Dosage Forms Exam 3 Tablets/buccal/sublingual

Front 1

What is NOT a characteristic of the lumen in the esophagus?
a. Coated with mucous
b. Narrow
c. A lot of water
d. Little water

Back 1

c. A lot of water

Front 2

When the drug dissolves in the esophagus it leads to high __________ and possible ________, _________ and ___________.

Back 2

Concentration
irritation
inflammation
ulceration

Front 3

These are the 6 ___________ ___________ to ___________
Shape
Size
Surface properties
Patient position
Volume of water
Disease (diabetes, alcoholism, esophagitis from reflux)

Back 3

predisposing factors
adhesions

Front 4

True/False
The best position to take a tablet is supine

Back 4

False. is standing up. Supine position increases adhesion risk.

Front 5

What type of tablets are intended to dissolve slowly in the mouth over 30 minutes?

Back 5

Lozenges

Front 6

True/False
Lozenges generally provide a local effect.

Back 6

True
Note: Nicotine lozenges will have a systemic effect

Front 7

Lozenges (cough drops) are prepared and formulated like __________.

Back 7

Hard candy

Front 8

_______ are compressed into a hard disc.

Back 8

Troches

Front 9

How are chewable tablets prepared?

Back 9

Wet granulation, sometimes without a disintegrant (chewing takes its place)

Front 10

What ingredients do chewable tablets often have in them to give a cooling sensation in the mouth?

Back 10

Mannitol or xylitol

Front 11

The release of ___________ helps prepare effervescent disintegrants.

Back 11

CO2

Front 12

True/False
It is suggested that fast dissolve tablets be taken with water.

Back 12

False. Water is not needed.

Front 13

True/False
There is always a faster onset of action with fast-dissolving tablet.

Back 13

False. Not necessarily because the drug dissolution can be rate-limiting due to coated drug particles.

Front 14

What three methods are used to produce tablets that imbibe (absorb) water very quickly?

Back 14

Lyophilization
Direct compression (effervescent disintegrants)
Molding

Front 15

_____________ leaves the tablet very porous and usually brittle.

Back 15

Lyophilization (freeze drying)

Front 16

__________ tablets are to be dissolved in liquid prior to ingestion.

Back 16

Effervescent

Front 17

Effervescent excipients can be ____________ so the tablet must be well protected

Back 17

hygroscopic

Front 18

Ventral surface of the tongue and floor of the mouth is known as ________________.

Back 18

Sublingual

Front 19

The lining of the cheek, between the cheek and gums is known as___________.

Back 19

Buccal

Front 20

True/False
The purpose of administering drugs orally is to obtain a local effect.

Back 20

False. To obtain a LOCAL and SYSTEMIC effect.

Front 21

The structures and properties of oral mucosa are intermediate to _______ and ________. What type of cell does it have?

Back 21

Intestinal mucousa and epidermis
Squamous epithelium with mucous

Front 22

The principle barrier for drug absorption is ____________.

Back 22

Epithelium

Front 23

Because the epithelium is ___________ ____________, it is a good systemic source of delivery.

Back 23

highly vascularized

Front 24

True/False
Buccal and Sublingual membranes are not keratinized.

Back 24

True

Front 25

Is thickness of Buccal greater than or less than Sublingual?

Back 25

greater than

Front 26

Is permeability of Buccal greater than or less than Sublingual?

Back 26

less than

Front 27

Saliva has a pH of ______, has _________ variations in amounts, is critical for _______ __________.

Back 27

7
anatomical (due to the pool of saliva under tongue)
drug delivery (saliva has the ability to wash away and dissolve a drug)

Front 28

What are three Advantages to Sublingual/Buccal delivery?

Back 28

Avoid GI acid degradation/GI enzymatic degradation and the hepatic first pass effect.

Rapid onset of action and high blood levels (example: NTG)

Can be used for prolong action (buccal can be several hours)

Front 29

Which of the following is NOT one of the disadvantages to Sublingual/Buccal route?

a. Unpredictable bioavailability
b. Drug can be washed away
c. Low permeability for most drugs
d. All of the above are disadvantages

Back 29

d. All of the above are disadvantages

Front 30

What causes the low permeability of the drug in the sublingual/buccal route?

Back 30

Skin-like barrier properties

Front 31

How can a drug be washed away?

Back 31

Saliva, eating and drinking

Front 32

What causes unpredictable bioavailability?

Back 32

Due to mucosal variations

Front 33

Sublingual products were designed for __________ (rapid/slow) drug release over a ________ (short/long) period of time.

Back 33

rapid
short

Front 34

Why should the sublingual drug be absorbed quickly?

Back 34

To prevent it from being washed away by the saliva

Front 35

Buccal products were designed for ___________ (rapid/slower) release over a _________ (shortened/sustained) period of time.

Back 35

slower
sustained

Front 36

True/False
Some buccal products give fast relief.

Back 36

True. For example, fentanyl.

Front 37

True/False
Buccal products are a relatively easy to keep in place.

Back 37

True

Front 38

Why should the sublingual/buccal drug and excipients be bland and non-irritating?

Back 38

To not stimulate saliva flow, in order to have a high first pass effect.

Front 39

In sublingual administration, tablets are designed to dissolve _____________ (slow or rapidly), and leave ___________ (little/a lot) of residue.

Back 39

rapidly
little

Front 40

Name the two types of sublingual tablet forms.

Back 40

Compressed Tablets (lightly compressed to facilitate disintegration)
Molded tablets (Tablet Triturates)

Front 41

What are 2 examples of compressed sublingual tablets?

Back 41

Isosorbide dinitrate (Sorbitrate)
Nitroglycerin (Nitroquick, Nitrostat)

Front 42

What are the 2 purposes of Lactose in NTG Sublingual tablets?

Back 42

1. Diluent
2. Adsorbs to NTG to reduces volatility and explosive effect.

Front 43

True/False
Compressed sublingual tablets are softer than molded sublingual tablets.

Back 43

False. Molded sublingual tablets are softer.

Front 44

4 Steps for molding NTG tablets are __________, ____________, __________, and ____________.

Back 44

1. Powder mix is moistened in 60% alcohol
2. Moistened mass is pressed into mold plates
3. Wet tablets forced out
4. Tablets dried under ambient conditions (room temperature)

Front 45

Why are molded NTG tablets usually dried under ambient conditions?

Back 45

To limit NTG Evaporation

Front 46

What are the five forms of buccal administration?

Back 46

Chewing gum
Lozenges
Lollipops
Mucoadhesive Tablets
Orally Disintegrating Tablets

Front 47

What are two advantageous characteristics of nicotine chewing gum?

Back 47

High hepatic first pass
Good Buccal absorption

Front 48

Nicotine is bound to a(n) ______ exchange resin, and is formulated with buffer to raise the pH to ____.

Back 48

cation
8.5

Front 49

True/False
Basic pH decreases unionized form thus increasing absorption.

Back 49

False
Basic pH INCREASES the unionized form thus increasing absorption.

Front 50

What is the purpose of formulating the chewing gum with a buffer?

Back 50

To raise the pH to 8.5 so the drug becomes unionized and is absorbed.

Front 51

The systemic bioavailablity of chewing gum depends on what?

Back 51

The time the saliva is held in the mouth. If swallowed, nicotine is hepatically metabolized.

Front 52

Commit (nicotine polacrilex) is an example of
A. Chewing gum
B. Lozenge
C. Lollipop
D. Mucoadhesive tablet

Back 52

B. Lozenge

Front 53

How does Nicotine get out of chewing gum and lozenges?

Back 53

Nicotine is bound to a cation exchange resin and is released from this

Front 54

Fentanyl citrate (Actiq) is an example of what kind of buccal administration?

Back 54

Buccal lollipop (fast relief)
Lipophillic
High hepatic and intestinal first pass.

Front 55

What are two advantages of Fentanyl citrate (Actiq)?

Back 55

Lipophilic (fast relief)
High hepatic and intestinal first pass

Front 56

How long should fentanyl be sucked, and what is the absorption time frame from the mouth and GI?

Back 56

15 minutes
Rapid absorption in cheek, and prolonged absorption in GI

Front 57

What are 2 advantages of Lollipops?

Back 57

Unlikely to be swallowed
Can be removed easily

Front 58

These are examples of ______ class of buccal drugs.
Striant (testosterone buccal system)
Nitrogard (nitroglycerin)

Back 58

Mucoadhesive Tablets (slowly disintegrate or dissolve)
Striant (testosterone buccal system) - high hepatic first pass, bad oral candidate; stays until removed
Nitrogard (nitroglycerin)

Front 59

Nitroglycerin can be in which of the following dosage forms:
A. Sublingual tablet
B. Sublingual spray
C. Mucoadhesive tablet
D. All of the above

Back 59

D. All of the above

Front 60

True/False
All orally disintegrating tablets are meant for GI Absorption.

Back 60

False. Not all orally disintegrating tablets are meant for GI Absorption.

Front 61

Zelapar is an example of what class of ______ class of buccal drugs.

Back 61

Buccal
Zelapar - Placed on tongue where it rapidly dissolves

Front 62

How are orally disintegrated tablets prepared?

Back 62

Lyophilization