Lecture 5&6: ointments

Question 1

Tylenol/APAP toxicity to animals

Answer 1

Cats

Question 2

Chocolate and grape flavoring toxicity to animals

Answer 2

Dogs

Question 3

Xylitol toxicity to animals

Answer 3

Dogs and birds
profound hypOglycemia
hepatocellular necrosis

Question 4

Compounding needs for animal Rx

Answer 4

Dosage form
taste issues (tuna/beef flavoring)
mixing multiple medsfor easier application
customize dose
avoid toxicities in excipients of readily available Rxs

Question 5

Common errors in vetinary dispensing

Answer 5

1. identify breed of animal
2. Identify occupation/intended use

Question 6

Companion animal

Answer 6

least restriction of drug use

Question 7

Performance animal

Answer 7

service, military/police, competitive sport

Question 8

Food producing

Answer 8

drug use is strictly regulated and causes serious penalties if violated
AMDUCA: animal medicinal drug use claification act

Question 9

AMDUCA

Answer 9

Animal medicinal drug use clarification act 1996
1. must have relationship between prescriber and animal/client (CVPR)
2. Avoid drug residues in the food chain for food producing animals

Question 10

Algorithm for vet rx

Answer 10

check for all components:
1. licensed practitioner name, address, telephone, DEA if CS (vets don’t have NPI)
2. Owner name and info
3. Animal species/breed, DOB, weight, gender
4. Drug name and strength, directions, refill #

Question 11

Banned medications in food producing animals that have toxicities to humans

Answer 11

chloramphenicol, diethylstilbesterol, fluoroquinolones, etc

“abx free chicken”

Question 12

ointments

compounded

Answer 12

semisolid preps for external application to the skin or mucous membrane
pastes, gels, plasters, etc

Question 13

Common uses for compounded ointments

Answer 13

protect skin/mucuous membrane
provide hydration (emolient)
vehicle for medication (local vs systemic)

Question 14

Local ointment

Answer 14

antibiotic

Question 15

Systemic ointment

Answer 15

nitroglycerin

Question 16

Choosing an ointment base

Answer 16

decision depends on:
1. ointment use
2. properties of medication being incorporated
3. area of application

Question 17

5 types of ointment bases

Answer 17

1. hydrocarbon/oleaginous
2. anhydrous
3. water in oil emulsion
4. oil in water emulsion
5. water soluble

Question 18

Compounding materials for ointments

Answer 18

1. Slabs>pads
2. metal spatula>plastic (unless rxn w/ metal like iodine)
3. large scale - use mills or electric mixers

Question 19

Levigating agents

reduce particle size by triturating w/ small amount of immicible liquid

Answer 19

Required to:
1. make ointment smooth elegant
2. adequately wet the solid (viscous, low surfance tension)
3. ex: mineral oil, glycerin, propylene glycol, PEG400, cottonseed oil, castor oil, etc
4. solid must be insoluble in levigating agent

Question 20

Dissolution

Answer 20

1. solid powder must be soluble in solvent
2. solid dissolved in solvent prior to adding to ointment base
3. absorption base is used to absorb the aqeuous solution

Question 21

When are levigating agents NOT required?

Answer 21

1. solid is very fine particle
2. small quantity
3. soft ointment base
4. ointment intended to be a stiff paste

Question 22

Ideal properties of ointment

Answer 22

1. spreads easily
2. compatible w/ toipcal use (hypoallengergic)
3. stable (no bacteria)
4. smooth and pliable (not hard or runny)
5. softens/melts at room temp
6. readily released medication
7. easily removed (doesn’t stain clothing)

Question 23

what increases drug release and penentration into the skin?

semisolid dosage forms

Answer 23

1. more pressure
2. greater surface area
3. broken skin/open wound (thin = systemic adr)
4. type of base (depends on drug)
5. use of occlusive dressing

Question 24

Dissolution examples

Answer 24

1. solid, water-soluble powder –> petrolatum
   — dissolve in distilled water
2. solid, oil-soluble powder –> petrolatum
   – dissolve in mineral oil

Question 25

anhydrous ointment bases

Answer 25

more challenges not as washable spreads less more occlusive (protectant) can incorporate fewer drugs poor release of polar drug

Question 26

hydrous ointment bases

Answer 26

spreads more easily more washable not as occlusive more drugs can be incorporated (but not oils) better release of polar drugs

Question 27

Anhydrous vs hydrous base

Answer 27

most of the time hydrous > anhydrous

Question 28

Types of anhydrous bases

Answer 28

hydrocarbon (white petrolatum, white ointment) anhydrous (hydrophillic petrolatum, anhydrous lanolin, aquaphor, aquabase) water soluble (PEG ointment, polybase)

Question 29

Types of hydrous bases

Answer 29

Water/oil (cold cream, hydrous lanolin, hydrocream, eucerin) oil/water (dermabase, velvachol, unibase) water soluble (PEG ointment, polybase)

Question 30

Hydrocarbon

Answer 30

white petrolatum white ointment

Question 31

Anhydrous

Answer 31

hydrophillic petrolatum anhydrous lanolin aquaphor aquabase

Question 32

Water/oil base

Answer 32

cold cream hydrous lanolin hydrocream eucerin

Question 33

oil/water base

Answer 33

dermabase velvachol unibase

Question 34

Water soluble

Answer 34

PEG ointment Polybase

Question 35

Ointment compounding | depends on # of ingredients

Answer 35

1-2 ingredients: mix everything together 3 or more ingredients: add sequentially to base (geometrically)

Question 36

ointment: choosing agent

Answer 36

must be chemically similar to ointment base always use minimal amount of levigating agent unless otherwise specified by the prescriber

Question 37

ointment: dissolution

Answer 37

dissolve solid in solvent prior to adding to ointment base when: 1. solids are hard to incorporate 2. powdered solid must be soluble in solvent always use smallest amount of solvent (based on dissolution data)

Question 38

ointment: adding liquid to ointment

Answer 38

1. must be carefully spatulated or triturated into base 2. place semisolid base on slab, create depression 3. pour liquid in, keep contained 4. spatulate in small proportions until well incorporated

Question 39

ointment procedure

Answer 39

depends