4. What is IV infusion?
An IV infusion is a slow
drip of medication into
the vein over a set period
of time to deliver a
constant volume of
therapy
5. History of IV infusion
Intravenous technology started from
studies on cholera treatment in 1831
It was further developed in 1930s but
was not widely available until the 1950s
6. Intra Venous Infusion
Procedure & Equipment's
•Equipment's
•Containers
•Drip chamber
•Tubing
•Filters
•Spikes
•Needle
•Adhesive tape
•Constricting band
•Antiseptic and 2 x 2 gauze
7. IV Infusion Procedure
a. Select a suitable vein for venipuncture.
b. Prepare the venipuncture site.
(1) Apply a constricting band two inches above the venipuncture site. The
constricting band should be tight enough to occlude venous flow, but not so
tight that distal pulses are lost.
(2) Select and palpate a prominent vein.
(3) Cleanse the skin with an alcohol swab .Allow the site to dry.
c. Don gloves.
d. Perform the venipuncture.
(1) With the dominant hand, position the distal bevel of the needle up and insert the
cannula into the vein at approximately a 30 degree angle (figure 1-10).
8. (2) continue inserting the needle until blood is observed in the flash
chamber of the catheter.
(3) decrease the angle to 15 to 20 degrees and carefully advance the
cannula approximately 0.5 centimeter farther (figure 1-11).
9. (4) Place a finger over the vein at the catheter tip and put pressure
on the vein to prevent blood from flowing out the catheter
(5) Remove the needle while maintaining firm catheter control.
IV Infusion Procedure
10. IV Infusion Procedure
E. Remove the constricting band.
F. Obtain venous blood samples as required.
G. Attach the administration tubing to the cannula hub
while maintaining stabilization of the hub with the non-dominant
hand.
11. H. Open the flow-regulator clamp and observe for drips in the drip chamber. Allow
the fluid to run freely for several seconds.
I. Adjust to the desired flow rate.
J. Clean the area of blood, if necessary, and secure the hub of catheter with tape,
leaving the hub and tubing connection visible.
Make a small loop in the iv tubing and place a second piece of tape over the first to
secure the loop
12. IV Infusion Procedure
K. Apply a 2×2 or a transparent dressing tegaderm over the venipuncture site
L. Label a piece of tape with date and time the IV was initiated, the catheter size,
and your initials.
Secure the tape over the dressing.
M. Monitor the casualty and continues to observe the venipuncture site for signs
of infiltration.
N. Remove your gloves and disposes of them appropriately.
O. Document the procedure on the appropriate medical form.
13. Plasma drug concentration
for IV infusion following one
compartment model
The pharmacokinetics of a drug
given by constant IV infusion
follows zero order input
process in which the drug is
infused directly into the
systemic blood circulation .
CpDBVD
R K
14. For most drugs elimination of drug from the plasma is first
order process.
Therefore in the one compartment model infused drug
follows zero order input and first order.
15. Here,
𝒅𝑫𝑩
𝒅𝒕
= rate in – rate out DB = amount of drug in the body
𝒅𝑫𝑩
𝒅𝒕
= R- K.DB R= infusion rate
dDB = (R-K.DB) dt K= Elimination rate constant
DB =
𝑹
𝑲
(1 – e-kt)
Cp.VD =
𝑹
𝑲
(1- e-kt)
Cp =
𝑹
𝑽𝑫.𝑲
(1- e-kt) [DB = Cp.VD]
When, t = ∞ at he study state concentration the equation
will be Css =
𝑹
𝑲.𝑽𝑫
16. Calculation the
elimination rate
constant for a
drug given
through IV
infusion
In case of IV infusion , plasma drug concentration at
any time is :
Cp = R/K .VD (1 –e-kt )
At steady state ,t=α time ,
CSS = = R/K .VD
So , Cp = CSS (1 –e-kt )
→ Cp - CSS = CSS .e-kt
→ Cp - CSS / CSS = e-kt
→ -kt = ln (Cp - CSS / CSS )
→ -kt/ 2.303 = log (Cp - CSS / CSS )
→ K = -2.303/t . log (Cp - CSS / CSS )
17. Loading Dose
Loading dose is the minimum effective dose
which is given initially at a time to obtain the
steady state plasma drug concentration as early
as possible.
18. we use a
loading dose
to rapidly
achieve
therapeutic
concentration
of a drug
Css achieved immediately
Obtained desired
concentration
20. Time required
for achieving
99% of steady
state level in
terms of t1/2
An infinite long period of time is required to reach
steady state drug levels. In practice, it is quite
acceptable to reach 99% steady state level.
We know that,
Css =R/K.Vd
99% steady state level is:
99% r/ k.Vd
21. In case of IV infusion, plasma drug concentration at any time,
Cp = R/ K.VD (1-e-kt)
→ 99% r/ k.Vd = r/ k.VD (1-e-kt) [as css = cp]
→ 99% = (1-e-kt)
→ 1-(99/100) = e-kt
→ e-kt = 0.01
→ -kt = ln(0.01)
→ -Kt = -4.61
→ 0.693/ t1/2 × t = 4.61
→ T = (4.61/ 0.693) × t1/2
So, t99%ss = 6.65 t1/2
22. Cp=Css
IV infusion
Loading dose
IV bolus dose
Steady state
Plasma drug
concentration
24. tk
d
Ltk
p
elel
e
V
D
eCC
1
For loading dose:
For IV infusion:
)1(2
tk
eld
el
e
kV
R
C
DL plus IV infusion:
)1( tk
eld
tk
d
L
p
elel
e
kV
R
e
V
D
C
Loading dose plus IV infusion:
25. Loading dose plus IV infusion cont…
DL is used to reach ss rapidly:
)1( tk
eld
tk
d
L
p
elel
e
kV
R
e
V
D
C
tk
eldeld
tk
d
L
p
elel
e
kV
R
kV
R
e
V
D
C
tk
eld
tk
d
L
eld
p
elel
e
kV
R
e
V
D
kV
R
C
26. Loading dose plus IV infusion cont…
Let, DL = CssVd But, CssVd = R/kel
tk
eld
tk
d
L
eld
p
elel
e
kV
R
e
V
D
kV
R
C
Therefore, if a DL = R/kel is given SS will
eld
p
kV
R
C
eld
ss
kV
R
C and
28. Main reason for giving a drug by slow iv
infusion
In case of IV infusion ,When drug is administered rapidly , it tends
to increase the volume of the blood . As a result, hypervolemia may
occur, thereby slowly infused.
Slow IV infusion may be used to avoid side effects due to rapid drug
administration .eg: Intravenous immune globulin may cause a rapid
fall in blood pressure when infused rapidly.
29. Main reason for giving a drug by slow iv
infusion
Some antisense drug injected rapidly by IV to the body, it cause a
rapid fall in blood pressure.
The rate of infusion is particularly important in administering anti-
arrythmic agents in patients.
The rapid IV bolus injection of many drugs that follow the
pharmacokinetic of multi-compartmental models, may cause an adverse
response due to the initial high drug conc.eg: If heparin is injected or
infused at a faster rate, cardiac arrest may arise.