Drug Formulations and Patient Counseling - Quiz 1

Question 1

What are the benefits of using long duration meds?

Answer 1

Reduces peaks and side effects

Question 2

Examples of OROS?

Answer 2

1. Concerta
2. Cardura XL
3. Procardia XL
4. Delzicol

Question 3

Counseling on long acting capsules and tablets?

Answer 3

1. Dont crush or chew
2. Some capsules can be sprinkled on food but do not chew contents
3. Cut on score lines (Toprol XL, carbidopa/levodopa ER)

Question 4

Benefits of liquid oral solutions/suspensions?

Answer 4

Useful for children and difficulty swallowing

Question 5

Counseling for suspensions?

Answer 5

Shake before use

Question 6

Examples of chewable tablet?

Answer 6

Montelukast (Singular)
Lamotrigine (Lamictal)

Question 7

Benefits of using chewables?

Answer 7

Used in children who are unable to swallow tablets

Question 8

What are lozenges/troches used for?

Answer 8

Conditions of oral mucosa

Question 9

Benefits of using ODT?

Answer 9

1. Patient with dysphagia
2. Children who are unable to swallow
3. Non-adherence (cheeking)

Question 10

Benefits of SL or buccal methds?

Answer 10

1. Same benefits of ODT
2. Onset of action is faster
3. Less gut degradation and first pass metabolism

Question 11

How can you administer singulair granules?

Answer 11

In applesauce, carrots, rice, ice cream

Question 12

How can you administer Vyvanse granuales?

Answer 12

Water, yogurt, orange juice

Question 13

Counseling points for granuales, powders, capsules?

Answer 13

1. Don’t chew pellets
2. Don’t let mixture sit too long (entire mixtre should be ingested)
3. Don’t add to anything warm or hot

Question 14

Types of sweeteners?

Answer 14

1. Sorbitol
2. Phenylalanime (aspartame)
3. Lactose

Question 15

Formulations containing phenylalanime?

Answer 15

ODT, chewable, granules

Question 16

CI of phenylalanine?

Answer 16

Phenylketonuria (PKU): genetic deiciency in enzyme that degrades phenylalanine

Question 17

ODT Counseling points?

Answer 17

1. Tablets are friable and you should peel back the foil
2. Place tablet on tongue and dissolve in seconds

Question 18

What medications can be self-administered?

Answer 18

SC:
* Eanercept (Enbrel)
* Teriparatide (Forteo)
* Sumatriptan (Imitrex)
* Insulins, GLP1 agonists
* Enoxaparin (Lovenox)
* Naloxone
* Methotrexate (Otrexup)

Question 19

Injection counseling?

Answer 19

1. Warfarin
2. Prepare injection
3. Select and clean site
4. Inject
5. Discard syringe

• Inject at least 1 inch away from previous site
• Only use needle once
• Don’t rub anticoag injection (Lovenox, fondaparinux)
• Don’t heat up cold injections
• DOn’t use if discolored
• EpiPen can be rubbed

Question 20

How to store/handle biologics?

Answer 20

Easily denature:
* Don’t shake
* Don’t expose to extremem temperatures

Question 21

Application site of Xulane? Frequency?

Answer 21

Back, abdomen, arm, buttocks

Weekly (3 wks on, 1 wk off)

Question 22

Application site of daytrana? Frequncy

Answer 22

Hip

QAM, remove at PM

Question 23

Frequency of NicoDerm

Answer 23

QD

Question 24

Lidoderm frequency?

Answer 24

12 hrs on, 12 hrs off

Question 25

Oxytrol application site? Frequency?

Answer 25

Abdomen, hip, buttock Twice weekly

Question 26

Vivelle dot application site? Frequency?

Answer 26

Lower abdomen, buttock Twice weekly

Question 27

Transderm-Scop site? Frequency?

Answer 27

Behind the ear Q72H

Question 28

Fentanyl patch frequency?

Answer 28

72H

Question 29

What patches can be cut?

Answer 29

Lidoderm and Qutenza

Question 30

Why avoid heat on patches?

Answer 30

Increases absorption

Question 31

What to do if patient has skin irritation?

Answer 31

1. Don't apply on irritated skin 2. Alternate the site 3. Skin should not be shaved

Question 32

What patches should be taken off before MRI? Why?

Answer 32

1. Clonidine (Catapress-TTS) 2. Rotigotine (Neupro) 3. Scopolamine (Transderm-Scop) 4. Testosterone (Androderm) Contains metal and can burn the skin

Question 33

Patches that can have adhesive dressing?

Answer 33

Fentanyl, Butrans

Question 34

What patch comes with its own adhesive cover?

Answer 34

Catapres-TTS

Question 35

Frequency of Catapess-TTS?

Answer 35

Weekly

Question 36

What patches need to be disposed of in the toilet?

Answer 36

Hihly potent narcotic patches: Fentanyl, Butrans, Daytrana

Question 37

Benefits of topicals?

Answer 37

Local effects and decreased systemic side effects

Question 38

Benefits of nasal sprays?

Answer 38

1. Faster onset 2. Useful for acute conditions 3. Bypass gut absorptin and first pass-metabolism

Question 39

Counseling for nasal spray?

Answer 39

**Before use:** 1. Shake bottle gently 2. Prime the pump before first use 3. Blow your nose **Using the spray:** 1. Close one nostril and insert applicator 2. Start to breath in through your nose, and press firmly and quickly down 3. Breathe out through mouth 4. wipe applicatory 5. Don't blow nose right away

Question 40

Counseling for eye drops?

Answer 40

1. Shake a few times 2. Look up and pull down lower lid 3. Apply drop in space between lower lid and eye 4. Close eye and press finger between eye and top of nose for 1 min