Intravenous Injection Administration Research Articles

Clinical Characteristics and Management of Hypercalcemic Crisis in 155 Patients: A Single Center Retrospective Study.

This study aimed to analyse the etiology and clinical characteristics of hypercalcemic crisis in a large cohort of Chinese patients and summarised our clinical experience in the management of this serious endocrinological emergency. This was a retrospective analysis of a cohort of patients with hypercalcemic crisis hospitalized in the First Medical Center of Chinese PLA General Hospital between January 2009 and March 2024. The general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, and prognosis were analysed. A total of 155 patients with hypercalcemic crisis (91 males and 64 females) with a mean age of 54.60 ± 16.99 years old were enrolled. The most frequent disease-causing hypercalcemic crisis was hyperparathyroidism (41.94%), followed by solid malignancy (41.29%) and multiple myeloma (9.03%), et al. Patients mainly presented with symptoms of the digestive system (78.10%), nervous system (63.30%), skeletal system (59.60%), urinary system (59.50%), and cardiovascular system (34.90%). These 155 patients with hypercalcemic crisis got effective therapies that included simultaneous administration of intravenous injection (IV) isotonic saline, subcutaneous calcitonin, bisphosphonate, or hemodialysis in serious cases. After emergency treatment, all the symptoms in the patients were relieved obviously. The cure rate of hypercalcemic with etiological treatments was 84.50% (131/155). Hypercalcemic crisis is a serious endocrinological emergency with a variety of etiologies and a high risk of mortality. A prompt diagnosis and the implementation of a comprehensive and effective treatment can efficiently alleviate this endocrinological emergency. Etiological treatment targeting different causes can improve prognosis significantly.

Impact of an immersive virtual reality simulator education program on nursing students' intravenous injection administration: A mixed methods study

BackgroundUndergraduate nursing students often face limited opportunities to gain hands-on experience in performing invasive procedures and techniques. Immersive media tools may be helpful in training and enhancing skill development among nursing students. ObjectivesThe specific aims of this study were threefold: (1) to describe the development process of an intravenous injection virtual reality simulator (IIVRS) program, (2) to determine the effect of the IIVRS program on intravenous injection knowledge, and (3) to examine the acceptability, learning motivation, and experience of the IIVRS program among nursing students. MethodsThis study is a mixed method design, encompassing a one-group pre- and post-test approach and the utilization of reflection logs among 128 second-year nursing students enrolled at a university in northern Taiwan. An innovative gamification IIVRS program was developed by our research team. Knowledge of intravenous injection was assessed using a point visual analog scale at pre-and post-testing. Acceptability and motivation were assessed using items on a 5-point Likert scale. The IIVRS program experience was evaluated using open-ended questions of reflection. A paired t-test was used for comparing knowledge at pre-and post-tests, independent t-tests were conducted to compare levels of acceptance and learning motivation among different students' characteristics, and content analysis was used for qualitative data. ResultsStudents' knowledge of intravenous injection was significantly improved (Pre-test Mean = 3.08 vs. Post-test Mean = 4.96, p < 0.001). Students reported high levels of acceptance (Mean = 4.65) and learning motivation (Mean = 4.69). Students reported three themes of their experience: (1) attracts my attention and stimulates my motivation to learn, (2) enhanced memorization of the skill and process, and (3) a sense of presence and realism/unrealism. ConclusionThe virtual reality program for intravenous injection administration can be an effective education tool, fostering students' motivation to learn and a heightened sense of accomplishment.

Subcutaneous injection of a bortezomib-loaded thermosensitive hydrogel for the treatment of multiple myeloma

Multiple myeloma (MM) is incurable as one of the most common hematologic malignancies. Bortezomib (BTZ) is a first-in-class reversible proteasome inhibitor in the clinic for the treatment of MM. BTZ was initially approved for the administrator by only the intravenous injection route in 2003. Then, subcutaneous administration was approved in the US and EU in 2012 in addition to the intravenous injection route. The rates and severity of peripheral neuropathy were significantly lower than those of intravenous injection administration. Injectable thermosensitive hydrogels are a potential drug delivery system for controlled release. But it is difficult to achieve the aim of local therapy of MM. A subcutaneous delivery system for a long time may be a potential therapy method due to the subcutaneous administration of BTZ. Here, we designed a BTZ-loaded injectable hydrogel system to sustain drug release for a period of days. It could lower the side effects, enhance the therapeutic effect, and reduce the injection time.

Abstract P2-15-09: Systemic corticosteroid use in patients with metastatic triple-negative breast cancer treated with first-line therapy in the United States

Abstract Background: Corticosteroids (CS) have immunosuppressive properties that may diminish the efficacy of cancer immunotherapy (CIT). In retrospective analyses of clinical trial data, the use of CS for immune-mediated adverse events after starting CIT does not clearly appear to adversely affect outcomes; however, patients (pts) receiving CS at the start of CIT may have shorter overall and progression-free survival (Arbour, J Clin Oncol, 2018). With the increasing use of CIT for pts with metastatic triple-negative breast cancer (mTNBC) following the approval of atezolizumab in combination with nab-paclitaxel, it is important to understand the landscape of CS use as part of first-line (1L) treatment. Here we describe patterns of CS use in pts receiving 1L therapy for mTNBC, with a focus on taxanes. Methods: A total of 974 pts with confirmed mTNBC diagnosed from Jan 1, 2011, to Jul 5, 2018, and treated in the 1L setting from the de-identified Flatiron Health electronic health record-derived database were included in the study. Pts were categorized as having no CS use during 1L treatment, CS use at the start of 1L treatment or CS use after the start of 1L treatment. Results: The median age at mTNBC diagnosis was 60 years. The majority of pts were female (99%), treated at community centers (94%), and had recurrent disease (59%). Among the most common regimens in 1L were those containing capecitabine (n=208), paclitaxel (n=204), or nab-paclitaxel (n=131) (Table 1). Capecitabine was administered as monotherapy more frequently than paclitaxel and nab-paclitaxel (86% vs 67% and 52%, respectively). Most pts receiving capecitabine did not receive CS during 1L therapy (79%), whereas the majority of pts receiving paclitaxel and nab-paclitaxel did (&amp;gt;95% and 78%, respectively). However, among pts treated with nab-paclitaxel, CS use during 1L was more common in pts receiving combination regimens (88%) than those receiving monotherapy (67%). In general, pts who were treated with paclitaxel or nab-paclitaxel and initiated CS use at the start of 1L treatment continued it throughout their 1L treatment. CS was given (orally or intravenously) with 92% of paclitaxel administrations, 67% of nab-paclitaxel monotherapy administrations, 77% of nab-paclitaxel combination therapy administrations, and 81% of administrations when agents were given in combination with capecitabine. Among pts who received nab-paclitaxel monotherapy, pts who used CS during 1L tended to be younger and less likely to have visceral metastases or recurrent disease than pts who did not use CS. Conclusions: Overall, CS use was common at 1L initiation of most regimens used for the treatment of mTNBC, with the exception of capecitabine. Among pts who were treated with taxanes, those who initiated CS at 1L treatment tended to continue CS treatment for the duration of 1L. Despite the lack of requirement for the use of CS with nab-paclitaxel, the majority of pts treated with nab-paclitaxel monotherapy still received CS at the start of 1L treatment, suggesting use as premedication. None of the assessed pt characteristics were associated with CS use in pts who were treated with nab-paclitaxel monotherapy; however, due to widespread use of CS in the population and small sample size, definitive conclusions are difficult. Larger data sets with reasons for CS use are needed to further understand the observed patterns. Table 1CapecitabinePaclitaxelNab-Paclitaxel Othera(n=208)(n=204)(n=431)MonotherapyCombination(n=63)(n=68)Key baseline characteristicsAge at mBC diagnosis, median (IQR), years63 (53, 74)62 (53, 71)63 (57, 72)60 (52, 67)58 (61, 67)White, non-Hispanic, n (%)133 (64)115 (56)35 (56)41 (60)260 (60)De novo mBC, n (%)35 (17)106 (52)22 (35)23 (34)142 (33)mBC diagnosis later than 2015, n (%)112 (54)111 (54)42 (33)38 (56)261 (61)Bone-only mets at diagnosis, n (%)44 (21)38 (19)&amp;lt;5 (&amp;lt;8)11 (16)62 (14)Visceral mets at diagnosis, n (%)118 (57)121 (59)45 (71)37 (54)266 (62)Time from initial to mBC diagnosis (recurrent), median (IQR), months33 (20, 68)40 (23, 83)47 (24, 86)44 (27, 86)30 (17, 57)1L regimen typeMonotherapy, n (%)179 (86)68 (33)63 (100)0 (0)159 (37)Combination therapy, n (%)29 (14)136 (67)068 (100)272 (63)Duration, median (IQR), months3.9 (2.1, 7.0)3.2 (2.0, 4.8)3.2 (1.8, 5.0)5.0 (3.1, 7.3)2.8 (1.6, 4.4)CS use, n (%)No use during 1L164 (79)&amp;lt;6 (&amp;lt;3)21 (33)8 (12)88 (20)Use during 1L44 (21)&amp;gt;198 (&amp;gt;97)42 (67)60 (88)343 (80)Chemotherapy administrations with CS given on the same day, n (%)No39 (19)b177 (8)285 (33)231 (23)820 (27)Yes163 (81)b2104 (92)587 (67)780 (77)2236 (73)a Top 5 other regimens were carboplatin + gemcitabine (n=77), cyclophosphamide + doxorubicin (n=56), eribulin (n=25), carboplatin + docetaxel (n=23), and docetaxel (n=19).b These numbers comprise capecitabine combination regimens only, as chemotherapy administrations did not capture oral capecitabine monotherapy.1L, first-line; CS, corticosteroid; IQR, interquartile range; IV, intravenous injection administration; mBC, metastatic breast cancer; met, metastasis. Citation Format: MK Downer, Patricia Luhn, David Miles, Matthew Kent, Kenneth Russell, Joyce O’Shaughnessy. Systemic corticosteroid use in patients with metastatic triple-negative breast cancer treated with first-line therapy in the United States [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-15-09.

Injectable medications: self-reported practices of nursing professionals.

To identify the self-reported injectable medications of nursing professionals in the state of São Paulo. Survey study that assessed the self-reported frequency of injection medications through a validated electronic questionnaire, applied from September to December 2017. The 1,295 computed responses showed non-compliances such as sharing multidose vials for two or more patients (10.8%), reusing single-use supplies, such as use of saline flush syringes for different patients (1.2%) and needle recapping after use (4.9%). Greater adherence to glove use for administration of intravenous injections (80.5%) and lack of training for handling safety devices (13%) were reported. Correlational data showed that, the older the age, the better the self-reported injecting practices. Although most practices are within Safe Injecting practices, there are reports of risky practices, such as sharing single-use supplies. Training for the use of safety devices is not yet a reality for all professionals, since many reported it as rare.

Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial.

To determine whether the virtual reality as a distracting intervention could reduce pain and fear in school-age children receiving intravenous injections at an emergency department. An intravenous injection is the most common invasive procedure that paediatric patients encounter in emergency department. School-age children seldom show their fear or discomfort during the procedure which may be ignored. A randomised controlled trial was conducted from December 2017-May 2018 and performed according to the CONSORT guidelines. One hundred and thirty-six children aged 7-12years were randomly allocated to receive either a routine intravenous injection procedure or one with an immersive virtual reality experience. Children were asked to rate their pain and fear along with their caregivers and nurses on the Wong-Baker FACES Pain Rating Scale and Children's Fear Scale, respectively. The time required for successful intravenous insertion was also assessed in the emergency department. Clinical trial registration was done (ClinicalTrials.gov.: NCT04081935). Pain and fear scores were significantly lower in the virtual reality group, as were the children's ratings as perceived by their caregivers and nurses. The children's ratings of pain and fear were positively correlated with the caregivers' ratings and the nurses' ratings as well. The time required for successful intravenous insertion was significantly lower in the virtual reality group. Visual reality intervention can effectively reduce the pain and fear during intravenous procedure in school-age children in emergency department. The results of this study indicate the feasible clinical value of virtual reality interventions during the administration of intravenous injections in school-age children in emergency departments.

An Analytical Study on Practices Regarding injection Administration among Staff Nurses

Injection administration is one of the greatest responsibilities of a nurse. It is an integral part of the nurse’s role, therefore the nurses must adapt the principles and techniques of medication administration to render quality nursing care. This study aimed to assess the injection administration practices among staff nurses working in selected hospital and analyzing the practices with current injection administration literature. A quantitative research approach with analytical research design was adopted. 100 staff nurses were selected through non probability convenient sampling technique. Data was collected using observational checklist. Out of 100 staff nurses observed for injection administration, 70 staff nurses administered intravenous injection and 30 staff nurses administered intramuscular injection. The collected data was analyzed by using descriptive and inferential statistics. Study showed that majority of the staff nurses 28 (93.3%) were having good intramuscular injection administration practices and 36 (51.4%) staff nurses had good intravenous injection administration practices. Study also revealed that there is no significant association of intramuscular and intravenous injection administration practices with age, gender, educational qualification, area of work and work experience. Total 43 literatures were referred for analyzing the findings related to practices of intramuscular and intravenous injection administration.

Ultra-high-performance liquid chromatography tandem mass spectrometry method for the determination of gambogenic acid in dog plasma and its application to a pharmacokinetic study.

A highly sensitive and rapid ultra-high-performance liquid chromatography-tandem mass spectrometry method was developed and validated for the determination of gambogenic acid in dog plasma. Gambogic acid was used as an internal standard (IS). After a simple liquid-liquid extraction by ethyl acetate, the analyte and internal standard were separated on an Acquity BEH C18 (100 × 2.1 mm, 1.7 µm; Waters ) column at a flow rate of 0.2 mL/min, using 0.1% formic acid-methanol (10:90, v/v) as mobile phase. Electrospray ionization source was applied and operated in the positive ion mode. Multiple reaction monitoring mode with the transitions m/z 631.3 → 507.3 and m/z 629.1 → 573.2 was used to quantify gambogenic acid and the internal standard, respectively. The calibration curves were linear in the range of 5-1000 ng/mL, with a coefficient of determination (r) of 0.999 and good calculated accuracy and precision. The low limit of quantification was 5 ng/mL. The intra-and inter-day precisions (relative standard deviations) were <15%. The methodology recoveries were more than 66.63%. This validated method was successfully applied to a pharmacokinetic study after intravenous injection administration of gambogenic acid in dogs at a dose of 1 mg/kg.

Effectiveness of cartoon distraction on pain perception and distress in children during intravenous injection

Background: Intravenous injection is a medical procedure, often accompanied by pain and distress in children. Thus the reduction of such pain and distress becomes the responsibility of health care professionals to an extent as possible while maintaining patient safety by using various pharmacological and non pharmacological interventions. Method: A quasi - experimental study was undertaken on children of 4 to 12 years age who were undergoing intravenous injections to determine the effectiveness of Cartoon Distraction as a strategy to reduce the pain perception and distress. The study comprised of 30 children selected through purposive sampling method. In present study the assessment of pain and distress done in morning without cartoon distraction and in evening with cartoon distraction at initiation, at five minutes and at termination of administration of intravenous injection on FACES pain scale and on distress assessment scale respectively on day 1. While on day 2, to understand the diurnal effect of pain and distress, there was assessment of pain and distress in morning with cartoon distraction and in evening without cartoon distraction at initiation, at five minutes and at termination of administration of intravenous injection Result: The results revealed that there is significantly (p <0.005) less pain and distress in children with cartoon distraction at initiation, at five minutes and at termination of administration of intravenous injection. The findings also revealed that there is no influence of gender on perception of pain but there was an inverse relation of behavior pain response with age of the child. Children who had history of previous hospitalization had an increased perception of pain and distress during the current hospitalization. Pain and distress is also directly proportional to time duration of administration of intravenous injection and number of intravenous injection per day and the presence of caregiver had no role on the same. Conclusion: It was concluded that cartoon distraction is an effective distraction strategy to reduce pain and distress among children during intravenous injection.

A novel subcutaneous infusion delivery system based on osmotic pump: in vitro and in vivo evaluation

An economical, convenient portable drug delivery system combining osmotic pump with subcutaneous infusion was developed, which was composed of three primary components: water chamber, osmotic pump chamber and support base. Ceftriaxone sodium (CRO) was selected as the model drug and osmotic pump tablets were prepared. The influence of osmotic agents on drug release profiles was evaluated. As the adjustment made by the osmotic agents was limited, the compositions of semipermeable membrane were investigated to determine significant associations of factors based on orthogonal design. The in vitro release profiles of the optimum formulation achieved to the predetermined value (15 ± 3 min for the initial release time Ti and 5.75 ± 0.25 h for the extent release time Te). The pharmacokinetic profiles of this drug delivery system were evaluated in Beagle dogs. In vivo results demonstrated that the osmotic pump subcutaneous infusion administration was equivalent to intravenous injection administration in terms of bioavailability. Moreover, constant drug plasma levels with minimized fluctuations could be achieved with this osmotic pump subcutaneous infusion system, compared with intravenous injection.

La muerte de Daniel Alcides Carrión: una revisión crítica

El experimento de Daniel Alcides Carrión marcó un hito en la historia de la medicina peruana. Alrededor de él ha existido mucha controversia. Quizás, el principal tema de debate sea la causa de su muerte. En la controversia, ha pasado desapercibido un hecho objetivo ocurrido en las últimas horas del experimento: la administración de inyecciones endovenosas de ácido fénico. Esta fue una terapia propuesta en Perú en aquella época como tratamiento del carbunco. Los médicos de la junta médica, en la agonía de Carrión, probablemente no administraron la transfusión sanguínea a Carrión, para experimentar con este tratamiento. La junta médica pensaba quizás repetir con la bartonelosis el éxito descrito que tuvieron las inyecciones de ácido fénico con el carbunco. Desconocían la actualmente demostrada toxicidad de esta sustancia. Probablemente, el evento precipitante de la muerte de Carrión fue una intoxicación por ácido fénico en un paciente con bartonelosis en fase anémica.

Synthesis and application of methoxy poly(ethylene glycol)‐bile salts conjugates in physicochemical characterization and the pharmacokinetics of the liposomal bifendate in rats

AbstractStealth liposomes have been broadly investigated as drug delivery or diagnostic agent. However, the materials that possess the ability of stealth, such as DSPE‐PEG and Chol‐PEG, are either costly or synthetic complex. In this research with different molecular weights (2000–6000 g/mol) of methoxy poly(ethylene glycol)(MePEG), a series of MePEG‐bile (MePB) conjugates were generated by an economical and simple method and confirmed by FTIR and 1H‐NMR spectrum. The properties in aqueous solution were studied, including viscosity and surface activity, over a wide concentration range. To elucidate the application of MePB in liposomes (MePBL), conventional liposomes (CL) were prepared, and the influence of the grafting density and the chain length of MePB in liposomes were investigated. The ability of long circulation of MePBL was evaluated by intravenous injection administration in rats. Results indicated that all the liposomes prepared, with or without MePB composition, were similar in micrograph, and the contents of MePB in MePBL were more important than the chain length of MePB for a long circulation in vivo. © 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2011

Complications of Minor Skin Surgery Performed under Local Anesthesia

Minor surgical procedures performed under local anesthesia are the most common surgical procedures routinely carried out in every plastic surgical practice. The objective was to evaluate the prevalence of immediate local and systemic complications of such procedures. Records of 2,600 procedures performed under local anesthesia on 2,431 patients between November 2001 and May 2004 were reviewed. Local anesthetic complications and all surgical-related complications were recorded. Procedure-related complications were 51 presyncope (1.9%), 4 true syncope (0.16%), 2 minor burns (0.08%), and 1 facial laceration (0.04%). True allergic reaction to lidocaine is extremely rare and none was noted in our study. Most patients who claimed that they had suffered from such a reaction were probably experiencing symptoms related to intravenous injection administration, a reaction to the added vasoconstrictor (adrenaline), or a vasovagal reaction, which is a common trait among young adults.

Determination of helicidum and its metabolites in dog plasma by LC/UV/MS/MS and its application to pharmacokinetic studies

A simple, rapid and reliable method was developed for the identification and quantification of helicidum and its metabolites in beagle dog plasma by liquid chromatography/ultra-violet/electrospray ionization-ion trap mass spectrometry (LC/UV/ESI-ITMS). Two metabolites were identified by MS: formylphenyl-O-beta-d-pyranosyl alloside (I) and hydroxylmethylphenyl-O-beta-d-pyranosyl alloside (II). UV was used for concentration determination with the wavelength of 270 nm. Liquid-liquid extraction was used and the extraction recovery exceeded 90%. Kromacil C(18) column (5 microm, 4.6mm i.d. x 250 mm) was used as the analytical column. Linear detection responses were obtained for helicidum concentration ranging from 1.76 x 10(-4) to 70.4 x 10(-4) micromol/mL (0.050-2.00 microg/mL). The precision and accuracy data, based on intra- and inter-day variations over 3 days, were less than 5%. The limit of determination and quantitation (LOD, LOQ) for helicidum was 0.010 and 0.030 microg/mL, respectively. Pharmacokinetic data of helicidum and the two metabolites were obtained with this method after administration of intravenous injection and a single oral dose of tablets to six beagle dogs, respectively.

CTLA4IgG gene delivery prevents autoantibody production and lupus nephritis in MRL/ lpr mice

MRL MP - lpr lpr ( MRL lpr ) mice spontaneously develop an autoimmune syndrome closely resembling systemic lupus erythematosus (SLE) in humans, characterized by hypergammaglobulinemia, various autoantibody production, and the development of fatal glomerulonephritis. We have previously demonstrated that systemic administration of soluble form of CTLA4IgG prevented autoantibody-related diseases in MRL lpr mice. To test the potential protective effects of CTLA4IgG gene delivery on the development of lupus nephritis, we injected MRL lpr mice with a recombinant adenovirus vector containing CTLA4IgG gene, AdexlCACTLA4IgG (AdCTLA4IgG). It was demonstrated that a single administration of intravenous injection of AdCTLA4IgG into MRL lpr mice resulted in almost complete amelioration of lupus nephritis.

An accurate and economical method for the biological assay of aconite tincture

A method is described for the quantitative assay of aconite tincture. The principle employed involves the administration of intravenous injections of the tincture in mice. A comparison of LD 50 doses of Reference Standard Aconitine Solution with diluted tinctures is employed for the assay. The standard error of a series of assays was found to be less than two per cent.