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Practice · Reconstitution · continued

Converting between mg/mL and units per dose, both directions posts 121–143

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.

EO
e.okaforTL28 Dec 2024#121

Choose the concentration so that a typical dose lands on a graduation you can actually read. A dose that falls between two marks on a 1 mL barrel is a dose you will get wrong sooner or later.

3 likes 20mo
NV
n.vogelTL29 Dec 2024 · edited#122

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

0 likes 20mo
OC
o.cousineauTL3Regular9 Dec 2024#123
v.klausen, post #80: Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise. Go to post

Where I part company with post #119, and it is a narrow parting.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

Posting it because the silence on this was starting to look like agreement.

22 likes in reply to #80 20mo
SF
s.ferreiraTL210 Dec 2024#124

Post #123 is the version of this I will quote in future. One addition.

Reconstituting a multi-strength kit: if a kit contains 5 mg, 10 mg, 15 mg vials and you are reconstituting all of them, writing the concentration on each vial in permanent marker as you go is the single most useful thing you can do to avoid dose errors later.

Second-hand, so weight it accordingly.

10 likes 20mo
ZY
z.yildizTL211 Dec 2024#125

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

I would rather post the uncertainty than round it away.

5 likes 20mo
CA
c.adebayoTL212 Dec 2024#126

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

1 like 20mo
HK
h.karlsenTL212 Dec 2024#127
LT
l.trevinoTL213 Dec 2024#128

Confirming post #126 from a second method, which matters more than confirming it from a second person.

A 0.3 mL barrel has more space between graduations than a 1 mL barrel for the same volume, which is the entire practical argument for the smaller syringe. Resolution, not capacity.

Reading it again, the caveat matters more than the finding.

15 likes 19mo
CD
cohort_driftTL3Regular14 Dec 2024#129

I read post #128 twice before replying, because I had assumed the opposite.

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

This is where my knowledge stops and I would rather mark the edge than blur it.

9 likes 19mo
PB
p.boatengTL214 Dec 2024#130
e.ferreira, post #25: Building on post #22 rather than restating it. Reconstituting a multi-strength kit: if a kit contains 5 mg, 10 mg, 15 mg vials and you are reconstituting all of them, writing the concentration on each vial in permanent marker as you go is the single most useful thing you can do to avoid dose errors later. Flagging that the sources on… Go to post

Post #128 answers the question as asked. The question underneath it is different.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

Anyone with a larger sample, please post it.

2 likes in reply to #25 19mo
N
NLoughranTL3Regular15 Dec 2024#131

Choosing a concentration on purpose rather than by accident: starting with "I want to draw 0.5 mL per dose" and working backward to the required concentration is more efficient than picking a diluent volume and hoping the math works out. State your target volume, then the required concentration follows.

The interesting part of this is the exception, and I do not understand the exception.

24 likes 19mo
IB
i.beaulieuTL216 Dec 2024#132
v.bhattacharya, post #31: A 0.3 mL barrel has more space between graduations than a 1 mL barrel for the same volume, which is the entire practical argument for the smaller syringe. Resolution, not capacity. Go to post

The decimal-point error: computing 5 mg / 2 mL as 0.25 mg/mL instead of 2.5 mg/mL is the most common arithmetic error in this subcategory. The habit that catches it: writing the units in every step of the calculation.

I am describing what is, rather than arguing for what should be.

0 likes in reply to #31 19mo
I
IMainwaringTL3Regular17 Dec 2024#133
m.silva, post #75: Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. Go to post

This follows post #130 rather than contradicting it.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

3 likes in reply to #75 19mo
BA
b.adeyemiTL217 Dec 2024#134

Same experience here, different supplier, so it is at least not unique to one of them.

11 likes 19mo
O
OFalkenbergTL1Member18 Dec 2024#135

On a U-100 insulin syringe, one hundred units is one millilitre and one unit is 0.01 millilitres. Units are volume marks. They mean nothing until you know the concentration.

That is the version I would defend. It is not the version I started with.

17 likes 19mo
VO
v.okonkwoTL219 Dec 2024#136

Coming back to post #132, because the follow-up matters more than the original answer.

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

0 likes 19mo
F
FFaulknerTL3Regular19 Dec 2024 · edited#137
f.espinoza, post #63: Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise. Go to post

Picking up post #135: that is the part I would want checked first.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

1 like in reply to #63 19mo
JC
j.cabreraTL220 Dec 2024#138

Two people can reconstitute the same vial to different concentrations and both be right. The dose is the same; only the volume drawn differs. This confuses more discussions here than any other single point.

I have deliberately not rounded that, because the rounding is where the argument starts.

7 likes 19mo
CR
crossover_reviewTL3Regular21 Dec 2024#139

The arithmetic in post #138 is right; the assumption feeding it is the part to check.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

0 likes 19mo
KB
k.batistaTL221 Dec 2024#140

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

1 like 19mo
JM
j.mwangiTL4 Moderator22 Dec 2024#141

Swirling until fully clear before drawing is worth the extra minute. A partially dissolved preparation is not uniform and the first dose out of it is not the same as the last.

18 likes 19mo
CR
c.ramosTL223 Dec 2024#142

Post #141 is right about the mechanism and I think understates the practical bit.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

I am not the right person to answer the follow-up to this.

8 likes 19mo
C
chromatogramTL4Analytical chemist24 Dec 2024#143
diluent_index, post #68: I read post #65 twice before replying, because I had assumed the opposite. Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise. It reads as pedantry until the day it does not. Go to post

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

That is the version I use. It may not be the version that is correct.

1 like in reply to #68 19mo

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