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ForumsCompounding & FormulationHas anyone dealt with dumb question - what is bacteriostatic water exactly? Page 2

Has anyone dealt with dumb question - what is bacteriostatic water exactly?

NauseaFreeNow Thu, Apr 4, 2024 at 10:28 PM 49 replies 2,765 viewsPage 2 of 10
VendorMark
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Apr 5, 2024 at 11:24 AM#6
Dr.RenalNash said:
Dead space is the answer to the missing dose.

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.

10 13DebRD_ATL, KristenIndy, MarkLI_maint and 7 others
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BiostatsBrad
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Apr 5, 2024 at 4:31 PM#7
NauseaFreeNow said:
Two of us with identical vials and identical diluent arrived at different unit counts, which means one of us has a conceptual error rather than a…

Compounding pharmacy dose accuracy check for dosing arithmetic: I always verify my first dose from a new vial by weighing it on a milligram scale. Draw up your dose, weigh the syringe, subtract empty syringe weight, compare to expected water weight at that volume.

For a 10-unit dose (0.1mL): expected weight ~100mg of water. If it's significantly off, your syringe may be inaccurate. Cheap insulin syringes can have ±5% volume accuracy. Spring for quality brands like BD or Terumo.

11 14Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 8 others
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NurseLeah_Nash
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Apr 5, 2024 at 9:38 PM#8
VendorMark said:
I am going to disagree with reconstituting low as a general rule.

Regarding dosing arithmetic multi-dose vial contamination prevention: after reconstituting, I wipe the vial stopper with a fresh alcohol swab before EVERY single draw. I also never touch the stopper with my fingers and use a new needle for each draw.

Even with bacteriostatic water preservative, contamination is cumulative. One sloppy draw can introduce bacteria that multiply over days. Aseptic technique isn't optional — it's essential for injectable medications.

Last edited: Apr 5, 2024 at 10:38 PM
12 15PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 9 others
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rachel_ABQ
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Apr 6, 2024 at 2:46 AM#9

A narrower follow-up, since the general answer is now clear:

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?

Last edited: Apr 6, 2024 at 7:46 AM
13 16SkepticalSean, Dr.CardioMD, EndoResFellow and 10 others
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NauseaFreeNow
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Apr 7, 2024 at 3:23 AM#10

Reporting back.

Follow-up: it was dead space. Switching to a low-dead-space fixed-needle syringe gave me the tenth dose back.

Last edited: Apr 7, 2024 at 7:23 AM
43 16cory_ATX, lori_vegas, Dr.PulmRoch and 40 others
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