Ch 6: Drug Formulations & Patient Counseling Flashcards
What are the benefits Osmotic controlled-release oral delivery systems (OROS)?
Decreased frequency of drug administration due to its extended-release formulation
Afast drug delivery due to the rapid dissolution of the overcoat, which allows for a quicker onset of action
Reduced fluctuations in serum drug levels due to the controlled release of drug as the OROS is activated
Brand:Generic
Detrol LA
tolterodine
Tx overactive bladder symptoms
Brand:Generic
Rapamune
sirolimus
Brand:Generic
Suprax
cefixime
Brand:Generic
Mycelex
clotrimazole
Brand:Generic
Cepacol
benzocaine/menthol
Brand:Generic
Nurtec
rimegepant
Brand:Generic
Remeron SolTab
mirtazepine ODT
Brand:Generic
Zyprexa Zydis
olanzapine ODT
Brand:Generic
Edluar
zolpidem SL
Brand:Generic
Subsys
fentanyl SL spray
Brand:Generic
Actiq
fentanyl lozenge
Brand:Generic
Fentora
fentanyl buccal tab
Drugs that can be sprinkle on applesauce
Adderall XR - dextroamphetamine/amphetamine ER
Coreg CR - carvedilol
Dexilant - dexlansoprazole
Focalin XR - dexmethylphenidate
Namenda XR - memantine
Nexium - esomeprazole
Ritaline LA - methylphenidate
What can this drug be mix with?
Cambia (diclofenac potassium)
powder
water
What can this drug be mix with?
Creon
and other pancreatic enzyme products
on soft food w/ low pH:
applesauce
pureed pears or banana
What can this drug be mix with?
Depakote Sprinkles (valproic acid)
soft food
What can this drug be mix with?
Kadian (morphine)
applesauce or soft food
What can this drug be mix with?
potassium chloride ER
Capsules
applesauce or pudding
What can this drug be mix with?
Questran (cholestyramine)
Including Questran Light
2-6 oz of water or non-carbonated liquid
What can this drug be mix with?
Singulair (montelukast)
5 ml baby formula or breast milk OR
In a spoonful of applesauce, carrots, rice, or ice cream
What can this drug be mix with?
Vyvanse (lisdexamfetamine)
water
yogurt
orange juice
Which sweetener produces gas, cramping, & bloating?
In sensitive pts including those w/ IBS
Sorbitol
Which sweetener is dangerous for those w/ phenylketonuria (PKU)?
phenylalanine
Use in ODT, chewable, & granule
Brand: Generic
Invega Sustenna
& Invega Trinza
paliperidone
LA IM injection
Brand: Generic
Risperdal Consta
reperidone
LA IM injection
Brand: Generic
Vivtral
naltrexone
LA IM injection
Brand: Generic
Zyprexa Relprevv
olanzapine
LA IM injection
Self-Administered Injections
Which ones require refrigeration?
glatiramer (Copaxone)
etanercept (Enbrel)
adalimumab (Humira)
certolizumab pegol (Cimzia)
golimumab (Simponi)
teriparatide (Forteo)
abaloparatide (Tymlos)
Self-Administered Injections
Which ones does not require refrigeration?
enoxaparin (Lovenox)
fondaparinux (Arixtra)
methotrexate (Otrexup)
sumatriptan (Imitrex, Zembrace, SymTouch)
Self-Administered Injections
Which injection should you not rub the skin and why?
Anticoagulant injections (e.g. enoxaparin, fondaparinux)
Can cause severe bruising
Which injections should not be shaken?
Monoclonal Antibodies
Most patches can be applied to?
Chest (upper)
Back (upper & lower)
Upper arm (on the part facing out)
Flanks (sides of the body, abdomen level)
Patch Site Exception
Exelon
Normal sites except not on the flanks
Rivastigmine
Patch Site Exception
Butrans
Normal sites except the flank is chest level
Patch Site Exception
Which patches are applied the affected area?
diclofenac (Flector)
lidocaine (Lidoderm, Salonpas)
capsaicin (Qutenza)
Patch Site Exception
Where do you apply Daytrana?
hip
methylphenidate
Patch Site Exception
Where do you not apply estrogen patches?
breast
Patch Site Exception
Where do you not apply testosterone patches?
scrotum
Which patches can be applied to the buttock?
Xulane
oxybutynin (Oxytrol)
Vivelle-Dot
Which patches are applied twice daily?
diclofenac (Flector)
Which patches are applied daily ?
methylphenidate (Daytrana) - 2 hrs prior to school
nicotine (NicoDerm CQ)
rivastigmine (Exelon)
rotigotine (Neupro)
selegiline (Emsam)
testosterone (Androderm) - nightly
Which patches are applied Q72H ?
fentanyl (Duragesic) - can be change to Q48H if it wears off after 48 hours
scopolamine (Transderm Scop): Q72H PRN
Which patches are applied twice weekly?
estradiol (Alova, Vivelle-Dot)
oxybutynin (Oxytrol)
Which patches are applied weekly?
donepezil (Adlarity)
buprenorphine (Butrans)
clonidine (Catapres-TTS)
estradiol (Climara) - continuous or cyclic
estradiol/levonorgestrel
ethinyl estradiol/norelgestromin (Xulane, Zafemy) - cyclic
ethinyl estradiol/levonorgestrel (Twirla) - cyclic
Cyclic - 3 weeks on, 1 week off
Lidocaine patch instruction
1-3 patches daily PRN on for 12 hrs, off for 12 hrs
Lidoderm
nitroglycerin patches
1 patch daily, on for 12-14 hrs, off for 10-12 hrs
Which patches can be cut?
Lidoderm & Qutenza
What can be applied for skin irritation from the patch?
topical steroids (e.g. hydrocortisone) after removing the patch
Which patches has to be removed before an MRI?
clonidine (Catapres-TTS)
rotigotine (Neupro)
scopolamine (Transderm Scop)
testosterone (Androderm)
Which patch can be covered by tape and what type of tape?
fentanyl & buprenorphine (Butrans)
Bioclusive or Tegaderm
Which patches should be flush?
narcotic patches (e.g. fentanyl, Butrans)
Daytrana
Nasal Spray Counseling
Before use
Shake gently
Prime - 1st use or haven’t used within 7-14 days
Blow nose before use
Nasal Spray Counseling
Using
Close one nostril
Breathe in through your nose then pres firmly & quickly down on applicator
Breathe out through mouth
Use for the labeled # of spray and discard, even if it’s not empty
Do not blow your nose after spray
Eye Drop Counseling
Before
Shake a few times
Gels - inverted & shaken once
Eye Drop Counseling
After
Close eyes
Press a finger between eye & the top of the nose for 1 minute
How many minutes between drops?
5 minutes between doses
5-10 minutes between medications
10 minutes between gels
Drops w/ benzalkonium chloride (BAK)
remove soft contacts & wait 15 minutes
Ear drop administration for adults
Pull ear up & back
Ear drop administration for childrens < 3 y/o
Pull ear down & back
Ear drops
How long do you stay on your side?
5 minutes
What is the position for administrating enemas?
Lying on the left side
Left leg extended
Right leg flexed forward
Insert applicator tip slightly toward the navel
How long does the patient have to remainin in the same position after an enema?
30 minutes
How long do you need to keep the suppository in?
1-3 hrs
