Some liquid drugs delivered in vials are relatively expensive. One way to save money is to use every bit of drug possible. However, some methods of doing this can be very hazardous to patients.
Undesirable Method If Attempting to Maximally Use Liquid Medication
More Desirable Method
multiply accessing a vial designed for single use
using vials intended for multiple use
using a formulation without preservatives
using a formulation with preservatives
failing to carefully decontaminate the vial diaphragm
scrupulously clean the diaphragm before accessing
pooling multiple vials repeatedly
never pool multiple vials
storing pooled drug for later use in suboptimal conditions
never store pooled solutions
using the same needle and syringe to pool many vials
change needles and syringes if going between vials
Some incentives to the practice:
(1) single use vials without preservatives may be cheaper than multi-use vials with preservative
(2) single use vials tend to contain a generous surplus of drug to ensure delivery of the stated amount
If undesirable techniques are used, then it is possible to contaminate the drug with bacteria with the risk for injection site abscesses or bacteremia.
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