Now that I think about it, I don't think ethanol nor MCT would be smart to IV directly. Most of my research tends towards ethanol being given as a dilute solution, and MCT-steroid solutions are meant for IM/SC use (not IV). Think about it: would your veins appreciate a 100% ethanol injection? I think not. Same as injecting (basically) vegetable oil into your veins. That's a good way to cause an oil embolism, which can cause respiratory distress as your lungs fill with oil instead of blood and cease to excahneg oxygen and CO
2 effectively. See also:
PubMed reference on some poor bastard who managed to get a testosterone-oil mixture in his bloodstream, which caused shortness of breath but thankfully resolved on its own after a week in the hospital.
So, any injections of such should be formulated as an emulsion or solution, preferably mostly aqueous.
If you were injecting MCT oil you'd probably want to form an emulsion. It's a bit of an involved process, for instance the Wikipedia article on the formulation of Diprivan (propfol emulsion for injection) reads:
The currently available preparation is 1% propofol, 10% soybean oil, and 1.2% purified egg phospholipid (ed. note: egg lecithin) as an emulsifier, with 2.25% glycerol as a tonicity-adjusting agent, and sodium hydroxide to adjust the pH. Diprivan contains EDTA, [...]Newer generic formulations contain sodium metabisulfite or benzyl alcohol as antimicrobial agents.
Note, approx. 85% of that injection is
water. Your body can tolerate fats and oils in the bloodstream - it's normal after all to have some percentage of fatty acids and triglycerides in it - but there comes a limit where the protiens and other emulsifying agents can't manage.
Fat embolsim syndrome is a related end case where your blood is overloaded with fat that it can't move (usually only in extreme injuries) - it's not a good situation and is managed by supportive care only. So it's absolutely key to administer an emulsion that stays stable and has a minimum amount of non-water-soluble components.
Luckily, I was trained under a chemist who was an emulsion master! (He made aqueous emulsions of a steroid - androstenone - as a boar mating pheromone, to detect when female pigs want to rut by spraying it at them and watching them "assume the position". A bit crude, but a market nonetheless.) So I've learned a few thing about making (and breaking) emulsions in my time.
If I were going to make an emulsion of BZDs for injection, I'd:
1. prepare a very strong solution of BZD in my MCT oil. You want to minimize the amount of oil used, so maximize the amount of BZD dissolved in it. 1g/mL would be good if you can manage it.
2. add a defined amount of Tween 80 (or other suitable food grade emulsifier). More is not better. Usually the sweet spot is between 0.05% and 2%, often towards the lesser end. You can always add more but you can't remove it if you overshoot.
3.
Make sure to add bacteriostatic agents/preservatives if you plan to store solution for any amount of time. Benzyl alcohol 0.5% or something. Calcium disodium EDTA. Maybe sorbic acid? I don't know, exactly.
3. Whip the shit out of it (high-speed, high-shear mixing, e.g. a whisk on a hand drill) in sterile distilled water to make a fine, milky emulsion. Use a minimum amount of oil. [(You are basically making an oil-in-water salad dressing
sans vinegarette.) A 5% oil-in-water with 1000mg/mL benzo (in oil) works out to 50mg/mL in the final emulsion, which should be PLENTY! Even a 1% emulsion is 10mg/mL at that loading. Milk of amnesia, indeed.
4. optional: do some tonicity calculations, adjust tonicity as needed to match 900
mOsm - same as saline - not strictly neccesary for small volume injections. Mix at high speed again to homogenize. Large volume injections should be as close to isotonic as possible to avoid pain on injection.
5. While mixing, adjust pH to neutral (pH 6.5-7.5 best, 6-8 OK), dropwise, with dilute NaOH / HCl (0.1M solutions in distilled water). (optional if it's neutral to start)
6. (for first-time formulations) Test stability by letting it sit for 24-48 hours, it should stay milky and not seperate. If it does you need to change the formulation, try adding a little more emulsifier (lecithin/Tween) or mixing at a higher speed or for different time. (There is a sweet spot, overmixing is just as bad as undermixing). The finished product should look like milk and exhibit the
Tyndall effect as you shine light through it.
7. Inject slowly and carefully...
A smart person would do a test injection on a large-gauge vein of a VERY small amount (0.05 - 0.1 mL) to confirm it doesn't cause anaphylaxis or vein damage.
Oh, and of course, all this should be done in as close to sterile conditions as possible.
Emulsion pro tips: Shake vigorously before using, store at room temperature, do not boil or refrigerate,
This is how diazepam was once administered IIRC. It's a lot of hassle to formulate as you can see. Not as easy as throwing shit in a cooker and heating it.
If you want further reading, I can try to find a patent document for injectable diazepam formualtions. That would have a recipe as well.
