4.9 Advance (12)/Parental

Question 1

_____ injectables (SC or IM) the goal is to inject a drug product that slowly release its active ingredient. Suspension approach takes a long time for drug to be release or dissolve.

Answer 1

Depot

Question 2

Prodrug approach in depot injections where the drug is (hydrophilic or lipophilic) thus slow partitioning from the injected oil to interstitial fluid.

Answer 2

lipophilic

Question 3

Product drug called ____ is a bio-erodible microsphere (Parenteral IM 1,3,4), The microspheres are prepared as a copolymer of poly (lactic acid) and poly (glycolic acid). Break down to lactic and glycolic acids.

Answer 3

Lupron Depot

Question 4

Polymer ____ (subcutaneous)– membrane controlled reservoir controlled by non-biodegradable polymer membrane. Require surgical insertion and removal.

Answer 4

Implants

Question 5

Drug product called _____, have solid matrix to be stiff enough to be inserted surgically. Surrounding by rate-controlling EVA membrane (zero-order release) and contains barium sulfate.

Answer 5

Nexplanon (membrane-matrix hybrid)

Question 6

Barium sulfate makes implants…

Answer 6

radioopague for detection

Question 7

Drug product called ______, is an example of membrane-matrix hybrid that is implanted in the arm. Used for central precocious puberty differ in delivery rates from Histrelin with immediate released followed by a year of steady release.

Answer 7

Suprellan LA

Question 8

Drug product called ___ used for opioid dependence where four implants are inserted and stay in place for 6 months.

Answer 8

Probuphine

Question 9

A drug product called ___, is a intracranial implant of carmustine homogenously dispersed in bioerodible polymer matrix. Made of microspheres compressed into disc shape. Delivered locally into the surrounding brain-tissue.

Answer 9

Gliadel Wafer

Question 10

Mechanical implants - Implantable Infusion pumps that use (positive or negative) pressure to deliver medication.

Answer 10

positive

Question 11

Implantable infusion pumps are self-contained consisting of pumping mechanism, drug reservoir and catheter, that can be surgically implanted in a subcutaneous pocket in the subclavian fossa or abdomen. Made of ___ which is good biocompatibility and used for both spatial and temporal control.

Answer 11

titanium (metal)

Question 12

Drug product called _____, example of mechanical implant where drug solution is pumped from reservoir into catheter by peristaltic mechanism (rotating cams squeeze tubing as they rotate thereby pushing fluid out). Reservoir is refilled through a septum.

Answer 12

SynchroMed

Question 13

Codman 3000 constant flow infusion system uses a drug-fluid containing bellows, that is compressed by a propellant to force drug fluid out through a ____

Answer 13

flow restrictor (controls how fast it flows out)

Question 14

Implantable pumps can be catheterized in intrahepatic chemotherapy and intrathecal baclofen (for MS). They can be programmed externally (by telemetry, boluses, constant fusion, or complex ____ patterns)

Answer 14

circadian

Question 15

External infusion pumps also use positive pressure to deliver medication. Include electronic and ____ disposable pumps (e.g. spring, gas, elastic rebound like Codman 3000), range in size.

Answer 15

stored-energy

Question 16

_______ pump allows patient to deliver his or her own pain med. Mainly IV but also epidural, parameters that can be programmed include bolus dose, dose limits, background infusion rate and lockout interval (specifies the minimum amount of time between doses i.e. when pt press button does not mean they will always get the dose=overdose)

Answer 16

Patient-Controlled analgesia (PCA)

Pt can press button but programmed by DR

Question 17

Drug product called ___, is an insulin pump. Small external insulin pumps can be programmed to deliver insulin according to patient-specific needs. (e.g. basal insulin delivery, plus bolus doses as needed) some with integrated real-time glucose sensor. Helps with tighter glucose control and one model has automatic cutoff if glucose values reach a preset low threshold.

Answer 17

Minimed

Question 18

Approved as first “artificial pancreas” minimed combines a glucose monitor and insulin pump in a hybrid closed-loop system …. and will shut off if blood glucose drops too low.

Answer 18

it only automates background (basal) insulin and requires manual boluses.

Question 19

______ infusion pumps are a type of stored-energy disposable pump that uses an elastic membrane to provide the force for fluid delivery. Consist of disposable container with an inner elastic bladder (aka balloon) that is filled with fluid. Flow restriction controls the delivery rate but not as accurate.

Answer 19

Elastomeric

Question 20

Two types of products that offer some spatial control of parenteral drug delivery –> Particle (_____+____) and macromolecules.

Answer 20

Liposomes and albumin nanoparticles

Question 21

Drug product called ____, example of “Stealth” liposome (invisible cloak by PEG chains) IV for Kaposi’s sarcoma drug is water-soluble (inside liposome) and increase doxurubicin and localized to tumor sites.

Answer 21

Doxil

Question 22

________ systems includes macrophages in the liver, lung, spleen, and intestines.

Answer 22

Mononuclear Phagocyte System (MPS)

Question 23

____ liposomes with PEG chains attached to lipid headgroups. PEG chain shield the liposomes from MPS recognition and very hydrated (making it difficult to distinguish from surrounding plasma).

Answer 23

“Stealth”

Question 24

Drug product called _____, is an IV antifungal product (liposome product) where drug is lipid-soluble (within membrane) and decrease renal accumulation of amph, B. (less nephrotoxicity)

Answer 24

Ambisome

Question 25

Drug product called _____, an injectable suspension example of albumin nanoparticle with lipophilic drug. And no need for cremophor or alcohol in formulation.

Answer 25

Abraxane

Question 26

____ a surfactant used for paciltaxel to dissolve the drug however it cause significant reaction that require glucocorticoid pre-medication.

Answer 26

Cremophor

Question 27

Macromolecule = _______ a recombinant protein, combining interleukin 2 and diphtheria toxin– targets cells with IL-2 recepters to deliver the toxin

Answer 27

Denileukin diftitox