6. Drug Formulations + Patient Counseling Flashcards
Drug formulation considerations: Olanzapine: What formulations does it come in?
IR tablet, ODT, short-acting injection, and long-acting injection
Drug formulation considerations: Ondansetron: What formulations does it come in?
IR tablet, oral solution, ODT, oral film, and short-acting injection
Which drugs use an osmotic controlled-release oral delivery system (OROS)
Concerta, Cardura XL, Procardia, XL, Asacol HD, Delzicol
How does osmotic controlled-release oral delivery system (OROS) work?
Water from gut is absorbed into the delivery system by osmosis, which increases pressure inside and forces the drug out through a small opening. Tablet/capsule shell may be visible in the patient’s stool (ghost tablet/capsule) but drug has been released (important counseling point).
In general, long-acting formulations should not be crushed or chewed (can release drug all at once, may be fatal)
Some long-acting capsules like __ or ___ can be opened and the contents sprinkled on certain foods. Capsule contents should not be crushed or chewed. Always consult packing labeling.
Some long-acting tablets like __ or ___ cannot be crushed but cut on the score line
Can be sprinkled: Kadian (morphine ER) or Xtampza ER (oxycodone ER)
Can be split on score line but not crushed: Toprol XL (metoprolol XL) or carbidopa/levodopa ER
Augment and Children’s Tylenol are examples of liquid oral ___ and they must be shaken prior to admin
suspensions
Constulose (lactulose, for hepatic encephalopathy), Neurontin (gabapentin), and Rapamune (sirolimus) are examples of liquid oral ____ and they do not need to be shaken prior to admin
solutions
What are some examples for chewable tablets
Suprax (cefixime)
Singulair (montelukast)
Lamictal (lamotrigine)
Typically for children
What are some examples for lozenges
Mycelex (clotrimazole, for oral thrush)
Cepacol (benzocaine/menthol, for sore throat)
What are some examples of ODT
Lamictal ODT (lamotrigine, for seizures)
Nurtec (rimegapant, for migraines)
Remeron SolTab (mirtazapine, for depression)
Zyprexa Zydis (olanzapine, for schizophrenia)
Ondansetron (for nausea, dysphagia)
When is ODT/SL often helpful?
When pt cannot swallow (dysphagia) or children unable to swallow tabs/caps
Nausea but not vomiting (if vomiting, use non-oral option)
Non-adherence: ODT dissolve quickly
Note: Paralysis of throat muscles from stroke is most common cause
___ (sweetener) metabolism produces gas, cramping and bloating in sensitive patients, including those with IBS
Sorbitol
____ is found in the sweetener aspartame, which is used in many ODT, chewable and granule medication formulations. It is a dangerous sweetener for those with ____, a genetic defect in which the enzyme that degrades this substance is absent.
Phenylalanine
Phenylketonuria (PKU)
___ is the most commonly used excipient in drug formulations. May be an issue in patients with lactose intolerance.
Lactulose
What are common application sites for patches?
Chest, back, upper arm, flanks
___ patches are applied to chest back, upper arm, but NOT flanks
Exelon (Rivastigmine)
____ patches are applied on the hip, alternating righ and left hips daily
Daytrana (methylphenidate, for ADHD)
___ is applied behind the ear, at least 4 hrs before needed, alternating ears every 72 hrs
Transderm Scop (Scopolamine, for N/V)
Patch frequency: Diclofenac
Twice daily
Patch frequency: methylphenidate (Daytrana)
QAM, 2 hrs prior to school
Patch frequency: nicotine (Nicoderm CQ)
daily
Patch frequency: rivastigmine (Exelon)
daily
Patch frequency: rotigotine (Neupro)
Daily
Patch frequency: Selegiline (Emsam)
daily
Patch frequency: Testosterone (Androderm)
Nightly, not on scrotum