Chapter 6: Drug Formulations & Patient Counseling Flashcards

1
Q

Which 5HT3-RA comes in a long-acting patch?

A

Granisetron

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2
Q

Which sweetener added to some drug formulations causes gas, cramping, and bloating in sensitive patients (i.e. patients with IBS)?

A

Sorbitol

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3
Q

Which sweetener is dangerous for those with phenylketonuria (PKU)?

A

Phenylalanine

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4
Q

What is the most commonly used excipient in drug formulations?

A

Lactose

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5
Q

What should you instruct patients on when using granules, powders or capsules that can be opened and sprinkled into soft food and water?

A
  • Do not chew any long-acting pellets or beads that are emptied out from a capsule
  • Do not let the mixture sit too long if capsule contents are mixed in food or liquid
  • Do not add to anything warm or hot
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6
Q

T or F: you can crush or chew long-acting medications

A

false; this could lead to a fatal dose

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7
Q

What are osmotic release oral systems?

A

They provide fast drug delivery followed by an extended release in one drug

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8
Q

What is an important counseling point about osmotic release oral systems (OROS)?

A

The tablet/shell may be visible in the patient’s stool (called a ghost tablet/capsule)

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9
Q

Why are long-acting medications used?

A
  • To avoid nausea or provide a long duration of action

- Reduces high “peaks” which reduces side effects

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10
Q

T or F: some long-acting opioid capsules can be opened and the contents sprinkled on certain foods

A

True

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11
Q

Which long-acting medications can be cut at the score line?

A

Toprol XL and Sinemet CR (carbodopa/levodopa)

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12
Q

Where on the body can patches be placed?

A

chest (upper), back (upper and lower), upper arm (on the part facing out), flanks (sides of the body, abdomen level)

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13
Q

Where is Daytrana patch applied?

A

To the hip, alternating between right and left hip daily

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14
Q

Where is Transderm Scop patch applied?

A

Behind the ear at least 4 hours before needed, alternating ears Q72H

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15
Q

Which patch can be cut into pieces?

A

Lidoderm

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16
Q

What happens if you apply heat to a patch?

A

Heat causes rapid absorption of the medication

17
Q

Which patches can be covered with adhesive film if it does not stick?

A

Fentanyl (duragesic) and buprenorphine (Butrans) only with the permitted adhesive film dressings, Bioclusive or Tegaderm

Catapres-TTS comes with its own adhesive cover

18
Q

T or F: you can flush some highly potent narcotic patches down the toilet to remove it from the home immediately?

A

True - these include Duragesic, Butrans and Daytrana

19
Q

What are some counseling points for all monoclonal antibodies?

A

Do not shake the medication and avoid exposing the drug to extreme temperatures (hot or cold)

20
Q

How many times should a gel eyedrop be shaken prior to use?

21
Q

How long should you wait to use another medication in your eye after using an eye drop?

A

5-10 minutes

22
Q

How long should you wait to use a gel in your eye after using an eye drop?

A

10 minutes

23
Q

What should you do if your eye drop contains a preservative called benzalkonium chloride (BAK) and you wear soft contact lenses?

A

remove the lenses prior to administration (wait 15 min to reinsert)

24
Q

When using eardrops on an adult, how would you pull the ear when administering?

For a child?

A

adult: up and back
child: down and back if < 3 years

25
How long should you keep your ear facing up after administering an ear drop
5 minutes
26
When would an ODT be useful
Patients with dysphagia, children, nausea, vomiting, non-adherence
27
Why would sublingual or buccal delivery with a tablet, film, powder or spray be useful
Has a faster onset of action & less drug is lost to gut deterioration & first-pass metabolism
28
Singulair granules can be mixed in 5 ml baby formula or breast milk or:
Spoonful of applesauce, carrots, rice or ice cream
29
Exelon patch is NOT applied to which part of the body that most patches can be placed
flanks (sides of body, abdomen level)
30
How is lidocaine patch applied
1-3 patches, on for 12 hours, then off for 12 hours (as needed)
31
How is nitroglycerin patch applied
On for 12-14 hrs then off for 10-12 hrs
32
When applying an eye drop, how long should you press down between your eye and the top of your nose after applying a drop
one full minute
33
Patches that are applied daily
Daytrana patch - QAM, 2 hours prior to school Nicotine (NicoDerm CQ) patch Rivastigmine (Exelon) patch Rotigotine patch Selegiline patch Testosterone patch - nightly (not on scrotum)
34
Which two patches are applied Q72H
Fentanyl and Scopolamine
35
Which patches are applied weekly
buprenorphine (Butrans) Clonidine Estradiol (Climara) Estradiol/Levonorgestrel
36
Which patches are applied twice weekly
Estradiol (Alora, Vivelle-Dot) | oxybutinin (Oxytrol)
37
Which patch is applied weekly for 3 weeks, off for the 4th week
Ethinyl estradiol/Norelgestromin (Xulane)
38
Which patch is applied twice daily
Diclofenac - (remember, di=2)