Lung Function medical gas mixture 4.

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Medical Gas Data Sheet (MGDS) Lung Function medical gas mixture 4. Essential safety information. BOC: Living healthcare

02 03 4.4 Special warnings and precautions for use is used for diagnostic and research purposes. The mixture contains carbon monoxide which is toxic, and not more than a few full breaths should be taken because of its great affinity for haemoglobin. Care is needed with the use and handling of cylinders. 4.5 Interaction with other medicinal products and other forms of interaction 4.6 Pregnancy and lactation does not adversely affect pregnancy and lactation. 1. Name of the medicinal product. 4.7 Effects on ability to drive and use machines 4.8 Undesirable effects In normal circumstances, does not affect ability to drive or to operate machinery. 2. Qualitative and quantitative composition is a medicinal gas mixture of carbon monoxide, helium, oxygen and nitrogen. The mixture specification is as follows: carbon monoxide 0.30% +/- 0.03% helium 10.00% +/- 0.50% oxygen 21.00% +/- 1.00% nitrogen balance. The oxygen complies with Ph. Eur. Monograph (0417). The nitrogen complies with Ph. Eur Monograph (1247). The helium complies with the Ph. Eur. Monograph (2155). 4.9 Overdose 5. Pharmacological properties 5.1 Pharmacodynamic properties Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via The Yellow Card System www.mhra.gov.uk/yellowcard ATC CODE RO7AX 3. Pharmaceutical form 4. Clinical particulars 4.1 Therapeutic indications 4.2 Posology and method of administration 4.3 Contraindications Medicinal gas, compressed. is used in pulmonary function tests to measure gas transfer in the lung. Carbon monoxide is more easily absorbed than helium. By differential calculation, deficiencies in gas transfer and diffusion across the alveolar membrane can be measured. is administered through the lungs by inhalation through volumetric metering and absorption analysis devices. It may be administered by mask or by means of a tent. There are no contraindications for the use of in any age group. The use and dosage of is determined entirely by the respiratory function test being applied. There are no distinctions between children, adults and the elderly, but patients with cardiac or lung disorders who require therapeutic oxygen will require more oxygen than in the mixture. This is determined by the investigator. 0.28% may be a lethal concentration if continued for some 30 minutes 2000ppm (0.20%) will cause unconsciousness due to poisoning after 30 minutes at rest or 10 minutes exertion. The characteristics of carbon monoxide are: odourless, colourless gas molecular weight 28.00-192 C (at 1bar(g)) 1.165kg/m3 (at 15 C). The characteristics of helium are: inert, odourless, colourless gas molecular weight 4.00-269 C (at 1bar(g)) 0.169kg/m3 (at 15 C). Helium has no physiological activity and will not support life. The characteristics of oxygen are: odourless, colourless gas molecular weight 32.00-183.1 C (at 1bar(g)) 1.355kg/m3 (at 15 C). Oxygen is present in the atmosphere at 21% and is an absolute necessity for life. The characteristics of nitrogen are: odourless, inert, colourless gas molecular weight 28.00-196 C (at 1bar(g)) 1.185kg/m3 (at 15 C). Nitrogen is a non-toxic inert gas. It has no physiological activity and will not support life.

04 05 5.2 Pharmacokinetic properties 5.3 Preclinical safety data 6. Pharmaceutical particulars 6.1 List of excipients None stated. None. Leaks Having connected the regulator or manifold yoke to the cylinder check the connections for leaks using the following procedure: should leaks occur this will usually be evident by a hissing noise should a leak occur between the valve outlet and the regulator or manifold yoke, depressurise and remove the fitting and fit an approved 'O' ring reconnect the fitting to the valve with moderate force only, fitting a replacement regulator or manifold tailpipe as required sealing or jointing compounds must never be used to cure a leak if leak persists, label cylinder and return to BOC. 6.2 Incompatibilities 6.3 Shelf life 6.4 Special precautions for storage is chemically inactive and will not react with other compounds at normal temperatures. 36 months. cylinders should be: stored under cover, preferably inside, kept dry and clean and not subjected to extremes of heat or cold and away from stocks of combustible material stored separately from industrial and other non-medical cylinders stored to maintain separation between full and empty cylinders used in strict rotation so that cylinders with the earliest filling date are used first stored separately from other medical cylinders within the store. Warning notices prohibiting smoking and naked lights must be posted clearly in the cylinder storage area and the Emergency Services should be advised of the location of the cylinder store. Care is needed when handling and using cylinders. Use of cylinders When cylinders are in use ensure that they are: only used for medicinal purposes turned off, when not in use, using only moderate force to close the valve only moved with the appropriate size and type of trolley or handling device handled with care and not knocked violently or allowed to fall firmly secured to a suitable cylinder support when in use not allowed to have any markings, labels or batch labels obscured or removed not used in the vicinity of persons smoking or near naked lights. After use When the cylinder is empty ensure that the: cylinder valve is closed using moderate force only and the pressure in the regulator or tailpipe released valve outlet cap, where fitted, is replaced empty cylinders are immediately returned to the empty cylinder store for return to BOC. 6.5 Nature and contents of container All cylinders used for the storage of are manufactured from aluminium with a designed working pressure of at least 150bar(g). A summary of cylinders, their size and construction, type of valve fitted and valve outlet connection is detailed below: Cylinder Size Gas content (litres) Cylinder construction Valve outlet Valve construction Brass 7. Marketing authorisation holder BOC Ltd The Priestley Centre 10 Priestley Road The Surrey Research Park GUILDFORD Surrey, GU2 7XY AV 1,500 Aluminium BS 341 No.4 Side outlet AK 6,000 Aluminium BS 341 No.4 Side outlet Brass 8. Marketing authorisation number(s PL 00735/0012R. 6.6 Special precautions for disposal and other handling The cylinder valves are constructed from high tensile brass with a steel spindle fitted with a Nylon 6.6 insert. All personnel handling cylinders should have adequate knowledge of: properties of the gas correct operating procedures for the cylinder precautions and actions to be taken in the event of an emergency. 9. Date of first authorisation/renewal of the authorisation 10. Date of revision of the text Date first granted: 20/03/1991. Date of renewal: 14/10/1998. 25/05/2016 Preparation for use To prepare the cylinder for use: remove the tamper evident seal and the valve outlet protection cap. Ensure cap where fitted, is retained ensure that an appropriate medical gas regulator with a BS 341 No.4 inlet connector (with a design pressure of at least 150bar(g)) is fitted do not remove and discard any batch labels fitted to the cylinder ensure the connecting face on the regulator is clean and the 'O' ring fitted is in good condition connect the regulator, using moderate force only and connect the tubing to the regulator/flowmeter outlet only the appropriate regulator should be used for the particular gas concerned open the cylinder valve slowly and check for any leak. 11. Dosimetry (if applicable 12. Instructions for preparation of radiopharmaceuticals (if applicable) Not applicable. Not applicable.

6 7 Additional Safety Information 4. Accidental release measures If a large volume of is released if it is safe to do so, you should close the cylinder valve and where possible, eliminate all sources of ignition. If release continues evacuate the area and ensure that the affected area is adequately ventilated before re-entry. Self-contained breathing apparatus is required to be used if is released into a confined area without adequate ventilation. 5. Exposure controls When using ensure adequate ventilation of the Lung Function test area. Caution: Long term exposure to, inhaled for periods longer than those indicated for clinical use (in excess of 15 minutes) may cause the user to become unconscious and may cause harm to the unborn foetus (due to the carbon monoxide component of the gas). 1. Contact information BOC telephone number to be used in the event of an emergency UK 0800 111 333 The UK exposure limit for carbon monoxide (as defined in EH40/2005) specifies the Long Term Exposure Level (TWA over 8 hours) should not exceed 30 ppm. A Short Term Exposure level (15- minute reference period) should not exceed 200 ppm. 2. Hazards Classification labelling and packaging regulations Warning. Contains gas under pressure; may explode if heated (H280). Protect from sunlight: store in a well-ventilated place (P410 + P403). 6. Disposal considerations It is recommended that cylinders should not be vented after use they should be returned to BOC with any residual gas where they will be vented before refilling in a safe environment. Dangerous Preparations Directive Keep out of the reach of children (S2). If, for safety reasons, a cylinder is required to be vented after use, the gas should be vented to atmosphere in a well ventilated area. Contact BOC if further guidance on venting cylinders is required. COMPRESSED GAS 2 Additional safety statements No smoking or naked flames near medical gas cylinders. Use no oil or grease. Keep away from extremes of heat and combustible material. Store cylinders under cover in a clean, dry and well ventilated area. is supplied as a compressed gas in a high pressure cylinder. Cylinders may explode if subjected to extremely high temperatures (if involved in a fire). 7. Transport of cylinders When cylinders are required to be transported, ensure that the cylinders are: located in a compartment separated from the driver adequately restrained not leaking and have their valves closed. The vehicle must be adequately ventilated. Ensure the driver is aware of the potential hazards of the load and knows what to do in the event of an accident or an emergency. It is advisable to provide the driver with written instructions that detail the actions to be taken in the event of an accident or emergency. 3. Fire fighting measures If cylinders are involved in a fire: if it is safe to move the cylinders, --close cylinder valve to stop flow of product --move cylinders away from source of heat. if it is not safe to move the cylinders, --cool with water from a protected position. All types of fire extinguishers may be used when dealing with a fire involving Lung Function medical gas mixture 4 cylinders. Fire fighters should use self-contained breathing apparatus when dealing with a fire in which Lung Function medical gas mixture 4 cylinders are involved. 8. Transport information Cylinders should be removed from the vehicle as soon as possible. UN number UN1956 compressed gas N.O.S. Material: Class 2 Labels 2.2 Hazard identification number 20 Emergency Action Code 2TE Tunnel Restriction Code E Transport category 3

BOC Healthcare Customer Service Centre, Priestley Road, Worsley, Manchester M28 2UT Tel 0800 111 333, Fax 0800 111 555, bochealthcare-uk@boc.com, www.bochealthcare.co.uk BOC Healthcare is the trading name of BOC Limited, registered office: The Priestley Centre, 10 Priestley Road, Surrey Research Park, Guildford, GU2 7XY, England. Number 337663 English Register. Authorised and regulated by the Financial Conduct Authority. The stripe symbol and the letters BOC are registered trade marks.. BOC Limited 2016 HLC/604630/UKS/BAMC/0616