If you want to know about iv infusion then follow this

2. Md, Nahid Hassan Mitoo
 Department of pharmacy
Worlduniversityof Bangladesh

3. IV infusion
 Intravenous technology started from studies on cholera treatment in
1831.It was further developed in 1930s but was not widely available
until the 1950s.
 Iv infusion : It is a therapy that delivers liquid substances directly
into a vein. Iv drug solution may be given either as a bolus dose or
infused slowly through a vein into the plasma at a constant or zero-
order rate . Toxicity usually no toxic effect can be precipitated.

4. History of IV infusion
 Intravenous technology started from studies on cholera treatment in
1831
 It was further developed in 1930s but was not widely available until
the 1950s

5. IV Infusion Procedure
 A. Select a suitable vein for venipuncture
 b. Prepare the venipuncture site.
 (1) Apply constricting band two inches above the venipuncture site. The
constricting band should be tight enough to occlude venous flow, but not
so tight that distal pulses are lost
 (2) Select and palpate a prominent vein.
 (3) Cleanse the skin with an alcohol swab .Allow the site to dry
Cleanse the skin with an alcohol swab .Allow the site to dry
c. Don gloves.
d. Perform the venipuncture.

6.  With the dominant hand, position the distal bevel of the needle up
and insert the cannula into the vein at approximately a 30 degree
angle
 continue inserting the needle until blood is observed in the flash
chamber of the catheter.
 decrease the angle to 15 to 20 degrees and carefully advance the
cannula approximately 0.5 centimeter farther .
 Place a finger over the vein at the catheter tip and put pressure on
the vein to prevent blood from flowing out the catheter
 Remove the needle while maintaining firm catheter control.

7.  Place a finger over the vein at the catheter tip and put pressure on
the vein to prevent blood from flowing out the catheter
 Remove the needle while maintaining firm catheter control

8. Plasma drug concentration for IV infusion
following one compartment model
 The pharmacokinetics of a drug given by constant IV infusion
follows zero order input process in which the drug is infused
directly into the systemic blood circulation.

9.  For most drugs elimination of drug from the plasma is first order
process.
 Therefore in one compartment model infused drug follows zero
order input and first order

13. PURPOSE OF INTRAVENOUS
INFUSION
 To provide patient with fluid when adequate fluid intake cannot be
achieved through oral route.
 When the patient is unable to swallow, e.g. unconscious patient.
 When it is undesirable for the patient to take fluids or food by mouth
e.g. post operative patients.
 To keep the vein open for administration of drugs or when waiting
for blood transfusion.
 To maintain and correct electrolyte s of the body when the patient is
losing fluids or salts in excess like in persistent diarrhoea and
vomiting , in severe burns.

14. Types of IV Solutions
IV Solutions
Isotonic Hypotonic
Hypertonic

15. Types of IV Fluids
Isotonic solutions Hypotonic Hypertonic
0.45 % (N/2) Saline Normal (0.9) Saline 3% Saline
0.18 % (N/5) Saline Hartmann’s solution Mannitol
5% Albumin 20% Albumin
Isotonic Hypotonic and Hypertonic solutions :

16. Function includes
Replace Lost
blood
Replace lost fluids
Provide nutrients
Deliver
Medications

17. Main reason for giving a drug by slow Iv
infusion
 In case of IV infusion ,When drug is administered rapidly , it tends
to increase the volume of the blood . As a result, hypervolemia may
occur, thereby slowly infused.
 Slow IV infusion may be used to avoid side effects due to rapid drug
administration .eg: Intravenous immune globulin may cause a rapid
fall in blood pressure when infused rapidly.
 Some antisense drug injected rapidly by IV to the body, it cause a
rapid fall in blood pressure.

18.  The rate of infusion is particularly important in administering antiarrhythmic agents in
patients.
 The rapid IV bolus injection of many drugs that follow the pharmacokinetic of multi-
compartmental models, may cause an adverse response due to the initial high drug conc.eg:
If heparin is injected or infused at a faster rate, cardiac arrest may arise.

19.  The rate of infusion is particularly important in administering
antiarrhythmic agents in patients.
 The rapid IV bolus injection of many drugs that follow the
pharmacokinetic of multi-compartmental models, may cause an
adverse response due to the initial high drug conc.eg: If heparin is
injected or infused at a faster rate, cardiac arrest may arise.

20. Plasma drug concentration for IV infusion
Plasma drug concentration for IV infusion following one compartment model
The pharmacokinetics of a drug given by constant IV infusion follows zero order
input process in which the drug is infused directly into the systemic blood circulation
.For most drug elimination of drug from the plasma is a first order process. The
changes in the amount of drug in the body at any time during the infusion is the rate
of input – rate of output.

21. Plasma drug concentration for IV
infusion following one compartment
model graph

23. Steady state drug concentration (Css) and
time
 The rate of drug leaving the body is equal to the rate of drug
entering the body (infusion rate).Whenever the infusion stops either
at steady state or before steady state is reached ,the long drug
concentration declines according to first order kinetics with the
slope of the elimination curve equal to –k/2.3.Mathematically, the
time to reach true steady state drug concentration , Css would take
an infinite time .The time required to reach steady state drug
concentration in the plasma is dependent on the elimination rate
constant of the drug for a constant volume of distribution.

24.  For a zero order elimination process ,if the rate of input is greater
than the rate of elimination ,plasma drug concentration will keep
increasing and no steady state will be reached. This is potentially
dangerous situation that will occur when saturation of metabolic
process occurs. During the iv infusion ,the drug concentration
increases in the plasma and the rate of drug elimination increases
because rate of elimination is concentration depend.in clinical
practice ,the activity of the drug will be observed when the drug
concentration is close to the desired plasma drug concentration ,
which is usually the target to desired steady sate drug concentration.

25. Time required for achieving 99% of steady
state level in terms of t1/2

28. Loading Dose
Loading dose is the minimum effective dose which is given
initially at a time to obtain the steady state plasma drug
concentration as early as possible.
we use a loading dose to rapidly achieve therapeutic
concentration of a drug Css achieved immediately Obtained
desired concentration.

29.  IV Infusion with loading dose : Iv Infusion with loading dose. The
loading dose is given by iv bolus injection at the start of the
infusion. plasma drug concentrations decline exponentially after
whereas they increase exponentially during the infusion. The
resulting plasma drug concentration versus time curve is straight
line due to the summation of the two curves.

30. IV Infusion with loading dose

31. Advantages
 Rapid administration of solution
 Avoids first pass metabolism
 100% bioavailable
 Prevent the growth of cancerous cells
 Rapid delivery of the
 drug/fluid to target sites
 Suitable route
 Plasma level
 Body Temperature

32. Disadvantage

34. Thank You