Administering Perseris: A Step-by-Step Guide for Professionals
Administering Perseris is a multi-step process that demands careful attention to detail to ensure proper administration and patient safety. The medication is supplied in a single-dose kit containing a powder syringe, a liquid syringe, and a safety needle, all of which are essential for reconstitution and injection. The procedure outlined below is intended for healthcare professionals who are trained in medication administration.
Preparation and Mixing
The initial phase of administering Perseris involves specific preparation steps that must be followed precisely. It is essential to only prepare the medication immediately before it is administered.
Key Preparation Steps:
- Room Temperature: Remove the Perseris kit from the refrigerator and allow it to sit at room temperature for at least 15 minutes before mixing.
- Inspection: Visually inspect the components. The liquid should be colorless to yellow, and the powder should be white to off-white to yellow.
- Tap the Powder: Hold the powder syringe upright and tap it gently to dislodge any compacted powder from shipping.
- Uncap and Connect: Remove the caps from both the liquid and powder syringes. Connect the liquid syringe to the top of the powder syringe with a twist, careful not to touch the plungers during this step.
- Mix in Two Stages: The mixing process is thorough and precise. First, transfer the liquid into the powder syringe and gently push the plunger back and forth for 5 cycles. Then, continue mixing more vigorously for an additional 55 cycles. A correctly mixed suspension will be cloudy and uniform in color, which can range from white to yellow-green.
- Prepare for Injection: Transfer all contents into the liquid syringe. Gently pull back the liquid syringe plunger while twisting the syringes apart. Attach the sterile safety needle by twisting it on firmly. Finally, hold the syringe upright to let air bubbles rise and slowly push the plunger to expel excess air.
Injection Site Selection and Procedure
Perseris is administered exclusively as a subcutaneous injection in the abdomen or the back of the upper arm. The site must be free of any skin irritation, bruising, or scars. To minimize irritation over time, it is recommended to rotate injection sites with each monthly dose.
Performing the Injection:
- Clean the Site: Use an alcohol pad to thoroughly clean the chosen injection site.
- Pinch the Skin: Pinch a fold of skin around the cleaned area to lift the adipose (fatty) tissue away from the underlying muscle. This prevents accidental intramuscular injection, which is not the correct route for Perseris.
- Insert the Needle: Insert the needle fully into the subcutaneous tissue. The angle of injection may vary.
- Inject Slowly: Depress the plunger in a slow and steady motion until all the medication has been injected.
- Withdraw and Lock: Withdraw the needle at the same angle it was inserted, then lock the needle guard and dispose of the syringe in a sharps container.
Post-Injection Care and Considerations
Patient instruction following the injection is as critical as the procedure itself. Immediately after administration, a small, firm lump or depot will form under the skin. This depot is the medication's extended-release mechanism.
- No Rubbing or Massaging: The most important instruction is to not rub or massage the injection site. Doing so could disrupt the depot and interfere with the medication's release over the month.
- Bandage if Needed: If there is minor bleeding, a small amount of pressure with a gauze pad is acceptable, but it should be minimal.
- Awareness of Clothing: Patients should be advised to be aware of tight clothing, belts, or waistbands that might rub or irritate the injection site.
Perseris vs. Other Risperidone Injectables
Perseris is one of several long-acting risperidone formulations, but its subcutaneous administration and monthly dosing schedule differentiate it from others that are given intramuscularly.
| Feature | Perseris | Risperdal Consta | Uzedy |
|---|---|---|---|
| Injection Type | Subcutaneous (SC) | Intramuscular (IM) | Subcutaneous (SC) |
| Injection Site | Abdomen or upper arm | Deltoid or gluteal | Abdomen or upper arm |
| Frequency | Once monthly | Every 2 weeks | Once monthly or once every 2 months |
| Mixing Required | Yes, requires reconstitution at time of use | Yes, requires mixing | No, pre-filled, no reconstitution |
| Oral Overlap | Not recommended | Required for the first 3 weeks | Not recommended |
Safety and Efficacy
Clinical trials have demonstrated the efficacy of Perseris in managing the symptoms of schizophrenia, with statistically significant improvements in symptom scales compared to placebo. A key benefit is enhanced patient compliance due to the predictable monthly schedule. However, like all medications, Perseris carries risks, including a boxed warning about increased mortality in elderly patients with dementia-related psychosis, for which it is not approved. Other potential side effects include metabolic changes, tardive dyskinesia, and injection site reactions.
Conclusion
How do you inject Perseris correctly is a procedure for healthcare professionals that requires strict adherence to preparation and administration guidelines. The once-monthly subcutaneous injection in the abdomen or upper arm forms a depot that provides sustained therapeutic levels of risperidone. Proper training in the mixing process and injection technique, combined with thorough patient education on post-injection care, is essential for safe and effective treatment. This protocol ensures the medication works as intended to manage schizophrenia, improving adherence and overall patient outcomes.
For more detailed prescribing information and instructions, healthcare providers can refer to the official document on the FDA's website: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/210655s010lbl.pdf.
