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⚠ Contaminated BAC water from Amazon seller — what worked for you?

greg_boulder Fri, Mar 22, 2024 at 1:39 AM 26 replies 2,290 viewsPage 1 of 6
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greg_boulder
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Mar 22, 2024 at 1:39 AM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

Concentration choice is a precision decision, not a preference. Reconstitute high and every dose is a tiny volume where one unit of syringe error is a large fraction of the dose. Reconstitute low and you get more graduations per dose, so the same hand tremor costs proportionally less. Against that, more diluent means more benzyl alcohol and a shorter comfortable in-use window.

Where I think it is weakest: the population was selected and supported in ways a real cohort is not, so I would read the effect size as a ceiling rather than an expectation.

The narrow version of the question is how much material I am losing to dead space, and whether that explains why a 10mg vial gives me nine usable draws rather than ten. If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
15 10denise_HTX, raj_cambridge, ingrid_STO and 12 others
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sarah.morrison
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Mar 22, 2024 at 3:12 AM#2
greg_boulder said:
Concentration choice is a precision decision, not a preference.

Agreeing with greg_boulder, and the qualification matters more than the agreement. Dead space is the answer to the missing dose. A fixed-needle insulin syringe holds a few microlitres in the hub and needle after the plunger bottoms out, and on small draws that is a measurable percentage of every dose. Across ten draws it adds up to most of an eleventh, which is exactly the "nine draws from a ten-dose vial" complaint. Luer-lock syringes are worse; low-dead-space fixed-needle designs are better.

Last edited: Mar 22, 2024 at 4:12 AM
14 9roxy_nash, tony_orlando, Dr.NephBHM_UK and 11 others
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Dr.AddMedPHL
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Mar 22, 2024 at 4:45 AM#3
greg_boulder said:
Concentration choice is a precision decision, not a preference.

I am going to disagree with reconstituting low as a general rule. More diluent, more punctures, more in-use days at room temperature, and the stability trade-off is real. Precision is not the only variable being optimised.

13 8mike.trainer_LA, sarah_nash92, FitDadDave and 10 others
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MASHdoc_SA
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Mar 22, 2024 at 6:18 AM#4

Answering the narrow version, because the broad one does not have a single answer. Do it in two steps and it stops being confusing. First concentration: 10mg into 2ml is 5mg/ml. Then volume: a 0.5mg dose is 0.5 ÷ 5 = 0.1ml. Then units, and this is where people go wrong — a U-100 syringe is graduated in hundredths of a millilitre, so 0.1ml is 10 units. The word "units" has nothing to do with milligrams; it is a volume marking that exists because insulin happens to come at 100 units per ml.

12 7LabKate, kate.chem, DataDave and 9 others
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SleepFixSam
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Mar 22, 2024 at 3:20 PM#5
sarah.morrison said:
Dead space is the answer to the missing dose.

Second this.

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