Formulation and Administration

Question 1

What routes are paraenteral? (5)

Answer 1

Anything bypassing the GI tract

IV
SC
IM
Intrathecal - spinally
Topically - nasal, eye drops, gels, patches

Question 2

what routes are enteral? (11)

Answer 2

Enema
capsule
coated tablet
effervescent tablet
MR tablet
oral solution
oral syrup
oral suspension
rectal suppository
soluble tablet
tablet

Question 3

what are 9 factors to consider when choosing an appropriate formulation for a child?

Answer 3

age and developmental stage
accepatbility and palatability
frequency of dosing
ease of administration
convenient and reliable administration
impact on lifestyle
minimum exposure to excipients
viable dosing
route of administration acceptability

Question 4

what are excipients?

Answer 4

pharmacologically inactive substances that alter acceptability, self life or stability of medication

Question 5

in what patients should aspartame be avoided?

Answer 5

those with phenylketonuria

found in augmentin suspensions

Question 6

in what patients should arachis oil be avoided?

Answer 6

those with peanut allergies

Question 7

what are the 4 stages of phamacokinetics?

Answer 7

ADME

Absorption
Distribution
Metabolism
Excretion

Question 8

what is chelation?

Answer 8

the binding of electrolytes (ions) to medications to reduce or stop absorption

Question 9

what is enteric coating?

Answer 9

protects drug from acidic environment of stomach to protect stomach lining
Drug bipasses stomach and enters small intestine - has implications for patient with ileostomy

Question 10

what factor affects IM drug absorption?

Answer 10

blood flow through a muscle

Question 11

what is bioavailability?

Answer 11

the proportion of the medicine that makes the systemic circulation where it is available to act at the effector site

Question 12

what is the bioavailability for IV medications?

Answer 12

100%

Question 13

what are 5 medications that should be prescribed by brand?

Answer 13

diltiazem MR preparations
Some antiepileptics
Lithium salts
theophylline preparations
some immunosuppressants - tacrolimus

Question 14

what are 3 particular medications where caution is needed with switching to different formulations?

Answer 14

fusidic acid
phenytoin
perindopril

due to different preparations

Question 15

what can reduce absorption of ciprofloxacin?

Answer 15

taking with indigestion remedies due to dilavent ions forming insoluble chelates reducing it’s absorption

Dairy products - due to calcium ions

Question 16

when does plasma conc peak after metronidazole administration?

Answer 16

20 mins to 3 hours

Question 17

what amount of digoxin elixir is equivalent to 62.5 micrograms of tablet?

Answer 17

50 micrograms of elixir

Question 18

what are biosimilar medicines?

Answer 18

cheaper similar versions of biological medicines which have come off patent - should still be prescribed by brand

Question 19

what are specials medications?

Answer 19

unlicenced preparations of medications - most often liquid versions of solid oral dosages for patients with dysphagia

Question 20

when should levothyroxine be taken?

Answer 20

in the morning at least 30 mins before breakfast

Question 21

when should simvastatin be taken?

Answer 21

at night

Question 22

what are 6 medications which should be adminstered at specific times?

Answer 22

antimicrobials
insulin
nitrates
parkinsons meds
MR morphine
timolo eye drops

Question 23

what are 2 medications that interact with enteral feeds?

Answer 23

Phenytoin - reduces absorption, usually changed to IV

Quinolones - absorption reduced, changed to IV usually

Question 24

what 6 things should be discussed with the patient before prescribing?

Answer 24

adverse effects
administration
alternatives
effectiveness
expected duration of treatment
formulation

Question 25

what are 5 principles of the mental capacity act?

Answer 25

assumed to have capacity unless established otherwise
must be helped to make decisions
unwise decisions are allowed
must act in best interest if no capacity
act in least restrictive manor

Question 26

what are the two stages of identifying a need for capacity testing?

Answer 26

does the patient have a condition which impaires their decision making

does the impairement mean they are unable to make a specific decision

Question 27

what are the 4 components of capacity testing?

Answer 27

able to understand, retain, weigh up and communicate decision