LARGE VOLUME PARENTERAL (LVP) &

SMALL VOLUME PARENTERAL (SVP)

Apt. Teguh Imanto, M. Farm.

Universitas Muhammadiyah Surakarta
Content
Classification Of Parenterals

Small Volume Parenterals

Large Volume Parenterals

Types of LVP

Examples Of IV fluids

Difference Between SVP & LVP

Classification Of Parenterals
Based on State of
Based on Volume: Product according to
USP (SVP)

Small Volume Solution Or Emulsion of

Parenterals(SVP), medicament,

Dry Solids or Liquid

Large Volume
Concentrate without
Parenterals(LVP).
additives,

Dry Solids or Liquid

Concentrate with additives,

Suspension of solids not for

IV or Intra Spinal use,

Dry solids on reconstitution

become suspension
Small Volume Parenterals
USP : An Injection that is packed in containers labeled as
containing 100 mL or less
Components of SVP
Vehicle/ Solvent

No. Type Example

1. Aqueous Purified Water,WFI,Sterile WFI,etc
2. Water Miscible PEG, Glycerin, etc
3. Non-Aqueous Vegetable Oils
4. Synthetic Ethyl oleate, Isopropyl Myristate
Component Example Usual Conc.
Antimicrobial Benzalkonium Cl, 0.01%
Preservative Benzyl Alcohol, etc. 1-2%
Antioxidants Water soluble : Sulfurous & Ascorbic a. 0.1-0.2%
Thiol derivative 0.1%
Water Insoluble: Propyl Gallate 0.1%
BHT & BHA 0.1%
Buffers Acetate Buffer & Citrate Buffer pH 3-6
Phosphate Buffer pH 6-8
Glutamate Buffer pH 8-10
Tonicity Electrolyte : NaCl 0.5-0.9%
Adjusting Non-Electrolyte : Dextrose 4-5 %
Surfactant Poly-oxy ethylene : Tween & Pluoronic 0.1-0.5%
Sorbitan mono oleate : Spans 0.05-0.25%
Chelating A. Di Sod. EDTA 0.01-0.05%
Bulking Lactose 1-8%
agents Mannitol & Sorbitol 1-10%
Large Volume Parenterals
• LVP are Parenterals designed to provide
• Fluid(water)
• Calories(Dextrose)
• Electrolytes(Saline)
• Combination of these.
• Volume 101-1000mL
• IV infusion technique is “Venoclysis”.
Requirements for LVP

o Sterile
o Non Pyrogenic
o Free from Particulate matter
o Volume 101-1000mL
o Single dose unit
o No Preservative
o No dapar
o Clear solution except Fat Emulsion
o Isotonic but Hypertonic also administered in TPN.
Types of LVP

Hyperalimentation Solution

Types of LVP
Cardioplagic Solution

Peritoneal Dialysis Solution

Irrigating Solution
Hyperalimentation Solution
• Campuran Nutrisi dalam jumlah besar untuk pasien yang tidak
dapat makan secara oral, dengan asupan kalori 4000 kCal /
hari.
• Kanulasi vena subklavia: Infus larutan hipertonik.
• Formulasi: Dekstrosa, Asam Amino, Lipid, Elektrolit, & Vitamin.
• Penggunaan: Obat penyelamat / penopang hidup untuk pasien
koma/ tidak sadarkan diri, pasien yang sedang menjalani terapi
penyakit GI
Total Parenterals Nutrition
• Istilah modifikasi untuk Hiperalimentasi
• Sediaan IV yang terdiri dari Kalori, Nitrogen, & nutrisi lain
dalam jumlah yang cukup untuk mencapai sintesis &
anabolisme jaringan
Content Sources
1.Calories Dextrose,
2.Nitorgen Crystalline amino Acids
3.Electolyte Na, K, Mg, Cl, Po4
4.Vitamin Water soluble & Fat soluble
5.Elements Traces of Zn, Cu, Mn, Cr
Indication For Use of TPN

▪ GI disease,
▪ Major trauma, Septicemia,
▪ Major Abdominal Surgery,
▪ Malignancy of Small Bowel,
▪ Radiation Enteritis,
▪ Chemotherapy & Radiotherapy,
▪ Bone Marrow Transplantation,
▪ Prolonged Coma.
Cardioplagic Solutions
• LVP digunakan dalam operasi jantung untuk mencegah cedera
pada miokardium selama reperfusi, serta untuk mempertahankan
area bedah operasi tanpa adanya darah.
• Mempertahankan Diastolic arrest, menghindari disfungsi diastolic
• Pemberian dalam suasana dingin.
• Sedikit basa untuk mengkompensasi asidosis metabolik,
• Hipertonik
• Penggunaan: Untuk meminimalkan cedera reperfusi akibat edema
jaringan
Peritoneal Dialysis Solution

• Secara intraperitoneal
• Formulasi: Glukosa, Antibiotik sebagai Profilaksis
• Kegunaan :
✓Penghapusan zat beracun dari tubuh.
✓Untuk membantu & mempercepat ekskresi normal.
✓Untuk mengobati insufisiensi ginjal akut
Irrigating solutions
• Untuk membilas & membantu membersihkan luka pada tubuh.
• Larutan IV (Normal Saline) dapat digunakan sebagai larutan
irigasi, tetapi larutan yang dirancang sebagai Larutan irigasi
tidak boleh digunakan secara parenteral
Examples Of LVP
No LVP Common Name Conc. % Therapeutic Use

1. Dextrose Inj Glucose 5,10, Fluid & Caloric

20,50, Supplement
2. NaCl Inj. Normal Saline 0.9, 3.5 Fluid & Electrolyte
Soln Supplement
3. Ringers Soln Ringers Soln Nacl 0.86 Fluid & Electrolyte
KCl 0.03 Supplement
CaCl2 0.033
4. Lactate Hartmann’s Nacl-0.6, KCl-0.03 Systemic Alkaliser,
Ringer Inj. CaCl2 - 0.02 Fluid & Electrolyte
Na.Lactate -0.3 Replishner
5. Mannitol Inj. _ 5, 10, 15, 20. Osmotic Diuresis
6. IV fat _ 10, 15, 20 Caloric
emulsion
SVP & LVP
PARAMETER SVP LVP
Volume 100 mL or Less 101-1000mL
Routs IV, IM, & SC IV-LVP & Non-IV-LVP
Dosage Unit Single or Single
Multiple( USP=max. size 30mL)
Technique Vein Puncture Venoclysis
Needle 1½″, 20-22 Gauge 1½″, 18-19 Gauge
Preservative Used Not Used
Buffers Used Not Used
Formulations Soln, Emulsion, Suspension. Soln, &
o/w Nutrient Emulsion
Isotonicity Not Essential Must
Pyrogenicity Not Essential Must
Formula LVP
Formula SVP