IC8 Flashcards by Ziqi Wong

Nayzilam is the brand name for ____

Midazolam

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Dosage form: Nayzilam

Nasal spray

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Dose for one spray of nayzilam

5mg

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Nayzilam: Max dose & treatment duration

No more than 2 doses of NAYZILAM to treat a single episode.
NAYZILAM be used to treat no more than one episode every three days and no more than 5 episodes per month

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Nayzilam: When should you not administer a second dose?

if the patient has trouble breathing or - if there is excessive sedation that is uncharacteristic of the patient during a seizure cluster episode

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Class of nayzilam

Benzodiazepine

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Use of Nayzilam and______ may result in profound sedation, respiratory depression, coma, and death.

opioids

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Is nayzilam a controlled substance?

Yes, under schedule IV

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Nayzilam: adverse effects

Cardiorespiratory (resp depression, airway obstruction, oxygen desaturation, apnea, cardiac arrest, death)
Risk of abuse

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Imitrex is the brand name for _____

Sumatriptan

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Imitrex: dosage form & avail doses

Nasal spray in 5mg/ 20mg

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Imitrex: indication

Acute treatment for migraine

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Imitrex: When to take an additional 2nd dose?

2 hours after 1st dose if:
- migraine has not resolved by 2 hours after taking IMITREX nasal spray, or
- returns after a transient improvement

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Imitrex: Max daily dose

40mg

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Imitrex: storage condition

Store IMITREX between 2°C to 30°C
Protect from light

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Ideal drug candidate for CNS drug delivery (Lipinski’s rule of 5)

</= 5 H bond donor (H bonded to EW atom)
</= 10 H bond acceptor (EW atom e.g. Cl, O)
MW < 500 Da
(< 300 Da for access of hydrophilic drugs
< 1 kDa for access of lipophilic drugs)
LogP < 5
Unionised

How do in-situ gels work

Low viscosity solutions initially but increase viscosity once administered (activated by stimulus e.g. changes in salt conc, pH, temp)

Advantages for intranasal route

Non-invasive
Can be self-administered
Bypass hepatic first-pass effect
Short onset of effect

Disadvantages for intranasal route

Irritation (esp powder)

_____occurred at a similar rate in both midazolam groups, but euphoric mood occurred at a ____ in NAYZILAM compared to the oral midazolam syrup

Somnolence; greater rate

Physical dependence is a state of adaptation that is manifested by a ____ that can be produced by abrupt cessation, rapid dose reduction, decreasing blood levels of the drug, and/or administration of an antagonist.

specific withdrawal syndrome

NAYZILAM is supplied in boxes of __ nasal spray units, each contained within ______.

2; an individual blister pack

NAYZILAM: STORAGE & handling

Do not open the blister packaging until ready to use.
Do not test or prime before use.
Do not use if the nasal spray unit appears damaged.
Store at controlled room temperature 20°C to 25°C

Can you sell or give away NAYZILAM ?

No, it may harm others and is against the law.

When to take a second spray of NAYZILAM?

One additional spray into the opposite nostril may be administered after 10 minutes if the patient has not responded to the initial dose. if NO trouble breathing or excessive sedation that is uncharacteristic of the patient during a seizure cluster episode

Max use for tx of headache episodes for Imitrex / month

4 headaches (in 30 days); maybe can use more but safety not proven

Imitrex: side effects

Local irritative symptoms such as burning, numbness, paresthesia, discharge, and pain or soreness symptoms were transient and generally resolved < 2h

Imitrex: Is administration of two 5-mg doses, 1 dose in each nostril, equivalent to administration of a single 10-mg dose in 1 nostril?

Yes

Counselling for imitrex

* Your healthcare provider may change your dose. Do not change your dose without first talking with your healthcare provider. * If your headache comes back after the first nasal spray or you only get some relief from your headache, you can use a second nasal spray 2 hours after the first nasal spray. * Do not use more than 40 mg of IMITREX nasal spray in a 24-hour period. * It is not known how using IMITREX nasal spray for a long time affects the nose and throat. * If you use too much IMITREX, call your healthcare provider or go to the nearest hospital emergency room right away. * You should write down when you have headaches and when you use IMITREX so you can talk with your healthcare provider about how IMITREX is working for you.

Inactive ingredients in IMITREX

monobasic potassium phosphate NF, anhydrous dibasic sodium phosphate USP, sulfuric acid NF, sodium hydroxide NF, and purified water USP.

Unique regulations for nasal sprays

1. Pump delivery (Durability of device & Reproducibility of pump spray weight) 2. Spray Content Uniformity (SCU) (Amount of drug delivered per pump) 3. Spray Pattern and Plume Geometry

Advantages & disadvantages of breath-powdered delivery system

(+) avoids negative pressure and "traps" powder in nasal cavity -> Less loss of drug (-) may cause irritation

Situations where buffering/ pH adjusting agents is not needed

- Single use - No ionisable compound