering medications & blood products.
There are different types of IV fluids & different ways on how to classify them.
The most common way to categorize IV fluids is based on their tonicity:
IV solutions can also be classified based on their purpose:
Irrigation Solutions are topical preparations used intra-operatively during some surgeries.
Irrigation Solutions are sterile or nonpyrogenic isotonic solutions, made under sterile conditions. They are intended to irrigate, flush & aid in cleansing body cavities & wounds.
Plasma Volume Expanders (PVEs) are fluids given intravenously to increase or retain the volume of fluid in the circulatory system. They are used to treat hemorrhage or cardiogenic shock (a life-threatening condition in which the heart cannot pump enough blood that is needed by the body). PVEs are given to restore vascular volume that has been lost due to injury or any other medical condition. They stabilize the dynamics of blood flow & allow adequate fluid to pass through the circulatory system to organs & supply oxygen.
Plasma expanders are agents that have relatively high molecular weight & boost the plasma volume by increasing the osmotic pressure. Shock occurs due to reduced blood volume & it is necessary to get the blood volume back to normal as quickly as possible. PVEs restore vascular volume, stabilizing circulatory hemodynamics & maintaining tissue perfusion.
Blood is the main body fluid that helps in the transportation of nutrients, oxygen, carbon dioxide, & waste products to carry out waste products. It is composed of Plasma, WBC, RBC, & platelets.
Plasma is the liquid component of the blood excluding blood cells. It is composed of Water (90%), Protein, Nutrients, Waste products, Clotting factors, Minerals, Hormones, & Carbon dioxide.
Lets evaluate the use of blood volume expanders:
There are two main types of volume expanders: Crystalloids & Colloids.
Crystalloids are aqueous solutions of mineral salts or other water-soluble molecules. Colloids contain larger insoluble molecules, such as gelatin; blood itself is a colloid. There are also a few other volume expanders that may be used in certain situations:
Another common volume expander includes Hydroxyethyl Starch which is considered a colloid. An intravenous solution of hydroxyethyl starch is used to prevent shock following severe blood loss caused by trauma, surgery, or another problem. It increases the blood volume, allowing red blood cells to continue to deliver oxygen to the body. When tissue blood perfusion is maintained, shock is averted as the dangerous compensatory mechanisms of shock aren’t activated.
A diuretic is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from the body, through the kidneys. There exist several classes of diuretic, & each works in a distinct way. In medicine, diuretics are used to treat heart failure, liver cirrhosis, hypertension, influenza, water poisoning, & certain kidney diseases.
An electrolyte is a substance that conducts electricity when dissolved in water. Electrolytes are essential for a number of functions in the body.
Everyone needs electrolytes to survive. Many automatic processes in the body rely on a small electric current to function, & electrolytes provide this charge. Electrolytes interact with each other & the cells in the tissues, nerves, & muscles. A balance of different electrolytes is crucial for the body to function.
Electrolytes regulate nerve & muscle function, hydrate the body, balance blood acidity & pressure, & help rebuild damaged tissue. The muscles & neurons are sometimes referred to as the “electric tissues” of the body. They rely on the movement of electrolytes through the fluid inside, outside, or between cells.
The electrolytes in human bodies include Sodium, Potassium, Calcium, Bicarbonate, Magnesium, Chloride, Phosphate. For example, a muscle needs calcium, sodium, & potassium to contract. When these substances become imbalanced, it can lead to either muscle weakness or excessive contraction. The heart, muscle, & nerve cells use electrolytes to carry electrical impulses to other cells.
When the kidneys fail to function adequately, dialysis may be necessary. This medical treatment removes waste, such as excess salts & fluids, from the body & this process is repeated on a recurring schedule. There are three different types of dialysis:
2. Peritoneal Dialysis (PD)
3. Continuous Renal Replacement Therapy (CRRT)
Depending on the type of treatment, dialysis fluid can have different meanings. Dialysis solution is also known as Dialysate & Dialysis Fluid.
Dialysis fluids are solutions of electrolytes formulated in concentrations similar to those of extracellular fluid or plasma. They contain, or may contain sodium; chloride; bicarbonate or lactate; calcium; magnesium; potassium; glucose; amino acids; icodextrin. The exact concentration varies based on whether Hemodialysis or PD is used. Furthermore, it is important to note it is not the same thing as the fluids removed during treatment.
During treatment, excess fluid & wastes are removed from the body. Although the blood is “cleaned” by the machine, the blood itself does not pass through a filter in the most literal sense. Waste products from the body are dissolved within & carried by the serum in the blood. It would be impractical to remove dissolved waste products with a simple filter. This is where Dialysate comes into play.
Dialysate facilitates the diffusion of waste products from areas of higher concentration—the blood & cellular tissues—to areas of lower concentration—within the filter. The blood moves through tiny tubes within the artificial kidney. The dialysate passes through in the opposite direction outside of these tubes. The tubes are semi-permeable, similar to the cell membranes of tissues.
The dialysate is the mechanism that removes waste products from the body. In addition, the machine removes excess body fluids from the blood as well. Removing too much fluid can affect treatment & a person’s health.
For example, changes in the volume & speed of blood flowing through the machine may affect blood pressure, heart rate & state of consciousness.
Dialysate is also used in a comparable manner in PD. The fluid enters the abdominal cavity & surrounds the organs. The permeable nature of cells allows diffusion of waste products & excess fluid into the dialysate. Upon completion, the solution is removed via the same port of entry.
Disclaimer: The information provided here is for informational purposes only.