We've come a long way
When Outpatient Surgery
asked me to help you buy pre-
filled syringes with confi-
dence, I was more than happy
to share my expertise. I was
also struck by what was
acceptable a few decades ago
that today would get you run
out of the profession.
For example, in the 1970s
and 80s at the military hospi-
tal, we'd draw up specific
doses in Tubex syringes under
laminar flow hoods. Tubex are
no longer available and com-
pounding under a laminar flow
hood is no longer acceptable.
We'd also fill plastic disposable syringes with keflin 1g and then freeze
them until they were needed for a bolus before surgery. When we got
the call, we'd send a frozen syringe up to the nurses station. A nurse
would microwave the syringe to thaw the antibiotic. We didn't know
what we didn't know about a drug's stability profile — that freezing a
drug could change its molecular structure and turn a solution into a sus-
pension or a slurry. We didn't know that defrosting a syringe of keflin in
the microwave would accelerate the release of unintended compounds
from the plastic. And we thought it was OK to use disposable syringes as
storage devices. If only I knew then what I know now.
OSM
7 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 8
• 503B? Was that prefilled syringe compounded at an FDA-registered
outsourcing facility?
Mr. Smalley (csmalley@valsource.com) is a pharmaceutical and compounding
pharmacy consultant with ValSource in suburban Philadelphia.
