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362 Cards in this Set
- Front
- Back
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What is secundum artem?
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According to the art
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What should we compound compounding?
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1) noncompliant patients
2) Difficulty in handling or measuring dosages 3) Physiological barriers that prevent dosing by one route of administration 4) Home care settings 5)Unique dosages depending on PK of the patient 6) Commerical product is not the best formulation or dosage amount for the patinet 7) Orphan drugs 8) Veterinary practice |
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What are the different types of stability?
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1) Chemical
2) Physical 3) Microbiological 4) Therapeutic 5) Toxicological |
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What factors can affect stability?
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1) pH: affects solubility
2) temperature 3)solvent 4) light 5) air 6) humidity 7) particle size: smaller particles stay in suspension better, are harder to resuspend |
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Water acts as a....
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1) solvent
2) Binder for compressed tablets 3) Liquid portion for pills Many different types, depends on use |
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Ethanol acts as a ...
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1) solvent
2) Liquid portion for pill preparation |
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Isopropanol acts as a...
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solvent-can be used topically
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Glycerin acts as a ...
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1) solvent
2) wetting agent 3) reducing agent 4) Liquid portion for pill preparation |
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Fixed oils acts as a...
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solvent
Use cautiously due to allergies May have pharmacological effect themselves (eg mineral oil) |
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DMSO acts as a ...
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solvent
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What are some ways to decrease light?
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Put in dark bottle, but can be difficult to see final product
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What are eutectics, and what do they cause?
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Solids that mix to form liquid
eg: APAP, camphor, menthol, phenol, thymol, salicylic acid, lidocaine |
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What are some ways to deal with eutectics?
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1) Separate and mix
2) Add inert powders (Mg carbonate, Mg oxide, Ca carbonate, lactose)-add after liquid formed 3) Keep ingredients separated as much as possible 4) Add absorbent powder (talc starch, lactose, calcium phosphate) |
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What is an example of a compound product that precipitates at lower temperature/fridge?
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Metronidazole
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What is an example of a product that forms large cation/anion complexes?
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Heparin sodium and gentamicin sulfate
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What chemical groups undergo hydrolysis?
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1) esters
2) amides 3) imides 4) thioesters |
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What chemical groups undergo oxidation?
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1) Catecholamines
2) Phenols 3) steroids Factors: oxygen, light, heavy metal ions, temperature , pH and other oxidizing agents |
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T/F Cisplatin is easy to keep in solution.
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False
Compounds may complex with ions |
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What are some examples (drugs) of complexation chemical change?
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1) Tetracycline
2) Aminophylline |
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What are some examples of drugs that undergo racemization?
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1) Epinephrine
2) Bupivacaine 3) Amphetamine |
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If manufactured nonaqueous liquids and/or solids are used in compounding, what is the beyond-use-date?
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25% of the time remaining on manufacturer's expiration date
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If ingredients in compounding are USP or an NF substance, what is the beyond-use-date?
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Should be no later than 6 months
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If compound contains water, what is the beyond-use-date?
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14 days when stored in fridge
Shorter due to concerns about hydrolysis |
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Chlorobutanol is used for...
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Opthalmic preservative
hydrolyzes to HCL salt, but is inactivated by polysorbate 80, PVP methylcellulose (adsorption) |
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What are some disadvantages to using chlorobutanol as a preservative?
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1) Loses microbial effect
2) Changes inpH can lead to precipitation, changes in hydrolysis |
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When are preservatives not necessary?
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1) Used immediately
2) No water present 3) No nutrients present 4) pH: <3, >9 5) Already have ingredients with antimicrobial properties |
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When are preservatives contraindicated?
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1) Neonates: benzyl alcohol can cause neurotoxic effect
2) Opthalmic products with non-intact cornea or injections 3) Parenteral products >50mL |
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Alcohols and glycols can be used in topical products as a ....
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1) preservative: needs to be at least 15%
2) alcohol: Binder for compressed tablets alcohol: biting taste Glycols like glycerin |
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Organic acids (benzoic acid, sorbic acid) can be used in topical products as a ...
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preservatives
are weak acids |
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Parabens can be used in prodcuts as a ...
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preservative
AKA esters of p-hydroybenzoic acid more common and more effective in acidic environment methylparaben: aroma, gauze pads propyl and butyl paraben: numbness in mouth |
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When are preservatives not necessary?
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1) Used immediately
2) No water present 3) No nutrients present 4) pH: <3, >9 5) Already have ingredients with antimicrobial properties |
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When are preservatives contraindicated?
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1) Neonates: benzyl alcohol can cause neurotoxic effect
2) Opthalmic products with non-intact cornea or injections 3) Parenteral products >50mL |
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Alcohols and glycols can be used in topical products as a ....
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preservative
needs to be at least 15% Glycols like glycerin |
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Organic acids (benzoic acid, sorbic acid) can be used in topical products as a ...
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preservatives
are weak acids |
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Parabens can be used in prodcuts as a ...
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preservative
AKA esters of p-hydroybenzoic acid more common and more effective in acidic environment |
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What are organic mercurial derivatives and their use?
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1) Phenylmercuric acetate NF, phenylmercure nitrate NF, thimersol USP
2) preservative, but not really used anymore |
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Benzylalkonium chloride NF is used for...
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preservative, esp in topicals
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Glycols can be used as...
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solvent
eg: glycerin, propylene glycol, polyethylene glycol Ideal product is water, may need to dissolve drug |
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T/F isopropyl alcohol can be used as a solvent in external products.
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True
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What are the different types of alcohols for solvents?
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1) Ethyl alcohol: dehydrated alcohol, rubbing
2) Isopropyl alcohol: external use only |
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Ascorbic acid is used as ...
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AQUEOUS antioxidant
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Hydrophosphorous acid is used as...
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Aqueous antioxidant
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Potassium and Sodium metabisulfites are used for
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Aqueous antioxidant
may cause allergy |
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Sodium thiosulfate is used as a ...
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aqueous antioxidant
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Sodium formaldehyde sulfoxylate is used as a ...
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aqueus antioxidant
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Ascorbyl palmitate is used as a ...
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oil system antioxidant
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BHA is used as a ....
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oil system antioxidant
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BHT is used for...
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oil system antioxidant
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Propyl gallate is used for..
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oil system antioxidant
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Tocopherol is used for...
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oil system antioxidant
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Edetate disodium is used as a ...
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chelating agent
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Edetic acid is used for...
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chelating agent
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Tartaric acid is used as a ...
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chelating agent
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What is used as an opthalmic buffer?
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Boric acid/sodium borate
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What are commonly used as an oral dosage form buffer?
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phosphate/ bisphosphate
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Glacial acetic acid is...
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acidifying agent
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Boric acid is...
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acidifying agent
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HCl is ...
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acidifying agent
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Sodium acetate is ...
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alkalizing agent
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Sodium carbonate is...
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alkalizing agent
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Nad, K hydroxide is...
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alkalizing agent
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Aceitic acid is
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acidic buffer
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Citric acid is ...
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1) acidic buffer
2) chelating agent 3) flavor intensifier 4) efflorescent powder |
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Lactic acid is ...
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acidic buffer
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Sodium bicarbonate is ...
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1) alkaline buffer
2) Base of insert (tablet) |
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Na, K citrate
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alkaline buffer
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Dibasic or monobasic phosphate is ...
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alkaline buffer
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Acacia is...
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1) natural polymer: viscotiy agent (suspending agent)
2) can act as a binder 3) Vehicle in pill preparation 4) Demulcent |
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Methylcellulose is
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semi-synthetic cellulose
VERY pH sensitive most commonly used, can manipulate easily |
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Carboxymethylcellulose is..
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semi-synthetic cellulose
VERY pH sensitive most commonly used, can manipulate easily |
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Hydroxypropylcellulose is ...
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semi-synthetic cellulose
VERY pH sensitive most commonly used, can manipulate easily |
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Hydroxypropyl methylcellulose is...
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semi-synthetic cellulose
VERY pH sensitive most commonly used, can manipulate easily |
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Tragacanth is ...
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1) natural polymer: viscosity agent
2) Vehicle for pill preparation |
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Xanthum gun is ...
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natural polymer
viscosity agent |
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Carbomer NF is ...
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synthetic polymer
viscosity agent Good for SR |
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Poloxamer is ....
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synthetic polymer
viscosity agent Has pH sensitivity Good for SR |
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Bentonite and veegum are...
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viscosity agent
particulate colloid Bentonite: vehicle for dusting powder; suspending agent in lozenges |
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Silicone dioxide is ..
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1) particulate colloid: viscosity agent
2) Glidant |
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Microcrystalline cellulose is...
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1) particulate colloid: viscosity agent
2) Diluent in compressed tablets |
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Soft soaps are ...
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salts of fatty acids in which the positive is univalent
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Hard soaps are...
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Salts of fatty acids in which the cation is polyvalent
eg lava soap |
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Stearyl alcohol is ...
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natural non-ionic surfactants
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Cetyl alcohol is ....
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natural non-ionic surfactant
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Tweens are...
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synthetic non-ionic surfactants (most common type used)
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Spans are....
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synthetic non-ionic surfactants (most common type used)
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What flavor/taste results from the following: inorganic salts, high MW< unsaturation, polyhydroxyl compounds.
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1)inorganic acid: salty
2) High MW: bitter 3) Unsaturation (DB): sharp biting taste 4) polyhydroxyl compounds: sweet |
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What are some other ways to mask bad taste?
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1) Hot taste: mild counterirritante
2) astringent taste: tannins and acids 3) coarseness: texture 4) Coolness: negative heat of solution-absorbs heatm chewable tablets with mannitol |
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Definition of Topicals
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Preparations applied to the skin either for their physical effects of for the specific effect of a medicinal agent.
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T/F Topicals are compounded most often in community pharmacies.
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True.
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What are the types of topicals agents?
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Protectants, lubricants, emollients, drying agents, astringents
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What are taste preference in adults? children?
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1) adults: bitter is ok
2) children: like sweet |
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What is blending?
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Flavoring techniques
Use a flavor that blends with drug taste (eg acid drugs with citric flavor) |
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What is overshadowing?
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Flavoring technique
Use a flavor with a stronger intensity eg wintergreen oil |
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What are some physical methods for flavoring?
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1) Formation of insoluble compounds (metronidazole benzoate)
2) Emulsification of oils 3) Effervescent additives (good for salty) 4) High viscosity (syrups) |
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What are chemical methods for flavoring?
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1) Adsorbing
2) Complexing eg Cylcodextrin makes a pallatable powder by hiding bad tasting drug |
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What are physiological methods for flavoring?
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1) Cooling: mannitol
2) Anesthetic action: menthol, peppermint, spearmint 3) Heat and numbness: cinnanmon, cloves |
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What is purpose of transdermals?
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Designed to support passage of drug substances from the surface of the skin, through the various layers, and even into the systemic circulation
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What are two challenges of using transdermals?
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1. to get the drug all the way through the skin
2. dose-dumping (fentanyl) |
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What are the functions of dermatologists?
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1. Protect injured areas from the environment
2. Provide for skin hydration (emollient - may be used for antimicrobial) 3. Vehicle for medication transport |
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Drug penetration is dependent upon what? (in order of importance)
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1. Condition of the skin (burn victim)
2. Base used (Oil based drugs stay in oil base, where as they leave water base) 3. Surface area covered 4. Amount of pressure (vigor and rubbing) AND Occlusive dressing use |
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Classical Ointment Base Classifications (Hint there are 3)
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Epidermic: topical only (calamine, zinc oxide)
Endodermic: middle (minoxidil/Rogaine) Diadermic: all-the-way-thru (fentanyl) |
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Monosodium glutamate is ...
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flavor intensifier
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Maleic or tartaric acid is...
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flavor intensifier
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Vanilla is for...
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flavor intensifier
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Ointment base classification in relationship to water
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1) Oleaginous
2) Absorption 3) Water Soluble 4) Emulsion (o/w, w/o) |
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What are the characteristics of oleaginous ointment bases?
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1.) Water insoluble (can NOT wash off)
2.) Not water washable (need soap) 3.) Can't absorb water |
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What is an advantage of an oleaginous ointment base?
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Good protective ability
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What are disadvantages of oleaginous ointment bases?
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Oily, occlusive, lack cosmetic appeal
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Hydrocarbons are used as what type of base?
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Oleaginous
(examples: mineral oils, petrolatums, paraffins, waxes) |
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Cyclodextrin is used in _____ because it does _____.
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1) flavoring
2) complexes with a drug Cyclodextrin is a ring of sugar molecules with cavity in middle for drugs to complex with |
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T/F Lozenges do not need as much flavoring.
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False, actually need more flavoring since lozenges are on the tongue longer
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What are some examples of substance that flavoring oils can be dissolved in?
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1) glycerin
2) sorbitol |
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What are some non-caloric sweetners?
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1) saccharin: 200-500x more sweet, bitter after taste
2) Aspartame: 200x, stability problems with pH and temperature |
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What is a popular natural sweetner in compounding?
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stevia
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What is the advantage of metronidazole benzoate?
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1) ester hides bitter taste; however, not soluble, so decreases solubility
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What are the uses of following agents and excipients:
1) metronidazole 2) propylene glycol 3) methylcellulose agent 4) simple syrup |
1) API
2) viscosity agent and wetting agent 3) base 4) flavor/taste |
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Zinc oxide can be used to ...
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natural color (pharmaceutical elegance; improve acceptability)
Adhesiveness to powder |
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Ferric oxide can be used to...
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natural color (pharmaceutical elegance; improve acceptability)
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Titanium oxide can be used to...
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natural color (pharmaceutical elegance; improve acceptability)
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What type of bases are synthetic esters?
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Oleaginous Bases
examples: glyceryl monosterate, butylsterate, isopropyl lanolate, cetyl alcohol, stearyl alcohol) |
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Which synthetic ester (oleaginous base) is used most often?
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glyceryl monosterate
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Animal/Vegetable fats/oils are ______ products for a ________ base.
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NATURAL product
OLEAGINOUS base |
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What are some characteristics of Absorption Ointments?
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1) Water insoluble
2) Not water washable (need soap) 3) CAN absorb water due to excipients 4) Anhydrous |
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What are some disadvantages to Absorption ointments?
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Oily, Occlusive, and lacks cosmetic appeal
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T/F All dyes must be approved by the FDA, but only for oral or topical dosage forms.
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False, only synthetic dyes
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What are some products that should not get dyes?
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1) IV
2) Internal products -other than oral products |
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What some classic examples of oleaginous bases?
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White Petrolatum
White Ointment |
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What are two types of absorption bases?
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1) Hydrophilic petrolatum
2) Wool fat |
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Hydrophilic Pertolatum is made of up:
-White Beeswax -Stearyl Alcohol -Cholesterol -White petrolatum What is each one in there for? |
-White Beeswax --> stiffness
-Stearyl Alcohol --> surfactant -Cholesterol --> surfactant -White petrolatum --> base |
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How much water can be added to hydrophilic petrolatum (an absorption base)?
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20 to 40%
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What are two trade names for absorption bases?
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Aquaphor and Aquabase
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EDTA is used as a ...
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1) preservative
2) can irritate skin and mucous membranes (vaginal and rectal tissue) |
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Sodium benzoate is for...
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preservative
pH dependent (best at 5-7) |
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What can parabens do?
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1) Form eutectics
2) May bind to macromolecules and precipitate |
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What are the organisms preservatives must protect against?
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1) Candida albicans
2) Aspergillis niger 3) Pseudomonas aeruginosa 4) Staph aureus 5) E. coli |
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What are the general principles of weighing and measuring?
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1) Select weighing equipment and measuring devices appropriately
2) Use devices appropriately 3) USe smallest possible to measure amount needed 4) Maintain the equipment and retain tolerances |
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Describe Wool Fat for me...
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Well Katie... It is a sticky, unctuous, odorous vehicle and it exhibits color instability
aka -- smelly and oily unctuous -- means fatty or bland |
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Can water be incorporated into Wool Fat?
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Why yes it can
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Characteristics of Emulsion bases that are Water - in - Oil (w/o)
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1) Water insoluble
2) Nat water washable 3) Can absorb water 4) Contains water |
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Cold cream (aka Petrolatum-Rose Water Ointment) is an example of what kind of base?
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emulsion (w/o)
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What is another name for Wool Fat?
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Anhydrous lanolin
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Definition of capacity
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maximum weight that can be placed on a balance pan
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Definition of sensitivity (in weighing)
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smallest weight that gives a perceptible change in the indicatin element
ie the smallest detectable difference |
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Definition of readability
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smallest weight increment that can be read ont he dial, weigh bean or digital display
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Definition of accuracy
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closeness of the displayed weight to the trus weight
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Definition of precision
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reproducibility of the weighing measurement as expressed by a standard deviation
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T/F The term scale can be used interchangeably with balance.
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False...Scales have springs, balances do not
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What is the sensitivity requirement for a Class A prescription balance? Capacity?
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6 mg
15.5 gm |
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Electronic single pan balances must have a precision of...
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1 mg
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How do you calculate minimum weighable quantity?
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MWQ = 20 * sensitivity
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What are the tests performed on balances?
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1) sensitivity requirement
2) Arm ratio test 3) Shift tests 4) Rider and graduated beam test Tests are done once a year |
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What are some advantages of emulsion bases that are w/o?
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Easy to spread, more cosmetically elegant, and occlusive dressings
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Characteristics of emulsion bases that are Oil - in Water (o/w).
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1) Water insoluble
2) WATER WASHABLE -Water is the external phase - Up to 80% oil in the internal phase -- the more internal phases, the less stable 3) Can absorb water 4) Contains water |
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An emulsion base (o/w) called hydrophilic ointment contains:
-Mthyl paraben -Propyl paraben -Sodium lauryl sulfate -Propylene gylcol -Stearyl alcohol -White petrolatum -and purified water What is each thing for? |
-Methyl paraben --> perservatives
-Propyl paraben --> perservatives -Sodium lauryl sulfate --> surfactant -Propylene gylcol -->humectant -Stearyl alcohol --> synthetic ester oleaginous base -White petrolatum --> oil base -and purified water --> water :) |
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The list below are examples of what?
-Velvachol -Unibase -Dermabase -Vanicream -Acid Mantle |
Emulsion bases OIL - IN - WATER
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Define humectant
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a substance that promotes retention of water
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T/F Apothecary weights can be used interchangeably with Avoirdupois weights.
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False
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What is/are calibrated 'to contain' (TC)?
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Volumetric flasks
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What is/are calibrated 'to deliver' (TD)?
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Graduates, pipettes, burrettes
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What are some types of humectants?
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1) Glycerin
2) Propylene glycol (most popular) 3) Sorbitol 70% |
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Characteristics of WATER SOLUBLE bases.
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1) Water soluble (DUH!)
2) Water washable 3) Can absorb water --> less protective 4) Anhydrous or hydrous All water soluble... NO OIL PHASE |
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Veegum is a _________ agent.
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THICKENING agent
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What are some examples of water soluble bases?
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1) Polyethylene gylcol
2) Biozyme ointment 3) Desenex ointment 4) Whitfields ointment 5) Veegum 10% and 5% |
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For polyethlene glycol (PEG)...the higher the number...the ______ the melting point.
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HIGHER the melting point.
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What are bulk powders? Requirements? uses? examples?
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1) Intended to be administered in dosage quantities which are safe for the patient to measure
2) Should pass through a 100-mesh sieve 3) Dusting powders, aerosols, dentifrices, antacids, laxatives, dietary nutrient supplements, douches |
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What are some advantages of divided powders?
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1) Allows prescriber to prescribe precise amount of drug
2) More stable than liquid form of most drugs 3) Usually dissolve more rapidly than compressed solid dosage forms 4) rapid dissolution (can cause faster blood levels, and possibl less GI irritation) |
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Define the different types of powders (very coarse, coarse, moderately coarse, fine, very fine).
|
1) Very coarse: 2 mesh
2) Coarse: 20 mesh 3) Moderately coarse: 40 mesh 4) Fine: 60 mesh 5) Very fine: 80 mesh |
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What level of coarseness do pharmacies want.
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fine (60 mesh)
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Definition of communition
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particle size reduction
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T/F. The release rate a substances is constant throughout all the ointment bases.
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False
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In a dermatological sense, where are lotions (low viscosity) used?
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intertriginous areas (where skin rubs on skin --> arm pits, thighs, between toes)
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In a dermatological sense, where are creams (o/w, w/o) used?
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Moist, weeping lesions (ex: bug bites that ooze)
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In a dermatological sense, where are ointments used?
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Dry, scaly lesions
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Define Ointments.
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Semisolid preparations intended for external application to teh skin or mucous membranes which soften or melt at body temperature.
They should spread easily and be non-gritty. |
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Defintion of powder
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Fine substance resulting from the comminution of any dry substance
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What are the disadvantages of powders?
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1) Not suitable for bitter, nauseatng or corrosive drugs
2) Preparation is time-consuming, therefore more $ 3) Exposure of powder to atmospheric conditions, since are loosely wrapped, not free of moisture |
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Definition of granules
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A glomeration of particles (4-10 mesh)
Formed by passing moistened, blended powders through a screen or special granulator, then dry -OR- Formed by slugging: by passing 'slugs' through a coarse mill (do not need water) Granules are good option for unstable drugs (less surface area and less change to react with water/gas in air) |
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What are the requirements for dusting powders?
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1) Must be homogenous
2) Must be free from potential of causing local irritation 3) Should flow easily and spread evenly 4) Should cling to sking upon application |
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What are large surface area concerns?
|
1) atmospheric exposure
2) rapid dissolution 3) High sorptive powders (not for oozing wounds) |
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Kaolin is used as ....
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1) Vehicle for dusting powder
2) Adhesiveness to powder 3) Excipient that can absorb water |
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Magnesium carbonate is used as a ...
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Vehicle for dusting powder
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Starch is used as a ...
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1) Vehicle for dusting powder
2) Disintegrator for compressed tablets 3) Lubricant for compressed tablets |
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Aluminum stearate is used ...
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Adhesiveness to powder
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Magnesium stearate is used for ....
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1) Adhesiveness to powder
2) Lubricant: enhance lubrication and flow characteristic...so good for compressed tablets |
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T/F Most ointments follow Semisolid Plastic Flow Characteristics.
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true
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What is Definite Yield Value
|
flows when small amount of force is applied (yield flow in minimal flow)
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|
|
What are pastes?
|
Thick, stiff ointments that do not ordinarily flow at body temperature, and therefore serve as protective coatings over the areas to which they are applied.
Usually > 20% solids |
|
|
What is an examples of pastes?
|
Zinc oxide paste
|
|
|
What are some characteristics of pastes?
|
1) Good protection, poor penetration
2) Semisolid Dilatant flow 3) Definite Yield Value 4) don;t want to be gritty |
|
|
Zinc stearate is used as...
|
Adhesiveness to powder
|
|
|
Why are aromatics used in powders? example?
|
1) Gives pleasant smell, so makes it 'medicinal'
2) Camphor |
|
|
What are the ways to apply powders?
|
1) Topical dusting
2) Insufflation, puffers 3) Oral administration 4) Toothpaste 5) Insufflations: for application to body cavities 6) Powder aerosols |
|
|
What are the 2 major steps in powder preparation?
|
1) Comminution: particle size must be within rande
2) Mixing: need active ingredient evenly distributed |
|
|
What are some reasons to focus on particle size?
|
1) Dissolution: smaller particles dissolve faster
2) Suspendability: smaller particles easy to suspend and settle slower 3) Uniformity: aids in mixing and distribution 4) Penetration for inhalation (smaller size is better) 5) Non-grittiness for ointmetns, creams and gels |
|
|
Resistance to flow _____ as application continues for ointments.
|
DROPS
|
|
|
Resistance to flow is ________ as force of application is increased. (for pastes)
|
INCREASED
|
|
|
Describes what creams are.
|
opaque, soft solids, or thick liquids intended for external application, consisting of medicaments dissolved or suspended in water soluble or vanishing cream bases.
|
|
|
What are some flow characteristics of creams?
|
1) Semisolid Pseudoplastic flow
2) Very little Yield value 3) Won;t flow under force of gravity but small force will initiate flow 4) Viscosity is VERY variable |
|
|
T/F Creams are always emulsions.
|
False... they are usually but not always
|
|
|
T/F. the term "cream" is most frequently applied to soft, cosmetically acceptable types of preparations that smell nice.
|
True
|
|
|
T/F Lotions are dilute creams.
|
FALSE, FALSE, FALSE
|
|
|
Describe/Define lotions.
|
Aqueous preparations with insoluble material for external applictaion without friction
|
|
|
What is a classic example of a lotion?
|
Calamine Lotion
|
|
|
What are the flow characteristics of lotions?
|
1) Fluid Preparations Newtonian Flow (?)
2) No Yield Valve 3) they flow under gravity |
|
|
What are the different types of mortar and pestles, and where they can be used?
|
1) Wedgewood: fine porcelin, that is awesome for communition
2) Ceramic: more sturdy, better for coarse particle reduction 3) Glass: not really great for communition, but good for mixing or if potent/staining medications |
|
|
What are the manual methods of communition?
|
1) Trituration: pill tile & spatula, mortar & pestle
2) Levigation: triturate with additional agent (eg glycerin) 3) Pulverization: using solvent |
|
|
What are the mechanical methods of communition?
|
1) Ball mills
2) Fluid energy mills 3) Lyophilization 4) Spray drying |
|
|
Sodium lauryl sulfate is used for...
|
1) Neutralize electrostatic charges
2) Surfactant |
|
|
What are come small sacle blending equipment?
|
1) Pill tile and spatula
2) Mortar and pestle 3) Bottle/container 4) Plastic baggie |
|
|
Describe/ Define CERATES.
|
Semisolid preparations containing a relatively high wax content. (usually > 50% wax)
|
|
|
Cerates are seen most in what field/setting?
|
the natural product / herbal setting
|
|
|
Flow characteristics of cerates
|
1) Semisolid
2) High Yield Point 3) Not to be directly rubbed onto skin --> rather apply softly to skin |
|
|
Define/Describe Plasters.
|
Solid or semisolid preparations which can NOT be spread at room temperature
|
|
|
What are some storage and labeling concerns for powders?
|
1) Store in dry place
2) Protect from light, in some cases 3) Keep out of reach of children |
|
|
Define the type of powder:
1) Ammonium Bromide/chloride/iodide 2) Calcium bromide/chloride 3) Ephedrine sulfate 4) Hyoscyamine HBr/Sulfate 5) Lithium bromide 6) Phenobarbital sodium 7) Potassium acetate/citrate 8) Sodium bromide/iodide/nitrate 9) Physostigmine sulfate/HCl/HBr 10) Pilocarpine |
1) Ammonium Bromide/chloride/iodide: hygroscopic
2) Calcium bromide/chloride: hygrocopic 3) Ephedrine sulfate: Hygrocopic 4) Hyoscyamine HBr/Sulfate: Hygroscopic 5) Lithium bromide: hygrocopic 6) Phenobarbital sodium: deliquescent 7) Potassium acetate/citrate: deliquescent 8) Sodium bromide/iodide/nitrate: deliquescent 9) Physostigmine sulfate/HCl/HBr: deliquescent 10) Pilocarpine: deliquescent |
|
|
Definition of hygroscopic
|
Substances which absorb moisture from the air
|
|
|
Definition of deliquescent
|
Substances which absorb moisture from the air to the extent that they liquefy by partially or wholly forming a solutiion
|
|
|
What is water of imbibition?
|
colloidal substances that may absorb large amounts of water and retain the appearance of dry powders
May cause problesm in weighing Varies with humidity eg. Cellulose, starch, agar, gelatin |
|
|
Definition of efflorescent powders
|
Crystalline substance which become powdery and liberate their water of crystallization
|
|
|
Alums are...
|
efflorescent powders
|
|
|
Atropine sulfate is ..
|
efflorescent powder
|
|
|
Caffeine is
|
efflorescent powder
|
|
|
Cocaine is ...
|
efflorescent powder
|
|
|
What are substances form eutectics?
|
1) ASA
2) Benzocaine 3) Camphor 4) Chloral hydrate 5) lidocaine 6) menthol 7) phenol 8) prilocaine 9) salicylic acid 10) thymol |
|
|
Potassium chlorate/nitrate/permanganate is...
|
1) Oxidizing agent
|
|
|
Sodium peroxide is...
|
1) oxidizing agent
|
|
|
Silver nitrate/oxide is...
|
1) oxidizing agent
|
|
|
Charcoal is ...
|
1) Reducing agent
|
|
|
Hypophosphites are...
|
1) reducing agent
|
|
|
Sulfur is ....
|
1) reducing agent
|
|
|
Sulfides are .....
|
1) reducing agent
|
|
|
Tannic acid is ...
|
1) reducing agent
|
|
|
What do efffervescent granules contain?
|
1) Citric acid
2) Tartaric acid 3) Sodium bisphosphate + bicarbonate 4) Medicinal agent Carbonated solution is a pleasant vehicle and lessens the bitter and salt taste of salts (eg magnesium sulfate) |
|
|
What are some examples of effervescent granules and what must they be dispensed in?
|
1) Lactines, Bassoran, Zantac
2) Packets, baggies, powder papers, wide-mouth bottles Do NOT want them to effervesce too quickly |
|
|
In this compound, what is the purpose of each ingredient:
1) Menthol 2) Camphor 3) Zinc stearate 4) Zinc oxide 5) Talc |
1) eutectic
2) eutectic 3) flow 4) absorb liquid 5) absorb liquid |
|
|
What are the advantages of capsules?
|
1) Mask odor and/or taste of unpleasant drugs
2) Easy to prepare 3) Can vary dosage and combination of drugs |
|
|
Definition of capsule
|
Unit doses of powder, semisolid or liquid drugs enclosed within either a hard or soft shell or envelope
NO WATER IN CAPSULE....or there would be no capsule, it would dissolve |
|
|
Applications for a capsule
|
1) Place on tongue and swallow with liquid
2) May need to break capsules open and sprinkle on food 3) Dissolve contents in water or mix contents with food 4) Rectal and vaginal (not used much, usually suppository) |
|
|
What are the disadvantages of capsules
|
1) not suitable for administering very soluble ionic salts
2) May be too much API to put into capsule that patient can swallow |
|
|
Gelatin capsule shell is composed of...
|
1) gelatin
2) sugar 3) water: soft capsules have more water 4) sulfur dioxide (preservative) |
|
|
Sulfur dioxide is...
|
preservative
|
|
|
What is the break-up process for capsules?
|
1) Dissolution: gelatin shell
2) Disintegration: packed powder particles 3) Dissolution of drug |
|
|
Why would you put a coloring agent or tracer in a powder mixture?
|
To see how well mixed the powder is
|
|
|
What are the steps involved in capsule preparation?
|
1) Comminution
2) Blending 3) Determine capsule size 4) Add additional diluent 5) Encapsulate 6) Clean 7) Quality control 8) Package and label |
|
|
What are the capsule sizes for animals? humans?
|
1) animals: 7 to 13
2) humans; 000 to 5 The smaller the # the number the larger the capsule |
|
|
T/F Capsules are often different colors for identification purposes.
|
True
|
|
|
What are the methods for encapsulating?
|
1) Individual hand-fill
2) Capsule machine fill 3) Filling capsules with semi-solid mass 4) Filling capsules with liquid |
|
|
What are the ways to close and seal the capsule?
|
1) Lock-caps
2) Hot pin 3) Moist towel 4) Gelatin band |
|
|
Stearic acid is for...
|
Delay-release in capsules
|
|
|
Cellulose acetate phthalate is for ...
|
Delay-release in capsules
|
|
|
What are some examples of specialty capsules?
|
1) Rapidly-disintegrating capsules
2) Vaginal administered capsules 3) Capsules for pre-measuring drugs 4) Veterinary capsules |
|
|
T/F The term tablet can not be used interchangeabley with pill, since pills are rolled and tablets are not.
|
True
|
|
|
Definition of tablet
|
Solid dosage form containing medicinal substances with or without suitable diluents
|
|
|
What are the advantages of tablets?
|
1) Accurate dosage, minimum variabillity
2) Absence of alsohol 3) Concentration variability: easily disperse APR so OK to split tablet 4) Elegance 5) Patient acceptance 6) Convenience: light and compact 7) Tamper resistant 8) Low cost 9) Easiest/cheapest to make 10) Product identification is simple 11) Ease of administration 12) Suited for large-scale production |
|
|
What are the disadvantages of tablets?
|
1) Swallowing
2) Difficult to extemporaneously prepare some types of tablets 3) Poorly wetting drugs, slow dissolving drugs, and intermediate to large dosage forms may have problems 4) Bitter taste or bad odor 5) Oxygen or moisture sensitive: may require coating |
|
|
What are molded tablets?
|
Small tablets made by molding a soft mass (consists of potent medication diluted with lactose and moistened with alcohol)
|
|
|
What are binders? examples?
|
1) Adhesive materials used to hold powders together, like with compressed tablets
2) water, alcohol, 15% starch paste, 70% sucrose syrup, 15% gelatin mixture |
|
|
What are disintegrators? examples?
|
1) Aid in the breaking up of the tablet
2) Starch, cellulose derivatives |
|
|
What are lubricants? examples?
|
1) Used in compressed tablets to improve powder flow, decrease adhesion & wear to punch/die, and facilitate tablet ejection
2) Calcium stearate, magnesium stearate, starch, talc, |
|
|
Calcium stearate is for...
|
Lubricant for compressed tablets
|
|
|
Talc is for...
|
1) Lubricant in compressed tablet
2) Glidant |
|
|
What are glidants? examples?
|
1) Improve flow properties of powders as it passes through hopper
2) Colloidal silicone dioxide, talc |
|
|
What is friability?
|
Ability to crumble
|
|
|
Tablets: What it the importance of room temperature?
|
1) Use arrhenius equation to relate temperature to rate of degradation
2) Want it to be stable for >1 yr |
|
|
What are concerns regarding tablet deterioration?
|
1) Loss of volatile constituents
2) Oxidative detrioration 3) Moisture and carbon dioxide 4) Cementation: separation with chewable tablet 5) eutectics 6) Encrustation 7) Mottling/spotting/mold growth |
|
|
What are inserts?
|
Specially shaped tablets for insertion into the vagina
|
|
|
Lactose is for ...
|
1) diluent
2) base of insert (tablet) |
|
|
What are buccal/sublingual tablets?
|
Small, flat or kidney-shaped tablets that are placed betweeen the cheekc and gums or under the tongue, respectively
2) Compressed with moderate force so they dissolve in about 30 seconds |
|
|
What are pellets or implants?
|
Small, STERILE rod or oval-shaped tablets, often implanted
|
|
|
What are lozenges or troches?
|
Small masses of medicinal substances intended to be adminsitered by dissolving slowly in the mouth for local or systemic effects
|
|
|
what are lamellae?
|
Small, medicate, glycerogelatin discs for opthalmic use
Forerunner of the Ocusert |
|
|
What are confections?
|
Heavily saccharinated, soft masses of medicinal agents
|
|
|
What are pastilles?
|
A SOFT variety of a lozenge, consisting of a medicament in a gelatin base
|
|
|
Based on the following, what is the purpose of each ingredient:
1) Terpin hydrate 2) Thymol 3) Menthol 4) Gelatin (mass) 5) Glycerin 6) Purified water |
1) Terpin hydrate: API
2) Thymol: eutectic 3) Menthol: eutectic 4) Gelatin (mass): base 5) Glycerin: base 6) Purified water: not clear from slide, to soften or a solvent??? |
|
|
In this compound, what is the purpose of acacia?
Tannic acid Sucrose Acacia Tolu tincture Purified water |
Acacia is a binder
|
|
|
What is a pill?
|
Small, round or egg-shaped solid for internal use
|
|
|
How are pills made?
|
Mix in mortar, roll in pipe, divide, shape into spheres and dry
|
|
|
For hard sugar lozenges what should be added?
|
1) powdered sugar
2) light corn syrup 3) purified water 4) API 5) Mint extract 6) Food coloring Basically making cangy |
|
|
What are linguets?
|
Oral dosage form that stays on the tongue for a LONG time, so poses taste challenges
|
|
|
Glycyrrhiza is for...
|
1) taste (licorice)
2) binder |
|
|
T/F For powder sugar troches, you must first slowly heat the powdered sugar before adding the API.
|
False, you do not heat posered sugar lozenges
|
|
|
What is a good reason to use lozenges or troches?
|
Good dosage form if patient can not swallow a pill to get medication
|
|
|
What is/are the problems with troches or lozenges?
|
Sometimes it is hard for the patient to remove the mold
|
|
|
Match these up appropriately:
1. Hard lozenges 2. Soft lozenges a. Demulcent effects b Deliquescent effects c. Pastilles |
1. Hard lozenges: edmulcent effects
2. Soft lozenges: pastilles |
|
|
Silica gel is for...
|
1) Increase viscosity and decrease sedimentation
|
|
|
What is gelatin? type A? type B?
|
1) Partial hydrolysis of collagen from the skin, connective tissues and bones of animals
2) Type A: porcine 3) Type B: other animals |
|
|
Gelatin is for ...
|
1) coating
2) Vehicle |
|
|
What is a suppository?
|
Solid dosage form that is used to administer medication via rectum, vagina or urethra
Melt (oleaginous), soften (oleaginous) or dissolve (water) in the body cavity to release API |
|
|
What are the shapes and sizes (weight) of the following:
1) Rectal suppositories 2) Vaginal suppositories 3) Urethral suppositories |
1) rectal: cylindrical or conical (~2g)
2) Vaginal: ovoid, globular or other shape (3-5g) 3) Urethral: shape depends on gender: male (4g), female (2 g) |
|
|
For whom are suppositories a good dosage form?
|
1) Administering drugs to infants/small children
2) Severely debilitate patients (hospice) 3) Those who can NOT take oral medications 4) Those who can NOT have IV |
|
|
How are drugs deliverd, physiologically, when use suppository?
|
1) Melt at body temperature
2) Dissolving in aquesous secretions of the mucous memebranes 3) Blood supply in the rectal area: avoid 1st pass |
|
|
What is the difference in dissolution of oleaginous base versus water coluble base in suppositories?
|
1) Oleaginous: melt, soften
2) Water soluble: dissolve |
|
|
Cocoa butter is for ...
|
1) Oleaginous base (suppository)
|
|
|
Synthetic triglyceride mixture is for...
|
1) oleaginous base (suppository)-easier to handle compared to cocoas butter issues
|
|
|
Glycerinated gelatin is for ...
|
1) water soluble base in suppositories...esp in vaginal
|
|
|
Polyethylene glycol polymers are for...
|
1) water soluble base in suppositories (#1 base)
|
|
|
What is the challenge with cocoa butter?
|
Gamma form (melts at 18C), Alpha form (melts at 22C), Beta prime form (melts at 27C), Beta form (melts at 30-35C)
So if pick wrong form, suppository could melt before administration |
|
|
How do you make glycerinated gelatin?
|
1) Boil gelatin
2) Allow time to hydrate 3) Add glycerin 4) cool |
|
|
What are polyethylene glycol bases?
|
1) polymers of different MW
2) Water soluble 3) relatively low melting points 4) Stable 5) Dissolve in body fluids |
|
|
How can you slow the release of medication from suppository?
|
1) Oil-soluble drug in oleaginous base, or water soluble drug in water-soluble base
2) Harder suppository (soft suppository releases meds faster....or high insertio-but there is a limit on that |
|
|
What should you consider with supposities?
|
1) Water
2) Hygroscopicity 3) Incompatabilities 4) Viscosity 5) Brittleness 6) Density 7) Volume contraction 8) Dosage replacement 9) Weight/volume control |
|
|
Classify the following as:
1) Ionized drug in lipophilic base 2) Unionized drug in lipophilic base 3) Ionized drug in hydrophilic base 4) Unionized drug in hydrophilic base Answer choices: a. Delayed absorption b. Delayed/slow release c. Fast release d. Fast effect |
1) Ionized drug in lipophilic base: Immediate effect
2) Unionized drug in lipophilic base: Delayed absorption 3) Ionized drug in hydrophilic base: Slow release 4) Unionized drug in hydrophilic base: fast release |
|
|
How does white wax help with suppository formulation and compounding?
|
1) Increases melting temperature
2) Makes it stiffer and easier to use |
|
|
What are the methods for compounding suppositories?
|
1) Hand moulding
2) Fusion: most common; use mold 3) Cold compression |
|
|
What are some problems you may encounter with suppository preparation?
|
1) Vegetable extracts: lower melting point
2) Hard crystalline materials: need to be small so no settling out 3) Liquid ingredients 4) Excess powder: powder needs to be <30% |
|
|
What are some quality control tests that can be performed on suppositories?
|
1) Melting range test (Oleaginous base)
2) Liquefaction time test (PEG base) 3) Breaking test: to see how brittle 4) Softening/liquefaction temperature test |
|
|
Identify purpose of the following: (suppository)
1) PEG 800 2) PEG 1540 3) cetyl alcohol 4) purified water |
1) PEG 800: base
2) PEG 1540: base 3) cetyl alcohol: counters water 4) purified water: less irritating to mucosa, dissolved drug...PEG also has dehydrating effect |
|
|
Identify purpose of the following: (suppository)
1) Ondansetron 2) Micronized silica gel 3) Fatty acids |
1) Ondansetron: API
2) Micronized silica gel: suspending agent; slows settling 3) Fatty acids: base |
|
|
Alginic acid is for...
|
1) Slows release of API in suppositories; reacts in presence of calcium to form hydrated polymer (very viscous)
|
|
|
What are medication sticks?
|
Convenient dosage form for administering topical medications
Similar to suppositories, but not water-soluble base...need melting or moistening bases |
|
|
Cetyl esters wax is for ...
|
(in medication stick)
1) hard emulsifying agent; high MW ester |
|
|
Who should get total parenteral nutrition?
|
1) People who can't eat: eg severe burns
2) People who won't eat 3) People who shouldn't eat: eg pancreatic cancer or parncreatitis 4) Patient who can't eat Basically if you can someohow still use the gue, then that 's the way to go...otherwise TPN. |
|
|
What do the ASPEN guidelines say about how long for no oral foods?
|
1) Severe stress or malnutrition NPO >/= 4-5 days
2) Moderate stress or malnutrition NPO >/= 7-10 days 3) Nonstressed or mormal nurished NPO >10days 4) No indication for TPN <4 days |
|
|
Nutritional assessment should include...
|
1) Dietary history
2) Any weight loss in last 6 months 3) Anthropometry: BMI, triceps-skinfold, mid arm muscle cirucumference, bioelectric impedance, hand-grip dynamometry, urinary creatinine |
|
|
How can you estimate you total caloric expenditure?
|
Normally ~2000 cal/day
TEE = REE + activity factor REE: resting energy expenditure, found with Harris-Benedict equation |
|
|
Define hyperalimentation
|
Old term for TPN
|
|
|
Define CPN
|
Central parenteral nutrition (old term)
|
|
|
Define PPN
|
Peripheral parenteral nutrition
|
|
|
Define MVI
|
Multiple vitamins
|
|
|
Define TE
|
Trace elements
|
|
|
How are IV fats used in TPN?
|
as an emulsion type product
|
|
|
Leucine is a _______ aa
|
essential
Branched chain aa Can be metabolized in the muscle |
|
|
Isoleucine is a _____aa
|
essential
Branched chain aa Can be metabolized in the muscle |
|
|
Valin is a ________aa
|
essential
Branched chain aa, Can be metabolized in the muscle |
|
|
Methionine is a _________ aa
|
essential
|
|
|
Threonine is a _______ aa
|
essential
|
|
|
Tryptophan is a ______aa
|
Essential
Aromatic aa May decrease in liver failure |
|
|
Lysine is a ________ aa
|
Essential
|
|
|
Systein and glutamate aa that are given a lot to what population in TPN?
|
Children
|
|
|
What is the major aa in TPN product?
|
glycine
|
|
|
What is the max rate of infusion for CHO in critcal care patient? IS it important?
|
1) Not >4 mg/kg/min
2) It is important |
|
|
What it the most common calorie source for CHO?
|
Dextrose
|
|
|
Xylitol, in TPN, has been used for...
|
provide non-protein calories
an insulin dependent pathway through liver metabolism |
|
|
What can happen if patient is given too many CHO in TPN?
|
Too much CHO gets converted to fat and carbon dioxide, such that death is a possibility
|
|
|
What is/are goals of TPN therapy?
|
1) Provide daily nutritional requirememts and to correct nutritional deficits by meetign specific caloris, protein, vitamin and mineral reuirements that can not be met orally
|
|
|
What is the tonicity of lipids
|
Isotonic, can be given peripheral or central vein
9kcal/gm |
|
|
Who might have a bad reaction to lipids?
|
1) Egg allergy
2) Lecithin allergy |
|
|
T?F Lipids can be filterd with a 0.25 um filter.
|
True, the smallest it can go through is 0.22 um
If use 0.22 um there will be no oils in the TPN, they will be in the filter |
|
|
What are the max recommended amounts of CHO and fats?
|
1) CHO:4 mg/kg/min dextrose (ie <6 g/kg/day)
2) Lipids: 0.7 mg/kg/min (ie <1 g/kg/day) |
|
|
How do you decide how much protein to give?
|
1) Based on calorie:nitrogen ratio (want ~150 cal/g of N)
2) Based on degree of stress and body weight 3) Based on nitrogen balance: used the measure of lost N |
|
|
Water requirements for maintenance
|
30-40 mL/kg/day
Generally ~2-3 L/day |
|
|
What are the advantages of standardization for TPN formulations?
|
1) Meets requirements of most patients
2) Assists physican in order writing 3) Reduces errors: writing, transcriptiom and order enrty 4) Increases pharmacy efficiency 5) Cost savings |
|
|
What are the advantages of customization fo TPN formulations?
|
1) COnsistent with current recommendations, even though customized
2) Can be accomplished with and without automated compounder |
|
|
What constitutes a clinical review?
|
1) Clinical examination
2) Vital signs 3) Fluid balance 4) Catheter care 5) Sepsis review 6) Blood sugar profile 7) Body weight |
|
|
What are complications from TPN?
|
1) mechanical complications
2) metabolic complications 3) Infectious complications |
|
|
Why should you wean slowly off TPN?
|
To avoid hypoglycemia
Monitor blood glucose level during wean Give IV dextrose 10% solution at previous infusion for at least 4-6hr |
|
|
What does the usual TPN contail?
|
1) Basic nutrients: deextrose, aa, fat, electrolytes, vitamins and trace minerals
2) Non-protein calories: dextrose, fat 3) H2 antagonists |
|
|
What are the requirements for the following:
1) Fluids 2) protein 3) Non-protein kCla requirements |
1) Fluids: 2500-3500mL or 30-35 mL/kg
2) Protein: 1-1.5 g/protein/kg IBD; ~1-2 g/kg 3) Non-protein: 20-35 kcal/kg IBW (or use Harris-benedict eqn) |
|
|
What are the factors that can affect precipitation of calcium phosphate?
|
1) pH: more soluble in acidic solutions
2) Concentration of calcium: higher conc = higher ppt risk 3) Salt of calcium: gluconate is less likely to ppt 4) Concentration of phosphate 5) Concentration of aa: use higher aa conc to avoid ppt; buffer, complexes with calcium, the higher the better 7) Composition of aa: cycstein HCl decreases pH 8) Concentration of dextrose 9) Temperature of solution: refridgerate; higher temp favors dissociation of calcium, add heat = decrease solubility 10) Order of mixing: first add phosphate to aa, then add calcium to dextrose, |
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How can insulin be lost from TPN bag?
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Adsorption to EVA system
~5-15%, still add to TPn since considered physically compatable and therapeutically appropriate |
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What in the minimum dose of insulin per bag?
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10U/bag
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What are the steps to ordering TPN?
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1) Determine total fluid volume
2) Determing protein requirements 3) Determing non-N caloric needs: decide how much fat and CHO 4) Determine electrolyte and trace elemnt 5) Determine need for additives from physical and chemical standpoint |
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In TPN, zinc recommended for ...
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poor wound healing
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In TPN, copper recommended for ...
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anemia
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In TPN, chromium recommended for ...
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glucose intolerance
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In TPN, selenium recommended for ...
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Keshan's disease, usually in Asian women
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Does iron needed to be added to TPN? Why or why not?
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No
Have stores of3-4 gm Average daily loss ~1 mg |
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What are the recommended vitamins for TPN?
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1) Fatsoluble: A,D,E,K
2) Water soluble: thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, C, folic acid, B12, biotin |
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How often, per day, can vitamins be added to TPN?
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Once, usually
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When, in the process of preparation, are the vitamins added to the TPN?
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Last
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What are the different ways to administer a TPN solution?
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1) Cetral line: requires chest x-ray, max 35% dextrose
2) Peripheral line: max 12.5% dextrose 3) Infusion pump |
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How long are TPN solutions stable? Why that length of time?
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1) 24 hrs
2) Microbial growth |
