Formulation and Administration Flashcards
What routes are paraenteral? (5)
Anything bypassing the GI tract
IV
SC
IM
Intrathecal - spinally
Topically - nasal, eye drops, gels, patches
what routes are enteral? (11)
Enema
capsule
coated tablet
effervescent tablet
MR tablet
oral solution
oral syrup
oral suspension
rectal suppository
soluble tablet
tablet
what are 9 factors to consider when choosing an appropriate formulation for a child?
age and developmental stage
accepatbility and palatability
frequency of dosing
ease of administration
convenient and reliable administration
impact on lifestyle
minimum exposure to excipients
viable dosing
route of administration acceptability
what are excipients?
pharmacologically inactive substances that alter acceptability, self life or stability of medication
in what patients should aspartame be avoided?
those with phenylketonuria
found in augmentin suspensions
in what patients should arachis oil be avoided?
those with peanut allergies
what are the 4 stages of phamacokinetics?
ADME
Absorption
Distribution
Metabolism
Excretion
what is chelation?
the binding of electrolytes (ions) to medications to reduce or stop absorption
what is enteric coating?
protects drug from acidic environment of stomach to protect stomach lining
Drug bipasses stomach and enters small intestine - has implications for patient with ileostomy
what factor affects IM drug absorption?
blood flow through a muscle
what is bioavailability?
the proportion of the medicine that makes the systemic circulation where it is available to act at the effector site
what is the bioavailability for IV medications?
100%
what are 5 medications that should be prescribed by brand?
diltiazem MR preparations
Some antiepileptics
Lithium salts
theophylline preparations
some immunosuppressants - tacrolimus
what are 3 particular medications where caution is needed with switching to different formulations?
fusidic acid
phenytoin
perindopril
due to different preparations
what can reduce absorption of ciprofloxacin?
taking with indigestion remedies due to dilavent ions forming insoluble chelates reducing it’s absorption
Dairy products - due to calcium ions
when does plasma conc peak after metronidazole administration?
20 mins to 3 hours
what amount of digoxin elixir is equivalent to 62.5 micrograms of tablet?
50 micrograms of elixir
what are biosimilar medicines?
cheaper similar versions of biological medicines which have come off patent - should still be prescribed by brand
what are specials medications?
unlicenced preparations of medications - most often liquid versions of solid oral dosages for patients with dysphagia
when should levothyroxine be taken?
in the morning at least 30 mins before breakfast
when should simvastatin be taken?
at night
what are 6 medications which should be adminstered at specific times?
antimicrobials
insulin
nitrates
parkinsons meds
MR morphine
timolo eye drops
what are 2 medications that interact with enteral feeds?
Phenytoin - reduces absorption, usually changed to IV
Quinolones - absorption reduced, changed to IV usually
what 6 things should be discussed with the patient before prescribing?
adverse effects
administration
alternatives
effectiveness
expected duration of treatment
formulation
what are 5 principles of the mental capacity act?
assumed to have capacity unless established otherwise
must be helped to make decisions
unwise decisions are allowed
must act in best interest if no capacity
act in least restrictive manor
what are the two stages of identifying a need for capacity testing?
does the patient have a condition which impaires their decision making
does the impairement mean they are unable to make a specific decision
what are the 4 components of capacity testing?
able to understand, retain, weigh up and communicate decision
