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Compound My Ass ( P2 Fall) > Final Exam (sem 1) > Flashcards

Final Exam (sem 1) Flashcards

1
Q

1 oz = _____g

A

28.35g

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2
Q

1 z3 = _____g

A

31.1 g

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3
Q

1 oz & 1 z3 = ____ml

A

29.57ml

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4
Q

definition of compounding

A

the physical and/or chemical modification of a substance resulting in a drug/dosage form which is suitable for administration to a patient

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5
Q

reasons for compounding

A
  • drug or dosage forms not available commercially

- dose unavailable, pt comfort and compliance

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6
Q

extemporaneous compounding

A

-compounding pursuant to: a specific patient, for a specific prescription, & for 1 dispensing of the medication

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7
Q

extemporaneous compounding does NOT apply to

A

batching, manufacturing & refills

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8
Q

batching

A

compounding “ahead of time” in anticipation of outstanding refills or unfilled oral Rxs

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9
Q

what is needed to be kept record of when batching (for all drug sources)?

A
  • manufacturer’s name
  • lot numbers
  • expiration dates
  • assign a pharmacy batch lot to each product
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10
Q

manufacturing

A

compounding for long term inventory and sale

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11
Q

what is NOT a part of manufacturing

A

not:
-pursuant to a particular patient
-pursuant to a particular RX
-within the scope of pharmacy practice
~need special license and manufacturing facility~

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12
Q

manufacturing is subject to _____ (3 things)

A
  • -special law
  • inspection
  • industrial regulation*
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13
Q

what is a violation of manufacturing?

A
  • batching more than you need*
  • beyond the scope of hospital and/or community pharmacy practice
  • can get fines, imprisonment, OPD, FDA, BCS, FBI, CIA, KGB etc.
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14
Q

Stability: the extent to which a Rx prep remains within specified limits in terms of …..(3)

A
  • -chemical composition
  • physical composition
  • microbiologic activity/contamination
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15
Q

expiration date is a function of _____ (2)

A
  • -stability

- storage conditions*

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16
Q

whats the most important consideration for storage of medications?

A

keep out of reach of children

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17
Q

what is room temp?

A

20C-25C

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18
Q

what is refrigerated temp?

A

2C-4C

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19
Q

what is trituration? (verb & noun)

A

verb- particle size reduction

noun- mixed powder product

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20
Q

which 4 products need to be pre-refined?

A
  • salicylic acid
  • calamine
  • zinc oxide
  • sulfur ppt
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21
Q

when is geometric combination needed?

A

-indicated when mass of powders to be mixed differ by a factor greater than 3

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22
Q

Define powders

A

USP: intimate mixtures of dry, finely divided drugs and/or chemicals that may be intended for internal or external use

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23
Q

bulk powders

A
  • external use

- medication dose is very non-specific due to highly subjective administration

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24
Q

what are unit dose powders?

A
  • internal use: capsules & charts

- external use: antimicrobial otic powders

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25
Q

ways to reduce powder size:

A
  • pulverization (mechanical, intervention)

- trituration (refinement, mixing)

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26
Q

Efflorescent powders:

A
  • contain waters of hydration*
  • due to hydrogen binding
  • delicate crystal structures may be altered when exposed to: mechanical stress(trituration), changes in humidity or changes in temperature
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27
Q

hygroscopic powders

A

subject to moisturization from ambient humidity

h= getting hot/moist in here

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28
Q

deliquescent powders

A

hygroscopic yes but…will actually dissolve forming an H2O solution
(d = disappears into water)

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29
Q

what are eutectics?

A
  • a combination of 2 or more substances where the melting point is less than that of any part when taken alone
  • lowest melting point occurs at an optimum ratio of masses
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30
Q

powder papers aka charts

A

-contain a specific dose of medication: pt RX label should indicate quantity of active ingredient contained in one dose

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31
Q

lozenges

A
  • solid oral dosage form
  • designed to dissolve or disintegrate in the mouth
  • intended primarily for local drug delivery and effect (analgesics, anesthetics, antimicrobials)
  • can be a delivery vehicle for systemic medications as well
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32
Q

lozenges are also known as___ (2)

A

pastilles & troches

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33
Q

pills

A
  • small, round/spherical

- have been replaced by other solid oral dosage forms

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34
Q

tablets

A
  • prepared as: compressed unit-dose powders (most common) or solidification molded (less common)
  • may be enteric-coated
  • may be scored
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35
Q

Excipients

A

-INACTIVE ingredients used as fillers, binders and glidants

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36
Q

Disintegrates help for

A

aids to GI absorption

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37
Q

coloring agents and flavoring agents are used for:

A

pharmaceutical elegance and pt compliance

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38
Q

liquid content capsules

A
  • not suitable when gelatin capsule dissolves in contents (H2O based compounds)
  • OK when gelatin capsule is insoluble in contents: some alcohols (NOT ETOH), fixed oils & volatile oil
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39
Q

advantages of liquid content capsules

A
  • extemporaneous prep (custom dosing, enhanced patient compliance)
  • -easy to swallow
  • taste concealment
  • rapid drug release*
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40
Q

disadvantages of liquid content capsules

A
  • liquid content is problematic: aqueous agents dissolve capsule shell, time consuming to make
  • incompatible with hygroscopic and deliquescent materials: absorbs H2O from gelatin = brittleness!
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41
Q

Extemporaneous capsules

A
  • gelatin capsules (hard): telescoping- body & cap

- may contain ~0.15% sulfur dioxide (gives glossy appearance & prevents decomposition)

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42
Q

gelatin capsule exposed to LOW humidity

A

-may become brittle due to gradient = gives up its water

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43
Q

gelatin capsule exposed to HIGH humidity

A
  • may become soft

- -> hygroscopic: can absorb ~10x its mass in H2O

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44
Q

selecting a capsule size (general rule)

A

*as capsule size number increases, capsule content capacity decreases

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45
Q

what capsule sizes are used in adults?

A

optimum size = 2 or 3

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46
Q

what capsule size are used in children?

A

choose smaller of the 2 (cap size #3)

-if the capsule needs to be sprinkled - use size #1

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47
Q

solutions include:

A

syrups, elixirs, spirits, tinctures & lotions

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48
Q

advantages of liquid dosage forms

A
  • precise dosing
  • nonstandard dosing is easy (peds)
  • easy to swallow
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49
Q

disadvantages of liquid dosage forms

A
  • inconvenient dosing (need accurate measuring devices)
  • prone to error
  • unpleasant tastes can be difficult to mask
  • specific storage conditions
  • drug is often less stable than dry form
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50
Q

solutions

A

*molecular dispersion of a solute in a solvent which resulting product

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51
Q

solvent

A

*base liquid, pure or mixture of miscible liquids

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52
Q

solute

A

*substance which is dissolved in the solvent

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53
Q

Preservatives

A
  • not commonly used in extemporaneous compounded oral solutions
  • NEVER use with interthecal preparations
  • commonly used with ophthalmics
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54
Q

advantages of solutions

A
  • suspending agent is not required

- easily absorbed

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55
Q

disadvantages of solutions

A

-generally less stable than suspensions or dry dosage forms

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56
Q

FDA march 13 1996 alcohol ruling on alcohol concentrations

A
  • children <6 –> 0.5%
  • children 6-12 –> 5%
  • children > 12 –> 10%
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57
Q

what is the 20% rule?

A

smallest volumetric measurement is 20% of the containers full rated volume

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58
Q

what is an equivalent?

A
  • a mole of mono-valent charge pairs

- a mole = avogadros # (6.022 x 10^23)

59
Q

What is a suspension and its uses?

A
  • liquid preparation that consists of solid pariticles dispersed throughout a liquid phase in which the particles are not soluble
  • useful as oral, topical, ophthalmic & IM
60
Q

what is the purpose of suspensions?

A

1) to provide a liquid form for H2O insoluble drugs

2) as an alternative to EtOH based solutions

61
Q

why are oral suspensions prepared in and with an aqueous base?

A

1) physiology is water based

2) water is inexpensive and ubiquitous

62
Q

advantages of suspensions with tablet/capsule drug source:

A

1) rapid decomposition

2) particle size already appropriate

63
Q

disadvantages of suspensions with tablet/capsule drug source:

A

1) drug may be soluble in the solvent, could have made a solution where it not for the excipients
2) more expensive

64
Q

advantages of suspensions over solutions

A
  • 1) drugs contained therein are more stable
    2) much higher drug concentrations are achievable
    3) alcohol can be avoided in many cases *
65
Q

disadvantages of suspensions w/ respect to solutions

A
  • 1) suspending agents are usually required
    2) compounding procedure is more complicated
    3) cant QS in a graduated cylinder
    4) must be shaken prior to administration!*
66
Q

Levigation

A
  • the wetting of INSOLUBLE powder agent in a minimal amount of qs media or levigating agent forming a smooth homogenous paste
  • -> this is done via mortar and pestle, ointment slab and spatula
67
Q

How do suspending agents work?

A
  • 1) by increasing the products viscosity

2) thus decreasing particle settling rate*

68
Q

examples of some suspending agents:

A

-acacia, bentonite, methylcellulose (ora plus), xanthan gum, tragacanth, carbomer etc

69
Q

ratio strength (3:4)

A
  • 3 g of ingredient in 4 total grams of product

- -> 3g/4g

70
Q

parts notations (3:4)

A
  • 3 g of ingredient PLUS 4 gram of ingredient
  • total of 7 grams of product
  • -> 3g/7g
71
Q

nested sieves

A

-shaker apparatus that shakes the chamber in various frequencies –> designed so that any powders that we put in that are shifted down and become fractionated as they travel down to the bottom

72
Q

Micron gauge

A

-limited compared to the nest of sieves, can tell us the smallest particle size we can achieve but it doesnt have the ability to fractionate those particle sizes into a series of ranges nor the ability to tell us anything other than what the SMALLEST PARTICLE SIZE is that weve been able to achieve

73
Q

sedimentation rate in suspensions (3 things)

A
  • -varies directly with particle size
  • varies directly with particle density
  • varies INDIRECTLY with suspension viscosity*
74
Q

sedimentation time in suspensions (3 things)

A
  • -varies indirectly with particle size
  • varies indirectly with particle density
  • varies. DIRECTLY with suspension viscosity*
75
Q

deflocculated suspension

A

-long sedimentation time (advantage)
-dense, difficult cake formed (disadvantage)
(D= dat hard cake)

76
Q

flocculated suspension

A

*-short sedimentation time (disadvantage)
-sediment redisperses easily (advantage) *
(flaccid penis is short)

77
Q

10% rule in IVs

A
  • if a volume to be added to an IV bag is greater than or equal to 10% of the bag’s rated capacity, a volume equivalent to the add must be removed from the bag prior to the addition.
  • if the volume to be added is less than 10% of the bags rated capacity a corresponding withdrawal prior to the addition is not needed
78
Q

emulsions

A

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

79
Q

emulsification

A

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

80
Q

role of emulsifying agents

A

-promote the formulation of droplets and their charge based separations

81
Q

creaming

A

migration (surfacing or settling) of droplets

82
Q

cracking/coalescence

A

merging of droplets, separation of phases

-throw it out! no good!

83
Q

internal phase of emulsions

A
  • droplets and micelles
  • usually contains active ingredient
  • discontinuous
84
Q

external phase of emulsions

A
  • suspension medium
  • continuous (droplets move around and have their mobility)
  • interconnected
85
Q

water-in-oil emulsions

A 
-droplets of hydrophilic liquid in a lipophilic suspension medium, 
usually external ( w= wait outside)
86
Q

oil-in-water emulsions

A

droplets of lipophilic liquid in an aqueous suspension medium
-internal use ( O = open your mouth)

87
Q

active ingredients are most commonly dissolved or suspended in the internal phase. why?

A

since it tastes bad and hides that

88
Q

When would active ingredients may also be dissolved or suspended in the external phase

A

When we want bioavailability to its max when dealing with an external emulsion

89
Q

what determines emulsion type?

A
  • the chemical nature of ingredients (whether its going to become oil in water or water in oil)
  • by far the molecular geometry of the emulsifier is the greatest in the driving force as to whether or not the product is going to be oil in water or water in oil
90
Q

what 2 tests can we use to determine they type of emulsions?

A

1) drop test/drop dissolution test

2) electrical conductiviity test

91
Q

what type of emulsion is this:

“micelles form as spheres with polar head groups toward the outside and non-polar hydrocarbon chains on the inside”

A

oil in water

92
Q

what type of emulsion is this:

“soap based emulsifiers usually form inside-out micelles”

A

water-in-oil

93
Q

examples of emulsifiers

A

acacia, lecithin, tween 80, alcohols etc

94
Q

what is a primary emulsion?

A

has no active ingredients and has no desired pharmacologic effect

95
Q

what are gels?

A
  • semi-solid emulsions
  • consists of a matrix formed by hydrogen bonds: gel base/gel base, gel base/active ingredient & micelle/micelle
  • organic matrix can be interrupted by heat; may be destroyed by alcohol
96
Q

why are emulsions the most complex of all liquid dosage forms?

A
  • -design
  • calculation
  • compounding procedure
  • storage and administration*
97
Q

electrical conductivity test: pass for oil-in water:

A

conducts electricity

98
Q

electrical conductivity test: pass for water-in-oil

A

does not conduct electricity

99
Q

what are some ways that the additions of energy is done in emulsions?

A
  • -stirring
  • mortar and pestle
  • shaking
  • homogenization (gay syringe/peepee hole touching)*
100
Q

what is homogenuzation?

A

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

101
Q

what type of emulsion is used internally?

A

oil-in-water

102
Q

what type of emulsion is used externally?

A

water-in-oil

103
Q

what are the emulsifier components are in olive oil?

A

-oleic acid –> calcium oleate

104
Q

what are the advantages of using surfactants?

A
  • much more diverse than gums or soaps
  • much more flexible than gums or soaps
  • RPh has more control over internal/external phases
105
Q

what are the disadvantages of using surfactants?

A
  • low viscosity( this could be the advantage if looking for a low thin viscosity product)
  • viscosity enhancers
  • added levels of complexity
106
Q

HLB values 1-9 define

A

water-in-oil

107
Q

HLB vlaues 9-20 define

A

oil-in-water

108
Q

Surfactants UBSOP general policy

A

when formulating a surfactant based emulsion, the emulsifier should represent 15% w/v of the emulsions internal phase

109
Q

what are 4 peripheral access devices?

A
  • butterflies
  • angio catheters
  • midlines
  • subcutaneous catheters
110
Q

butterflies and angio catheters

A
  • both are inserted into small veins
  • induration is 3-5 days
  • infiltrate often so new lines must be placed
  • must carefully consider drugs since they will be going to small veins
  • irritant drugs are not ideal
111
Q

midlines

A
  • inserted into larger veins (from upper arm to bend of the elbow)
  • long induration of up 3 months
  • allow some drug flexibility since they are in larger veins & are easier to maintain
112
Q

subcutaneous catheters

A
  • placed in the tissue, generally in the belly (for adequate absorption)
  • a short duration (no more than 7 days)
  • therapies are limited- usually hydration or pain management
113
Q

peripheral lines and positive pressure caps use:

A

SAS

114
Q

central lines and implantable ports use:

A

SASH

115
Q

factors in determining the choice of venous access device (5)

A
  • patient location
  • duration/type of therapy
  • method of insertion
  • drug characteristics
  • maintenance of line
116
Q

indications for TPN (4)

A
  • intractable vomiting (pancreatitis, hyperemesis gravidarum)
  • diarrhea (short or irritable bowel, radiation enteritis with weight loss)
  • bowel obstruction or resection (adhesions/scleroderma)
  • bowel rest (fistula, crohns disease, ulcerative colitis, anastomtic leak)
117
Q

TPN components

A
  • protein source (amino acid)
  • carbohydrate source (dextrose)
  • fat source (lipids)
  • “condiments” - vitmanins, trace metals and electrolytes
  • free water
118
Q

additives added daily

A
  • multivitamins

- trace metals

119
Q

additives added as needed

A
  • insulin

- vitamin K

120
Q

how do you derive sensitivity when you know MWQ and accuracy?

A

sensitivity = (accuracy)(MWQ)

121
Q

1 grain = ____mg

A

64.81mg

122
Q

when do you add a dilauent?

A
  • less than MWQ
  • quantity of powder is too small
  • doesnt fit properly in any capsule size
  • improve ease of packing
  • improve flow of powder
123
Q

utility and cautions of ethyl alcohol as an ingredient in liquid dosage forms

A
  • aid to solubilization
  • preservative
  • emulsifier
  • sedative (undesired side effect)
124
Q

cock shit

A

d. Female IBW: 45.5 + (2.3 x height in inches > 5 feet)
e. Male IBW: 50 + (2.3 x height in inches > 5 feet)
g. Creatinine Clearance= [(140-age)(body mass)]/ [72x serum creatine]
i. Female times 0.85
ii. Units ml/min

125
Q

what is a lotion?

A

-liquid or semi-liquid preparations which contain one or more active ingredients in a suitable vehicle

126
Q

where to lotions fit in?

A
  • suspensions
  • solutions
  • emulsions
  • NEVER syrups
127
Q

what are intertriginous areas?

A
  • skin touches skin
  • gluteal fold
  • abdominal fold
  • beneath breasts
128
Q

the composition of lime water is

A
  • calcium hydroxide 3g

- purified water 1000 mL

129
Q

1 gallon

A

3785ml

130
Q

1 pint

A

16oz

131
Q

professional judgment: is the Rx legally correct:

A
  • signed by the prescriber
  • properly dated
  • DAW box correctly marked
132
Q

professional judgment: is the prescribed dose consistent with:

A
  • patient age
  • patient weight
  • indication
133
Q

professional judgment: is the prescribed medication appropriate:

A
  • the apparent indication
  • patient allergy profile
  • drug-drug interactions
134
Q

Eutectics

A

-Camphor and Menthol can occur near room
temperature
-Lead and Tin can occur above room temperature

135
Q

what is the minimum weighable quantity, if the sensitivity is =5mg and accuracy is 5%

A

sensitivity = (accuracy)(MWQ)
-The minimum weighable quantity(5mg/X) x100=5%
X=5mg/0.05
X=100mg

136
Q

what is the minimum weighable quantity, if the sensitivity is =6mg and accuracy is 5%

A

sensitivity = (accuracy)(MWQ)
-The minimum weighable quantity(6mg/X) x100=5%
X=6mg/0.05
X=120mg

137
Q

what not to do with Solutions

A

Do not shake

138
Q

Equivalence

A
  • May be applied to all dosage forms(solutions, suspensions, capsules.etc)
  • Applicable to hydro-ionizable compounds upon dissolution
  • Not applicable to un-ionizable compounds(such as sucrose, dextrose)
139
Q

what factors must be optimized to yield a eutectic with the lowest possible melting point?

A

optimum ratio of masses

140
Q

the composition of and the incorporation order of 4:2:1 emulsion

A

4: Mineral oil 2: water 1: Acacia

141
Q

drop dissolution test

A

O/W: if you place a drop of water in and O/W emulsion, the emulsion would simply get diluted, indicating the water is in the external phase.

W/O: if you place a drop of water in W/O emulsion, the drop will be separated and it will be apparent because water is in the internal phase.

142
Q

Extemporaneous compounding devices that assess the particle sizes

A
  • visual
  • sieves
  • micron gauge
  • feel
143
Q

Specific Gravity in emulsion

A

the ratio of mass to that of an equivalent volume of water

144
Q

Know some examples of commercially available pharmaceutical emulsions

A

-TPN, HAL lipid formulations (Intralipid, Liposyn)
-Amphotericin B (Ambisome, Ablecet)
-Propofol (Diprivan)
Examples: Hydrophilic petroleum, aquabase, aquaphor, hydrocream, eucerin, nivea, cold cream, dermabase, velcachol

Compound My Ass ( P2 Fall) (4 decks)

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