IV mixtures

• Intravenous Admixture System

  A combination of one or more sterile products added to an IV fluid for parenteral administration
• Preparations for parenteral, ophthalmic and irrigation purposes

  • Must be free from chemical and physical contaminants, accurately and correctly compounded, sterile and free of pyrogens, stable until their beyond use date and properly packaged and labeled for use
• Intravenous admixtures


  A combination of one or more sterile products added to an IV fluid for parenteral administration. It must be sterile and pyrogen free. Aseptic technique must be followed.
• Aseptic technique

  A means of manipulating sterile products without compromising their sterility. Proper use of a Laminar Airflow Workbench (LAFW) and strict aseptic technique are the most important factors in preventing the contamination of sterile products.
• Final container for a compounded sterile preparation

  • Needs to be sterile and maintain the sterility of the preparation to the beyond use date. It should also protect the final preparation from chemical degradation especially if the preparation is light sensitive.
• Choice of package for a sterile preparation

  • Should take into account the use of the preparation.
• Specific requirements for labeling sterile preparations and IV admixtures

  • Name and amounts or concentrations of ingredients
  • Total volume of the compounded sterile preparation/IV admixture
  • Beyond use date
  • Appropriate route of administration
  • Storage conditions
  • Cautionary statements, initials of responsible pharmacists, disposal instructions
• Patient specific labeling

  • Patient name and identification number
  • Patient location/Room number
  • Name and amount of drugs added and the name of the admixture solution
  • Time and date of scheduled administration
  • Time and date of preparation
  • Administration instructions
  • Initials of the persons who prepared and check the IV admixture
• Drug incompatibility

  A phenomenon which occurs when one drug is mixed with others and produces unsuitable products by some physicochemical means that are no longer safe or effective for patient's use.
• Types of Incompatibilities

  • Physical incompatibilities
  • Chemical incompatibilities
  • Therapeutic incompatibilities
• Factors Affecting Compatibility

  • pH of admixture
  • Complexation
  • Light
  • Degree of dilution
  • Time
  • Parenteral Solution
  • Temperature
  • Buffer capacity of additive or solution
  • Order of mixing
• Physical Incompatibilities


  • Insolubility
  • Immiscibility
  • Precipitation
  • Liquefaction
  • Polymorphism
  • Loss of water
• Chemical Incompatibilities


  • Precipitation
  • Oxidation
  • Reduction
  • Hydrolysis
  • Photolysis
  • Racemization
  • Explosive combination
  • Gelatinization
  • Cementation
  • Polymerization
• Flowchart for IV Admixture Preparation

  Steps in the flowchart
• Macrodrip

  Delivers 1 cc of solution for every 10 drops of fluid that falls from the bag into the drip chamber. Used when a relatively large volume of fluid must be administered.
• Microdrip


  Delivers 1 cc in every 60 drops, and are used when smaller fluid volumes or precise dosages are required, such as in pediatrics and in delivering intravenous medications.
• Kinds of IV Administration Sets

  • IV bolus and IV push
  • Continuous IV or Drip infusion
  • Intermittent IV infusion
  • Heparin lock or heparin well system
  • Infusion Pump
• Infusion Pump

  A device that infuses fluids, medication or nutrients into a patient's circulatory system, generally used intravenously.
• Syringe Pump

  A device used to deliver a very small amount of medications, mechanically moving the piston of a syringe to send medication into IV tubing.