Ch 14: Drug Formulations

Question 1

sorbitol metab

Answer 1

produces gas, cramping, and bloating in sense pts (concern in IBS)

Question 2

phenylalanine

Answer 2

used in ODT, chewable, granule med forms. dangerouse sweetener in pt with phenylketouria (PKU)

Question 3

PKU

Answer 3

phenylketouria, genetic defect where enz that degrades phenylalanine is absent

Question 4

lactose

Answer 4

most common excipient

Question 5

ODTs

Answer 5

commonly used for pts with dysphagia (like from stroke) or children. helpful in nausea and non-adherence (cheeking)

Question 6

SL tabs

Answer 6

onset of action is faster than ODTs, drug is absorbed under the tongue (unlike ODTs dissolve but still need to be swallowed). less drug is lost to gut degradation and first pass metab because it is readily absorbed into the venous circulation

Question 7

chewable tabs

Answer 7

used in children and asa for ACS + select others like phosphate binders to bind phosphate in gut, and calcium tabs because they are huge to swallow

Question 8

granules

Answer 8

primarily for geriatric and ped pts with difficulty swallowing. granules, powders, or caps that can be opened and sprinkled into food or water. do not chew any LA pellets or beads that are emptied from a capsule. do not let mixture sit too long if mixed in food or water. do not add anything warm or hot to med. not all caps should be opened and admin, check PI for specifics like foods/liquids studied in. pH could be critical

Question 9

nasal sprays

Answer 9

faster onset than GI route –> good for conditions that need acute mgmt, bypass gut absorption so proteins that would get destroyed by GI are admin this way (calcitonin), or pts lacking intrinsic factor for b12 thru GI would get nasal b12

Question 10

can i cut the patch in pieces?

Answer 10

no unless lidoderm

Question 11

can patch be exposed to heat?

Answer 11

no

Question 12

patch is bothering skin, solution?

Answer 12

alternate sites, do not shave (only clip hair) before application (shaving is irritating), consider using topical steroid AFTER patch is removed

Question 13

patch does not stick, what to do?

Answer 13

clean skin, clip hair, do not touch sticky side. only fentanyl and buprenorphine permit adhesive film specifically bioclusive or tegaderm, catapres-TTS comes with own adhesive cover.

Question 14

daytrana application

Answer 14

methylphenidate. alternate left and right hips

Question 15

transderm scop

Answer 15

apply behind ear, alternate ears q72h

Question 16

estrogen patches

Answer 16

apply to lower abd, some to upper buttock, never to breasts

Question 17

testosterone patch

Answer 17

never applied to scrotum

Question 18

patch disposal

Answer 18

press adhesive surfaces together. controlled substances flush down toilet.

Question 19

weekly patches include

Answer 19

estradiol (some are 2s/wkly), Xulane, clonidine

Question 20

twice daily patches

Answer 20

diclofenac (flector)

Question 21

daily special patches

Answer 21

lidoderm is up to 3 patches on 12 h then off 12 h, nitroglycerin is on for 12-14 h then off for 10-12 h