299:
1211:
421:, also known as balloon pumps or ball pumps, rely on the gradual contraction of an internal elastomeric reservoir to deliver medication at a pre-determined flow rate over several hours or days. These pumps do not require electricity and offer simplicity and portability, making them suitable for administering various medications, including antibiotics, in situations where continuous, low-rate infusion is required. These features make them useful for infusions in outpatient settings, such as
845:
287:
1318:
1558:
439:
839:
32:
129:
1380:
1084:
477:. That is, no single cause of failure should cause the pump to silently fail to operate correctly. It should at least stop pumping and make at least an audible error indication. This is a minimum requirement on all human-rated infusion pumps of whatever age. It is not required for veterinary infusion pumps.
523:(FDA) has launched a comprehensive initiative to improve their safety, called the Infusion Pump Improvement Initiative. The initiative proposed stricter regulation of infusion pumps. It cited software defects, user interface issues, and mechanical or electrical failures as the main causes of adverse events.
489:
An "air-in-line" detector. A typical detector will use an ultrasonic transmitter and receiver to detect when air is being pumped. Some pumps actually measure the volume, and may even have configurable volumes, from 0.1 to 2 ml of air. None of these amounts can cause harm, but sometimes the air can
358:
cuff around a bag of fluid. The battlefield equivalent is to place the bag under the patient. The pressure on the bag sets the infusion pressure. The pressure can actually be read-out at the cuff's indicator. The problem is that the flow varies dramatically with the cuff's pressure (or patient's
379:
An air filter is an essential safety device in a pressure infusor, to keep air out of the patients' veins. Small bubbles could cause harm in arteries, but in the veins they pass through the heart and leave in the patients' lungs. The air filter is just a membrane that passes gas but not fluid or
371:
plastic, and can be produced by the same machines that make plastic soft-drink bottles and caps. A pressure bottle, restrictor and chamber requires more nursing attention than electronically controlled pumps. In the areas where these are used, nurses are often volunteers, or very inexpensive.
177:
Infusion pumps can administer fluids in ways that would be impractically expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too small for a drip), injections every minute, injections with repeated
502:
Many pumps include an internal electronic log of the last several thousand therapy events. These are usually tagged with the time and date from the pump's clock. Usually, erasing the log is a feature protected by a security code, specifically to detect staff abuse of the pump or
242:
To get the entire dose of antibiotics into the patient, the "volume to be infused" or VTBI must be programmed for at least 30 CCs more than is in the medication bag; failure to do so can potentially result in up to half of the antibiotic being left in the IV tubing.
395:
Spring-powered clockwork infusion pumps have been developed, and are sometimes still used in veterinary work and for ambulatory small-volume pumps. They generally have one spring to power the infusion, and another for the alarm bell when the infusion completes.
391:
power. Basically, a bag of salt solution absorbs water through a membrane, swelling its volume. The bag presses medicine out. The rate is precisely controlled by the salt concentrations and pump volume. Osmotic pumps are usually recharged with a syringe.
399:
Battlefields often have a need to perfuse large amounts of fluid quickly, with dramatically changing blood pressures and patient condition. Specialized infusion pumps have been designed for this purpose, although they have not been deployed.
518:
Infusion pumps have been a source of multiple patient safety concerns, and problems with such pumps have been linked to more than 56,000 adverse event reports from 2005 to 2009, including at least 500 deaths. As a result, the U.S.
567:
Diamantis S, Dawudi Y, Cassard B, Longuet P, Lesprit P, Gauzit R (February 2021). "Home intravenous antibiotherapy and the proper use of elastomeric pumps: Systematic review of the literature and proposals for improved use".
362:
Places that must provide the least-expensive care often use pressurized infusion systems. One common system has a purpose-designed plastic "pressure bottle" pressurized with a large disposable plastic syringe. A combined
375:
The restrictor and high pressure helps control the flow better than the improvised schemes because the high pressure through the small restrictor orifice reduces the variation of flow caused by patients' blood pressures.
407:. They are carefully designed so that no single cause of failure can harm the patient. For example, most have batteries in case the wall-socket power fails. Additional hazards are uncontrolled flow causing an
756:
486:
A "down pressure" sensor will detect when the patient's vein is blocked, or the line to the patient is kinked. This may be configurable for high (subcutaneous and epidural) or low (venous) applications.
250:
is infusion on-demand, usually with a preprogrammed ceiling to avoid intoxication. The rate is controlled by a pressure pad or button that can be activated by the patient. It is the method of choice for
224:
usually consists of small pulses of infusion, usually between 500 nanoliters and 10 milliliters, depending on the pump's design, with the rate of these pulses depending on the programmed infusion speed.
344:. Classically, they use computer-controlled rollers compressing a silicone-rubber tube through which the medicine flows. Another common form is a set of fingers that press on the tube in sequence.
506:
Many makes of infusion pump can be configured to display only a small subset of features while they are operating, in order to prevent tampering by patients, untrained staff and visitors.
499:
Mechanisms to avoid uncontrolled flow of drugs in large volume pumps (often in combination with a giving st based free flow clamp) and increasingly also in syringe pumps (piston-brake)
749:
337:
Within these classes, some pumps are designed to be portable, others are designed to be used in a hospital, and there are special systems for charity and battlefield use.
828:
742:
510:
By 2019 intravenous smart pumps were being introduced. They could include wireless connectivity, drug libraries, profiles of care areas, and soft and hard limits.
1708:
720:
469:
The range of safety features varies widely with the age and make of the pump. A state of the art pump in 2003 might have had the following safety features:
359:
weight), and the needed pressure varies with the administration route, potentially causing risk when attempted by an individual not trained in this method.
483:
Anti-free-flow devices prevent blood from draining from the patient, or infusate from freely entering the patient, when the infusion pump is being set up.
298:
422:
306:
in a German hospital in 2015, with two staples of four to five stationary infusion pumps each, on top right behind him (resp. behind the visitor).
411:, uncontrolled lack of flow, causing an underdose, reverse flow, which can siphon blood from a patient, and air in the line, which can cause an
1963:
1917:
613:"Feasibility, Effectiveness and Safety of Elastomeric Pumps for Delivery of Antibiotics to Adult Hospital Inpatients-A Systematic Review"
1113:
262:
are delivered, with the device coded to stop administration before a dose that may cause hazardous respiratory depression is reached.
1701:
115:
1776:
193:, they can inject controlled amounts of fluids subcutaneously (beneath the skin), or epidurally (just within the surface of the
2053:
1827:
1194:
425:(OPAT). However, due to their limited features and programmability, they are not suitable for all medications or flow rates.
53:
49:
96:
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2022:
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68:
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520:
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183:
2006:
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An "up pressure" sensor can detect when the bag or syringe is empty, or even if the bag or syringe is being squeezed.
75:
1912:
1871:
1804:
1607:
1176:
547:
274:
Some pumps offer modes in which the amounts can be scaled or controlled based on the time of day. This allows for
266:
42:
2027:
1892:
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1584:
1171:
1118:
952:
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A drug library with customizable programmable limits for individual drugs that helps to avoid medication errors.
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1953:
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1968:
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1309:
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790:
217:
of pumps usually requests details on the type of infusion from the technician or nurse that sets them up:
194:
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944:
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303:
844:
1622:
1416:
1371:
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367:, air filter and drip chamber helps a nurse set the flow. The parts are reusable, mass-produced
155:
1983:
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341:
179:
20:
89:
1786:
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404:
364:
315:
275:
230:
has a "high" infusion rate, alternating with a low programmable infusion rate to keep the
734:
639:
612:
452:
Please help update this article to reflect recent events or newly available information.
1973:
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or nutrient solutions large enough to feed a patient. Small-volume pumps infuse
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open. The timings are programmable. This mode is often used to administer
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351:-controlled motor turning a screw that pushes the plunger on a syringe.
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Batteries, so the pump can operate if the power fails or is unplugged.
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866:
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354:
The classic medical improvisation for an infusion pump is to place a
331:
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167:
1083:
310:
There are two basic classes of pumps. Large volume pumps can pump
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1060:
962:
921:
800:
297:
285:
182:
requested by the patient, up to maximum number per hour (e.g. in
1690:
738:
270:
usually requires an infusion curve similar to normal mealtimes.
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1144:
432:
25:
1378:
1316:
1209:
611:
Spencer-Jones J, Luxton T, Bond SE, Sandoe J (August 2023).
189:
Because they can also produce quite high but controlled
662:
Davis, S.; Blanchard, C.; Lewis, J. (26 October 2018).
278:
which may be required for certain types of medication.
384:. When a large air bubble reaches it, it bleeds off.
664:"Implementing Smart Pumps to Enhance Patient Safety"
186:), or fluids whose volumes vary by the time of day.
2015:
1994:
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961:
939:
852:
799:
785:
776:
721:"White Paper: Infusion Pump Improvement Initiative"
490:
interfere with the infusion of a low-dose medicine.
132:
A type of infusion pump, manufactured by
Fresenius.
56:. Unsourced material may be challenged and removed.
19:"Underdose" redirects here. For the InMe song, see
238:, or other drugs that can irritate a blood vessel.
403:Many infusion pumps are controlled by a small
1702:
750:
8:
340:Large-volume pumps usually use some form of
1728:
1709:
1695:
1687:
1515:
1056:
958:
796:
782:
757:
743:
735:
687:
638:
628:
116:Learn how and when to remove this message
423:outpatient parenteral antibiotic therapy
387:Some of the smallest infusion pumps use
255:(PCA), in which repeated small doses of
127:
559:
429:Safety features available on some pumps
1918:Peripherally inserted central catheter
7:
54:adding citations to reliable sources
1114:Heated humidified high-flow therapy
14:
710:Pharmacy Practice News, May 2010
347:Small-volume pumps usually use a
174:infusions are occasionally used.
1556:
1082:
843:
837:
437:
30:
41:needs additional citations for
330:, or other medicines, such as
197:– a very popular local spinal
1:
2023:Needle and syringe programmes
882:Effervescent powder or tablet
1666:Patient-controlled analgesia
971:Orally disintegrating tablet
582:10.1016/j.medmal.2020.10.019
521:Food and Drug Administration
253:patient-controlled analgesia
184:patient-controlled analgesia
630:10.3390/antibiotics12091351
2075:
1913:Peripheral venous catheter
1177:Relative analgesia machine
548:Total parenteral nutrition
294:Colleague CX infusion pump
267:Total parenteral nutrition
18:
2028:Supervised injection site
1554:
1080:
835:
446:This section needs to be
766:Routes of administration
680:10.1177/0018578718809252
1979:Thermodilution catheter
1928:Central venous catheter
1292:Extra-amniotic infusion
897:Molecular encapsulation
829:Osmotic delivery system
824:Time release technology
570:Infectious Diseases Now
475:single point of failure
158:. It is generally used
1844:Immunoglobulin therapy
1595:Central nervous system
1383:
1321:
1249:Mucoadhesive microdisc
1214:
318:, medications such as
307:
295:
195:central nervous system
133:
2054:Drug delivery devices
1438:Transfersome vesicles
1382:
1320:
1297:Intravesical infusion
1213:
473:Certified to have no
301:
289:
228:Intermittent infusion
131:
1969:Implantable catheter
1864:Parenteral nutrition
1124:Metered-dose inhaler
1109:Anesthetic vaporizer
538:Pharmacy informatics
292:Baxter International
50:improve this article
1922:Seldinger technique
1750:Fresh frozen plasma
1733:Blood-based product
1718:Intravenous therapy
1549:Transdermal implant
1509:(into tissue/blood)
1286:Intrauterine device
1167:Anaesthetic machine
1162:Oxygen concentrator
304:intensive care unit
222:Continuous infusion
1828:Sodium bicarbonate
1725:Infused substances
1661:Nanocell injection
1384:
1322:
1215:
1069:Dry-powder inhaler
727:. 14 January 2020.
308:
296:
248:Patient-controlled
156:circulatory system
134:
2036:
2035:
1984:Dialysis catheter
1901:
1900:
1684:
1683:
1680:
1679:
1511:
1473:Transdermal spray
1468:Transdermal patch
1458:Medicated shampoo
1189:
1188:
1185:
1184:
1172:Medical inhalants
1119:Medical inhalants
1047:Respiratory tract
1041:
1040:
935:
934:
668:Hospital Pharmacy
467:
466:
419:Elastomeric pumps
312:fluid replacement
209:Types of infusion
126:
125:
118:
100:
2066:
1823:Ringer's lactate
1795:Ringer's lactate
1777:Hemoglobin-based
1769:Blood substitute
1729:
1711:
1704:
1697:
1688:
1560:
1516:
1507:
1094:
1090:
1086:
1057:
986:Sublingual drops
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632:
608:
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601:
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533:Intravenous drip
462:
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441:
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433:
342:peristaltic pump
276:circadian cycles
121:
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110:
107:
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99:
58:
34:
26:
21:Underdose (song)
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2032:
2011:
1990:
1937:Other equipment
1932:
1897:
1876:
1858:
1832:
1809:
1787:Volume expander
1781:
1763:
1758:Cryoprecipitate
1754:Cryosupernatant
1720:
1715:
1685:
1676:
1656:Intraperitoneal
1628:musculoskeletal
1626:
1617:
1589:
1585:Intra-articular
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931:
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787:Digestive tract
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556:
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463:
457:
454:
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442:
438:
431:
405:embedded system
365:flow restrictor
316:saline solution
284:
211:
122:
111:
105:
102:
65:"Infusion pump"
59:
57:
47:
35:
24:
17:
12:
11:
5:
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2019:
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2009:
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1995:Specific risks
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1888:Drug injection
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1849:Gamma globulin
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1819:
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1805:Sugar solution
1802:
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1590:
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1587:
1582:
1577:
1575:Intracavernous
1571:
1569:
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1364:
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1358:Nutrient enema
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1016:
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1004:
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703:
674:(4): 217–219.
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603:
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543:Syringe driver
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356:blood pressure
302:Patient in an
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239:
225:
215:user interface
210:
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124:
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106:September 2011
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36:
29:
16:Medical device
15:
13:
10:
9:
6:
4:
3:
2:
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2049:Medical pumps
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2029:
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2020:
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2014:
2008:
2007:Extravasation
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1944:Infusion pump
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1941:
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1929:
1926:
1923:
1919:
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1911:
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1906:Access points
1904:
1894:
1893:Ascorbic acid
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1806:
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1800:Normal saline
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458:February 2024
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67: –
66:
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61:Find sources:
55:
51:
45:
44:
39:This article
37:
33:
28:
27:
22:
2059:Dosage forms
2002:Air embolism
1943:
1651:Intraosseous
1641:Intracardiac
1580:Intravitreal
1542:Injector pen
1537:Subcutaneous
1508:
1500:
1478:Jet injector
1463:Dermal patch
1276:Vaginal ring
1244:Insufflation
996:Effervescent
770:dosage forms
724:
715:
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671:
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657:
620:
616:
606:
576:(1): 39–49.
573:
569:
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417:
413:air embolism
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164:subcutaneous
137:
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112:
103:
93:
86:
79:
72:
60:
48:Please help
43:verification
40:
1837:Medications
1741:Whole blood
1636:Intravenous
1623:Circulatory
1608:Intrathecal
1532:Intradermal
1524:transdermal
1491:Parenterals
1397:Topical gel
1353:Murphy drip
1331:Suppository
1219:Nasal spray
1153:Oxygen mask
1002:Chewing gum
941:Oral mucosa
623:(9): 1351.
617:Antibiotics
320:antibiotics
236:antibiotics
162:, although
2043:Categories
1854:Interferon
1496:Injections
1259:Urogenital
1195:Ophthalmic
1051:inhalation
1025:Toothpaste
953:sublingual
917:Suspension
887:Herbal tea
554:References
326:, such as
260:analgesics
203:childbirth
199:anesthesia
145:medication
76:newspapers
1501:infusions
1433:Liposomes
1229:Eye drops
1224:Ear drops
1135:Vaporizer
1130:Nebulizer
1020:Mouthwash
949:sublabial
872:Electuary
862:Decoction
598:230762015
382:pathogens
191:pressures
153:patient's
149:nutrients
2016:See also
1672:PIC line
1613:Epidural
1453:Lip balm
1428:Hydrogel
1419:solution
1402:Liniment
1387:Ointment
1346:Hydrogel
1341:Solution
1326:Ointment
1266:Ointment
1239:Hydrogel
1234:Ointment
1030:Ointment
991:Lozenges
981:Lollipop
927:Tincture
912:Solution
892:Hydrogel
877:Emulsion
819:Pastille
698:31320768
649:37760648
640:10525832
590:33576336
527:See also
503:patient.
409:overdose
349:computer
324:hormones
314:such as
172:epidural
168:arterial
143:fluids,
1815:Buffers
1372:topical
1310:enteral
1271:Pessary
1101:Liquids
1074:Smoking
1012:Liquids
907:Softgel
854:Liquids
814:Capsule
791:enteral
689:6628554
448:updated
389:osmotic
369:sterile
332:opiates
328:insulin
232:cannula
180:boluses
151:into a
141:infuses
90:scholar
1567:Organs
1448:Lotion
1368:Dermal
1306:Rectal
1281:Douche
1061:Solids
998:tablet
963:Solids
945:buccal
902:Powder
867:Elixir
809:Tablet
801:Solids
696:
686:
647:
637:
596:
588:
257:opioid
92:
85:
78:
71:
63:
1881:Other
1872:Sugar
1443:Cream
1407:Paste
1336:Enema
1288:(IUD)
1204:nasal
1126:(MDI)
1034:Spray
922:Syrup
594:S2CID
97:JSTOR
83:books
1974:Port
1964:PICC
1746:PF24
1668:pump
1520:Skin
1417:DMSO
1412:Film
1200:otic
1155:and
976:Film
778:Oral
694:PMID
645:PMID
586:PMID
213:The
201:for
170:and
69:news
1959:MLC
1954:SLC
1949:CVC
1145:Gas
725:FDA
684:PMC
676:doi
635:PMC
625:doi
578:doi
205:).
147:or
136:An
52:by
2045::
1756:+
1202:,
951:,
947:,
768:,
723:.
692:.
682:.
672:54
670:.
666:.
643:.
633:.
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619:.
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592:.
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574:51
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415:.
334:.
290:A
166:,
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1920:(
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1752:(
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1696:v
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580::
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456:(
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119:)
113:(
108:)
104:(
94:·
87:·
80:·
73:·
46:.
23:.
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