Distilled sterile water. Description of water for injection - composition, instructions for use and shelf life Nuances of using water for injection and expiration dates

Content

Many medications intended for injection must first be dissolved or diluted to the desired concentration. For this purpose, a universal solvent is used - water. To be used for medical purposes, it must meet certain requirements. Water for injection, unlike saline solution, which contains sodium chloride, is distilled, sterile water, processed in a certain way.

What is water for injection

Liquid for injection can be used as a carrier of the main drug (parenteral use) or as a diluting agent for infusion and injection solutions with inappropriate concentrations. Water is produced in the form of glass or polymer fiber ampoules of various filling volumes. Intended, among other things, for external use: wetting dressings, washing wounds and mucous membranes. Medical instruments are soaked and washed in injection water during the sterilization process.

Compound

Sterile water has no taste, color or smell. In a special way, the composition of water for injection is purified from all inclusions: gases, salts, biological components, as well as any microimpurities. This is achieved in two stages. The first is purification by reverse osmosis, during which organic inclusions are separated from water. The second is distillation: the liquid is converted into a vapor state and then returned to its original form. In this way, maximum purity is achieved. Injection water does not have pharmacological activity.

Indications

Used for the preparation of sterile injection solutions from dry matter (powders, concentrates, lyophilisates). Can be used to prepare infusions for subcutaneous, intravenous and intramuscular administration. The dosage and method of administration are determined by the drug to be diluted (the manufacturer prescribes these features in the instructions for the drug). The only universal rule is that water must be used under aseptic conditions from the moment the ampoule is opened until the syringes are filled.

Contraindications

Although water is considered a universal solvent, there are preparations that involve the use of another type of liquid. For example, saline solution, oil solvents, etc. These kinds of features must be prescribed in the instructions for the diluted medicinal product. The injection liquid cannot be mixed with preparations for external use, since they use a different type of solvent.

Requirements for water for injection

The pH value of injection water should not be higher than 5.0-7.0. The concentration of microorganisms in 1 ml is no more than 100. It must be pyrogen-free (devoid of substances that cause an increase in temperature when injecting liquid into the body), with a normalized ammonia content. In water that meets the requirements, the presence of sulfates, chlorides, heavy metals, calcium, nitrates, carbon dioxide and reducing substances is unacceptable.

Instructions for use of water for injection

Doses and rates of administration must comply with the instructions for medical use of the diluted drug. When mixing injection water with powder or concentrate, close visual monitoring of the condition of the resulting liquid should be carried out, since pharmaceutical incompatibility is possible. The appearance of any sediment should be a signal to stop using the mixture. Low osmotic pressure does not allow direct intravascular injection of water - there is a risk of hemolysis.

The shelf life of preparations such as injectable water is no more than 4 years (the release date must be indicated by the manufacturer on the packaging). The storage conditions for the liquid are determined by the temperature range from 5 to 25 degrees. Freezing of the drug is not allowed. After opening the ampoule, it must be used within 24 hours. At the same time, it is stored under sterile conditions. The drug is available in pharmacies by prescription.

What to replace

Often, the injection liquid can be replaced with saline solution or a solution of 0.5% novocaine (used for diluting antibiotics and some physical preparations, the administration of which is accompanied by painful sensations). However, this kind of replacement is permissible only when such a possibility is specified in the instructions for the drug being diluted. If there are no additional recommendations on this matter, you should consult with your pharmacist or your doctor about the possibility of replacing water with other liquids.

Price for water for injections

The cost of the liquid depends on the manufacturer and the volume of filling ampoules in the package. You can buy it at almost any pharmacy. The price level in retail outlets in Moscow and St. Petersburg is approximately the same, but if you order the drug in online stores, it will cost slightly less.

	Manufacturer and packaging	Price (in rubles)
	Microgen (Russia), ampoule 2 ml, 10 pcs. packaged

	Biokhimik (Russia), ampoule 5 ml, 10 pcs. packaged
	Grotex (Russia), ampoule 2 ml, 10 pcs. packaged
	Atoll (Russia), ampoule 2 ml, 10 pcs. packaged
	Novosibkhimpharm (Russia), ampoule 2 ml, 10 pcs. packaged
ZdravCity	Borisov Medical Preparations Plant (Republic of Belarus), 5 ml ampoule, 10 pcs. packaged
	Mapichem AG (Switzerland), ampoule 5 ml, 10 pcs. packaged
	Update (Russia), ampoule 2 ml, 10 pcs. packaged
ElixirPharm	Grotex (Russia), ampoule 10 ml, 10 pcs. packaged

To create infusion solutions, special sterile water for injection must be used. It is a clear liquid that is odorless, colorless and tasteless. It allows you to prepare an essence that can be injected into the human circulatory system for the latter’s therapy.

Composition and pharmacological group of water for injection

The composition of water for injection consists of only one element - water itself, which is the active component of the drug. One ampoule contains two or five milliliters of liquid, depending on the form of release.

Water for injection, based on the classification of medical substances, belongs to the group of solvents and diluents.

The main pharmacological properties are:

Lack of pyrogens;
Chemical inactivity;
Lack of therapeutic and curative effect.

The substance provides the correct conditions for the optimal use of substrates in the treatment of patients. Homeostasis is maintained by the introduction of water and electrolytes through the renal system.

Main indications and contraindications

Indications for use:

Necessity of preparation. Both powders and lyophilisates, as well as various concentrates, which are subsequently injected into the human body, can be used. Sterile administration of the drug using all available methods. This applies to all techniques: subcutaneous, intramuscular and intravenous.

If the manufacturer indicates a different type of solvent in the instructions for use, water for injection should not be used with this medicine. Most often, isotonic saline solution is used as an alternative to dilution.

Features of application

Water must be used in full accordance with the rules and regulations defined by the manufacturer. This also applies to both the method of its use and dosages.

Solutions may only be prepared under sterile conditions. This applies to all stages of work, such as:

Opening the ampoule;
Filling the syringe;
Carrying out the injection.

A prescription for water for injection is not required to purchase it at a pharmacy kiosk. Direct administration of this medication intravenously without the use of other drugs is prohibited. This is due to low osmotic pressure, which in turn can lead to hemolysis.

When mixing with other substances, it is necessary to carry out constant visual monitoring to ensure their compatibility. This applies primarily to such drugs as:

Solutions for infusions;
Concentrates for the preparation of infusions;
Mixtures for injections;
Powdered products;
Dry substances.

Sometimes pharmacological incompatibility may occur between water for injection and other drugs included in the listed groups. In such situations, the prepared solution cannot be used for further therapy of the patient, as this can lead to adverse consequences for his life and health.

Difference between water for injection and saline

Water for injection and saline are the substances most often used for therapeutic infusion or injection mixtures. However, there is a significant difference between them. Doctors warn against replacing one medicine with another, as this leads to improper preparation of the drug for treatment. The main differences between water for injection and saline solution are:

Water for injections. This is a homogeneous substance that does not contain additional components. Its chemical formula is H20. To fill ampoules, only distilled liquid is used, which does not contain any impurities.
Saline solution. It is a 0.9 percent aqueous solution of sodium chloride, the chemical formula of which is as follows: NaCl. This liquid is isotonic in blood plasma. Therefore, it can be administered subcutaneously, intravenously and intramuscularly, either alone or together with other drugs.

The main difference between water for injection and saline solution is the ability to introduce the second into the body independently without the use of additional components.

Use during pregnancy and lactation

The manufacturer does not prohibit the use of the drug during women's pregnancy or lactation. The risks of treatment during these periods are directly determined by the nature of the second medicinal substance, which is dissolved in the liquid for further administration.

Does not lead to any adverse consequences for either the pregnant woman or her fetus or newborn child.

Overdose and its consequences

If you use the product for its intended purpose, the risk of overdose or other adverse effects is zero.

The manufacturer draws attention to the possibility of provoking hemolysis. It is the destruction of red blood cells with the release of hemoglobin into the environment. This problem occurs when large volumes of hypotonic solutions are infused.

The problem of using water for injection can arise if a large number of drugs aimed at lowering blood pressure are dissolved in it. Signs and characteristic symptoms of overdose are not directly related to the use of water for injection. They are based only on those medications that are used to dissolve in a given sterile liquid.

Water is pharmacologically indifferent, accessible and readily dissolves many medicinal substances, but at the same time, some medicinal substances are hydrolyzed quite quickly in it and microorganisms multiply. This is the cheapest solvent used in 68% of cases of making solutions (excluding tinctures and decoctions). Water is close in structure and composition to the internal environment of the body; it is easily absorbed in the gastrointestinal tract and intramuscular injections (unlike oil solutions) are painless; intravenous administration of medicinal substances that can dissolve in water is also possible, since it is quite easy to achieve the required pH level solution (human blood pH 7.36-7.42), in contrast to the impossibility of administering other (for example, alcohol) solutions.

Demineralized water (Aqua demineralisata)

Demineralized water is obtained by desalting tap water using special ion exchange resins. Demineralized water can be used for washing pharmaceutical glassware and various packaging. Demineralized water should not be used for parenteral use, but can be used for the preparation of all liquid dosage forms, solutions, and reagents. If demineralized water is used to prepare ophthalmic medications, it must be sterilized immediately before preparing the medication.

Recently, attention has been paid to the use of demineralized water instead of distilled water. This is due to the fact that electric distillers often break down. The high salt content in the source water leads to the formation of scale on the walls of the evaporator, which worsens the distillation condition and reduces the quality of the water. Various installations are used to desalinize water. The principle of their operation is based on the fact that water is freed from salts when passing it through ion exchange resins. The main part of such installations are columns filled with cation exchangers and anion exchangers. The activity of cation exchangers is determined by the presence of carboxyl or sulfonic groups, which have the ability to exchange H + ions for ions of alkali and alkaline earth metals. Anion exchangers - most often products of poly- and amines with formaldehyde, exchange their hydroxyl groups OH for anions. The installations also have containers for solutions of acid, alkali and distilled water for resin regeneration

Water for injection (Aqua pro injectionibus)

Water for injection (GFC, article No. 74). To prepare injection dosage forms of water-soluble drugs (as well as eye drops, solutions for irrigation and washing of wound surfaces), water for injection is used, which, in addition to the requirements for distilled water, must satisfy the requirement for the absence of pyrogenic substances (the latter means quite complex products vital activity of microorganisms introduced into the distillate with tiny droplets of water; the result of pyrogens entering the body with injection is an increase in temperature and blood pressure, headache, etc.).

Water for injection is stored under special conditions that exclude the possibility of microorganisms from the environment entering it (aseptic conditions). Water for injection is suitable for the preparation of appropriate dosage forms within no more than 24 hours from the moment of its receipt.

Distilled water (Aqua destillata)

Distilled water (GFC, article No. 73). As you know, drinking water always contains impurities of various chemical compounds dissolved in it and is therefore not suitable for preparing medicines. Solutions of medicinal substances for external and internal use are prepared only with distilled water.

Distilled water is the most widely used solvent in the manufacture of medicines and its quality is standardized by a special article of the Civil Code.

Distilled water should be colorless, transparent, odorless and tasteless: the pH of distilled water should be in the range of 5.0-6.8. Distilled water should not contain chlorides, sulfates, nitrates, nitrites, calcium salts and heavy metals. After evaporating 100 ml of distilled water, the residue, brought by drying at 100-105 ° C to constant weight, should not exceed 0.001%. After boiling for 10 minutes 100 ml of distilled water in the presence of 1 ml of 0.01 N. a solution of potassium permanganate and 2 ml of dilute sulfuric acid, the pink color of the solution should remain (reducing substances). After shaking distilled water with an equal volume of lime water in a well-closed and filled to the top container for 1 hour, there should be no cloudiness (carbonic anhydride).

To obtain distilled water in a pharmacy, tap water is used; in rural areas where there is no centralized water supply, well water or from artesian wells is used. In the first case, the water is distilled directly, without any treatment; in the second case, preliminary preparation is necessary: softening, destruction of organic impurities, binding of ammonia.

and as for water for injection, it is ordinary distilled water.

Correctly, they have already told you that, first of all, the difference is in the composition:

physical solution or saline solution is a 0.9% NaCl solution (salt);
water for injection does not contain salts or any special substances.

Another difference is that drugs/medicines for IM and SC routes of administration are diluted with water for injection. Phys. the solution is mainly administered intravenously.

If you are going to perform an IV injection, then saline solution is suitable (you can also use glucose, etc.).

If the injection is intramuscular, then there is water for injection, but if the person is sensitive or the drug is painful, then it is better to do it with novocaine.

Phys. the solution is a 0.9% salt solution, it is used to dissolve almost any medication (in other cases, the instructions indicate that it cannot be dissolved with saline, it is indicated what to replace it with) and is suitable for any injections, but intramuscular injections are more painful.

Water for injection is pure salt-free water, so it is less painful for intramuscular injections. It can also be used for any type of injection unless otherwise indicated.

Description of water for injection - composition, instructions for use and shelf life

What is water for injection

Compound

Indications

Contraindications

Requirements for water for injection

Instructions for use of water for injection

What to replace

What is the best replacement for saline solution for inhalation?

Inhalations are good at clearing the upper respiratory tract of mucus accumulation and saving the mucous membrane from drying out. Previously, steam inhalations were done over boiled potatoes or over a bowl of medicinal herbs. Nowadays, inhalers and medicinal solutions can be used for this procedure. Let's consider the question of how to replace saline solution for inhalation, and how to do it correctly? What compositions for inhalation can you make yourself, with your own hands?

Therapeutic effect of saline solution

Sodium chloride for inhalation is a regular salt solution. It is called physiological because it corresponds to the natural composition of salt in the body. The medicine is diluted with saline solution for injection, because it completely matches the composition of human blood. Each cell of the body contains some sodium chloride for normal functioning.

The saline solution does not cause irritation to the mucous membranes and is perceived by the body as a moisturizing medium. Therefore, inhalation with water for injection is a common method of treatment for colds.

Is it possible to prepare a substitute for saline solution for inhalation yourself? It is possible if you strictly observe the proportions of water and salt. How do pharmacy solutions differ from homemade ones? They use distilled water. To prepare home inhalation solutions, you can use regular tap water. However, it is pre-filtered to remove unnecessary impurities.

Important! To prepare the inhalation liquid, take 0.9 grams of salt per 100 ml of boiled water. If sediment forms, carefully drain off the clean water.

Is it permissible to use unboiled water? Sometimes adults make solutions without boiling them first, but in inhalations it is safer for children to use boiled water.

How many days can you use the saline solution you prepared yourself, how many times do you inhale? Make a fresh solution every day in the morning, and pour it out in the evening. To accurately weigh salt, you need to use an electronic scale.

Inhalation procedure

How to do saline inhalation correctly? First, cool the prepared liquid to 40 degrees. The procedure should be carried out in between meals. You can breathe through your mouth or nose:

inhalation through the mouth is done for diseases of the bronchi and lungs;
Inhalation through the nose is done for respiratory diseases.

Breathing should be smooth and leisurely. When treating pulmonary and bronchial diseases, inhale deeply (all the way), then hold in the air and exhale.

Using a nebulizer

For inhalation with a nebulizer, you can also use a saline solution. If you use a ready-made solution in ampoules, 2 or 5 ml are consumed per procedure. If you bought saline solution in a 200 or 400 ml bottle, use a syringe to pierce the rubber stopper. The liquid must remain in a sealed container, so the rubber stopper must not be opened.

The principle of operation of a nebulizer is based on atomizing liquid to the smallest particles - aerosols. They easily penetrate the lower layers of the respiratory tract, so the use of an inhaler is indicated for diseases of the bronchi and lungs. For respiratory ailments, it is better to use regular steam inhalations.

To use the inhaler solution, you must follow the instructions for it - maintain the dosage accuracy.

Important! The solutions used in the nebulizer should not be oily. This will provoke the development of oil pneumonia.

What formulations can be used for the inhaler? It is allowed to use only saline solution and special liquids, otherwise the device may go out of operating mode. Most nebulizers cannot withstand filling with syrups, decoctions and infusions - they break. If you need a special composition for inhalation, use the steam procedure.

Cough treatment

To get rid of a cough, you need to use antitussive or expectorant preparations. What can replace the saline solution in this case? If a cough accompanies an inflammatory process in the mucous membrane, a saline solution is used together with:

Note! The doctor must prescribe medications and the required dosage.

If there is no ready-made pharmaceutical saline solution, you can use water for injection and alkaline mineral water without gas for inhalation with Berodual. How many times should I inhale? At the beginning of a cold, inhalation is done 3-4 times a day. The device is held in the hands, the mask is put on the nose.

Treatment of a runny nose

For rhinitis, drops and rinsing the nasal passages with saline or just salt water help well. The water should be at room temperature or slightly warmed, but not higher than body temperature, to avoid possible complications.

It is prohibited to inhale:

at high temperature;
with purulent and bloody discharge;
for pain in the ears;
in a weakened state.

Remember that after inhalation you should not go out onto the balcony or street, or eat for an hour after the procedure.

When should you use a nebulizer, and when should you use a regular steam procedure? A nebulizer is indicated for diseases of the lower respiratory tract; it is useless for rhinitis. Flushing your sinuses with salt water is the way to go. Is it possible to replace saline solution in a nebulizer with oily liquids? No, the device is not designed for oils and syrups. Prepare your own saline solution for the nebulizer or buy ready-made saline solution. To prevent rhinitis, you can use mineral water without gas - Borjomi or Narzan.

water for injections!

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If this is about saline solution, then no way.

there are juices and potassium and sodium... what the hell is boiled water.

I understand everything... no, in theory you can’t replace it, if no pharmacy sells it, then replace it with saline solution, it will be safer than diluting it with boiling water, iron remains in the boiling water.

Why at least inject? and replace with a tablet

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How does “water for injection” differ from “saline solution”?

How does “water for injection” differ from “saline solution” or is it the same thing? Is there a difference on what to give injections?

The saline solution contains dissolved salt, which in concentration corresponds to blood plasma. and as for water for injection, it is ordinary distilled water.

As for injections into a vein, you should absolutely not use distilled water; you need to use saline solution.

And for intramuscular administration, both are possible.

The physiological solution contains table salt and its concentration is isotonic to the composition of the blood, it can also be injected into a vein, but water cannot be injected into a vein, because hemolysis will occur, that is, the destruction of red blood cells, and for intramuscular injections there is no big difference, the only intramuscular injection of distilled water is somewhat painful compared to saline solution.

Water for injection is actually water. Distilled.

Saline solution (isotonic), the simplest (one-component) of them is 0.9% NaCl solution (table salt).

Ringer's solution (actually saline solution)

Simply put, a solution of salts present in the blood in the composition and quantity necessary for life, that is, roughly speaking, physiology. Hence the name.

These are just basic saline solutions.

Based on Ringer's solution, even more complex formulations are prepared with the addition of nutrients, antibiotics and antifungal drugs. But this is for intravenous drip administration.

Some drugs can react with salts, losing or changing their properties, which is why water for injection is prepared using double distillation. Information about this must be on the drug packaging or in the attached annotation, if this is critical.

The difference lies in the name itself:

saline solution is a 0.9% aqueous solution of sodium chloride (NaCl), in other words it is salt and water mixed in certain proportions. The liquid is isotonic to blood plasma. Saline solution can be administered intravenously, subcutaneously, or by enema. It is also used in inhalers and for some other therapeutic and prophylactic purposes.
water for injection is just sterile water, without any additives. Its composition meets stringent requirements. Unlike saline solution, water for injection is not recommended to be introduced into the body on its own; it is used exclusively for the preparation of solutions for injection from powder, concentrated and some other forms of drugs.

The instructions for the drugs usually indicate the solvent that is acceptable for it, and that is what you should use.

How can you replace water for injections?

should be washed only with distilled water. The pharmacy offers

water for injections. It is the same?

Distilled water is usually sold in pharmacies where there is

production of medicines according to doctors' prescriptions.

inject antibiotics. wrote: ceftriaxone, water for injection

1.0 2% solution of lidocaine N5, how many units is this? and how to dilute?

For intramuscular administration

The contents of the bottle (1 g) are dissolved in 3.6 ml of water for injection.

After preparation, 1 ml of solution contains about 250 mg

ceftriaxone. If necessary, you can use more

diluted solution. The dosage of such a solution (how much should you take

ml) should have been indicated by the attending physician.

As with other intramuscular injections, Ceftriaxone is administered at a relatively

large muscle (gluteus); test aspiration helps to avoid

unintentional insertion into a blood vessel. Recommended

inject no more than 1 g of the drug into one muscle. To reduce pain

for intramuscular injections, the drug should be administered with a 1% solution

lidocaine. Do not administer lidocaine solution intravenously.

It is better not to inject yourself, but to consult a healthcare professional.

lidocaine 10amp. 2 ml of 2% solution and the same package of water for

injections, having learned that I am allergic to novocaine. However, the instructions

Cortexin doesn’t say anything about lidocaine.

Is it possible to use lidocaine solution to dilute Cortexin, and

if so, what percentage of lidocaine solution should be. Answer

please send by email. mail.

Sincerely, Alexander.

Active ingredient: Sulodexide* (Sulodexide*)

Pharmacological group: Anticoagulants

Nosological classification (ICD-10): G93.4 Encephalopathy

unspecified. I79 Lesions of arteries, arterioles and capillaries during

diseases classified elsewhere. I79.2

Peripheral angiopathy in diseases classified in

Composition and release form:

Solution for injection 1 amp.

sulodexide 600 LE

excipients: sodium chloride - 18 mg; water for

preparation of injections - q.s. up to 2 ml

in ampoules of 2 ml; There are 10 ampoules in a box.

sulodexide 250 LE

excipients: sodium lauryl sulfate - 3.3 mg; colloid

silicon dioxide - 3.0 mg; triglycerides - 86.1 mg

capsule composition: gelatin - 55.0 mg; glycerin - 21.0 mg; sodium

ethyl p-hydroxybenzoate - 0.24 mg; sodium propyl-p-hydroxybenzoate - 0.12

mg; titanium dioxide (E171) - 0.30 mg; red iron oxide - 0.90

25 pcs in blister; There are 2 blisters in a box.

Description of dosage form: Solution for injection: light yellow

or yellow transparent solution placed in ampoules of dark

Capsules: soft gelatin capsules, oval, brick-shaped

Characteristics: Natural product isolated from the mucosa

membranes of the small intestine of a pig. Represents natural

mixture of glycosaminoglycans: heparin-like fraction with molecular

massoydalton (80%) and dermatan sulfate (20%).

Pharmacological action: Anticoagulant, angioprotective,

Pharmacokinetics: 90% is absorbed in the vascular endothelium (creates in

it has a concentration that is several times higher than its concentration in

tissues of other organs) and is absorbed in the small intestine.

Metabolized in the liver and kidneys. Unlike

unfractionated heparin and low molecular weight heparins,

sulodexide is not subject to desulfation, which leads to

decrease in antithrombotic activity and significantly accelerates

elimination from the body. The dose distribution among organs showed

that the drug undergoes extracellular diffusion in the liver and

kidneys 4 hours after administration.

24 hours after IV administration, urinary excretion is 50%

drug, and after 48 hours - 67%.

Pharmacodynamics: The fast-flowing heparin-like fraction has

affinity for antithrombin III, and dermatan affinity for the cofactor

heparin II. The anticoagulant effect is due to

affinity for heparin cofactor II, which inactivates thrombin.

The mechanism of antithrombotic action is associated with suppression

activated factor X, with increased synthesis and secretion

prostacyclin (PGI2), with a decrease in plasma fibrinogen levels

The profibrinolytic effect is due to an increase in blood

level of tissue plasminogen activator and a decrease in the content

The angioprotective effect is associated with the restoration of structural and

functional integrity of vascular endothelial cells, with

restoration of normal negative electrical density

charge of the pores of the vascular basement membrane. In addition, the drug

normalizes the rheological properties of blood by reducing the level

triglycerides (stimulates the lipolytic enzyme -

lipoprotein lipase, which hydrolyzes triglycerides included in

Reduces blood viscosity, inhibits cell proliferation

mesangium, reduces the thickness of the basement membrane.

Indications: Angiopathy with an increased risk of thrombosis, in

incl. after myocardial infarction: brain disorders

blood circulation, including the acute period of ischemic stroke and

early recovery period; encephalopathy,

caused by atherosclerosis, diabetes mellitus, hypertension

illness; vascular dementia; occlusive lesions

peripheral arteries atherosclerotic and diabetic

genesis; phlebopathy, deep vein thrombosis; microangiopathies

(nephropathy, retinopathy, neuropathy) and macroangiopathy (syndrome

diabetic foot, encephalopathy, cardiopathy) with diabetes

diabetes; thrombophilic conditions, antiphospholipid syndrome

(together with acetylsalicylic acid, and also following

low molecular weight heparins); treatment of heparin-induced

thrombotic thrombocytopenia (GTT), since the drug does not

causes and does not aggravate GTT.

Contraindications: Hypersensitivity, hemorrhagic diathesis and

diseases accompanied by decreased blood clotting,

pregnancy (first trimester).

Use during pregnancy and lactation: During pregnancy

prescribed under the strict supervision of a physician. There is a positive

experience of use for the treatment and prevention of vascular

complications in patients with type 1 diabetes in the II and III trimesters

pregnancy, with the development of late toxicosis of pregnant women -

Side effects: From the gastrointestinal tract: nausea, vomiting, pain in

Allergic reactions: rash.

Other: pain, burning, hematoma at the injection site.

drugs affecting the hemostasis system (direct and indirect

Overdose: Symptoms: bleeding or bleeding.

Treatment: drug withdrawal, symptomatic therapy.

Method of administration and dosage: IM, IV (vml physiological

solution), inside. At the beginning of treatment, administer the contents of 1 ampoule

daily intramuscularly for days, then 1 caps. 2 times a day

orally between meals during the day. Full course

should be repeated at least 2 times a year. At the doctor's discretion

dosage may be changed.

drug under coagulogram control. At the beginning and end of treatment

It is advisable to determine the following indicators: APTT (normal - 30-

40 s, depending on the type and concentration used

activator may be or), antithrombin III (normal

mg/l), bleeding time (normal according to Dukemin),

coagulation time of unstabilized blood (normal according to the method

Miliana modified by Moravitsamine). Wessel Due F

increases normal values by approximately one and a half times.

Comment: Wessel Due F, capsules - packaging Pharmakor Production

Wessel Due F, ampoules - packaging Pharmakor Production (Russia).

Shelf life: 5 years

Storage conditions: List B. At a temperature not exceeding 30 °C

Release forms and composition.

Film-coated tablets: 30 pcs per pack.

1 tab. contains standardized extract of Ginkgo biloba 40 mg.

Other Ingredients: Lactose, microcrystalline cellulose, corn starch, colloidal silica anhydride, talc, magnesium stearate, polyethylene glycol 400, polyethylene glycol 6000, hypromellose, titanium dioxide, red iron oxide.

Oral solution: 30 ml in a bottle.

1 ml - standardized extract of Ginkgo biloba 40 mg.

Other ingredients: lemon essential oil, orange essential oil, sodium saccharin, ethyl alcohol, water.

A standardized and titrated herbal preparation, the effect of which is determined by the nature of its influence on metabolic processes in cells, the rheological properties of blood and microcirculation, as well as on the vasomotor reactions of blood vessels. Improves cerebral circulation and supply of oxygen and glucose to the brain. It has a vasoregulatory effect on the entire vascular system: arteries, veins, capillaries. Helps improve blood flow, prevents red blood cell aggregation (anti-sludge effect), has an inhibitory effect on platelet activating factor (anti-PAF effect). Normalizes metabolic processes and has an antihypoxic effect on tissues. Prevents the formation of free radicals and lipid peroxidation of cell membranes. It has a pronounced anti-edematous effect both at the level of the brain and at the periphery. Affects the release, re-uptake and catabolism of neurotransmitters (norepinephrine, dopamine, acetylcholine) and their ability to bind to membrane receptors.

Dyscirculatory encephalopathy of various origins (consequences of stroke, consequences of traumatic brain injury, in old age), manifested by attention and/or memory disorders, decreased intellectual abilities, feelings of fear, sleep disturbances;

Disorders of peripheral circulation and microcirculation, incl. arteriopathy of the lower extremities, Raynaud's syndrome;

Neurosensory disorders (dizziness, tinnitus, hypoacusia, age-related macular degeneration, diabetic retinopathy).

Prescribe 1 tablet. or 1 ml of solution for oral administration 3 times a day with meals. The average duration of treatment is 3 months.

Possible digestive disorders, headaches, allergic reactions.

The first signs of improvement appear 1 month after the start of treatment.

Composition and release form:

nicergoline - 5 mg

Film-coated tablets - 1 tablet.

nicergoline - 10 mg

excipients: disubstituted calcium phosphate dihydrate; MCC; magnesium stearate; sodium carboxymethylcellulose; sugar coating

25 pcs in blister; There are 2 blisters in a cardboard pack.

Film-coated tablets - 1 tablet.

nicergoline - 30 mg

excipients: disubstituted calcium phosphate dihydrate; MCC; magnesium stearate; sodium carboxymethylcellulose; film casing

15 pcs in blister; There are 2 blisters in a cardboard pack.

Lyophilisate for preparing solution for injection - 1 fl.

nicergoline - 4 mg

excipients: lactose monohydrate; tartaric acid

solvent: sodium chloride; benzalkonium chloride; water for injections

in 4 mg bottles, complete with solvent in 4 ml ampoules; There are 4 sets in a cardboard pack.

Pharmacological action: alpha-adrenolytic, vasodilator. Dilates blood vessels, reduces vascular resistance, increases arterial blood flow, improves cerebral circulation and oxygen and glucose consumption by brain tissue. Increases blood flow rate in the extremities, reduces pulmonary vascular resistance, inhibits platelet aggregation and improves hemorheological parameters.

Indications: acute, chronic vascular or metabolic cerebral insufficiency (atherosclerosis, thrombosis or embolism of cerebral vessels, transient cerebral ischemia); acute or chronic peripheral vascular insufficiency (obliterating vascular diseases of the extremities, Raynaud's syndrome); headache, migraine, arterial hypertension (as an additional remedy), hypertensive crisis.

Contraindications: hypersensitivity to nicergoline, acute bleeding, acute myocardial infarction, orthostatic hypotension.

Use during pregnancy and breastfeeding: Not recommended.

Side effects: arterial hypotension, dizziness (after parenteral administration), rarely - dyspeptic symptoms (mild), feeling of heat, flushing of the face, sleep disturbances (drowsiness or insomnia - rarely).

Interaction: enhances the effect of antihypertensive drugs.

Directions for use and dosage: Inside. In between meals - 5-10 mg 3 times a day at regular intervals.

Dosage, route of administration, duration of treatment are individual and depend on the severity of the disease. In some cases, it is advisable to begin treatment with parenteral administration of the drug, followed by switching to oral administration during the period of maintenance therapy.

The finished solution can be used for no more than 7 days.

Instill 1-2 drops into the conjunctival sac 6-8 times a day. Gradually the number of instillations is reduced to 3-4 times a day. If there is no effect within 7 days, you should consult your doctor.

How to properly dilute the antibiotic Ceftriaxone? What solvents to use (novocaine, lidocaine, water for injection) to reduce pain and what quantity is needed to obtain a dosage of 1000 mg, 500 mg and 250 mg for adults and children

In the article we will talk about diluting the antibiotic Ceftriaxone with a solution of Lidocaine 1% and 2% or water for injection for adults and children to obtain the initial dosage of the finished drug solution of 1000 mg, 500 mg or 250 mg. We will also look at what is better to use for diluting the antibiotic - Lidocaine, Novocaine or Water for injection and what better helps relieve pain during the injection of the prepared Ceftriaxone solution.

These questions are the most common, so now there will be a link to this article so as not to be repeated. Everything will be with examples of use.

In all instructions for Ceftriaxone (including drugs under a different name, but with the same composition), 1% Lidocaine is recommended as a solvent.

1% Lidocaine is already contained as a solvent in packages of such drugs as Rosin, Rocephin and others (the active ingredient is Ceftriaxone).

Advantages of Ceftriaxone with solvent in packaging:

no need to buy a solvent separately (figure out which one);
the required dose of solvent is already measured in the ampoule of the solvent, which helps to avoid mistakes when drawing the required amount into the syringe (no need to figure out exactly how much solvent to take);
in the ampoule with the solvent there is a ready-made solution of 1% lidocaine - there is no need to dilute 2% lidocaine to 1% (it can be difficult to find exactly 1% in pharmacies, you have to dilute it additionally with water for injection).

Disadvantages of Ceftriaxone with a solvent in the package:

An antibiotic together with a solvent is more expensive (choose what is more important to you - convenience or cost).

How to dilute and inject Ceftriaxone

For intramuscular injection, 500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine (or for 1000 mg (1 g) of the drug - 3.5 ml of Lidocaine solution (usually 4 ml is used, since this amounts to 2 ampoules of Lidocaine 2 ml each)). It is not recommended to inject more than 1 g of solution into one gluteal muscle.

The dosage of 250 mg (0.25 g) is diluted in the same way as 500 mg (250 mg ampoules did not exist at the time of writing this instruction). That is, 500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine, and then draw half of the finished solution into two different syringes.

So let's summarize:

1. We obtain 250 mg (0.25 g) of the finished solution as follows:

500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine and the resulting solution should be drawn into two different syringes (half of the finished solution each).

2. We obtain 500 mg (0.5 g) of the finished solution as follows:

500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine and draw the resulting solution into 1 syringe.

3. We obtain 1000 mg (1 g) of the finished solution as follows:

1000 mg (1 g) of the drug should be dissolved in 4 ml (2 ampoules) of a 1% solution of Lidocaine and draw the resulting solution into 1 syringe.

How to dilute Ceftriaxone with 2% lidocaine solution

Below is a plate with dilution schemes for the antibiotic Ceftriaxone with a 2% solution of Lidocaine (a 2% solution is found in pharmacies more often than a 1% solution; the dilution method we have already discussed above):

Abbreviations in the table: CEF - Ceftriaxone, R-l - solvent, V injection - water for injection. Below are examples and explanations.

The child was prescribed a course of Ceftriaxone injections twice a day, 500 mg (0.5 g) for 5 days. How many vials of ceftriaxone, ampoules with solvent and syringes will be needed for the entire course of treatment?

If you bought Ceftriaxone 500 mg (0.5 g) (the most convenient option) and Lidocaine 2% at the pharmacy, you will need:

10 vials of ceftriaxone;
10 ampoules of lidocaine 2%;
10 ampoules of water for injection;
20 syringes, 2 ml each (2 syringes for each injection - add the solvent with one, draw and inject with the second).

If you bought Ceftriaxone 1000 mg (1.0 g) at the pharmacy (you didn’t find Ceftriaxone 0.5 g) and Lidocaine 2%, you will need:

5 vials of Ceftriaxone;
5 ampoules Lidocaine 2%
5 ampoules of water for injection
5 syringes of 5 ml and 10 syringes of 2 ml (3 syringes to prepare 2 injections - add the solvent with one, draw the required volume with the second and third, inject the second immediately, put the third in the refrigerator and inject after 12 hours).

The method is acceptable provided that the solution is prepared for 2 injections at once and the syringe with the solution is stored in the refrigerator (freshly prepared ceftriaxone solutions are physically and chemically stable for 6 hours at room temperature and for 24 hours when stored in the refrigerator at a temperature of 2° to 8°C ).

Disadvantages of this method: injection of an antibiotic after storage in the refrigerator may be more painful; during storage, the solution may change color, which indicates its instability.

The same dosage of Ceftriaxone 1000 mg and Lidocaine 2%, although the regimen is more expensive, but less painful and safer:

10 vials of ceftriaxone;
10 ampoules of lidocaine 2%;
10 ampoules of water for injection;
10 syringes of 5 ml and 10 syringes of 2 ml (2 syringes for each injection - one (5 ml) we add the solvent, the second (2 ml) we draw and inject). Half of the resulting solution is drawn into the syringe, the rest is thrown away.

Disadvantage: treatment is more expensive, but freshly prepared solutions are more effective and less painful.

Now popular questions and answers to them.

Why use Lidocaine, Novocaine for diluting Ceftriaxone and why can’t you use water for injection?

To dilute Ceftriaxone to the required concentrations, you can also use water for injection, there are no restrictions, but you need to understand that intramuscular injections of the antibiotic are very painful and if this is done in water (this is what they usually do in hospitals), then it will hurt as much as when injected drug, and for some time after. So it is preferable to use an anesthetic solution as a means for dilution, and use water for injection only as an auxiliary solution when diluting Lidocaine 2%.

There is also a point that it is not possible to use Lidocaine and Novocaine due to the development of allergic reactions to these solutions. Then the option of using water for injection for dilution remains the only possible one. Here you will have to endure pain, since there is a real chance of dying from anaphylactic shock, Quincke's edema, or getting a severe allergic reaction (the same urticaria).

Also, Lidocaine cannot be used for intravenous administration of an antibiotic, only STRICTLY intramuscularly. For intravenous use, the antibiotic must be diluted in water for injection.

What is better to use Novocaine or Lidocaine to dilute the antibiotic?

Novocaine should not be used to dilute Ceftriaxone. This is due to the fact that Novocain reduces the activity of the antibiotic and, in addition, increases the risk of the patient developing a fatal complication - anaphylactic shock.

In addition, according to the observations of the patients themselves, the following can be noted:

pain during the administration of Ceftriaxone is better relieved by Lidocaine than Novocaine;
pain during administration may intensify after the administration of not freshly prepared solutions of Ceftriaxone with Novocaine (according to the instructions for the drug, the prepared solution of Ceftriaxone is stable for 6 hours - some patients practice preparing several doses of the Ceftriaxone + Novocaine solution at once to save antibiotic and solvent (for example, solutions of 250 mg of Ceftriaxone from powder 500 mg), otherwise the remainder would have to be thrown away, and for the next injection use a solution or powder from new ampoules).

Is it possible to mix different antibiotics in one syringe, including Ceftriaxone?

Under no circumstances should ceftriaxone solution be mixed with solutions of other antibiotics, because it may crystallize or increase the patient's risk of developing allergic reactions.

How to reduce pain when administering Ceftriaxone?

It is logical from the above - you need to dilute the drug with Lidocaine. In addition, the skill of administering the finished drug also plays an important role (you need to administer it slowly, then there will be little pain).

Can I prescribe an antibiotic myself without consulting a doctor?

If you are guided by the main principle of medicine - Do no harm, then the answer is obvious - NO!

Antibiotics are medications that cannot be dosed or prescribed yourself, without consulting a specialist. Since choosing an antibiotic based on the advice of friends or on the Internet, we thereby narrow the field of activity for doctors who can treat the consequences or complications of your disease. That is, the antibiotic did not work (it was injected or diluted incorrectly, it was taken incorrectly), but it was good, and since the bacteria are already accustomed to it as a result of the incorrect treatment regimen, you will have to prescribe a more expensive backup antibiotic, which, after incorrect previous treatment, will also help unknown whether. So the situation is clear - you need to go to the doctor for a prescription and appointment.

Also, allergy sufferers (ideally, again, all patients who are taking this drug for the first time) are also advised to prescribe scratch tests to determine an allergic reaction to prescribed antibiotics.

Also, ideally, it is necessary to inoculate biological fluids and human tissues and determine the sensitivity of the inoculated bacteria to antibiotics so that the prescription of a particular drug is justified.

I would like to believe that after the appearance of this article in the Directory, there will be fewer questions on the methods and dilution schemes for the antibiotic Ceftriaxone, since I have analyzed the main points and schemes here, all that remains is to read carefully.

Water for injection is a special sterile liquid that has no color, taste or smell. Water is extremely important for humans, because it is what maintains the normal course of metabolic processes. Therefore, for injections it is often necessary that a solution of the drug be prepared in the required dosage. This is why this water is used, standardized according to several pharmacopoeial articles (hereinafter referred to as FS). Let's figure out what it is and what it is theoretically needed for.

When is it used?

This water for injection is used either as a carrier or as a diluent in the preparation of infusion or injection solutions from:

powders;
dry substances for preparing injections;
concentrates for preparing infusions;
lyophilisates;
infusion and injection solutions with inappropriate concentrations, and so on.

That is, water for injection is needed to dissolve or dilute drugs (depending on what requirements their instructions impose) before they are administered intramuscularly, intravenously or subcutaneously. The form of release of such liquid is ampoules. The shape is almost always the same, but the volume can vary.

Water for injection is not the same as saline solution. If the saline solution is sodium chloride, then the water for injection is distilled/sterile water, previously prepared in a special way.

Here is some more information about this water:

Composition and creation

Water for injection is water that has been purified from any biological or chemical impurities, including:

gases;
salt;
pyrogenic substances;
microorganisms;
any other form of microimpurities.

Such liquid is purified using the reverse osmosis method, that is, a special technology for separating organic compounds. Also, such water can be distilled so that its composition is certainly pure. In order for it to be distilled, it is first transferred into steam and then returned back to the liquid state. All these procedures are carried out in compliance with the highest hygienic requirements, everything takes place in a special aseptic unit, where it is unacceptable to carry out any other actions not directly related to the distillation of water. That’s why this water always comes out sterile. Such application requirements are imposed by the FS, and the requirements for the use of the FS must be complied with. It is also necessary to respect the expiration date; if the expiration date is violated, the effects may be negative.

Characteristics

Water for injection necessarily has a number of characteristics (they are required by the FS; in addition to the FS, distilled/sterile water is standardized according to GOST), which distinguish it from any other water. Here are the parameters and requirements that must be observed:

pH value cannot be higher than 5.0-7.0;
there cannot be any amount of reducing substances, calcium, chlorides, nitrates, carbon dioxide, or heavy metals;
According to the Federal Law, one milliliter of water cannot contain more than one hundred microorganisms;
water must certainly be pyrogen-free;
ammonia content must be standardized;
antimicrobial type substances cannot be present;
no additives may be present at all.

Application

Instructions for use of this liquid depend on which medications it is used with. The requirements are imposed precisely by the medicine that is diluted in this water, therefore it is necessary to use the instructions for use that come with this particular medicine. The dosage that will be used to dilute these medications must be indicated there.

If we talk about the requirements common to all medicines, it is that water for injection must be used under aseptic conditions so that there is not the slightest risk that it will not be sterile enough.

Interaction

When water for injection is mixed with other drugs, it is necessary to visually monitor compatibility. If you do not do this, you may miss pharmaceutical incompatibilities.

It is important to remember that if the requirements for the drug indicate the need to use a different type of liquid, for example, a special saline solution must be used, then drinking water is unacceptable. It also cannot be used for external use; the requirements for them are also completely different.

Suitability

The shelf life of such water can be up to three years. When the expiration date has expired, this water should not be consumed. It is important to remember that the expiration date is for storage at an approximate temperature of 2 to 25 ° C without freezing.

What is an intravenous infusion?
Why is calcium chloride used intravenously? Peripheral intravenous catheter - an effective tool for blood vessels