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c/reconstitution·posted 2 years ago by u/emeka_delgado

[Question] how do you actually verify insulin syringe

Question Well Actually ×3 Slow Clap ×1 Cold Box ×2

Asking properly rather than in a comment on somebody else’s thread: how do you actually verify insulin syringe.

Shook the first vial because nobody told me not to. It was fine, but I have swirled every one since.

Wrote the date on the vial as well as the concentration after losing track of which one was opened first.

Started reconstituting everything to a round concentration and the six-in-the-morning error rate went to zero.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

22,305 up / 17,107 down57% upvoted65 commentsid 1j9nxq27 Nov 2023

65 comments

25 in this archive, depth 5

best — the order this archive was captured in

u/elodie_grimaldi791 points·2 years ago

Bacteriostatic water contains benzyl alcohol as a preservative, which is what makes repeated entry into the same vial reasonable. Plain sterile water has no preservative.

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u/britta_nakamura532 points·2 years ago

Agreed on the swirl. There is no reason to shake it and a good reason not to.

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[removed]398 points·2 years ago

[removed by moderator]

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u/sofia_danquah346 points·2 years ago

Correction: that gives 15 units, not what you have written. 10mg into 3mL is 3.33mg/mL and the division follows from there.

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u/elodie_grimaldi95 points·2 years ago

Correction: that gives 15 units, not what you have written.

Adding one thing — put the date on the label too. Concentration plus date and you can never mix two vials up.

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u/rina_bergstrom440 points·2 years ago

The dead space question sent me down a rabbit hole for a week. It is a fraction of a unit and it is the same every draw.

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u/lurker_for_years149 points·2 years ago·edited

That only works if the fill weight is exactly the label weight, and it usually is not exactly anything.

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u/emeka_delgadoOP56 points·2 years ago

That is sterile water, not bacteriostatic. Same appearance, different product, and it matters for a multi-draw vial.

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u/oskar_ibarra28 points·2 years ago

Small fix — a U-100 syringe is 100 units per mL. If yours is marked differently it is not U-100 and the whole calculation changes.

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u/clara_weiss260 points·2 years ago

Careful — that arithmetic is wrong. 5mg in 3mL is 1.67mg/mL, so 0.25mg draws to 15 units, not what you wrote.

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u/aleksi_lehtinen-24 points·2 years ago

Asked CPC what volume they reconstitute to for their own stability testing and they answered in one line. Useful thing to know.

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u/reflux_report175 points·2 years ago

The lyophilised cake displaces a small volume, so the true concentration is very slightly lower than the arithmetic suggests. It is a fraction of a percent and it is dwarfed by fill tolerance.

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u/iman_falk66 points·2 years ago

The arithmetic in full: concentration is mass over volume, so 20mg into 2mL gives 10mg/mL. A U-100 syringe is graduated at 100 units per millilitre, so 2.5mg is 2.5 divided by 10 millilitres, which is 25 units.

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u/andres_sorensen15 points·2 years ago

Spent 24 weeks confused about this until somebody drew the table for me. 10mg, 2mL, 5mg/mL, 0.75mg is 15 units. That is the whole thing.

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u/wanjiru_varga4 points·2 years ago

Reconstituted at 3mL when I meant to use a different volume. Caught it because the units looked wrong on the barrel. Now I write 10mg/mL on the glass before I put the cap back.

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u/cardio_endpoint_c0 points·2 years ago

This. Showing the working is the fastest way for somebody else to spot the mistake.

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u/emeka_delgadoOP29 points·2 years ago

I keep a laminated card in the drawer with the arithmetic on it. Looks ridiculous. Has never once let me draw the wrong volume.

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u/runa_cabrera15 points·2 years ago·edited

I keep a laminated card in the drawer with the arithmetic on it.

Disagreeing with this line only: adding more water is not a safety margin, it is a different divisor.

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u/tuva_kirchner7 points·2 years ago

Yes, and the dead-space point is worth repeating: it is small, it is real, and it is the same for every draw.

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u/karl_fischer_kev216 points·2 years ago

Is that a U-100 syringe? The barrel markings change the answer completely.

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u/cesar_ivaturi56 points·2 years ago

Adding more water does not change how much peptide is in the vial. It changes the concentration, which changes the volume you draw for the same amount. That is the entire relationship.

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u/sock_puppet_spotter119 points·2 years ago

Are you accounting for the powder volume, or is that where the confusion is?

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u/niels_roos42 points·2 years ago

I would not round that figure. At 5mg/mL a rounding error of two units is a real fraction of the intended amount.

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u/santiago_ndiaye30 points·2 years ago

the powder cake sits at the bottom, the volume you add is the volume that counts

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u/kenji_kimani83 points·2 years ago·edited

if the maths gives you a fraction of a unit, change the concentration

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About c/reconstitution

The arithmetic and the technique. Bacteriostatic versus sterile water, reconstitution volume as a concentration choice, converting mg/mL into insulin-syringe units, dead space, swirl-not-shake, stopper coring, and how long a reconstituted vial is actually good for. Math errors get corrected fast and politely.

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