International journal of pharmaceutical compounding
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Midazolam is a short-acting benzodiazepine central nervous system depressant available as an injection, tablet, or oral syrup. The need for alternative dosage form options for patients unable to take tablets and shortages of other forms of the drug have led compounding pharmacies to seek alternatives, mainly solutions and suspensions. Additionally, some patients are unable to use suspending agents containing alcohol or sorbitol. ⋯ The method was validated for its specificity through forced-degradation studies. The samples remained within 90% to 110% of the initial concentration throughout the course of the study. Based on the data collected, the beyond-use date of these preparations is at least 58 days when protected from light at both refrigerated and room temperature storage conditions.
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Understanding decontamination technology as it applies to compounding sterile preparations and its role in achieving an acceptable level of sterility assurance in compounded preparations is essential. Delivering safe preparations to patients requires the key elements that make up an acceptable sterility-assurance level. Those key elements are decontamination of the preparation components and the environment in which they are compounded, aseptic technique, and proper air quality of the compounding environment. This article explores the concept of sterility assurance as it applies to sterile preparations.
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By educating their clients (especially prescribing physicians, nurses, and home healthcare aides) about the advantages of using needle-free devices to administer intravenous medications, compounding pharmacists can help prevent complications associated with vascular access devices and needlestick injuries. Despite state and federal efforts to reduce the incidence of sharps injuries among healthcare workers, percutaneous needle-stick injuries remain a source of emotional stress, morbidity, and possible mortality in those individuals. According to the Centers for Disease Control and Prevention, 50% or more of surveyed healthcare personnel do not report their occupational percutaneous injuries, and an estimated 385,000 sharps-related injuries occur annually among healthcare workers in hospitals alone. ⋯ For the intgravenous administration of medications, however, devices safer than those requiring the use of needles are available, and pharmacists have a key role in educating caregivers about needle-free equipment and its use. In this article, we explain the types of intravenous needle-free devices of interest to compounding pharmacists and the clients they serve, and we answer frequently asked questions about that equipment. Compounders who understand the design features and capabilities of such products, their clients' intended use of those devices, patients' specific needs can improve treatment outcomes and protect healthcare workers against needlestick injury.
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Compounding pharmacists who repackage commercial sterile products must be familiar with the standards set forth in the United States Pharmacopeia-National Formulary concerning this topic. Parts 1 and 2 of this two-part article examine the general chapters of the United States Pharmacopeia-National Formulary as they relate to repackaging and differentiates between commercial repackagers and pharmacists that repackage in their pharmacy for their patients.