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What is the arithmetic to convert 20 mg in 1.5 mL into units on a U-100 scale?

Asked 15 Aug 2024Modified 20 months agoViewed 37k times
18

Stated plainly: 20 mg · 1.5 mL.

The units are where I keep going wrong, so please be explicit about them.

I have sanity-checked the order of magnitude and it seems right, which is not the same as being right.

Is my approach right even if my number is wrong?

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askedcoldbox913k2815 Aug 2024

5 Answers

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Rounding to the nearest whole syringe unit is usually the right error to make, but understanding which direction it is and why matters.

Breaking it down further: if a 10 mg vial has 96.5 per cent content, you have 9.65 mg of peptide. Divide that by 2.00 mL and your concentration is 4.825 mg/mL, not 5.00 mg/mL, which is a 3.5 per cent systematic error in every dose calculation.

Specifically, on filtration: a 0.22 µm syringe filter will remove particulates and organisms, and it will also adsorb a fraction of your peptide onto the membrane — with a low-binding PVDF or PES membrane the loss is typically a few per cent.

One qualification: if your arithmetic and someone else's disagree by a factor of ten, one of you has made a unit error, and writing out the units at every step is the diagnostic.

If in doubt, use more diluent and accept the shorter usable window.

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answeredorla_ferriter47k387 Sept 2024
4I have seen exactly this failure mode twice and both times it was the diluent. – petra_hovland 2 months ago
5The distinction between purity and content cannot be repeated often enough here. – RP_C18 4 months ago
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28

The answer depends on exactly which dose and which vial you are asking about, but the method is always the same.

Dead space quantified: a fixed-needle insulin syringe holds roughly 3 to 5 µL in the hub and needle after the plunger bottoms out. A luer-lock syringe with a detachable needle holds 35 to 100 µL depending on the hub design. At 5 mg/mL that is 15 to 25 µg lost per draw on the insulin syringe and 175 to 500 µg on the luer-lock — which over ten draws is the difference between losing a rounding error and losing half a milligram.

In practice, do not use the same needle to pierce the stopper and to administer. The tip is blunted by the stopper, and the hub now contains a dose you are about to lose to dead space anyway.

The Arrhenius relationship for drawing kinetics means that cold solution takes noticeably longer to draw than room-temperature solution.

Write the arithmetic on the vial label. It costs nothing and removes the step where you reconstruct it from memory.

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answeredpetra_hovland42k3818 Sept 2024
4The distinction between purity and content cannot be repeated often enough here. – nils_karlberg 4 months ago
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18

Write the units at every step, because units errors are the failure mode that catches everyone eventually.

Room temperature before drawing is worth the ten minutes. Cold solution is more viscous, draws slower, and condensation on a cold barrel makes it harder to read the meniscus.

Worked example, because the general form is easier to trust once you have seen it once. Take a 10 mg vial and add 2 mL of diluent: the concentration is 10 ÷ 2 = 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL. On a U-100 syringe, where 1 unit = 0.01 mL, that is 0.1 ÷ 0.01 = 10 units. Change the diluent to 1 mL and the same dose becomes 5 units — same dose, half the resolution.

Do the arithmetic twice, ideally with someone else doing it independently.

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answeredDr_Lena_Ostrowska42k3811 Oct 2024
17

The underlying point is that this is one of those calculations where checking your work takes two minutes and prevents a very consequential error.

The rounding error accumulates if you round too many times — rounding concentration to 5.0, rounding the dose volume to 0.1 mL, rounding the unit reading to 10 — and the safest approach is to work the full precision and round only the final answer.

The limitation is that technique reduces risk, it does not remove it, and nothing you can do outside a controlled environment makes a non-sterile preparation sterile.

If in doubt, use more diluent and accept the shorter usable window.

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answeredcoldpack_8837k3822 Nov 2024
3Confirming from the other direction: I did the wrong thing and got exactly the predicted outcome. – Dr_Aoife_Brennan 9 months ago
2Is there a reason to prefer the second method over the first, other than cost? – jo_vandeberg 8 months ago
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-1

More usefully, the single most useful thing to do is write the arithmetic on the vial label, because you will reconstruct it from memory at an inconvenient moment if you do not.

The concentration you actually work with is label claim times content fraction divided by actual diluent volume, which is usually not the same as the nominal concentration because content is usually not 100 per cent and you rarely measure the diluent volume to 0.1 mL precision.

Write the arithmetic on the vial label. It costs nothing and removes the step where you reconstruct it from memory.

edited 24 Oct 2024 by kwn_analytical — added a caveat about sampling

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answeredkwn_analytical89k24829 Sept 2024

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