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N. A. Martin, D. B. Roth; Reliable and Reproducible Dosing of Extemporaneously Prepared Triamcinolone Acetonide. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5792.
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To evaluate dose reproducibility after various manipulations of KENALOG®-40.
Five methods of 4mg TA preparation were assessed. Factors examined include drug powder washing, drug powder quantitation before reconstitution, volume of BSS reconstitution, and syringe inversion.
There was no difference between the techniques of TA preparation from a known quantity of washed or unwashed drug when a small volume of TA suspended in BSS was aspirated from the vial (p=0.963). A statistically significant difference was noted between the TA dose administered from the first vs. last 0.1mL aliquot dispensed in three trials (p=0.0064, p<0.0001, p=0.0018). Syringe inversion significantly influenced the dose administered from the last 0.1mL aliquot dispensed (p=0.0005).
Extemporaneous preparation of intravitreal TA is reproducible using certain techniques. Aspirating a smaller volume into the syringe and inverting the syringe prior to intravitreal administration optimize dosing accuracy and precision. These data provide additional guidance to clinicians regarding the suitability of these techniques for the extemporaneous preparation of intravitreal TA.
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