Exam 3

Question 1

what is an emulsion?

Answer 1

two phase systems in which one liquid is dispersed throughout another in the form of small droplets

Question 2

define emulsification

Answer 2

added energy through trituration or homogenization creating small droplets of one liquid phase in another and a static charge around those droplets

Question 3

define emulsifying agents

Answer 3

promotes the formation of droplets (micelles) and their charge based seperation (basically promotes formation of emulsion)

Question 4

creaming

what happens?

can it be fixed?

Answer 4

migration (surfacing or settling) of droplets

yes: can be fixed by shaking

Question 5

cracking or coalescence

what happens?

can it be fixed?

Answer 5

merging of droplets, causing a separation of the phases

no it cannot be fixed. needs to be discarded

Question 6

what are the 2 phases of an emulsion.

what is each phase composed of

Answer 6

internal phase: droplets, micelles

external phase: suspension medium

Question 7

two type of emulsion

Answer 7

Water in oil (w/o)

Oil in water (o/w)

Question 8

water in oil emulsion.

what is it composed of

Answer 8

droplets of hydrophilic liquid (possibly containing water soluble drug) in a lipophilic suspension medium

Question 9

oil in water

what is it composed of

Answer 9

droplets of lipophilic liquid (possibly containing fat soluble drugs) in an aqueous suspension medium

Question 10

emulsions for ingestion

where are the active ingredients usually dissolved or suspended?why?

Answer 10

in the internal phase because they can hidden from the taste buds. increases pt compliance if it the drug tastes bad

Question 11

emulsions for external use

where are the active ingredients usually dissolved or suspended? why?

Answer 11

in the external phase. want max bioavailability, which will occur in the external phase.

Question 12

where phase of emulsions are flavoring agents usually found in? why?

Answer 12

eternal phase because that is the phase that is in contact with the pts taste buds

Question 13

is the ratio of oil to water always an indicator of o/w or w/o emulsions?

Answer 13

no

Question 14

what indicated whether an emulsion is w/o or w/o

Answer 14

order of incorporation and the chemical natural of the ingredients

Question 15

identification tests for emulsions

drop test( drop dissolution test)

Principle:
test:
result:

Answer 15

drop test( drop dissolution test)

Principle: all emulsions are easily miscible with their continuous/ external phase

test: Add drop of water or oil to an emulsion

results:
if sample is easily diluted in water OR does not dissolve in oil, it is an O/W emulsion

if sample is easily diluted in oil OR dose not dissolve in water, it is an W/O emulsion.

Question 16

identification tests for emulsions

electrical conductivity test

Principle:
test:
result:

Answer 16

electrical conductivity test

Principle: water is good conductivity of electricity, hence an emulsion in which water forms a continuous phase acts as a conductor.

test: a small low striking voltage neon lamp connected in series with a bayonet fitting plug and two electrodes Eg. Two-piece of copper wire. Dip these electrodes in a sample emulsion, apply the Current and observe the results.
result:

1. w/o
   a. Pass: if it doesn’t conduct electricity
   b. fail: if it does conduct electricity
2. o/w
   a. pass: if it does conduct electricity
   b. fail:if it doesn’t conduct electricity

Question 17

what is the viscosity of the emulsion due to

Answer 17

micelle diameter and weak hydrogen bonding between micelles

Question 18

how do micelles form

Answer 18

in o/w, micelles form as spears with polar head groups facing the outside and non polar chain facing inside

w/o, it is the opposite

Question 19

examples of emulsifiers

Answer 19

Acacia
Lecithin
polysorbate 80, tween 80
alcohol (s)
Pluronic F68

Question 20

routes of administration for emulsions

Answer 20

topical, PO, parenteral (IM, etc.)

Question 21

primary emulsion

Answer 21

no active ingredients. has non pharmacologic effects

Question 22

dry gum method

ingredients
how much of each ingredient

what order do the ingredient go in

Answer 22

Mineral oil, distilled water, acacia

4 parts mineral oil
2 parts DI water
1 part acacia

acacia->then mineral oil->then di water

Question 23

in order to emulsify, you must add energy.

what methods can you do that

Answer 23

mortar and pestle
mixing devices
shaker jar
homogenizer
mixer

Question 24

homogenization

what is it?
what is the benefit?

Answer 24

forcing 2 immiscible liquids through an orifice under high pressure for the purpose of mixing.

increases the stability of the product

Question 25

types of emulsifiers what kind of emulsions do they tend to form examples of each

Answer 25

1. gums a. tend to form o/w b. ex: acacia, xanthum gum 2. soaps a. tend to form w/o b: olive oil/ lime water * olive oil contains oleic acid, which is the precursor to the real emulsifier - calcium oleate that forms with the combo of olive oil and lime water. 3. surfactants a. can form both o/w and w/o(flexible) b. Tween 60, propylene glycol monolaurate

Question 26

advantages of surfactants

Answer 26

``` more diverse more flexible (can form w/o or o/w) low viscosity (can be advantage or disadvantage) ```

Question 27

disadvantages of surfactants

Answer 27

need viscosity enhancers | complex

Question 28

HLB index what is it? applies to what? what is the index range

Answer 28

hydrophile, lipophile index indicated the type of emulsion (o/w or w/o) that the emulsifier is best suited for applies to surfactant type emulsifiers range 1-20

Question 29

HLB value 1-9 indicates what

Answer 29

w/o emulsion

Question 30

HLB value 9-20 indicates what

Answer 30

o/w emulsion

Question 31

optimal HLB values for an emulsion

Answer 31

2 distinct values: 1. specifiied for o-w 2. specified for w/o

Question 32

what is the purpose of using the optimal HLB value for selected emulsifying components

Answer 32

provides greatest stability in terms of micelle formation and integrity, creaming, and cracking

Question 33

UBSOP how much surfactant to use when compounding emulsion

Answer 33

total surfactant =15% w/v of the emulsions internal phase

Question 34

how to convert surfactant mass into volume when calculating

Answer 34

use specific gravity. add units to turn it into density. use density to convert from mass to volume

Question 35

if an active ingredient is dissolved in any phases of an emulsion, can a primary emulsion be made?

Answer 35

NO it cannot. by definition, a primary emulsion is one that does not have any active ingredients

Question 36

types of infusion settings

Answer 36

Institutial: hospital | Non institutional: skilled nursing facilities, infusion centers, physician offices

Question 37

accèss for infusions

Answer 37

1. peripheral IV lines 2. central IV lines 3. peripheral inserted central lines (PICC) 4. SQ lines

Question 38

types of peripheral access devices

Answer 38

butterflies- good formal veins. up to 3-5 days angio catheter-good formal veins. up to 3-5 days midlines: larger veins. up to 3 mo. easy to maintain SQ catheters: insufulon: allows for multiple sq injections throughout the sday

Question 39

Central venous acmes devices

Answer 39

CVP lines: placed by physicians. up to 10 days. site of insertion increases risk for infection. flexibility of drugs that can be used silastic catheters: surgically placed. lower risk of infection. flexibility of drugs can be used ex: hickman implantable ports: placed surgically placed under the tissue. used for intermittent therapies. lower risk of infection. long duratin PICC lined: used up to 3 mo. but could be longer. not surgically placed

Question 40

PICC lines how is it inserted how long can it be kept in internal or external device

Answer 40

non surgical insertion 3 month duration external device

Question 41

how should lines be maintained?

Answer 41

line flushing | dressing changes

Question 42

methods to flush lines purpose:

Answer 42

determine potency, as well as flush lines before and after drug administration SAS: saline, administer drug, saline SASH:saline, administer drug, saline, heparin

Question 43

which lines use which flush methods

Answer 43

peripheral lines: SAS central lines: SASH Implantable ports: SASH Positive pressure caps: SAS

Question 44

do positive pressure caps need heparin to flush?

Answer 44

no

Question 45

dressing changes when do they occur what are we checking for

Answer 45

``` day after insertion weekly thereafter check site for 1. infections 2. signs of embolism 3. line migration ```

Question 46

how to pick venous access device?

Answer 46

1. patient location 2. duration/ the of therapy 3. method of insertion 4. drug characteristics 5. maintenance of line

Question 47

common drugs for infusoin

Answer 47

``` ABX antifungals anti emetics steroids chemotherapy analgesics electrolytes/ vitamins cardiac medications ```

Question 48

infusion methods

Answer 48

gravity bolus rate controlled infusion pumps:MOST COMMON

Question 49

pharmacist considerations for infusion orders

Answer 49

1. what venous access device it is 2. drug characteristics 3. what diluent 4. stability of solution 5. volume of infusion 6. rate of infusion

Question 50

expiration dates

Answer 50

``` can fin din package insert handbook of injectable drugs extended stability of injectable drugs literature manufacturer ```

Question 51

TPN what is it

Answer 51

feeding IV when feeding orally is no an option

Question 52

when is tPN INDICATED

Answer 52

intractable vominting diarrhea bowel obstruction or resection bowel rest

Question 53

what is included in TPN

Answer 53

1. protein a. branched chain amino acids 2. dextrose hypertonic dextrose used when adding to tan 3. lipids a. lipid emulsions with essentially fatty acids 4. electrolytes ``` 4.additional additives: multivitamins trace metals insulin vitamin K ```

Question 54

Harris and Benedict Equation

Answer 54

calculates basic energy expenditure for a patient at rest

Question 55

caloric needs categories

Answer 55

mild impairment: 25-28kcal/kg/day moderate impairment 28-32 kcal/kg/day sever impairment: 30-35

Question 56

TPN ordering

Answer 56

develop formula based on pt needs. never an emergent therapy

Question 57

complications of tpn

Answer 57

CATHETER SEPSIS vt HEAPTIC FATTY LIVER OR CHOLECYSITITIS metabolic conditions

Question 58

what to monitor for with TPN

Answer 58

weight: weight gain of 1-2 lbs per week 2. nutritoinal profile 3. BMP 4. glucose (finger sticks) 5. urea nitrogen

Question 59

TPN for special populations

Answer 59

``` diabetes acute renal failure pulmonary disease (give them more fat than dextrose) hepatic disease cardiac disease ```

Question 60

methods to preparing TPN solutions

Answer 60

1. manual mixing | 2. automated compounders

Question 61

TPN infusions done with what device

Answer 61

via pump

Question 62

how to find composite hlg when given surfactant quantities

Answer 62

1. ude density and surfactant volume to find the mass of each surfactant 2. add the masses of the 2 to get the total masses of emulsifiers 3. find the value of f for first surfactant by dividing the mass of the surfactant by the total mass of the 2 surfactants. 4. find f of second surfactant by subtracting f of first from 1. do the cross method with the middle part being x. you will get the parts equation for each. set up a whole equation to figure out the parts