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

reading concentration threads from 2024 and half of it aged badly

Explainer Receipts ×1 Well Actually ×2

reading concentration threads from 2024 and half of it aged badly — a position I have arrived at slowly and would like tested.

Aim the stream down the wall of the vial rather than into the cake. Reconstitution is a solubility problem, not a mixing problem, and mechanical shear does nothing helpful.

Reconstituted at 1mL when I meant to use a different volume. Caught it because the units looked wrong on the barrel. Now I write 30mg/mL on the glass before I put the cap back.

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

I will update this if the picture changes rather than quietly leaving it up.

3,644 up / 1,310 down74% upvoted39 commentsid 1kdmci26 Sep 2023

39 comments

25 in this archive, depth 5

best — the order this archive was captured in

u/spain_receta367 points·2 years ago

The failure modes I have actually seen posted here, in order of frequency.

One: reconstituting at a different volume than intended and not writing it down, so the next draw is based on a remembered concentration. Two: treating units as a dose rather than a volume, which breaks the moment the concentration changes. Three: assuming a syringe is U-100 when it is not.

All three are solved by the same two habits — do the arithmetic before the water goes in, and write the result on the glass. Neither costs anything and between them they cover almost every question this board gets.

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u/emeka_delgado181 points·2 years ago

If your calculation produces a fraction of a unit, the concentration is wrong for your dose. Change the water volume until the numbers land on whole units.

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[deleted]133 points·2 years ago

[deleted]

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u/nabila_espinoza58 points·2 years ago

the number you write down is the number you will trust at 6am

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u/honest_syringe_maybe0 points·2 years ago

the number you write down is the number you will trust at 6am

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

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u/bruno_dumitru111 points·2 years ago

bacteriostatic water has the preservative, sterile water does not

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u/georgi_adebayo0 points·2 years ago

What is written on the vial right now?

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u/andres_sorensen53 points·2 years ago

Yes. Writing 5mg/mL on the vial takes four seconds and removes the entire class of error this board exists to fix.

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u/katrin_marchetti12 points·2 years ago

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

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u/emil_zamora3 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/anjali_tamm2 points·2 years ago

more water is not more drug, it is the same drug in a bigger volume

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u/yusuf_nakamura68 points·2 years ago

Disagree with the "more water is safer" framing. It is not safer, it is just a different number to divide by.

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u/sigrid_kaufmannOP28 points·2 years ago

units are a volume on a U-100 syringe, not a dose

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u/india_generic_g42 points·2 years ago

Not quite. Bacteriostatic and sterile water are not interchangeable for a multi-draw vial, and the difference is the preservative.

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u/anjali_tamm99 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/sigrid_kaufmannOP-30 points·2 years ago

The lyophilised cake displaces a small volume, so the true concentration is very slightly lower than the arithmetic suggests.

anjali_tamm has the units point exactly right. They are a volume on the barrel and nothing else.

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u/swirl_dont_shakeMOD55 points·2 years ago

Reminder: this board does maths, not dosing. Nobody here tells another member what amount to take.

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u/yusuf_nakamura15 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/britta_nakamura32 points·2 years ago

The arithmetic in full: concentration is mass over volume, so 5mg into 2mL gives 2.5mg/mL. A U-100 syringe is graduated at 100 units per millilitre, so 1mg is 1 divided by 2.5 millilitres, which is 40 units.

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u/elin_ferrari15 points·2 years ago

Careful — that arithmetic is wrong. 20mg in 2mL is 10mg/mL, so 5mg draws to 50 units, not what you wrote.

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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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