Mosby's 2014 Nursing Drug Reference (355 page)

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Only suspend in the diluent provided and with the supplied needle; do not substitute any components of the dose pack including the SmartSite Needle-Free Vial Access Device or Needle-Pro device

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Before admixing, remove the dose pack from the refrigerator and allow to come to room temperature for about 30 min before reconstituting

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Remove the plastic colored cap from the vial without removing the gray rubber stopper; wipe top of the gray stopper with an alcohol wipe and allow to dry

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Peel back the blister pouch and remove the Vial Access Device by holding between the white Luer cap and the skirt; do not touch the spike tip at any time

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Place the vial on a hard surface and hold the base; orient the Vial Access Device vertically over the vial so that the spike tip is at the center of the vial’s rubber stopper

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With a straight downward push, press the spike tip of the Vial Access Device through the center of the vial’s rubber stopper until the device securely snaps onto the vial top; improper placement of the Vial Access Device on the vial could result in leakage of the diluent upon transfer

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Hold the base of the vial and swab the syringe connection point (blue circle) of the Vial Access Device with an alcohol wipe and allow to dry before attaching the syringe

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During syringe assembly steps, avoid over-tightening or syringe component parts might loosen from the syringe body

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To open the syringe, hold syringe only by the white collar and snap off the smooth white cap; do not twist or cut off the white cap; remove white cap together with the rubber tip cap inside

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While holding the white collar of the syringe, insert and press the syringe tip into the blue circle of the Vial Access Device and twist in a clockwise motion to secure the connection of the syringe to the Vial Access Device; hold the skirt of the Vial Access Device during attachment to prevent it from spinning; keep the syringe and the Vial Access Device aligned

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Inject the entire contents of the syringe containing the diluent into the vial

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Holding the plunger down with the thumb, shake the vial vigorously for a minimum of 10 sec; suspension should appear uniform, thick, and milky colored, and all the powder is dispersed in liquid; the microspheres will be visible in liquid, but no dry microspheres remain

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Invert completely and slowly withdraw the contents of the suspension from the vial into the syringe; tear the section of the vial label at the perforation and apply the detached label to the syringe

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While holding the white collar of the syringe, unscrew the syringe from the Vial Access Device, then discard both the vial and the Vial Access Device appropriately

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Select the appropriate color-coded needle provided with the kit; two distinct needles are provided: The needle with the yellow hub and print is for injection into the gluteal muscle (2-inch needle) and the needle with the green hub and print is for deltoid muscles (1-inch needle); they are not interchangeable; do not use the needle intended for gluteal injection for deltoid injection, and vice versa

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Peel the blister pouch of the Needle-Pro safety device open halfway; grasp the transparent needle sheath using the plastic peel pouch; to prevent contamination, do not touch the orange Needle-Pro safety device’s Luer connector; while holding the white collar of the syringe, attach the Luer connection of the orange Needle-Pro safety device to the syringe with an easy clockwise twisting motion

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While holding the white collar of the syringe, grasp the transparent needle sheath and seat the needle firmly on the orange Needle-Pro safety device with a push and a clockwise twist; seating the needle will secure the connection between the needle and the orange Needle-Pro safety device

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While holding the white collar of the syringe, pull the transparent needle sheath straight away from the needle; do not twist the sheath because this can loosen the luer connection

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Resuspension is necessary before administration, because settling occurs after reconstitution; resuspend the microspheres in the syringe by shaking vigorously

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Refer to the Instructions for Use section of the product labeling for detailed visual aids that accompany the written instructions

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Only for IM; do not give IV

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Resuspension is necessary before administration, because settling occurs after reconstitution; resuspend the microspheres in the syringe by shaking vigorously

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Remove any air bubbles by tapping the syringe and slowly depressing the plunger with the needle in an upright position

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Inject the entire contents of the syringe into the upper outer quadrant of the gluteal area or the deltoid muscle; inject immediately after reconstitution to avoid settling; gluteal injections should be alternated between the two buttocks

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After the injection is complete, press the needle into the orange Needle-Pro safety device by gently pressing the orange Needle-Pro safety device against a flat surface with one hand; as the orange Needle-Pro safety device is pressed, the needle firmly engages into the orange Needle-Pro safety device

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Visually confirm full engagement of the needle into the Needle-Pro safety device, then appropriately discard both the used and unused needle provided in the dose pack

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Do not store the vial after reconstitution or the suspension will settle

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Do not combine 2 different dosage strengths of RisperDAL Consta in a single administration

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The dose pack device is for single use only; do not reprocess for subsequent reuse because the integrity of the device may be compromised, leading to a deterioration in performance

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Once in suspension, the product may remain at room temperature, but it must be used within 6 hr; always resuspend before administration if not used immediately

 
Increase:
serotonin syndrome, neuroleptic malignant syndrome—CYP2D6 inhibitors (SSRIs, SNRIs)