Hi Guys
Just a thought, when you have opened a vial or ampoule and drawn up what you need to treat a fish what do you do with the left over?
Throw it away? if so how down the sink/toilet, onto the garden ?
Put it back in the box a put it on the shelf?
Draw it up into the syringe put the top over the needle and put it in the fridge?
Put the unused material either in the vial or a syringe in the freezer?
Another thought how many of you dilute Amikacin before you give it and what if anything do you dilute it with ?
I would be very interested in your answers and will try and draw some consensus out and get hold of other info to see if it is possible to make general recommendations.
Peter
What do you do with left over injections ?
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Re: What do you do with left over injections ?
When I had some baytril it was kept in a cupboard at room temp I was told it wont go off weather this is right or not I don't know 
Re: What do you do with left over injections ?
Well I have heard that Baytril should be kept in the fridge, but I dont know how long it lasts(shelf life) , maybe someone can enlighten me. Barry
Re: What do you do with left over injections ?
hi all
All my antibiotics are kept in a fridge in the garage (Cold shelf) along with my pituitary glands, if i have part of a loaded syringe left this is where this goes too till i deem it's needed to be junked, at which point they are incinerated usually with the contents of my sharps box
i dont freeze antibiotics i have never had occasion to do this
the only dilution i do is with gentamycin i used to use with this injectable water obtained from my vet nearly as expensive as the antibiotic 100ml costs 4 quid, i take 5ml of water from this vial and add 5ml of 10% gentamycin in its place this makes a working solution of 0.5% or 5mg per ml i inject this at 1ml per kg of fish
i have now sourced 5% gentamycin, this i just double the previous amounts 10 ml out 10 ml of gent back in and 1ml per kg as before
dunc
All my antibiotics are kept in a fridge in the garage (Cold shelf) along with my pituitary glands, if i have part of a loaded syringe left this is where this goes too till i deem it's needed to be junked, at which point they are incinerated usually with the contents of my sharps box
i dont freeze antibiotics i have never had occasion to do this
the only dilution i do is with gentamycin i used to use with this injectable water obtained from my vet nearly as expensive as the antibiotic 100ml costs 4 quid, i take 5ml of water from this vial and add 5ml of 10% gentamycin in its place this makes a working solution of 0.5% or 5mg per ml i inject this at 1ml per kg of fish
i have now sourced 5% gentamycin, this i just double the previous amounts 10 ml out 10 ml of gent back in and 1ml per kg as before
dunc
Re: What do you do with left over injections ?
Hi girls & guys;
As always Duncan has got it right but I have added a few does and dont's based on my experience.
The reason I opened this topic is I read on another forum that unused antibiotics should be frozen and there was other garbage as well which worried me on disposal etc. I am currently checking with the manufacturers to get their medical information departments to send me there stability data for the commonly used antibiotics.
The basic rules for antibiotics that come in liquid form are;
1) Store in a refrigerator at 4 – 8 degrees. The shelf life printed on the labels will for most antibiotics say “store at room temperature”. This is to allow for some flexibility in storage conditions (4 – 25 deg C normally) for pharmacists. If you store at 4 – 8 you will normally be able to extend the use by date for 12 months.
2) Never freeze liquid antibiotics most of them break down very rapidly when frozen. The exception being Chloramphenicol.
3) Storing unopened vials at room temperature is fine but don’t store them in a shed or enclosed space open to the sunlight. At temperatures over 25 in the presence of sunlight antibiotics degrade quickly. That’s why Baytril and Chloramphenicol are in dark glass bottles. The worse place is on the back window ledge of a car on a hot sunny day!
4) Always let antibiotics warm up to room temperature before administration. This applies especially to the oily ones.
5) Once you have stuck a needle through the cap of the antibiotic vial two things happen;
a) You introduce air into the vial which encourages degradation. The space above the liquid in the vials is normally a slight vacuum or more commonly nowadays nitrogen.
b) Unless you are very careful bugs will be introduced into the vial and the ones that will live and grow in the vial are, by definition, resistant to the antibiotic. Not ones you would want to inject into your favourite koi.
6) Although the volume we dispose of is small it is probably best practice if you cannot incinerate them to tip an old or partially used onto a patch in the garden rather than down the drain. Plastic syringes burn well. Never, please NEVER just put partially used ampoules or vials into the general household rubbish.
7) Once you have drawn the antibiotic up into the syringe it will start to degrade. Partly because of the exposure to air in that bubble and partly due to interaction with the lubricant (normally silicon) on the walls of the syringe and partly through interaction with the plastic that the syringe is made from. So even if kept in the fridge I would not recommend they be used after about a month.
Antibiotics that come as a dry plug in the bottom of the vial and have to have diluent added (mainly the betalactams (penicillin like) antibiotics have all the above conditions but are particularly problematic. The reason they are freeze dried and dispensed as a dry plug or cake is that they are intrinsically unstable when in solution. So as soon as you add the diluent they start to break down. I would not recommend that any of these be used later than 48 hours after reconstitution.
As Duncan said sterile water for injection to dilute antibiotics is almost as expensive as the antibiotics themselves and therefore the same vial is often used time and time again and therefore the risk of contamination is high. You can reduce the risk by wiping the top with alcohol before sticking the needle in each time. Always check you are using the right diluent. Most antibiotics can be safely diluted with either “water for injection” or “normal saline” (0.9% - that magic salt concentration again !)
Oral antibiotics that come as tablets or capsules are generally more stable but the storage conditions mentioned for the injectable ones still apply. If the antibiotics capsules come in foil that is because they are particularly sensitive to moisture so don’t pop them out of the foil until they are needed. Again out of date or spare antibiotics are best disposed of by incineration (wonderful things wood burning stoves).
Just a few thoughts hope they help.
Peter
As always Duncan has got it right but I have added a few does and dont's based on my experience.
The reason I opened this topic is I read on another forum that unused antibiotics should be frozen and there was other garbage as well which worried me on disposal etc. I am currently checking with the manufacturers to get their medical information departments to send me there stability data for the commonly used antibiotics.
The basic rules for antibiotics that come in liquid form are;
1) Store in a refrigerator at 4 – 8 degrees. The shelf life printed on the labels will for most antibiotics say “store at room temperature”. This is to allow for some flexibility in storage conditions (4 – 25 deg C normally) for pharmacists. If you store at 4 – 8 you will normally be able to extend the use by date for 12 months.
2) Never freeze liquid antibiotics most of them break down very rapidly when frozen. The exception being Chloramphenicol.
3) Storing unopened vials at room temperature is fine but don’t store them in a shed or enclosed space open to the sunlight. At temperatures over 25 in the presence of sunlight antibiotics degrade quickly. That’s why Baytril and Chloramphenicol are in dark glass bottles. The worse place is on the back window ledge of a car on a hot sunny day!
4) Always let antibiotics warm up to room temperature before administration. This applies especially to the oily ones.
5) Once you have stuck a needle through the cap of the antibiotic vial two things happen;
a) You introduce air into the vial which encourages degradation. The space above the liquid in the vials is normally a slight vacuum or more commonly nowadays nitrogen.
b) Unless you are very careful bugs will be introduced into the vial and the ones that will live and grow in the vial are, by definition, resistant to the antibiotic. Not ones you would want to inject into your favourite koi.
6) Although the volume we dispose of is small it is probably best practice if you cannot incinerate them to tip an old or partially used onto a patch in the garden rather than down the drain. Plastic syringes burn well. Never, please NEVER just put partially used ampoules or vials into the general household rubbish.
7) Once you have drawn the antibiotic up into the syringe it will start to degrade. Partly because of the exposure to air in that bubble and partly due to interaction with the lubricant (normally silicon) on the walls of the syringe and partly through interaction with the plastic that the syringe is made from. So even if kept in the fridge I would not recommend they be used after about a month.
Antibiotics that come as a dry plug in the bottom of the vial and have to have diluent added (mainly the betalactams (penicillin like) antibiotics have all the above conditions but are particularly problematic. The reason they are freeze dried and dispensed as a dry plug or cake is that they are intrinsically unstable when in solution. So as soon as you add the diluent they start to break down. I would not recommend that any of these be used later than 48 hours after reconstitution.
As Duncan said sterile water for injection to dilute antibiotics is almost as expensive as the antibiotics themselves and therefore the same vial is often used time and time again and therefore the risk of contamination is high. You can reduce the risk by wiping the top with alcohol before sticking the needle in each time. Always check you are using the right diluent. Most antibiotics can be safely diluted with either “water for injection” or “normal saline” (0.9% - that magic salt concentration again !)
Oral antibiotics that come as tablets or capsules are generally more stable but the storage conditions mentioned for the injectable ones still apply. If the antibiotics capsules come in foil that is because they are particularly sensitive to moisture so don’t pop them out of the foil until they are needed. Again out of date or spare antibiotics are best disposed of by incineration (wonderful things wood burning stoves).
Just a few thoughts hope they help.
Peter