PART B1:

1. Describe how did you set up the Y-site assembly to collect a sample containing amoxicillin, parenteral nutrition (PN) and lipid that could be used to investigate the chemical and physical incompatibility of amoxicillin, PN and lipid. In addition, using a suitable clinical example discuss - why administration of total parenteral nutrition (TPN - PN +lipid) and anidulafungin would be required to a patient using a Y-site assembly.

Approximately 250 to 300 words

2. A. In week 2, you were provided with the samples containing amoxicillin, PN and lipid. The concentrations of amoxicillin, PN and lipid were calculated based on the doses of amoxicillin (infused over a period of 30 minutes) and TPN (infused over a period of 24 hours) used in 0.5kg (Sample A) and 5kg (Sample B) patients. The samples were then subjected to centrifugation. Report the results obtained after centrifugation. If the results obtained from the two samples (prepared based on 0.5 and 5kg body weights) were different from each other then discuss the potential reasons for this difference.
Approximately 150 to 200 words

B. In week 2, lipid free sample containing amoxicillin, PN and water was prepared. The concentrations of amoxicillin and PN were calculated based on the doses of amoxicillin and TPN used in 5 kg (Sample C) patients. The sample was then subjected for visual and microscopy analyses. Report and DISCUSS the results obtained after these analyses. Your discussion should also include whether the results obtained after visual and microscopy analyses (Sample C) were different from the results obtained after centrifuging the lipid-containing sample (B).
Approximately 150 to 200 words

C. In week 3, you prepared a lipid free sample (either sample D, E or F) containing flucloxacillin, PN and water. The concentrations of flucloxacillin and PN in the sample were calculated based on the doses of flucloxacillin and TPN used in either 0.5kg (Sample D), 3kg (Sample E) or 5kg (Sample F) patients. Report and discuss the results obtained after these analyses. In your discussion, you are required to discuss - why the results obtained from the analyses of three samples (D, E and F) were similar and/or different from each other.
Approximately 150 to 200 words

D. In week 4, a lipid free sample containing amoxicillin, PN and water was prepared. The concentrations of amoxicillin and PN were calculated based on the doses of amoxicillin (infused over a period of 24 hours) and TPN (infused over a period of 24 hours) used in 0.5 kg (Sample E) patients. Microscopic and visual analyses of the sample did not show the signs of precipitation or particles.

Answer the following questions:
1. Briefly describe the methodology you used to prepare the lipid free sample.
2. In clinical practice, would it be appropriate to infuse amoxicillin over a period 24 hours (also referred to as continuous infusion)?
3. Which one of the two types of amoxicillin infusion (1- continuous and 2 - intermittent infusion; e.g. three times a day) has a better clinical efficacy? Support your answer using a suitable example.
Approximately 150 to 250 words

3. Why is it important to evaluate the pH of an admixture (antibiotic-PN-lipid) collected at y-site? Support your answer with at least two suitable examples.
Approximately 200 to 300 words

4. Briefly describe the important limitation of UV spectrophotometer in determining the number of particles present in an admixture (3ml - containing amoxicillin, PN and lipid) collected at Y-site.