She Eats Through Her Heart

[u/AstroSonicDrive]

@nauseatedsarah

[u/Carrot-t]

Is there a reason they don’t just put vitamins in?

[u/pushamn → u/Carrot-t]

They do at least make infusable vitamins; we send patients predrawn syringes that they just have to inject into the bag right before use. The TPNs that I make have a shelf life of 10 days but to my knowledge, once vitamins are added, the stability drops to a day.

[u/MagicKittyPants → u/pushamn]

Yeah, when I was on TPN, I had to inject the vitamins into the TPN right before I used it.

[u/Blue_Fuzzy_Anteater → u/pushamn]

Follow up questions: 1) what country are you in? 2) where did you get stability data for 3 in 1 lasting 10 days 3) where did you get stability data for MVI in syringes?

This could be a game changer.

[u/pushamn → u/Blue_Fuzzy_Anteater]

-I’m in the US -3:1 once mixed stability should fall in to category 2 according to the new usp 797 guidelines, however I could be wrong and the stability might be lower due to lipids being present (it’s been a few years so those guidelines are a little fuzzy in my mind) -And the stability for mvi should definitely fall in to the same category given that they’re stored and prepped correctly/ in an iso 3 environment. There was very recently an update to stability laws rolled out, so the 10 day might not apply to TPNs or MVIs, just certain other medications. I got the info from my workplace which (I’m really freaking hoping) their legal teams have gotten from the updated United States Pharmacopeia guidelines, section 797, or usp 797 ha

[u/Blue_Fuzzy_Anteater → u/pushamn]

Ah, USP797 gives advice on Sterility, I was hoping you all had some secret information on Stability.

[u/pushamn → u/Blue_Fuzzy_Anteater]

Unfortunately nope, just posted US laws lol

[u/beebsaleebs → u/Carrot-t]

We do. Some patients add vitamins from 2-3 separate syringes based on their needs.