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Pharmacy practise > Lec.11 > Flashcards

Lec.11 Flashcards

1
Q

Selection Criteria for Route of Administration

A 
Drug physicochemical properties
Drug pharmacokinetic properties
Drug dose & therapeutic index
Patient condition/status
Desired site of action
Desired onset of action
Desired duration of action
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2
Q

Routes of Systemic effect:

A

Enteral
Parenteral
Transdermal
Inhalation

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3
Q

Routes of local effect:

(site-specific)

A

Topical & Inhalation

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4
Q

Gives the fast action?

A 
Ans: IV- (quickest) effect
Inhalation
Sublingual
IM
Subcutaneous
rectal
oral transdermal ( lowest)
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5
Q

Enteral advantages ?

A

Ease of administration (No pain or discomfort)
 Safe (No sterility issues)
 Less expensive (Economical)
 Sustained (controlled) release tablet  Better compliance

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6
Q

Issues with crushing SR tablets?

A

Crushing SR tablet =Dose Dumping =Drug toxicity

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7
Q

Issues with crushing Enteric-coated tablets?

A

Crushing enteric coated tablet = Drug degradation = Therapeutic failure

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8
Q

Enteral disadvantages?

A
  • Slow onset of action (Not for emergency)
  • Drug degradation by gastric juices (acidity and enzymes) (e.g. insulin)
  • First-pass effect (first-pass metabolism) (e.g. lidocaine)
  • Not suitable for unconscious, vomiting or pediatric patients
  • Gastric irritation and unpleasant taste with some drugs
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9
Q

The drug is held under the tongue or in the mouth and absorbed
through the oral mucosa?

A

Sublingual/Buccal

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10
Q

Dosage form of; sublingual

A

tablet, lozenge, gum

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11
Q

Sublingual Advantages?

A
  • Rapid absorption and action (e.g. nitroglycerin for angina)
  • Bypass first-pass metabolism
  • Easy to terminate the effect
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12
Q

Sublingual Disadvantages?

A
  • Might be inconvenient (might cause irritation)
  • Only suitable for small doses
  • Unpleasant taste of some drugs
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13
Q

Rectal Advantages?

A
  • Suitable for unconscious, vomiting or pediatric patients
  • Bypass first-pass metabolism (“partially”)
  • Local (e.g. laxative) or systemic effects (e.g. analgesic/antipyretic)
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14
Q

Rectal disadvantages?

A
  • Discomfort

- Erratic absorption

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15
Q

Parental Dosage form?

A
  • Subcutaneous (SC/SQ)
  • Intramuscular (IM)
  • Intravenous (IV)
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16
Q

Parenteral advantages?

A

Rapid onset of action (suitable for emergency)
Suitable for unconscious or vomiting patients
Bypass first-pass metabolism and GIT enzymes
No Bioavailability issues

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17
Q

Parenteral disadvantages?

A
  • Painful administration
  • Sterility issues (risk of infection)
  • Safety issues (cannot terminate effect)
  • Expensive preparation and administration
  • Requires equipment: syringe, needles, cannula. infusion set, vial, ampoule
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18
Q

The short needle length is used for?

A

Subcutaneous route

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19
Q

The long needle length is used for?

A

IM

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20
Q

What are lower gauge ( thicker) needles used for?

A

Viscous Medication ( for deeper injection)

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21
Q

What are higher gauge (thinner)needles used for?

A

less painful

22
Q

drug delivered directly under the skin?

A

Subcutaneous

23
Q

Drugs used subcutaneously?

A
  • only suitable for small volumes ( less than 2ml)

- commonly used for insulin

24
Q

IM absorption depends on?

A

Muscle type & blood flow

25
Q

Used to test allergy of penicillin?

A

Intradermal

26
Q

Drug delivered directly into a vein?

A

IV

27
Q

Advantages of IV ?

A

Suitable for large volume/dose
Immediate onset of action
Suitable for irritant drugs (e.g. anti-cancer drugs)
Titratable dosing without fluctuation (infusion)
Total parenteral nutrition (TPN) in critical illness

28
Q

Disadvantages of IV?

A
  • Not suitable for oily solutions & insoluble substances
  • Risk of embolism
  • Thrombophlebitis
  • Extravasation
  • Increased risk of allergic & adverse drug reactions
  • Special skills required for administration
29
Q

Intravenous Delivery Systems

A
  • Direct Push (IV Bolus)
  • Continuous Infusion (IV Drip or Infusion Pump)
  • Intermittent Infusion (IV Piggyback)
30
Q

IV access?

A
  • Peripherally ( Short-term )

- Centrally (Large volumes)

31
Q

Which Iv access is used for anti-cancer drugs?

A

Centrally

32
Q

Why do we sterile IV material?

A

IV route =Bypass natural body barriers (Skin & GIT)= Risk of Infection

33
Q

2 types of laminar airflow?

A
  • Horizontal ( air flows outward

- Vertically ( air flows downwards

34
Q

which airflow is used for anti-cancer/toxic drugs?

A

Vertically (AWAY FROM YOU)

35
Q

which airflow is used for regular/nontoxic drugs?

A

Horizontally ( towards you)

36
Q

Types of IV incompatibilities?

A
  • Physically
  • Therapeutic/Pharmacological
  • Chemically
37
Q

Causes of IV incompatibilities?

A

Drug in inappropriate IV diluents or adjuvants
Drug in inappropriate IV containers
Interaction between two or more drugs

38
Q

Consequences of IV incompatibilities ?

A
  • Toxicity
  • Therapeutic failure
  • Particulate embolism
39
Q

Examples of High alert medications? IMP*

A 
PINCH:
Potassium chloride injection
Insulin
Narcotics and opiates
Neuromuscular blocking agents
Chemotherapeutic agents
Heparin
40
Q

Drug is delivered to the bloodstream through the skin

via absorption from an applied patch

A

Transdermal

41
Q

Examples of transdermal patch: *IMP

A

Nicotine, nitroglycerin, scopolamine, clonidine, fentanyl patches

42
Q

Advantages of topical formulations:

A

Local & direct therapeutic effect

Minimal systemic side effects

43
Q

Topical Dosage forms:

A

Cream, ointment, gel, drops, spray etc.

44
Q

Inhalation Dosage forms:

A

Metered Dose Inhalers (MDI), Dry Powder Inhalers

(DPI), Nebulizer

45
Q

Transdermal:absorption depends

mainly on ?

A

drug molecular weight and lipophilicity

46
Q

Rectal dosage form?

A

Enema & Suppostories

47
Q

Drug is delivered directly under the skin.

A

Subcutaneous

48
Q

Drug is delivered directly into the muscle (gluteal muscle (buttock)
or deltoid muscle (upper arm)).

A

Intramuscular

49
Q

Drug is delivered directly into a vein (systemic circulation).

A

IV

50
Q

(Immediate injection, small volume, rapid high drug concentration)

A

Direct Push (IV Bolus)

51
Q

(long duration, with or without drug (fluids), uninterrupted)

A

Continuous Infusion (IV Drip or Infusion Pump)

52
Q

(shorter duration, dilute drug solution, given periodically)

A

Intermittent Infusion (IV Piggyback)

Pharmacy practise (3 decks)

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