How to dilute medicines

To achieve the maximum therapeutic effect in the process of antimicrobial treatment of a wide range of infectious pathologies, you need to know exactly how to dilute ceftriaxone, an antibiotic drug of the third generation of cephalosporins, which has high chemotherapeutic activity. The medicine is capable of destroying many types of pyogenic microorganisms, showing increased resistance to special enzymes - lactamases, which produce harmful bacteria to weaken the effectiveness of the antibiotic.

Dilution of antibiotic powders

The powder in the bottle should be white.
The powder can only be dissolved with water for injection (saline solution, glucose solution, tap water :-), etc.).
You need to take as much solvent as possible (as little as possible).
The diluted powder should be transparent and colorless.

You will find answers to all these questions in the instructions for the drug. The powder may be dark - this may be its normal color, or it may be an indicator of unsuitability. Some antibiotics release gas or form a cloudy solution when dissolved. The powder should be dissolved only with the solution and volume specified in the instructions.

First of all, you need to prepare everything for the procedure, read the doctor’s prescription and instructions again, check the prescribed dosage, check whether you have purchased everything that was prescribed, note how many injections all the medications are enough for, so as not to rush to all the surrounding pharmacies at the last moment . Cover the table with a clean napkin so you can put everything you need on it. Prepare cotton wool, medical alcohol (not pure, no more than 70%), if there is no pure ethyl alcohol, you can use medical alcohol solutions - salicylic acid, chloramphenicol, furatsillin. Colognes and lotions are not recommended.

Remove the foil from the bottles so as to open the middle of the rubber stopper. If the solvent is in ampoules, then prepare a cutter for ampoules - such a cutter is included in each box of ampoules. Prepare a disposable syringe - remove the packaging from it, but it is advisable not to remove the cap from the needle. It is better to use 2 syringes: one for injection - the smallest permissible volume (equal to the volume of the required solvent). That is, if you dilute the powder with 2 ml of solvent, you should not take a 10 ml syringe. The fact is that usually smaller volume syringes have thinner needles. It is better to take the second syringe 5-10 ml, they have thicker needles, with their help you can prepare a powder solution much easier and faster, and the sterility of the solution will be higher.

Wash your hands with soap and wipe with an alcohol solution. Then wipe the ampoules and rubber stoppers of the bottles with alcohol. Open the required ampoules.

Which solvent should I choose?

In most cases, the doctor will tell you which solvent to use. If for some reason he did not do this and there is no way to clarify further, what should he do?

Consult a pharmacist at the pharmacy, read the instructions for the drug. Remember the peculiarities of diluting the drug - for example, gas bubbles are released, the solution turns a certain color, and a suspension is formed.

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Rules for diluting antibiotics and drawing the drug from a bottle

Target:

parenteral administration of drugs.

Indications:

doctor's prescription.

Contraindications:

expired shelf life of the drug, violation of the sterility of the bottle.

Equipment:

a bottle of medicine, a syringe with a needle; 70% alcohol, cotton balls, scissors.

Rules for diluting antibiotics:

Solvents: 0.25% or 0.5% novocaine solution, 0.9% sodium chloride solution, sterile water for injection.

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles of 250,000, 500,000, 1,000,000 units. Dosed in action units.

1 ml of solution should contain 100,000 units of penicillin

Thus, if the bottle contains 500,000 units, then you need to take 5 ml of novocaine.

Algorithm of actions of the nurse:

1. Read the name of the medicine, its dosage, and expiration date on the bottle.

2. Bend the metal cap with tweezers and treat the rubber stopper with alcohol.

3. Fill the syringe with the required amount of solvent, pierce the stopper with a large-diameter needle and inject the solvent into the bottle.

4. Remove the bottle along with the needle from the needle cone and, shaking the bottle, ensure that the powder is completely dissolved.

5. Place the needle on the needle cone.

4. Turn the bottle upside down, pull the plunger towards you - the medicine flows into the syringe.

5. Having collected the required amount of the drug, remove the needle from the bottle.

Note.

Opened bottles must be used within 24 hours.

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Pharmacological properties and indications for use

Medicinal properties

Ceftriaxone has a powerful antimicrobial effect - it destroys harmful microorganisms by destroying their cell membrane. The drug is capable of suppressing many different types of bacteria, including aerobic and anaerobic forms, gram-positive and gram-negative species.

The therapeutic substance actively spreads through the bloodstream, easily reaching all organs, including cerebral and bone tissue, and fluids, including intra-articular, spinal and pleural. About 4% of the amount of medicinal substance found in the blood plasma is found in human milk.

Bioavailability, that is, the amount of ceftriaxone sodium reaching the abnormal focus, is almost 100%.

The maximum concentration in the blood is observed 90 - 120 minutes after the intramuscular injection, and with intravenous infusion - at the end of the procedure.

The medicinal substance can remain in the body for a long time, maintaining its antimicrobial effect for 24 hours or more.

The half-life of the drug (the time when half of the pharmacological activity is lost) is 6–8 hours, and in patients over 70 years of age it is extended to 16 hours, in infants from one month of age - up to 6.5 days, in newborns - up to 8 days.

For the most part (up to 60%), ceftriaxone is eliminated in the urine, and partially in the bile.

With weak kidney function, the removal of the medicinal substance slows down, and therefore its accumulation in tissues is possible.

Features of water for injection

Water for injection is a medicine that can be bought at every pharmacy. It is not used as monotherapy. Its main purpose is to dissolve drugs for their subsequent parenteral administration: intravenous, intracavitary, subcutaneous, intraarticular, intramuscular.

It is a tasteless, colorless liquid without odor or foreign inclusions. It is packaged in plastic or glass sealed ampoules with a volume of 1 to 10 ml. To open the latter, manufacturers insert special cutting metal strips into the cardboard box. The package contains 10 ampoules along with detailed instructions for use.

Water for injection is sterile, so it must be used immediately. To dissolve which dosage forms of drugs it is used:

Often, water for injection is used to dilute standard solutions for parenteral administration. In this way, the concentration of their active ingredients is reduced. Medicines in reduced doses are indicated in the elderly, senile, children and adolescents, in the presence of severe liver and kidney diseases.

Why dilute Ceftriaxone?

Initially, Ceftriaxone comes in the form of a white (sometimes with a barely noticeable yellowish tint) crystalline powder. In hospitals, doctors use it as a powder to eliminate bedsores, skin ulcers and wounds, the healing of which has taken a long time. But in dissolved form, the medicine can be used even at home. At the same time, its effectiveness increases significantly.

Intravenous or intramuscular injection of Ceftriaxone is prescribed for:

peritonitis;
gynecological problems;
venereal diseases;
problems with urination;
skin inflammations;
infections in the respiratory system.

In clinical practice, it is Ceftriaxone injections that contribute to rapid (literally the next, maximum on the third day) improvement in the condition of a sick person.

Main characteristics of water for injection

The drug is produced by many domestic and foreign pharmaceutical factories. At all technological stages, it undergoes thorough purification from foreign impurities, the penetration of which into the human body leads to a deterioration in well-being. At the initial stage of production, mineral salts are removed from water by heating it. This way it softens, becomes completely chemically inert, and does not interact with the ingredients of medications.

Then it undergoes distillation - distillation, evaporation of the liquid, followed by cooling and condensation of the vapor. This helps get rid of all other impurities:

microscopic gas bubbles;

In factories producing water, all aseptic rules are observed. After purification distillation, it is packaged in primary packaging and then sterilized in industrial autoclaves. The resulting product is completely free of chlorides, sulfates, nitrates, calcium, and the acidity level varies from 5 to 7, which corresponds to the pH level of blood plasma. A special requirement for water quality is pyrogen-free. This is the absence of metabolic products of microorganisms. It is their penetration into the human body that leads to a sharp increase in temperature, chills, and feverish conditions.

How to use the medicine

The dosage of water for injection depends on the amount of the drug that is diluted with it. As a rule, when determining an individual dosage regimen, the doctor indicates how much solvent should be used. In other cases, you should follow the recommendations of the instructions for use. But not water, but a drug that needs to be diluted.

Manufacturers of some medicines immediately put solvents in the packaging. But more often they need to be purchased separately. The annotation indicates which solvent is needed for a particular drug. If the medicine can only be diluted with isotonic sodium chloride solution, then you need to buy it. The use of water in such cases provokes a decrease in the therapeutic effectiveness of the active ingredients.

Before carrying out the treatment procedure, you must thoroughly wash your hands and dry them. Then proceed as follows:

remove the aluminum protective cap from the bottle with the drug;

open the ampoule of water and use a sterile syringe to take out the required volume;

use a syringe needle to pierce the rubber or plastic stopper of the bottle and inject the collected water;

Shake the bottle well, use the second syringe to take out the required amount of solution and inject.

Please note that it is not always necessary to shake the bottle until the substance is completely dissolved. Some pharmacological drugs are, in principle, incapable of dissolving in water. They are administered in the form of a suspension.

When is it prescribed?

With the help of this antibiotic medication, inflammatory pathologies caused by microbial agents that react to the antibacterial activity of ceftriaxone are treated.

Among them are infections:

stomach, urinary and biliary organs, reproductive system, intestines (pyelonephritis, epididymitis, cystitis, cholangitis, prostatitis, peritonitis, gallbladder empyema, urethritis);
lungs, bronchi and ENT organs (pneumonia, purulent otitis, bronchitis, agranulocytic tonsillitis, purulent sinusitis, pulmonary abscess, pleural empyema);
skin, bones, subcutaneous tissue, joints (osteomyelitis, streptoderma, burns and wounds affected by pathogenic microbial flora);

In addition, Ceftriaxone with a pronounced therapeutic effect treats:

bacterial damage to the membranes of the brain (meningitis) and the inner lining of the heart (endocarditis);
uncomplicated gonococcal infection, syphilis; dysentery, tick-borne borreliosis;
septicemia when pyogenic bacteria and their poisons enter the blood; purulent-septic pathologies arising in the form of postoperative complications;
typhus, acute intestinal damage by salmonella;
infections occurring against the background of weakened immunity.

Special instructions for the use of water for injection

Water for injection is devoid of any pharmacological activity. This means that it has no contraindications for use and is not capable of provoking the development of local and systemic adverse reactions. Only drugs that have been diluted are responsible for all negative effects. In what cases can adverse reactions be caused by parenteral administration of water:

non-compliance with the instructions for use, use of water for injection for other purposes;

using an expired drug or storing the medicinal solution for too long under sterile conditions.

Some medications, for example, cephalosporin antibiotics, when administered parenterally, cause quite severe pain. Therefore, doctors recommend dissolving the powder simultaneously in both water and lidocaine with pronounced analgesic properties. If this method of performing the injection is not indicated in the instructions, then it is better to abandon it. Or ask your doctor to carefully calculate the dosage of solvents.

When preparing a medicinal dilution, care must be taken to ensure that it does not change its physical properties. The solution should not become cloudy or acquire uncharacteristic shades. Parenteral administration should be abandoned if sediment forms at the bottom when mixing two clear liquids. This indicates an undesirable drug interaction, the loss of the main drug’s therapeutic properties.

Contraindications, side effects and overdose

The antibiotic Ceftriaxone is not allowed to be prescribed:

with severe allergies to ceftriaxone, other cephalosporins, penicillins, carbopenems;
for patients up to 12–13 weeks of pregnancy;
nursing mothers (during therapy, the baby is transferred to feeding with milk formula);
newborns receiving intravenous infusions of calcium-containing solutions against the background of abnormally high levels of bilirubin in the blood;
patients with severe renal and liver failure at the same time (strictly according to indications).

The drug should be used with caution in the treatment of:

premature babies, newborns with high bilirubin in the blood, patients with drug and food allergies,
pregnant patients after 12 weeks of gestation;
patients with ulcerative colitis provoked by previous antibacterial treatment;
elderly and frail people.

Most patients tolerate treatment with Ceftriaxone well.

In some cases it is possible:

the appearance of itchy skin rash, blisters, chills, swelling of the eyelids, tongue, lips, larynx (if contraindications for patients with allergies are violated);
nausea, vomiting, loose stools, impaired taste, gas formation;
“thrush” (candidiasis) of the mucous membranes of the mouth, tongue, genitals;
inflammation of the mucous membranes of the mouth and tongue (stomatitis, glossitis);
headache, sweating, heat on the face;
cholestatic jaundice, hepatitis, pseudomembranous colitis;
phlebitis (inflammation of a vessel), pain at the injection site;
decreased urine output (oliguria), non-infectious pyelonephritis;
acute pain in the right hypochondrium due to pseudocholelithiasis of the gallbladder;
anemia.

With long-term treatment with high doses, changes in laboratory blood parameters are possible:

increased or decreased number of leukocytes;
increased activity of liver enzymes, alkaline phosphatases, creatinine;
very rarely - changes in blood clotting, including both a decrease in the number of platelets (hypoprothrombinemia) and the appearance of blood in the urine and nosebleeds, and an abnormally high level of platelets (thrombocytosis) with a risk of thrombosis.

In the urine there is a high content of urea and sugar (glucosuria).

Taking large doses of an antibiotic for 3 to 4 weeks can cause signs of overdose, which manifest themselves in the appearance or intensification of these undesirable side reactions. In this case, it is necessary to discontinue the medication and prescribe pharmaceuticals that eliminate the negative signs that have appeared. Methods for blood purification, including hemo- and peritoneal dialysis, do not give a positive result in case of overdose.

Where can I buy in Moscow and Odintsovo

Water for injection and other drug solvents are sold in all pharmacies. But you should buy them only in trusted medical institutions, whose employees carefully monitor their expiration dates and storage conditions. Such a responsible approach to the health of their clients is typical of pharmacists and pharmacists working in the largest pharmacy chain “Vasha No. 1”. It is well known among residents of Moscow and Odintsovo for its widest range of medicines and medical products. At Vasha No. 1 you can always buy them at a budget price. And the products sold are of the highest quality.

The pharmacy chain has long been extremely popular among residents of Moscow and Odintsovo. It is difficult to imagine a situation where a client left without the drug solvent he needed. Pharmacies are conveniently located, within walking distance from metro stations and bus stops. Soon it is planned to expand the network and open branches in other localities of the country. Now their residents will not have problems purchasing high-quality and inexpensive medicines.

In which online store can you find any solvents for medications?

The Vasha No. 1 pharmacy chain is very popular thanks to the online store created on its basis. It is convenient to make purchases here, track bonuses and discounts, and store the necessary information about injectable drugs and means for their dilution that were previously purchased. There are many advantages to placing an order at the “Your No. 1” online pharmacy. What is she known for:

100% guarantee of high quality medicines;

simple ordering;

frequent bonuses and discounts from the online store and manufacturers;

24/7 communication with operators;

availability of quality certificates.

The online pharmacy “Your No. 1” sells a variety of medications for dissolving medications. Here you can buy inexpensive water for injection in glass or plastic ampoules from domestic manufacturers. Imported Ringer's and glucose solutions are also sold, which never provoke the development of adverse reactions.

How to order medications for dissolving medications from the warehouse

You should definitely take advantage of this function of the “Your No. 1” online store. All pharmacological preparations, including those intended for diluting other drugs, which are stored in the pharmacy warehouse are significantly cheaper. Markups are made by employees only after they are delivered to the branches. Therefore, it is possible to buy water for injection, isotonic solution or glucose solution at a reduced cost. True, you will have to wait 1-2 days until you receive an SMS notification or email asking you to pick up the required medication from the pharmacy closest to your home.

Search for drug solvents in the online pharmacy “Your No. 1”

The online pharmacy “Your No. 1” has an intuitive interface. Creating a personal account greatly simplifies the search for drugs and their solvents. You need to fill out the table by entering your name, contact phone number or email address in its columns. Your personal account is ready to track order statuses, receive discounts and bonuses, and store information about purchases made. Finding a drug dissolving agent in the catalog is not difficult - you need to use one of these methods:

scroll the alphabetical index to the letter “b” if you need water for injection;

enter the first letters “water d” into the search bar to open the entire range of water with various volumes of ampoules;

click on the catalog, find the column “Medicines” then “Dissolvents for drugs”, select the required product, study its dosage regimen, indications for use, expiration dates.

And the easiest way to find water for injection, sodium chloride solutions, glucose is to go to your personal account and put the drug back into the “Basket”. But this can be done provided that it has already been purchased previously and was added to the “Favorites” section.

What is best for diluting the drug?

What else is this antibiotic diluted with, besides lidocaine and novocaine? Sodium chloride and even distilled water are often used as a solvent. To understand which solvent is better, you should consider that:

injection with an aqueous solution is more painful than with an anesthetic solution;
Each patient has an individual sensation of pain in response to a particular solvent;
the body may not accept the solvent or its components.

Therefore, each patient is first tested to determine the tolerance and intensity of pain. The essence of the test: two small scratches are made on the hand. Literally a drop of antibiotic and solvent is applied to them. If within 5-10 minutes there is no redness or swelling in these areas, and the patient does not experience pain, then this solvent is suitable for him.

For intramuscular injection

Both the manufacturer and medical practitioners recommend using Ceftriaxone with lidocaine to reduce acute pain during intramuscular injection of an antibiotic. This injection is less painful than an injection based on novocaine, and the likelihood of adverse reactions is significantly reduced.

When administered intravenously using a syringe

To increase the effectiveness of the antibiotic’s effect on the body and reduce the discomfort from the pain experienced by the patient, the drug is administered intravenously.

For intravenous injections with a syringe, anesthetics are not used as a solvent for Ceftriaxone. The drug is diluted exclusively with water for injection. To reduce pain, the solution from a syringe is injected deeply, smoothly and slowly (at least 2-4 minutes).

When infused into a vein using a dropper (infusion)

If the jet injection of the drug with a syringe (even slowly) causes discomfort in the patient, then an infusion (dropper) is prescribed at a dosage of the drug of 1 mg or higher. In this case, Ceftriaxone is diluted with a 0.09% sodium chloride solution. Reduction of pain is achieved through the use of a drip (gradual) administration of the drug. For example, a solution with a volume of 1000 ml is administered over 30 minutes.

As a rule, IVs are placed in hospitals. But drip administration of the composition at home is not prohibited, provided that the patient is monitored by a qualified healthcare professional.

How to find out the price (cost) of drug solvents

The search for a drug solvent in the online pharmacy “Your No. 1” ends with the opening of its image. Nearby is detailed information about the manufacturer, pharmacological properties, and restrictions on use. The price is indicated here, and not even just one. The lower one indicates how much it will cost to purchase a drug solvent if you pre-order its delivery from the warehouse. A little lower there is a higher cost. It informs about the price of water or solution, which is currently available in the “Your No. 1” pharmacy closest to the client’s place of residence.

Will Ceftriaxone help with coronavirus, how does it help fight

Ceftriaxone is prescribed for coronavirus only in one case - viral pneumonia complicated by a bacterial infection, which it can fight. This occurs in severe cases of COVID-19 due to suppression of local (in the respiratory tract) and general immunity, and the development of an active inflammatory reaction in the lungs. Simplified, this can be represented in the form of the following reasons:

viruses make lung cells easily vulnerable to other microbes;
the immune system is “busy” fighting the coronavirus and does not respond to bacteria;
prescribed drugs for extensive viral pneumonia suppress the immune response.

Ceftriaxone is effective against bacterial pneumonia that develops against the background of coronavirus infection, as it is an antibiotic with a wide spectrum of antibacterial action.

According to doctors who treated patients for pneumonia, about 95% of deaths were associated with secondary infection, blood poisoning (sepsis), and septic shock. It was most often caused by streptococci, pneumococci and Haemophilus influenzae. Ceftriaxone destroys most types (strains) of these bacteria, therefore helping to recover from COVID-19.