لو عايزه ادي الميرونام extend infusion ع مدار ٣ ساعات
بحله ازاي كده يعني الفينال كونستريشن يبقي كام ويتحل في ايه
Meropenem, for extended infusion, must be diluted with 0.9% NS to a concentration between 1 to 20 mg/ml.
Some data support stability for extended and continuous infusion when admixed with NS at a concentration of 14.3 mg/mL at room temperature for ≤7 hours (Fawaz 2019) and at a concentration of 20 mg/mL under refrigeration for ≤24 hours (Patel 1997).
Pharmacokinetic data support the use of an admixture of 10 mg/mL in NS is stable at room temperature for an infusion duration ≤12 hours (Venugopalan 2018).
For a patient wt=1.7kg and dose of 40mg/kg
Reconstituted solution 500mg/10ml
The patient will receive 40×1.7x(10/500)=1.4ml
That will be further diluted to a concentration between 1 to 20 mg/ml
The idea here is that concentrations above 20mg/ml is not stable for the 3 hrs required for administration.
So, let’s say dilute to final volume 15 ml, this will give a final concentration of about 4.5mg/ml which is within the range required.
تمام يا دكتور وهيبقي كده استابل ل ٣ ساعات الانفيوشن صح كده
والحل الاول هيبقي ب swfi
والتاني بسلاين
طيب هو انا امتي ادي الميرونام بالطريقة ديه وامتي بولس أو انفيوشن ع مدار نصف ساعة
Remember that the meropenem reconstituted solution’s stability is very limited to max 1 hour according to most references, so I recommend to directly further dilute to the concentration of 20mg/ml with NS. That will keep the stock solution stable for 24 hrs in refrigeration so the remaining portion van be used in the next doses safely.
Extended infusion over 3 hrs of meropenem is considered to be more effective against severe infections, according to some studies.
Although bolus is safe in some situations, I think it will be better if you don’t use bolus especially in infants to avoid administration related side effects.
يعني لو بيبي وزنه ١.٧ كيلو وبدي ب meningitis dose اللي هي ٤٠
هحل الفيال في ١٠ وبعدين اسحب الدوز اللي هتكون تقريبا ١.٧ وبعدين اخففها ب ٥ او ٧ سم ملح علشان اوصل لتركيز ١٥ او ١٠تقريبا انفيوشن ع مدار ٣ ساعات
مش كده قليل خالص
وفي نفس الوقت انا عايزه ليه stability