P. Ceutics C12 ( Compounding and stability of TPN )

Preparation of TPN solution a few category

• Compounding storage

• Gravity fill

• Manually gravity fill

• Automated compounding device

Gravity fill :

• Used to transfer the base components into the final container.

• Disadvantages : limits flexibility in the volume of base components used. Volume cannot be

  measured accurately

• Used to transfer the additional components into the final container.

• Disadvantages : limits flexibility in the volume of base components used. Volume can be

  measured accurately

• Other components are added by drawing each up into a syringe and injecting them through an injection port into the final container

What is contain in All In One (AIO)

• Fat emulsion

• Glucose solution

• Sodium Chloride

• Amino acid solution

• Additives

Complexity of the admixture

• Addictive of ING can range from 5 -20, Lots of interaction

• Precipitation, Emulsion destabilization.

• Container material, Homogenization

• Container material, External conditions: light, oxygen,

  temperature

• Precipitation, Clouding

Mixing sequences (1)

• 1. 1. Additives are added to the macronutrients, 2. Add trace elements and electrolytes to the amino acid solution, 3.Add phosphate preparations to the glucose solution, 4. NEVER ADD CALCIUM & PHOSPHATE TO THE SAME CONTAINER

• 1. Additives are added to the macronutrients, 2. Add phosphate preparations to the glucose solution , 3.Add trace elements and electrolytes to the amino acid solution, 4. NEVER ADD CALCIUM & PHOSPHATE TO THE SAME CONTAINER

• 1. Add phosphate preparations to the glucose solution, 2. Additives are added to the macronutrients , 3.Add trace elements and electrolytes to the amino acid solution, 4. NEVER ADD CALCIUM & PHOSPHATE TO THE SAME CONTAINER

• 1.Add trace elements and electrolytes to the amino acid solution , 2. Additives are added to the macronutrients , 3. Add phosphate preparations to the glucose solution, 4. NEVER ADD CALCIUM & PHOSPHATE TO THE SAME CONTAINER

Mixing sequences (2)

• 1. After sequence 1 are completed, the separate solutions are now ready to be transferred to a bag, 2. Homogenize the content of the bag before transferring the fat emulsion, 3. first, transfer amino acid and glucose solution

• 1. After sequence 1 are completed, the separate solutions are now ready to be transferred to a bag, 2. First, transfer amino acid and glucose solution, 3. Homogenize the content of the bag before transferring the fat emulsion.

• 1. first, transfer amino acid and glucose solution, 2. After sequence 1 are completed, the separate solutions are now ready to be transferred to a bag, Homogenize the content of the bag before transferring the fat emulsion, 3. Homogenize the content of the bag before transferring the fat emulsion

• 1. Homogenize the content of the bag before transferring the fat emulsion, 2. First, transfer amino acid and glucose solution, 3. After sequence 1 are completed, the separate solutions are now ready to be transferred to a bag.