The Top 100 Drugs in Sterile Compounding — Part 2: Fluids, Electrolytes & Parenteral Nutrition
By the NPTA Editorial Team · Clinically reviewed by Josh Cano, CPhT-Adv, BCSCPT, BCHCPT, BCNCPT
Published September 21, 2026
In Part 1, we covered the IV anti-infectives that fill most of the cleanroom’s day. Part 2 turns to the foundation underneath nearly every CSP: the base fluids you dilute into, the electrolytes you add, and the components that build a parenteral nutrition (PN) bag, historically often called total parenteral nutrition (TPN).
The short version: These aren’t glamorous, but they’re everywhere — and several are high-alert. Get comfortable with your base solutions, your electrolyte additives, and the anatomy of a PN, and you understand the backbone of sterile compounding.
What are soft skills, and why do they matter more than you think?
Soft skills are the non-clinical abilities that determine how you actually function in a pharmacy: how you talk to people, how you manage your own time and emotions, how you handle conflict, how you adapt when the plan falls apart. They’re not softer in difficulty — they’re just harder to put on a resume.
Here’s what that looks like on shift, not in a textbook.
Base fluids & diluents
- Sodium chloride 0.9% (normal saline) — the most common IV fluid and diluent.
- Sodium chloride 0.45% (half-normal saline) — hypotonic maintenance fluid.
- Dextrose 5% in water (D5W) — common fluid and diluent.
- Dextrose 10% in water (D10W) — higher-concentration dextrose; neonatal and hypoglycemia.
- Dextrose 50% (D50) — severe hypoglycemia; concentrated dextrose used in PN. High-alert.
- Lactated Ringer’s (LR) — balanced crystalloid for fluid resuscitation.
- Sterile water for injection — used for reconstitution or as a diluent when appropriate; must not be administered IV without an appropriate solute because it is hypotonic and can cause hemolysis. Large-volume containers (≥100 mL) are included on the ISMP high-alert list
Electrolytes & additives (several are high-alert)
- Potassium chloride (KCl) — potassium replacement. High-alert when supplied as an injection concentrate; never administer undiluted concentrate.
- Potassium phosphate — provides both potassium and phosphate. High-alert.
- Sodium phosphate — phosphate repletion.
- Potassium acetate — potassium repletion (acetate salt).
- Sodium acetate — sodium/acid-base management; common PN additive.
- Sodium bicarbonate — metabolic acidosis. High-alert.
- Magnesium sulfate — magnesium replacement; also used for specific obstetric indications. High-alert.
- Calcium gluconate — calcium repletion; preferred for peripheral lines.
- Calcium chloride — calcium repletion; central lines and codes.
Parenteral nutrition (TPN) components
- Amino acid solutions (Travasol, Clinisol) — the protein source in PN.
- Lipid injectable emulsion (Intralipid, SMOFlipid) — fat and calorie source.
- Adult multivitamin for infusion (MVI) — vitamin component of PN.
- Multi-trace elements — zinc, copper, manganese, chromium, selenium blends.
- L-cysteine — additive that acidifies neonatal PN and improves calcium/phosphate solubility.
- Zinc sulfate — individual trace-element supplementation.
- Insulin, regular (human) — added to PN and IV fluids to manage glucose. High-alert.
- Famotidine — H2 antagonist; sometimes added to PN or given IV.
- Heparin — may be included in select PN formulations or used for catheter-related indications according to institutional protocol. High-alert.
Technician takeaway
This is where accuracy and the high-alert mindset matter most. Concentrated electrolytes, insulin, and heparin are among the most dangerous products in the pharmacy — and Parenteral nutrition preparations are themselves considered high-alert medications. PN compounding involves multiple ingredients, calculations, compatibility considerations, and opportunities for error, making standardized preparation and verification especially important. Precision here protects patients directly.
Ready to get IV certified?
Reading the list is one thing — doing the work is another. If sterile compounding is where you want your career to go, get the training behind it. NPTA’s Sterile Compounding Certification program has been used by more than 20,000 pharmacists and pharmacy technicians to build real, job-ready IV skills: https://cpht.org/advanced-certifications-old/sterile-compounding-certification/
And when you’re ready to prove your expertise at the highest level, the Board Certified Sterile Compounding Pharmacy Technician (BCSCPT) credential from the Board of Pharmacy Technician Specialties (BPTS) is the gold standard: https://bpts.org/credentials/board-certified-sterile-compounding-pharmacy-technician/
Series navigation: [Part 1 — Anti-Infectives] · Part 2 · [Part 3 — Critical Care] · [Part 4 — Oncology & Hazardous]
Educational disclaimer: Educational overview only — not compounding directions. Follow USP <797>, manufacturer stability/compatibility data, and your facility’s policies for all diluents, concentrations, additive sequences, stability, and beyond-use dating (especially for TPN).