RxPrep Drug Formulations & Patient Counseling

IR tablet,

long-acting injection,

ODT,

short-acting injection

What 4 formulations does olanzapine come in?

immediate-release

What does IR stand for?

orally disintegrating tablet

What does ODT stand for?

ODT

What drug formulation is useful to prevent the patient from hiding the medication in the mouth and then spitting it out when no one is watching?

long-acting injection

What drug formulation can improve adherence?

short-acting injection

What olanzapine drug formulation works quickly and is useful for acute agitation?

IR tablet, ODT, oral film, oral solution, short-acting injection

What 5 formulations is ondansetron available in?

injection

An (injection/oral medication) is most useful when a patient is vomiting.

true

True or False: An ODT or oral film can be useful in patients with nausea without vomiting.

oral solution

What drug formulation would be preferred in dysphagia, esophageal ulcers, esophageal strictures, or esophageal tumors?

long-acting patch

Granisetron comes in a(n) ________ formulation that prevents chemotherapy-induced nausea for up to seven days.

long-acting

The suffixes XL, XR, ER, LA, SR, CR, CRT, SA, TR, and "cont" indicate a(n) ________ formulation.

osmotic controlled-release oral delivery system

What does OROS stand for?

Asacol HD, Cardura XL, Concerta, Delzicol, Procardia XL

What are 5 examples of drugs that use OROS?

OROS

What drug formulation can leave a ghost tablet/capsule in the stool?

Concerta

Which drug uses an OROS with an outer layer that allows for fast drug delivery, followed by an extended-release?

long-acting tablet/capsule

What drug formulation can reduce side effects?

long-acting tablet/capsule

What drug formulation requires counseling to ensure the patient doesn't crush or chew it which could lead to the medication being released all at once?

carbidopa/levodopa ER, Toprol XL

What 2 drugs are long-acting formulations that may be cut on the score line?

solutions, suspensions

What 2 drug formulations are useful in children or other patients with swallowing difficulty?

suspension

What drug formulation must be shaken to redisperse the medication prior to administration?

false

True or False: Solutions require shaking before administration.

chewable tablet

What drug formulation is primarily used for children who are unable to swallow tablets?

calcium

Chewable ________ products are popular because they're large and hard for many people to swallow.

lozenge/troche

What drug formulation is used to treat a condition in the oral mucosa?

saliva

ODTs disintegrate rapidly in ________.

stroke

What is the most common cause of dysphagia?

children, dysphagia, nausea, non-adherence

What are 4 situations where ODT formulations are helpful?

non-oral

If vomiting is present or expected, a(n) ________ route of administration should be used.

ODT

SL and buccal formulations have the same benefits as ________ formulations.

faster

The onset of action of SL/buccal formulations is (faster/slower) than with a tablet or capsule that's swallowed.

sublingual

What does SL stand for?

first-pass metabolism, gut degradation

When SL/buccal formulations are used, less drug is lost to ________ and ________.

Adderall XR, Coreg CR, Dexilant, Focalin XR, Namenda XR, Nexium, Ritalin LA

What are 7 capsules that can be opened and sprinkled on applesauce?

dextroamphetamine/amphetamine ER

What is the generic name for Adderall XR?

carvedilol

What is the generic name for Coreg CR?

dexlansoprazole

What is the generic name for Dexilant?

dexmethylphenidate

What is the generic name for Focalin XR?

memantine

What is the generic name for Namenda XR?

esomeprazole

What is the generic name for Nexium?

methylphenidate

What is the generic name for Ritalin LA?

applesauce, carrots, ice cream, rice

What are 4 options to sprinkle montelukast granules in?

orange juice, water, yogurt

What are 3 options to open and sprinkle Vyvanse in?

geriatric, pediatric

In what 2 populations are granules, powders, or capsules that can be opened and sprinkled most common in?

true

True or False: It's less expensive to give an oral medication via NG tube rather than converting to an IV formulation.

false (they'll dissolve too quickly)

True or False: When adding granules/powders to a liquid or food, the liquid or food should be hot in order for it to dissolve quickly.

sorbitol

________ metabolism produces gas, cramping, and bloating in sensitive patients, including those with IBS.

phenylalanine; aspartame

________ is found in the sweetener ________, which is used in many ODT, chewable, and granule medication formulations.

phenylketonuria

Aspartame is a dangerous sweetener for those with ________, a genetic defect in which the enzyme that degrades phenylalanine is absent.

lactose

What is the most commonly used excipient in drug formulations?

true

True or False: ODTs shouldn't be pushed through foil backings. The backing should be peeled off in order to take them out.

on tongue

Where in the mouth should ODTs be placed?

IM

What type of injections use a longer needle and generally hurt more?

monoclonal antibodies; mabs

________, or "-________", are injectable proteins used to treat many diseases. They may require premedications due to injection reactions.

subcutaneous

What does SC stand for?

SC

What injection formulation is used for rapid effect or for drugs that would degrade or not be absorbed if given orally?

long-acting IM

Various drugs come in ________ injection formulations to improve adherence or to decrease the need for more frequent injections.

intramuscular

What does IM stand for?

intravenous

What does IV stand for?

IV

What injection formulation bypasses the oral route for patients who are intubated or sedated, has a fast response, and avoids loss of drug due to nausea/vomiting?

false

True or False: The skin should be rubbed around the injection site after administering an anticoagulant injection.

true

True or False: Devices should not be used to heat up cold injections prior to administration.

false

True or False: Injections that are discolored should still be used as long as it's prior to the expiration date.

true

True or False: Monoclonal antibody injections should not be shaken prior to administration.

back, chest, flank, upper arm

What are 4 common application sites for patches?

flank

What application site should Exelon patches not be applied to?

hip

What application site do Daytrana patches use?

behind the ear

What application site do Transderm Scop patches use?

false (should alternate sites for any patch except topical pain patches)

True or False: Patch sites do not need to be alternated and should be applied to the same area each time.

BID

What is the frequency used for diclofenac patches?

QD

What is the frequency used for methylphenidate (Daytrana) patches?

QD

What is the frequency used for nicotine (NicoDerm CQ) patches?

QD

What is the frequency used for rivastigmine (Exelon) patches?

QD

What is the frequency used for rotigotine (Neupro) patches?

QD

What is the frequency used for selegiline (Emsam) patches?

QD

What is the frequency used for testosterone (Androderm) patches?

QD, on for 12 hours then off for 12

What is the frequency used for lidocaine (Lidoderm) patches?

QD, on for 12-14 hours then off for 10-12

What is the frequency used for nitroglycerin patches?

Q72H

What is the frequency used for fentanyl patches?

Q72H

What is the frequency used for scopolamine (Transderm Scop) patches?

twice weekly

What is the frequency used for estradiol (Alora, Vivelle-Dot) patches?

twice weekly

What is the frequency used for oxybutynin (Oxytrol) patches?

QW

What is the frequency used for donepezil (Adlarity) patches?

QW

What is the frequency used for buprenorphine (Butrans) patches?

QW

What is the frequency used for clonidine (Catapres-TTS) patches?

QW

What is the frequency used for estradiol (Climara) patches?

QW

What is the frequency used for estradiol/levonorgestrel patches?

QW

What is the frequency used for ethinyl estradiol/norelgestromine (Xulane, Zafemy) and ethinyl estradiol/levonorgestrel (Twirla) patches?

Lidoderm

What patch can be cut into pieces?

rapid absorption

What happens when a patch is exposed to heat like that from an electric blanket?

alternate application sites, don't apply to irritated skin, don't shave application site, topical steroid after removal

What are 4 things to do to prevent a patch from bothering the skin?

metal

Patches containing ________ need to be removed prior to an MRI.

clonidine, rotigotine, scopolamine, testosterone

What are 4 patches that need to be removed prior to an MRI?

true

True or False: Most patches cannot be covered with tape to prevent it from falling off.

Butrans (buprenorphine)

What patch can be covered with permitted adhesive film dressings to prevent it from falling off?

Bioclusive, Tegaderm

What are 2 adhesive film dressings permitted to be used with Butrans (buprenorphine) patches?

Catapres-TTS

What patch comes with its own adhesive cover to hold it in place?

adhesive surfaces pressed together

How should most patches be disposed of?

Butrans, Daytrana, fentanyl

What are 3 highly potent patches that may be recommended to be disposed of by flushing down the toilet to remove from the home immediately?

adhesive, reservoir

What are 2 locations where the drug can be located in a patch?