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PHM 651/652: Professional Practice > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what is an emulsion?

A

two phase systems in which one liquid is dispersed throughout another in the form of small droplets

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2
Q

define emulsification

A

added energy through trituration or homogenization creating small droplets of one liquid phase in another and a static charge around those droplets

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3
Q

define emulsifying agents

A

promotes the formation of droplets (micelles) and their charge based seperation (basically promotes formation of emulsion)

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4
Q

creaming

what happens?

can it be fixed?

A

migration (surfacing or settling) of droplets

yes: can be fixed by shaking

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5
Q

cracking or coalescence

what happens?

can it be fixed?

A

merging of droplets, causing a separation of the phases

no it cannot be fixed. needs to be discarded

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6
Q

what are the 2 phases of an emulsion.

what is each phase composed of

A

internal phase: droplets, micelles

external phase: suspension medium

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7
Q

two type of emulsion

A

Water in oil (w/o)

Oil in water (o/w)

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8
Q

water in oil emulsion.

what is it composed of

A

droplets of hydrophilic liquid (possibly containing water soluble drug) in a lipophilic suspension medium

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9
Q

oil in water

what is it composed of

A

droplets of lipophilic liquid (possibly containing fat soluble drugs) in an aqueous suspension medium

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10
Q

emulsions for ingestion

where are the active ingredients usually dissolved or suspended?why?

A

in the internal phase because they can hidden from the taste buds. increases pt compliance if it the drug tastes bad

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11
Q

emulsions for external use

where are the active ingredients usually dissolved or suspended? why?

A

in the external phase. want max bioavailability, which will occur in the external phase.

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12
Q

where phase of emulsions are flavoring agents usually found in? why?

A

eternal phase because that is the phase that is in contact with the pts taste buds

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13
Q

is the ratio of oil to water always an indicator of o/w or w/o emulsions?

A

no

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14
Q

what indicated whether an emulsion is w/o or w/o

A

order of incorporation and the chemical natural of the ingredients

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15
Q

identification tests for emulsions

drop test( drop dissolution test)

Principle:
test:
result:

A

drop test( drop dissolution test)

Principle: all emulsions are easily miscible with their continuous/ external phase

test: Add drop of water or oil to an emulsion

results:
if sample is easily diluted in water OR does not dissolve in oil, it is an O/W emulsion

if sample is easily diluted in oil OR dose not dissolve in water, it is an W/O emulsion.

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16
Q

identification tests for emulsions

electrical conductivity test

Principle:
test:
result:

A

electrical conductivity test

Principle: water is good conductivity of electricity, hence an emulsion in which water forms a continuous phase acts as a conductor.

test: a small low striking voltage neon lamp connected in series with a bayonet fitting plug and two electrodes Eg. Two-piece of copper wire. Dip these electrodes in a sample emulsion, apply the Current and observe the results.
result:

  1. w/o
    a. Pass: if it doesn’t conduct electricity
    b. fail: if it does conduct electricity
  2. o/w
    a. pass: if it does conduct electricity
    b. fail:if it doesn’t conduct electricity
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17
Q

what is the viscosity of the emulsion due to

A

micelle diameter and weak hydrogen bonding between micelles

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18
Q

how do micelles form

A

in o/w, micelles form as spears with polar head groups facing the outside and non polar chain facing inside

w/o, it is the opposite

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19
Q

examples of emulsifiers

A 
Acacia
Lecithin
polysorbate 80, tween 80
alcohol (s)
Pluronic F68
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20
Q

routes of administration for emulsions

A

topical, PO, parenteral (IM, etc.)

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21
Q

primary emulsion

A

no active ingredients. has non pharmacologic effects

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22
Q

dry gum method

ingredients
how much of each ingredient

what order do the ingredient go in

A

Mineral oil, distilled water, acacia

4 parts mineral oil
2 parts DI water
1 part acacia

acacia->then mineral oil->then di water

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23
Q

in order to emulsify, you must add energy.

what methods can you do that

A 
mortar and pestle
mixing devices
shaker jar
homogenizer
mixer
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24
Q

homogenization

what is it?
what is the benefit?

A

forcing 2 immiscible liquids through an orifice under high pressure for the purpose of mixing.

increases the stability of the product

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25
Q

types of emulsifiers

what kind of emulsions do they tend to form

examples of each

A
  1. gums
    a. tend to form o/w
    b. ex: acacia, xanthum gum
  2. soaps
    a. tend to form w/o
    b: olive oil/ lime water
    * olive oil contains oleic acid, which is the precursor to the real emulsifier - calcium oleate that forms with the combo of olive oil and lime water.
  3. surfactants
    a. can form both o/w and w/o(flexible)
    b. Tween 60, propylene glycol monolaurate
26
Q

advantages of surfactants

A 
more diverse
more flexible (can form w/o or o/w)
low viscosity (can be advantage or disadvantage)
27
Q

disadvantages of surfactants

A

need viscosity enhancers

complex

28
Q

HLB index

what is it?

applies to what?

what is the index range

A

hydrophile, lipophile index

indicated the type of emulsion (o/w or w/o) that the emulsifier is best suited for

applies to surfactant type emulsifiers

range 1-20

29
Q

HLB value 1-9 indicates what

A

w/o emulsion

30
Q

HLB value 9-20 indicates what

A

o/w emulsion

31
Q

optimal HLB values for an emulsion

A

2 distinct values:

  1. specifiied for o-w
  2. specified for w/o
32
Q

what is the purpose of using the optimal HLB value for selected emulsifying components

A

provides greatest stability in terms of micelle formation and integrity, creaming, and cracking

33
Q

UBSOP how much surfactant to use when compounding emulsion

A

total surfactant =15% w/v of the emulsions internal phase

34
Q

how to convert surfactant mass into volume when calculating

A

use specific gravity. add units to turn it into density. use density to convert from mass to volume

35
Q

if an active ingredient is dissolved in any phases of an emulsion, can a primary emulsion be made?

A

NO it cannot. by definition, a primary emulsion is one that does not have any active ingredients

36
Q

types of infusion settings

A

Institutial: hospital

Non institutional: skilled nursing facilities, infusion centers, physician offices

37
Q

accèss for infusions

A
  1. peripheral IV lines
  2. central IV lines
  3. peripheral inserted central lines (PICC)
  4. SQ lines
38
Q

types of peripheral access devices

A

butterflies- good formal veins. up to 3-5 days

angio catheter-good formal veins. up to 3-5 days

midlines: larger veins. up to 3 mo. easy to maintain

SQ catheters: insufulon: allows for multiple sq injections throughout the sday

39
Q

Central venous acmes devices

A

CVP lines: placed by physicians. up to 10 days. site of insertion increases risk for infection. flexibility of drugs that can be used

silastic catheters: surgically placed. lower risk of infection. flexibility of drugs can be used
ex: hickman

implantable ports: placed surgically placed under the tissue. used for intermittent therapies. lower risk of infection. long duratin

PICC lined: used up to 3 mo. but could be longer. not surgically placed

40
Q

PICC lines

how is it inserted
how long can it be kept in
internal or external device

A

non surgical insertion
3 month duration
external device

41
Q

how should lines be maintained?

A

line flushing

dressing changes

42
Q

methods to flush lines

purpose:

A

determine potency, as well as flush lines before and after drug administration

SAS: saline, administer drug, saline

SASH:saline, administer drug, saline, heparin

43
Q

which lines use which flush methods

A

peripheral lines: SAS
central lines: SASH
Implantable ports: SASH
Positive pressure caps: SAS

44
Q

do positive pressure caps need heparin to flush?

A

no

45
Q

dressing changes

when do they occur

what are we checking for

A 
day after insertion
weekly thereafter
check site for 
1. infections
2. signs of embolism
3. line migration
46
Q

how to pick venous access device?

A
  1. patient location
  2. duration/ the of therapy
  3. method of insertion
  4. drug characteristics
  5. maintenance of line
47
Q

common drugs for infusoin

A 
ABX
antifungals
anti emetics
steroids
chemotherapy
analgesics
electrolytes/ vitamins
cardiac medications
48
Q

infusion methods

A

gravity
bolus
rate controlled
infusion pumps:MOST COMMON

49
Q

pharmacist considerations for infusion orders

A
  1. what venous access device it is
  2. drug characteristics
  3. what diluent
  4. stability of solution
  5. volume of infusion
  6. rate of infusion
50
Q

expiration dates

A 
can fin din package insert
handbook of injectable drugs
extended stability of injectable drugs
literature 
manufacturer
51
Q

TPN

what is it

A

feeding IV when feeding orally is no an option

52
Q

when is tPN INDICATED

A

intractable vominting
diarrhea
bowel obstruction or resection
bowel rest

53
Q

what is included in TPN

A
  1. protein
    a. branched chain amino acids
  2. dextrose
    hypertonic dextrose used when adding to tan
  3. lipids
    a. lipid emulsions with essentially fatty acids
  4. electrolytes
4.additional additives: 
multivitamins
trace metals
insulin
vitamin K
54
Q

Harris and Benedict Equation

A

calculates basic energy expenditure for a patient at rest

55
Q

caloric needs categories

A

mild impairment: 25-28kcal/kg/day

moderate impairment 28-32 kcal/kg/day

sever impairment: 30-35

56
Q

TPN ordering

A

develop formula based on pt needs. never an emergent therapy

57
Q

complications of tpn

A

CATHETER SEPSIS
vt
HEAPTIC FATTY LIVER OR CHOLECYSITITIS
metabolic conditions

58
Q

what to monitor for with TPN

A

weight: weight gain of 1-2 lbs per week
2. nutritoinal profile
3. BMP
4. glucose (finger sticks)
5. urea nitrogen

59
Q

TPN for special populations

A 
diabetes
acute renal failure
pulmonary disease (give them more fat than dextrose)
hepatic disease
cardiac disease
60
Q

methods to preparing TPN solutions

A
  1. manual mixing

2. automated compounders

61
Q

TPN infusions done with what device

A

via pump

62
Q

how to find composite hlg when given surfactant quantities

A
  1. ude density and surfactant volume to find the mass of each surfactant
  2. add the masses of the 2 to get the total masses of emulsifiers
  3. find the value of f for first surfactant by dividing the mass of the surfactant by the total mass of the 2 surfactants.
  4. find f of second surfactant by subtracting f of first from 1.

do the cross method with the middle part being x. you will get the parts equation for each. set up a whole equation to figure out the parts

PHM 651/652: Professional Practice (6 decks)

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