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186 Cards in this Set
- Front
- Back
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The following Rx was compounded on Dec 1, 2007, with the indicated ingredients.
Expiration Date Atorvastatin Calcium 10 mg Dec 1, 2009 (Lipitor 20 mg Tablets) Hydrochlorothiazide 25 mg USP Grade Methylparaben 0.5 mg USP Grade Lactose qs USP Grade MTD #30 Capsules (Use size #1 hard gelatin capsules Sig 1 cap po qd Amount of lactose to fill #1 capsule 340 mg Amount of hydrochlorothiazide to fill #1 capsule 300 mg Amount of methylparaben to fill #1 capsule 425 mg Amount of triturated Lipitor tablets to fill #1 size capsule 400 mg The weight of a Lipitor 20 mg tablet is 300 mg The chemical structure of Atorvastain calcium is shown below. The molecular weight of the compound is 1209 g/mol. What “Beyond Use Date” would be correct for the compounded prescription? A) Jan 2008 B) Feb 2008 C) June 2008 D) Dec 2008 E) Dec 2009 |
C) June 2008
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The following Rx was compounded on Dec 1, 2007, with the indicated ingredients.
Expiration Date Atorvastatin Calcium 10 mg Dec 1, 2009 (Lipitor 20 mg Tablets) Hydrochlorothiazide 25 mg USP Grade Methylparaben 0.5 mg USP Grade Lactose qs USP Grade MTD #30 Capsules (Use size #1 hard gelatin capsules Sig 1 cap po qd Amount of lactose to fill #1 capsule 340 mg Amount of hydrochlorothiazide to fill #1 capsule 300 mg Amount of methylparaben to fill #1 capsule 425 mg Amount of triturated Lipitor tablets to fill #1 size capsule 400 mg The weight of a Lipitor 20 mg tablet is 300 mg The chemical structure of Atorvastain calcium is shown below. The molecular weight of the compound is 1209 g/mol. How many 20 mg Lipitor tablets would be required for the prescription? A) 5 B) 10 C) 15 D) 20 E) 30 |
C) 15
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The following Rx was compounded on Dec 1, 2007, with the indicated ingredients.
Expiration Date Atorvastatin Calcium 10 mg Dec 1, 2009 (Lipitor 20 mg Tablets) Hydrochlorothiazide 25 mg USP Grade Methylparaben 0.5 mg USP Grade Lactose qs USP Grade MTD #30 Capsules (Use size #1 hard gelatin capsules Sig 1 cap po qd Amount of lactose to fill #1 capsule 340 mg Amount of hydrochlorothiazide to fill #1 capsule 300 mg Amount of methylparaben to fill #1 capsule 425 mg Amount of triturated Lipitor tablets to fill #1 size capsule 400 mg The weight of a Lipitor 20 mg tablet is 300 mg The chemical structure of Atorvastain calcium is shown below. The molecular weight of the compound is 1209 g/mol. What method should be used to blend the powders together for the prescription? A) Pulverization by Intervention B) Spatulation C) Trituration D) Levagation E) Geometric Dilution F) Trituration or Geometric Dilution |
F) Trituration or Geometric Dilution
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The following Rx was compounded on Dec 1, 2007, with the indicated ingredients.
Expiration Date Atorvastatin Calcium 10 mg Dec 1, 2009 (Lipitor 20 mg Tablets) Hydrochlorothiazide 25 mg USP Grade Methylparaben 0.5 mg USP Grade Lactose qs USP Grade MTD #30 Capsules (Use size #1 hard gelatin capsules Sig 1 cap po qd Amount of lactose to fill #1 capsule 340 mg Amount of hydrochlorothiazide to fill #1 capsule 300 mg Amount of methylparaben to fill #1 capsule 425 mg Amount of triturated Lipitor tablets to fill #1 size capsule 400 mg The weight of a Lipitor 20 mg tablet is 300 mg The chemical structure of Atorvastain calcium is shown below. The molecular weight of the compound is 1209 g/mol. How much of the Lipitor tablet triturate (in mg) is required to obtain the 10 mg dose? A) 25 B) 50 C) 66 D) 75 E) 150 |
E) 150
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The following Rx was compounded on Dec 1, 2007, with the indicated ingredients.
Expiration Date Atorvastatin Calcium 10 mg Dec 1, 2009 (Lipitor 20 mg Tablets) Hydrochlorothiazide 25 mg USP Grade Methylparaben 0.5 mg USP Grade Lactose qs USP Grade MTD #30 Capsules (Use size #1 hard gelatin capsules Sig 1 cap po qd Amount of lactose to fill #1 capsule 340 mg Amount of hydrochlorothiazide to fill #1 capsule 300 mg Amount of methylparaben to fill #1 capsule 425 mg Amount of triturated Lipitor tablets to fill #1 size capsule 400 mg The weight of a Lipitor 20 mg tablet is 300 mg The chemical structure of Atorvastain calcium is shown below. The molecular weight of the compound is 1209 g/mol. How much (in mg) lactose would be required for the total prescription? Assume that you need 90 mg of the tablet triturate per capsule. Pick the one answer closest to the calculated one. ** I gave you an amount of tablet triturate to make it easier** A) 7,050 B) 9,050 C) 14,050 D) 15,050 E) 20,050 |
A) 7,050
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True or False You would have to use an aliquot method in preparing this compound since there is a powder below the minimum weighable quantity in the procedure.
A) False B) True |
B) True
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All of the correct procedures were done in the preparation of the blended powder for the capsule fill. Upon setting it was noted that the hydrochlorothiazide powder settled to the bottom of the container. Which of the following is the most likely reason for this segregation?
A) Difference in surface tension of the particles B) Difference in viscosity of the powders C) Difference in melting point of the ingredients D) Difference in the molecular weight of the compounds E) Difference in particle size |
E) Difference in particle size
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True or false. USP 795 outlines the guidelines for compounding aseptic prescriptions.
A) True B) False |
B) False
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True or False. A graduate cylinder that is designated TC would contain a larger volume of liquid than one designated TD when filled to the same 50 ml mark on the container.
A) True B) False |
B) False
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Which of the following is an effective preservative for an oral liquid?
A) Isopropanol B) Sorbic Acid C) Methylcellulose D) Sodium Dodecylsulfate E) Stevia |
B) Sorbic Acid
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Which of the following is an example of a viscosity inducing agent?
A) Sodium Dodecylsulfate B) Methylcellulose C) Ascorbyl Palmitate D) Tocepherol E) Disodium Edetate (EDTA) |
B) Methylcellulose
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The process of determining particle size is known as?
A) Intervention B) Dissolution C) Punching D) Levigation E) Sieving |
E) Sieving
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For the following prescription
Atropine Sulfate 0.4 mg Hydroxypropylcellulose 200 mg Lactose qs for Capsule size #2 Dispense 30 capsules Which of the following would be the best for blending the powders together? A) Levigation using a Wedge Wood Mortar and Pestle B) Trituration using a Glass Mortar and Pestle C) Triuration via geometric dilution with a Wedge Wood Mortar and Pestle D) Trituration using pile tile and metal spatula E) Mixing with via the addition of ethanol |
B) Trituration using a Glass Mortar and Pestle
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Which of the following is FALSE about lozenges?
A) They have traditionally been used for local effects to administer topical anesthetics and demulcents B) The common practice today is to use them to deliver some drugs systemically. C) They are useful for patients who have difficulty swallowing oral solid dosage forms D) They are always made from compression methods E) They are useful for medications that give maximum benefit when in prolonged contact with local tissues |
D) They are always made from compression methods
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How much PEG base would be required for the following prescription?
Progesterone 200 mg PEG Base qs M & ft Suppositories #10 Sig Insert 1 supp vaginally ut dict for PMS Information: Density of progesterone 0.67 g/ml, Density of PEG Base 0.9 g/ml Weight of a Blank Suppository 1.9 g, weight of a medicated suppository 1.75 g DF = B/(A-C+B) (A=blank, B= weight of drug, C= medicated suppository) A) 7.8 g B) 8.6 g C) 9.4 g D) 10.7 g E) 15.5 g |
E) 15.5 g
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The Q10 equation is t90 (T2) = t90(T1)/Q10(ΔT/10) . A new drug monograph states that the reconstituted suspension is stable for 14 days in a refrigerator (5oC). What would be its reduction shelf-life at room temperature (25oC)? Use a Q value of 3.
A) 1.5 days B) 3.5 days C) 0.9 days D) 12.5 days E) 9.5 days |
D) 12.5 days
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Which of the following is would be a good levigating agent that can be used in an oleaginous base?
A) Propylene Glycol B) Potassium metabisulfate C) Mineral Oil D) Butylated hydroxyanisole (BHA) E) Citric Acid |
C) Mineral Oil
Question discarded? |
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Which of the following agents could be used to add a cooling sensation in the mouth of an oral dosage form
A) Vanilla B) Cyclodextrin C) Mannitol D) Menthol E) Metronidazole benzoate |
C) Mannitol
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Dyes can be added to all of the following compounded prescriptions EXCEPT?
A) Syrup B) Tablet C) Capsule D) Suppository E) Troche |
D) Suppository
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Which of following agents is often added to dusting powders as an aromatic?
A) Benzene B) Trition X 100 C) Menthol D) PEG E) Polyox |
C) Menthol
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A prescription requires 10 ml of a 2 % lidocaine (mw 234) solution but the pharmacist only has lidocaine HCl (mw 288) in stock, how many milligrams of lidocaine HCl should be used? W = ab/de
A) 81 mg B) 123 mg C) 163 mg D) 246 mg E) 535 mg |
D) 246 mg
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What is the function of methylparaben in the following compounded prescription?
GELATIN BASE Glycerin 155 mL Gelatin 3.4g Methylparaben 440 mg Purifiedwater 21.6mL A) Binder B) Flavoring Agent C) Preservative D) Surfactant E) Suspending agent |
C) Preservative
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Which of the following excipients would be found in an effervescent tablet formulation but not a regular capsule formulation?
A) Lactose B) Citric Acid C) Sodium dodecylsulfate D) Dextrose E) Stevia |
B) Citric Acid
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Which of the following statements is FALSE for Acaica?
A) Is a synthetic polymer B) Can absorb twice its weight in water C) Can be used as a thickening agent D) Can be used in Troche compounding E) Can be used in Lozenge Compounding |
A) Is a synthetic polymer
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Which of the following is typically used as a levigating agent?
A) Benzyl Alcohol B) Sodium Dodecylsulfate C) PEG 3000 D) Glycerin E) Acacia |
D) Glycerin
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True or False In compounding a PEG suppository the pharmacist calculates the displacement factor of a drug is 1. This means the drug will displace the same amount of PEG suppository base during suppository formulation.
A) True B) False |
A) True
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The upper limit of BUD of non-aqueous USP/NF liquids and solids is:
a. 30 days b. 14 days c. 6 months d. 14 days at a cool temperature e. 3 months |
c. 6 months
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Chemical changes include all BUT
a. Racemization b. Displacement c. Adsorption d. Evolution of gas e. Epimerization |
c. Adsorption
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Which of the following does NOT affect segregation of a compounded product?
a. pH b. particle size c. particle shape d. density e. dielectric constant f. pH or dielectric constant |
f. pH or dielectric constant
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Which of the following correctly describes efflorescent powders?
a. They absorb moisture to form a solution. b. They absorb moisture but do not form solution. c. They become powdery by liberating their water of crystallization during trituration d. If not stored correctly can lead to dosing errors in compounding e. none of the above are correct |
d. If not stored correctly can lead to dosing errors in compounding
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If you have an efflorescent powder and do not recognize it, you are most likely to:
a. Overdose the patient b. Underdose the patient c. Make the dosage form taste bad d. Make the dosage form smell bad e. Create an polymoprh |
a. Overdose the patient
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Which definition of the phenomena associated with gels is correctly defined?
a. Swelling - The taking up of a certain amount of liquid without a measurable increase in volume b. Imbibition - The taking up of a liquid by a gel with an increase in volume. c. Syneresius - Reversible gel-sol formation with no change in volume or temperature d. Thixotropy - Interaction between particles of the disperesed phase is great so that the dispensing medium is squeezed out in droplets and the gel shrinks. e. None of the above, they are all wrong. |
e. None of the above, they are all wrong.
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Which suppository base & examples are correctly matched?
a. oleaginous : hydrophilics b. oleaginous : gelatin c. water-soluble : cocoa butter d. water-soluble : PEG |
d. water-soluble : PEG
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Which of the following is FALSE regarding segregation of particles:
a. Smaller particles migrate to the bottom while larger particles migrate to the top b. Particles that are denser tend to migrate to the bottom c. Only size and density impact segregation d. In order to decrease segregation, the shape of all the particles should be similar e. Electrostatic interactions can impact on segregation |
c. Only size and density impact segregation
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Which buffer is commonly used in ophthalmic preparations?
a. citric acid b. edetic acid c. boric acid d. posphate buffers e. acetate buffers |
c. boric acid
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Solid dosage forms that are used to administer medication via the rectum, vagina or urethra are known as
a. Suppositories b. Pills c. Lozenges d. Troches e. None of the above |
a. Suppositories
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What method of flavoring includes the use of additives that cause a cooling sensation?
a. Blending b. Overshadowing c. Physical d. Chemical e. Physiological |
e. Physiological
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Which of the following pairs are mismatched:
a. chelating agent: Edetate Disodium b. viscosity inducing agent: glycerin c. antioxidant: trition X 100 d. surfactant: Tweens e. flavor enhancer: monosodium glutamate |
c. antioxidant: trition X 100
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Which of the following concerning taste and chemical structure is true?
a. inorganic salts(salty), high molecular weight(bitter), unsaturation(sharp biting taste), polyhydroxyl compounds(sweet) b. inorganic salts(salty), high molecular weight(sharp biting taste), unsaturation(bitter), polyhydroxyl compounds(sweet) c. inorganic salts(salty), high molecular weight(sweet), unsaturation(sharp biting taste), polyhydroxyl compounds(bitter) d. inorganic salts(salty), high molecular weight(sour), unsaturation(sharp biting taste), polyhydroxyl compounds(sweet) e. inorganic salts(salty), high molecular weight(bitter), unsaturation(sweet), polyhydroxyl compounds(sharp biting taste) |
a. inorganic salts(salty), high molecular weight(bitter), unsaturation(sharp biting taste), polyhydroxyl compounds(sweet)
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Which of the following statements regarding mortars and pestles is false?
a. Ceramic mortars and pestles are appropriate to use when mixing potent drugs. b. Because porcelain mortars and pestles are porous, they should not be used with ingredients that stain. c. The mortar and pestle are made of three types of materials: glass, Wedgewood, or porcelain. d. Wedgewood is generally reserved for grinding hard powder particles, and porcelain is used for pulverizing soft aggregates or crystals. e. Glass mortars and pestles are preferable for mixing liquids and semisolid dosage forms. |
a. Ceramic mortars and pestles are appropriate to use when mixing potent drugs.
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Which of the following is- CORRECT about the characteristics of Oil in Water (o/w) emulsion base?
a. They are water soluble b. They are water washable c. They can absorb water d. A lipophilic compound would be the external phase e. Lanolin is an example |
Question thrown out?
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In which of the following conditions would the addition of a preservative be considered necessary?
a. If the preparation does not contain water b. If the ingredients have antimicrobial properties c. If the preparation is used immediately d. If the preparation has a pH <9 e. all of the above are true |
d. If the preparation has a pH <9
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An appropriate antioxidant for an oil system would include
a. Ascorbic acid b. Sodium thiosulfate c. Tocopherol d. Potassium metabisulfite e. Hypophosphorous acid |
c. Tocopherol
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Which of the following is true?
a. Elixirs contain alcohol. b. Glycerin can increase cap lock c. Increasing viscosity will increase the sedimentation rate. d. Decreasing the particle size will increase the sedimentation rate. e. Simple syrup USP requires preservatives. |
a. Elixirs contain alcohol.
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Which of the following would be part of a eutectic mixture?
a .Ferrous sulfate b. Citric acid c. Menthol d. Calcium Lactate e. All of the above |
c. Menthol
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When compounding effervescent granules which of the following is FALSE:
a. usually contain a mix of citric or tartaric acid with a medicinal agent b. the vehicle is a contains sodium hydroxide to activate the acid c. Lessens the salty/bitter tastes of different inorganic salts d. It gives the patient a pleasant taste e. all of the above are False |
b. the vehicle is a contains sodium hydroxide to activate the acid
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Which of the following are False?
a. Oil soluble drugs have a fast release in an oily base. b. Water soluble drugs have a fast release in an oily base. c. Oil soluble drugs have a fast release in a water miscible base. d. A&B e. B & C |
a. Oil soluble drugs have a fast release in an oily base.
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What is the minimum weighable quantity to prevent inaccuracy?
a. 0.05 grams b. 0.05 mg c. 120 mg d. 20 mg e. 120 gr |
c. 120 mg
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Which of the following is a natural polymer?
a. Methylcellulose b. Poloxamer c. Tragacanth d. Silicone dioxide e. Carbomer |
c. Tragacanth
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Which of the following buffering agents is INCORRECTLY listed with its actions?
a. Boric acid – decreases pH b. Sodium carbonate – increases pH c. Citric acid – decreases pH d. Sodium acetate – decreases pH e. Sodium citrate – increases pH |
d. Sodium acetate – decreases pH
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Which method is most commonly used to determine the chemical stability of a compounded preparation
a. the Eureka Equation b. the degradation equation c. the Q10 method d. the ideal gas law e. the Mobley equation |
c. the Q10 method
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Which of the following is false regarding beyond-use dating?
a. The beyond-use dating should be no later than 14 days in water-containing formulas stored at a cold temperature. b. The beyond-use dating can be exceeded if valid supporting stability information is available for the specific preparation. c. If the source of a non-aqueous liquid or solid is a USP or NF substance, the beyond-use date is no later than 6 months. d. If the source of a non-aqueous liquid or solid is a manufactured drug product, the beyond-use date should be no later than 50% of the time remaining on the original product’s expiration or 6 months (whichever is earlier). |
d. If the source of a non-aqueous liquid or solid is a manufactured drug product, the beyond-use date should be no later than 50% of the time remaining on the original product’s expiration or 6 months (whichever is earlier).
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Which of the following drugs may adsorb to plastic IV tubes or bags
A) Bactrim B) Ampicillin C) Nitroglycerin D) Gancicloivr E) Glycerin |
C) Nitroglycerin
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Which of the following is an example of a water soluble antioxidant
A) hexylresorcinol B) sodium acetate C) ascorbic acid D) glycerin E) thimersol |
C) ascorbic acid
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How much daily protein is required for a normal 50 kg adult
A) 25 g B) 70 kg C) 110 g D) 60 g E) 75 mcg |
D) 60 g
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In chronic obstructive pulmonary disease which of the following aspects of TPN may produce a detrimental effect.
Select all appropriate answers. A) High amounts of glucose B) Excess trace elements C) High amounts of lipids D) High amounts of proteins E) High amounts of gultamic acid |
B) Excess trace elements
C) High amounts of lipids |
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Which class of compounds has not been reported to leach out of IV tubes
A) phthalate B) insulin C) polyvinyl chloride D) glycerin E) polypropylene |
D) glycerin
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What is the Limulus Amebocyte Lysate test used for
A) sterility B) tonicity C) pH D) pyrogens E) specific gravity |
D) pyrogens
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Which of the following filters could remove most bacterial from a solution?
A) 1000 nm B) 500 nm C) 240 mm D) 100 nm E) 0.2 meters |
A) 1000 nm
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A typical TPN nutrient solution contains
A) 50 gm of fat, 350 g of amino acids, 100 gm of glucose B) 150 gm of fat, 200 gm of amino acids, 50 gm of glucose C) 75 gm of fat, 100 mg of amino acids, 200 gm of glucose D) 63 gm of fat, 60 gm of amino acids, 350 gm of glucose |
D) 63 gm of fat, 60 gm of amino acids, 350 gm of glucose
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Which of the following infusates requires preliminary test dosing?
A) branched chain amino acids B) lipids C) potassium acetate D) fructose |
C) potassium acetate
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21) A pharmacist receives a medication order for 200,000 units of penicillin G potassium to be added to 500 mL of D5W. The directions on the 1,000,000 unit package state that if 1.6 ml of the solvent are added, the constituted solution will measure 2 mL. How many milliliters of the constituted solutions must be withdrawn and added to the D5W?
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A constituted solution containing 500,000 units of polymyxin B sulfate in 10 ml of sterile water for injection is added to 250 ml of D5W. The infusion is to be administered over 1 hour. If the dropper in the venoclysis set calibrates to 20 drops/mL, at what infusion rate in drops per minute, should the flow be adjusted to administer the infusion over the designated time interval.
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How many milliliters of a 5%(w/v) solution of ammonium chloride (NH4Cl, mw 53.5) should be administered intravenously to a patient to provide 75 mEq of ammonium chloride?
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The normal calcium level in the blood is 10 mg%. Express this concentration in terms of mEq/L. MW Ca = 40 g/mol
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How many total milliosmoles per liter is in the following parenteral product
D5 1/2 NS with 30 mEq of KCl Molecular weights dextrose 180 g, sodium chloride (NaCl) 58.5, potassium chloride 74.5 (KCl) |
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What grade of chemical would be the best choice for compounding a prescription _____________________?
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The Q10 method is useful for ______________________________________________?
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List two excipient classes which can be added to decrease free radical induced drug degradation
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Contrast efflorescent and hygroscopic.
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Efflorescent releases water of hydration upon trituration or storage in low humidity (may result in overdose).
Hygroscopic absorb moisture from air (may result in underdose) |
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Which of the two preservatives would you expect to impacted the most by alterations in pH?
Benzoic acid Benzyl Alcohol |
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List 2 advantages of using methylcellulose instead of glycerin as a viscosity enhancer?
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Which flavor would be a great choice for overshadowing a bad tasting drug?
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What is the purpose of propylene glycol in the following prescription?
Metronidazole 5 g Propylene glycol 1 ml Simple Syrup 100 mL |
?
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What is the purpose of Zinc Sterate in the following?
Menthol 100mg Camphor 200 mg Zinc sterate 500 mg Talc 30 g |
?
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What is the purpose of Lactose in the following?
Morphine sulfate 1 g Dextromethophan HBr 3 g Lactose 35 g |
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List two excipients that are used in producing tablet triturates?
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What is Stevia?
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What is the purpose of silica gel in this prescription?
Estradiol 1 mg Silica gel 20 mg Fatty Acid Base qs |
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Below is a script for a dusting powder. Does it an absorbent?
Benzocaine 0.75 g (Salicylic Acid 0.75 g Benzoic Acidc 1.5 g Camphor 1 g Methyl Salicylate Talc qs ad 30 g |
?
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What is the purpose of Trolamine in this script?
Silver Sulfadiazine-Hydrocortisone Non-alcoholic Gel for Burns Claudia?s Prescription Silver Sulfadiazine 1g Hydrocortisone 2g Carbopol 940 0.5g Mineral Oil 8mL Polysorbate 80 1.5mL Trolamine 10-15drops Purified Water qs 100g |
?
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What is the purpose of hydroxypropylcellulose in this script?
Hydrocortisone ointment for seborrhea Prescription Hydrocortisone 2% Hydroxypropylcellulose 1.05 g Propylene glycol 2.4 ml (2.5 g) Polysorbate 80 1.3 g Isopropyl alcohol 70% qs ad 60 g |
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Which is the correct order of mixing
a. Dextrose-Fat-Aminoacid b. Fat-aminoacid-dextrose c. dextrose-aminoacid--fat d. all are correct |
c. dextrose-aminoacid--fat
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What is the purpose of methylparaben in this scrip?
Thioridazine Hydrochloride Concentrated Solution Thioridazine hydrochloride 10mg Alcohol 95% 4.5 ml Glycerin. 10ml Methylparaben 200 mg Propylparben 20mg Sorbitol 70% solution 60ml Sucrose 10g Sodium hydroxide and or HCl qs. |
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True/False
IV admixtures must be warmed to body temperature (37 C) before administration |
False
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Transfer of volumes from multiple ampuls or vials into a single, final sterile container or product is an example of
a. Low risk level CSPs b. Medium risk level CSPs c. High risk level CSPs d. none of the above |
b. Medium risk level CSPs
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CSP stands for
a. Compounded safe preparations b. Compounded sterile preparations c. Common sterile Practices d. Common Safety Procedures |
b. Compounded sterile preparations
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When reconstituting Amphotericin B
a. Use sterile water without bacteriostatic agent b. Dilute with 5% Dextrose c. Directly dilute with saline d. More than one is true |
d. More than one is true
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What does “Secundum Artem” mean?
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According to the Art
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What special license is required for a pharmacist to compound?
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Don’t need a special license, just being a pharmacist allows you to compound
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List the 3 legislative entities concerned with compounding
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USP/NF
FDA-Modernization Act Florida Board Rules and Regulations |
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What USP chapter governs Aseptic Compounding?
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USP Chapter 795
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What is the highest quality standard for compounding ingredients?
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USP/NF
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____________ is defined as “The extent to which a product retains, within specified limits, and throughout its period of storage and use, the same properties and characteristics that it possessed at the time of its manufacture”
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Stability
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Chemical stability means that each active ingredient retains its chemical integrity and labeled potency within specified limits. Drugs degrade by either a ____________ or ____________ order
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Zero Order
First Order |
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USP <797> requires an ISO Class 7 cleanroom environment for which of the following compounding situations?
a. Only high-risk compounding when using nonsterile ingredients. b. Only medium-risk compounding such as parenteral nutrient formulations. c. Low, medium, and high-risk compounding. d. Only CSPs with beyond-use dating extended to 30 days. |
c. Low, medium, and high-risk compounding.
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____________ is the process by which a certain fixed amount of substance degrades over time
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Zero Order
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Which of the following agents could be used to intensifier the flavor of an oral
formulation? A) Vanilla B) Cyclodextrin C) Mannitol D) Menthol E) Metronidazole benzoate |
A) Vanilla
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Which inducing viscosity agent increases its viscosity with an increase in temperature?
A) Methycellulose B) Poloxamer C) Carbomer D) Acacia E) Carboxymethcellulose |
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How many mLs of a 40% ethanol solution would you added to 100 ml of a 80% ethanol
solution to make a finial concentration of 70%? A) 25 mL B) 33 mL C) 50 mL D) 18.5 ml E) 27.5 ml |
?
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What is the function of methylparaben in the following compounded prescription?
GELATIN BASE Glycerin 155 mL Gelatin 3.4 g Methylparaben 440 mg Purified water 21.6 mL A) Binder B) Flavoring Agent C) Preservative D) Surfactant E) Suspending agent |
C) Preservative
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What is the most common incompatibility in the preparation of TPN. List two things which can limit this incompatibility.
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Incompatibility
Calcium & Phosphate Precipitation Methods to limit incompatibility A) low pH B) low temperature C) high amino acid D) high dextrose E) high cysteine |
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Explain why Amphotericin B should be diluted in D5W in stead of NS
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Salting out +5
Precipitate formation +4 |
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In class we discussed the three MACRO nutrients used in TPN therapy. Please list these i)three nutrients and indicate a ii)pathology that can limit their use finally iii)explain the mechanism behind this limitation
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a)___carbohydrates____
_pulmonary/glucose__ high CO2/low insulin b)_____lipid_________ _cancer/RES saturation _TNF-alpha__ c)_____proteins_______ _renal/ liver failure____ _inability to metabolize aromatic aa & excrete aa |
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A solution contains 1.25 mg per mL of drug. At what rate should the solution be infused (drops/min) if the drug is administered at a rate of 100 mg/h? The infusion set delivers 20 drops/mL).
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27drops/min
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A hospital medication order calls for the administration of 100 g of mannitol to be given over a 24 hour period. Calculate how many milliliters of a 15 (w/v) mannitol solution should be administered per hour. (Molecular weight of mannitol is 182 g/mol)
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27.78 ml/hr
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How many mEq of CaCl2 are represented in each prescribed dose? Molecular weight of CaCl2 is 111 g/mol
Calcium Chloride 10% Cherry Syrup qs ad 480 mL Sig 1 Tablespoonful BID |
27 mEq +5
18mEq +3 9 mEq +3 |
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How many grams of boric acid should be used in compounding the following prescription? E for Zinc Sulfate = 0.15; E for Boric Acid = 0.52
Zinc Sulfate 0.2 % Boric Acid q.s. Purified water 30 |
0.502 g
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How many milliosomoles (mOsm) are in one liter of the following solution
D10W with 1/3 NS and 40 mEq KCl Molecular weights: Dextrose = 180 g/mol NaCl = 58.5 g/mol KCl = 74.5 g/mol |
555.5+102.56+80 = 738 mOsm
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Which of the following is most likely to contain benzyl alcohol
A) Sterile water for injection B) Bacteriostatic water for injection C) Ringer’s Lactate D) Ethanol E) Elliott’s Solution |
B) Bacteriostatic water for injection
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____________ is the process by which a certain percent of the original amount of substance degrades over time
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First Order
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List 7 factors that affect stability (and, concomitantly, Aseptic products).
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• PHALTSS
• pH • Humidity • Air Exposure • Light • Temperature • Solvent • Size (of particle) |
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____________ is used more than the Arrhenius Equation for determining the reaction rate (chemical stability) of a compound
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Q10 method
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List 8 types of solvents
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•Water
•Ethanol •Isopropanol •Glycerin •Fixed oils •DMSO •DMF • Propylene Glycol |
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Which of the above solvents are Organic Solvents?
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•DMSO
•DMF |
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These general types of compounds tend to absorb light more easily than others
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Colored Compounds
Unsaturated compounds |
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How can a compound be made less likely to absorb light?
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•Wrap it fully and/or store in an opaque container
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Catechols (like epinephrine) are susceptible to what type of destabilizing factor?
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•Oxidation
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List two methods of preventing drug/chemical degradation by oxidation
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•Limit exposure
•Add antioxidants |
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Carbon dioxide can affect solubility and stability in what ways
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•Carbon dioxide dissolves in water and lowers pH (pH affects solubility and stability)
•Carbon Dioxide can cause the formation of insoluble carbonates to form in solid dosage forms (affecting solubility) |
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Humidity (water vapor) can also cause chemical instability as well as causing the conglomeration of dry particles, which can affect efficacy. List two methods of prevention of drug degradation due to humidity
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•Limit Exposure
•Add Desiccants |
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____________ compounds absorb moisture from the air. Compounds like these that absorb so much moisture from the air that they actually go into solution are called ____________ compounds.
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•Hygroscopic
•Deliquescent |
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A semisolid topical medication that retains its configuration, but flows with little pressure has ________ flow characteristics:
a. plastic b. dilatant c. pseudoplastic d. newtonian |
c. pseudoplastic
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This compound is so hygroscopic that its weight reading on a scale changes during the short time that it is being weighed.
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•Calcium chloride
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These types of powders contain “water of hydration” which may be released upon trituration (mixing) or storage in a low humidity environment.
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•Efflorescent powders
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When two dry powders are mixed in such a way that their respective melting points are lowered and they form a liquid/solution, they are called ____________.
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•Eutectics
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What two methods can be used to prevent formation of eutectics.
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•Keep known eutectics separated
•Add inert powders to absorb liquid |
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List three inert powders used to prevent eutectic formation.
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•Magnesium carbonate (MgCO3)
•Magnesium Oxide (MgO2) •Calcium Carbonate (CaCO3) |
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List 5 compounds known to form eutectics
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•Camphor
•Menthol •Phenol •Thymol •Salicylic Acid |
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Catecholamines, phenols, and steroids are susceptible to what type of chemical instability or degradation
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•Oxidation
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List 4 types of compounds that are susceptible to hydrolysis
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•Esters
•Thioesters •Amides •Imides |
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List the two major ways to limit hydrolysis susceptible compounds (like Esters, thioesters, amides, and imides)
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•Limit the amount of water in the formulation
•Adjust the pH or reaction rate |
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31. One of the chemical changes that can take place besides oxidation and hydrolysis is called Displacement. To prevent this from occurring, Cisplatin (a susceptible drug) is ALWAYS reconstituted/diluted in __________ instead of __________.
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•Saline
•D5W |
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Why is Cisplatin always dissolved in saline and NOT D5W?
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•Cisplatin requires the presence of a chloride ion
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What chemotherapeutic agent must be reconstituted in NaCl and not D5W?
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•Cisplatin
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Beyond-Use Dating for non-aqueous liquids and solids is not longer than __________ of the time remaining in the original product’s expiration date OR __________, whichever is most restrictive (shorter time)
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•25%
•6 months |
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The Beyond-Use Dating for a water-containing formulation is __________
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•2 weeks (14 days)
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For all other formulations besides water-containing formuations, non-aqueous liquids and solids, the BUD is either __________ or the duration of __________
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• 30 days
• Intended therapy |
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This compound is no longer used in parental because it hydrolyzes (degrades) to HCl, causing the pH to drop, affecting both its solubility and stability
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•Chlorobutanol
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For what 4 situations would preservatives NOT be needed?
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•Immediate (or single-use) medications
•No water is present •No nutrients present •Ph <3 or >9 Antimicrobial properties in ingredients |
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What preservative is contraindicated in neonates and why?
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Benzyl Alcohol
Benzyl Alcohol can be a neurotoxin, especially to neurons in the eye |
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In what two other conditions are preservatives contraindicated?
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Small volume parenteral products (<50ml)
In ophthalmic solutions with non-intact cornea or injections |
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T/F Preservatives are concentration dependent
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•True
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What percent sugar must a product be to be considered “self-preserving”?
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•85% (all water being used to keep sugar in solution, bacteria can’t use it)
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Isoproyl and Ethyl alcohol are very good water-soluble preservatives; what other substances are often used as preservatives but are not very water soluble (these are esters of p-hydroxybenzoic acid)?
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• Parabens (e.g. methylparaben)
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How can the water solubility of a paraben be increased?
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• Adding small concentrations of different parabens
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Which solvents are used more, alcohols or glycols?
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•Glycols
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List 3 antioxidants found in aqueous systems
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•Ascorbic Acid (Vit C)
•K metabisulfite •Na metabisulfite |
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List 2 antioxidants found in oil systems
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•Butylated hydroxyanisole (BHA)
•Butylated hydroxytoluene (BHT) |
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What do chelating agents do (why are they damaging)?
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•Chelating agents interact with heavy metals that propagate free-radical production
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List four (4) chelating agents
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•Edetate disodium
•Edetic Acid •Citric Acid •Tartaric Acid |
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List two (2) commonly-used ophthalmic buffers
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•Boric Acid
•Sodium borate |
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List two (2) classes commonly-used non-ophthalmic buffers
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•Phosphates
•Acetates |
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What characteristic is a fluid said to have when its flow properties do not change based on pressure exerted upon the fluid?
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•Newtonian (Newtonian fluids do NOT change their flow properties based on the pressure)
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Do aqueous solutions display Newtonian or non-Newtonian flow properties? Is this desirable?
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•Aqueous solutions display Newtonian flow properties
•This is NOT desirable |
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This type of viscosity-adding agent becomes less viscous (flows better) after agitation
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•Pseudoplastic
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64. The three most commonly-used types of viscosity-inducing agents include pseudoplastics and these two types
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•Thixotropy
•Dilatant |
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Shear thinning is associated with __________ type viscosity-inducing agents, shear thickening is associated with __________ type viscosity-inducing agents, and __________ type viscosity-inducing agents lose consistency when sheer is applied.
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•Pseudoplastic
•Dilatant •Thixotropy |
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List the three common pseudoplastic viscosity-inducing agents mentioned in class
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Acacia
Tragacanth Methylcellulose Carboxymethylcellulose |
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Carboxymethylcellulose and methylcellulose are semi-synthetic cellulose viscosity agents; what are Acacia and Tragacanth classified as?
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•Natural Polymers / Gums
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Besides semi-synthetic cellulose, natural polymers, and synthetic polymers, what fourth class of viscosity agents exists? List two examples of this type
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•Particulate Colloids
•Silicone dioxide, Microcrystalline cellulose |
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What detergents are most often seen being used as surfactants/emulsifying agents?
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•Salts of alkyl sulfates
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These synthetic, non-ionic surfactants are also commonly used.
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•Tween
•Spans |
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Functionally, surfactants/emulsifying agents reduce the __________ between __________ and __________ to allow their molecules to get closer together.
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•Interfacial (surface) tension
•Oils •Water |
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(Taste) Changing the taste of a formulation often has an effect on the dosage form because most flavors are __________ and they decrease __________, therefore affecting both stability and solubility
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•Acidic
•pH |
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Overstimulating the taste buds can cause them to de-sensitize; this condition is called __________ and can be used to an advantage in masking unpalatable drugs
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•Flavor fatigue
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List three demographic characteristics that affect a patient’s sensitivity to odor (which is usually more sensitive than their taste)?
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•Age (Smell declines with age)
•Gender (F > M for odor) •Current disease state |
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One of the most common flavoring techniques involves using a flavor that mixes with the drug taste; this is called__________
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•Blending
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Using a flavoring with stronger intensity than the drug taste is called__________
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•Overshadowing (masking)
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List four (4) physical methods/techniques for flavoring?
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•Forming insoluble compounds (drug must be in solution to be tasted)
•Emulsifying oils •Effervescent additives (e.g. carbonation) •Increasing Viscosity |
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List three (3) chemical methods/techniques for flavoring?
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•Adsorbing
•Complexing •Forming Inclusion complexes |
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As stated before, Mannitol has a cooling effect; what two flavors introduce heat and numbness? What three flavors tend to have anesthetic actions?
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•Cinnamon and clove
•Spearmint, peppermint, menthol |
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Monosodium glutamate (MSG), citric, maleic, and tartaric acids, and vanilla are types of __________
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•Flavor intensifiers
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These two dosage forms require more flavoring simply because they spend more time in the oral cavity?
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•Lozenges and gummy gels
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This sweetening agent is 200-500 times sweeter than sugar, has a bitter aftertaste, and has been shown to cause cancer in laboratory rats (at astronomical doses)
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•Saccharin
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This sweetening agent is 200times sweeter than sugar but has stability problems outside of certain pH and temperature (no bitter aftertaste)
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•Aspartame
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This sweetening agent is naturally-occurring and very powerful; it is used when attempting to avoid synthetic sweeteners.
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•Stevia
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List two major problems with dosing metronidazole
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•Tablets may be too large
•Bitter taste, very hard to mask •Child dosing may be small (dividing tablets into fifths or tenths is impractical) |
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List three reasons for compounding a suspension (vice another DF)
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•Adult patients with difficulty swallowing tablets/capsules
•Pediatric patients who are too young to swallow tablet/capsule •For patients who desire this DF and it’s not commercially available |
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97. Though colors don’t usually impart any pharmaceutical effects, they can have an affect on this property of a drug, and vice versa
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•pH
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The prevention or inhibition of microbial growth is called __________; four types of these compounds are
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•Preservation
•EDTA •Anhydrous chlorobutanol •Sodium benzoate •Parabens phenol |
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List the five (5) organisms for which preservatives are specifically added
|
• CAPES (not SPACE)
•Candida albicans •Aspergillus niger •Pseudomonas aeruginosa •E. coli •Staph aureus |
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What antibiotics are susceptible to complexation? Why is this undesirable?
|
•Fluoroquinolines (and tetracyclines)
•FQ’s can no longer be absorbed so they lose their biological activity |
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What atoms (4) can cause complexation?
|
• Calcium (Ca)
• Magnesium (Mg) • Iron (Fe) • Aluminum (Al) |
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The presence of one chiral center in a compound makes it susceptible to __________ while the presence of multiple chiral centers makes it susceptible to __________
|
• Racemization
• Epimerization |
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What are the 2 purposes of cosolvents?
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Increase solubility and decrease precipitation
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