Total Parenteral Nutrition Flashcards
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Questions and Answers

What is the microbial growth-promoting soybean-based product added to?

A compounding preparation

What defines medium-risk level Compounded Sterile Preparations (CSPS)?

  • Mixed in nuclear pharmacies
  • Prepared from sterile ingredients
  • Stored for up to 30 hours at room temperature (correct)
  • Prepared using complex manipulations (correct)

    • Which of the following is an example of high-risk level CSPS?

  • Patient-controlled analgesia
  • TPN
  • Aseptic non-touch technique
  • Radioactive products used in cancer treatment (correct)

    • What role do pharmacy technicians play in quality assurance?

    <p>Participating in quality assurance and medication error prevention programs.</p> Signup and view all the answers

    What are the guidelines provided by USP 797 and 800?

    <p>Guidelines regarding procedures and practices to prevent patient harm or death.</p> Signup and view all the answers

    Nonsterility is the most common type of medication error.

    <p>True</p> Signup and view all the answers

    What does quality assurance programs provide?

    <p>Means to ensure product and service quality meet standards</p> Signup and view all the answers

    What is the definition of bulk repackaging?

    <p>Repackaging medications into a single dose.</p> Signup and view all the answers

    What are some common reasons pharmacies repack from bulk medications?

    <p>To save on costs</p> Signup and view all the answers

    What is the beyond-use date (BUD) for a repackaged drug?

    <p>The earliest of the repackaged date or manufacturer's date</p> Signup and view all the answers

    Which ingredient is NOT a part of a nonsterile compound?

    <p>Preservatives</p> Signup and view all the answers

    What are excipients?

    <p>Inert ingredients used to promote effectiveness</p> Signup and view all the answers

    When measuring using a Class A balance, __________ should be used to adjust the weights.

    <p>tweezers</p> Signup and view all the answers

    Molded tablets disintegrate easily upon exposure to moisture.

    <p>True</p> Signup and view all the answers

    What does TPN stand for?

    <p>Total Parenteral Nutrition</p> Signup and view all the answers

    What is the general daily caloric requirement for adult patients on TPN?

    <p>2500 to 3000</p> Signup and view all the answers

    What are the primary goals of TPN? (Select all that apply)

    <p>Maintain nutritional balance</p> Signup and view all the answers

    TPN solutions are made up of?

    <p>Macronutrients and micronutrients</p> Signup and view all the answers

    What are the two ways of preparing TPN?

    <p>Automated compounder machines</p> Signup and view all the answers

    What guidelines must technicians follow prior to TPN administration?

    <p>Aseptic preparation to avoid contamination and destabilization</p> Signup and view all the answers

    What can cause TPN to destabilize? (Select all that apply)

    <p>Aggregation</p> Signup and view all the answers

    What should be done when preparing micronutrients for TPN?

    <p>Draw each micronutrient individually and follow manufacturer instructions</p> Signup and view all the answers

    What special considerations should be taken when preparing TPN?

    <p>Use aseptic technique</p> Signup and view all the answers

    What type of technique must TPN solutions be prepared using?

    <p>Aseptic technique</p> Signup and view all the answers

    What are the energy sources for TPN solutions?

    <p>Macronutrients such as carbohydrates, fats, and proteins</p> Signup and view all the answers

    What do TPN solutions for long-term therapy contain?

    <p>Electrolytes such as potassium, sodium, magnesium, and phosphorous</p> Signup and view all the answers

    What are some classes of IV chemotherapeutic agents? (Select all that apply)

    <p>Alkylating agents</p> Signup and view all the answers

    What should be used to handle hazardous drugs properly?

    <p>Biological safety cabinets (BSC) or compounding aseptic containment isolators (CACI)</p> Signup and view all the answers

    Chemotherapeutic agents are only toxic to cancerous cells.

    <p>False</p> Signup and view all the answers

    What do regulations regarding investigational drugs focus on?

    <p>Eligible patients, adverse effects monitoring, documentation, and waste disposal</p> Signup and view all the answers

    What are the responsibilities of pharmacy technicians in home IV infusion therapy?

    <p>Preparing sterile IV admixtures, gathering equipment and supplies, maintaining progress notes, billing, cleaning, and quality control</p> Signup and view all the answers

    What are critical components of quality assurance practices? (Select all that apply)

    <p>Training for all personnel</p> Signup and view all the answers

    What does quality control involve?

    <p>Maintaining the quality of products and services to meet standards</p> Signup and view all the answers

    Match the following types of infusion pumps with their uses:

    <p>Volumetric pumps = High-potency drugs Peristaltic pumps = Enteral feeding Syringe pumps = Small doses of high-potency drugs PCA pumps = Patient-controlled pain relief Ambulatory pumps = Lightweight delivery of IV therapy</p> Signup and view all the answers

    Study Notes

    Total Parenteral Nutrition (TPN) Overview

    • TPN is used to deliver essential nutrients directly into the bloodstream for patients unable to eat or absorb nutrients via the digestive tract.
    • Daily caloric requirement for adults on TPN typically ranges from 2,500 to 3,000 calories.

    Primary Goals of TPN

    • Replace nutritional deficits in patients.
    • Promote wound healing and recovery.
    • Increase weight or limit weight loss.
    • Prevent malnutrition and ensure nutritional balance.

    Composition and Preparation of TPN

    • TPN solutions consist of macronutrients (carbohydrates, fats, proteins) for energy and micronutrients for additional health benefits.
    • Can be prepared via gravity method or automated compounder machines.

    Aseptic Preparation Guidelines

    • Strict aseptic techniques must be followed to prevent contamination.
    • Guidelines include performing calculations in designated areas, decontaminating preparation zones, and mixing in a controlled environment.

    Destabilization of TPN Solutions

    • TPN can become unstable due to:
      • Creaming: Fat particles rising to the top.
      • Cracking: Separation of oil and water phases.
      • Coalescence: Smaller fat particles merging into larger ones.
      • Aggregation: Fat particles clumping together.

    Micronutrient Preparation

    • Draw each micronutrient separately and consult manufacturer guidelines for compatibility.
    • Vials should be prepared for pharmacist verification to avoid incompatibility issues.

    Special Considerations for TPN Administration

    • TPN must be refrigerated immediately after preparation and infused or discarded within 24 hours.
    • Use appropriate filters based on lipid content (1.2 micron for TPN with lipids, 0.2 micron for TPN without).
    • Monitor patient vital signs and lab values every 4 to 6 hours.

    Chemotherapy and Hazardous Drug Handling

    • Chemotherapeutic agents are toxic to both cancerous and healthy cells; common symptoms of exposure include skin rashes and gastrointestinal effects.
    • Proper handling includes using Biological Safety Cabinets (BSC) and Personal Protective Equipment (PPE).

    Safe Waste Disposal Protocols

    • Chemotherapy waste must be disposed of in specially marked containers.
    • Use of needle-free devices to minimize risks during hazardous drug administration.

    Patient Education on Home Infusion Therapy

    • Patients must understand IV catheter insertion, use of PICCs and CVCs, and medication flushing techniques (SASH method).
    • Awareness of complications related to PICCs should be emphasized.

    Types of IV Therapy in Home Settings

    • Treatments can include chemotherapy infusion via specific arteries, pain management techniques, and anti-infective therapies.

    Infusion Pump Types

    • Volumetric pumps deliver precise drug volumes, while peristaltic pumps are used for enteral feeding.
    • PCA pumps allow patient-controlled pain relief, enabling patients to self-administer medication.

    Pharmacy Technicians' Role in IV Therapy

    • Responsibilities include preparing sterile mixtures, maintaining equipment, documenting patient progress, and ensuring quality control.

    Quality Assurance and Medication Error Prevention

    • The importance of quality assurance (QA) and control is emphasized to prevent medication errors in sterile compounding.
    • Patient rights in medication management include ensuring the right patient, medication, strength, route, and time.

    Education Resources for Pharmacy Technicians

    • Stay updated with pharmacy practice through professional organizations and educational institutions.### Compounding Categories
    • Category 1: Compounds with a maximum BUD of 12 hours or less at room temperature or 24 hours or less refrigerated.
    • Category 2: Compounds with a maximum BUD of greater than 12 hours at room temperature or greater than 24 hours refrigerated.

    Compounding Areas

    • Category 1: Can be compounded in a segregated compounding area (SCA) without a buffer and ante room.
    • Category 2: Must be compounded in a facility with a separate walled ante room (ISO class 8) and buffer room (ISO class 7) areas.

    Pharmacy Technician Responsibilities

    • Participating in quality assurance and medication error prevention programs.
    • Bulk repackaging and nonsterile compounding.

    Bulk Repackaging

    • Involves repackaging medications into a single dose.
    • Reasons for repackaging: medications not available for purchase as single doses, cost savings, faster dispensing, reduced error, and stocking medications.

    Good Manufacturing Practices (GMP)

    • US FDA guidelines that guarantee safe and effective products for consumers.
    • Examples of GMP guidelines: checking drugs by a registered pharmacist, equipment maintenance, beyond-use date, packaging, and logging.

    Equipment and Techniques

    • Automated packaging machines, pill-counting trays, and spatulas.
    • Aseptic technique recommended for bulk repackaging.
    • Wear laboratory coat, keep hair pulled back, perform handwashing, and wear face mask and gloves.

    Expiration and Beyond-Use Dates

    • Beyond-use date (BUD) is one year from the repackaging date or the manufacturer's expiration date, whichever is earlier.

    Compounding

    • Allows the preparation of medication for a specific patient.
    • Reasons for compounding: medication no longer manufactured, patient allergy, special drug strength, or patient compliance.

    Nonsterile Compounding

    • Preparation of patient-specific medication doses without a clean room.
    • Three parts to a nonsterile compound: active ingredient, inactive ingredient(s), and vehicle or diluent.

    Compounding Area and Equipment

    • USP 795 guidelines for setting up compounding areas.
    • Personal protective equipment, measuring devices, mixing equipment, and weighing equipment.

    Weighing and Measuring Substances

    • Techniques for using Class A and Class II balances.
    • Leveling the balance, adding weighing papers, and zeroing out the balance.

    Solubility and Dosage Forms

    • Concepts of solubility: particle size, dissolution rate, and viscosity.
    • Buffers: solutions that resist pH changes.

    Molded Tablets and Capsules

    • Steps to compound molded tablets: preparing powder mixture, moistening, and pressing into a cavity plate.
    • Benefits of capsules: masking taste and easier to swallow.

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    Test your knowledge on total parenteral nutrition (TPN) with these flashcards. Learn about daily caloric requirements, primary goals, and more essential concepts related to TPN. Perfect for healthcare students and professionals.

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