exam 2 review

compressed tablets

compressing granules formed from powder particles into definite shape, made of AI and II, inactive ingredients usually take up most space

what excipients do compressed tablets have

diluents (fillers) to add bulk for shape, binders (adhesives) to keep integrity of tablet shape, disintegrators to promote breakup after administration, glidants to enhance flow before compression, lubricants to prevent sticking (also gives sheen), flavorants and colorants

tablet diluent examples

dicalcium phosphate, calcium sulfate, lactose, cellulose, kaolin, mannitol, starch, glucose

tablet binder examples

starch, gelatin, sugars (sucrose, lactose, maltose, dextrose), gums like acacia, sodium alginate, carboxymethylcellulose (CMC), methylcellulose, polyvinylpyrrolidone, veegum, waxes

tablet lubricant examples

sodium benzoate, leucine, carbowax 4000, magnesium lauryl sulfate

tablet glidant examples

silica, colloidal silicon dioxide, talc sometimes

tablet disintegrant examples

starches, clays, celluloses, algins, gums, corn, potato starch

tablet flavorant examples

aspartame

coated tablets

sugar-coated tablets, film-coated tablets, enteric-coated tablets

sugar-coated tablets

mask taste, if too objectionable will be made into capsule, enhance appearance, increase size by 50%, Advil

film-coated tablets

more durable and less bulky, polymers (poly vinyls and celluloses) that will disintegrate in gastric juices, Viagra

enteric-coated tablets

resists acidic pH of stomach, popular for acidic or caustic medications that may irritate sensitive stomach, Ecotrin

sublingual tablets

flat and oval, dissolve under tongue or buccal pouch, useful for medications destroyed by gastric juices and medications that need quick onset (nausea), Nitrostat, Suboxone film

chewable tablets

people who cannot swallow tablets, palatable, not compacted so easy to chew, effervescent tablets

effervescent tablets

citric acid gives fruity taste, easier to drink, Theraflu, Prilosec packets, usually OTC

tablet triturates

not used as much, basically sublingual, closest compounded pellet tablet, Nitrostat is closest example

what do inactive ingredients do in a tablet?

hold the tablet together until swallowed, absorb gastric juices, disintegrate tablet, help with dissolving of particles in gastric solution

wet granulation

blend AI with disintegrants and fillers, add liquid binder, screen into granules (pellets), spread gloop on trays for drying, dry the granules, add lubricants and blend, compress tablet

dry granulation

blend AI and additives together, roll crush and sieve powders, lubricant is blended, resultant powder compressed into tablet

direct compression

materials have free flowing characteristics and cohesive properties, no need to make granules

what is the purpose of granules?

make powdered drug ingredients easier to handle and manufacture into a dosage form

friability test

test for tablet hardness, friability is tendency of tablet to break under stress, hardness = USP 1216

hard gelatin capsules

gelatin, sugar, water, and colorant, similar lubricants to those in tablet compression, no need for adherents, comes from collagen of white connective tissue and bones of animals, soluble in hot water, in gastric fluids the gelatin is digested and absorbed, for size a higher number = smaller capsule, has banding for tamper proof, long body and short cap

soft gelatin capsules

hard gelatin formula but with glycerin or sorbitol, flexible, usually contains suspensions or liquids, not compounded in pharmacies, requires elaborate equipment, vitamin d3, OTC docusate sodium

what is the Noyes Whitney principle of dissolution?

the rate of dissolution of solids depends on the rate of diffusion of a very thin layer of saturated solution that forms around each solid particle

what is sink condition?

a drug is instantaneously absorbed as soon as it dissolves

what factors influence drug dissolution?

particle size and surface area, unionized and ionized, drug formulation, gastric emptying and intestinal transit times

what is the relationship between surface area and dissolution?

direct, as particle size decreases surface area increases

compare solubilities of salt forms and “free” acids or bases

salt forms (N+, Cl-) of weak bases or acids are more water soluble than the unionized form

compare and contrast increasing pH or decreasing pH on degree of ionization and unionization for acids and bases

acids = when pH decreases, ratio moves tenfold in favor of unionized, 1 molecule of ionized : 10 molecules unionized

bases = when pH decreases, ratio moves tenfold in favor of ionized, 1 molecule unionized : 10 molecules ionized

distinguish the role of gastric emptying time on drug dissolution

time is inversely proportional to rate, gastric emptying time is shorter when fasting vs with food

what is liberation of drug from a dosage form?

liberation happens prior to absorption, drug must be “liberated” from dosage forms, then particles must dissolve in body fluids

what is molarity?

moles of solute per 1000 mL of solvent

what is molality?

moles of solute in 1000g of solvent

what is normality?

the gram equivalent weight of solute in 1000 mL of solvent

what is osmotic pressure?

movement of pure solvent into solution in an attempt to dilute the solute in the solvent and raise the vapor pressure back to its original value, the pressure needed to push against the pure solvent to prevent movement of pure solvent into the solution

vapor pressure vs particles

the presence of particles in solution causes vapor pressure to decrease

what does isosmotic mean?

when two solutions have the same osmotic pressure

what is the Van’t Hoff (i) factor and how is it used?

solutions of electrolytes produce more osmotic pressure, i accounts for the contributions of ions in solution

how does the knowledge of freezing point depression help in calculating isotonicity?

you can test freezing point of medicine, if it freezes below what is expected (-0.52) then it is NOT isotonic

what is the utility of the sodium chloride equivalent (E value)?

most medicinal salts approximate the extend of dissociation of sodium chloride in weak solutions, E is the factor that relates the needed weight of NaCl that would have the same freezing point depression as 1 gram of drug in 1000 mL, E is an evaluation of the relative ionic strength of the API compared to NaCl

sodium chloride (E) equation

(MW NaCl / (i NaCl) x (i of API / MW substance)

if the E value of 1 g of atropine sulfate in a 100 mL solution is 0.12, what does that mean?

the osmotic pressure generated by 1 gram of atropine is the same osmotic pressure generated by 0.12 g of NaCl

what is osmolarity?

the concentration of a solution expressed as number of particles per liter, molar concentration and osmotic pressure

how is tonicity a function osmolarity?

as mOsmol increases, more tone is exerted, range is 240-340

what is a “mol”?

6.02 × 10²³ particles, the molecular weight of a substance in g

what is a milliequivalent?

the concentration of electrolytes in a solution, VALENCE

what terms of this section are influenced by charge?

mEq, valence, electrolytes

what terms of this section are influenced by species?

Osmol, Van’t Hoff, i, osmotic pressure

what terms of this section are influenced by mass?

normality, equivalent weight

intraarticular

into/between articulating joints

intraspinal/intrathecal

directly into cerebral spinal fluid

intravenous

into veins

thrombus

blood clot formed in vessel due to slowing of bloow flow

embolus

circulating thrombus

embolism

an embolus obstructs a vessel which creates a blockage

pulmonary embolism

obstruction in microvasculature of lungs

intramuscular

into muscle, vaccines, most common route for pharmacists, deltoid/quadricep/gluts

subcutaneous

under the skin, insulin products, usually self-administered

6 solvents

sterile water for injection, bacteriostatic water for injection, sodium chloride for injection, bacteriostatic sodium chloride, ringer’s solution, lactated ringer’s solution

sterile water for injection

less than 1-L package (50, 100, 250, 500 mL), used topically for rinsing

bacteriostatic water for injection

antimicrobial, less than 30mL, do not give to baby, multi-dose vials

sodium chloride for injection

sterile, isotonic solution of NaCl, no antimicrobials

bacteriostatic sodium chloride for injection

NaCl with added antimicrobial, less than 30mL, multi-dose vials, do not give baby

ringer’s injection

sterile solution of sodium chloride, potassium chloride, and calcium chloride, vehicle for injection or fluid replenisher (no drug)

lactated ringer’s injection

sterile solution of sodium chloride, potassium chloride, calcium chloride, sodium lactate, vehicle for injection, fluid replenisher (no drug)

what parentals do pharmacists administer

intramuscular

what parentals do patients administer

subcutaneous (insulin)

what is SNAC in semaglutide and how does it function?

a penetration enhancer that increases pH in stomach (protects semaglutide from acid), affects transcellular pathways that allow HUGE molecule to be absorbed in stomach

radiopharmaceuticals decay at what rate order? what does that mean?

first order rate, rate of decay is dependent on concentration, high concentration = rate increase

2 examples of radiopharmaceuticals discussed in class

Technetium-99 (99Tc) and sodium iodide 123

what are the time limitations of compounding radiopharmaceuticals?

around 30 hours

importance of isotonicity in ophthalmic

isotonicity is required to prevent tissue damage

general technique of instilling ophthalmic drops

wash hands, pull eyelid down, drop medication inside lower eyelid while looking up, slowly close eye, use tissue to wipe away liquid, wait 10 minutes before next administration

general technique of instilling ophthalmic ointment

wash hands, lower eyelid, look up, squeeze ¼ inch ribbon into lower eyelid, close eye and rotate eyelid, wait 10 minutes before next administration

tan cap

anti-infective

gray cap

nonsteroidal anti-inflammatory

pink cap

steroid anti-inflammatory

dark blue cap

beta blocker/combo

yellow cap

beta blockers

orange cap

carbonic anhydrase inhibitors

dark green cap

miotic (shrink pupil)

red cap

mydriatics (dilate pupil)

turquoise cap

prostaglandin analog

purple cap

adrenergic agonist, treats glaucoma

gel-forming – reasons to use

stay in eye longer, ER

nasal – technique and use of gels to increase contact time

insert into nose and tilt to the side, gels stick to inner nares and increase contact of medication

compare and contrast sterility and pH and tonicity between ophthalmic and otic

ophthalmic has to be sterile and otic does not, otic has lower pH and ophthalmic has close to 7, want isotonicity in eye and ear

what are the factors affecting percutaneous absorption?

drug concentration, surface area, attraction of the drug to the skin over the vehicle, molecular weight, hydration of skin, skin thickness, contact time, penetration enhancers manipulation of TDDS

how do skin penetration enhancers function?

encourage skin to take up more drug, chemicals help move large molecular weight drugs across skin

what are the differences between the reservoir patch and the matrix patch?

reservoir - four layer system with backing, reservoir of drug, membrane, and adhesive with usually some drug, large excess of drug, dose dumping, gel patches, transderm scop, fentanyl

matrix - no reservoir, drug dispersed in adhesive, tape patch

what is compounding?
what is NOT compounding?

mixing or altering and existing drug form to create new medication by tailored to individual needs, regulated by state board pharmacy, not large scale, 20 or more to be compounding in 30-day period, cannot be existing drug with adding a couple things to it

USP involvement in compounding

USP 797, 795, 800

SC Board of Pharmacy checklists and requirements

make 20 or less within 30 days = not compounding, reconstituting is not compounding

arguments against compounding

less oversight than FDA, does not need GMP, do not need to be tested for safety and efficacy, do not need to report ADE, may act as manufacturers

quality control

use professional judgement

documentation of compounding

keep for two years

compounding examples and rationale (reason to compound)

aliquot for estradiol, cannot swallow stuff make lollipop, rectal rocket, allergies, cannot use existing dosage, sugar or dye free, do not meet needs

know the classes of Recalls

class I = death

class II = medically reversible effects

class III = labelling/packaging issues

SC Board of pharmacy requirements on recalls

PIC is responsible