COMPOUNDING AND IV ADMIXTURES IN HOSPITALS
Compounding in Hospitals:
Compounding is the process in which a pharmacist mixes, combines, or modifies drug ingredients to prepare medicines according to individual patient needs.
Example: Preparing dye-free medicine for allergic patients.
Bulk Compounding
- Large-scale preparation of medicines
- Used when drugs are not commercially available
Control Systems in Bulk Compounding:
1. Manufacturing Process Control:
- Ensures product quality, purity, and strength
- Proper labeling and packaging
2. Quality Control:
- Raw material checking
- Equipment checking
- Environment control
- Finished product testing
3. Budgetary Control:
- Controls cost of production
- Includes raw material, staff, and equipment cost
Requirements for Bulk Compounding:
- Manufacturing requirements
- Raw and packaging materials
- Equipment availability
- Skilled personnel
- Clean facilities
- Cost management
Maintenance of Equipment:
- Regular inspection
- Prevent breakdown
- Ensure proper functioning
IV Admixtures:
IV admixture is a sterile mixture of drugs added to intravenous fluids for administration under aseptic conditions.
Advantages:
- Rapid action
- Suitable for unconscious patients
- Provides fluids and nutrients
- Accurate dosing
- Improves patient care
Disadvantages:
- Risk of incompatibility
- Risk of infection
- Requires trained staff
- Needs aseptic environment
Preparation Steps:
- Prepare label
- Use laminar airflow hood
- Follow aseptic technique
- Reconstitute drugs
- Mix properly
- Check for particles
- Seal and label
Incompatibilities in IV Admixtures:
- Physical: precipitation, colour change
- Chemical: hydrolysis, oxidation
- Therapeutic: opposite drug effects
Prevention:
- Use compatible drugs
- Mix properly
- Use fresh solutions
- Limit drug combinations
- Check references
- Monitor patient
Role of Pharmacist:
- Supervise preparation
- Ensure compatibility
- Prevent errors
- Train staff
- Maintain records
Total Parenteral Nutrition (TPN)
TPN is a method of providing complete nutrition through intravenous route, bypassing the gastrointestinal tract.
Composition:
- Proteins (amino acids)
- Carbohydrates (dextrose)
- Fats (lipids)
- Vitamins, minerals, electrolytes
Types:
- Central Parenteral Nutrition
- Peripheral Parenteral Nutrition
Indications:
- GI disorders
- Surgery
- Cancer therapy
- Severe illness
- Premature infants
Administration:
- Given through catheter
- Prepared aseptically
- Dose adjusted gradually
Complications:
- Infection
- Blood clots
- Liver problems
- Blood sugar imbalance
Dr. Saint Paul is a pharmacy educator, Pharm.D graduate, and academic content creator from Jawaharlal Nehru Technological University Kakinada (JNTUK), where he completed his Doctor of Pharmacy (Pharm.D) degree between 2015 and 2021.
He has more than 7 years of experience creating pharmacy educational content, writing study materials, and reviewing academic articles for pharmacy students. He has also contributed guest articles to pharmacy education platforms, including PharmD Guru.
At D.PharmGuru, his work focuses on simplifying complex Diploma in Pharmacy (D.Pharmacy) subjects into easy-to-understand notes, practical explanations, and exam-oriented educational resources for students across India.
His areas of focus include Human Anatomy and Physiology, Pharmaceutics, Pharmacology, Pharmaceutical Chemistry, Hospital and Clinical Pharmacy, and other core D.Pharmacy subjects.
