Case 4 definitions

Question 1

temp at which suppositories melt, dissolve, soften

Answer 1

98.6F or 37C

Question 2

cocoa butter

Answer 2

fat from the seeds of chocolate beans; natural TGs

Question 3

cocoa butter advantages

Answer 3

non irritating and excellent emollient

Question 4

cocoa butter disadvantages

Answer 4

poor and erratic release
stored at fridge temp
easily overheated = polymorph forms

Question 5

PEG

Answer 5

water soluble base; do not melt at body temp but dissolve in body fluids; different hardness or dissolution is achieved by combining different kinds

Question 6

glycerinated gelatin

Answer 6

mix of 70 pts glycerin; 20 pts gelatin, 10 pts water to create a soft rubbery consistency

Question 7

PEG and glycerinated advantages

Answer 7

dissolve in 30-40 minutes
do not melt
do not leak
do not required monitored temperature

Question 8

PEG and glycerinated disadvantages

Answer 8

irritating to body cavity tissues

Question 9

cocoa butter melts between _____ it must be formulated

Answer 9

31-34; slowly and evenly without overheating due to possibility of polymorph forming

Question 10

Wecobee or Witepsol

Answer 10

synthetic TGs less hard to formulate than cocoa butter but more expensive

Question 11

Fattibase

Answer 11

composed of mixture of FAs; does not have formulation difficulties; less expensive than wecobee and witepsol but still more than cocoa butter

Question 12

polybase

Answer 12

PEG mixture of 40% 8000 and 60% 400 used to create water soluble bases

Question 13

glycerinated gelatin is

Answer 13

hygroscopic; it absorbs moisture from the air must be stored in airtight container

Question 14

important factors to consider when selecting a suppository base

Answer 14

patient comfort: fatty bases = more comfortable
compatibility and stability
speed and consistency of drug release

Question 15

oil sol drug + oil base =

Answer 15

slow release / poor escaping tendency

Question 16

water sol drug + water base =

Answer 16

rapid erratic release

Question 17

oil sol drug + water base

Answer 17

moderate release

Question 18

water sol drug + water base =

Answer 18

moderate release based on diffusion

Question 19

fatty bases are preferred for ____ and PEG bases are preferred for ____

Answer 19

rectal suppositories; vaginal and urethral suppositories

Question 20

advantages of hand rolling suppositories

Answer 20

special equipment is not required

Question 21

disadvantages of hand rolling suppositories

Answer 21

requires experience and good technique

final product does not have an elegant appearance

Question 22

advantages for fusion method

Answer 22

does not require well developed compounding tech

final product is elegant

Question 23

disadvantages for fusion method

Answer 23

special molds required
caution must be used with drugs sensitive to heat
there are a lot of calculations involved to do it correctly

Question 24

practical aspects of dispensing suppositories

Answer 24

indicate route of administration
state preparation
aux labels should be used
rectal suppositories must be inserted passed the sphincter so they are not immediately ejected (1 inch in adult and 1/2-1 in children)
sit for 15 minutes and avoid emptying bowels for an hour unless its a laxative

Question 25

rectal cavity

Answer 25

terminal portion of the colon; 8 inches in length composed of rectum, anal canal, anus

Question 26

rectum

Answer 26

terminal section of the intestine; relative straight serves as a transitional area from the colon to the external part of the body simple columnar and cuboidal epithelium lacking microvilli + goblet cells

Question 27

anal canal

Answer 27

last 1 inch of the rectal cavity

Question 28

upper 2/3 of the anal canal

Answer 28

simple columnar epithelium

Question 29

lower 1/3 of the anal canal

Answer 29

non keratinized stratified squamous then transitions to keratinized stratified squamous in the anus

Question 30

rectal smooth muscle

Answer 30

outer layer of longitudinal fiber + inner circular layer

Question 31

rectal cavity is has

Answer 31

a rich blood supply; venous return occurs through rectal hemorrhoidal veins

Question 32

drugs carried by the superior hemorrhoidal veins

Answer 32

undergo first pass

Question 33

drugs carried by the middle and inferior hemorrhoidal veins

Answer 33

bypass first pass

Question 34

5 barriers to rectal drug delivery

Answer 34

unfavorable to passive absorption ( small SA and lack microvilli ) lacks dissolution media (when empty only contains 2-3 mL of fluid) minimal buffering capacity (easily altered in pH with presence of drugs) location influences first pass avoidance occupancy and bowel movements affect drug absorptions (evacuated absorbs drugs better since there is a better chance of it reaching the surface; diarrhea and tissue dehydration can reduce drug absorption)

Question 35

local conditions for rectal suppositories

Answer 35

inflamed hemorrhoids, constipation, UC

Question 36

system conditions for rectal suppositories

Answer 36

nausea, fever, pain, motion sickness, epilepsy

Question 37

general rectal dosage formulations

Answer 37

suppositories, ointments, creams, gels, solutions, suspensions

Question 38

correct administration of an enemas

Answer 38

shake well remove cover assume correct position insert tip tilt so that the nozzle is aimed towards the back squeeze bottle firmly with steady pressure withdraw and discard remain in position for 30 minutes retain enema all night unless its a laxative

Question 39

advantages for rectal drug delivery

Answer 39

nausea and vomiting no taste bypass first pass minimal enzyme activity

Question 40

disadvantages for rectal drug delivery

Answer 40

interruption in absorption due to defecation SA is v small erratic and unpredictable leak or can be difficult to retain in the rectal cavity

Question 41

vaginal cavity

Answer 41

fibromuscular tube shaped organ of fixed length; 4-6 inches in size that connects to the uterus

Question 42

inner canal of the vagina is

Answer 42

lined with stratified squamous epithelium and mucus produced by underlying glands; surface features micro ridges in longitudinal or circular patterns that give the vagina absorptive capacity

Question 43

musculature of the vaginal cavity consists of three layers

Answer 43

outer fibrous middle muscular inner stratified squamous muscles only used when a women is in labor therefore there is not a natural urge to contract and expel dosage forms as seen with rectal administration

Question 44

blood flow travels from the vagina through a venous network that empties into the

Answer 44

internal iliac veins; bypassing first pass

Question 45

vaginal cavity has a great amount of

Answer 45

buffering capacity; surface is covered with an aqueous film whose volume, pH, and composition vary with age, stage of mensural cycle and location; pH change high pH as you more in; large amounts of glycogen that forms organic acids upon degradation that serve to retard bacterial growth

Question 46

local conditions for vaginal dosing

Answer 46

contraceptives, antiseptics, antimicrobial agents

Question 47

systemic conditions for vaginal dosing

Answer 47

hormone replacement, prostaglandins, contraceptives

Question 48

general vaginal dosage formulations

Answer 48

suppositories or pessaries, ointments, creams, vaginal tablets, intrauterine devices, contraceptive vaginal rings

Question 49

vaginal suppositories

Answer 49

have an oviform; egg shape to encourage retention; heavier weight 3-5 g

Question 50

advantages in vaginal drug delivery

Answer 50

fairly consistent drug absorption option for local and systemic delivery potential for long term administration bypass 1st pass

Question 51

disadvantages in vaginal drug delivery

Answer 51

dosage forms can be expelled | risk of toxic shock syndrome with long term retention

Question 52

urethral route of drug administration

Answer 52

urethral suppositories are typically used to deliver antibacterials and anesthetics; muse (alprostadil) is a urethral microsuppository for treatment of ED

Question 53

E value

Answer 53

equal to how much NaCl is represented by 1 g of the compound

Question 54

E value =

Answer 54

58.5 * i / MW * 1.8

Question 55

i

Answer 55

dissociation factor